learning programme workbook - · pdf filewe are surrounded by micro-organisms ... with...

Preventing Infection in Care

Infection Prevention and Control:

Older Person Care Homes & Home Environment

Learning Programme Workbook

© NHS Education for Scotland 2011. You can copy or reproduce the information in this document for use within NHSScotland and for non-commercial educational purposes. Use of this document for commercial purposes is permitted only with the written permission of NES.

Preventing Infection in CareInfection Prevention and Control: Older Person Care Homes & Home Environment 2

Preventing Infection in Care In health and care settings preventing and controlling infection is everyone’s business, alongside the safety and wellbeing of those you are caring for, visitors, staff and yourself.

We are surrounded by micro-organisms – they are found inside us, on our bodies, they’re in our food and they’re in the environment and can be picked up from contact with contaminated surfaces or objects or by contact with infected persons. Most micro-organisms are harmless, but some can have serious consequences particularly for vulnerable groups including older people or people with certain medical conditions.

Healthcare Associated Infection (HAI) is defined as an infection that is acquired as a result of healthcare interventions.

For surveillance purposes this is an infection that is not present when a patient is admitted to a hospital or healthcare facility. If the infection develops in a patient 48 hours or more after admission to the hospital or healthcare facility, the infection is referred to as a hospital-acquired or healthcare associated infection.

Infections that occur within the first 48 hours of admission are considered to be community-acquired infections and were picked up in the community before admission to the hospital or healthcare facility.

The information contained within the Preventing Infection in Care DVD Programme is the simple and practical steps that you can take to break the chain and prevent infections in care.


Section 1 Introduction 4

About this Workbook 5

Section 2 Causes of Infection 6

Outlining bacteria, viruses 6

Howmicro-organismsgrowandmultiply 6

Section 3 Specific Infections 7

Clostridiumdifficile(C.diff) 7

Norovirus 7

Scabies 7

MeticillinresistantStaphylococcusaureus(MRSA) 7

Section 4 Outbreak Management 8

What is an Outbreak? 8

Whyactionisrequired? 8

Section 5 Standard Infection Control Precautions 9

HandHygiene 9

PersonalProtectiveEquipment(PPE) 11

RespiratoryHygieneandCoughEtiquette 12

ManagementofBloodandBodyFluidsSpillages 13

OccupationalExposureManagement 14

ControloftheEnvironment 15

ManagementofCareEquipment 16

CareintheMostAppropriatePlace 18

ManagementofLinen 20

SafeManagementofWaste 21


Section 1 IntroductionAbout this Workbook

ThisWorkbookisnotatrainingcoursebutitdoesprovideyouwithastructuredapproachtoassessinganddevelopingyourknowledgeandskills.ItcanalsoprovideevidenceforyourPersonalDevelopmentPlan(PDP);ProfessionalDevelopmentReview(PDR);SVQPortfolioevidence;ContinuingProfessionalDevelopment(CPD)orContinuousLearningFramework(CLF)

ThisisyourWorkbookforyoutorecordwhatyouhavelearnedanddemonstratethatyouhavetheknowledgeandskillsneededtocarryoutyourroleaspartoftheCareHomeorCareatHometeam.Therearespacesinwhichyouoryourlinemanager/supervisorcanwritedownnotesandanswerstoyourquestions.

You

Name:

Job Title:

DateCommencedWorkbook:

DateCompletedWorkbook:

LineManager/Supervisor:

Place of Work:

Supervisor

Discusswithyoursupervisor/linemanagerhowyouwillcompletetheWorkbookandlearnhowyoursupportwillbegiven.

Why a Workbook?

Infectionpreventionandcontrolisanimportantpartofhealthandsocialcareandcanmakeadifferencetotheexperienceofpeople:livingincarehomes,beingcaredforathome,staffandvisitorsthroughoutScotland.

