IPC notes Flashcards
What is a “key part” of equipment?
key part - component of equipment, which if contaminated, increases risk of infection
not contaminating is the single most important factor in achieving asepsis
What are steps of aseptic not-touch technique?
clean hands
clean aseptic surface
gather equipment for procedure
clean hands and put on gloves
identify key parts
perform procedure - ensure only sterile items come into contact with susceptible sites
remove gloves and clean hands
Who is classified as being at higher risk of transferring gastroenteritis?
Individual with doubtful personal hygiene
Children in pre-school
People working with food
Healthcare workers - particularly care home workers
Which GI infections need school/ work exclusion for 48 hours from first formed stool?
Norovirus
Rotavirus
HAV - until 7/7 after onset of symptoms/ jaundice
How long does children need excluded from school from with these rashes?
Chickenpox
Shingles
Rubella
Measles
Mumps
HFM
Cold sores
Roseola infantum
Parvo virus
Chickenpox - all vesicles crusted
Shingles - only if lesions cannot be covered
Rubella - 4/7 from rash onset
Measles - 4/7 from rash onset
Mumps - 5/7 after onset swelling
HFM - no exclusion
Cold sores - no exclusion
Roseola infantum - no exclusion
Parvo virus - no exclusion
What is the definition of an outbreak?
2 or more linked cases of same disease linked in time and place
or number of cases exceeds expected normal number of cases. e,g more than 3 case of diarrhoea on a ward
What are the main aims outbreak control?
Identify primary cases
Source control primary cases, to prevent any further secondary cases
prevent further episodes
Outbreak investigation
How do we confirm there is an outbreak?
very diagnoses - e.g send stool samples
look at surveillance data
Outbreak investigation
What are first steps of outbreak investigation?
Manage cases
isolate
prevent admissions
remove obvious source
Outbreak investigation
You plan to convene outbreak control team
Who is involved?
DIPC
Consultant Microbiologist (may be the DIPC)
ICNs
Lead consultant for the clinical area & affected patients
Ward manager/Senior nurse
If serious – medical director
Chief executive/nominated officer
Senior domestic / cleaning staff member
Administrative and clerical support
If pseudomonas/legionella –
Estates & Facilities manager
HPU specialist
If sensitive/serious/media interest - Communications office
Outbreak control
What steps are taken during case identification?
Develop a case definition - possible, probable, confirmed
Case finding - based on symptoms/ results
Develop hypothesis - common organism/ source e.g environment issue, hand hygiene failure
Outbreak control
What IPC measures can we put in place?
Isolation
Cleaning & disposal of soiled material
Environmental decontamination
–
may
need increased domestic input
Staffing – many need increased nursing/medical staff
Controlling admissions / transfers / visitors –
need to close beds/units
Other specific infection control measures directed at cause
Communication –
Signage, staff, rest of
hosp, patients, visitors, press
Outbreak control
Outbreak is beginning to end
What ongoing management is required?
daily assessment of cases
surveillance with new cases
checking control measures still in place
generating a report - includes information about changes to training/ equipment/ staff to ensure doesn’t occur again
after outbreak over, back to routine surveillance
