Policy for the Control of Infection in College

HEALTH AND SAFETY

User-group: 14-16 year old Students, FE Students, HE Students, International Students, Employers, Permanent Academic Staff, Part Time Hourly Paid Academic Staff, Permanent Support Staff, Temporary Support Staff.

Category: Health and Safety. Date Approved: 26 February 2013 Review Date: 26 February 2014. Approved By: Health and Safety Committee Commissioning Author: Louise Burke – Health and Safety Advisor Contact Person: Louise Burke – Health and Safety Advisor 0161 920 3359

Person Responsible:

College Mission Statement:  The Manchester College regards the promotion of Health and Safety as a mutual objective for the College community including management, employees and students and is committed to ensuring high standards of Health and Safety throughout the organisation.  It is the intention of the college to develop, maintain and implement required standards by continually reviewing its operations against developing legislation, codes of practice and other initiatives.  The College recognises its responsibilities under Health and Safety legislation and is committed to the development, promotion and implementation of high standards to ensure a safe and healthy environment through the active engagement of the college community.  The College is part of a healthy colleges network and senior managers have developed healthy College standards appropriate for further education. The model works at all levels from policy through to practice, acting both to promote current wellbeing in college and to safeguard learners’ future Wellbeing through a variety of educative practices, which raise awareness of health issues in a city With disproportionate indices of ill-health. The college will build on and embed strategies to maintain and extend the measures to ensure learner’s health and broader wellbeing.

Policy Title: Infection Control Policy Author: Louise Burke Last Modified: 04/04/2018

1 EXECUTIVE SUMMARY:

This policy provides guidance and consistency in protecting the population of the College from infectious diseases, that may from time to time be present in the staff or student population.

DEFINITIONS:

Jargon/Key words Definition

AIDS Acquired Immunodeficiency Syndrome

BBV Blood Borne Virus

GP General Practitioner

HIV Human Immunodeficiency Virus

HPU Health Protection Unit

Micro-organisms Organisms too small to be seen with the unaided eye, including bacteria.

Pathogenic Capable of causing disease, any disease- causing agent.

2 Policy for the Control of Infection in College

Contents Page Number

Aim of the policy 4

Introduction 4

Essential Items for Infection Control 4

1. Practical Guide to Infection Control 4

i. Hand washing 4 ii. Personal Protective equipment 5 iii. Food Handling and Hygiene 5

2. Preventing the spread of Blood Borne Viruses 6

i. Modes of transmission 6 ii. Occupational risk areas 7 iii. Universal precautions 8 iv. Additional guidance for first aid team members 8 3. Waste disposal 9

i. Principles and guidance for disposal of clinical waste 10 ii. Containment 11 iii. Clinical waste bags 11 iv. Sharps containers 11 v. Storage 11 vi. Handling 12 vii. Spillages 12

4. College trips 12

i. General principles & guidance 12

5. Exclusion periods for communicable diseases 13

6. Related Policies 16

7. Related Procedures and Forms 16

8. Useful Web Addresses 16

9. Appendices 17

3 Aim of the policy

Our overall aim of this policy is to prevent and control the spread of cross infection within the college.

Introduction

Infection control is a fundamental requirement for safe practice where exposure to potential pathogenic micro- organisms can occur.

This document is intended as a general guide to the most common communicable diseases; it is not an exhaustive guide to communicable diseases. It is not intended to act as a guide to diagnosis. This should only be undertaken by an appropriately qualified health professional. Whenever there is any doubt about the management of a communicable disease, further advice is available from:

 The Community Infection Control Team (CICT);  The individuals GP;  Health Protection Unit.

Essential Items for Infection Control

1. Practical Guide to Infection Control

I. Hand Washing

Good hand washing removes most micro-organisms from soiled hands, and is the single most important procedure for preventing cross infection. Good hand washing techniques apply to all users of the college.

The Illustration below demonstrates the effective hand washing technique.