Learningforyouisessential,toensurethatyourknowledgeandskillsareuptodatewithstandardsandguidanceforinfectionpreventionandcontrol. Careandsupportcanthenbedeliveredinascleanandsafeenvironmentaspossible


How to Use this Workbook

• Beforecommencing,discussyourpostandlearningneedsforyourrolewithyourlinemanager/supervisor

• Considerthetraining/learningyouhavealreadyreceivedsuchasinductionprogrammesandothercoursesattended

• Areasyouareunsureof,seekadvicefromyourlinemanager/supervisor

• YoucancheckyouranswersinthefeedbackbookletfoundontheaccompanyingCD

Recording Knowledge and Skills

Whenyouhavecompletedthequestionsandtaskssatisfactorily,yourlinemanager/supervisorshouldreviewyourworkbookandsignanddatethelearningoutcomessummarypagewherestatedtoensureyoucompleteanaccuraterecordofyourlearning.

Thefinalpageisacertificateoflearningthis,alongwiththeLearningOutcomesSummarypage,shouldbekeptforyourrecords.

Further Reading and Resources

Alltheinformationnecessarytocompletethisworkbookwillbefoundwhenviewingthe Preventing Infection in Care DVD programmeandfromthelocalpolicieswithinyourworkplacesetting.FurtherinformationandreadingcanalsobefoundontheFurther Reading and Support documentofthemainCD.YouwillalsofindaGlossaryofcommonlyusedtermsonthisCDifneeded.

AlternativelyallfilescanbedownloadedfromNHSEducationforScotland,HealthcareAssociatedInfectionwebpages:

www.nes.scot.nhs.uk/initiatives/healthcare-associated-infection


Section 2 Causes of Infection

1.Growthandmultiplicationofmicro-organisms

Can you give an example of a bacteria and an example of a virus?

Bacteria

Virus

2.Canyouname3conditionsmicro-organismsneedtomultiply?

3.Howquicklytheycangrow?

4.Canyoudescribeinyourownwordswhatismeantbythe“ChainofInfection”?

5. Usinganexampleofacommoncoldtickallthatapply

Infectious Agent Reservoir Portal of

Exit TransmissionPortal

of Entry

Susceptible host

Sneezingopenlywithoutcovering nose & mouth

Common cold virus

Respiratorysystem

Unwashedcontaminatedhands

Personyoucarefor

Touchingyoureyes,mouth or nose


Section 3 Specific InfectionsPlease give at least one answer to each

Clostridium difficile Infection (CDI, C.diff )

Spreadby:

Symptom:

Prevention&Control:

Norovirus

Spreadby:

Symptom:

Prevention&Control:

Scabies

Spreadby:

Symptom:

Prevention&Control:

Meticillin resistant Staphylococcus aureus (MRSA)

Spreadby:

Symptom:

Prevention&Control:


Section 4 Outbreak Management

1.Describewhatyouunderstandbytheterm“Outbreak”

2.Whydoyouthinkimmediateactionisrequired?

3.Whowouldyouseekadviceandinformationfrominthecarehome?

4.Inyourrole,doyouknowwheretolocatethepoliciesandguidanceforwhattodo?

5.Ifyouoracolleaguehaddiarrhoeaand/orvomitingwhatwouldyoudo?

6.Canyouremembersomeoftheimportantpointsforpreventinginfectionduringanoutbreak?


Section 5 Standard Infection Control Precautions

5.1 Hand Hygiene

1.Thisisthesinglemostimportantthingyoucandotopreventthespreadofinfection. Why?

2.Give3examplesofwhenyoushouldcarryouthandhygiene?

3.Whenshouldalcoholbasedhandrubnot be used?

4. Putinorder. TickifstepappliestoAlcoholBasedHandRub

Number Step Tick Number Step Tick

Wetyourhands Rubpalmtopalmwithfingersinterlaced

DryyourhandsthoroughlyRubthetipsoffingersintheoppositepalminacircularmovement

Rubhandspalmtopalm Applysoap/alcoholbasedhandrubfromadispenser

Rubeachthumbinturn,holdingitinoppositehandwithrotationalmovement

Rinseyourhandswithrunningwater

Disposeofpapertowelincorrectwaste bin

Rubbackofhandswithpalmofotherhand,fingersinterlaced

Rubbackoffingerstotheopposingpalmwithfingersinterlocked

Turnofftapswithyourwristsorapapertowel


4.Goodpracticesuggestsyoushouldadoptabarebelowtheelbowapproach,freefromalljewelleryexceptaplainbandring.Whatistheuniformandjewellerypolicyinyourworkenvironment?

