1. IS EVERYONE’S BUSINESS!
N F
E C T
I O N C
O N T R O L
IS EVERYONE’S BUSINESS!
Angela Billings
Infection Prevention and Control Practitioner

2. HEALTHCARE ASSOCIATED INFECTIONS
(HCAI) are believed to cost the
NHS at least £1billion annually
and causes at least 5000 deaths”
(National Audit Office 2000, 2004)

3. SO WHY IS IT YOUR CONCERN?
Micro-organisms are HARDY, RESISTANT AND VIRILE creatures. Unfortunately they are not clever enough to know the difference between clinical and non-clinical personnel or between clinical and non clinical areas. As a result they…….
GET EVERYWHERE!!!

4. HOW CAN THE SPREAD OF INFECTION BE PREVENTED?
Soap and water, it’s the future!!!!

5. (The Centre for Disease Control and Prevention (CDC))
HAND HYGIENE
It is estimated that 80% of all infections are spread by hands
(The Centre for Disease Control and Prevention (CDC))
Hand hygiene is proven to be the most effective measure in reducing the spread of infection, e.g. from your hands to your face or to other people
Most important, whatever we do for a patient, directly or indirectly, we use our hands. They’re the only tool we have. etc

6. INDICATIONS FOR HAND-HYGIENE
When hands are visibly dirty, soiled or contaminated, wash with plain or antimicrobial soap and water (with a physical hand-washing with the soap and water for around 20 seconds)
If hands are not visibly soiled, use an alcohol-based hand rub for routinely decontaminating hands
With one exception … C diff or diarrhoea

7. SPECIFIC INDICATIONS FOR HAND-HYGIENE
BEFORE:
Patient contact
Preparing food and beverages
Eating
AFTER:
Cleaning equipment
Using the toilet

8. SELF-REPORTED FACTORS FOR POOR ADHERENCE WITH HAND-HYGIENE
Handwashing agents cause irritation and dryness
Sinks are inconveniently located/lack of sinks
Lack of soap and paper towels
Too busy/insufficient time
Understaffing/overcrowding
Patients needs take priority
Low risk of acquiring infection from patients

9. HAND WASHING DO YOU HAVE ON YOUR PREMISES…..
A designated hand wash basin with easy access?
A handwash basin in each treatment/ clinical area?
Liquid soap and paper towels in wall mounted dispensers?
Free of clutter and inappropriate items?
All hand wash facilities are clean and intact, e.g. splash backs?

10. ALCOHOL HAND RUB - THE BENEFITS
Requires less time than handwashing
More effective for standard handwashing than soap
More accessible than sinks
Reduces bacterial counts on hands, killing 99.5% of transient and residual pathogens initially and 99% at 180 minutes
Improves skin condition
Safe for use with contact lenses
Ensuring that the alcohol hand rub is dry before handling contact lenses.

11. The most common mode of transmission of pathogens is via the hands.
DON’T TAKE IT HOME!
The most common mode of transmission of pathogens is via the hands.
POTENTIAL HAZARDS FOR HARBOURING MICRO-ORGANISMS:
Stoned rings/jewellery
Artificial nails, nail varnish or Nail Art
HCWs not using hand-creams or lotions,
leading to dry and cracked skin
Cuts or broken skin
ALWAYS
Wear plain band ring
No artificial nails, nail polish or nail jewellery
Hydrate hands e.g. with hand cream
Cover cuts/abrasions with a waterproof dressing
Keep nails short

12. THE ENVIRONMENT CONSIDER YOUR WORKPLACE ENVIRONMENT & ASK YOURSELF:
Who is responsible for the cleaning or decontamination of the environment, equipment, etc?
What maintenance programme is in place?
What is it cleaned with? How often?
What if it gets dirty interim? What procedures are in place?
Where is this information recorded?
The cuddly toys, play areas are present, little johnny vomiting. The CQC have been introduced to assess compliance against cleanliness and infection control. It is recognised that Primary care providers are not the same as Acute Trusts and there are no plans to include Optometrists and pharmacists with GPs and Dentists who have to register by April But all providers have to “display adequate systems of IP&C”

13. THE ENVIRONMENT
Clean surfaces with detergent to remove contaminants and dry thoroughly
If a surface has potentially or known infectious material on it, follow the cleaning with a solution containing chlorine 1000 parts per million (p.p.m) or for visible blood stained 10,000 p.p.m
Cracks and exposed areas will harbour bacteria, ensure areas are filled or sealed
Ensure equipment, surfaces, floors, etc are in a good state of repair

14. LEGISLATION The Health and Safety at Work Act (1974)
Control of Substances Hazardous to Health Regulations 2002 (COSHH)
The Health and Social Care Act 2008 (The Hygiene Code)
EU Directives relating to Waste 2006
Consumer Protection Act 1987
CPA 1987 includes the use of defective equipment . The reuse of a single instrument renders the manf. Not liable and the user adopts this liability. Therefore, don’t reuse single use instruments.

15. WASTE MANAGEMENT AND SEGREGATION
Household Waste BLACK
E.g. paper towels, tissues, etc
Offensive Waste TIGER
E.g. disposable tonometer probes
Infectious (hazardous) Waste ORANGE
E.g. a patient with an eye infection with identified risk of infection
Anatomical Waste YELLOW
Cytotoxic/Cytostatic Waste PURPLE e.g. Chloramphenicol
Non hazardous Pharmaceutical Waste YELLOW container
E.g. Minims
Just wish to raise awareness of the differing waste streams which came into force under the EU legislation for Healthcare Waste in 2006.

16. WASTE MANAGEMENT AND SEGREGATION
Each optometrist should:
Review all waste generated to ensure it is segregated and disposed of appropriately
Ensure each work area has the appropriate waste streams and waste bin in place
Ensure that the bag is no more than two thirds full and the neck is fastened securely.
The Trust or the individual can be fined up to £150,000 for incorrect disposal of waste
When there’s only one bin in a room, more often than not it’s a yellow clinical waste bin.
All clinical waste in Rotherham is autoclaved and sent to landfill. Sharps are still transported for incineration.