· web viewequilibrium chiropractic ltd infection control policy . contents. infection control...

ContentsInfection control Policy 15th April 2020 revision – Covid-19..................................................................2

Introduction.......................................................................................................................................2

Standard Precautions........................................................................................................................3

HAND HYGIENE..............................................................................................................................3

CUTS AND ABRASIONS...................................................................................................................3

SHARPS..........................................................................................................................................3

Protective Clothing............................................................................................................................4

Spillage..............................................................................................................................................4

Waste................................................................................................................................................5

Contaminated Linen..........................................................................................................................5

Treatment Tables/Medical Devices/Linen.........................................................................................5

Miscellaneous....................................................................................................................................5

Procedures for Managing Control of Infection..................................................................................5

Hand hygiene.................................................................................................................................6

Summary indications:....................................................................................................................7

Gloves............................................................................................................................................7

Facial protection (eyes, nose, and mouth).....................................................................................7

Aprons/Gowns...............................................................................................................................7

Prevention of needle stick injuries.................................................................................................7

Environmental cleaning.................................................................................................................7

Waste disposal...............................................................................................................................8

Patient care equipment.................................................................................................................8

Donning and doffing PPE...................................................................................................................8

Special measure during the Covid pandemic.......................................................................................10

Pre-attendance triage..................................................................................................................10

Procedure for assessing health status of patient (for clinicians).....................................................10

Ensuring triage, early recognition, and source control....................................................................12

Emergency and urgent care only.................................................................................................12

Informed Consent........................................................................................................................13

Social Distancing and protecting others......................................................................................13

Protecting vulnerable groups.......................................................................................................13

Educating Patients and Caregivers...................................................................................................15

EQUILIBRIUM CHIROPRACTIC LTD INFECTION CONTROL POLICY 1

Staff Wellbeing................................................................................................................................17

Support yourself, support each other..........................................................................................17

Exposure of healthcare staff........................................................................................................17

Wellbeing advice for healthcare professionals............................................................................17

Stay physically active during self-quarantine...................................................................................18

Scenarios - Q and A.........................................................................................................................18

References...........................................................................................................................................19

Infection control Policy 15th April 2020 revision – Covid-19

Introduction Healthcare acquired infection (HAI) affects nearly 1 in 9 patients, resulting in increased need for care and treatment. An estimated 5,000 deaths in England are directly attributable to HAI. The purpose of this policy is to give guidance on methods of infection prevention and control within Equilibrium Chiropractic and Holistic Health. Guidelines from the Department of Health, NHS and other expert groups have been incorporated into these policies. The policy will be updated and reviewed annually (or more often) by: Anna Hindley

The responsibilities of the Management include:

• Monitoring, identification, investigation and control of outbreaks of infection

• Surveillance of HAI

• Formation of Policies and Procedures for prevention of infection reflecting recognised best practice

• Dissemination and implementation of Infection Prevention and Control Policies

• Education of all employees and other service users on principles of infection prevention and control

• Provision of information on prevention and control of infection, assessing risk; and

• Advising on resources required to reduce the risk of infection within Equilibrium Chiropractic and Holistic Health.

IN THE EVENT OF AN INFECTION CONTROL CONCERN, Anna hindley of Equilibrium Chiropractic and Holistic Health. SHOULD BE CONTACTED IMMEDIATELY.


Standard Precautions

The following measures are standard precautions. They should be used for all contact with patients, even if the patient is not known to have an infection. All body fluids must be handled with the same precautions as blood. The following fluids are not likely to pose a risk of blood-borne virus transmission, however guidance relating to standard precautions should apply:

• Nasal secretions

• Sweat

• Urine

• Vomit

• Sputum

• Tears

• Faeces

HAND HYGIENE

Wash hands with soap and water if visibly contaminated. If hands are visibly clean, use an alcohol hand rub between patients and around procedures. Hands must be decontaminated before and after contact with the patient and/or their immediate environment. During the current covid crisis, it is to be assumed that all surfaces that have made contact with the patient or other persons are contaminated.

CUTS AND ABRASIONS

Before your shift, cover all cuts and abrasions with waterproof dressings on areas of the body likely to come into contact with the patient.

