WWW.THESES.XLIBX.INFO
FREE ELECTRONIC LIBRARY - Theses, dissertations, documentation
 
<< HOME
CONTACTS



Pages:     | 1 |   ...   | 6 | 7 || 9 | 10 |   ...   | 11 |

«Policy Number IC01 Policy Title INFECTION PREVENTION AND CONTROL POLICY Accountable Director Director of Infection Prevention and Control Author Lead ...»

-- [ Page 8 ] --

Individuals in mental health trusts should be screened only if they fall into specific ‘higher risk’ groups. Guidance from the department of health has suggested several categories which should be considered for screening. These are as follows ♦ Those admitted following recent* surgery (nasal and wound screen) ♦ Those admitted following recent* admission to an acute trust. (nasal screen) ♦ Recent* Intravenous drug users (nasal and wound/abscess screens) ♦ Those who self harm (nasal and wound screens) ♦ Those with chronic wounds e.g. leg ulcers or indwelling devices such as catheters (nasal and wound or catheter site screens) * Where recent activity is indicated in the above criteria this is considered to be within the last 2 weeks, if clinical presentation suggests that a client may be at risk after a longer period please contact the Infection Prevention and Control Team for advice.

All of the above should be identified and screened following a risk assessment process upon admission, readmission from an acute trust or if they come into one of the categories following deterioration in their health which would place them into one of the above groups.

These risk factors should be considered upon admission, and at any other relevant time in the service user’s journey within our trust.

Those who self harm should only be screened if the self harm is of an invasive nature which would create a route for bacteria to get into the body thus placing them at risk of acquiring an infection, e.g. cutting.

Where following risk assessment the service user is identified as belonging to a higher risk group, screening should be carried out and where possible the service user should be accommodated in a single room.

Data Collection Healthcare Associated Infection HCAI Monthly Surveillance data collection form (Appendix 3) must be completed and sent each month even if you have no cases (nil returns) these should be e-mailed to Divison Leads, who are to collate and forward these data to the Infection Prevention and Control team.

Page 45 of 94 Infection Prevention and Control Policy

Isolation – Risk Assessment Service users identified as being at higher risk of colonisation or infection with MRSA should where possible be accommodated in a single room. Before imposing isolation on clients consideration should be made of the impact that isolation may have to their mental wellbeing.

Where isolation is not implemented or is terminated due to it having a significant negative impact on the mental wellbeing of a client, the client should be managed locally to reduce the risk of transmission this is particularly important if other clients in the areas are vulnerable to infection.

Screening Swabs Should clearly identify the site swabbed e.g.

Nose, groin, Wound as appropriate.(follow the Royal Marsden’s Clinical Procedure or check with IPCT). http://www.royalmarsdenmanual.com/online/toc.asp Occlusive dressings should not be removed just to obtain a swab, staff should wait until the dressing is due to be removed or replaced as clinically indicated.

Suppression Therapy A suppression therapy reduction regime consists of a course of treatment with antimicrobial agents, this aims to reduce the amount of bacteria that are living on the individual (bacterial load) to a level that significantly reduces the risk of cross infection from that individual to others. It also reduces the risk of invasive infection occurring in the carrier (autoinfection).

Any suppression therapy should be carried out under the advice of the IPCT as repeated use of these antimicrobial agents can lead to resistance.

• Nasal Carriers Mupirocin ointment 3 times a day for 5 days. Effective treatment of nasal MRSA is dependent on strict adherence to the administration regime.

• Skin Carriers Daily baths/showers with a skin cleanser (as indicated in the antimicrobial guide). For 5 days, the skin should be moistened and the skin cleanser must be applied thoroughly to all areas, paying particular attention to the known carriage sites of axillae, groin and perineal areas. The hair should also be washed with the skin cleanser. Change bedding, clothing and night attire following each day’s decontamination.

All used laundry must be washed as infected. For service users with eczema, dermatitis or other skin conditions, emollient bath additives may be used.

Nasal and skin carriers must have treatment concurrently.

• Colonised Wounds See wound formulary

• Colonised Catheterised Service users See IPC procedure for the management of urinary catheters

–  –  –

Medical Devices Any instruments or equipment (e.g. stethoscopes, sphygmomanometers, lifting slings, commodes, wheelchairs, and physiotherapy exercise machines) should be single patient use and identified with the patient’s name for the duration of infectivity. All items to be decontaminated after use as per Medical Device Policy.

Environmental Hygiene Whilst MRSA infection is difficult to treat, bacterium is not difficult to destroy in the environment with routine cleaning Maintaining high standards of environmental hygiene is essential to reducing the risk of cross infection. Rooms should be kept clutter free and dust should not be allowed to collect.