II. Personal Protective Equipment

4  Plastic Aprons

The front of the body is the part most frequently contaminated by micro-organisms. Any member of staff or student, who undertakes tasks involving exposure to blood or bodily fluids, should wear plastic disposable aprons, as they will provide adequate protection in most circumstances.

 Gloves

Any member of staff or student who undertakes tasks involving exposure to blood or bodily fluids should wear disposable gloves in order to:

o Protect the hands from becoming contaminated with micro-organisms; o Minimise cross infection by preventing the transfer of organisms.

Natural Rubber Latex gloves have been the preferred glove in recent times, as they are proven to provide protection against blood borne viruses. However, due to the increased incidence of latex allergy, the H&S Department advise use of nitrile gloves for first aid use. Nitrile gloves are free from allergenic protein, and offer a good level of protection to the user. The H&S Department would advise that all departments using gloves for undertaking tasks where exposure to BBV’s is possible should use latex free gloves.

III. Food Handling and Hygiene

Every person working in a food handling area must maintain a high level of personal hygiene at all times, this includes:  Wearing clean clothing;  Wearing protective clothing as required;  Hair tied back;  Wearing suitable head covering when preparing food;  No wearing of jewelry or watches when preparing food (with the exception of a plain wedding band);  No touching of the face or hair when handling food;  No smoking, spitting, sneezing, eating, chewing gum, when handling food;  Effective hand washing: o Every time you enter the food handling area; o Before preparing food; o After touching raw food (e.g. meat/poultry/eggs/soiled vegetables); o After handling food waste and emptying a bin; o After cleaning; o After blowing your nose; o After a break; o After visiting the toilet; o Every time you change tasks in the catering area.

You must not work if you: Policy Title: Infection Control Policy Author: Louise Burke Last Modified: 04/04/2018

5  Are suffering from or carrying a disease likely to be transmitted through food (see appendix 1);  Have infected wounds, skin infections, sores;  Have diarrhoea and/or vomiting.

Section 5 provides guidance on exclusion periods for staff or students suffering from specific illnesses.

2. Preventing the spread of Blood Borne Viruses (BBV’s)

I. Modes of Transmission

BBV’s are infections spread by direct contact with the blood of an infected person through:

 Unprotected sexual intercourse with an infected person;  Sharing contaminated needles of other injecting equipment;  An infected mother to her baby, either before or during birth or though breast- feeding;  Tattooing, body piercing or acupuncture with unsterilised equipment;  Blood transfusion in countries where blood donations are not screened for BBV’s;  Occupational exposure sharps injuries;  Contact with blood (or in rare cases, other bodily fluids) through open wounds, skin abrasions, eye/nose/mouth splashes.

The main BBV’s of concern are:

 HIV/AIDS

The Acquired Immunodeficiency Syndrome (AIDS) is caused by infection with the Human Immunodeficiency Virus (HIV). It is spread in the same way as Hepatitis B, but is less infectious. Most infections are transmitted sexually or by the use of contaminated needles and syringes, tattoo or ear-piercing equipment contaminated with infected blood. Between 10-20% of babies born to infected mothers are themselves infected before birth, at the time of birth or later as a result of breast- feeding, therefore, breast-feeding is not recommended for HIV positive mothers. HIV is not spread by ordinary social contact, and will not spread in families, schools or day nurseries. There is an initial self-limiting influenza-like illness. After a period of several years, patients may develop a long-lasting generalized enlargement of the lymph glands. Nonspecific illnesses such as fever and night sweats are associated with progressive immune deficiency. The development of AIDS is characterized by the appearance of opportunistic infections and tumours.

 Hepatitis B

6 Hepatitis B is a blood borne viral infection (HBV). The infection is spread through sexual contact with an infected person, sharing an infected needle, or by blood from an infected person entering the bloodstream through broken skin or the mucous membranes (mouth, eyes, and genital area). The latter may occur through a bite which breaks the skin or if the skin is pierced by an object which has been in contact with someone else’s body fluids. People infected with the Hepatitis B virus may become unwell with jaundice (yellowing of the skin and whites of the eyes), fever, abdominal pain, vomiting and joint pain, or more commonly, may show no signs of the infection. They may remain Infectious for years and are then known as carriers. Often they are not aware that they are infectious. Some of those infected, develop serious liver disease. The virus is much more infectious than HIV.