SHARPS Sharps handling and disposal is vital to prevent the risk of blood borne virus transmission. A sharp can be defined as any item that is capable of penetrating the skin and may be contaminated with blood or body fluids. The person using the sharp is responsible for handling the device in a safe manner and for its safe disposal.

• Eliminate any unnecessary use of sharp instruments and needles.

• An approved sharps containers must be available at the point of use.

• Take sharps box to bedside or point of patient care.

• Use the temporary closure mechanism when not in use.

• Dispose of acupuncture needles in one unit.

• Do not overfill the sharps container, no more than ¾ full – change once at the fill line.

• All sharps boxes must be kept out of reach of children.


• Sharps containers are to be stored safely away from children and unauthorised people.

• All sharps boxes to be dated.

Protective Clothing Protective clothing is worn to reduce the potential risk of cross infection. Protective clothing should be available in all areas where staff are giving direct patient care or likely to come into contact with blood, body fluids and substances listed under COSHH.

Gloves must be worn where direct contact with blood, body fluids, mucous membranes or contaminated equipment is anticipated. Gloves must be discarded after each procedure and hands washed with soap and water. Plastic aprons Must be worn when there is a risk of exposure to blood or body fluids, contaminated equipment, non-intact skin or an infectious patient and their linen. Aprons should be readily available. Aprons must be changed between each patient contact or care procedure. All aprons should be removed by breaking the neck strap, disposed of as clinical waste followed by hand hygiene.

Face, eye and respiratory protection Face masks and eye protection (e.g. goggles or visors) should be worn where there is a risk of blood, body fluids, secretions, foreign bodies and excretions splashing into the face and eyes.

All protective equipment should be washed at the end of each session using hot water and detergent, rinsed and stored dry.

During the Corona pandemic, and any other notifiable pandemic in the future, these precautions regarding protective clothing (gloves, masks and aprons) should apply whenever you are closer than 2 metres to the patient and whenever you touch a patient. Eg chiropractor

Anyone working more then 2 metres from the patient should also wear a mask eg reception staff

Spillage All blood and body fluids should be considered potentially infectious. Single use disposable gloves and an apron must always be worn when dealing with a spillage. Materials for dealing with spillages must be readily available.

Blood / blood stained body fluids on impervious flooring: 1. Wear protective clothing (gloves and apron)

2. Cover spillage with paper towels and then saturate with a disinfectant

3. Leave for 2 minutes then wearing gloves and apron wipe up the spillage disposing of waste produced into the covered foot operated waste bin.

4. Clean area using a solution of hot water and detergent, using disposable cloths, rinse and dry.

5. Remove protective clothing and wash hands.

6. Dispose of immediately after use into the covered bagged waste bin followed by hand hygiene.

Spillages of urine/vomit/faeces: 1. Wear protective clothing (gloves and apron)


2. Soak up spillage with paper towels and dispose of as clinical waste.

3. Clean area thoroughly with a solution of hot water and detergent using disposable cloths, rinse and dry.

4. Wipe over the area with a fresh solution of disinfectant

5. Remove protective clothing and wash hands

6. When the spill occurs on a carpeted area/ soft furnishing mop up the spillage using paper towels and then clean area with a solution of hot water and detergent.

Waste • Waste should always be disposed of according to type.

• All waste bins should be rigid and be able to withstand cleaning

• Waste bins should be foot operated

• Waste sacks should only be handled by the neck

• On no account should waste sacks or sharps bins be left in corridors or areas accessible to the public prior to collection

Contaminated Linen

• Clean linen should be stored in a clean area and protected from contamination.

Used linen should be placed directly into a linen bag.

• An apron and gloves should be worn when handling used linen.

• Towels and bench coverings to be washed above 60 degrees.

Treatment Tables/Medical Devices/Linen

• Treatment tables to be covered head roll/fabric cover or couch roll for each patient

• After each treatment session per patient, clean the treatment table with disinfectant provided.

• Please DO NOT USE couch covers for the treatment tables.

Miscellaneous• Run hot taps for 3-5mins on a weekly basis, run cold taps and flush toilets weekly to avoid Legionnaires

Procedures for Managing Control of Infection


Equilibrium Chiropractic and Holistic Health require all staff working for the organisation to follow the following procedures steps to avoid infection:

Hand hygiene Hand washing (40–60 sec): wet hands and forearms and apply soap; rub all surfaces; rinse hands and dry thoroughly with a single use towel.

