Download Handout 1 (2 pages) Infections

Care Certificate Standard 15: Learning Resources
Handout 1 (2 pages)
Infections
Background
 Infections are caused by microorganisms/microbes such as viruses, bacteria and
fungi. The treatment for the infection depends upon what type of infection the
person has e.g. antibiotics are for treating bacterial infections.
 Different diseases pass from one person to another by different routes e.g. you
cannot be infected with a sexually transmitted disease through breathing the
same air as someone infected.
 Different types of diseases can have different incubation periods and some
people can be infectious before they know they have the disease, this applies to
some well-known infections associated with childhood such as measles.
 Some infections come from one-to-one contact with the person or their body
products directly, or indirectly or via droplets. Others can be passed on
without contact with the person through touching a contaminated object which an
infected person or something infected has touched.
 Some diseases may make a person immune for life after they have had it (e.g.
measles) whereas others can be caught over and over again or carry immunity for
a limited period (e.g. common cold, flu, norovirus).
Main routes into the body are through:
Body fluids – A body fluid such as blood, urine, faeces, pus, saliva from one person
enters the body of another e.g. through cuts or other means e.g. sexual intercourse
(e.g. syphilis, HIV etc.). Through saliva (e.g. glandular fever). Through contaminated
substances entering the bloodstream e.g. tetanus is often contracted through wounds
when handling contaminated soil.
Through the air – e.g. tuberculosis, measles. Droplet infections are carried through
the air through coughs and sneezes (e.g. common cold, carried through the air
through coughs and sneezes (e.g. common cold, respiratory viruses.
Through the skin/touch
 Those which people catch by directly touching the skin of someone who has a
particular kind of infection such as chickenpox.
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Care Certificate Standard 15: Learning Resources
Care Certificate Standard 15: Learning Resources
 Touching an infected object which someone who is infected has touched e.g. door
handles, paper and cooking implements – e.g. Norovirus (winter vomiting
infection).
Through ingestion
– Through contaminated food (e.g. salmonella) or water
(e.g. cholera).
Through bites or stings from other creatures
– e.g. infections from
dog and cat bites, (e.g. blood poisoning/sepsis) or through parasites e.g. insect bites
(e.g. malaria). [Note an infection from a bite or sting is not the same as having an
allergic reaction to it.]
If you have a communicable disease you have a duty to follow your doctor’s advice
with regards to attending or returning to work and need to flag it up with your
employer. For example, some diseases may result in you not being able to handle
food for a period even after you feel well. Some diseases, are classed as notifiable
diseases, this means that people have a legal duty to report them and to follow the
Department of Health’s regulations and advice on who, when and how to report them
and on how long people should refrain from having direct contact with other people.
Examples of notifiable diseases are food poisoning and many of the illnesses
associated with childhood e.g. measles, mumps, scarlet fever etc.
Remember your duty of care and that the people at risk with whom you work may be
more prone to infection than the general population.
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Care Certificate Standard 15: Learning Resources
Care Certificate Standard 15: Learning Resources
Handout 2 (4 pages)
15.1b – Effective Hand-Hygiene
General hand-hygiene procedure
Quality Standards produced by the National Institute for Clinical Excellence
were
updated
in
April
2014
(QS
61)
and
can
be
found
in
full
at:
http://www.nice.org.uk/guidance/qs61
[Key points below quoted directly from this link appear in inverted commas. Some
emboldening of the text has been done by us to stress particular points. The terms
“healthcare worker” “clinical staff” apply, in this case, to anyone doing relevant care
activities and not just to people with a healthcare worker role i.e.
they apply to
informal carers and social care workers too. “Patient” means any service user. NICE
owns the copyright of the statements in quotation marks.]
Before doing any personal care task:
“Healthcare workers should ensure that their hands can be decontaminated effectively
by:
 removing all wrist and hand jewellery;
 wearing short-sleeved clothing when delivering patient care;
 making sure that fingernails are short, clean, and free from false nails and nail
polish;
 and covering cuts and abrasions with waterproof dressings.”
Hand hygiene
“Hands must be decontaminated:
 immediately before each episode of direct patient contact or care, including
clean/aseptic procedures;
 immediately after each episode of direct patient contact or care;
 immediately after contact with body fluids, mucous membranes and non-intact
skin;
 immediately after other activities or contact with objects and equipment in the
immediate
patient
environment
that
may
result
in
the
hands
contaminated; and
 immediately after the removal of gloves.”
This includes doing this immediately
 After using the toilet or assisting someone else to use it.
 After handling incontinence products.
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Care Certificate Standard 15: Learning Resources
becoming
Care Certificate Standard 15: Learning Resources
 After any contact with your own body fluids or those of another person e.g. urine,
blood, ear wax, tears, saliva, excrement etc.
 Before, during and after handling any food or drink.
 After handling raw meat or items which have had contact with raw meat.
 Before and after performing any personal care task.
 After blowing or wiping your own or someone else’s nose or after putting the hand
in front of your face when coughing/sneezing.
 Before and after handling medicines.
 After handling rubbish.
 After coming into contact with any animal.
 Before and after treating a cut or wound or changing dressings.
