SECTION TWO

STANDARD
INFECTION CONTROL
PROCEDURES
2. STANDARD INFECTION CONTROL PROCEDURES
2.0 INTRODUCTION
Many communicable illnesses have the capacity to spread within any
communal environment where there is shared eating and living
accommodation, such as an elderly persons home.
Although this is possible, it is largely an avoidable complication if simple
Infection Control practices are adopted to minimise the spread of infection
from one person to another.
Standard Infection Control precautions are ways that employees can prevent
the transmission of infection from one person to another. They are practices
which should be routinely adopted with every individual regardless of whether
or not that person is known to have an infection.
2.1 STANDARD PRECAUTIONS TO PREVENT CROSS INFECTION
ffective hand washing by staff and service users is the single most
important Infection Control measure and should be carried out after
every contact. !See Section ".#$
%isposable gloves and plastic aprons should be worn for all personal
care tasks and when in contact with blood or body fluids. !See Section
"."$
Cuts and abrasions or skin lesions !broken skin, ec&ema and psoriasis$
should be covered by a waterproof dressing.
'lood and body fluids spillages should be dealt with immediately, as
detailed in Section ".(
Sharps should be disposed of into an appropriate container !See
Section ".)$
Clothing and bedding should be handled and machine washed, as
detailed in Section ".*
Contaminated waste should be dealt with, as detailed in Section ".+
,rotect eyes, mouth and nose from blood splashes.
2.1.1 TRAINING
Training is of vital importance for staff, if they are to undertake their work
safely.
-nder the re.uirements of the /ational Minimum Care Standards, workers in
the care sector are re.uired to be suitably trained in Infection Control. This
publication forms an essential part of 0eicestershire County Council1s Adult
Social Care Service, Infection Control training programme.
The Care 2ome 3egulations "445 section 56 !*$ !b$ re.uire that care workers
have 7 "qualifications suitable for work that he is to perform and the skills
necessary for that work.
2.2 PERSONAL PROTECTIVE EQUIPMENT
What protet!"e e#$!p%e&t 'ho$() *e a"a!(a*(e+
%isposable gloves
%isposable plastic aprons
,rotective eye goggles 8 visors
Masks !there may be rare occasions when this is re.uired$
Wh, 'ho$() protet!"e e#$!p%e&t *e $'e)+
The hands and clothing of staff can become contaminated with germs
and potentially spread infection.
If used correctly, protective e.uipment can prevent the spread of
infection and also protect the wearer from cross infection.
Whe& 'ho$() protet!"e e#$!p%e&t *e $'e)+
%isposable plastic aprons and gloves should be worn when there is a
potential or actual risk of coming into contact with blood or body fluids.
,rotective eye wear should be worn when carrying out procedures
involving a risk of blood or body fluid splashes to the eyes or mucous
membranes e.g. mouth
2.- .AND WAS.ING AND .AND ./GIENE
Wh, 'ho$() ha&)' *e 0a'he)+
2and washing is the single most important measure in reducing cross
infection. ffective 9hand hygiene: will reduce the risk of staff contaminating
themselves with germs from the environment and from transmitting the same
germs to service users and other staff.
.a&) .,1!e&e
92and 2ygiene: is the term we now use for the process of hand washing.
2and hygiene relates not ;ust to hand washing but all the processes involved,
e.g. rinsing, drying and care of skin afterwards.
It is important that nails are kept short and clean. /ail polish, false nails and
infills can be a possible source of cross infection and in;ury. <itchen staff
specifically, are prohibited from wearing ;ewellery and nail polish, false nails
and infills. ach unit may need to undertake a risk assessment to decide on
the appropriateness of such issues !see Appendi=$.
>ccupational %ermatitis is caused by the skin coming into contact with certain
substances at work? it affects all industry and business sectors. It is not
infectious but hands that are constantly being washed need to be cared for.
-se a moisturising cream before and after work to prevent water loss from the
outer layer of your skin by covering it with a protective film. This keeps the
water in the skin and helps keep infections and other harsh substances out
!see Appendi= (.@, ,reventing >ccupational %ermatitis$.
2.- .AND WAS.ING AND .AND ./GIENE 2 o&t.
