Practicalities of Infection Prevention & Control

Introduction

What's most important!

Understanding the importance of Infection Prevention and Control and using this knowledge to reduce the risk of infections that may cause harm to those you support, your colleagues and yourself.

Spreading infection is easy

The "break the chain" video shows how easy it is for hospital-acquired infections like MRSA and Clostridium ... May 26, 2010 - Uploaded by University Hospitals

Birmingham NHS Foundation Trust.

The video is 4 min 30 sec in duration. This resource is useful even if you watch it for just 2 minutes

Geographical distribution of COVID-19 cases – worldwide as of 31 May 2020 : European Centre for Disease Prevention and Control

Objectives

• Develop awareness of the possible types and sources of infection, and its transmission .
• Understand how micro-organisms can cause illness
• Understand infection transmission, and how you can work to stop it.
• Understand your responsibilities in terms of assessing and managing / controlling risks in your own service
• Understand the practice of ‘Standard Precautions,’ and how to apply these at all times in all settings, irrespective of a suspected or confirmed infection status

The Language of Infection Prevention & Control

Rehab Group Infection Prevention and Control Policy : Pages 17 to 28

This course tries as much as possible to explain terms as you are introduced to them. However, it is recommended that you also refer to the Rehab Group Infection Prevention and Control Policy. This policy contains Appendix 3: (Definitions, Terms and theory of infection prevention and control)

This will help you in developing your understanding further.

Supporting and Guidance Information Resources

Rehab Group, Infection

Prevention and Control Policy

HSC-OPS-001

• Rehab Group Safety Statement;
• RG Food Handling Policy and Handbook;
• Personal and Intimate Care Policy;
• RG Care / Support Planning Policy and procedures;
• RG Risk Management procedures
• RG Human Resources: Absence Management and Pre-Employment Background Checks Policy and procedures

Sharepoint Home Page

• (1) Coronavirus COVID-19 resource
• (2) COVID-19 Guidance and Reference Documents for Managers and Staff

Rehab Group – Standard Operating Procedures [SOPs]

• SOP 9 - Safe Handling and Disposal of Sharps
• SOP10 – Managing Needlestick and other Exposure Injuries
• SOP11 – Precautions during First AId
• SOP12 – Transmission Based precautions inc suspected outbreaks
• SOP13 – D&V and managing an outbreak in an RG Service
• SOP14 – Managing Common Infestations
• SOP15 – Immuno-Supressed SU Precautions
• SOP16 – Staff Health and Hygiene

Rehab Group – Standard Operating Procedures

• SOP1 – Hand Hygiene
• SOP2 – Respiratory Hygiene & Cough Etiquette
• SOP3 – PPE ( Personal Protective Equipment)
• SOP4 - General Home Hygiene & Cleaning in the Service
• SOP5 – Cleaning of Equipment & Medical Devices
• SOP6 – Safe Handling of Laundry
• SOP7 – Management of Spillages of Body Fluid
• SOP8 – Safe Waste Disposal

Infection Prevention & Control

Infection prevention and control is the discipline and practice of preventing and controlling infection and the spread of infectious diseases in a health or community environment.

Many infections are avoidable if simple measures are taken to address risks that have the potential to cause such infections.

Rehab Group Infection Prevention and Control Policy : page 8 & 29

Infection

Infection happens when a micro-organism (infectious agent) enters and multiplies within the body, resulting in the person becoming unwell. They develop clinical signs and symptoms of infection. For example

• increased temperature
• chills and sweats
• pain, soreness or swelling
• cough

Infectious Diseases - Video

This video is a brief overview of Infectious Diseases, what they are, some terms used to ...

Feb 26, 2017 - Uploaded by Let's Learn Public Health

Micro-organisms

VRE - Bacteria

Norovirus

Knowing which Pathogen is responsible for causing an infection allows for particular medical treatment to be given to the person infected.

It is equally important that we all work in ways that prevents the spread of infections in the first place, and control those may develop.

HIV (virus)

Hepatitis Virus

Thrush - Fungus

https://www.hse.ie

Conditions and Treatments

Pathogens - Illness - Symptoms

Bacteria , Viruses , important differences

bacteria and viruses? NPS MedicineWise ... Antibiotics treat bacterial infections and won't work for viral ...Jun 25, 2012 - Uploaded by NPS MedicineWise

Rehab Group Infection Prevention and Control Policy : page 31

Stopping Transmission - Breaking the Chain of Infection

Source: This is also called the reservoir.

Here the infectious micro-organism, lives and multiplies in number.

Susceptible Host: A non-infected person who could become infected. With reduced immunity, there is a greater chance that infection can happen.

Exit: Here the pathogen leaves the human body, and go on to infect another person. The portal of exit then is the nose , mouth rectum and any break in the skin. It is any opening in the body, through which infectious body fluids may pass.

A portal of entry: is any opening that allows the pathogen to enter the body.

• Nose
• Mouth
• Skin wound
• (among others)

Rehab Group Infection Prevention & Control Policy Page 31

Susceptible Hosts

Rehab Group SOP 15

Susceptible hosts are non infected people who could become infected.

Some people may be more susceptible to infection than others.

Our immune systems can be weakened for a variety of reasons.

Hand Hygiene Video Resource

This clip was originally used by Medical Students at the University of Leicester as part of a larger teaching ...

Oct 6, 2009 - Uploaded by University of Leicester

[ 5 min 27 sec]

Routes of Transmission

Rehab Group Infection Prevention and Control Policy : page 29 & 30

Droplet Direct

Insect and Animal carriers

Direct contact

Droplets on surfaces

Airborne

Food contamination

Picked up from surfaces

Bloodborne

Faecal Oral Route

Break the Chain of Infection with your hands

Designed to break the chain of infection, by preventing you transmitting pathogens to those you support, and preventing pathogens passing from one individual to another carried on your hands.

