protrainings infection control course · protrainings infection control course or a classroom-based...

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ProTrainingsInfectionControlCourseWelcometoyourProTrainingsInfectionControlCourse.Thiscoursecanbetakenonlineatwww.proinfectioncontrol.co.ukorwithaProTrainingsapprovedinstructor.Youcanfindapprovedinstructorsbysearchingonwww.procourses.co.ukorbycontactingusdirectlyonsupport@protrainings.euor01206805359.

ThismanualisdesignedtobeusedexclusivelybystudentswhohavecompletedanonlineProTrainingsInfectionControlCourseoraclassroom-basedcoursethathasbeencertifiedbyaProTrainingsapprovedinstructor.Oncompletionofaclassroomcourse,youwillreceiveacertificateandwalletsizedcardasshownbelow.

OnlinestudentscanprintoffacertificateandcertifiedCPDcertificateuponcompletionoftheircourse.YoucanvalidatethatyourcertificateisvalidaswellasreceiveaPDFversiononlinefromthebottomofwww.proinfectioncontrol.co.uk.ThiscanbedownloadedandprintedfromyourfreeProTrainingsloginarea.

Thismanualisforallversionsofourinfectioncontrolcourses.

Makesureyouregisteronlineforthelatestupdates.Onlinestudentsareautomaticallysigneduptoreceiveupdates.Yourinstructorshouldhaveregisteredyoualready,andifyouaredoinganonlinecourse,youwillhavealreadyreceivedyourlogindetailsifyouhavethisbook.Ifyouhaveanyproblemslogginginorwithcertification,pleaseemailorcallus.

ThisisanexampleoftheProTrainingsclassroomcertificatethatyouwillreceiveinthepostafteryourcourse.Onlinecoursesyouprintyourcertificateonline.


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Whoisatriskfrominfection?Theriskofinfectionfrombloodbornepathogensisnotjustlimitedtodoctorsandnurses,butalsotopeopleinthesevocations:

• Custodialservices(prisons,detentioncentres,homes)• Education• Embalmingandcrematoriumwork• Emergencyservices(ambulance,fire,police,rescue)• Firstaid• Hairdressingandbeauticians’work• Healthcare(hospitals,clinics,dentalsurgeries,pathologydepartments,community

nursing,acupuncture,chiropody,associatedcleaningservices)• Laboratorywork(forensic,research,etc.)• Localauthorityservices(streetcleaning,parkmaintenance,refusedisposal,public

lavatorymaintenance)• Medicalordentalequipmentrepair• Military• Mortuarywork• Needleexchangeservices• Plumbing• Sewageprocessing• Socialservices• Tattooing,earandbodypiercing• Vehiclerecoveryandrepair

Thislistisaguideandtherearemanyotherareaswhereyoucanbeatrisk,includingtheriskthatyouareunderinoutsideworklife.


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TheInfectionCycleItisimportanttounderstandthatinfectionanddiseaseisnotthesamething.Infectionoccurswhenanorganismentersthebodyandstartstogrow.However,diseaseonlyoccursiftheorganismstartstomultiplyandproducesymptoms.Ourbodieshavetremendouscapacitytofightofforganisms.Diseasesresultwhentheseprotectivemechanismfailorarecompromised.

Entrancetothehostgenerallyoccursthoughthenormalopenings,suchastheoralcavity,nose,eyes,genitalia,anusandopenwounds.Whileafeworganismscangrowattheinitialsiteofentry,manyinvadeandstarttogrowindifferentorganswheretheyarehardtodetect.Someorganismsgrowwithinthehostcells,whereasothersgrowfreelyintheblood.

Foranorganismtocausedisease,thereareseveralfactorsthatmustbemetbeforeaninfectioncanoccur.

Theorganismmustbeabletogrow,multiply,beabletoenterthebodyandhavetheabilitytocausedisease.

Infectiousagents,whichcausediseaseinhumans,include:• Bacteria• Viruses• Parasites• Fungi

Cross-infectionisthephysicalmovementortransferofharmfulbacteriafromoneperson,objectorplacetoanother,orfromonebodyparttoanother(suchastouchingastaph-infectedhandtotheeye).

Whenthiscross-infectionoccursinacarehomeorlong-termcarefacilityitiscallednosocomialinfection.Community-acquiredinfectionsarethosecontractedanywhereexceptahospitalorlong-termcarefacility.

BloodbornePathogensBloodbornepathogens(BPP)aremicro-organisms(suchasviruses)thatarepresentinhumanbloodandcancausediseaseinhumans.Thesepathogensinclude,butarenotlimitedto,hepatitisBvirus(HBV),hepatitisC(HCV),andhumanimmunodeficiencyvirus(HIV)

BBParenotineverybodilyfluid,butwemustalwaysassumetheyareinordertobesafe.


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HowareBloodbornePathogensSpread?Bodilyfluids,especiallythosevisiblycontaminatedwithblood,havethepotentialtotransmitdisease.

• Cerebrospinalfluid(brain)• Synovialfluid(joints)• Pleuralfluid(lungs)• Amnioticfluid(uterus)• Pericardialfluid(heart)• Peritonealfluid(abdomen)• Semen• Vaginalsecretions• Blood• Anybodilyfluidcontaminatedwithblood• Bodyfluidsthatcannotberecognised

Sexualcontactistheprimarymodeoftransmissionforbloodbornepathogens;however,theriskofexposuredoesexistwhileprovidingmedicalorfirstaidcare.

Othermethodsoftransmissioninclude:• Contaminatedsharpobjects,whichcutorpuncture

theskin.Examplesincludeneedlestick,illegaldrugusage,cutfrombrokenglass,bite• Infectedbodilyfluid,whichgetintoanopenwoundormucusmembrane(insideeyes,

mouth,earsornose)

Infectioncanevenoccurwhencontaminatedobjectstouchinflamedskin,acneorskinabrasion.

HowareBloodbornePathogensNOTSpread?Intactskinisperfectlycreatedtoperformafirstlevelofdefenceagainstdiseaseandinfection.Bloodbornepathogenscannotsoakthoughintactskin.

Casualcontact,suchashandshaking,kissing,hugging,talking,sharingfood,doorknobs,toiletseats,swimmingpools,etc.,alsodoesnotposearisk.


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HIVandAIDSHIVattacksyourbody’sabilitytoprotectitselfagainstdiseaseanditcausesAIDS.

Approximately1.1millionpeopleintheUSarelivingwithHIV/AIDS.Approximately40,000peoplebecomeinfectedwithHIVeachyear.

Symptomsmayormaynotbepresent.Youmaybeinfectedforyearsandnotknowit.Onlyabloodtestcandeterminetheinfection,notsymptoms.

Symptomsinclude:• Fever• Fatigue• Weightloss• Rash

TheHIVvirusisfragileandonlysurvivesafewsecondsoutsidethehumanbody.TheamountofHIVpresentinthebodilyfluidandtheconditionswilldeterminehowlongtheviruslives.

HIVisprimarilyspreadbysexualcontactwithaninfectedpersonorbysharingneedlesand/orsyringes(primarilyfordruginjection).Babiesmaybecomeinfectedbefore/duringbirthorbreast-feeding.Onlyafractionoflessthan1%ofthoseinfectedcontractedthevirusfromprovidingmedicalcare.