Hand rubbing (20–30 sec): apply enough product to cover all areas of the hands; rub hands until dry.

Handwashing protocol(WHO, 2020)

Clean your hands regularly, for at least 20 seconds.

● Hand hygiene includes either cleansing hands with an alcohol-based hand rub or with soap and water;● Alcohol-based hand rubs are preferred if hands are not visibly soiled;● Wash hands with soap and water when they are visibly soiled.

For HCW-specific information on handwashing, please see Hand hygiene.


Summary indications:

Before and after any direct patient contact and between patients, whether or not gloves are worn. Immediately after gloves are removed.

Before handling an invasive device. After touching blood, body fluids, secretions, excretions, non-intact skin, and contaminated

items, even if gloves are worn. During patient care, when moving from a contaminated to a clean body site of the patient. After contact with inanimate objects in the immediate vicinity of the patient.

Gloves Wear when touching blood, body fluids, secretions, excretions, mucous membranes, nonintact skin. During the covid-crisis, gloves must be worn for any physical contact with a patient.

Change between tasks and procedures on the same patient after contact with potentially infectious material.

Remove after use, before touching non-contaminated items and surfaces, and before going to another patient.

Perform hand hygiene immediately after removal.

Facial protection (eyes, nose, and mouth) Wear a surgical or procedure mask and eye protection (face shield, goggles) to protect mucous membranes of the eyes, nose, and mouth during activities that are likely to generate splashes or sprays of blood, body fluids, secretions, and excretions or during any direct patient contact during the current pandemic.

Aprons/Gowns Wear to protect skin and prevent soiling of clothing during activities that are likely to generate splashes or sprays of blood, body fluids, secretions, or excretions. During the covid crisis, wear an apron for any direct patient contact.

Remove soiled gown as soon as possible, and perform hand hygiene.

Prevention of needle stick injuries Use care when handling needles, and other sharp instruments or devices. Dispose of used needles correctly.

Respiratory hygiene and cough etiquetteUnder normal circumstances, persons with respiratory symptoms should apply source control measures: cover their nose and mouth when coughing/sneezing with tissue or mask, dispose of used tissues and masks, and perform hand hygiene after contact with respiratory secretions. However, during the covid crisis, any patient with symptoms should not be admitted.

Environmental cleaning Use adequate procedures for the routine cleaning and disinfection of environmental and other frequently touched surfaces.

Waste disposal Ensure safe waste management.


Discard single use items properly

Patient care equipment Handle equipment soiled with blood, body fluids, secretions, and excretions in a manner that prevents skin and mucous membrane exposures, contamination of clothing, and transfer of pathogens to other patients or the environment.

Clean, disinfect, and reprocess reusable equipment appropriately before use with another patient.

Donning and doffing PPE

It is extremely important to take great care when removing and disposing of used PPE to avoid exposure to infection. It is important to practice before using these techniques in a clinical setting, ideally with a colleague to provide guidance and feedback.

The following is the correct sequence for doffing your PPE:

1. Gloves;


2. Face shield or goggles;3. Gown;4. Mask or respirator.5. Hand hygiene.

The sequence for removing PPE is intended to limit opportunities for self-contamination. The gloves are considered the most contaminated pieces of PPE and are therefore removed first.


Special measure during the Covid pandemicCovid-19 suspected or confirmed symptomatic patients must not enter the clinic during the covid-19 crisis if possible.

All patients must be triaged by phone or teleconsultation within the 24 hours before attending, to screen for symptoms that could indicate Covid-19. This includes:

Pre-attendance triage“During the last 7 days have you experienced any of the following? Has anyone in your household or anyone you have a had face to face contact with experienced any of these in the last 14 days?”

Fever Cough Shortness of breath Chills Repeated shaking with chills Muscle pain Headache Sore throat New loss of taste or smell

Procedure for assessing health status of patient (for clinicians)During the initial triage perform a risk assessment to determine if the patient is symptomatic. You may want to use an infrared thermometer and/or oximeter and to determine the patient’s health status.

Why do we perform a risk assessment?

The risk assessment will give you guidance if someone should seek medical attention and/or the extent of Post-COVID-19 pulmonary lesions.

