DOCSLIB.ORG

Isolation Precautions UHL Policy

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Isolation Precautions UHL Policy Isolation Precautions UHL Policy Including A-Z of conditions and Personal Protective Equipment Approved By: Policy and Guideline Committee Date of Original 28th October 2011 Approval: Trust Reference: B62/2011 Version: 4 Supersedes: V3 (August 2015) Trust Lead: Debbie McMahon Infection Prevention Board Director Chief Nurse Lead: Date of Latest 15 February 2019 – Policy and Guideline Committee Approval Next Review Date: February 2022 CONTENTS Section Page 1 Introduction and Overview 3 2 Policy Scope – Who the Policy applies to and any specific exemptions 3 3 Definitions and Abbreviations 3 4 Roles- Who Does What 4 5 Policy Implementation and Associated Documents-What needs to be 6 done. 6 Education and Training 8 7 Process for Monitoring Compliance 8 8 Equality Impact Assessment 8 9 Supporting References, Evidence Base and Related Policies 8 10 Process for Version Control, Document Archiving and Review 9 Appendices Page 1 Source and cohort isolation precautions 11 2 Protective isolation precautions 18 3 Strict isolation precautions 21 4 A-Z of conditions and isolation precautions required 25 5 Personal Protective Equipment 36 6 Donning and Doffing of PPE for patients who require strict isolation 40 precautions REVIEW DATES AND DETAILS OF CHANGES MADE DURING THE REVIEW Change to the title of the policy and the keywords 1. Review date February 2022 2. Title changed to Isolation Precautions Policy Including A-Z of conditions and Personal Protective Equipment KEY WORDS Isolation Precautions Barrier nursing Source Strict Enhanced Protective PPE personal protective equipment VHF, Ebola, haemorrhagic fever Page 2 of 46 Isolation Precautions Policy including A-Z of conditions and PPE V4 approved by Policy and Guideline Committee on 15 February 2019 Trust Ref: B62/2011 Next Review: February 2022 NB: Paper copies of this document may not be most recent version. The definitive version is held on INsite Documents 1 INTRODUCTION AND OVERVIEW 1.1 Transmission of infectious agents within a healthcare setting requires three elements: a source or reservoir; a susceptible host with a portal of entry and a mode of transmission. There are several measures that affect the transmission of infectious agents: cultural behaviour, the construction of the hospital & facilities available and clinical practice. People are the primary source of infectious agents in a hospital setting although inanimate environmental sources are implicated in transmission. Human reservoirs can be patients, staff and visitors and may be colonised with pathogenic organisms, asymptomatic/incubating period or have active infection. 1.2 Infection results from a complex inter-action between a potential host and an infectious agent. Most of the factors that influence infection and severity of the disease relate to the host such as immune status, age, underlying disease, medication/treatment/surgical procedures, presence of indwelling devices and implants 1.3 Many different types of pathogens can cause infection, including bacteria, viruses, fungi, parasites and prions. Modes of transmission vary by type of organism or agent and some may be transmitted by more than one route. 1.4 Transmission can be avoided by interrupting the mode of spread by using standard precautions in conjunction with isolating the patient with the infectious agent and minimising the exposure to other patients by the use of single rooms or cohort nursing. 2 POLICY SCOPE 2.1 The policy and attached guidelines are intended for use by anyone employed within UHL delivering health care, either on a permanent or temporary contract, volunteers and anyone in a training capacity. 3 DEFINITIONS AND ABBREVIATIONS 3.1 Airborne transmission: Small particles containing infectious agents that can be breathed in are carried in the air. They may be dispersed over long distances by air currents and may be inhaled by individuals who have not come face to face or even shared the same room with the infected person. Prevention of spread often requires the use of special air handling and ventilation systems. 3.2 Contact transmission: • Direct: Micro-organisms are transferred to a person from an infected person without an intermediate contaminated person or object. • Indirect: Micro-organisms are transferred to a person through a contaminated person or object. Examples of this are via hands of healthcare workers, patient equipment and instruments, clothing or the environment. Page 3 of 46 Isolation Precautions Policy including A-Z of conditions and PPE V4 approved by Policy and Guideline Committee on 15 February 2019 Trust Ref: B62/2011 Next Review: February 2022 NB: Paper copies of this document may not be most recent version. The definitive version is held on INsite Documents 3.3 Droplet transmission: Respiratory droplets carrying infectious organisms transmit infection when they travel directly from the respiratory tract from the infectious person to the mucosal surfaces of the recipient such as during coughing, sneezing or respiratory suction. The maximum distance for droplet transmission is undetermined but studies show an area of approximately three feet around the patient. Factors affecting droplet transmission include velocity of propulsion, density of respiratory secretions, temperature and humidity of the environment and virulence of the organisms. The size of the droplets and therefore the length of time they are suspended in the air may also affect infectivity. 