Preventing Infection

Preventing and Controlling Infection

Introduction

Being admitted to hospital can be a worrying time. It may be helpful to you and your relatives to know the different measures that are constantly in place, in our Trust, to help prevent and control infection.

Our commitment

South Tyneside NHS Foundation Trust is committed to the prevention of infections, or their spread when they occur. This commitment starts with the Chief Executive who has overall responsibility for infection control in the Trust.

The Trust has a Director for Infection Prevention and Control. On a day-to-day basis, responsibility for infection control lies with a Link Director, who reports to the Trust Board. This Link Director is a member of the Control of Infection Committee.

This committee includes doctors, managers, Health & Safety and Occupational Health representatives and Infection Control Nurses from the Trust, Primary Care Trust and Health Protection Agency. It discusses the infection rates within the hospital and any infection news or issues that may affect our patients. It makes sure that the policies the team produce are evidence-based and can be used by the staff. A plan is produced each year for the Infection Prevention & Control Team to achieve.

The Infection Prevention & Control Team

The Consultant Microbiologist leads the Infection Prevention & Control Team, which includes two Infection Control Nurses. The team has many tasks to perform, including:

  • Identify when an outbreak of infection is occurring, and ensure steps are taken to prevent further spread.
  • Collect surveillance data.
  • Prepare policies to tell staff how to prevent the spread of different infections.
  • Give training to all staff on infection control.
  • Give advice to staff, patients and visitors when requested.
  • Support the "Clean Your Hands" Champions and "Saving Lives" Infection Control Leaders, who work in the wards and departments throughout the Trust.

"Clean Your Hands" campaign

This was introduced by the National Patient Safety Agency in 2004. It aims to reduce the number of infections by improving the hand hygiene of staff. This is done by making sure that soap and/or alcohol gel is readily available for staff to use, and that staff know when they need to clean their hands. A link to the "Clean Your Hands" website can be found on the Links sestion of the Home Page.

Gel is available at the "point of care" e.g. the patient's bedside. Patients and their visitor are encouraged to use this.

The Champions make sure this happens in their areas. They also use posters to remind people of the need for hand hygiene.

Visit our Hand Hygiene page in the Hot Topics Section to learn how to perform hand hygiene effectively.

"Clean, safe care"

The "Saving Lives" programme was introduced by the Department of Health in 2005, to reduce infections in healthcare settings. This programme has since changed its name to "Clean, safe care". Our Chief Executive agreed to use this programme to access up-to-date information on preventing infection, which the staff could use in their areas.

Wards and departments have Infection Control Leaders who use this programme in their areas. This includes performing audits, where they look at current working and decide if they could do better. The Leaders then talk to their managers about the results. These results are also reported to the Divisional Managers, Control of Infection Committee and the Trust Board.

Staff Training

Infection Prevention & Control training is given to all staff groups working in the Trust. The Infection Control Team have developed different training sessions for different staff groups so that each member of staff receives sufficient training for their job. There are also infection control information leaflets, which are given to our volunteers and contractors to ensure they also help us to reduce the spread of infection.

Antibiotics

We use antibiotics and antimicrobials to:-

  • Prevent infection
  • Treat infection

Our Consultant Microbiologist and pharmacists have developed an antibiotic policy, which helps our doctors to choose the correct treatment for their patients. The consultant Microbiologist also provides additional advice to ensure our patients receive the best treatment if they develop an infection.

Healthcare Acquired Infections

Healthcare Acquired Infections (HCAIs) are caused by a wide range of micro-organisms. These infections are linked to medical care and treatment, both within hospitals and in the community. The more serious infections are usually seen in hospitals, but, health care provided in any setting can pose a risk of HCAI.

Many hospital patients are very sick and vulnerable to infection. Elderly patients are also at a greater risk of developing infection. The medical procedures that patients undergo are often invasive and present an opportunity for infection. Whilst not all HCAIs can be prevented, it is the number of preventable infections that we aim to reduce. To achieve this, we provide a high standard of patient care in safe and clean surroundings.

We have information leaflets about a number of different infections. These are available electronically, in the Patient Information Centre, or you can ask a member of staff to print a copy for you.

National Performance Targets

MRSA Bloodstream Infection

The Department of Health aimed to halve the number of MRSA bloodstream infections by the end of March 2008. Each acute Trust was given an annual target to achieve. We are the only Trust in the region to consistentley achieve our target.

We continue to be given annual targets. We have identified various measures to ensure we reduce this type of infection as far as possible.

Clostridium difficile Infection

The Department of Health aims to reduce the number of Clostridium difficile infections by 30% by the end of March 2011. Each Trust is given an annual target to achieve.  Our Trust is working towards achieving our target and we are reducing the number of Clostridium difficile cases.

We continue to be given annual targets. We have identified various measures to ensure we reduce this type of infection as far as possible.

Care Quality Commission

The Care Quality Commission (formerly Healthcare Commission) set national standards for us to achieve. They perform an annual assessment which looks at how well the Trust works and the standards we achieve. In our last annual health check (2007-2008) we were judged to have excellent quality of services and use of resources. Only four Trusts in the northeast region achieved this, and South Tyneside is the only Trust to have achieved excellence in use of resources for the last 3 years.