Parameters:

Temperature >37.8°, Respiratory rate >20 breaths pm, Heart rate >100 beats pm, O2 saturation <94% (risk assess for 90-94%).

Screening patients will minimize COVID-19 exposure and ensure safety to those who belong in the high-risk group. Patients can be split into 5 main groups:

Group 1: Patients presenting with mild respiratory dysfunction and/or MSK dysfunctions post-COVID-19 infection

Group 2: Patients currently symptomatic or positive with COVID-19, mild or severe. Group 3: High risk patients, not symptomatic Group 4: Patients not at risk and not symptomatic with need for emergency care Group 5: Patient without need for emergency care


Symptoms, risk, and need for care assessment Action required

Group 1: No fever and improvement of other COVID-19-related symptoms in the last >72 hours, COVID-19 symptoms development >7 days prior to contacting the clinic and/or 2 negative COVID-19 tests 24 hours apart NOT belonging to high-risk category AND with need for emergency care.

Educate and offer remote consultation if possible.

Arrange face-to-face appointments and follow PPE protocol.

Group 2a: Mild fever, cough or shortness of breath AND/OR having been in contact with a suspected or confirmed COVID-19 case in the last 14 days.

Recommend to self-isolate.

Offer remote consultation and check on symptoms in 12-24 hours .

Group 2b: Severe and deteriorating cough, shortness of breath, fever AND/OR difficulty breathing, persistent chest pain, new confusion, central cyanosis, cold and mottled skin, difficult to rouse, decreased urinary output, neck stiffness, non-blanching rash. Crucial parameters if patients have equipment: temperature >38°, Respiratory rate >20 bpm, Heart rate >100 bpm, O2 saturation <94%.

Refer to emergency services. If this is impossible, arrange follow up by video for symptoms monitoring. Only under extreme circumstances offer home visit with adequate PPE protocol.

Group 3: No current COVID-19-related symptoms, no contact with suspected or confirmed COVID-19 cases in the last 14 days BUT belonging to high-risk category.

Recommend to self-isolate.. Offer remote consultation if possible. .

Group 4: No current COVID-19-related symptoms, no contact with suspected or confirmed COVID-19 cases in the last 14 days, not belonging to high-risk category WITH need for emergency face to face consultation (i.e. ICU-AW, post-operative, urgent MSK problem or respiratory deficits also post COVID-19).

Arrange face-to-face appointments. Educate and offer telemedicine if possible. Required to follow PPE protocol.

Group 5: No current COVID-19-related symptoms, no contact with suspected or confirmed COVID-19 cases in the last 14 days, not belonging to high-risk category WITHOUT need for emergency face to face consultation.

Recommend to keep isolating.

Offer remote consultation.

Ensuring triage, early recognition, and source control(WHO, 2020)


● Health Care Workers (HCW) should have a high level of clinical suspicion during phone and face-to-face triaging;

● Establishing a well-equipped triage station at the entrance to the facility, supported by trained staff;● Using screening questionnaires according to the updated case definition.● Posting signs in public areas reminding symptomatic patients to alert HCWs.

Hand hygiene and respiratory hygiene are essential preventive measures

Emergency and urgent care onlyTo minimise unnecessary attendance each patient should also be asked:

“Do you consider your condition to be an emergency or in need of urgent care?”

The criteria include:

Symptoms that are getting worse or not responding to simple painkillers, rest, exercises, hot/cold.

Symptoms which include pins and needles (anywhere)/ significant muscular weakness, Symptoms which prevent you from sleeping or doing your normal day-to-day tasks or

prevent you from working.

Red flag screening should also be performed and the patient directed appropriately

Red flags include

Thoracic pain. Age of onset less than 20 or more than 55 years. Loss of control of the bowel or bladder. Weakness or numbness in a leg or arm. Foot drop, disturbed gait. High fever. Saddle anaesthesia (numbness of the anus, perineum or genitals). Loss of bladder or bowel control History of carcinoma. Structural deformity.

If non- clinical staff are performing the pre-attendance assessment, they must report this to a clinical staff member

This should all be recorded in the file

Informed ConsentThe patient should also be informed that they are still at risk of catching covid-19 if they attend despite us taking all precautions. A consent form will be sent electronically wherever possible and the patient will be offered an opportunity to discuss the risks. Otherwise, the risk will be explained by telephone and a paper consent signed on arrival.