3.4 Endogenous infections: Infections that arise within the body, caused by micro- organisms that are normal flora. 3.5 Exogenous infections: Infections that arise within the body, caused by micro- organisms that are not normal flora. 4 ROLES 4.1 Infection prevention is the business of every employee within University Hospitals of Leicester NHS Trust. Specific roles and responsibilities are described below. 4.2 Chief Executive - The Chief Executive is the accountable officer and devolves responsibility for infection prevention to the Trust’s Director of Infection Prevention (DIPaC). 4.3 Chief Nurse/Director of Infection Prevention (DIPaC) - The DIPaC is responsible for the Trust’s infection prevention strategy, implementation of the annual infection prevention programme and for providing assurance on infection prevention to the Trust board, the commissioners and the general public. The DIPaC is the focal point for the integration of infection prevention into the Trust’s clinical governance systems and for ensuring the safety of patients from infection is not forgotten. The DIPaC will chair the Trust Infection Prevention Assurance Committee. The DIPaC is directly accountable to the chief executive and to the board and they will be responsible for the Trusts Infection Prevention Team. The DIPaC will also be responsible for producing an annual report on Infection Prevention within the Trust. The Chief Nurse is responsible for the professional performance of nursing and midwifery staff within the Trust ensuring that they know what is expected of them with regard to infection prevention and to ensure that they fulfill their responsibilities as part of their duty of care. 4.4 Medical Director - The Medical Director is responsible for the professional performance of medical staff within the Trust ensuring that they know what is expected of them with regard to infection prevention and to ensure that they fulfill their responsibilities as part of their duty of care. Page 4 of 46 Isolation Precautions Policy including A-Z of conditions and PPE V4 approved by Policy and Guideline Committee on 15 February 2019 Trust Ref: B62/2011 Next Review: February 2022 NB: Paper copies of this document may not be most recent version. The definitive version is held on INsite Documents 4.5 Director of Estates and Facilities - The Director of Estates and Facilities is accountable for the quality of the domestic and estate services across the Trust. The post holder is required to work in close co- operation with the DIPaC and Lead Nurse Infection Prevention to ensure a safe clean patient care environment. 4.6 CMG Clinical Directors - The CMG Clinical Director is accountable for the CMG’s infection prevention performance. The CMG Clinical Director is expected to set a good example and ensure that others do the same by complying with infection prevention policies. 4.7 CMG Medical Lead For Infection Prevention - The CMG Medical Lead is accountable to the CMG Clinical Director for performance in relation to infection prevention within the CMG. The medical lead is expected to set a good example and ensure that others do the same by complying with infection prevention policies. The CMG Medical Lead may devolve the lead for infection prevention to another member of the CMG consultant medical team. 4.8 CMG Infection Prevention Lead Clinician - The CMG infection prevention Lead Clinician is responsible for the development and implementation of the CMG annual IP plan. It is expected that the Lead Clinician will represent the CMG at the Trust Infection Prevention Committee. The CMG Infection Prevention Lead Clinician is also expected to promote infection prevention policies and guidelines and challenge poor infection prevention and medical practice. They have a key role in persuading their clinical colleagues when there is a need to change their behaviour, e.g. hand washing, antimicrobial prescribing and dress code compliance. 4.9 CMG Head of Nursing - The CMG Head of Nursing is responsible for ensuring that nursing and midwifery staff within the CMG are compliant with infection prevention policies and guidelines. The CMG Head of Nursing is expected to participate in infection prevention audits and observations of practice. They are responsible for ensuring that High impact intervention audits are carried out within the CMG. The CMG Head of Nursing is also expected to reinforce the importance of good infection prevention practice and challenge poor practice. 4.10 Matron - Matrons have a particular role in ensuring that the environment in which care is provided meets expected standards. They are responsible at a local level of leading and driving a culture of cleanliness in clinical areas and for monitoring, recording and reporting compliance with standards.