Whe& 'ho$() ha&)' *e 0a'he)+
'efore and after each work shift or work break
After handling potentially contaminated items such as waste, used
linen, soiled wound dressings or medical e.uipment
'efore and after any clinical procedure e.g. when emptying 8 changing
a catheter bag or when undertaking wound care
'efore putting on and after removing protective clothing
After using the toilet
Ahenever hands become visibly soiled
'efore eating, drinking or handling food
After removal of gloves
/' B Staff in residential units should not use residents1 bar soap or hand
towels
2.- .AND WAS.ING AND .AND ./GIENE 2 o&t.
.o0 'ho$() ha&)' *e 0a'he)+
Aet hands up to wrists under running water
Apply a li.uid soap
-sing the ( steps techni.ue rub soap evenly over all areas of hands
including front, back, in between fingers, thumbs and the tips of the
fingers of both hands
3inse off every trace of lather with running water
%ry hands thoroughly, preferably with disposable paper towels or hot
air dryer
All staff should ensure that wounds, cuts and abrasions to hands are
covered with a waterproof dressing while at work
=periments have shown that the tips of thumbs and fingers are often
missed when washing hands, the pictures overleaf show how to wash
hands effectively and efficiently
Ahere hand washing is not possible and hands are not visibly soiled,
alcohol hand rubs may be useful
Goo) .a&) Wa'h!&1 G$!)e
Cood 2and Aashing Cuide B 0et1s all do the ( steps poster
2.-.1 3EWELLER/ AT WOR4 GUIDANCE NOTES
Several incidents have arisen nationally that highlight the need for advice on
the wearing of ;ewellery in the workplace, particularly in social care work. It is
acknowledged that some types of ;ewellery are worn specifically as an
indicator of a religious belief or practice, and therefore the wearing of ;ewellery
can become a delicate issue. 2owever, these guidance notes seek only to
address speculation on best practice from an Infection Control and Dood,
2ealth E Safety perspective.
Ahen social care staff, particularly those who carry out personal care duties,
wear ;ewellery there is a potential for harm both to the service user and the
wearer. Fewellery can potentially be snatched or grabbed, or become
entangled in e.uipment. Aatches, rings, bracelets, brooches etc with stones
or engravings have the potential to cut or scratch a service user. >rnate
;ewellery, apart from harbouring dirt and bacteria, may also easily tear
disposable gloves, which are necessary for the prevention of infection. In
addition all ;ewellery has the potential to harbour dirt and bacteria, leading to
cross contamination and infection. It is recognised that there are certain
aspects of care work where it is acceptable to wear fob watches, e.g. nursing.
In situations such as this the latter must be positioned where they can cause
no harm to anyone and not be easily grabbed.
2.-.1 3EWELLER/ AT WOR4 GUIDANCE NOTES2 o&t.
Managers may choose to carry out their own risk assessments on the wearing
of ;ewellery. 2owever, the consensus view amongst local authorities
nationwide is as followsG B
/o ;ewellery with the potential to cause harm to service users and8or
that can be grabbed or snatched, i.e. necklaces, earrings, bracelets,
brooches, watches !wrist or fob$ or other facial ;ewellery should be
worn at work. The possible e=ceptions to the above are studHtype
earrings or other studHtype facial piercing. 2owever, if these are still
considered to be a potential problem they can be covered with
waterproof plasters.
Ahere practicable any ;ewellery being worn by persons delivering care
should be either removed or covered using a waterproof plaster.
'ody piercings should remain covered by clothing or where this is not
possible, removed before commencing duty.
3ings with stones which may cut or scratch, particularly whilst carrying
out personal needs duties, should not be worn. The only e=ception to
this is a plain, bandHtype ring, i.e. wedding ring and, if deemed
necessary, this can be taped over and covered in a waterproof plaster.
In a kitchen or food preparation setting Dood Safety 0egislation and
departmental policy, detailed in the departmental the good food guide
prohibits the wearing of ;ewellery other than sleepers and plain band
!wedding$ rings.
2.-.2 3e0e((er, at Wor5 Po'ter
U&!6or%' a&) Dre'' G$!)a&e
For 4!the& Sta66
The wearing of ;ewellery, namely wrist watches, fob
watches, earrings, rings, necklaces, bracelets,
bangles, anklets or brooches is forbidden, as they
harbour dirt and bacteria. The only e=ception to this
rule is sleepers in pierced ears and plain band
rings. The only facial ;ewellery permitted is a small
stud without stones. This must be safely secured to
avoid physical contamination which contravenes
food safety legislation.