Terminal clean of the room must be carried out, where the patient has been cared for suppression therapy is completed or the service user is discharged or moved.





Movement of Service users with MRSA If a patient known to be colonised or infected with MRSA who requires to attend for treatment or investigation in another part of the trust or in another trust, the ambulance or transport service must be informed and liaison with the receiving area, to ensure that the risk of transmission of infection to others is minimised.

When service users are discharged/transferred with MRSA, please complete an inter-healthcare Infection Prevention and Control transfer form (Appendix

1) and notify: The Health Centre (Ashworth only).

• The Infection Prevention and Control Team.

• The Patient’s GP

• The Ambulance or Transport Service

• Receiving Hospital/Nursing Home If re-admission to Mersey Care NHS Trust occurs, please advise: The Infection Prevention and Control Team

• The Nurse in Charge of the Ward

• The Escorting Staff Discharge letters Where appropriate, letters must include information regarding screening and what suppression therapy has been carried out. It is not necessary to report negative results.

6.13 Surveillance Surveillance does not just refer to the reporting of organisms or disease, it is the continuing process of data collection, analysis, interpretation and the dissemination of information to enable appropriate action to be taken.

–  –  –

• There is alert organism and alert condition surveillance to detect outbreaks of infection.

• Clinical Area reporting of infections including MRSA and C.difficile to the IPCT.

• Monitoring of staff sickness rates in conjunction with Managers and the Occupational Health departments occurs at times of risk, e.g. Influenza.

• There is a procedure for monitoring and reporting adverse incidents associated with infection. Involving safety of service users and staff or others, via Datix. For Steiss and Riddor.

Reportable incidents (by the Infection Prevention and Control Team) are those

that:

• Result in significant morbidity or mortality.

• Involve highly virulent organisms.

• Are readily transmissible.

• Require control measures that have an impact on the care of other service users including limitation of access to health services.

These are: Outbreaks, two or more linked cases of infection in a health care setting.

• Infected health care worker or patient or incidents necessitating look back investigations, (e.g. TB, vCJD and BBV infections).

• There is regular reporting of adverse events to the ICC.

• The Microbiology laboratories used by the Trust are CPA approved, and support the Infection Prevention and Control Team by processing data, surveillance, specialist testing and providing results.

Alert Condition Surveillance Alert conditions are conditions and organisms that may give rise to hospital outbreaks. The Infection Prevention and Control Team must be advised of any occurrence of the following conditions at the earliest possible opportunity.

–  –  –

Alert Organism Surveillance Alert organisms are usually isolated in the laboratory; the laboratory staff are responsible for informing the Infection Prevention and Control Team.

–  –  –

Transfer into the trust of service users with known infective organisms Should a patient be transferred in to Mersey Care NHS Trust with a positive diagnosis for any of the following organisms, then the Infection Prevention and Control Team should be notified: Urine

• Gentamicin resistant gram negative bacilli

• Staphylococcus aureus

• MRSA Faeces

• Salmonella

• Campylobacter

• E-coli (0157)

• Cryptosporidium

• Clostridium difficile toxin Swabs

• MRSA

• Staphylococcus aureus

• Group A streptococcus

• Pseudomonas aeruginosa

• Gentamicin / multi resistant gram negative Viral Isolates / Positive Antigen Tests

• Herpes zoster

• Parvovirus

• Respiratory viruses

• Rotavirus

• Norovirus Notifiable Diseases “Notifiable Diseases” is a legal term denoting diseases that must, by law, be reported to the “proper officer,” who is the Consultant in Health Protection.

The Notification of Disease Report book is kept in the Infection Prevention and Control Department and the Infection Prevention and Control Nurse ensures that the relevant Consultant signs the documentation.

–  –  –

6.14 Isolation Isolation is a precaution of physical separation utilised to prevent the transmission of organisms responsible for infection. It aims to minimise the risk of transmission and limit the spread of infection to protect other service users, staff and visitors. The Health and Social Care act 2008 requires all trusts to have isolation provision identified within policy Isolation precautions can be applied to an individual case, a patient in a single room, cohorting a number of service users with the same infection in a bay, wing or ward. The system implemented will be dependant on the infection, the number of people infected and the isolation facilities available.

The need for isolation must be regularly reviewed and will only be implemented for the duration of infectivity.

Levels of Isolation, and Facilities Required There are different levels of precautions and isolation required to prevent the

spread of infection and these include:

• Contact precautions/ isolation.

• Respiratory isolation.

• Strict isolation.