Load more

Recommended publications
  • Guidance on Isolation Precautions for the Prevention and Control of Infections in the Healthcare Setting
    GUIDANCE ON ISOLATION PRECAUTIONS FOR THE PREVENTION AND CONTROL OF INFECTIONS IN THE HEALTHCARE SETTING Ownership: Document Code: Total Pages: 43 DIRECTOR-GENERAL MEDICAL AND DGMHS / IPC / GIPPCIHCS / V.1 / 09 HEALTH SERVICES (DGMHS) OFFICE / 2020 Version: 1 Title: 1st Version: - GUIDANCE ON ISOLATION PRECAUTIONS FOR THE PREVENTION AND Issued: Sept 2020 CONTROL OF INFECTIONS IN THE HEALTHCARE SETTING Next Review: Sept 2025 TABLE OF CONTENTS 1. INTRODUCTION .................................................................................................................. 3 2. PURPOSE ............................................................................................................................. 3 3. SCOPE .................................................................................................................................. 3 4. DEFINITIONS ....................................................................................................................... 4 5. ROLES AND RESPONSIBILITIES ............................................................................................ 6 6. BACKGROUND INFORMATION ........................................................................................... 6 7. STANDARD PRECAUTIONS ................................................................................................. .8 8. TRANSMISSION-BASED PRECAUTIONS ............................................................................. 12 9. PROTECTIVE PRECAUTIONS .............................................................................................
    [Show full text]
  • Cases of Lassa Fever in the Netherlands Ex Sierra Leone
    RAPID RISK ASSESSMENT Cases of Lassa fever in the Netherlands ex Sierra Leone 28 November 2019 Summary On 20 and 24 November 2019, respectively, the Dutch public health authorities confirmed two imported cases of Lassa fever from Sierra Leone. Both were Dutch healthcare workers who worked in a rural hospital in Sierra Leone. They were probably infected during surgery they conducted together on two local patients on 4 November 2019. Both healthcare workers had onset of symptoms on 11 November and were medically evacuated to the Netherlands, where one of them died. Whilst in the prodromal phase of the disease and still afebrile, the Dutch healthcare worker who later died in the Netherlands attended an international surgical training event in Freetown, Sierra Leone (11–12 November 2019). ECDC has been informed of contact tracing activities being carried out in several EU countries including the Netherlands, Germany, Denmark and the United Kingdom. Outside of the EU, contacts were identified in Sierra Leone, Uganda and India. The risk level for secondary transmission among healthcare workers in the EU/EEA and Sierra Leone depends on several factors such as closeness, duration of contact and the type of activity performed (e.g. by medical staff or those handling bodies of deceased Lassa fever patients in preparation for funeral). The type of personal protective equipment used is another factor. Healthcare workers involved in invasive care procedures are at increased risk of exposure. In healthcare settings, when appropriate infection prevention and control precautions and laboratory biosafety measures are in place, the secondary attack rate for Lassa virus transmission is extremely low.
