Download Standard 15 - Infection Prevention and Control

Surrey Skills Academy with support from Health Education Kent Surrey Sussex
The Care Certificate Framework
For
Adult Social Care Workers
&
Healthcare Support Workers
Standard 15
Name of Learner:
Role:
Organisation:
Mentor:
Assessor:
Date started:
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Surrey Skills Academy with support from Health Education Kent Surrey Sussex
The Care Certificate Framework
Infection prevention and control
Standard 15
Main areas:
 I will prevent the spread of infection
Links:
Compassion in Practice (6 C’s):
Care, Compassion, Competence, Communication, Courage and Commitment
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Surrey Skills Academy with support from Health Education Kent Surrey Sussex
Standard 15
This standard is about the spread of infection and identifies the main routes by
which infection can get into the body and how your own health or hygiene
might pose a risk to the individuals you support. It then looks at common types
of personal protective clothing, equipment and procedures, including handwashing and the principle of handling infected / soiled linen and clinical waste.
An infection can be defined as, the invasion and multiplication of micro-organisms
such as bacteria, viruses, fungi and parasites that are not normally present within the
body. An infection may cause no symptoms and be subclinical, or it may cause
symptoms and be clinically apparent. An infection may remain localised, or it may
spread through the blood or lymphatic vessels to become systemic (body-wide).
The mode of transmission is the method by which an infectious agent passes from
one person or place to another, and it is important to be aware of this, when we
explore later how to implement the measures required to prevent it.
The different modes of transmission include: 
Direct contact
This is person to person spread of infection through physical contact
between people.

Indirect contact
This occurs when someone comes into contact with a contaminated object.

Insects (vector transmission)
This is where insects can for example bite someone, e.g. mosquitoes and
malaria.

Droplet
This occurs when people sneeze, cough or talk and they expel droplets of
respiratory secretions and saliva. These droplets will travel about one
metre from the person expelling them and may contain agents responsible
for respiratory infections such as flu or tuberculosis.

Airborne
Airborne also involves droplets or particles containing infectious agents,
but on a small enough scale that the particles can remain suspended in the
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air for long periods of times, and this may include such infections as
measles or chicken-pox.

Parental
This occurs when blood or other body fluids containing infectious agents
come into contact with mucous membranes or exposed tissue.

Faecal-oral
This is the route of much of the gastrointestinal illnesses and water and
food-borne disease.
Based on the above the common entry points for infection include:

Gastrointestinal tract (through the mouth or anus – affecting stomach to the
bowels)

Upper Respiratory tract (through the nose and mouth - affecting the lungs)

Urogenital tract (affecting the urinary tract)

Broken / Injured skin

Blood

Mucous membranes (through eyes)
It is important to consider the chain of infection, when looking at how infections are
spread:
Fig 1 – The Chain of Infection
The stages of the chain of infection: Page 4 of 20
Surrey Skills Academy with support from Health Education Kent Surrey Sussex

Infectious agent – An organism with the ability to cause disease. The
greater the organism's ability to grow and multiply, ability to enter tissue
and ability to cause disease, the greater the possibility that the organism
will cause an infection.
Infectious agents are bacteria, virus, fungi, and parasites.

Reservoir - A place within which micro-organisms can thrive and
reproduce. For example, micro-organisms thrive in human beings, animals,
and inanimate objects such as water, table tops, and doorknobs.

Portal of exit - A place of exit providing a way for a micro-organism to leave
the reservoir. For example, the micro-organism may leave the reservoir
through the nose or mouth when someone sneezes or coughs. Microorganisms, carried away from the body by faeces, may also leave the
reservoir of an infected bowel.

Mode of transmission - Method of transfer by which the organism moves or
is carried from one place to another. The hands of the health care worker
may carry bacteria from one person to another.

Portal of entry - An opening allowing the micro-organism to enter the host.
Portals include body orifices, mucus membranes, or breaks in the skin.
Portals also result from tubes placed in body cavities, such as urinary
catheters, or from punctures produced by invasive procedures such as
intravenous fluid replacement.

Susceptible host - A person who cannot resist a micro-organism invading
the body, multiplying, and resulting in infection. The host is susceptible to
the disease, lacking immunity or physical resistance to overcome the
invasion by the pathogenic microorganism.
Infections will spread if all stages of this chain are complete, preventing infection
means breaking the links in the chain so that an infection cannot spread.
Clients receiving health and social care are at risk of developing infection as a result
of their compromised state of health, underlying medical conditions, or as a result of
contact with health care interventions. In addition, health or social care settings can
provide ideal conditions for micro-organisms to be transmitted between those who
receive and give care. The close proximity and contact between each party and the
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Surrey Skills Academy with support from Health Education Kent Surrey Sussex
continuous contact in a shared working and living environment all contribute to
transmission. Micro-organisms by their very nature are opportunistic, exploiting
chances to grow or enter the body, which may result in infection.
Health care associated infections (HCAIs) may be caused by a large number of
different micro-organisms, a significant proportion of which are avoidable if
sustainable and robust systems are in place to manage risks associated with
infection. HCAIs are not confined to hospitals, and health care / social care workers
who practice in community settings (including GP surgeries, clients own homes and
care homes) all have the same responsibilities to prevent opportunities for infection
to occur.
Hand washing is the single most important measure in reducing cross-infection but
studies have shown that it is rarely carried out in a satisfactory manner. The areas of
the hands which are often missed are the wrist creases, thumbs, finger tips and
under the finger nails. Under jewellery is also an area where germs multiple and are
not clean satisfactory during hand-washing. This is the reason jewellery should, be
kept to an absolute minimum (e.g. wedding band only), and removed while washing
hands.
Hands should be washed:

