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

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)

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!!!

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

(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

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

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

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

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?

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.

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

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 2011. But all providers have to “display adequate systems of IP&C”

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

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.

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.

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.