    [Show full text]
  • FRAMEWORK and STRUCTURES for EBOLA OUTBREAK RESPONSE Introduction
    FRAMEWORK AND STRUCTURES FOR EBOLA OUTBREAK RESPONSE Introduction In an epidemic situation like this Ebola virus disease outbreak, events are unfolding quickly and multiple activities are running or need to take place concurrently Effective control of the outbreak therefore depends on effective coordination of all the intervention activities General strategy to CONTROL Ebola outbreak Women, associations Anthropological Triage Barrier Infection Traditional healers evaluation In/out nursing Opinion leaders control Psycho- Formal and informal Behavioural and Clinical case modes of social Organize communication social support Management funerals Social and interventions Clinical trials Cultural Ethics committee practices Communication Ethical Medias Duty of care Press Coordination Research Journalists aspects Active Security Epidemiological case-finding Police Control of Logistics vectors and investigation, Lodging reservoirs in surveillance Follow-up Food nature of contacts and laboratory Social and Specimens Epidemiological Finances Transport Search the Database Laboratory mobile teams Salaries Vehicles source analysis testing Pillars Pillars are composed of experts in those areas of interventions The Pillars are therefore responsible for the technical aspect of the control measures such as developing and designing strategies, planning, implementation, monitoring and supervision of activities ToR for Case Management/ IPC/PS Pillar Establish isolation facilities and provide clinical/ nursing care to patients Implement barrier nursing
    [Show full text]
  • Rapid Infection Control Nursing Is an Essential Read for All Frontline Nursing Staff Working in Hospitals Or Community Settings
    Infection Control Nursing The Rapids are a series of reference and revision pocket books that cover key facts in a simple and memorable way. Each book contains the common conditions that students and newly qualifi ed nurses encounter on the wards, in the community, and on placements. Only the basic core relevant facts are provided to ensure that these books are perfect and concise ‘rapid refreshers’. To see all the titles in the series, go to: www.wiley.com/go/rapids Rapid Infection Control Nursing is an essential read for all frontline nursing staff working in hospitals or community settings. Designed for quick reference, it explores the essential principles of infection control before moving on to an A–Z of the most commonly found infections. Each entry covers how the infection is spread, duration of the infectious period, key infection-control precautions, staff considerations, visitor information, and patient transfer advice. Covering all the key topics in infection prevention and control, this concise and easy-to-read title is the perfect quick-reference book for the wards. Ross All content reviewed by students for students Wiley Blackwell Health Science books are designed exactly for their intended audience. All | of our books are developed in collaboration with students. This means that our books are Furrows Infection always published with you, the student, in mind. If you would like to be one of our student reviewers, go to www.reviewnursingbooks.com to fi nd out more. Control Nursing www.wiley.com/go/nursing ISBN 978-1-1183-4246-6
    [Show full text]
  • Ebola and Marburg Virus Disease Epidemics Preparedness, Alert, Control, and Evaluation (Eng)
    EBOLA STRATEGY Ebola and Marburg virus disease epidemics: preparedness, alert, control, and evaluation August 2014 © World Health Organization 2014. All rights reserved. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. WHO/HSE/PED/CED/2014.05 Contents Acknowledgements............................................................................................................ 5 List of abbreviations and acronyms ................................................................................... 6 Chapter 1 – Introduction .................................................................................................... 7 1.1 Purpose of the document and target audience ..................................................... 8 1.2
    [Show full text]
  • Ebola Virus Disease Transmission November 5, 2014
    Ebola Virus Disease Transmission November 5, 2014 Key Points: The Ebola virus is transmitted from person to person through close personal contact with an infected individual or their blood or body fluids. Airborne transmission of Ebola virus has not been demonstrated in human studies. Individuals infected with Ebola are not infectious before the onset of symptoms. Individuals at the height of their illness or in the latter stages of fatal disease present the greatest risk for potential transmission. Strict adherence to infection prevention and control precautions, including the use of personal protective equipment, has been shown to be extremely effective in preventing Ebola virus transmission to health care workers. How is Ebola transmitted? The Ebola virus is considered a classic zoonotic pathogen with the suspected reservoir being the African fruit bat, with chimpanzees, apes, and humans being end hosts. Transmission to humans from contact with infected animals through the preparation of “bush meat” has been well documented in Africa1. Person to person transmission of the Ebola virus occurs through close personal contact with an infected individual or their blood or body fluids2. Transmission occurs from direct blood or body fluid exposure to non-intact skin or mucous membranes, or through percutaneous exposure (e.g. needle stick injury). In addition to blood, Ebola virus has been detected in other body fluids following symptom onset, including saliva, stool, semen, breast milk, urine, sweat, and tears3,4, and the World Health Organization has indicated that vomit can also be infectious5. Any body fluid from an infected patient that has blood mixed with it may potentially contain the virus.
    [Show full text]