Social Distancing and protecting othersDuring the covid crisis, practice social distancing of 2 metres or more with ALL patients and staff unless from the same household, unless staff using PPE.

Reception staff will be protected by screens and can remove mask whilst behind the screen and not in direct contact with patients.

Patients should be given the following instructions prior to attending:

When you come to the clinic, please wait in your car until you receive a call to ask you to come in.

Please attend your appointment alone if possible (if you are a single parent for example, please let us know ahead of time)

Please pay by contactless credit card As a courtesy to others, please cover your mouth and nose with a face mask or scarf. before

entering the clinic

Post visual alerts at the entrance to clinic instructing persons with possible symptoms not to enter

Take a remote temperature reading immediately the patient enters the clinic. For temperature over 37.8, the patient will be asked to leave and seek medical advice. An oximeter is also available – O2 levels should be over 94%

Making hand hygiene resources available in common areas and treatment rooms used for the evaluation of patients. Ask each patient to wash their hands on entry or use sanitizer provided

During the corona crisis, wipe down all surfaces with a disinfectant spray or wipe that come into contact with the patient before admitting another patient or staff member to the area.

Avoids transfer of pathogens to other patients, staff and or the environment.

Protecting vulnerable groups

Those at high risk may be accommodated after seeking advice from their GP but generally should not attend. This group includes

You may be at high risk from coronavirus if you:

• are 70 or older

• are pregnant

• have a learning disability

• have a lung condition that's not severe (such as asthma, COPD, emphysema or bronchitis)

• have heart disease (such as heart failure)

• have high blood pressure (hypertension)

• have diabetes

• have chronic kidney disease


• have liver disease (such as hepatitis)

• have a condition affecting your brain or nerves (such as Parkinson's disease, motor neurone disease, multiple sclerosis, or cerebral palsy)

• have a problem with your spleen or have had your spleen removed

• have a condition that means you have a high risk of getting infections (such as HIV, lupus or scleroderma)

• are taking medicine that can affect your immune system (such as low doses of steroids)

• are very obese (a BMI of 40 or above)

Anyone who has received a letter from the NHS saying the are very high risk of Covid-19 must not attend the clinic during the corona crisis.

This group includes:

have had an organ transplant

• are having chemotherapy or antibody treatment for cancer, including immunotherapy

• are having an intense course of radiotherapy (radical radiotherapy) for lung cancer

• are having targeted cancer treatments that can affect the immune system (such as protein kinase inhibitors or PARP inhibitors)

• have blood or bone marrow cancer (such as leukaemia, lymphoma or myeloma)

• have had a bone marrow or stem cell transplant in the past 6 months, or are still taking immunosuppressant medicine

• have been told by a doctor that you have a severe lung condition (such as cystic fibrosis, severe asthma or severe COPD)

• have a condition that means you have a very high risk of getting infections (such as SCID or sickle cell)

• are taking medicine that makes you much more likely to get infections (such as high doses of steroids)

• have a serious heart condition and you're pregnant

Educating Patients and Caregivers

Patients and their caregivers may be unsure of how to behave whilst directly affected by COVID-19. The following information may be recommended to patients and their caregivers when necessary.

Patient education (CDC, 2020)


In case a patient is showing mild respiratory signs and symptoms, they should be recommended to stick to the following instructions during isolation:

● Stay at home;● Stay in touch with their doctor and monitor their symptoms, making sure to get care in case of

worsening of the symptoms or development of other respiratory symptoms (i.e. severe and deteriorating cough, shortness of breath, fever >38°, difficulty breathing, persistent chest pain, new confusion, central cyanosis, cold and mottled skin, difficult to rouse, decreased urinary output, neck stiffness, non-blanching rash, respiratory rate >20apm, heart rate >100bpm, O2 saturation <94%);

● Avoid public transport;● Stay away from others (even using a personal “sick room” if possible, staying away from relatives and

pets until symptoms resolution);● Call ahead before visiting any healthcare facility;● Wear a surgical mask or a cloth face covering;● Cover their sneezes and coughs with their elbow or tissues (to be disposed immediately)● Wash their hands for at least 20’’, especially after:

blowing their nose, coughing, sneezing, going to the toilet, eating and preparing food;