=tract from the good food guide
,ractice Cuidance ,age 5)
,rocedures ,ages 5( and 5)
2.7 SAFE MANAGEMENT OF CONTAMINATED WASTE
All waste must be segregated depending on its type !see the chart below$.
Current guidelines from 0eicestershire County Council Aaste Management,
%D3A, 2S and CIC all indicate that waste collected from local authority
establishments will continue to be classified as 9domestic: and not 9clinical: or
9ha&ardous: waste, as defined under the terms of the 2a&ardous Aaste
!ngland and Aales$ 3egulations "44*.
.o0 'ho$() 0a'te *e 'e1re1ate)+
Staff should be taught the correct segregation of waste, basic hygiene and
infection control including dealing with body fluids and incontinence
management. Care workers should be made aware of the particular system
used within their work setting, as procedures may vary depending upon
facilities and staffing levels.
What t,pe o6 0a'te+ What 'ho$() ,o$ )o 0!th !t+
9Clinical waste: !as defined by the
above regulations$ produced by
health care professional visits
!doctor8nurse$ e.g. waste soiled with
blood or body fluids
The health professional may deal with
this 9clinical: waste themselves,
removing it typically in a yellow bag
marked for I/CI/3ATI>/ >/0J.
Alternatively some establishments
may make arrangements locally or
double bag. A flush toilet is ideal for
disposing of faeces and urine and
should be used whenever possible.
/ormal household waste, general
commercial waste
'lack or clear bags
Aaste handled by care staff e.g.
sanitary towels, nappies, incontinence
pads and dressings used in routine
care activities
-se system such as 9twist and seal:
or double bag and seal securely. Can
be placed in household waste in
normal black sacks B unless a risk
assessment highlights the need for
more stringent precautions.
,harmaceutical waste !such as
tablets, ointments, creams etc$
3eturn to chemist for disposal in
SPECIAL WASTE bin or other action
indicated by the department1s
Medication ,olicy
2.7 SAFE MANAGEMENT OF CONTAMINATED WASTE 2 o&t.
What t,pe o6 0a'te+ What 'ho$() ,o$ )o 0!th !t+
/eedles and other contaminated
sharps
Store in an appropriately si&ed
dedicated sharps bo= which complies
with 'S)#"4 and -/#"65. Should be
disposed of appropriately when the
line is reached.
In an emergency use a solid container
!e.g. sealed glass ;ar$.
Aaste bags should be securely fastened and ALWA/S deposited in
appropriate bins, which are inaccessible to the general public, animals and
vermin. All bins should be of 'ritish Standard, to ensure they are strong
enough to withstand fre.uent use.
2.8 SAFE MANAGEMENT OF LAUNDR/
The provision of clean linen is a fundamental re.uirement of care. Incorrect
handling, laundering and storage can pose an infection ha&ard.
Infection can be transferred between contaminated and non contaminated
items of clothing, laundry and the environment it is stored in. ven during a
normal washing cycle a number of microHorganisms can be passed between
clothing and linen and will only be partially removed during the rinse cycles.
Thorough drying of the laundry, however, does reduce the levels of
contamination to an amount that no longer poses a risk.
Although staff may not regularly handle soiled laundry, they should be taught
how to handle it safely. It is important to remember that it is not always
possible to know if linen is infected or contaminated with an infectious disease
and therefore it is vital that all used laundry is treated with care and Standard
,recautions !including wearing personal protection e.uipment$ are adopted at
all times.
2.8 SAFE MANAGEMENT OF LAUNDR/ 2 o&t.
Re#$!re%e&t' 6or La$&)r,
A )e'!1&ate) (a$&)r, area. Ideally, this area should have separate
ventilation and a dirty to clean through system so that dirty laundry can
arrive through one door and be .uickly washed before drying and
removal through a separate e=it to a clean storage area. Ahere this is
not possible arrangements must be made to ensure a dirty to clean
workflow, so that clean and dirty laundry is kept separate.
Aashing machines in residential care homes should have 9'pe!6!e)
pro1ra%%e a*!(!t,: to meet disinfection standardsK. Ideally this will
include a preHwash service cycle.