Standard Principles for the Prevention and Control of Infection

In any environment, there will always be some germs which may cause infection. To reduce this risk, all staff should use standard principles. These will protect patients and their carers from contamination. The standard principles are:

  • Make sure the environment is clean and safe.
  • Cover any cuts with a waterproof dressing.
  • Clean hands before and after caring for patients.
  • Wear gloves for all procedures where there may be contact with blood or body fluids.
  • Wear an apron for any direct patient contact.
  • Protect eye, mouth and nose from any splashing of body fluids.
  • Dispose of needles and other sharp objects into a proper sharps container.
  • Ensure all waste is disposed of appropriately.
  • Clean up any spillages of blood or body fluids as quickly as possible.

How can you help to prevention infection in hospital?

Infections can occur at any time. However, you may be particularly vulnerable to infection when you come into hospital for an operation or treatment. There are some things you can do to reduce the risk of infection whilst in hospital.

Hand washing

Hand washing is one of the simplest, but most effective ways to prevent infection. Washing hands with soap and water, then drying thoroughly on a clean towel, is usually all that is necessary. You should wash your hands:

  • When they look or feel dirty.
  • After using the toilet.
  • Before eating.

You may wish to bring some moist wipes into hospital with you, for the times when you may not be able to wash your hands.

Hand gel is available on every ward and at the bedside for most patients. This is mainly used by the staff before they take care of you please don't hesitate to remind the doctors, nurses, and other healthcare workers to use the gel. You may also wish to use the gel yourself. Please be aware that the gel only works on clean hands, so it is important that you continue to wash your hands with soap and water after using the toilet or if your hands are dirty.

Dropped items

If you drop cutlery, face masks, medicines etc onto the floor, please inform a member of staff so they can replace it.

Before an operation

Take a bath or shower before having an operation or procedure performed. However, please do not shave the operation area.

Drips

An intravenous line (drip) is a plastic tube (cannula) that allows fluid or medicine to be put directly into a vein. The area around the cannula can become reddened and sore. If this happens, please tell a member of staff. Ask if the cannula can be removed if it has not been used for 24hours.

Dressings

Dressings are used to keep cuts, wounds or cannula sites clean. This helps to prevent germs from entering the body. Only a member of staff should remove a dressing, so please do not be tempted to 'take a peek'. If your dressing becomes soiled, wet or loose, please tell a member of staff so they can change it.

Urinary catheters

Urinary catheters allow the drainage of urine from the bladder. The part of the catheter that can be seen should be washed daily during normal showering or bathing. Sitting or lying on the tubing can prevent the urine from draining properly and can also cause a sore. The drainage bag must be below the level of the bladder to prevent the urine from tracking back up the catheter. Your overnight bag should not lie in the bed next to you. Any discomfort should be reported to a member of staff.

Isolation of patients

There are two reasons why patients need to be isolated:

  • To prevent the spread of infection to other patients and staff.
  • To protect the patient who is more at risk from infection.

A patient may be isolated when it is known or suspected that they have an infection e.g. someone admitted with diarrhoea may have food poisoning. Patients should remain in their room, with the door closed. Please talk to a member of staff before leaving the room.

These rooms have special cleaning schedules to reduce the risk of spreading infection.

There is a leaflet about isolation and barrier nursing available, electronically, in the Patient Information Centre, or you can ask a member of staff to print a copy for you.

Visitors

Patients are susceptible to infections brought into hospital by visitors, therefore:

  • Anyone who is not feeling well should not visit a patient until they feel better.
  • Anyone with diarrhoea should not visit until they have had no diarrhoea for 48 hours.
  • Good hand hygiene will help to prevent the spread of infection. Visitors are requested to gel their hands on entering and leaving the ward.
  • Visitors should not sit on the patients' bed.
  • Visitors should be aware of the risks of food poisoning when bringing cooled cooked food into hospital for their relatives.

When visiting a patient who is in isolation, please talk to a member of staff about any precautions you may need to take. It is not advisable for small children and babies to visit patients in isolation.

Cleanliness

We have cleaning schedules for all our wards and departments to ensure we maintain high standards of cleanliness. However, sometimes areas can become dirty between cleaning, so please inform a member of staff if you find any area of the ward dirty, so that action can be taken.

Deep Cleans

In 2007, the government initiated the national 'Deep Clean' programme. The Trust participates in this, and introduced a schedule to deep clean the clinical areas. We also perform enhanced cleaning when patients are discharged to ensure the bed area or side room is thoroughly cleaned before occupation by the next patient.

MRSA Screening

Some groups of patients are at greater risk of developing an MRSA infection than others. These people may be carrying small numbers of MRSA germs on their skin or in their nose, without having an infection. This is known as colonisation. Swabs will be taken on admission to hospital to determine if these patients are infected and/or colonised. Those found to have MRSA will be treated appropriately.

In line with the recommendations from the Department of Health, from 1st April 2009, we will swab most routine admissions to the hospital to determine if these patients are colonised with MRSA. This may be performed at the pre-assessment clinic or on the day of admission. Those found to be carrying MRSA will be offered the appropriate treatment.

From December 2010, the Trust has also been screening patients who have been admitted as an emergency.

There is a leaflet about MRSA available, electronically, in the Patient Information Centre.

If you have any questions about your risk of infection, please ask your nurse, or ask to speak to one of the Infection Control Nurses.

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