 Hepatitis C

Hepatitis C virus (HCV) is a blood borne virus affecting the liver. HCV is present in blood and other body fluids and tissues and is spread in the same way as hepatitis B virus. The symptoms of the onset of Hepatitis C infection can often be vague with loss of appetite, fatigue, nausea and abdominal pain, or in apparent, with jaundice occurring less commonly than in Hepatitis B infection. Up to 80% of those infected may be carriers of the virus and can pass it on to others.

ii Occupational Risk Areas

In the vast majority of occupations, the risk of acquiring or transmitting blood born viruses (BBV’s) is extremely low. However, in more specific roles, where there may be contact with blood/body fluids, there is a risk. Such roles within the college are:

 First aid;  Hairdressing and beautician work (includes body piercing);  Some domestic/cleaning roles;  Plumbing;  Security.  Working in prisons

Departmental risk assessment will determine the level of risk and what control measures need to be in place.

iii Universal Precautions

Precautions to prevent the risk of transmission of infection from BBV’s should be adopted in all “at risk” roles within the college. The quality of infection control should be such that in principle, no extra precautions are required for people known to carry these viruses. There are 4 main areas of infection control: 1. Hand hygiene:  Staff/students should always clean their hands before and after each activity;  Staff should use correct hand hygiene procedure as described in the policy. Policy Title: Infection Control Policy Author: Louise Burke Last Modified: 04/04/2018

7 2. Personal Protective equipment (PPE):  Staff should wear protective equipment appropriate to their activity (i.e. gloves, aprons, masks, goggles);  Gloves and aprons should be worn as single-use items.

3. Clean and safe techniques:  Sterile equipment should be used at all times.

4. Safe disposal or sharps and clinical waste:  A sharps container should be available at the point of use;  The person using the sharp must dispose of it themselves;  Staff should not pass sharps from hand to hand;  Sharps containers should not be overfilled;  Clinical waste should be disposed in the correct containers and not in the general waste.

iv Additional Guidance for First Aid Team Members

First aiders should adopt the same principles of good infection control as above. However, in addition to these, the following additional precautions should be taken when dealing with blood or bodily fluids:

 When dealing with an open wound or where blood is present, the first aider should:

o Wash their hands before and after carrying out first aid treatment; o Always cover their own cuts and abrasions with a waterproof dressing; o Always wear gloves; o Use additional protection (i.e. eye protection, apron) if splashing is likely.

 When undertaking mouth-to-mouth resuscitation, the first aider should always use a polythene shield (resusciade) placed over the mouth of the patient. First aiders should be competent in the use of such items;

 When dealing with a body fluid spillage, the first aider should:

o Wear disposable gloves; o Use absorbent towels to cover the spillage; o Dispose of the soiled items as clinical waste; o Soiled linen should be washed separately in a washing machine on a hot cycle.

 When dealing with a sharps injury (patient of the first aider): o Encourage the wound to bleed; o Rinse thoroughly with water; o Seek medical advice.

8 Note that there have been, to date, no reported cases of transmission of infection arising out of the administration of first aid. The only risk of transmission of infection arises if infected blood or bodily fluids enter the body through breaks in the skin or the surfaces of the eyes or mouth. With standards precautions in place, as described above, there should be minimal risk to the first aider.