In care home settings an !&)$'tr!a( )r,er that !' re1$(ar(,
%a!&ta!&e) should be used to dry all clothing and linen.
In care homes, a re1$(ar 'er"!e a&) %a!&te&a&e !&'pet!o&
'he)$(e should be available for e=amination by CIC inspectors.K
A 0a'h ha&) *a'!& preferably with lever taps, li.uid soap and
disposable towels
K 3eference B %epartment of 2ealth, Infection Control Cuidance for Care
2omes !Fune "44($.
2.8 SAFE MANAGEMENT OF LAUNDR/ 2 o&t.
Tra!&!&1 6or La$&)r, Sta66
0egislation re.uires laundry staff to have training in the following areasGH
Infection Control
Manual 2andling !inanimate ob;ects$
C>S22
In addition laundry staff should receive instruction concerningGH
Cleaning Schedules
Standard Infection Control ,rocedures
2and 2ygiene
Sluicing
Colour coding for laundry
Type and category of laundry
2.8 SAFE MANAGEMENT OF LAUNDR/ 2 o&t.
.o0 'ho$() (a$&)r, *e ha&)(e)+
5. 0aundry must be handled, transported and processed in such a
manner that prevents skin and mucous membrane e=posure to staff,
contamination of their clothing and the environment and the infection of
service users.KK
". 'efore handling dirty laundry, staff should wear protective clothing
!gloves and apron$.
#. 0inen should be removed from residents1 beds with care, avoiding
creating dust and put in the appropriate bag outside the room.
+. ,ersonal clothing should also be removed with care and placed in the
appropriate linen bag and not on the floor.
*. 0inen should be separated into the correct containers, handled as little
as possible and bagged at the point of use.
(. 0inen bags containing infected laundry should be sealed and tied
before removal from the care area.KK
). Staff should never empty bags of linen onto the floor to sort it into
categories as this presents an unnecessary risk of infection.
@. 0inen should be segregated into # categories !see segregation$. Many
care homes use waterHsoluble 8 alginate bag liners within cotton sacks
in a washable, plastic, wheeled trolley to aide this separationG keeping
linen off the floor before taking the bags to the laundry.
6. All soiled laundry should be placed directly into the washing machine. If
this is not possible then soiled laundry should be placed into a plastic
bag until it can be put into the washing machine.
54. 2ands must be washed after handling dirty laundry and following
removal of personal protective e.uipment.
55. ach establishment 8 service should carry out their own risk
assessment if in doubt as to how laundry should be handled, ensuring
that dirty and clean linen are stored separately.
5". Ahere waterHsoluble bags are used these should never be opened
once sealed, prior to transfer into the washing machine.
2.8 SAFE MANAGEMENT OF LAUNDR/ 2 o&t.
.o0 'ho$() (!&e& *e 'e1re1ate)+
1. 0aundry facilities should be sited so that used 8 soiled items and
infected linen are not carried through areas where food is stored,
prepared, cooked or eaten and not intrude on service users.KK
2. nsure that dirty and clean linens are stored separately.KK
-. 3esidential care homes are re.uired to have sluicing facilities.
2owever, avoid manual sluicing where practicable.
7. Soiled communal laundry e.g. pillowcases, sheets, towels should be
washed at a temperature of (*LC or above.
8. Soiled communal laundry e.g. pillowcases, sheets, towels should be
washed separately from other clothing on the hottest temperature the
clothing will allow !(*MC or above$.
;. Doul 8 soiled or infected laundry to be washed at an appropriate
temperature !minimum of (*LC for not less than 54 minutes or )5LC for
at least # minutes$.K
<. The most recent guidance on Infection Control KK advises that 9laundry
can be safely washed in a domestic washing machine in water as hot
as the fabric will tolerate, washed separately from other linen, in a load
not more than half the machine capacity, in order to ensure ade.uate
rinsing and dilution? then tumble dried and ironed:.
References from:-
** The Department of ealth !andemic "nfluen#a $uidance.
"ssued in %ctober &''(
* )are omes for %lder !eople *ational +inimum ,tandards
** Department of ealth - "nfection )ontrol $uidance for )are omes
.une &''/
2.8 SAFE MANAGEMENT OF LAUNDR/ 2 o&t.
What t,pe o6 (a$&)r,+ What t,pe o6 (!&e& *a1+
0inen should be categorised as 9Infected: or 9-sed 8 or 9Soiled 8 Doul:
/ormal 9-sed: linen Standard linen bag, washable plastic
bucket, black plastic bags or similar
sealed container for collection by
laundry service or storage at
establishment prior to
washing8disinfecting on site.