HIVisnotspreadbycasualcontactlikehandshakes,sharingfood,doorknobs,sneezing,toiletseats,swimmingpools,etc.ThereisnovaccinationcurrentlyagainstHIV.

UKHIVstats• HIVisthefastestgrowingseriousmedicalcondition• Around97,400caseshavebeenreportedsincetheearly1980s• Over18,000peoplehavediedwithAIDSsincetheearly1980s• Therewere7,734newdiagnosesin2007• In2007,itwasestimatedthat28%ofpeoplelivingwithHIVdidnotknowtheywere

infected• 31%ofpeoplediagnosedwithHIVin2007werediagnosedlate• 41%ofnewHIVdiagnosesin2007wereamongmenwhohavehadsexwithmen

EuropeHIVstats• In2007,therewereapproximately730,000peoplelivingwithHIVinEurope.Therewere

also8,000AIDSdeathsandabout27,000newinfections• 33%ofthepeoplenewlydiagnosedwerebetween15and29yearsold• 46%ofthenewcaseswereinfectedthroughheterosexualsex,32%thoughsharing

equipmentforinjectingdrugsand20%thoughgaysex• 33%ofthenewdiagnoseswerewomen


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HepatitisBVirusHepatitisBvirus(HBV)reproducesinthelivercausinginflammationandpossiblycirrhosisorlivercancer.HBVaffectsover1.24millionpeopleintheUS.About70,000peoplebecomeinfectedwithHBVeachyear.About5,000peopledieasaresultofliverdiseasecausedbyHBV.Infectionshavedecreasedsince1982becauseoftheHBVvaccine.

Symptomsmayormaynotbepresent.Theoldertheperson,themorelikelyitisthattheywillhavesymptoms.Onlyabloodtestcandeterminetheinfection.

Symptomsmayinclude:• Yellowskin(jaundice)• Yellowingeyes• Tiredness• Lossofappetite,nausea• Darkurine• Claycolouredbowlmovements• Jointpain• Abdominaldiscomfort

HepatitisBisupto100timeseasiertocatchthanHIV.HBVcanliveoutsidethebodyforatleastsevendays,andlonger.90%ofadultswhocontractHBVclearthevirusfromtheirsystemwithinafewmonthsanddevelopimmunity.About10%becomechronic–thevirusstaysintheblood,infectinglivercellsdamagingthemovertime.

HBVisprimarilyspreadbysexualcontactwithaninfectedpersonorbysharingneedlesand/orsyringes(primarilyfordruginjection).Babiesmaybecomeinfectedduringbirth.

However,likeHIV,HBVisnotspreadbycasualcontactlikehandshakes,sharingfood,doorknobs,sneezing,toiletseats,swimmingpools,etc.

Occupationallyexposedemployeesincludethosewho:• Administerfirstaid• Providemedicalaidtostudents• Assistinbathroomcare• Workinmedicalordentaloffices• Performcustodialdutiesinvolvingthecleaninganddecontaminationofsurfacesthat

maybecontaminatedwithbloodandorotherpotentiallyinfectiousmaterials(OPIM)• Handleregulatedmedicalwaste

HBVvaccineThereisavaccineavailable,givenin3dosesoveraperiodof6months.Itisasafeandeffective.BoosterdosesofHBVvaccinearenotrecommendedasimmunememoryremainsindefinitelyfollowingimmunisation.TheHBVvaccinemustbeofferedfreetoemployeeswhofaceoccupationalexposuretobloodbornepathogens.


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HepatitisCVirusHepatitisCvirus(HCV)reproducesinthelivercausinginflammationandpossiblecirrhosisorlivercancer.Thediseasecanincubatefordecades.

Thereare4.1millioncarriersintheUSandaround26,000newcaseseachyear.Deathsfromchronicdiseaseeachyeararebetween8,000and10,000.About80%ofexposedpeopledevelopachronicinfection.20%areabletoclearthevirusbynaturallybuildingimmunity.

SymptomsarenotareliablewaytodetectHCV.Abloodtestisneeded.SymptomsmaylookthesameasHBV.UnlikeHIVorHBV,HCBisspreadprimarilythoughparenteralcontact:

• Illegalinjectiondruguse• Transfusionortransplantfrominfecteddonor• Tattoos

Occupationalexposuretobloodismostlythroughneedlesticks.HCVisalsospreadthough:• BirthtoHCV-infectedmother• Multiplesexpartners

Thereisnocureorvaccination.


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MRSAMRSAstandsformethicillin-resistantstaphylococcusaureus,whichisacommonskinbacteriathatisresistanttoarangeofantibiotics.

‘Methicillin-resistant’meansthebacteriaareunaffectedbymethicillin,atypeofantibioticthatusedtobeabletokillthem.AnMRSAinfectionmeansthebacteriahavegotintothebodythoughabreakintheskinandmultiplied,causingsymptoms.

ColonisationAboutoneinthreeofuscarriesthestaphylococcusaureus(SA)bacteriainournoseoronthesurfaceofourskin(especiallyinfoldslikethearmpitorgroin)withoutdevelopinganyinfection.Thisisknownasbeingcolonisedbythebacteria.

Inhospitals,theproportionofpeoplecolonisedbyMRSAishigherbecauseofmorecontactwithinfectedcases.

PeoplecancarryMRSAforafewhoursordays,orsometimesweeksormonths.Theyareunawaretheyarecarriersbecausethebacteriadonotharmthemorcausesymptoms,unlikeotherpeoplewhoareinfectedwithMRSA.

HowinfectionhappensIfSAbacteriagetintothebodythoughabreakintheskin,theycancauseinfectionssuchasboils,anabscessorimpetigo.Iftheygetintothebloodstream,theycancausemoreseriousinfections,suchasbloodpoisoning.

Whoismostatrisk?MRSAwillnotnormallyinfectahealthyperson.Althoughitispossibleforpeopleoutsidehospitaltobecomeinfected,MRSAinfectionsaremostcommoninpeoplewhoarealreadyinhospital.Thisisbecause:

• Theyoftenhaveanentrypointforthebacteriatogetintotheirbody,suchasasurgicalwoundoracatheter

• Theytendtobeolder,sickerandweakerthanthegeneralpopulation,whichmakesthemmorevulnerabletoinfection

• Theyaresurroundedbyalargenumberofotherpatientsandstaff,sothebacteriacanspreadeasily(throughdirectcontactwiththeotherpatientsorstafforviacontaminatedsurfaces)


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ScreeningforMRSAAllNHSpatientsgoingintohospitalforarelevantplannedprocedurearescreenedforMRSAbeforehand.ThishelpstheNHSreducethechanceofpatientsgettingandMRSAinfectionorpassingMRSAontoanotherpatient.

TreatmentScrupuloushandwashingbyhospitalstaffbeforeandaftercontactwithpatientsandbeforeanyprocedureisthesinglemostimportantinfectioncontrolmeasure.Bacterialinfectionsaretreatedwithantibiotics.However,MRSAbacteriaareresistanttomethicillin(atypeofpenicillinantibiotic)andusuallytosomeoftheotherantibioticsthatarenormallyusedtotreatSAinfections.Therefore,MRSAinfectionsaremoredifficulttotreatthanotherbacterialinfections.