 After coming into contact with someone with an infectious disease which can be
transmitted from person to person by touch or via objects.
 After handling items which have been contaminated by flood water or sewage.
 After gardening, touching plants and handling pesticides or weed-killer (see
poisoning below).
 When the hands look dirty.
 After smoking.
 After handling coins and banknotes.
 When arriving at and leaving the workplace.
 After handling chemicals e.g. cleaning fluids, leaking batteries, care maintenance.
[This is about addressing the risk of poisoning rather than infection but is
still very important.]
Routine for washing hands
“Effective hand washing technique involves three stages”:
Stage 1 -”Preparation: wet hands under tepid running water before applying the
recommended amount of liquid soap or an antimicrobial preparation.”
Stage 2 - Washing and rinsing: “the hand wash solution must come into contact
with all of the surfaces of the hands. The hands should be rubbed together vigorously
for a minimum of 10–15 seconds, paying particular attention to the tips of the fingers,
the thumbs and the areas between the fingers. Hands should be rinsed thoroughly.”
Stage 3 - Drying: “use good-quality paper towels to dry the hands thoroughly.”
Alcohol-based sanitizers/hand rubs
“Use an alcohol-based hand rub for decontamination of hands before and after direct
patient contact and clinical care, except in the following situations when soap and
water must be used:
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Care Certificate Standard 15: Learning Resources
Care Certificate Standard 15: Learning Resources
 when hands are visibly soiled or potentially contaminated with body fluids; and
 when caring for patients with vomiting or diarrhoeal illness, regardless of whether
or not gloves have been worn.”
“Alcohol-based hand rub should be made available at the point of care in all
healthcare facilities.”
Procedure for using an alcohol-based hand rub
“When decontaminating hands using an alcohol-based hand rub, hands should be free
of dirt and organic material, and:
 hand rub solution must come into contact with all surfaces of the hand; and
 hands should be rubbed together vigorously, paying particular attention to the tips
of the fingers, the thumbs and the areas between the fingers, until the solution
has evaporated and the hands are dry.”
Health and safety when using hand-cleansing products
“Clinical staff should be made aware of the potentially damaging effects of hand
decontamination products and encouraged to use an emollient hand cream regularly
to maintain the integrity of the skin. Consult the occupational health team or a
general practitioner if a particular liquid soap, antiseptic hand wash or alcohol-based
hand rub causes skin irritation.” If you are allergic to the hand cleaning
products or to the hand-cream/emollient provided then you need to flag this
up to your employer so that alternatives can be found and made available to
you.
Monitoring and compliance with hand hygiene
“Hand hygiene resources and healthcare worker adherence to hand hygiene guidelines
should be audited at regular intervals and the results should be fed back to healthcare
workers to improve and sustain high levels of compliance.”
“Healthcare organisations must provide regular training in risk assessment, effective
hand hygiene and glove use for all healthcare workers.”
“Local programmes of education, social marketing and audit and feedback should be
refreshed regularly and promoted by senior managers and clinicians to maintain focus,
engage staff and produce sustainable levels of compliance.”
“Patients and relatives should be provided with information about the need for hand
hygiene and how to keep their own hands clean.”
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Care Certificate Standard 15: Learning Resources
Care Certificate Standard 15: Learning Resources
“Patients should be offered the opportunity to clean their hands before meals; after
using the toilet, commode or bedpan/urinal; and at other times as appropriate.
Products available should be tailored to patient needs and may include alcohol-based
hand rub, hand wipes and access to hand-wash basins.”
Those instructed to wash their hands or to use a sanitizer MUST do so.
Remember you are protecting other people and yourself by decontaminating
your hands.
If in doubt wash your hands!
Use the space on the back of this page to write down any relevant details
about where washing facilities and hand cleaning products are available in
your work place(s).
You may also find it helpful to state how you flag up the need to replenish
stocks of soap etc.
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Care Certificate Standard 15: Learning Resources
Care Certificate Standard 15: Learning Resources
Handout 3 (2 pages)
15.1c, 15.1d – Some ways in which our own health or
hygiene may pose risks to others
Infectious diseases - Can be passed on to others by poor hygiene or by failure to
recognise periods when we are infectious. There is a need not only to consult a G.P. if
you have sickness, diarrhoea, or a known infection but also if you have had contact
with someone who has:
a)A Notifiable disease such as food poisoning - [A notifiable disease is one which
needs to be reported immediately under the Health Protection (Notification)
Regulations (2010) to a “Local Authority Proper Officer” this can be done via the G.P.]
Or
b)A disease with an incubation period such as influenza/flu.
There can be very serious consequences for a pregnant woman’s unborn child if the
woman has contact with anyone who may infect her with chickenpox or rubella/
German measles. This applies to women in the very early stages of pregnancy who
may not be aware that they are pregnant as well as to those who already are aware
that they are pregnant. If the worker is pregnant* or is seeking to become pregnant
adjustments may need to be made to her work to prevent her from being put at risk
of infection and/or other dangers to health.
Tiredness - Can affect the way we think and behave and our ability to do our job
(including driving).