● Use hand sanitizer with >60% alcohol if soap or water are not available;● Avoid to touch the T-zone (eyes, nose and mouth);● Avoid sharing personal household items, washing thoroughly after use;● Clean and disinfect the “sick room” everyday, letting a caregiver clean the rest of the house;● Focus the cleaning on “high-touch surfaces” (i.e. phones, remote controls, door knobs, toilets,

keyboards, bedside tables);

Isolation should be ceased when:

● Not experiencing fever for >72 hours AND other symptoms have improved AND at least 7 days have passed since the symptoms were developed (if not tested for COVID-19)

● Not experiencing fever for >72 hours AND other symptoms have improved AND they received 2 negative tests 24 hours apart (if tested for COVID-19)


Caregiver education(CDC, 2020)

Caregivers should:

● Monitor the symptoms of the person cared for and know the emergency warning signs;● Always have their healthcare provider contact on hand and contact them or 999 for medical

emergencies;● Isolate the symptomatic person to one room, if possible, using a separate bathroom and not using

household items;● Have them wearing a cloth face covering when other people (including the caregiver) are around;● Wear a cloth face covering if the symptomatic person cannot do so;● Wash their hands for at least 20 seconds, especially after interacting with the symptomatic person,

using hand sanitizer if soap and water are not available;● Avoid touching the T-zone;● Clean “high touch surfaces” daily;● Wash laundry thoroughly, wearing disposable gloves if the laundry is soiled, washing hands

immediately after gloves removal;● Avoid unnecessary visitors;● Make sure the sick person drinks plenty of fluid;● Providing recommended medicines;● Follow the same home isolation-ending measures as the sick person.


Staff Wellbeing

(Extracted from FutureLearn course Managing COVID-19 in General Practice)

Support yourself, support each other

In these challenging times, it’s very important that we work to maintain both our own wellbeing and the wellbeing of our colleagues. Healthcare workers face a number of risks to their physical and mental health, so we need to provide support and help to each other, so that we are able to continue to care for our patients effectively.

It is very valuable to debrief with the practice team regularly, especially those who are directly involved in patient management.

Identify vulnerable healthcare workers, such as pregnant or immunosuppressed individuals, and move them to non-patient facing roles. Seek advice from the occupational health service if available.

Exposure of healthcare staff

If a member of staff develops a fever of >37.8°C, shows respiratory symptoms, or lives in the same household as a person with symptoms, they should follow the local policy for testing and self-isolation.

Frontline staff are at increased risk of physical and mental health problems during the COVID-19 pandemic because of working in extremely challenging circumstances.

Wellbeing advice for healthcare professionals

● Talk to your friends and family and stay connected with them.● Seek help from your colleagues, supervisor and practice manager.● Turn to your peers and share your thoughts and feelings and listen to theirs.● Take regular breaks and try to reduce your screen time.● Avoid watching, reading or listening to the news that could cause you to feel anxious or distressed

and seek information updates at specific times.● Ensure you have time to wind down after work and get a good night’s sleep.● Stay well-hydrated and eat healthily by planning your meals and taking your time to enjoy your meals.● Try to reduce your intake of alcohol and caffeine.● Try a free wellbeing class or app.● For further tips and advice please visit the World Health Organisations (WHO) website.

○ Mental health and psychosocial considerations during the COVID-19 outbreak


Stay physically active during self-quarantine

Scenarios - Q and A

Q: Which of the following actions can patients take to help control the spread of infections?

A: Not visiting if they are unwell, challenge staff on hand hygiene, cleaning hands before eating and after the toilet.

Q: Who has responsibility for the control and prevention of infections in a healthcare environment? A: Everyone

Q: When should you use alcohol-based sanitiser to perform hand hygiene?

A: You should use alcohol-based sanitiser to perform hand hygiene when your hands are visibly clean.

Q: You can contribute to infection prevention and control by washing your hands correctly. The correct method of handwashing is:

A: Wet hands, apply liquid soap, lather with soap, rinse, dry with a individual towel

Q: Where might a micro-organism (germ) live?

A: Humans, Animals, Environment.

Q: Which of the following factors within the environment could increase the risk of infection?