MRSAPreventionInordertopreventhealthcare-associatedMRSA,hospitalstaff,patientsandvisitorsshouldfollowsimplehygienemeasurestohelppreventthespreadofMRSAandstopinfection.

Hospitalpatientscanreducetheirriskofinfectionbyalwayswashingtheirhandsafterusingthetoiletorcommode,alwayswashingtheirhandsorcleaningthemwithahandwipeimmediatelybeforeandaftereatingameal,makingsuretheirbedareaisregularlycleanedandreportinganyuncleantoiletorbathroomfacilitiestostaff.

HospitalvisitorscanreducethechanceofspreadingMRSAtootherpeoplebynotsittingonthepatient’sbedandbycleaningtheirhandsbeforeandafterenteringtheward.Theyshouldusehandwipesorhandgelbeforetouchingthepersontheyarevisiting.Handgelorhandwipedispensersareoftenplacedbypatients’bedsandattheentrancetohospitalwardsandclinicalareas.

HospitalstaffshouldmaintainveryhighstandardsofhygieneandtakeextracarewhentreatingpatientswithMRSA.Staffshouldthoroughlywashanddrytheirhandsbeforeandaftercaringforapatient,beforeandaftertouchinganypotentiallycontaminatedequipmentordressings,afterbedmakingandbeforehandlingfood.Ifhandsarenotvisiblydirty,afast-actingantisepticsolutionsuchasahandwipeorgelmaybeused,otherwisehandsshouldbewashedwithsoapandwater.

Hospitalstaffshouldweardisposablegloveswhentheyarecomingintocontactwithanopenwound,forexamplewhenchangingdressings,handlingneedlesorinsertinganintravenousdrip.Handsshouldbewashedaftergloveshavebeenremoved.Thehospitalenvironment,includingfloors,toiletsandbeds,shouldbekeptascleananddryaspossible.

PatientswithaknownorsuspectedMRSAinfectionshouldbeisolatedandshouldonlybetransferredbetweenwardswhenthisisstrictlynecessary.Allthesestepsaimtoreducethechanceofpatientsinfectingthemselvesandothers.


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Therearewaystopreventcommunity-associatedMRSA,suchaswashingyourhandsregularly,havingfrequentshowersorbaths,whichwillhelpreducetheriskofcatchingorpassingonMRSAoutsidehospital.Alsokeepyourfingernailsshortandcleanbecausebacteriacangrowunderlongernails.

Donotshareanyproductsthatcomeintocontactwithyourskin,suchassoaps,lotions,creamsandcosmetics.Donotshareunwashedtowels.Donotshareanypersonalitemsthatcomeintocontactwiththeskin,suchasrazors,nailfiles,combsorhairbrushes,withoutthoroughlycleaningthemfirst.

IfthepatientdevelopsaskinorsofttissueMRSAinfection,coveritwithadressingunlessthedoctorinchargeofyourcaretellsyounotto.Washyourhandsaftertouchingaffectedareasofskinandpotentiallyinfectedmaterials,suchasuseddressings.

Finally,withanyprocedureyoumustdisposeofanypotentiallyinfectedmaterialpromptlyandsafelyinasuitabledustbinorsimilarcontainerdesignedtodisposeofhazardousmaterial.

ClostridiumDifficileThesymptomsofclostridiumdifficilerangefrommildtoveryseverediarrhoea,socareneedstobetakentoavoiditsspreadtopeople.

Aclostridiumdifficileinfection(CDI)isatypeofbacterialinfectionthatcanaffectthedigestivesystem.Itmostcommonlyaffectspeoplewhoarestayinginhospital.ThesymptomsofaCDIcandevelopwhenyouaretaking,orhavejustfinishedtaking,anantibiotic.Occasionally,symptomsmayappearupto10weeksafteryoufinishtakingantibiotics.

ThemostcommonsymptomsofamildtomoderateCDIare:regularboutsofusuallyfoul-smelling,waterydiarrhoea,whichcansometimesbebloodstained.Mostpeoplehavearound3-5boutsofdiarrhoeaaday;abdominalcramping;andpain.

InmoreseverecasesofCDI,thecoloncanbecomeinflamed,whichisknownascolitis.Symptomsofcolitisinclude:morefrequentboutsofdiarrhoea,between10-15aday;ahightemperature(fever)of38oCorabove;moresevereabdominalcramping;dehydration;feelingsick;lossofappetite;andweightloss.

CDIcanalsocauselife-threateningcomplications,suchassevereswellingofthebowelduetoabuild-upofgas.Thistypeofswellingisknownastoxicmegacolon.

Itisworthnotingthatdiarrhoeacanbeacommonsideeffectofantibiotics,sohavingdiarrhoeawhiletakingantibioticsdoesnotnecessarilymeanyouhaveaCDI.IfthediarrhoeapersistsafterfinishingacourseofantibioticsyoushouldconsideraCDI.


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Sporesoftheclostridiumdifficilebacteriacanbepassedoutofthehumanbodyinfaecesandcansurviveformanyweeks,andsometimesmonths,onobjectsandsurfaces.

Ifyoutouchacontaminatedobjectorsurfaceandthentouchyournoseormouth,youcaningestthebacteria.

Theclostridiumdifficilebacteriadonotusuallycauseanyproblemsinhealthypeople.However,someantibioticscaninterferewiththebalanceof‘good’bacteriainthegut.Whenthishappens,clostridiumdifficilebacteriacanmultiplyandproducetoxins,whichcausesymptomssuchasdiarrhoea.

AmildCDIcanusuallybecontrolledbywithdrawingtreatmentwiththeantibioticscausingtheinfection.

Moreseverecasescanbetreatedusingdifferentantibiotics.Theconditionusuallyrespondswelltotreatment,withsymptomsimprovingin2-3daysandclearingupcompletelywithin7-10days.However,areturnofsymptomsiscommon,occurringinaround1in4cases.Arelapsewillrequirefurthertreatment.Somepeoplehavetwoormorerelapses.

Lifethreateningcasesmayneedsurgerytoremoveadamagedsectionofthebowel,whichisrequiredinaround1in100cases.SeverecasesofCDI,especiallywhentheyoccurinpeoplewhowerealreadyveryill,canbefatal.

Clostridiumdifficilebacteriaspreadveryeasily.Despitethis,CDIscanusuallybepreventedbypractisinggoodhygieneinhealthcareenvironments,suchaswashinghandsregularlyandcleaningsurfacesusingproductscontainingbleach.

Ifyouarevisitingsomeoneinhospital,youcanreducetheriskofspreadinginfectionbywashingyourhandsbeforeandafterenteringtheward.Alcoholhandgelisnoteffectiveagainstclostridiumdifficilespores,sotheuseofsoapandwaterisessential.

AsCDIsareusuallycausedbyantibiotics,themajorityofcaseshappeninahealthcareenvironment,suchasahospitalorcarehome.Olderpeoplearemostatriskfrominfection.Peopleagedover65accountforthreequartersofallcases.

Inrecentyears,thenumberofCDIshasfallenrapidly.Therewere17,414reportedcasesinEnglandduring2011,comparedto52,988in2007.

