Infection Control Guidance
Contents
Last Updated: September 2004
Review Date:
Ownership: Yvette Jones
Purpose
An explanation of why we need to practice infection control, universal infection control procedures and where to seek additional advice from.
Infection Control Guidance
Contents
Infection Control in the community 3
Further advice on Infection Control 4
Universal Infection control Procedures 4
Guideline 1 – General Hygiene Guidelines 5
Handwashing 5
Handwashing Technique 5
Gloves 6
Personal Care 7
Aprons and tabards 8
Disposal of waste 8
Clinical Waste 9
General cleaning 9
Crockery and cutlery 10
Laundry 10
Guideline 2 – blood and body fluids 12
Dealing with spillages of blood or body products 12
Puncture wounds 13
Dealing with “sharps” injuries 13
Spitting and biting 14
Vaccination 15
Animals 15
Care of a client with diarrhoea or vomiting – D & V 16
Cleaning 17
Longer term 17
If you have Diarrhoea and/or vomitting 17
Looking after a client with MRSA. 19
Guideline 5 - Scabies 21
Caring for someone with Scabies 21
Treatment of Scabies 22
Guideline 6 – Head lice 23
Caring for someone with head lice 23
Treatment 23
Guideline 7 – Blood borne infections - HIV infection and AIDS 25
Confidentiality 26
Other information 26
Guideline 8 – Blood borne infections – Hepatitis B and other forms of Hepatitis 28
Symptoms of HBV 28
Protection against HBV 29
Departmental Policy on HBV – Information and Vaccination 29
Infection Control Guidance
This information consists of:
An explanation of why we need to practice infection control.
Where to seek additional advice when needed.
An explanation of Universal Infection control procedures
Guideline 1
General guidance including:
Hand hygiene
Personal Care
Use of gloves, aprons and Tabard
Disposal of waste
Clinical Waste arrangement
General cleaning
Laundry
Guideline 2
Blood and body fluids including:
Dealing with spillages of blood or body products
Puncture wounds
Sharps injuries – needlestick injuries
Spitting and biting
Guideline 3
Gastroenteritis – Diarrhoea and/or vomiting
Guideline 4
MRSA – Methicillin Resistant Staphylococcus Aureus
Guideline 5
Scabies
Guideline 6
Headlice
Guideline 7
HIV and AIDS – including information on general departmental policy
Guideline 8
Hepatitis B
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Infection Control
Infection control is about preventing the spread of infection.
Infection Control in the community
Many people with an infection do not need to go to hospital, and can remain in the community quite safely. Hospitals and GP’s advise people and their carers about how to manage their infection, and their advice is always based on the risk the infection might pose the service user or to others visiting them or living with them.
Infections in the community setting are often managed very differently to how they would be managed in a hospital. This is to stop unnecessary precautions being taken which might restrict the service user’s normal life and recovery, and because the service user in the community is less likely to have close contact with people who are susceptible to infection.
In hospital nowadays most people are at high risk of catching an infection because they are mainly elderly, ill, frail, very young, have low resistance to infection due to drugs and treatment, or may have open wounds, drips or drains. Therefore precautions taken in hospital are very strict, but in the community this is usually not necessary.
Infection control is very important for Carers in any Social Services setting because you may have contact with or visit a number of older, frail vulnerable or ill people during your working day, and you have a duty to make sure you do not carry infection from one person to another. You also need to protect yourself from infection to avoid becoming unwell yourself, and you will want to make sure you do not carry infection home to your family.
It is very easy to control spread of infection in residential homes and community settings. These guidelines will give you general basic advice based on the most up-to-date information from the specialist Public Health Team who are responsible for infection control in the community.
Further advice on Infection Control
If you are ever worried about infection control, or not sure about what to do, you should ask your line manager to begin with. Where there is any doubt they can check our policy or advice with the Public Health Team. If you are still worried or want to check the guidance you have been given is correct – you can ring the Public Health team direct on 0118 960 5205. Ask for the Public Health Nurse for infection control in the community.
Universal Infection control Procedures
Universal Infection control Procedures must be used whenever you give care to any client – whether there is an infection present or not.
These procedures, when carried out correctly, will protect you, the client, other clients and your families from infection – including the bloodborne viruses such as HIV and Hepatitus B, and germs such as MRSA.
Good infection control practices apply equally for all clients, and are based on the care activities being carried out. This ensures you are always protected even if there is an infection present that we do not know about.
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Guideline 1 – General Hygiene Guidelines
This guideline details the various Universal Infection control Procedures which must be used whenever you are giving care to any client – whether there is an infection present or not.
Handwashing
The most important single thing you can do to control infection is good handwashing.
Use ordinary non-medicated soap for this. Do not use harsher soaps containing antiseptics unless these have been ordered as essential – as these can make your hands very chapped and dry and increase the risk of infection!
Handwashing Technique
1. Wet hands under running water.
2. Apply soap.
3. Rub all parts vigorously without adding more water for 10 – 15 seconds.
4. Rinse soap off hands under running water.
5. Dry hands thoroughly using a clean towel. If no clean towel available use kitchen roll or paper towels.
If there are no handwashing facilities available use anti-bacterial handgel (provided as part of home carers equipment.) It has instructions for use on it. Pump a big teaspoonful of the gel into the palm of your hand. Using the same motions as you do for handwashing – rub the gel all over your hands remembering the cracks and creases. Let the gel dry in the air – and then your hands are considered cleansed.
