• Persons who are or have been ill
• Persons who have or have had a mental disorder
• Persons who are disabled or infirm
• persons who are or have been dependent on alcohol or drugs.’
http://www.opsi.gov.uk/acts/acts2000/ukpga_20000014_en_2#pt1-pb1-l1g3
Each worker within the residential home has their own roles and responsibilities which they are required to follow when providing care for residents. The care home has a written policy which outlines these roles and responsibilities for each care worker. All staff within the residential care home should be aware of their role in infection control. Any procedures which may need to be carried out in order to prevent infection spreading, for instance; isolation of a resident; must comply relevant health and safety legislations and also most importantly the individuals needs must be taken into consideration at all times.
It is also important that staff within the care home are aware of The National Minimum Standards which apply to all care homes which provide accommodation and nursing or personal care for older people. Staff must be able to identify any possible outbreaks of infection within the home so that early diagnoses can be made and appropriate procedures can be put into place for the resident.
‘Symptoms in two or more patients which may indicate a possible outbreak are:
• cough and/or fever (e.g. influenza)
• diarrhoea and/or vomiting (e.g. Clostridium difficile/norovirus/food poisoning)
• itchy skin lesion/rash (e.g. scabies).’ http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4136384.pdf
In this instance, the member of staff who is in charge of the infection control within the residential home will make a decision as to how they will go about controlling the infection. This may mean the resident/s that have the infection being isolated from those that do not have the infection so it is not spread to other residents in the home. If the resident was suffering from a diahorrea and sickness virus they may be provided with a separate room with their own bathroom facilities which is cleaned thoroughly compared to the other bathrooms within the care home. As I have previously mentioned, due to the large number of residents in the care home infectious diseases have the potential to spread and as a result cause an outbreak. The most common ways in which outbreaks are caused in a health care setting like a residential home are through the air, for instance coughing and sneezing and also by food and water which is contaminated if the correct washing procedures are not followed.
Staff training is essential in the control of infection within a care home. Staff will have ongoing training whilst they work there as the training needs to be reinforced as it is very important. Training records will be kept so the manager of the care home is able to ensure that workers are up to date with their training. Inadequate staff training is another reason why the risk of infection increases.
Hand hygiene is one of the most important procedures in reducing the spread of infection in a health or social care setting. However, due to this procedure not been promoted enough and enforced, many health care workers do not wash their hands when providing care for their clients. It is compulsory that hand washing is performed before a care worker comes into direct contact with a client and also after any contact which could result in their hands becoming contaminated. For example, if a residential service user was sick unexpectedly and the care worker had their bodily fluids on their hands, they should wash them immediately as this is how infections can spread. Every member of staff should be trained in performing hand hygiene correctly using liquid soap and water and also an alcohol hand wash to eliminate any bacteria on the hands. To enable carers to perform hand hygiene correctly necessary facilities are required such as; a hand wash basin with both hot and cold water and also disposable paper towels. If any of these facilities are not available it may cause cross contamination of infections throughout the residential care home.
Personal Protective Equipment, referred to as PPE must be taken in consideration in every health and social care setting including a residential home. Personal Protective clothing may include; aprons, masks, visors, gloves, shoe covers etc. If PPE is not taken into account this could cause potential of contamination as a result of the carers clothing or skin coming in contact with the resident’s bodily fluids or excretions for example. Disposable gloves are required to protect the care worker and also the resident from risks of cross infection. Gloves are required when a carer is making contact with blood or body fluids of a service user. They should be used once and then disposed of, they cannot be reused as this is unsafe and could cause cross infection. If a carer was unable to wear natural rubber latex gloves due to sensitivity or an allergic reaction, then this should be taken into account and alternatives should be provided, e.g. nitrile gloves. In some situations a carer may be required to wear a mask or visor, for instance; if a carer was changing a service users bandage then they may be required to wear a visor to ensure their bodily fluids did not make contact with them. A disposable plastic apron should also be worn by carers providing direct patient care for service users for instance; bed-making, changing or bathing a service user or when decontaminating equipment. The apron should also be worn once and disposed of after it has been worn once. Aprons must be kept so that they do not build up dust particles or anything else which may be a source of infection. Uniform is also a form of PPE and is required when caring for service users within a residential home. A carer’s uniform should only be worn when they are in the care home and should be left at the workplace to enable it to be washed at the correct temperature. If uniform is worn outside then this may cause potential for cross contamination.
The safe handling and disposal of sharps is essential in every health and social care setting. Needles and similar medical supplies, such as syringes and lancets, are referred to as sharps. It is mandatory that staff are trained in this and that they follow the correct procedures for disposal. Staff that are trained should only be allowed to carry out treatments such as providing immunisations for service users like venepuncture and should be trained how to do this competently and they should know how to dispose of the needles correctly to ensure there is no potential for cross infection. If a needle is not disposed of correctly a carer or another patient may pick up the needle and come in contact with another service users bodily fluids, e.g. blood. A special rigid box with a lid is designed specifically for the disposal of used needles and other sharps.
General cleanliness is essential within a health and social care setting like a residential home to prevent infections been spread. If a residential home is kept clean at all times this will show the quality of care which is been provided for service users. If a residential home’s cleanliness does not meet the requirements then this may cause concern about the quality of care which is been provided for service users. To ensure that general cleanliness is maintained within the home a plan should be produced to ensure that each care worker has a responsibility within the home. E.g. cleaning the bathrooms etc. If contractors clean the nursing home then this does not mean that care workers do not have responsibilities to carry out domestic work. It is the manager’s responsibility to ensure that the contractors are cleaning to the correct standard.
Waste should be disposed following the correct method and have specific bins or bags of which they are disposed in. For instance, a yellow bag contains waste which must be incinerated as it may contain cytotoxic and cytostatic medications, body parts, etc.
An orange bag contains waste which requires going for treatment to an alternative technology plant. A black bag contains normal waste such as household waste or commercial waste. A sharps container is used when disposing needles, syringes, lancets etc and should only be filled three quarters full to prevent harm to an individual. Also, cardboard boxed should be used when disposing glasses which could be broken. It should be clearly stated on the box that it is fragile and all contents should be placed in a heavy duty plastic bag. The choice of decontamination method depends on the risk of infection to the patient who comes into contact with equipment. Such items can be categorised into three risk groups, these are;
• High risk – these include items which are used to penetrate skin or mucous membrane; or enter the vascular system or sterile spaces. They need to be sterilised if they are going to be reused.
• Medium risk – these are items which come into contact with intact mucous membranes or may be contaminated with particularly dangerous or readily transmittable organisms. Such items require cleaning followed by disinfection or sterilisation.
• Low risk – these are which come into contact with intact skin or do not contact
the patient directly. These items require cleaning.
Overall within this assignment I have looked closely at the standard precautions for the prevention and control of infection in a residential home. In order for infection not to be spread within a health and social care setting it is essential that care workers understand their roles and responsibilities.
Laura Wingfield Group B
Infection Control