Unfortunately,anewstrainoftheclostridiumdifficilebacteria,calledNAP1/027,hasemergedinrecentyears.Thisnewstraintendstocausemoresevereinfection.TherehasalsobeenanincreaseofCDIcasesoccurringoutsideofahealthcaresetting,knownascommunity-acquiredclostridiumdifficileinfection.


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SkinDiseasesPeoplewithinfectedwounds,opensores,boils,abrasions,orweepingdermatologicallesionsshouldavoidworkingwherethereisalikelihoodtheycouldcontaminatehealthcaresupplies,bodyartequipmentorworkingsurfaces.

Aworker’sskinshouldbefreeofrashorinfection.Healthcareworkers,tattooartistsandcaregiversshouldcoveranysoreswithbandagestoavoidthepotentialspreadofdisease.

Skinisthelargestorganofthebody.Skincontainsbloodvessels,sensoryreceptors,nervesandsweatglands.Itismadeupoftheepidermisandthedermis,andvariesinthicknessfrom1.5mmto4mmormore.

Ourskinisourfirstlineofdefenceagainstinfectionandtherearethreelayers:• Theepidermis-isthethickouterlayeroftissue• Thedermis-isthestrong,flexiblesecondlayerofconnectivetissue.Thedermisisfilled

withbloodvessels.Uncleantattooingorbodyartisahigh-riskactivityforbloodbornepathogensbecauseitinvolvesmultiplepuncturesoftheskintoinstilpigmentintothedermis

• Thehypodermis-isjustbelowtheskin.Itisthefattylayerandisalsocalledthesubcutaneouslayer

Therearemanycommonlyspreadskindiseases:• BacterialproblemslikeMRSAinfectioncanlooklikeanordinaryskinwound,boil,or

infectedsore• Viruslikeherpessimplex.Thisisgenerallyfoundontheface,scalp,arms,neckandupper

chest.Smallroundblisterswhenbrokencansecreteaclearoryellowishfluid.Peoplecontractherpesbytouchinginfectedsaliva,mucousmembranesorskin

• Fungalinfectionslikeathlete’sfoot,jockitchandringworm.Thesecausered,patchy,flaky,itchyareas.Theyarecontagiousandeasilyspreadfromonepersontoanother.Fungalinfectionscanbespreadwhenaninfectedareaonanotherpersonorcontaminatedsurfacesaretouched,suchasintheshowerorswimmingpool.Affectedareasneedtobekeptcleananddry

Somepeoplewiththefollowingconditionsaremorepronetoskindisorders.Healingmaybeadverselyaffectedbyreceivingtattoosorbodyart:

• HistoryofHepatitisBorHepatitisC• HIV/AIDS• Diabetes• Historyofhaemophiliaoranyotherblooddisorder/disease• Historyofskindiseasesorskinlesions• Historyofallergiesoradversereactionstopigments,dyes,latex,etc.• Immunedisorders


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StandardPrecautionsTreatallbodyfluidsfromeverypersonaspotentiallyinfectious.Followtherecommendationsintheemployer’sbloodbornepathogensexposurecontrolplan.

Anemployer’sbloodbornepathogensexposurecontrolplanshouldinclude:

• Variouslevelsofrisksofemployeesthatmayhaveoccupationalexposureto• Trainingrequirements• Workpracticecontrols• Engineeringcontrols• Procedureforanexposureincident

PersonalProtectiveEquipment(PPE)PPEisprovidedbyyouremployer.

• Gloves,CPRshields,masks,gowns,eyeprotection• KnowwherePPEislocatedatyourworkplace• KnowwhatPPEisavailableandhowtouseit• MakesurefirstaidkitsandemergencysuppliesincludedisposableglovesandCPRface

shieldsorrescuemasks


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HowtoReduceyourRisksDonoteat,drink,smoke,applycosmeticsorhandlecontactlensesinareaswherethereisthepossibilityofexposuretoBBP.

Whenchangingthelinersinawastecontainer,donotuseyourhandstoflattenthewasteinthebag.

Liftandcarrythewastebagawayfromyourbody.

Followyourfacility’sproceduresforhandlinglaundry.

Generallaundryprocedures:• WearPPE• Keepcontaminatedlaundryseparate

fromotherlaundry• Bagpotentiallycontaminated

laundrywhereitisused• Useleak-proofbagsforwetlaundry• Transportinproperlylabelledbags

Workplacepracticesrequireappropriate,commerciallyavailableandeffectivesafemedicaldevicesdesignedtoeliminateorminimiseoccupationalexposure.

Needlesandothersharpsmustbediscardedinrigidleak-proof,punctureresistantcontainers.

Donotbend,shear,breakorrecapneedles.Ifyoumustrecap,usetheone-handedmethod.

Liquidorsemi-liquidbloodorotherpotentiallyinfectiousmaterials(CPIM)Contaminateditemsthatwouldreleasebloodorotherpotentiallyinfectiousmaterialsinaliquidorsemi-liquidstateifcompressed-disposeofinalabelledbio-hazardcontainer,eitheraredbagorcontainerlabelledinanorangeororange-redwiththeBio-Hazardsymbol.

Properlylabelledandbundledwasteneedstobehandledaccordingtoyourfacility’sdisposalprocedures.


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CleanUpProceduresWheretherehasbeenafluidspill,itneedstobecleanedupbyatrainedpersonwiththecorrectequipmentandchemicals.Thespillneedstobecontainedintheareasothatitdoesnotspreadtootherareas.Thismayincludesealingofftheareafromotherpeople.Youwillneedtolookfortheguidancegivenbyyouremployerordoappropriateriskassessmentstodecideonpossibleactionensuringyouarefollowingthelawsandactslaiddown.

Anybloodspillcanbecleanedbytheuseofpapertowels,butyoumustalwaysmakesureyouarewearingthecorrectpersonalprotectiveequipment.

ThePPEcouldinclude:• Gloves• Apron• Eyeshields• Faceshields• Footwear• Specialbodilyfluidcleanupkits• Sharpsboxandinfectiousmaterialbags• Otherequipmentsuppliedbytheemployer

Theremaybesomepoliciesinplacethatrequirespeciallytrainedpeopletocleanupanypotentiallydangerousspills.

Youneedtobesureyoufullyunderstandyourworkplaceprotocolsbeforecarryingoutanycleanup.

Youcanalsousespecialcleaningwipesandcleansingsubstances.

Theuseofhandgeltoensureyourhandsarecleanisadvised.


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Gloves• Griponeglovenearthecuffandpeelit

downuntilitcomesoffinsideout• Cupitinthepalmofyourglovedhand• Placetwofingersofyourbarehand

insidethecuffoftheremainingglove• Peeltheglovedownsothatitcomes

offinsideout,overthefirstglove• Properlydisposeofthegloves


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HandWashingWashhandswell:

• Wetyourhandsandapplyliquid,barorpowdersoap• Rubhandstogethervigorouslytomakealatherandscruballsurfaces• Continuefor20-30secondsasittakesthatlongforthesoapandscrubbingtodislodge

andremovestubborngerms.Needatimer?Imaginesinging‘HappyBirthday’allthewaythoughtwice

HandGelsTherearewaterless,alcohol-basedhandwashsolutionsthatareaseffectiveassoapandwaterhandwashing.Thesepreparationsshouldonlybeusedwhenthereisnovisiblesoilingofthehands.

