DO NOT USE FOR CLINICAL PRACTICE
Please use current guidelines available on the UHNM intranet for patient treatment
Please use current guidelines available on the UHNM intranet for patient treatment
CLINICAL AREAS
Staff
- Carry out regular and thorough hand hygiene
- Cover all cuts and grazes with waterproof dressings
- Know hepatitis B status
- Up-to-date with all vaccination
- Report any symptoms of diarrhoea and/or vomiting developed when off-duty to the occupational health team
- remain off work until symptom-free for 48 hrs
- Report any symptoms of vomiting and/or diarrhoea while on duty to the staff member in charge
- inform your line manager
- return home until 48 hr after your symptoms have stopped
- Report any skin lesions or recurrent infections to the occupational health team
Patients
- Assess patients for infection risk on admission, before admission if possible and throughout their stay
- Check IC alert for any infection prevention alerts
- Consider infection risk in placement decisions
- Isolate patients with conditions that increase the risk of spreading micro-organisms to others
- suspected or known infectious diarrhoea
- exfoliative skin condition, large open wound
- productive cough
- Encourage patients to clean their hands
- before meals
- before taking oral medication
- after using the toilet, commode or bedpan/urinal
- at other times as appropriate
- Good oral hygiene
- consider use of oral chlorhexidine
Environment
- Maintain clean and dust-free environment
- Use hospital approved products for daily cleaning of hard surfaces in all adult areas
- Increase levels of cleaning in outbreak situations
- infection prevention team (IPT) will advise domestic services and ward manager on frequency and type of cleaning
General equipment
- Use single patient use or disposable equipment where possible
- Never attempt to decontaminate or reuse single use items
- Decontaminate reusable equipment after use
- Use hospital approved products
- Follow manufacturers' instructions for cleaning
Personal protective equipment (PPE)
- For invasive procedures, during contact with sterile sites, non-intact skin and mucous membranes, and when handling sharps and contaminated equipment, wear gloves
- When there is a risk that clothing or uniform will become contaminated, or there is close contact with a patient, wear disposable apron
- Use fresh apron and gloves for each patient and for each different care activity on the same patient
- If risk of extensive splashing, wear full-body fluid-repellent gown
- If risk of splashing into eyes or mouth, wear eye and face protection
- For multi-drug resistant pulmonary tuberculosis, SARS, COVID-19, wear an FFP3 mask which previously has been fit-tested to ensure it is effective.
- For more details see PPE guideline
Linen, waste and sharps
- Wear appropriate PPE
- Handle linen and waste correctly
- place soiled linen in skip at bedside
- place clinical waste in orange bag
- Use needle safety devices where there are clear indications that they will provide safer systems of working for healthcare staff
- Take sharps box (with blue tray) to point of use
- dispose of the sharp directly immediately into the sharps container after use
- never leave sharps for someone not involved in procedure to clear away
- Never re-sheath needles
- Dispose of needles attached to syringes as a single unit
- Do not fill sharps containers above the manufacturers marked line which indicates that they are full
Microbes isolated
- If alerted to identification of specific organism, see ESBL/MGNB/CARB, MRSA management or C-difficile infection guidelines
Antimicrobials
- Use antimicrobials rationally. See appropriate guideline in Medical, Surgical or Antimicrobial prescribing guidelines
- use narrow spectrum agents whenever possible with aid of microbiology results
- document clinical indication and reason for choice in medical records
- document clinical indication, route and duration on prescription chart
Review regularly
- Switch IV antimicrobials to oral route after 48 hr where possible
- Stop antimicrobials after a total of 5 days treatment (including IV treatment) unless a specific infection justifies an extended duration of treatment
- Review (consultant or SpR) indication for all prescribed gastric acid suppression
- If there is a compelling indication to prescribe acid suppression in a patient at risk of Cdifficile Infection:
- prefer H2 antagonist to PPI
- minimise dose and duration to the safest minimum