Before you handle food

Before giving out any medicines

Before handling any wounds

Before and after each work shift or work break

Before and after physical contact with each client

After you have used the lavatory

After assisting others to use the lavatory

After you cough, sneeze or use a tissue/hankie

After handling any dressings or wounds

After making beds

After handling rubbish

After handling raw food

After handling dirty or soiled laundry
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Surrey Skills Academy with support from Health Education Kent Surrey Sussex

After handling contaminated items such as bedpans, urinals, and urine
drainage bags

Whenever hands become visibly soiled

After performing any personal grooming (e.g. touching your hair, nose,
ears, arm-pits, etc)
This can be summarised, by linking to the 5 moments of Hand Hygiene issued by the
World Health Organisation (WHO), see below:
Fig 2 – 5 moments of Hand Hygiene from WHO guidance
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Hand washing should be performed as follows:
Fig 3 – Hand-washing technique – Health Protection Agency
Individuals you care for and support may have low immunity due to illness, side
effects of medication or poor nutrition. Therefore these individuals are at a higher risk
(vulnerability) of catching an infection or communicable disease. The most common
risk is through direct contact with an infectious person, or via an un-clean / infected /
used piece of equipment such as commodes, wheelchairs, and hoists. A high
standard of personal hygiene will need to be applied, as well as ensuring all
equipment is properly cleaned before use.
Your own personal and general hygiene therefore plays an important part in infection
control.

Your nails – should be kept short and free from dirt. You may need to give
serious consideration to this if you usually have long or false nails, as
these can contribute to the risk of cross infection
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
Your hair – should be clean, and tied up / away from the face if it is long.
Hair can come into contact with infectious agents (e.g. bodily fluids) and /
or be an infectious agent if not attended to properly

Your personal jewellery – should be removed apart from a wedding band.
Infection can be found under the jewellery or within stones. It can damage
skin surfaces during moving and assisting, or by accident.

Your clothing – regularly laundered and footwear kept clean, (if moving and
assisting is part of your role, you will need to ensure that your shoes fully
cover your toes, support the whole foot including the ankle, and is of a
material that provides adequate support and protection)
You should inform your line manager if you are in contact with contagious diseases
outside of work; as you could be carrying the infection to other people, and putting
others at risk. Diarrhoea and / or vomiting can be very serious for older adults and
very young children and can cause them to lose a large percentage of their body fluid
supply. You should therefore report to your line manager any episodes of diarrhoea
and / or vomiting and not attend work.
The use of personal protective clothing and equipment may vary slightly, according to
the setting that you are working in, but can include:
Uniforms
Reasons – they are worn within some organisations to reduce the risk of
pathogenic organisms being transferred from the outside environment on
the care workers clothing to the client and also to prevent pathogenic
organisms from the client being transferred outside the care environment.
See individual organisations policy on this

Gloves
Reasons – according to the World Health Organisation (2009), gloves are
worn for 2 main reasons:
1. To reduce the risk of contamination of health-care workers hands with
blood and other body fluids.
2. To reduce the risk of germ dissemination to the environment and of
transmission from the health-care worker to the patient and vice versa, as
well as from one patient to another.
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Gloves are therefore only required when there is a need to deal with
infected materials, such as bed pans, drainage bags, wound care and
dressings, or when dealing with blood, bodily fluids, mucous membranes or
broken skin. Gloves should not be worn when dealing with some aspects
of personal care e.g. dressing; unless it is in the care / support plan.
Sterile gloves, packed as a pair are used for clinical procedures.

Aprons
Reason – like gloves, an apron provides a physical barrier between the
care worker and other surfaces. Different colour aprons are used,
depending on task being completed, see individual organisational policy on
this, but can include white, blue, red and green.

Masks
Reasons – are used to protect healthcare workers from blood or body
fluids where there is a risk of airborne or droplet route infections being
transmitted. At times, they can also be used when the client is particularly
susceptible to infections, i.e. if they are immunosuppressed.

Goggles
Reasons – are worn to try and prevent blood or body fluids being splashed
into the eyes.

Hats
Reasons – they are not commonly used outside of the operating theatre,
although it is best practice for the chefs to wear catering style hats to
ensure that their hair does not fall into the food.

