The core knowledge outcomes that you must understand and learn:

A10.1

the techniques for infection control and why they are important in stopping the spread of infection

A10.2

the importance of good handwashing techniques and personal hygiene and how to practise this in relation to infection control

A10.3

the scientific principles of cleaning, disinfecting, sterilisation and decontamination

A10.4

the differences in procedures for cleaning, disinfecting and sterilisation

A10.5

the meaning of impact of antimicrobial resistance, including how this can potentially impact infection control and the ways in which to reduce microbial resistance.

Checking plaster cast

2) dressing change

IV antibiotics

Central line bloods

Catheter insertion

3) blood test

Catheter bag drainage

4) taking temperature

5) Making the bed

Taking away dirty linen

1. Bharti's partner is in hospital after heart surgery. Bharti goes to visit him every day. Today Bharti has had diarrhoea and vomiting. She now feels a little better and thinks she may be able to visit her partner this evening.

Explain to Bharti why this is not a good idea.

2. Patsy has responsibility for a ward in a large hospital. She has three new student healthcare workers starting next week. Explain three ways in which Patsy could encourage them to take care of their personal hygiene while on the ward.

3. Explain how the following legislation could be effective in infection control :-

a. Health and Safety at Work Act 1974

b. Control of Substances Hazardous to Health (COSHH) Regulations 2002

c. Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR).

4. Vinnie goes to his GP as he has a sore throat. His GP is reluctant to prescribe antibiotics for Vinnie as he has had two lots of antibiotics in recent months. Referring to advice from NICE/PHE, explain why his GP is concerned.

5. Explain the role that handwashing plays in infection control.

6. Name two super bugs that could be caught in hospital.

Use of PPE

Use of cleaning and disinfecting agents

Good personal hygiene and uniform requirements

Safe disposal of waste and sharps

*increased risk of injury

*spread of infection

Invalid results -

*contamination

*cross contamination

*Cleaning reduces the presence of microorganisms on surfaces and instruments by removing visible foreign matter.

*This minimises the risk of the transfer of microorganisms.

*The environment (eg. door handles, toilet flush handles, taps) plays an important role in cross infection during outbreaks.

*Special attention must be paid to these fittings and anywhere that people have contact with, particularly during outbreaks of infectious diseases such as norovirus.

*Accumulations of dust, dirt and liquid residues will increase infection risks and must be kept to a minimum by regular cleaning.

*Good design features and environmental lay out such as numerous, convenient handwashing sinks with automatic soap dispensers aid good hygiene and cleaning practices.

*A written cleaning schedule should be devised for each area, based on COSHH, to include the regular removal of dust by damp dusting both high and low horizontal surfaces.

*All health and social care settings should have a decontamination policy and cleaning schedule stating how and when to clean the different areas of the

environment,

fixtures, fittings and

specialist equipment (for example, a hoist);

what products and equipment to use when cleaning;

what to do and what product use when here is a spillage of blood or body fluids;

what training is needed for staff to implement the policy;

and a description of individual responsibilities for cleaning.

*Some items are too fragile for sterilisation as the temperature is too high for them to withstand.

*To sterilise means to kill all microbes and their spores - whether harmful or not - present on a surface or object, and therefore is more effective than disinfection.

*This can be done by using steam in machines called autoclaves which use steam heated to 121-134°C.

*Extreme care must be taken when using these machines as steam can scald the skin.

*Another method is to use direct heat, which can include incineration, boiling in water and dry heat, which inactivates and kills microorganisms in objects such as glass and metals.

*Items that can get damaged by heat are subjected to chemical sterilisation, e.g. biological materials, fibre optics, electronics and plastics.

*Irradiation, high pressure and filtration are other agents used in the sterilising process.

*Irradiation can be used for aseptic work areas and for sterilising surgical equipment.

*High-pressure sterilisation would be used to sterilise contaminated instruments.

*Filtration can be used to sterilise fluids such as drugs solutions which would be damaged by heat, irradiation or chemical sterilisation.

Body temperature water will remove large numbers of microorganisms from a surface, especially if the article can be rinsed.

Microorganisms reduce further as the surface dries.

Devices cannot be effectively disinfected or sterilised without having first been thoroughly cleaned and dried.

*Disinfectant is used to reduce the number of microorganisms on surfaces to a level that is considered safe.

*It may not necessarily destroy some viruses or bacterial spores.

*Disinfection is usually acceptable for items that pose a medium risk of infection if these devices cannot be effectively sterilised.

*Chemical disinfection is not as effective as heat disinfection.

*Heat disinfectants such as dishwashers, washing machines and washer-disinfectors clean the item and then expose the items to hot water for the required time to achieve thermal disinfection.

*Most chemical disinfectants are capable of inactivating bacteria and certain types of viruses (those which have an outer layer), but many are not so effective against some viruses, for example, the hepatitis viruses, cysts and bacterial spores.

*Decontamination is a process, or combination of processes such as cleaning, disinfecting and sterilising that removes or destroys contaminants so that infectious agents cannot cause infection.

*As soon as a piece of equipment is contaminated with urine, blood, vomit, etc., it should be removed from service immediately.

*It must be decontaminated as soon as possible but best practice is to do it immediately, away from busy areas in the healthcare setting.

*Decontamination is essential to lower the number of cross infections between people and to prevent Health Care Aquired Infections (HCAIs).

*It was adopted by hospitals in Britain, followed by the WHO in 2009.

*The 12-point technique is the NHS version based on the Ayliffe model of cleaning the hands thoroughly.

*The 5 moments defines the key moments when healthcare professionals should wash/clean their hands.

*To facilitate effective hand hygiene, healthcare workers should:

cover cuts with waterproof dressings to prevent harmful bacteria that may be present in the cut from being transferred to surfaces, patients or food.

keep their arms bare below the elbow, i.e. wear short sleeves or sleeves rolled up to elbows.

remove wrist or hand jewellery (for example, a watch or decorative rings with/without stones).

NB: slim plain rings such as wedding rings may still be worn as they have no crevices to allow an accumulation of bacteria.

keep nails short and clean, as long nails allow build-up of dirt and bacteria.

not wear nail polish and avoid acrylic/artificial nails which can harbour microorganisms.