9Soiled 8 Doul: linen soiled with blood,
faeces or urine
At premises with laundry facilities,
sluice immediately !using the preH
wash facility on the washing machine,
if available$ and machine
wash8disinfect. Some nonHresidential
establishments may decide to sluice
soiled items only and return item in
sealed plastic container to service
user. Minimise handling where
practicable.
9Infected: linen that has been in
contact with a client with a known
infection
Aear disposable apron and gloves,
then bag and wash8disinfect
separately. Minimise handling where
practicable. /.'. H Soluble alginate
bags which dissolve in the wash can
be purchased to avoid repeated
handling of the contents.
2.; SAFE MANAGEMENT OF =OD/ FLUID SPILLAGES
Ur!&e
-rine is sterile unless infected? therefore cleaning with generalHpurpose
detergent is ade.uate.
Aear disposable gloves and aprons
Aipe up spillage with paper towels
Clean with generalHpurpose detergent and hot water
3inse and dry
%ispose of ,, and wash hands
Faee'> "o%!t or p$'
Aear disposable gloves and apron
Aear protective eye goggles if there is a risk of splashes to the eyes
Aipe up spillages with disposable paper towels
%isinfect area with bleach !chlorine based solution i.e. Milton or 5N
sodium hypochlorite solution left for " minutes$ rinse and dry
,lace used paper towels, gloves and apron in yellow plastic bag or
double bag and dispose of as contaminated waste
N= =(eah must not be mi=ed with urine as it gives off a to=ic gas. It can
also cause discoloration of wood, and pitting of metals.
2.; SAFE MANAGEMENT OF =OD/ FLUID SPILLAGES 2 o&t.
M!&or =(oo) Sp!((a1e'
Aear disposable gloves and apron
Aear protective eye goggles if there is a risk of splashes to the eyes
nsure ade.uate ventilation
,lace paper towels over the spillage. Cently pour a 5 in 54 dilution of
household bleach or undiluted Milton onto a paper towel and wipe up
spillage. Clean area with bleach and leave for " minutes minimum.
Or use chlorine granules !2a& Tab$ to soak up the blood. Alternatively
a proprietary brand of cat litter can be used to mop up spillages. It is
relatively cheap and light to store and use. It does not have
guaranteed disinfection .ualities however, so cleaned surfaces will
also need to be disinfected !and dried$ as described above.
A single use spill kit is available for passenger transport which
provides sufficient ,, and chemicals for one incident. Contact your
0ine Manager for details of how to obtain a spill kit.
The treated surface and8or e.uipment should be rinsed with clean
water and dried, as bleach solutions can be corrosive. /o other
precautions are necessary
If blood has been spilt on absorbent surfaces !carpets8soft furnishings$
follow the same procedure as above and clean with hot water and
detergent
%iscard paper towels, gloves and aprons in an appropriate waste bag
If soft furnishings cannot be cleaned with bleach then they may need
to be destroyed
2.< SAFE USE AND DISPOSAL OF NEEDLES AND S.ARP
INSTRUMENTS
Sharp instruments may cause in;ury to service users and staff. If
contaminated with infected blood such in;uries can cause the transmission
of bloodHborne viruses such as 2epatitis ', 2epatitis C and 2IO. !Section
+.5$
What are 'harp'+
/eedles
Scalpels
'roken glass
3a&or blades
Any other item which may cause laceration or skin puncture and which
may have been contaminated with blood from another individual.
2.< SAFE USE AND DISPOSAL OF NEEDLES AND S.ARP
INSTRUMENTS 2 o&t.
.o0 a& the r!'5 o6 !&?$r, *e re)$e)+
To reduce the risk of sharps in;ury, the safe handling and disposal of sharps is
very important. The following advice needs to be followed when dealing with a
sharp instrument.