3. Waste Disposal

Clinical waste is defined in the Controlled Waste (England and Wales) Regulations 2012 as:

a. Any waste which consists wholly or partly of human or animal tissue, blood or other body fluids, excretions, drugs or other pharmaceutical products, swabs or dressings, or syringes, needles or other sharp instruments, being waste which unless rendered safe may prove hazardous to any person coming into contact with it; and

b. Any other waste arising from medical, nursing, dental, veterinary, pharmaceutical or similar practice, investigation, treatment, care, teaching or research, or the collection of blood for transfusion, being waste which may cause infection to any person coming into contact with it.

i. Principles and guidance for disposal of clinical waste

Waste Container Notes Group A  All human tissues including blood; Yellow bag. - Keep separate from all  Waste materials where assessment indicates other waste. a risk to staff handling them, e.g. from infectious disease cases;  Soiled surgical dressings, gloves, swabs and soiled contents of first aid hygiene packs. Group B  Discarded syringes, needles, cartridges; Sharps Container. - Keep separate from all  Small items of broken glass; other waste.  Other sharp instruments. Group C  Microbiological cultures; Yellow Sack. - Autoclave prior to  Potentially infected waste from laboratories; disposal.  Viable genetically modified organisms. - Keep separate from all other waste. Group D  Pharmaceutical and chemical waste. Secure container - Disposal as per hazardous e.g. bottles, jars waste guidance. NOT in a yellow sack or sharps container Policy Title: Infection Control Policy Author: Louise Burke Last Modified: 04/04/2018

9 Group E  Items used to dispose of urine, faeces and Yellow Bag - Keep separate from all other bodily secretions; other waste  Other bodily secretions assessed as not falling within Group A. Perceived (non) Clinical Waste  Discarded syringes, needles, scalpels and Sharps Container - Keep separate from all blades used in non-clinical activities; other waste  Other sharp objects not normally associated with clinical work. ii Containment

All Clinical Waste containers should be capable of containing the waste without spillage or puncture especially during transport and handling. iii Clinical Waste Bags

 Clinical Waste bags should conform to BS 6642:1985. The sacks should be coloured opaque yellow and clearly marked with the words “Clinical Waste - For Incineration Only”;  Sacks should be fitted to sack holders at the place of origin and should be changed when they are three quarters full. The weight should not exceed 5Kg;  Filled sacks should be effectively sealed either by tying at the neck or with a clinical waste bag tie;  Clinical Waste should never be placed in black refuse sacks and clinical waste sacks should not be used for any other purpose. iv Sharps Containers

 Sharps containers should conform to BS 7320. They should be puncture resistant, leak proof and capable of being handled and moved whilst in use with minimal danger of the contents spilling or falling out. The containers should be coloured yellow and clearly marked with the words “Danger Contaminated Sharps - To Be Incinerated”.  Sharps containers should be sealed when three quarters full. Sharps containers should be clearly marked with the place and date of origin, which will act as a point of reference should there be an accident or incident in the process of disposal.

v Storage

10  Clinical waste should be removed from its place of origin for storage prior to collection. The waste should not be allowed to accumulate in unsuitable places such as corridors. Bags should be removed when they are three quarters full or before they exceed 5kg in weight;  Storage areas should be washed down and disinfected weekly and after any accidental spillage;  A designated storage and collection point will be identified at each site where appropriate. Clinical waste should be taken directly to this point. vi Handling

 Clinical Waste bags should be handled with care and by the neck only. Bags should never be thrown or dropped, as this could result in the bag to split or burst exposing handlers to contaminated waste;  Sharps in containers must not be pressed down to create room for more. vii Spillages

Spillages of blood and bodily fluids should be cleaned using a spillage kit. These are available through the college Health and Safety Department. The following procedure should be applied when dealing with a spillage:

 Warn persons nearby to avoid contact;  Obtain spillage kit;  Put on disposable apron and gloves;  Slide a new yellow bag over the burst bag;  Using the scoop and spatula, shovel spilled waste into the new bag or, in the case of sharps, into a new container. DO NOT HANDLE CLINICAL SHARPS;  Thoroughly clean and wipe the area with disinfectant;  Place all used paper disposable protective clothing and equipment into the yellow bag and tie securely;  Ensure sharps containers are fastened;  Wash hands thoroughly.