5.Whyisthisimportant?

Pause Point: Itmightbeusefultothinkaboutallthethingsyoudoinadayandwhyhandhygieneisimportant.Youcanalsotalkaboutthiswithcolleaguesoryourlinemanager/supervisor


5.2 Personal Protective Equipment (PPE)

1.Whatlegislationisbeingreferredtowhenpersonalprotectiveequipmentisbeingused?

2.WhatarethemostcommontypesofPPEinuse?

3.WhendecidingwhenPPEisneeded,whatfactorswillyouneedtoconsider?

4.InwhatorderdoyouremovePPE?

5.WhereshouldPPEbestored?


5.3 Respiratory Hygiene and Cough Etiquette

1.Howarethecommoncoldandinfluenzaspread?

2.Whatisthepurposeofasneeze?

3.Name3measuresyoucantaketopreventthespreadofcoldandinfluenza

1.

2.

3.

4.Influenzavaccinationisavailableeveryyear. Who should be immunised?


5.4 Management of Blood & Body Fluid Spillage

1.Whenaspillageoccursyouneedtodoanassessmentofwhat?

1.

2.

3.

2.Canyoustatewhereyouwouldfindthepolicyfordealingwithaspillageofbloodorbodyfluid?

3.Whatistheprocessforcleaningaspillof:-Blood & body fluids Urine, vomit, faeces without visible blood

4.Howwouldyoucleanaspillonsoftfurnishings?

5.Whatkeyfactorsmustbenotedinthemanufacturer’sinstructionwhenusingcleaningsolutionsforBlood&BodyFluids?

1 2. 3.

6.WhatitemsofPPEareusedwhendealingwithaspillage?


5.5 Occupational Exposure Management

1.Canyoulistsomeoftheitemsthatyoumayencountertermed

Sharps Spillages

1. 1.

2. 2.

3. 3.

2.Whatactionshouldyoutakeifyouareexposedtoaspillage?

3.Whatisrecommendedifyouhaveanabrasionorcutinyourskin?

4.Name3importantpointsaboutthesafedisposalofsharpitems?

1.

2.

3.

5.Whatprocedurewouldyoufollowifyouhaveasharpsinjuryorabiteandtheskinisbroken?

1.

2.

3.

4.

5.


5.6 Control of the Environment

1.Inyourownwords,canyouexplainwhycleaningtheenvironmentisimportantwithin a care home?

2.Thinkaboutthecleaningsysteminyouplaceofworkandtheequipmentinuse. a)Isthereacolourcodingsysteminplaceforcleaning?Whatisit?

b)Isthereascheduleforfrequent,daily,weeklycleaning?Whatisit?

c)Canyoudescribehowthesystemworksandyourresponsibility?

3.CleaningsolutionsshouldbelockedawaytocomplywithCOSSH. Doyouknowwhereandhowtogetaccesstocleaningsolutions,24hrs/7days?

4.Describehowcleaningmaterialsandagentsarestoredandmaintainedinthecarehome.

5.WhatPPEshouldyouwearwhencleaning?


5.7 Management of Care Equipment

1.Careequipmentcanbecategorisedasbelow.Describewhatismeantbytheseterms?

a) Single use

Giveanexample

How it is cleaned and maintained

b) Single person use

Giveanexample


c) Multi-use

Giveanexample



2.Whydoyouthinkcleaningcareequipmentisparticularlyimportant?

3.Inyoursetting,whoisresponsibleforensuringcareequipmentiscleanandmaintained?


5.8 Providing Care in the Most Appropriate Place

1.Whyisitsometimesnecessarytoseparatesomeonewhenconcernedaboutinfection?