Parasites - Head lice, fleas, lice and scabies can be passed on from person to person
but measures can be put in place to prevent this.
State of mind - Stress, anxiety, depression, other mental ill health, whether work
related or not and the effects of bereavement can have an impact on the way we do
our job and behave towards others. They do not necessarily prevent us from earning
our living or going to work but our employer might need to make adjustments in order
to minimise any risks to ourselves or others.* Employers need to recognise that they
have a responsibility towards their employees and that sometimes difficulties in their
private life as well as from work need to be accounted for e.g. bereavement or the
effects of a divorce or workplace bullying can all have an impact on the person’s
performance and outputs.
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Care Certificate Standard 15: Learning Resources
Care Certificate Standard 15: Learning Resources
Our own physical long-term health conditions, allergies and any
disabilities. These may not prevent us from doing our job but we may need to flag
these up in relation to risk assessment and our individual needs with regards to the
tasks we do, the equipment we may need and the procedures we need to follow in
order to prevent ourselves and others being damaged. * For example, someone with a
back condition may put themselves and others at risk if they do not have their related
work tasks properly risk assessed and managed.
Smoking – Only where a specific contract of employment states that employees can
smoke are they allowed to smoke (established by case law).
Most workplaces do not permit it.
Smoking is banned in public places such as restaurants because of the risks it poses
to people’s health.
Carelessness when smoking may also be a fire risk.
[The law and policy on this varies in Scotland, Wales and England.]
Use and misuse of medicines, drugs and other substances – Some
prescribed medication and some substances which people misuse (e.g. alcohol) can
have an impact on how we function. The consumption of alcohol is usually banned
from workplaces for this reason. If you take medication which may have an impact
you need to flag this up e.g. some medication can make people drowsy.
Note that items showing * relate to where the Equality Act 2010 applies with
regards to our employers having a duty not to discriminate against us and to
make reasonable adjustments to enable us to do our job.
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Care Certificate Standard 15: Learning Resources
Care Certificate Standard 15: Learning Resources
Handout 4
15:.1d and 15.1e. List common types of personal protective clothing,
equipment and procedures and how and when to use them.
Produce one copy for each participant.
Item of
personal protective
clothing
When to use it
How to use it
Relevant procedures
I must follow and
how and when I
need to apply them
Item of protective
equipment
When to use it
How to use it
Relevant procedures
I must follow and
how and when I
need to apply them
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Care Certificate Standard 15: Learning Resources
Care Certificate Standard 15: Learning Resources
Handout 5 (2 pages) PowerPoint 1
15.1e Principles for the safe handling of infected and/or
soiled linen and clinical waste.
Clinical waste is any waste which consists either wholly or partially of:
 Human or animal tissue.
 Body fluid and excretions – such as blood, urine, saliva, faeces, vomit.
 Pharmaceutical products – such as medicines and associated equipment e.g. that
which has been used to dispense or administer it.
 “Sharps” – e.g. hypodermic needles, razors other sharp items which could pose a
risk. There are regulations about the particular containers used for sharps and
standards which these should meet. The containers should be sealed and not
reopened when full and should be separated from other waste for collection.
 Dressings and swabs – such as sanitary towels, incontinence pads, bandages, etc.
 Plasters, cotton wool, etc.
 Contaminated packaging e.g. packaging which was used for gathering laboratory
samples.
This waste is disposed of using specific procedures, for example, it might need to be
put in a yellow bag and collected separately from ordinary rubbish, or it might need
incinerating.
Wrongly disposing of waste, which has not been properly disinfected, which is related
to a notifiable disease can result in the person who disposed of it in this
incorrect way being prosecuted and fined.
Offensive/Hygiene Waste
According to the HSE, clinical waste, is not the same as
“offensive/hygiene waste”.
http://www.hse.gov.uk/biosafety/blood-borne-viruses/non-clinicalsetting.htm
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Care Certificate Standard 15: Learning Resources
Care Certificate Standard 15: Learning Resources
The following applies to domestic settings only.
(It, along with * above, is
defined by the Public Health (Control of Diseases) Act 1984).
Offensive/hygiene waste is waste from a non-clinical setting which:
 Is not from a person/animal with an infection.
and
 Has been deemed to fall into this category as result of a risk assessment which
has taken place.
Offensive/hygiene waste must not:
 Be dangerous to move or handle.
 Include any human or animal body parts, organs or blood products.
but
 It will still need to be separated from other products.
 May be disposed of with other rubbish without any additional “treatment” to it.
[Babies’ nappies, plasters from minor cuts and some incontinence pads, used in a
person’s home, may fall into this category].
As some waste materials could be classed as either clinical waste or offensive/hygiene
waste the risk assessment is key to determining the category into which it falls. The
care setting is also significant to the definition.
This waste may be put in ordinary rubbish bins if it is in small quantities but if larger
quantities are generated or they are produced over a long period of time it may need
bagging in yellow bags with a black stripe: “Tiger Bags” and to be stored in a
specific and secure place until it is specially collected.
Tiger bags have to show the post-code of the address where they have been used.
Local authorities vary in the rules they require people to follow and in the way in
which such waste is collected.
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Care Certificate Standard 15: Learning Resources