/ever reHsheath needles
%ispose of syringe and needle, as one unit, into a specific container
Sharp instruments, once used or when found, need to be placed into a
designated sharps bo= which must comply with uropean and 'ritish
standards
Sharps containers must be securely assembled prior to use
Sharp' %$'t &ot *e arr!e) aro$&). Take the sharps bo= to where
the sharp is going to be used or to where a possibly infected sharp has
been found. It can then be disposed of immediately
Sharps bo=es must be closed and sealed when they have reached the
full line
Sharps bo=es should be labelled with the name of the establishment
prior to disposal
Sharps bo=es must be stored in a safe place away from unauthorised
people and children
Consider the possibility of hidden sharps such as needles and ra&ors
when carrying out your work. Aear protective e.uipment and look
before touching
2.@ SAFE MANAGEMENT OF S.ARPS IN3URIES> =ITES> SCRATC.ES
A =LOOD OR =OD/ FLUID SPLAS.ES TO E/ES OR MOUT. A
=LOOD SPILLAGES
What 'ho$() ,o$ )o !%%e)!ate(, 6o((o0!&1 a 'harp' !&?$r, B!&($)!&1
*!te' or 'rathe' that )ra0 *(oo)+
Make the wound bleed freely !do not suck the in;ury$
Aash in;ury under warm running water while continuing to encourage
bleeding
%ry and cover in;ury with a waterproof dressing
Safely retain the sharp ob;ect for testing in a plastic bag inside a sealed
container
3eport immediately to a Dirst Aider, and8or your line manager. The
Community Infection Control /urse or your C, can provide further
advice and management
0CC staff should fill out an accident form and forward a copy as per
departmental instructions to the %epartmental Senior 2ealth, Safety E
Aellbeing Advisor or send an electronic copy by following the
instructions on the departmental intranet site
WAS. IT 2 =LEED IT 2 COVER IT 2 REPORT IT
2.@ SAFE MANAGEMENT OF S.ARPS IN3URIES> =ITES>
SCRATC.ES A =LOOD OR =OD/ FLUID SPLAS.ES TO
E/ES OR MOUT. A =LOOD SPILLAGES 2 o&t.
What 'ho$() ,o$ )o 6o((o0!&1 'p(a'he' o6 *(oo) to the e,e' or %o$th+
Splashes of blood or body fluids entering the eye should be removed
immediately by irrigation. Ideally sterile, saline or eye wash packs
should be used if available. If not running mains water can be used
instead. Irrigation should be continued until all traces of the
contaminated material have been removed
3eport immediately to a Dirst Aider, and8or your line manager. The
Community Infection Control /urse or your C, can provide further
advice and management
0CC staff should fill out an accident form and forward a copy as per
departmental instructions to the %epartmental Senior 2ealth, Safety E
Aellbeing Advisor or send an electronic copy by following the
instructions on the departmental intranet site
Dollowing these simple Dirst Aid measures the risk of transmitting infection will
be reduced and managed. In practice staff and service users will usually be
referred to their Ceneral ,ractitioner or 2ospital Accident and mergency
%epartment.
2.@ SAFE MANAGEMENT OF S.ARPS IN3URIES> =ITS> SCRATC.ES A
=LOOD OR =OD/ FLUID SPLAS.ES TO E/ES OR MOUT. A
=LOOD SPILLAGES
What 'ho$() ,o$ )o 6o((o0!&1 'p!((a1e o6 *(oo) o&to '5!&+
>/ -/'3></ S<I/ B wash off with copious warm water and soap,
paying particular attention to fingernails. /o further action necessary.
>/ '3></ S<I/ B wash off with copious warm water and soap. The
incident must be reported to your line manager and The Community
Infection Control /urse with the accident reporting procedure followed
as normal.
Significant blood spillages must be reported to your line manager and
the cleaning of such spillage should be discussed. %epartmental
Senior 2ealth, Safety E Aellbeing Advisors or The Dood E /utrition
Manager are available for further advice.
2.@.1 S.ARPS IN3UR/ FLOWC.ART
2.C ENVIRONMENTAL CLEANING
O$pat!o&a( eDpo'$re to *(oo) or *o), 6($!)'