Ifthereisvisiblesoiling,thensoapandwaterhandwashingshouldbeused.

Thesewaterlesspreparationscontainanemollientandaidinreducingdamagetothehands


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HandCleaningPoliciesTherearestandardpoliciesonhandhygiene,cleaningprovisionandsignstoensurethateveryeffortistakentoensurecleanlinessatalltimes.

Someexamplesofthesepoliciesare:• Nailsmustbeshort,cleanandfreeofnail

varnish,andfalsenailsshouldberemoved

• Separateclinicalwash-handbasinsforhandwashingareprovidedineachsurgeryanddecontaminationroom

• Basinsdonothaveplugsoroverflows,astheseareareaswherebacteriacancollect

• Basinsarefittedwitheithersensor-operatedorlever-operatedmixertaps,whichdonotdischargedirectlyintothedrainopeningtoavoidgeneratinganaerosolofwatervapour

• Wallmountedliquidhand-washdispenserswithdisposablesoapcartridgesarelocatedneartothesinks.Thenozzlesshouldbekeptclean.Refillablehand-washcontainersarenotusedatthepracticeasbacteriacanmultiplywithinthecontainerandactasapotentialsourceofcontamination.Barsoapshouldnotbeused

• Postersdepictingappropriatehandwashingtechniquesaredisplayedaboveorneartheclinicalwash-handbasinsinthepractice.Anexampleisavailableinourstudentdownloadarea

• Handsshouldbedriedcarefully,usingthedisposabletowelsprovided,toavoiddamagingtheskin.Disposeoftowelsinthefoot-operatedorsensor-operatedwastebin

• Attheendofasession,usethehandcreamprovidedtocounteractdryness.Handcreamshouldnotbeusedunderglovesasitencouragesthegrowthofmicro-organisms

• Alcohol-basedskin-disinfectanthand-rubs/gelscanbeusedonvisiblycleanhandsinconjunctionwithagoodhand-rubtechnique.Aposterdepictinganappropriatehandrubtechniqueshouldbedisplayedineachsurgeryanddecontaminationroom

• Followthemanufacturer’sinstructionsforthemaximumnumberofapplicationsforhand-rubs/gelsbeforehandwashingisrequired.Repeatedapplicationsleadstoabuild-upoftheproductonthehands;ifhandsbecomesticky,washasnormalusingaproperhand-hygienetechnique

• Alcohol-impregnatedwipesusedforcleaningsurfacesshouldnotbeusedinplaceofhand-rubs/gels;theyarenoteffectiveinhanddecontamination

• Bykeepingyourhandscleanandreducingtheriskofdamagingyourskin,youwillreducetheriskofinfectionorcrosscontamination


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LaundryandCleaningEachcareestablishmentshouldhavewrittenprotocolsforroutinegeneralcleaningtogetherwithawrittencleaningschedulethatensuresalloftheareasofthehomearecleanedtoasatisfactorystandard.

Staffundertakingcleaningwithinthecareestablishmentshouldhaveclearprotocolstofollowandaccesstoadequateresources.Dishwashersaremosteffectivebecausethewaterisveryhotandremovestheneedtohanddry.

Laundry• Allcuts,soresorabrasionsmustbecoveredwithawaterproofdressing• Weardisposableglovesandapron;PPE(thiswillhelpprotectyoufrominfection)• Iflaundryisblood-stained,itmustbewashedseparately,preferablyinawater-soluble

bag• Laundryshouldbeprocessedonacyclethatreaches71oCforatleastthreeminutesor

65oCforatleast10minutes.Workclothesneedtobewashedatthehottesttemperaturepossible

• Forclothingthatcannotwithstandsuchhightemperatures,drycleaningisanalternativeoption

• Afterhandlinglaundry,discardprotectiveclothingandwashhandsthoroughly

LaundryfacilitiesWhatisneeded?Adesignatedlaundryarea,ideallysited,sothatthesoiledarticlesarenotcarriedthoughareaswherefoodisstored,prepared,cookedoreaten.

Thelaundryfloormustbeofasmoothimpermeableandeasilycleanedmaterial.Thewallsmustbeinasoundconditionandeasilycleaned,andcolourcodedifpossible.

Acommercial/industrialwashingmachinewithbothasluiceandhotwatercycleprofessionallyinstalledandserviced.Aserviceagreement,whichsupportspromptrepairorreplacementofthemachine,isadvisable.

• Adesignatedareaforsoiledlaundry,separatefromwherecleanlaundryishandledandstored

• Handwashingfacilitiesforstaff• Supplyofprotectiveclothingforstaffuse• Washingpowdersandothersubstancesmustbekeptinalockedstoragecupboard.

Materialsafety,datasheetsforhazardoussubstancesmustbemaintainedandbeavailableforreference

• Domesticstaffshouldhaveaprogrammeforcleaningthelaundryenvironment


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Laundrypractices• Staffshouldalwayswearglovesandadisposableapronwhilsthandlinglaundry• Linenshouldberemovedfrombedswithcaretoavoidcreatingdust,andplacedinand

appropriatecontaineratthebedside• Soiledlinenmustberemovedtothedesignatedlaundryforprocessingassoonas

possible• Laundrycontaminatedwithbloodorbodyfluidsshouldbecontainedinawater-soluble

orsoluble,stitchedbagpriortobeingplacedinanormallinerbag-thisallowscontaminatedlaundrytobeplacedstraightintothewashingmachineonasluicecycle;therefore,reducingtheriskofcontamination.Afterremovalofprotectiveclothing,staffshouldwashanddryhandsthoroughly

Usedlinen• Alllinenused,exceptfoul/infectedlinen,shouldbeplacedinaWHITEbag• Foul/infectedlinenshouldbeplacedinawater-solublebagimmediatelyafterremoval,

thenplacedinaREDbag• Heatliablefabricsshouldbewashedatthehighesttemperaturepossible,accordingto

fabriccareinstructions

Launderingoflinenandclothing• Usedlinen-temperaturemaintainedat65oCfornolessthan10minutesor71oCforno

lessthan3minutes• Foul/infected-asluicecycleisnecessaryforfoullinen.Linenshouldbetransferredinits

water-solublebagintothewasherwithoutwatering


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DisposalofClinicalWasteClinicalwastegeneratedeverydayincarehomescanpresentriskstothehealthandsafetyofresidents,staffandvisitorsinthecarehome,aswellastothegeneralpublicifitisnotproperlysegregated,handled,transportedanddisposedofinaccordancewiththefollowingrelevantlegislation:

• HealthandSafetyatWorkAct1974• ManagementofHealthandSafetyatWorkRegulations1992(TheManagement

Regulations)• ControlofSubstancesHazardoustoHealthRegulations1999(COSHH)• ControlledWasteRegulations1992• EnvironmentalProtectionAct1990• EnvironmentalProtection(DutyofCare)Regulations1991• WasteManagementLicencingRegulations1994• SpecialWasteRegulations1996• HazardousWaste(EnglandandWales)Regulations2005• ThelistofWasteRegulations2005

Therehavebeensignificantlegislativechangesinrecentyears,whichhaveimplicationsonthewaythatclinicalwasteisdefinedandhowitshouldbedisposedof.Carehomecleaningpoliciesshouldincludeareastobecleaned,PPEequipment,personresponsibleforcleaningmaterialstobeusedforcleaning(chemicals)andmethods.