4. College Trips

i. General principles and guidance Some trips involve activities, which may be associated with a small risk of exposure to infection, particularly those involving water-based activities. Precautions to be followed to reduce the risk of infection:

 Swimming in canals and rivers is forbidden, except when undertaken in connection with prescribed water-based activities at Education; Authority residential centres. At residential centres, the advice given below should also be followed;  Students and staff engaged in any outdoor activity involving possible contact with water in rivers, canals, ditches, ponds etc. must ensure that all cuts, scratches and abrasions are covered with waterproof dressings. Smoking should not be permitted

11 during or immediately after such activity, and hands should be washed thoroughly before eating, drinking or smoking. The use of appropriate footwear is recommended to reduce the risk of cuts to the feet.  To reduce the risk of water contact with the mouth and eyes, unnecessary splashing should be discouraged. Swallowing water should also be avoided whenever possible;  Exercises such as ‘capsize drill’ and ‘rolling’ should ideally be practiced in swimming pools and never in stagnant or slow-moving natural bodies of water;  If accidental immersion does occur, the person(s) involved should have a hot bath or shower as soon as possible. All wet clothing should be dried as soon as possible;  Students and staff should always wash or shower after canoeing or rowing.

Detailed advice regarding trips is available from http://www.education.gov.uk http://www.rospa.com and/or www.hse.gov.uk . College guidance is also available from http://staff.themanchestercollege.ac.uk/document/trips-and-visits-guidelines-and- policy-staff

5. Exclusion Periods for Communicable Diseases

Disease & Incubation Period Period When Period of Exclusion Period of Exclusion of Contacts Infectious of Infectious Person  Bronchiolitis (2-8 days). During acute stage of Until the person is None. illness. well.  Chickenpox & Shingles 1-2 days before & 5 5 days after the first If contact is woman in last 3 (11-20 days). days after rash spots appear. weeks of pregnancy seek advice develops. from GP/Obstetrician  Conjunctivitis (12hrs-3 During active No exclusion if None. days). infection. staff/student is well.  Diarrhoea & Vomiting When having Until D&V has None. (D&V); symptoms of settled (no D&V in  Campylobacter; diarrhoea and previous 48 hrs).  Cryptosporidiosis; vomiting.  Dysentry;  E. Coli;  Food poisoning;  Gastro enteritis;  Giardasis ;  Salmonellosis; (Few hours - few days – refer to OHD or HPU for further advice).  Fifth disease. Infectious before Until the staff/ None. Parvovirus onset of rash. student feels well. Slapped cheek syndrome.  Glandular fever (from 4-6 While virus present Until the staff/ None. weeks). in saliva. student feels well.  Hand, foot & mouth disease During acute stage of Until the staff/ None. Policy Title: Infection Control Policy Author: Louise Burke Last Modified: 04/04/2018

12 (3-5 days). illness. student feels well.  Head & body lice As long as eggs or None. Treatment None. (pediculosis) (eggs hatch lice remain alive. should start as soon between 7-10 days). as condition has been confirmed.  Hepatitis A (2-6 weeks). 2 weeks before first Until the None (household contacts symptoms, until 1 staff/student feels should seek advice from their week after onset of well. GP). jaundice (most infectious before jaundice starts).  Hepatitis B (6 weeks to 6 Not infectious under Until the staff/ None. months). normal College student feels well. conditions.  Herpes Simplex (cold sore). During infection. None. None. (2-12 days).  HIV infection (variable). Not infectious under None. None. normal College conditions).  Impetigo (4-10 days). As long as septic Until lesions are None. spots are discharging crusted and healed. pus.  Measles (7-14 days). 1 day before first Until 5 days from None. symptoms until 4 onset of rash and the days after onset of staff/student feels rash. well.  Meningitis (2-10 days Clinical cases are Until the None (household contacts may depending on cause) rarely infectious. staff/student feels be given antibiotic treatment).  For meningococcal well. meningitis, contact HPU).  Mumps (2-3 weeks Infectious from 7 5 days from onset of None -average 18 days). days before swollen glands and symptoms appear to when staff/student 2-4 weeks after. feels well.  Ringworm – on body (4 10 As long as rash is None, treatment None. days). present. needed from GP. Tinea corporis.  Rubella (2-3 weeks). Most infectious 5 days from onset of None (if contact is pregnant German Measles. before rash appears. rash. woman, seek advice from GP). 1 week before until 4 days after.  Scabies (1 day to 6 weeks Until mites and eggs Until day after None (household contacts depending on previous are destroyed by treatment. should be treated at the same exposure). treatment. time).  Scarlet fever (12 hours – 5 Prolonged in 5 days from days). untreated cases. commencing antibiotics None.