/eedle stick in;uries, cuts, bites, splashes into eyes,
nose and mouth or other cuts8abrasions on skin
DI3ST AI%
ncourage wound to bleed. Aash contaminated area with copious amounts of water
%> />T S-C< T2 A>-/%,
%> />T SC3-' T2 A3A
>3 -S A /AI0 '3-S2
Cover wound with an appropriate dressing
3eport the accident to the person in charge as soon as possible
Complete an Incident 8 Accident form and send to the %epartmental Senior 2ealth, Safety E
Aellbeing Advisor
If in;ured member of staff
agrees that e=posure is
low risk B no further
action need be taken
Medium8high risk
0ow risk
Appropriate prophyla=is for 2epatitis '8immunoglobulin will
be offered if indicated by risk
Jour C, or AE staff will assess the risk 'lood samples
may be taken
Monday to Driday
Telephone your C, and ask to be seen as soon as
possibleK
At all other times
Telephone your local AE %epartment and ask to be
seenK
KTake a written account of the incident, agreed and signed
by the person in charge, and information on the
patient8resident8staff with whose blood8body fluids you
have been accidentally contaminated
Splash to broken skin8eyes
with blood or with other
bloodHstained body fluids
e.g. urine
Splash to intact skin with
blood or with other low risk
body fluids e.g. urine, />T
visibly bloodHstained
ffective cleaning is not only an essential Standard Infection Control
,rocedure, but is also an outward and visible sign of the overall .uality of care
provided.
As a general principal the overall appearance of care settings should be tidy,
ordered and uncluttered with only appropriate cleanable, well maintained
furniture used. Any presence of blood or body fluids is unacceptable. In
general all surfaces should be free from dust, dirt, debris, stains and spillages.
The fabric of the environment and e.uipment should smell fresh and pleasant.
Any deodorisers should be clean and functional.
A key component of providing consistent high .uality cleaning is the presence
of a clear cleaning schedule which sets out all aspects of the cleaning service
and its fre.uency. It should also clearly define the roles and responsibilities of
all those involved, from managers through to care, domestic and
housekeeping staff.
%epartmental publications The 0itchen 1o2 3ook and the 2ood food 2uide
contain e=amples of cleaning schedules. Cleaning schedules can also be
obtained from Fohnson %iversey. Ahere cleaning services are contracted
managers will need to ensure that an appropriate cleaning schedule is
agreed. Dor both in house and contracted cleaning services, managers must
ensure that suitable arrangements are in place to monitor the standards of
cleaning and deal with any poor or unsatisfactory performance. Dor 0CC staff
,roperty Services and The Dood E /utrition Manager play a role in this
monitoring when they undertake audits.
2.C ENVIRONMENTAL CLEANING 2 o&t.
Deo&ta%!&at!o&
Aithin care settings, decontamination of e.uipment, medical devices and the
environment should be a fre.uent occurrence. 2owever, it is e=tremely
unlikely that the sterilisation of medical devices will be re.uired. Indeed, if this
level of decontamination is needed it should be sought from an accredited
Sterile Services %epartment, or single use disposable instruments should be
used.
Deo&ta%!&at!o& proe''e'
%econtamination can be achieved by a number of methods, which fall into the
following # categoriesG
C(ea&!&1 physically removes contamination but does not necessarily
destroy microHorganisms. It removes microHorganisms and the organic
matter on which they thrive. Cleaning is a necessary prere.uisite to
effective disinfection or sterilisation. This will be the most common
choice of decontamination method within a care setting.
D!'!&6et!o& reduces the number of viable microHorganisms but may
not necessarily inactivate some microbial agents, such as certain
viruses and bacterial spores.
Ster!(!'at!o& renders an ob;ect free from viable microHorganisms
including viruses and bacterial spores.
The choice of decontamination methods depends upon the risk of infection to
the service user coming into contact with e.uipment or medical devices. Such
items can be categorised into # risk groupsG
.!1h r!'5 items are those used to penetrate skin or mucous
membraneG or enter the vascular system or sterile spaces, for e=ample
needles and catheters. They need to be sterilised if reusable, but single
use items are preferred.
2.C ENVIRONMENTAL CLEANING 2 o&t.
Deo&ta%!&at!o& 2 o&t.
I&ter%e)!ate r!'5 items are those which come into contact with intact
mucous membranes or may be contaminated with particularly virulent
or readily transmittable organisms, for e=ample commodes used by a
service user with a known infection. Such items re.uire cleaning
followed by disinfection or sterilisation.
Lo0 r!'5 items are those which come into contact with intact skin or do
not contact the service user e.g. floors, walls. They re.uire cleaning.