Shoes
It is important that shoes are not open toed because this will reduce the
risk of infection if blood or body fluids are spilt. In some specific clinical
areas, it is important that the footwear is not worn outside that specific,
area; otherwise there is a risk of organisms being carried into that
environment.
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Gloves need to be applied and removed as follows: -
Fig 4 – Application and removal of disposable gloves (Gloves Use Information Leaflet, WHO, 2009)
When handling infected or soiled linen and clinical waste, the procedure you follow,
will depend on your working environment. Waste can be defined as “any substance
or object the holder discards, intends to discard or is required to discard” European
Parliament, 2008. Waste material produced in either health or social care may carry
a risk of infection to people who are not directly involved in providing healthcare but
who are involved in the transport or disposal of that waste.
It is therefore important to ensure that waste is disposed of appropriately and in line
with your organisational policy on this.
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Where organisations have clinical waste collections, a colour coding scheme is in
use: Colour
Waste
Yellow
Waste which requires disposal by incineration
Yellow sharps box
Needles, syringes or other sharp instruments
Orange
Waste which may be “treated”
Yellow / black
Offensive waste
Purple
Cytotoxic waste
Black
Domestic waste
Fig 5 – Examples of colours of waste disposal
Clinical waste means any waste which consists wholly or partly of:

Human or animal tissue – usually applies to hospital and / or research
environments

Blood or body fluids

Excretions

Incontinence pads

Swabs or dressings

Syringes, needles or other sharp instruments – yellow sharps box
However, at times when working in the community, there is no provision for clinical
waste collections in which case, clinical waste is double bagged and placed in the
normal household rubbish – so it is imperative you check your organisations policy
on this.
Infection can be transferred between contaminated and uncontaminated items of
clothing, laundry and the environments in which they are stored. You need to be
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vigilant when dealing with heavily soiled linen / washing, which should be washed
immediately. Your working environment may make use of dissolvable red sacks for
such items of linen / washing; again, check your policy for more information on this.
Spillages should be cleaned up as quickly as possible adhering to the Infection
Control Policy and Procedures, again the location of your work will determine the
guidelines you adhere to here, so check your organisations policy on this.
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Surrey Skills Academy with support from Health Education Kent Surrey Sussex
Standard 15
Workbook
Infection prevention and control
Standard 15
Main areas:
 I will prevent the spread of infection
Links:
Compassion in Practice (6 C’s)
Care, Compassion, Competence, Communication, Courage and Commitment
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Surrey Skills Academy with support from Health Education Kent Surrey Sussex
Standard 15.1 – Prevent the spread of infection
15.1a Describe the main ways that infection can enter the body
1.
2.
3.
4.
5.
15.1a Describe the main methods of transmission that would enable infection to be
passed on
1.
2.
3.
4.
5.
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15.1c Describe how your own health or hygiene might pose a risk to the individuals
you support or work with
15.1d List the common types of personal protective clothing, equipment and
procedures you may use and explain how and when to use them
Type
When to use
1.
2.
3.
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How to use
Surrey Skills Academy with support from Health Education Kent Surrey Sussex
4.
5.
6.
15.1e Explain how you handle infected or soiled linen and clinical waste within your
organisation. If you come into contact with different types of clinical waste, then
specify each one
1. Infected or soiled linen
2. Clinical waste
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Surrey Skills Academy with support from Health Education Kent Surrey Sussex
Standard 15
Observation
Infection prevention and control
Standard 15
Main areas:
 I will prevent the spread of infection
Links:
Compassion in Practice (6 C’s)
Care, Compassion, Competence, Communication, Courage and Commitment
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Surrey Skills Academy with support from Health Education Kent Surrey Sussex
Standard
Observation
Signature &
Date of
observation
15.1b Demonstrate
effective hand
hygiene
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Surrey Skills Academy with support from Health Education Kent Surrey Sussex
Standard 15
Outcome
To meet this standard
Assessment
Prevent the
spread of
infection
15.1a Describe the main
ways an infection can get
into the body
Assessed by any of the
following methods:
- 1:1 discussion
- Group work
- Written
The assessment must
be observed in the
workplace as part of
the normal work duties
Assessed by any of the
following methods:
- 1:1 discussion
- Group work
- Written
Assessed by any of the
following methods:
- 1:1 discussion
- Group work
- Written
Assessed by any of the
following methods:
- 1:1 discussion
- Group work
- Written
15.1b Demonstrate effective
hand hygiene
15.1c Explain how their own
health or hygiene might
pose a risk to the individuals
they support or work with
15.1d List common types of
personal protective clothing,
equipment and procedures
and how and when to use
them
15.1e Explain the principles
of safe handling of infected
or soiled linen and clinical
waste
Evidence
Provided
Date
signed off
I am satisfied with the evidence of learning that it meets all the required standards.
Assessor’s Name:
Assessor’s Position:
Signature:
Date:
Learner’s Signature:
Date:
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