13  Streptococcal infection (12 Prolonged in None. None. hours – 5 days). untreated cases.  Threadworms (2-6 weeks As long as eggs are None but None (household contacts for life cycle to complete). shed in faeces. staff/student should should be treated at the same be treated. time).  Tuberculosis (4-16 weeks). As long as sputum Health protection None (close contacts may need TB. contains the team will advice on screening). bacteria. action.  Verrucae (2-3 months). As long as wart is None. None. Plantar Warts. present.

 Whooping cough (5-21 2 weeks. If treated Until 5 days after None. days). with antibiotics, this commencing Pertussis. may be reduced. antibiotic treatment. Otherwise 3 weeks.

For further information, contact the college H&S Dept 0n 0161 920 3359 or:

Community Infection Control Team – 0161 946 8242

Health Protection Agency – 0844 225 1295 pressing option 1 then option 3 for local office.

6. PROCEDURES / GUIDELINES: The Manchester College - Health and safety Arrangements: Blood Borne Viruses

HSE Publication - Blood Borne Viruses in the Workplace http://www.hse.gov.uk/pubns/indg342.pdf

7. RELATED POLICIES:

The Manchester College Health and Safety Policy

Occupational Health Policy

Health and Wellbeing Policy

14 8. Useful Web Addresses:

http://www.education.gov.uk

www.hse.gov.uk

http://www.rospa.com

www.hpa.org.uk/infections/default.htm

www.nice.org.uk

www.dh.gov.uk

9. APPENDICES:

Appendix 1 – Examples of Bacteria Which Cause Infection.

Appendix 1 Examples of Bacteria Which Cause Infection

Name Source Means of Infection Symptoms Safety Policy Title: Infection Control Policy Author: Louise Burke Last Modified: 04/04/2018

15 precautions Campylobacter Poultry;  Eating  Diarrhoea;  Thorough Meat; contaminated  Abdominal cramps. cooking;  Un-pasteurised foods;  Good milk;  Cross catering  Untreated water. contamination. practice;  Good personal hygiene. Clostridium Multi-products; Eating  Diarrhoea; As above. Perfringens Meats; contaminated  Abdominal cramps. Soil; foods; Human intestines. Cross contamination.  Salmonella Unpasteurised milk;  Eating  Vomiting; As above, Eggs; contaminated  Diarrhoea; testing for Meat; foods;  Additional illness human carriers. Poultry.  Cross depending on strain, contamination; e.g. lung infection.  Direct contact with infected human. Listeria The environment as  Eating Principally affects the Vulnerable a whole; contaminated vulnerable and pregnant avoiding listed Soft cheese and foods. women. Complications products; pates; with foetus. Good catering Many other foods. and personal hygiene.  E. coli – only  Beef;  Direct contact Bloody diarrhoea;  Thoroug certain strains;  Unpasteurised with infected Abdominal cramps; h cooking; many strains milk; animals or humans Complications leading to  Good are harmless.  Animal faeces. or land (from kidney/ anaemia/ catering and animal faeces). neurological problems, personal death. hygiene practices;  Avoid areas where animal faeces are likely, e.g. camping.