GuidanceonlocalpolicyshouldbesoughtfromtheEnvironmentalHealthOfficer(EHO)withresponsibilityforwastemanagement.

Underhealthandsafetylaw,carehomesoremployersgeneratingclinicalwastemustensurethattherisksfromitareproperlycontrolled.Remember,youhavealegaldutyofcareto:

• Assesstherisk• Developpolicies• Putarrangementsinplacetomanagetherisks• Monitorthewaythesearrangementswork

Ifyoudonotcomply,youmaybeprosecuted.


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CareHomeCleaning• Toensurethehigheststandardsofcleanlinesstomeetinfectioncontrolstandards

throughoutthecarehome• Toadheretothecleaningschedule,ensuringthecorrectandsafeuseofequipmentand

chemicals• Tocarryoutsystematiccleaningasrequiredwiththeuseofmachinery• Topracticesafehandlingofchemicals,alwaysfollowingthemanufacturer’sinstructions

andensuringregulationsareadheredto• Tomaintainandrequisitioncleaning

materialsinordertodelivercleaningservices

• Touseallmechanicalequipmentinacorrectandsafemanner.Toreportanydefectiveequipmenttothemanagerandtotakeitoutofserviceimmediately,ensuringthatitisclearlylabelledas“OUTOFORDER”

• Todisplay“WETFLOOR”warningcones,whennecessaryandremoveoncethefloorisdry

• Toalwaysfollowthecarehomepolicyoncolourcodingforequipmentandrubbishbags

• Toassistinthecleaningofclinicalanddomesticwasteanddirtylaundryfromareas

Generalresponsibilities• Toadheretotheoperationalpolicyregardingthewearingofjewellery,andtoalways

weartheuniformandotherprotectiveclothingprovided• To,atalltimes,maintainhighstandardsofpersonalhygieneandalwaysprojecta

positiveimageofbothyourselfandthecarehome• Toattendtrainingcoursesappropriatetothepost• Toensuresecurityofthepremisesismaintainedatalltimes,combinationcodesorkeys

mustnotbegiventonon-trustemployees• Tounderstandthatstaffmayberequestedtoworkinanyappropriateareawithinthe

department• Tomaintaintheconfidentialityofserviceusers,staffandvisitors• Toact,atalltimes,inaprofessionalandresponsiblemannerandhavedueregardto

confidentialityandinfectioncontrollegislation

Thisisanoutlinejobdescriptionandshouldberegardedasaninflexiblespecification.Responsibilitieswillbereviewedperiodicallyinlinewithserviceprioritiesanddutiesmaychangeornewdutiesbeintroduced.


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ColourCodinginHospitalsColourcodingofhospitalcleaningmaterialsandequipmentensuresthattheseitemsarenotusedinmultipleareas,thereforereducingtheriskofcrossinfection.TheNationalPatientSafetyAgency(NPSA)hasdevelopedaNationalColourCodingSchemeforcleaningmaterials.

TherecommendationisthatallNHSorganisationsadoptthiscodeasstandardinordertoimprovethesafetyofhospitalcleaning,ensureconsistencyandprovidingclarityforstaff,asthereiscurrentlynosinglecolourcodeinuseacrosstheNHS.TheNationalColourCodingSchemeisdesignedtostandardise,andinsomecasesstreamline,existingschemes.Itwillhaveminimalresourceimplicationsfortheservice.

Allcleaningmaterialsandequipment,forexample,cloths,re-usableanddisposable,mops,buckets,apronsandgloves,shouldbecolourcoded.Themethodusedtocolourcodeitemsshouldbeclear,permanentandinaccordancewithexistinglocalpractice.

Cleaningproductssuchasbleachanddisinfectantsdonotneedtobecolourcoded.Also,thecodedoesnotextendtocateringequipment,forexample,choppingboardsandknives,wherethereisalreadyawell-recognisedandwell-establishedproceduretoensurefoodhygieneandfoodseparationissuesareaddressed.

TheNPSArecommendsthatallNHSorganisationsprovidinginpatientservicesinEnglandandWalesshouldmakeapolicydecisiontoadopttheNationalColourCodingSchemewhereexistingpracticediffers.TheyrecommendallNHStrustsdevelopanactionplanforintroducingtheNationalColourCodingSchemeandraiseawarenessofanyrevisedpracticeamongsthealthcarestaff.ByhavingastandardcolourcodingsystemacrosstheNHS,itwillbeeasierforpeopletounderstandtheonecolourcodesystemwhentheymovefromdifferentlocations.

Thecolourcodingis:• Redisusedinbathrooms,washrooms,showers,toilets,basinsandbathroomfloors• Blueisusedingeneralareas,includingwards,departments,officesandbasinsinpublic

areas• Greenisusedincateringdepartments,wardkitchenareasandpatientfoodserviceat

wardareas• Yellowisusedinisolationareas

AcopyoftheNHSposterisavailableinyourstudentdownloadarea.


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BodyHandlingandDisposalWheneverthereisanexposureriskofcontactwithbloodandbodyfluidsinhandlingbodiesforanypurpose,youshouldalwayswearpersonalprotectiveequipment,andotherprotectiveequipmentthatisavailableasnecessary.

Sitesinthebodythatposeariskforleakingbodilyfluidsshouldbesealedassoonaspossible,forexample,openwoundsanddrainagetubesitesshouldbecoveredwithwaterproofdressings.

Ifyouareawareorsuspectthatthedeceasedpersonisinfectedwithabloodbournepathogen,itisyourdutytoensurethatthosewhoneedtohandlethebodyaremadeawarethatthereisapotentialriskofinfection.Forexample,funeralpersonnel,mortuaryandpost-mortemroomstaffshouldbeinformed.ThisisastatuaryrequirementundertheHSWA.

Thediagnosisshouldbekeptconfidential,butdiscreetuseof‘dangerofinfection’orsimilarlabellingshouldbeused.Youshouldalsoincludeonthelabelanoteofwhichtypeofprecautionsarerequired.

Abodythatisexternallycontaminatedwithblood,orissuspectedtobeinfectedwithabloodbornepathogen,shouldbeplacedinadisposableplasticbodybagassoonaspossible.Youshoulduseabsorbentmaterialifthereisaleakageofbodilyfluids.

Ifyouworkinamortuary,youshouldcommunicateproperlywithyourco-workersandotherstaffwhosubmitbodiesforpost-mortemexaminationorstorage,andwhocollectbodiesfordisposalpurposes.

Ifyouundertakepost-mortemexaminations,youshouldfollowsimilarpersonalprotectionasthoserecommendedbyyouremployerandthelatestguidelines.


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ExposureIncidentAnexposureincidentisdefinedasaspecificmucusmembrane,brokenskinorpuncturewoundwithbloodorOPIMthatresultfromtheperformanceofanemployee’sduties.

Whenthishappens,therelevantformsneedtobecompletedassoonaspossibleaftertheincident,butdonotdelaymedicaltreatment.