Contact Precautions/ Isolation These are used in situations where the mode of transmission of the infecting organism is via Bodily fluids – Blood to blood (e.g. Hepatitis), the faecal oral route (e.g. viral gastroenteritis and other enteric organisms), or by contact via hands, skin, mucous membranes or wounds (e.g. MRSA).

Isolation Facilities:

• a single room with en suite facilities.

• a single room with named single person commode.

• a single room next to an identified toilet for sole use of infected patient.

If no single room is available every effort must be made to provide a room on the ward including consideration of moving a non infectious patient to another ward.

–  –  –

An en suite single room is the preferred choice, but it may not always available.

Respiratory Isolation (e.g. T.B, Chickenpox) Respiratory isolation is to prevent the transmission of infectious diseases over short distances through the air and a single room is essential. Serious infections spread by the respiratory route will normally be transferred to Acute NHS Trusts.

Strict Isolation (e.g. suspected diphtheria, or viral haemorrhagic fever).

The Infection Prevention and Control Nurse must be notified immediately out of hours contact Silver on Call.

The trust is not equipped to treat some infectious diseases, arrangements will be made by the IPCT with the On Call Consultant in Communicable Diseases and the Infectious Disease Unit for transfer of service users with high risk infections.

The IPCN will also inform the receiving hospitals IPCT of the admission.

Single Room Isolation Single room isolation is necessary when a patient presents an infection risk to others or the patient is at risk from infection from others (immunocompromised), Ayliffe 2001.

Single room isolation will not, by itself, prevent the transmission of infection, it is part of the isolation procedure and must be used in conjunction with Infection Prevention and Control precautions.

The objective of single room isolation is to minimise infection, when there is a risk of airborne infection, the door must be kept closed and only essential staff should enter.

The psychological implications of isolation must be considered before it is implemented.

Individual patient care needs will be taken into account in the risk assessment process by the IPCT and the Clinical Team, which may increase the risk of spread of infection. Where the team decide not to implement isolation due to the mental state of the patient the rationale for this should be recorded in the clinical notes.

Such service users may need careful management with consideration of their potential to contaminate the environment. This may require increased cleaning and decontamination of areas affected.

Cohorting

–  –  –

This occurs when a number of service users with the same infection are nursed in a bay or area.

Communication It is important that staff, service users and visitors are aware of the infection

prevention and control precautions that have been put in place:



Pages:     | 1 |   ...   | 6 | 7 || 9 | 10 |   ...   | 11 |


Similar works:

«THE MARKET FOR LIBERTY MORRIS AND LINDA TANNEHILL Copyright © 1970 by Morris and Linda Tannehill P. O. Box 1383 Lansing, Michigan 48904 All rights reserved. First Printing, March, 1970 TABLE OF CONTENTS Acknowledgments iv PART I—The Great Conflict 1 Chapter 1. If We Don't Know Where We're Going 2 2. Man and Society 6 3. The Self-Regulating Market 16 4. Government—An Unnecessary Evil 32 PART II—A Laissez-Faire Society 43 Chapter 5. A Free and Healthy Economy 44 6. Property—The Great...»

«INTERNATIONAL DAIRY ARRANGEMENT 155 INTERNATIONAL DAIRY ARRANGEMENT PREAMBLE Recognizing the importance of milk and dairy products to the economy of many countries 1 in terms of production, trade and consumption; Recognizing the need, in the mutual interests of producers and consumers, and of exporters and importers, to avoid surpluses and shortages, and to maintain prices at an equitable level; Noting the diversity and interdependence of dairy products; Noting the situation in the dairy...»

«RGA White Paper Strategic Considerations for Automated Underwriting Paul Okeefe Assistant Vice President, Business Development, AURA Technologies December 2013 Abstract: According to a recent survey and report by Novarica, 85% of life insurers now have paperless underwriting processes, 77% of them use automated data requests (to third-party databases) for underwriting requirements, and 77% rely in part upon automated underwriting for decisionmaking.1 However, the statistics do not account for...»

«“Thy Word is All, If We Could Spell”: Romanticism, Tractarian Aesthetics and E. B. Pusey’s Sermons on Solemn Subjects, by Christopher Snook. ©2001 CHAPTER ONE ROMANTICISM AND THE OXFORD MOVEMENT: TOWARDS A TRACTARIAN AESTHETIC INTRODUCTION In his late nineteenth-century novel Jude the Obscure, Thomas Hardy refers to Christminister (his fictionalized Oxford) as “that ecclesiastical romance written in stone” (31). Within the economy of the novel, this comment reflects on more than the...»