The moments and their Meanings:

[1] Don’t infect the Service User

[3] Don’t infect yourself or the Service User

[4] & [5] Don’t infect yourself and others

The broken green line in the image, represents the physical zone surrounding the person you are supporting

The 5 moments - video

A HSE film explaining when Health Care Workers must perform hand hygiene, presented by Sheila Donlon ... [ 3 minutes 34 seconds ]

May 4, 2012 - Uploaded by HSE Ireland

Limiting conditions that encourage pathogen growth

[1] Time: Bacteria can divide and multiply rapidly when the conditions are right for this.

[2] Warmth: Standard room and body temperature allows this pathogen multiplication

[3] Oxygen: Some micro-organisms need oxygen to survive. Others do not.

[4] Food : Dirt and dust provide an ideal food source

[5] Moisture: Pathogens need moist or damp conditions in order to multiply.

Note: Pathogen = disease causing micro-organism

Protecting each other

Our best defence (Infection Prevention & Control )– building blocks

Additional Level including Transmission Precautions

Standard precaution Level. Measures that are used appropriately by all staff, all the time, and in the case of client support settings, for all clients.

Foundation Level

Building good Infection Prevention & Control into your work practice

Building good Infection Prevention & Control into your work practice

Standard Precautions should be practiced by all staff at all times and with all service users. Its not always possible to know who has an infection. Therefore, it is essential that standard precaution practices are applied routinely, for the following purposes.

For contact with:

• Blood
• All body fluids, secretions and excretions (urine, faeces, vomit) except sweat, regardless of whether or not they contain visible blood;
• wounds
• mucous membranes (eyes and mouth) Rehab Group IPC Policy page 8

Building good Infection Prevention & Control into your work practice

Building good Infection Prevention & Control into your work practice

Building good Infection Prevention & Control into your work practice

For people with known or suspected infections

• Consult with relevant medical & nursing personnel
• Precautions should be tailored to the specific infection
• Risk Assessment on behalf of all residents and staff
• Accommodation on basis of single rooms and dedicated bathroom facilities and other items and resources used.
• Enhanced PPE use
• Enhanced decontamination scheduling
• Service User education as much as possible

(SOP 12) ‘Transmission Based Precautions pages 1 & 2’

Local Infection Prevention & Control / Cleaning Procedure

In summary: Infection Prevention and Control throughout the Rehab Group

Before continuing with this course, it would be useful to remind ourselves of a number of points.

• All measures we take to reduce the spread of infection are based on the foundation of staff being knowledgeable about basic infection prevention and control principles, and focused enough to apply all precautionary measures in line with best evidence advice from within the Rehab Group, and by association Public Health guidance.
• Standard Precautions need to be applied appropriately, across all areas of the Rehab Group routinely, depending on the risk of exposure to body fluids , blood, broken skin or mucous membranes.
• For example: from the point of view of a blood borne pathogen, it is just as dangerous from an accidental wound in an office , or a training facility, as it is in a residential or day care facility. [ SOP 7 ] [ SOP 10 ]

In summary: Infection Prevention and Control throughout the Rehab Group

Thinking of the Covid 19 Pandemic, it is clear how international boundaries have offered no protection; and those with the greatest susceptibility have suffered the most from a disease to which no one has had immunity.

You could say that civilisation itself has had to use Transmission Based Precautions to cope with this infection, in terms of social distancing, community and travel restrictions, cocooning, widespread use of PPE and frequent decontamination of hands and surfaces.

This very sad period provides an extreme, but important lesson from which we can draw, when thinking of Transmission Based Precautions for any infection, or suspected infection.

Responding to potential and specific infection risks

Applying Infection Prevention and Control - All Areas

Through staff training, information, and the best practice procedures set out in the Rehab Group Infection prevention and Control Policy, SOPs / Guidelines, Rehab staff (and service users where possible) will understand the risks of infection applicable to their (service) environment, and take every practical precaution to manage those risks to protect themselves and others.

Rehab Group IPC Policy

Applying Infection Prevention and Control - NLN

Reflect:-

Considering the use of both these learning environments, reflect for a short while on the measures or precautions that are needed to minimise the risk of any infection spreading among learners and staff.

Applying Infection Prevention and Control - CareLink

What would be the minimum number of times, you would need to carry out hand hygiene?

Reflect:-

Home

Fuel stop

Visit 1

Visit 2

Toilet break

Lunch

Home

Visit 3

Applying Infection Prevention and Control - Enterprises

Reflect:-

Moving through an Enterprises facility, what areas and resources would you consider that present a risk of helping to spread any infectious organisms that may be present.

What’s the best way of reducing this risk ?

Applying Infection Prevention and Control - Residential / Respite

Reflect:-

What approach can you take, in enabling those you support, to limit the conditions that are needed for pathogens to grow and spread in their accommodation.

Applying Infection Prevention and Control - Day Services

Reflect:-

Involvement in meaningful and enjoyable activities, including those involving social engagement , may present challenges to the consistent application of Infection Prevention and Control principles.

There are also opportunities for learning about self care and care of each other, in an era of widespread public health alerts and public anxieties.

Applying Infection Prevention and Control - Group

Reflect:-

Which resource is the most adaptable ?

Which resource is more likely to be taken for granted ?

Which resource could provide a link to all the others in one day?

Which resource is the easiest to decontaminate?