,ee Table &.4.5 for ,u22ested Decontamination +ethods for )ommonly
6sed 7quipment.
2.C ENVIRONMENTAL CLEANING 2 o&t.
S!&1(e $'e !&'tr$%e&t'
As an alternative to sterilising reusable medical instruments, the use of single
use disposable e.uipment is becoming increasingly popular. Although many
items, such as syringes and needles, have been available for many years, the
cost, .uality and availability of other e.uipment and instruments have resulted
in a significant increase in single use devices. A&, )e"!e )e'!1&ate) a'
'!&1(e $'e %$'t &e"er B$&)er a&, !r$%'ta&e'E *e re$'e).
Ma&$6at$rer'F Re'po&'!*!(!t!e'
Manufacturers of reusable medical devices are re.uired by the Medical
%evices %irective !6#8+"8C$ to supply clear written decontamination
instructions, which should include appropriate cleaning, disinfection or
sterilisation methods.
Certain fabrics or materials can be difficult to decontaminate. It is therefore
advisable, prior to purchasing e.uipment, for e=ample hoists and slings to
assess carefully that the recommended decontamination methods are
practical, safe and reliable.
Ceneral principles for chemical disinfection
Chemical agents should only be used whereG
Sterilisation is not re.uired
It is impossible to disinfect using heat
Cleaning alone is insufficient
%isinfectants should not be used routinely as cleaning agents or
deodorants
%isinfectants must not be used for the storage of e.uipment e.g.
mops
2.C ENVIRONMENTAL CLEANING 2 o&t.
Ma&$6at$rer'F Re'po&'!*!(!t!e' 2 o&t.
>rganic debris !e.g. faeces, secretions$ may inactivate some
disinfectants. Items should be cleaned prior to chemical disinfection.
%isinfectants must be used at the recommended dilution.
%isinfectants must be stored and discarded in accordance with the
manufacturers1 instructions.
C>S22 regulations must be adhered to.
2.C.1 SUGGESTED DECONTAMINATION MET.ODS FOR COMMONL/
USED EQUIPMENT
If items are contaminated with blood or other body fluids, clean them thoroughly to
remove physical soil and then wipe with a freshly prepared solution of chlorineH
releasing agent with a concentration of 5444 p.p.m.
=e))!&1
=e)pa&' a&) $r!&a('
Co%*'
Co%%o)e'
C$rta!&'
Dr!p 'ta&)'
F(o0er "a'e'
.o!'t
G($o'eG%o&!tor!&1 e#$!p%e&t
Mattre''e' a&) o"er'
Ne*$(!'er'
S!''or'
Va1!&a( 'pe$(ae
Sp(!&t' a&) 0a(5!&1 6ra%e'
Ther%o%eter' Be(etro&!> ora(
a&) reta(E
Tro((e, B)re''!&1> %e)!!&eE>
ta*(e'
Whee(ha!r'
See ".* B Safe Management of 0aundry.
2eat disinfectionG (*LC for 54 minutes or )5LC for #
minutes.
Dor heatHsensitive fabrics use a low temperature at +4LC
and tumble dry
%ispose of singleHuse items. If reusable, heat disinfectant
in bedpan washerHdisinfector !e.g. @4LC for 5 minute$.
Store dry.
ach service user should have their own comb
Aash with detergent, rinse and dry.
Should be laundered at least si= monthly intervals.
Clean after each use.
Change water regularly. Aash vase in hot water and
detergent after use and store dry
Surface clean the hoist frame. =amine material and
clips for wear or damage before each use. Slings should
be laundered in the hottest wash cycle allowable and
ideally, not shared between service users.
Clean after each use.
Clean cover regularly as part of a routine and following
service users use. 3inse thoroughly and dry. Mattresses
should be enclosed in a waterproof cover and routinely
inspected for damage. %iscard if fluids have penetrated
into the mattress fabric.
Clean all parts thoroughly with detergent and hot water
between service users use. nsure all parts are
thoroughly dried. 3efill with sterile water only. %o not
share between service users.
%ispose of on service user1s discharge.
Clean following each use.
%ispose of singleHuse
Aash and clean with detergent
-se a singleHuse sleeve each time.
Clean with detergent and hot water and dry.
Clean, rinse and dry.