UndertherequirementsofRIDDOR,theemployerhasthelegaldutiestoreportcertainincidentsanddangerousoccurrencestotherelevantauthority.Ifanemployeehasbeeninjuredorputatriskfromabloodbornepathogen,itshouldbereported.MoreinformationonreportingRIDDORcanbefoundonthewww.hse.gov.uk/riddor.

Ifyouarecontaminatedwithbloodorotherbodilyfluids,youwillneedtotakethefollowingaction:

• Washoffwithrunningwateranduseanantibacterialsoap• Iftheskinisdamaged,encourageittobleedandthenrinsethewoundunderrunning

water.Donotsuckthewound• Washoffsplashedfluidfromface,eyesandmouthwithwater,butdonotswallowthe

water• Makeanoteofthesourceofthecontamination• Reporttheincidenttoyoursupervisororotherresponsiblepersoninthecompany

Promptmedicalattentionisvital.FollowyourlocalprotocolsorgotoyourdoctororlocalA&Ehospital.


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FoodPoisoningFoodpoisoningiscommonandusuallymild,butsometimesitcanbefatal,especiallyistheelderlyorsick.Symptomsinclude,butarenotlimitedto,stomachcramping/pain,vomiting/nauseaanddiarrhoea,whichcanoccureitherquicklyoraftermanyhoursfromtheinitialconsumption.Itcanjustaffectonepersonoragroupiftheyhaveallbeeninfected.

Themainsymptomsmaypasswithouttreatmentinafewhours,butmedicaladvicemaybeneeded.Dehydrationisamajorproblem,soincreasingfluidsisimportant.

Contaminationcancomeinthreemainways:bacterial–micro-organisms,bacterial,germs;physical–objectsinfood;andchemical–cleaningsubstancesinthefood.

Ifyouarepreparingorservingfood,youmustbefullyawareoftheworkplacepracticesandtakethecorrecttraining.

Somebasicpointswithfoodare:• Alwaysensurethatyourhandsarethoroughlyclean.Usethedesignatedhand-washing

basin.Ensureyourclothesandhairdonotdangleinthefoodorcatchfire• Alwaysensurethatsurfacesandequipmentthatyouaregoingtouseareclean,andyou

haveathanddetergentstoremovefoodparticlesplusdisinfectanttoremovegerms(bacteria)

• Alwaysuseseparatesurfacesandutensilsforrawandcookedfoods.Cleanutensilsasyougoifpossible

• Donottouchthewastebin,yourfaceorhair,orsneezeorcoughwhenpreparingfood.Ifyoudo,washyourhandsagain.Donotblowontofood,asgermswillcross-contaminatefromyourmouth

• Cookfoodthoroughly.Asaminimum,acoretemperatureof70oCfor2minutes• Coverfoodwhenbeingstored.Itpreventscross-contaminationfromrawtocookedfood• Coolfoodasquicklyaspossible,90minutesmaxbeforeputtinginthefridge• Thedangerzoneforrepopulationofgermsis5oCto63oC.Onegermcanbecomeone

hundredmillioninlessthan10hours• Iffoodistobereheated,ensureitisreheatedto82oC• Covercuts,scratchesandspotswithabluewaterproofplaster,andremovejewellery• Donottastefoodwithfingersordirtyutensils.Useaseparatespoonforeachtasting• Chillfoodbelow5oC.Freezefoodbelowminus18oC• Cleanupasyougoalongandleaveeverythingcleanandtidywhenyouhavefinished


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EmployerandEmployeeResponsibilitiesTheEmployerUndertheHealthandSafetyatWork1974andtheManagementofHealthandSafetyatWorkRegulations1999,theemployerhasthelegaldutytoprotectstaffandanyoneelsewhomaybeaffectedbytheactionsofthecompanyoranyofitssites.Theremustbeapolicyandconsultationwithtrainingtoreducetheriskandtocontrolthepossibleinfectionofanyone.Theemployermustmakesurethatallstaffarefamiliarwithallpolicies.

TheEmployeeTheemployeehasalegaldutytotakecareoftheirownhealthandthehealthoftheothersaffectedbytheiractions.Theyshouldalsocooperatewiththeemployersotheycancomplywiththelegaldutiesplacedonthembytheseacts.

PeoplewithBBVshouldbeabletoworknormallyunlesstheybecomeillandthentheyaretreatedthesameasanyotherpersonsickintheworkplace.

ReportingofInjuries,DiseasesandDangerousOccurrencesRegulations1995SometimesreferredtoasRIDDOR95orRIDDORforshort,theseregulationscameintoforceon1stApril1996.

Reportableillnessesanddiseaseinclude:• Outbreakofdiarrhoea• Scabies• Impetigo• Measlesandsickness• Certainpoisoning• Someskindiseases,suchasoccupationaldermatitis,skincancer,chromeulcer,oil

folliculitis/acne• Lungdiseases,includingoccupationalasthma,farmerslung,pneumoconiosis,asbestosis,

mesothelioma• Infections,suchasleptospirosis,anthrax,legionellosisandtetanus• Otherconditions,suchasoccupationalcancer,certainmusculoskeletaldisorders,

decompressionillnessandhand-armvibrationsyndrome


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COSHHRegulationsTheseregulationsapplytoallworkwithsubstanceshazardoustohealth(includingmicro-organisms).Thesubstanceshazardoustohealthwhichageneralpractitionerandhisstaffmightencounterincludenotonlythechemicalagentspresentintheworkplace,butalsodiseaseorganismsbroughtinbypatientstowhichstaffmightbeexposed.

COSHHinformationshouldbeavailablewherechemicalsarestored.

Theregulationsprovideacomprehensivepolicyfortheemployerto‘managerisks’.Theobjectistopreventexposuretohazardoussubstancesifreasonablypracticable.Ifnot,suchexposureshouldbecontrolledadequately.Methodsofcontrolwillvary,buttheuseofpersonalprotectiveequipmentsuchasgloves,gownsandapronsshouldberegardedasalastresort.

Themainfeaturesare:• IdentifysubstanceshazardoustohealthInworkplace• Formallyassess(inwriting)therisktoemployeesfromthesematerials• Controladequatelyandmonitortherisk• Providehealthsurveillancewhereappropriate• Provideadequateinstructionandtraining


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DentalInfectionControlPolicyInfectioncontrolprocedurescanonlybeimplementedsafelyandrealisticallywiththefullcomplianceofeveryoneinthedentalpractice.

Everydentalpracticeisrequiredtohaveadocumentedinfectioncontrolpolicy,whichshouldberoutinelydiscussedandupdated.Itistheresponsibilityoftheindividualpractitionertoensurethatalldentalstaffunderstandandpracticetheprocedures.

Thepoliciesshouldclearlyoutlineeveryaspectofinfectioncontrol,whichshouldbereadilyavailabletoallmembersofstafftoallowthemtorefertoittoensurethattheyarecompetentandconfidentinitsimplementation.

Implementingsafeandrealisticinfectioncontrolproceduresrequiresthefullcomplianceofthewholedentalteam.Theseproceduresshouldberegularlymonitoredduringclinicalsessionsanddiscussedatpracticemeetings.Theindividualpractitionermustensurethatallmembersofthedentalteamunderstandandpracticetheseproceduresroutinely.