2.Whoshouldbeconsultedinmakingthisdecision?

3.Doyouknowwheretofindthepolicyandguidanceforthisisinyourworkplace?


4.Wherewouldyoulookforadviceandhelpwhendealingwithpeoplewhohaveinfections?

5.WhatStandardInfectionControlPrecautionswillbeimportanttopreventthespreadofinfection?

6.Ifsomeoneneedstobeseparatedtheycanbeveryfrightenedandisolated. Thinkhowthiswouldfeelanddescribethestepsyoucouldtaketoalleviatethis.


5.9 Management of Linen

1.Statethefourcategoriesoflinenandbrieflyexplaintheterm

1.

2.

3.

4.

2.Describethesafemanagementofcleanlineninyourcaresetting?

Storage:

Transported:

PPE:

3.Describethesafemanagementofusedlineninyourcaresetting?

Assess for:

Removingusedlinen:

1

2

3

4. Whatisthecolourcodingsysteminyourworkplaceforsoiledandinfectedlinen?

5.Areyouclearaboutadvicewhenrelativesrequesttotakesoiledlinenhometowash?

Identify 3 “must not do” with soiled linen


5.10 Safe Disposal of Waste

1.IntheDVDwehavecategorisedwasteinto3categories.Completethetablebelowandidentifyhoweachtypeofwasteishandledinyourarea.

Name What waste goes in this category

What colour bag is used

How is this waste handled in your area

Any more information

2.Whoisresponsibleforthesafedisposalofwasteinyourcaresetting?

3.Howaresharpscontainersdisposedofwhenfullandreadytobecollectedbythewastesystem?

4.Whyisgoodhandhygieneimportantafterhandlingwaste?


Learning Outcomes YoumayusethistabletosummarisethecompletionofeachsectionanddemonstrateachievementoftheLearningOutcomes.Youmayaskyoursupervisor/Linemanagertoco-signthisworkbook.

Page No Section

Learning Outcomes

The learners should show an understanding of:

Learner

Initials & date

Supervisor/Line Manager

Initials & date

2 Causes of infection

• Differenttypesofmicro-organisms

• Whatconditionstheyneedtogrow

• Whatismeantbythe“ChainofInfection”

3 Specific Infections

Forthefourinfections

• Theinfectionandhowitaffectsthebody

• Thesymptomsassociatedwithit

• Thepreventionandcontrolprecautionsforthatinfection

4 Outbreaks of Infection

• Whatismeantbyanoutbreak

• Whatactionmustbetakenandbywhom

• Wheretofindtherelevantpolicyandguidance

5 Introduction to SICPs

5.1 Hand Hygiene • Theimportanceofhandhygiene(HH)inpreventingandcontrollinginfection

• WhentouseliquidsoapandwaterorAlcoholBasedHandRub(ABHR)

• Whenandhowhandhygieneshouldbecarried out

• Awarenessofthe“nojewellery”advice,hand and nail care and following local procedureregarding“barebelowtheelbowrule”

5.2 Personal Protective Equipment

• WhyPPEisimportant

• WhentowearPPEsuchasgloves,apronsandfacialprotection

• HowtocorrectlyremoveanddisposeofPPE

• UnderstandthecorrectprocedureregardingstorageofPPE


Page No Section

Learning Outcomes


Learner

Initials & date


Initials & date

5.3 Respiratory Hygiene and Cough Etiquette

• Howcoughsandcoldsandinfluenzacanspread

• Theimportanceofasneezingandcoughing“etiquette”(coveringthenoseandmouthduringcoughingandsneezing)

• Theimportanceofhandhygieneafterhandlingusedtissuesfollowingcoughingand sneezing

5.4 Management of Blood and Body Fluids

• Thepolicywithinthecarehomeregardingmanagingspillageofbloodandbodyfluids- faeces, vomit and urine

• Thecorrectprocedureusedtocleanaspillageofbloodorbodyfluidsonhardandsoftfurnishings