«A Massachusetts Guide to Insurance for Your Home and Ways to Help Reduce Your Insurance Premiums DEVAL L. PATRICK DANIEL O’CONNELL GOVERNOR SECRETARY OF HOUSING AND ECONOMIC DEVELOPMENT DANIEL C. CRANE DIRECTOR OF THE OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATION TIMOTHY P. MURRAY NONNIE S. BURNES LIEUTENANT GOVERNOR COMMISSIONER OF INSURANCE June 2007 How to Use This Guide Your home is your castle. It is your most valuable asset. It is where you keep many of your other assets, such as...»

«University of North Carolina at Asheville The Buncombe Turnpike and Its Impact on Western North Carolina’s Drovers and Economy A Senior Thesis Submitted to the Faculty of the Department of History in Candidacy for the Degree of Bachelor of Arts in History By Alicia Chapman Asheville, NC November, 2009 The Buncombe Turnpike had a tremendous impact on Western North Carolina. It allowed drovers to herd their animals to market and gave travelers better access to the area. The North Carolina...»

«Fernsehmotive Und Psychosoziale Dispositionen And sure never, you will be not on-going just to be the clear down for the in-house. Exactly, as we have to choose a pdf more in at the time you should uncover your attitude still at you is higher and well less. Of us do period ironically, you will cost you remember, and are you will improve a business. Such force or years to exploit middle people was as pressured, Fernsehmotive Und Psychosoziale Dispositionen with now required just. A access is any...»

«The 20 hopefuls are: Adam Egan Age: 29 Weight: 17st 7lbs County: Wicklow Young dad, Adam is living in Bray with his wife Emma and their 3 children, Liam (7), Aaron (4) and Ryan (3). Adam and Emma have been together for years but are newly weds since September. Adam is a gardener. The business was originally his father‟s, who died in 2005. Adam also lost his mum last year. Adam works very hard and things are just about ticking over. Despite the fact that gardening is a physical job, Adam...»

«Revista de Dirección y Administración de Empresas. Número 15, diciembre 2008 págs. 43-79 Enpresen Zuzendaritza eta Administrazio Aldizkaria. 15. zenbakia, 2008 abendua 43-79 orr. LA CONTABILIZACIÓN DEL IMPUESTO SOBRE BENEFICIOS EN EL NUEVO PLAN GENERAL DE CONTABILIDAD MIGUEL ÁNGEL ZUBIAURRE ARTOLA Dpto.: Economía Financiera I (UPV/EHU) VICENTE TEMPRANO GUTIÉRREZ Dpto.: Economía Financiera I (UPV/EHU) AINHOA SAITUA IRIBAR Dpto.: Economía Financiera I (UPV/EHU) RESUMEN Tras varias...»

«Una guía para ayudarle a mejorar su crédito, administrar su dinero y ser un propietario de casa responsable A Guide to Better Credit, Money Management, and Responsible Homeownership Manual de trabajo para el consumidor Consumer Workbook About Freddie Mac Freddie Mac is a stockholder-owned corporation established by Congress in 1970 to support homeownership and rental housing. Freddie Mac purchases single-family and multifamily residential mortgages and mortgage-related securities, which it...»

«TERMINOS DE INTERCAMBIO Y SALARIO REAL Pablo Iorio Clavijo Juan Manuel Regules Javier Bogliaccini pabblo@internet.com.uy jmregules@adinet.com.uy javierabp@hotmail.com ABSTRACT El presente trabajo pretende dar una explicación sencilla sobre la evolución del Salario Real. Para este propósito se desarrollaron dos modelos teóricos con enfoques distintos. El primero pertenece a Sebastian Edwards y esta basado en la aplicación del efecto StolperSamuelson para economías en desarrollo. El segundo...»

«ESTUDIOS ECONOMÍA APLICADA V O L. 29 2 2011 P Á G S. 561 – 574 DE Electricity Prices and Generation Costs in European Futures Markets with Implications for Spain LUIS MARÍA ABADIE Basque Centre for Climate Change (BC3), ESPAÑA. Email: lm.abadie@bc3research.org DAVID R. HERES Basque Centre for Climate Change (BC3), ESPAÑA. Email: david.heres@bc3research.org ABSTRACT This paper examines the influence of the cost of natural gas, coal and emission allowances on electricity prices. Quotes...»





 
<<  HOME   |    CONTACTS
2016 www.theses.xlibx.info - Theses, dissertations, documentation

Materials of this site are available for review, all rights belong to their respective owners.
If you do not agree with the fact that your material is placed on this site, please, email us, we will within 1-2 business days delete him.