Itmaybeappropriatetodisplayaninfectioncontrolstatementinyourpracticetohelpreassurepatientsandgaintheirconfidence.Itisimportanttotaketimetoanswertheirquestions.Ensureallthemembersofyourpracticestaffcananswerpatientqueriescompetentlyorknowwhotoreferthepatienttowhennecessary.

Havingareadilyavailablepolicy,whichdescribestheprocedureforthepractice,isgoodpractice.Itisalsoagoodideatomakesurethateachmemberofstaffisgivenacopyofthepolicyandtheyshouldsignadeclarationconfirmingthattheyhavereceivedacopyandthattraininghasbeenprovidedandthattheyhavereadandunderstoodthepracticeinfectioncontrolpolicy.

DutyofcareAlldentistshaveadutyofcaretotheirpatientsandstafftoensureadequateinfectioncontrolproceduresarefollowed.Itisimportantthatallstaffunderstandtheprinciplesofpersonalprotectionandthatcomplianceispartoftheircontractsofemployment.

Failuretoemployadequatemethodsofcross-infectioncontrolwouldalmostcertainlyrenderadentistliabletoachargeofseriousprofessionalmisconduct.


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CleanTechniqueTattooIndividualsundergoingbodypiercing,tattooing,brandingorscarificationareatriskfrombloodbornepathogens.

Tattooartistsandbodypiercersmustfollowhealthandsafetypracticesandcleantechniquetoprotectthemselvesandtheirclientsfrombloodbornepathogens.

Cleantechniquefortattooandbodyartistsisusedtopreventorreducethetransmissionofmicro-organismsfromonepersontoanother,orfromoneplacetoanother.Youneedtoprotectallitemsfromcontaminationandensurethatsterileitemsremainsterilebymaintainingthecleanlinessofallsuppliesandstoringtheminasanitarymanner.

Usebarriers,likeclean,disposable,single-useglovesandadoptproperhandhygieneatalltimesbefore,duringandafterallprocedures.

Thoroughlycleanandpreparetheskinareawithantibacterialsolutioninaccordancewiththemanufacturer’srecommendationwithanyequipmentused.

Allmaterialsappliedtoskinmustbefromsingle-usearticlesortransferredfrombulkcontainerstosingleusecontainers.Disposeofsingle-usecontainersaftereachperson.

Usedisposable,single-useneedlesandsupplieswheneverpossibleandfollowsafeinjectionpractices.

Maintainacleanandsanitaryenvironmentbyusingdetergenttoremovesoilandadisinfectantagenttocleanupaspillofbloodorotherpotentiallyinfectiousmaterials.

Reusabletoolsandequipmentmustbecleanedandsterilisedcorrectly.Sterilisationmachines,suchasautoclaves,mustberegularlytestedandservicedinaccordancewithmanufacturer’srecommendationsandservicerecordskept.

Disinfectchairsandworksurfacesbetweeneachperson,usingtheappropriatewipesorcleaners.

Needles,scalpels,razorsorothersharpsthathavecontactedskinorbodyfluidsshouldbeseparatedfromotherwasteandplacedinpunctureresistant,closedcontainers(sharpscontainers)immediatelyafteruse.

Sharpsdisposalcontainersmustbekeptinasafeplacethatiseasytoreach,clearlymarked,andchangedwhentheybecomefullanddisposedofcorrectly.


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GlossaryofTerms• Bloodmeanshumanblood,humanbloodcomponentsandproductsmadefromhuman

blood• Bloodbornepathogensmeanspathogenicmicro-organismsthatarepresentinhuman

bloodandcancausediseaseinhumans• Contaminatedmeansthepresenceorthereasonablyanticipatedpresenceofbloodor

otherpotentiallyinfectiousmaterialsonanitemsurface• Contaminatedlaundrymeanslaundrywhichhasbeensoiledwithbloodorother

potentiallyinfectiousmaterialsormaycontainsharps• Contaminatedsharpsmeansanycontaminatedobjectthatcanpenetratetheskin,

including,butnotlimitedto,needles,scalpels,brokenglass• Decontaminationmeanstheuseofphysicalorchemicalmeanstoremove,inactivateor

destroybloodbornepathogensonasurfaceoritemtothepointwheretheyarenolongercapableoftransmittinginfectiousparticlesandthesurfaceoritemisrenderedsafeforhandling,useordisposal

• Engineeringcontrolsmeanscontrols(e.g.sharps,disposalcontainers,self-sheathingneedles,safermedicaldevices,suchassharpswithengineeringsharpsinjuryprotectionsandneedlesssystems)thatisolateorremovethebloodbornepathogenshazardfromtheworkplace

• Exposureincidentmeansaspecificeye,mouth,othermucousmembrane,non-intactskin,orparenteralcontactwithbloodorotherpotentiallyinfectiousmaterialsthatresultfromtheperformanceofanemployee’sduties

• Handwashingfacilitiesmeansafacilityprovidinganadequatesupplyofrunningpotablewater,soapandsingle-usetowelsorhotairdryingmachines

• HBVmeanshepatitisBvirus• HIVmeanshumanimmunodeficiencyvirus• Occupationalexposuremeansreasonablyanticipatedskin,eye,mucousmembraneor

parenteralcontactwithbloodorotherpotentiallyinfectiousmaterialsthatmayresultfromtheperformanceofanemployee’sduties

• Otherpotentiallyinfectiousmaterialsmeansthefollowinghumanbodyfluids:semen,vaginalsecretion,cerebrospinalfluid,synovialfluid,pleuralfluid,pericardialfluid,peritonealfluid,amnioticfluid,salivaindentistprocedures,anybodyfluidthatisvisiblycontaminatedwithbloodandallbodyfluidsinsituationswhereitisdifficultorimpossibletodifferentiatebetweenbodyfluids

• Parenteralmeanspiercingmucousmembranesortheskinbarrierthoughsucheventsasneedlesticks,humanbites,cutsandabrasions

• Sterilisemeanstheuseofaphysicalorchemicalproceduretodestroyallmicrobiallifeincludinghighlyresistantbacterialendospores

• Universalprecautionisanapproachtoinfectioncontrol.AccordingtotheconceptofuniversalprecautionsallhumanbloodandcertainhumanbodyfluidsaretreatedasifknowntobeinfectiousforHIV,HBVandotherbloodbornepathogens

• Workpracticecontrolsmeanscontrolsthatreducethelikelihoodofexposurebyalteringthemannerinwhichthetaskisperformed


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ProTrainingsEuropeLtdFirstFloor,DigbyHouse,RiversideOfficeCentre

CaustonRoad,Colchester,[email protected]

Phone01206805359

SummaryIfyoucompletedouronlinecourse,youwillbeabletodownloadandprintyourcompletioncertificateonlineassoonasyouhavepassedthetest.Ifyoucompletedaclassroomcourse,youwillreceiveaProTrainingswallcertificateandwalletcardlikethebelowimageinthepostafterthecourse.YoucandownloadandprintbothversionsofyourCertifiedCPDcertificatefromyourfreeProTrainingsloginarea.

IfyourequireanyfurtherassistanceorwouldlikeinformationonthisoranyProTrainingscourse,[email protected].

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