A: Use of inappropriate products or equipment for cleaning, Cluttered and untidy work areas, Presence of rust or lime scale, Chipped or damaged work surfaces, Split flooring.

Q: What should you do if you suddenly develop diarrhoea and vomiting?

A: Report your symptoms to your line manager and not return to work until 48 hours after your symptoms stop.

Q: With which legislation do all providers of health and social care need to demonstrate compliance? A: The Health and Social Care Act 2008 Code of practice for the prevention and control of healthcare associated infection.

Q: Guidance on infection prevention and control can be found on which of the following?

A: Infection control posters in clinical areas, Public Health England website,

Q: What is a Healthcare Associated Infection (HCAI)?

A: An infection associated with accessing healthcare.

Q: Which of the following statements are true of the MRSA bacteria?

A: Many people are carriers of MRSA without even realising it, MRSA can be difficult to treat as the bacteria are resistant to many types of antibiotics.


Q: What are the links which make up the chain of infection?

A: Infectious agent, reservoir, method of exit, method of transfer, method of entry, susceptible host.

Q: What is the most effective way of preventing cross infection?

A: By practising good hand hygiene.

Q: How does Norovirus spread?

A: Contaminated environment, Contaminated hands, Vomiting/diarrhoea.

Q: How do microorganisms (germs) enter the body?

A: Sexual transmission, Inhalation, Ingestion.

Q: What are the three levels of decontamination of reusable medical devices?

A: Disinfecting, Cleaning, Sterilising.

Q: In what way is a single patient item used?

A: Only used on one patient.

Q: The 5 Moments for Hand Hygiene approach defines the key moments when healthcare workers should perform hand hygiene to reduce the risks of the spread of infection. The 5 moments are before touching a patient, after body fluid exposure/risk, after touching a patient, after touching patient surroundings and which other?

A: Before clean/aseptic procedures.

Q: When managing diarrhoea and vomiting, what must hands be decontaminated with?

A: Soap and water.

References Infection Control Nurses Association (1998) Guidelines for Hand Hygiene, Deb/ICNA, Edinburgh. Dept. of Health (2001) Developing National Evidence-based Guidelines for Preventing Healthcare Associated Infections, Journal of Hospital Infection, 47 (Supplement) p23-28. Plowman R et al (1999) Socio-economic burden of hospital acquired infection, PHLS, London AYLIFFE. G. LOWBURY, E. WILLIAMS, J. GEDDES, A. (1992) Control of Hospital Infection. A Practical Handbook. 3rd edition. Chapman and Hall. London. DEPARTMENT OF HEALTH. (1994) Health Technical Memorandum 2010. Sterilization. Parts 1-4. HMSO. London. DEPARTMENT OF HEALTH. (1994) Health Technical Memorandum 2031.Clean Steam. HMSO. London. DEPARTMENT OF HEALTH (2001) Decontamination Programme Technical Manual. NHS Estates, Leeds. UK. NHS ESTATES (1997) Health Technical Memoranda 2030 (HTM 2030) Washer Disinfectors. Management Policy, Design Considerations, Validation , Verification and Operational Management. London, HMSO. HEALTH AND SAFETY AT WORK ACT. 1974. HEALTH SERVICE CIRCULAR HSC 1999/179. Controls Assurance in Infection Control. Decontamination of Medical Devices. HEREFORDSHIRE NHS PRIMARY CARE TRUST. Infection Control in Physiotherapy / Occupational Therapy Policy. 2009. LAWRENCE, J. MAY, D. (2003) Infection Control in the Community. London. Churchill Livingstone. MEDICAL DEVICES AGENCY (1995). MDA DB9501. The Reuse of Medical Devises Supplied for Single Use Only. MDA.


London. MEDICAL DEVICE AGENCY (2000) Single-use Medical Devices: Implications and Consequences of Reuse. MDA, London. MEDICAL DEVICES AGENCY (1996) MDA DB9605. The Purchase, Operation and Maintenance of Bench –top Steam Sterilizers. MDA. London. MEDICAL DEVICES AGENCY (1998). MDADB9804. The Validation and Periodic Testing of bench-top Vacuum Steam Sterilizers. MDA. London. MEDICAL DEVICE DIRECTIVE 93 / 42 / EEC (1993).


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