Download guidelines for the control of outbreaks of gastroenteritis infections in

GUIDELINES
FOR
THE CONTROL OF OUTBREAKS OF
GASTROENTERITIS INFECTIONS IN
NURSING AND RESIDENTIAL CARE HOMES
Includes:

Guidelines for the control of outbreaks of gastroenteritis infections

Front door notice

Outbreak Log sheets

Bristol Stool Chart

Inter-healthcare Infection Control Transfer of a Patient Form

Hydration Patient Information leaflet / poster
Contact:
CDC Team Telephone Number: 0113 3785900
OUT-OF-HOURS Public Health Advice: 0114 3049843
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GUIDELINES FOR
THE CONTROL OF OUTBREAKS OF GASTROENTERITIS INFECTIONS
NURSING AND RESIDENTIAL IN CARE HOMES
Introduction
An outbreak can be defined as;
An incident in which 2 or more people experiencing a similar illness are linked in time /
place (www.phe.org.uk)
All symptomatic cases must be notified to the
Communicable Disease Control (CDC) Team: 0113 378 5900.
Out of hours Public Health Advice Tel: 0114 3049843
PLEASE ENSURE ALL MEMBERS OF STAFF READ, UNDERSTAND AND KNOW
EXACTLY WHERE TO LOCATE THIS DOCUMENT
Containment
Display a copy of the enclosed notice in a prominent position on each entrance door to the
premises. Restrict visitors. Those visitors that do come must be advised of the risks. Any
non emergency maintenance should be cancelled.
Identify and keep a record of symptomatic patients and staff using the outbreak log sheet
provided. Where possible isolate and segregate residents with symptoms until they have
been 48hrs symptom free.
To prevent symptoms of dehydration monitor and record the patient’s fluid input / output.
Patient hydration information leaflet enclosed.
One faecal specimen must be collected from all symptomatic cases, even if vomiting only.
Sample containers and laboratory forms must be completed correctly prior to submitting to
GP surgeries.
Close the home to admissions and respite care until cleared by the Communicable
Disease Control (CDC) Team.
Avoid transfers/discharge of residents to other health care settings. In the event of an
emergency, telephone and advise receiving hospital and transport of outbreak.
IMPORTANT:
The Inter-healthcare Infection Control Transfer Form must be completed, clearly
indicating the patient’s infection status, the completed form must accompany the
patient.
This will enable the receiving party to ensure appropriate infection control measures are
put in place to prevent the potential spread of infection to other patients/staff/visitors.
The outbreak will be concluded when the last person displaying symptoms is 48 hours
symptom free.
Staff (permanent or temporary) and students must not work at or visit other homes during
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the outbreak.
Organise the staff rota to minimise potential contamination of unaffected areas.
All symptomatic staff must stay off duty until they are 48 hours free of symptoms.
Hygiene
Hand hygiene: staff and visitors should be encouraged to wash hands on entry to and exit
from the premises.
Strict hand washing with liquid soap / drying with disposable paper towels.
Hot air hand dryers should not be used during outbreak.
Gloves and disposable aprons must be worn by all staff in contact with excreta or vomit
and discarded after each episode of use.
Restrict kitchen access to catering staff only. Kitchen staff should not visit other parts of
the home.
Staff must eat and drink in designated areas only.
Staff should not wear uniform outside the care home and a clean uniform should be worn
each day.
Environment
In the event of a body fluid incident, appropriate spillage kits must be used where
available. Spillage kits must not be used on urine. If unavailable, spillage must be
covered and enveloped in disposable / absorbent paper towels, the surface sprayed with
anti-bacterial/disinfectant spray and waste placed into clinical waste bag for disposal. If
there is no clinical waste stream, double bag prior to disposal.
Clean the area with hot water and detergent and allow to thoroughly dry.
After removal of any infected material and as part of the routine cleaning operations during
the outbreak, kitchen surfaces, toilets, commodes etc should be thoroughly cleaned using
detergent and hot water prior to disinfection. Disinfection can be achieved using a 0.1%
hypochlorite (bleach) solution. Where hypochlorite/bleach is not available, use antibacterial/ disinfection products.
Carpets should be thoroughly cleaned with hot soapy water and a vigorous rubbing
motion, simultaneously minimizing spread. Disinfection can be achieved with efficient
steam cleaning. *Do not use hypochlorite/bleach on carpets*
Solid linen and personal clothing must be placed immediately in an alginate stitched or hot
water soluble bag and sealed. This bag should then be placed in a clearly identifiable,
impermeable outer bag for storage and transfer to laundry. (The outer bag should be
washed at the same time as the contents).
External laundries should be informed of the outbreak.
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Any commode pots requiring emptying should be covered before being carried to the
sluice for emptying. The nearest point for disposal should be used and if there are any ensuite facilities to rooms where commodes are used then it may be better to empty the
contents into the en-suite WC.
Commode pots should be cleaned thoroughly with hot soapy water and returned to
individual residents rooms. (Ideally commode pots should be marked with room number to
ensure they are returned correctly.)
Ensure macerator / bedpan washer is operational. Faults must be dealt with as urgent.
Prior to flushing any toilet the lid should be closed to prevent aerosol of faecal and urinary
bacteria into the environment. Seat raisers must be thoroughly cleaned after use.
Hard surfaced floors must be cleaned daily. Linen mop heads used for this purpose should
be washed, rinsed, disinfected and stored upright to dry and laundered weekly.
Disposable mop heads should be used once then discarded.
Colour-coded cloths, mops, and buckets must be used.
Increase cleaning to horizontal surfaces, toilets, door handles, hand rails, tap tops, light
switches and other frequently touched areas.
Prevention and Education
Review cleaning procedure.
Ensure all toilets are provided with toilet paper in a wall mounted, sealed dispenser and
hand washing facilities with hot water, liquid soap and paper towels are always available.
Educate staff in personal hygiene and safe food handling precautions.
If you require any further information or assistance please contact:Communicable Disease Control (CDC) Team: 0113 378 5900
Environment and Housing
Environmental Action Service
Food and Health Team
Leeds City Council
Millshaw Park Way
LS11 0LS
OUT-OF-HOURS Public Health Advice: 0114 3049843
Updated: June 2016
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WOULD ALL
VISITORS TO
THE CENTRE
PLEASE REPORT
TO THE OFFICER IN -CHARGE
BEFORE
CONTINUING WITH
THEIR VISIT
THANK YOU FOR ASSISTING WITH
THIS INFECTION CONTROL
REQUIREMENT
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Symptomatic Log sheet
Complete daily and continue to record until outbreak is concluded
(Insert dates)
Room
Name &
Date Of Birth
Date Of
Onset
Symptoms
(see codes
below)
D;BD;V;N;A;H,
Recent
medication/
antibiotics
/ laxatives?
Fluid in/out
balance
chart?
Specimen
Sent date / &
result
Comments e.g. recent
visit elsewhere,
relatives affected, food
brought in, etc.
Day
1
Day
2
Day
3
Symptoms code: D=diarrhoea (record type as per Bristol stool chart); BD= diarrhoea containing blood; V=vomiting; N=nausea; A=abdominal pain;
H=headache; X=asymptomatic
1
Day
4
Log Continuation Sheet
Room
Name
Date of
onset
Day 5
Day 6
Day 7
Day 8
Day 9
Day
10
Day
11
Day
12
Day
13
Day
14
Day
15
Day
16
Symptoms code : D=diarrhoea; (record type as per Bristol stool chart) BD= diarrhoea containing blood; V=vomiting; N=nausea; A=abdominal pain;
H=headache; X=asymptomatic
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