• The correct method in the use of chlorine basedsubstancesforbloodspills

• TheuseofPPE

5.5 Occupational Exposure Management

• Whatitemsaretermed“sharpobjectsorspillages”

• Howtopreventexposuretosharpincidentsandbloodandbodyfluids

• Thecorrectsystemfordisposingofsharps

• Thecorrectprocedurefordealingwithincidentsfollowinganyexposure

5.6 Control of the Environment

• Theimportanceofcleaningtheenvironmentinthepreventionandcontrolofinfection

• Theroleofallstaffincontrollingtheenvironment

• Thecolourcodingsysteminuseforcleaningequipmentandareas

• CompliancewiththeCOSHHregulations


Page No Section

Learning Outcomes


Learner

Initials & date


Initials & date

5.7 Management of Care Equipment

• Thetermssingleuse,singlepatientuse,multi-use

• Whatcareequipmentisusedandhowitcanleadtothetransmissionofinfection

• Whencareequipmentshouldbecleaned

• Whatpoliciesandcleaningschedulesforcleaningequipmentareinplace

5.8 Providing Care in the Most Appropriate Place

• Thereasonsforseparatingpeopletoavoidtransmissionofinfection

• Theimportanceofarrangementsandplansintheeventoftheneedtomovepeopletoanother room or area

• Where to seek advice concerning infections

• Tobeawareofthepsychologicalneedsandissuesassociatedwithseparation

• Theneedforcorrectstandardinfectioncontrolprecautionsatalltimes

5.9 Management of Linen

• Thedifferentcategoriesandcolourcodedsystems

• Correct storage of clean linen

• The correct handling of used and soiled linen

• TheuseofPPE

5.10 Safe Disposal of waste

• Thedifferentcategoriesofwastewithinthe care home

• Thecolourcodedsystemfordifferenttypesofwaste

• Howtohandle,disposeof,andtransportwastecorrectlyandsafely

• Handhygieneafteralltasksassociatedwith waste

Statement of Completion

Thisistocertifythat

Name:

Job title:

Employer:

hascompletedstudyonthelearningprogramme

Preventing Infection in CareInfection Prevention & Control:

Older Person Care Homes & Home Environment

on

Date:

ThiscertificatemustbeaccompaniedbythedatedandsignedSummaryofLearningOutcomes

Education for InfectionPrevention and Control


AnswersAlltheanswerstothequestionscanbefoundwhenviewingthePreventingInfectioninCareDVDProgrammeorfrominformationonthelocalpolicywithinyoursetting.

YoumayalsochecktheDVDscriptsthatcanbefoundwithineachrelevantsectionoftheaccompanyingCD.

Section 2 Q5

Infectious Agent Reservoir Portal of

Exit TransmissionPortal

of Entry

Susceptible host

Sneezingopenlywithout covering nose & mouth

Common cold virus

Respiratorysystem

Unwashedcontaminated hands

Personyoucarefor

Touchingyoureyes,mouth or nose

Section 5

4. Putinorder. TickifstepappliestoAlcoholBasedHandRub

Number Step Tick Number Step Tick

Wetyourhands Rubpalmtopalmwithfingersinterlaced

DryyourhandsthoroughlyRubthetipsoffingersintheoppositepalminacircularmovement

Rubhandspalmtopalm Applysoap/alcoholbasedhandrubfromadispenser

Rubeachthumbinturn,holdingitinoppositehandwithrotationalmovement

Rinseyourhandswithrunningwater

Disposeofpapertowelincorrectwaste bin

Rubbackofhandswithpalmofotherhand,fingersinterlaced

Rubbackoffingerstotheopposingpalmwithfingersinterlocked

Turnofftapswithyourwristsorapapertowel

AlternativelyallinformationcanbedownloadedfromNHSEducationforScotland www.nes.scot.nhs.uk/initiatives/healthcare-associated-infection

1

23

5

6

7

8

49

10

11

12

NHS Education for ScotlandHanover Buildings66 Rose StreetEdinburgh EH2 2NNtel: 0131 220 8600fax: 0131 220 8666

www.nes.scot.nhs.uk

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