Keep your hands in good condition – avoid skin contact with harsh abrasive chemicals such as bleach – and keep your nails neat and clean. All breaks in your skin should be covered with a waterproof plaster whenever you are at work, and these are supplied to you for this purpose. If you use a hand cream – use your own supply which is not shared with others. If your hands get sore or chapped – talk to your line manager to get advice.
You must wash your hands:
· Before and after undertaking personal care tasks – even if you were using gloves
· Before any food preparation or feeding a client or giving medication
· After using or cleaning a lavatory or commode or undertaking any task related to toiletting or catheters
· After taking off disposable gloves or other protective gloves – always do this
· after undertaking cleaning duties – even if you were wearing marigold type gloves
· after unexpectedly handling any body products – which includes blood, urine, faeces, vomit, semen, mucus, pus, saliva or sputum.
· When homecarers finish with a client and are leaving the household.
· Whenever you have been to the toilet or sneezed/blown your nose
· Before you eat, drink or smoke.
· At the end of your working day
Gloves
Disposable gloves are provided as single use items – and should be discarded after use. They are not an alternative to handwashing – and you should always wash your hands after removing them.
Disposable gloves MUST be worn whenever there is potential or actual contact with blood, faeces, urine, vomit and other body fluids, and it is West Berkshire policy that you wear them when delivering all personal care.
Disposable gloves should be changed between “clean” and “dirty” tasks.
NB: Staff should never have contact with open wounds. If a dressing is found to be badly wrinkled or soiled the District Nurse should be called to come in and attend to the dressing. Similarly if a new sore or wound is discovered the District Nurse should be called. You should inform your line manager and in the case of home carers call the Home Care duty desk.
Gloves should be removed by pulling down the hand from the wrist, and left inside-out. You should never wash and re-use gloves. Used gloves can be disposed of in the normal household rubbish – except where the council provides special bags for disposal of soiled items as “clinical waste”. (See Guideline 3 about Clinical waste.)
Non-disposable gloves – such as marigold rubber gloves – are to be used for all household tasks and contact with cleaning agents. They are not usually disposed of – and should be left clean and dry ready for use. You should wash your hands after removing gloves.
If you find using gloves seems to make your hands sore – make sure you raise this with your manager. We are able to provide alternative makes of gloves if this is found to be necessary.
Personal Care
When giving personal care always use disposable cloths/wipes for washing the genital area, stoma areas, and for cleaning up any incontinence or body products. This is to ensure a wash cloth is not later used on the face inadvertently. You should also use a disposable cloth/wipe if washing any area of broken skin. As a general principle try to start a wash with the ‘clean’ areas of the body such as the face, and end the wash with the “dirty” or potentially contaminated areas such as the genital area. If disposable cloths are not available, make sure the cloth used on the ‘dirty’ areas is easily identifiable, and that all flannels and cloths are washed out thoroughly in hot soapy water and left hanging to dry quickly.
Record and report any breaks in the client’s skin immediately.
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Aprons and Tabards
Disposable aprons are provided as single use items – and should be discarded after use. Do not re-use these.
You should wear a disposable apron when you are providing personal care – to protect your uniform or tabard from contamination. You should remove the apron and dispose of it before doing a “clean” task such as administering medication, food preparation or feeding a client. Used disposable aprons can be disposed of in the normal household rubbish – except where the council provides special bags for disposal of soiled items as “clinical waste” (See Guideline 3 about clinical waste.)
Home Carers may have tabards made of cloth too. These are not disposable. If you have a stripey tabard – you should only wear this in a client’s house, and should take it off when leaving the home, replacing it when you get to the next household.
If you have a plain green tabard, provided for doing “dirty” household tasks – such as attending to coal fires, this should only be worn for the duration of the task. Green tabards are no longer provided to new Home Carers – who should use a disposable apron instead.
Disposal of Waste
Almost all waste can be disposed of in the household rubbish – even that which is contaminated by blood or body fluids. Sanitary towels should be bagged and put into the household bin. Tampons may be flushed down the toilet, unless the household is not connected to mains sewers (i.e. has a septic tank) – in which case tampons should be disposed of as for sanitary towels. Nappies should also be disposed of into normal household waste.
Urine and faeces should be flushed down the toilet in the usual way – but be careful when undertaking this task and wear a disposable apron and disposable gloves.
When it has been decided that a situation requires special disposal of this sort of waste because of an infection risk, a special waste collection will be arranged – usually known as “clinical waste” or “infected waste” – see below.
Clinical Waste
A clinical waste collection is usually set up by the waste department of the council - by either the District Nurse or the Home Care office. All residential homes have clinical waste bins which are emptied each week on contract. This waste is collected separately from normal household waste, and is incinerated by the contractor in special incinerators. You must not burn waste.
Special collecting bags will be provided by the waste department – these are a distinctive colour – usually bright yellow. Before articles are placed in these bags they should be bagged in another household bag first for safety. This is referred to as “double bagging”. Supermarket carrier bags can be used for this purpose providing they have no holes in them.