Learning outcome 1 Understand roles and responsibilities in the prevention and control of infections
1.1 Explain employees’ roles and responsibilities in relation to the prevention and control of infection
It is the responsibility of employees to take safety measures to prevent and control the spread of infection in the workplace; this includes working safely to protect myself, other staff, visitors and individuals from infections. There are legislation and regulations that are associated to the control and prevention of infection. This includes the Health and Safety at Work Act (HASAWA), the Control of Substances Hazardous to Health (COSHH) and the Reporting of Injury, Disease and Dangerous Occurrences Regulations (RIDDOR). It is very important that the employees are knowledgeable of these legislations and regulations, thus can work safely. Every work place has a requirement of information provided in the health and safety file and COSHH file.
As employees we must make sure we attend the essential trainings that our employers offer regarding infection control and prevention. Also to have the competence and confidence to spot abuse or bad practices, to know who to report it to. Employees have a duty to have safe ways of working and put into practice; for example, by effective hand washing, not coming to work ill for the reason that you can put other individuals at risk, not to wear jewellery when cooking or supporting service users in other activities because jewellery can carry immeasurable pathogens are microorganisms – such as bacteria and viruses – that cause disease. Bacteria release toxins, and viruses damage our cells, you must always wear protective clothing.
They need to make certain that their own health and hygiene will not cause a risk to other service users and colleagues, to make certain that effective hand washing is conducted while working with service users, when giving personal care, handling or preparing food.
1.2 Explain employers’ responsibilities in relation to the prevention and control of infection
It is the duty of the employer to uphold a safe setting. Is to uphold and protect the best interests of the people that they support. Employers are in charge of providing PPE, cleaning equipment and materials. They need to sustain equipment and provide appropriate areas for food preparation, washing, toileting and disposing of waste. They have to arrange training for staff. They have to carry out any risk assessment and are in general accountable for the health and safety of staff in the work environment.
The employers have to notify all staff of any infection control policies, procedures and updates which will protection staff and to be up to date with any required information that they can follow safely when work and abide by the law.
Learning outcome 2 Understand legislation and policies relating to prevention and control of infections
2.1 Outline the current legislation and regulatory body standards which are relevant to the prevention and control of infection (Will also cover 5.4)
The Health and safety at work act is like an umbrella and covers several acts and regulations, outline each of the following:
1 Public health act (infectious diseases) 1984, regulations 1988
Under this legislation, doctors in England and Wales have a legal duty to notify the local authority if they are aware that, or have a reason to be suspicious that, a patient is suffering from one of the reportable diseases. The doctor must complete a document stating:
• the name, age and sex of the patient and the address of the location where the patient is;
• the reportable condition from which the patient is, or is supposed to be, suffering;
• the date, or estimated date, of when condition started.
• if the place is a hospital, the day that the patient was admitted, the address of the location from which he/she came there, the condition from which the patient is, or is suspected to be, suffering was contracted in hospital.
2 COSHH 2002
A hazardous substance is defined as a substance labelled harmful, toxic, irritant or corrosive. For example, cleaning chemicals, hazardous micro-organisms such as bacteria and viruses found in hospitals and care homes. A dust of any kind in the substantial concentration, any other substance which may cause harm.
Substances must be kept in good condition, and try to avoid any harbouring infection or stimulating microbial growth. Hazardous substances will need to be store safely to avoid any accidents for example tripping. Will need to have the correct storage for all cleaning products in correspond with COSHH and to will need to avoid chemical hazards like spillages or ingestions.
3 RIDDOR 1995
Reporting of injuries, diseases and dangerous occurrence regulations. These include the following:
• Fatal accidents
• Specified major injuries
• Dangerous occurrences
• 7 consecutive days
• Certain reportable diseases
4 Food safety act 1990
Framework for regulations that govern
• activity of food businesses
• composition and labelling of foods
• chemical safety
• food hygiene
Enforcement is the responsibility of local authority environmental health officers.
5 Environmental protection (duty of care) regulations 1991
This act aims to decrease or eliminate harmful acts of waste crime such as fly tipping. This act promotes householders to work with their local council to prevent fly-tipping and other illegal waste dumping.
The Duty of Care includes an obligation on anyone who produces, imports, carries, keeps, treats or disposes of controlled waste to ensure it is only constantly moved to someone who is authorised to receive it. This is aimed to eliminate the problem of fly tippers posing as authorised waste disposal teams.
6 Health protection agency bill, hazardous waste regulations 2005
The purpose of the Bill is to establish the Health Protection Agency as a UK-wide non-departmental public body. The Agency will be able to undertake both health functions and radiation protection functions (including functions currently carried out by the National Radiological Protection Board which will be wound up). These more integrated arrangements are intended to improve the UK\’s ability to tackle the problems posed by infectious disease and other hazards, including the UK\’s response to chemical, biological, radiological and nuclear (CBRN) terrorism.
Health and Safety at Work Act, 1974 – as an employer there is a duty of care towards his employees, service users and others that visit or work at a care home or in the community care or any care organisation, they have to provide a safe place of work and provide personal protective equipment.
The Management of Health and Safety at Work Act (amended 2006) – it states that all employer have to make a suitable and sufficient
• the risks to the health and safety of all his employees to which they are exposed when at work assessments of:
• the risks to the health and safety of every person that are not in his employment arising in connection with the conduct by him of his responsibility.
The Food Safety (General Food Hygiene) Regulation (Department of Health, 1995)- this is to make sure that safe practices for food so that it can avoid any contamination and spreading of any infections, this will also include handling and storing and disposals of food.
some people are more vulnerable to food poisoning than others. Young children, elderly, pregnant mothers, immuno-comprised people and allergy sufferers. Many of these types of people are found in hospitals or care environment. This is why hygiene is important.
At United Response all staff will receive training on kitchen hygiene, the safe storage and preparation of food together and the basic legal requirements. All staff will know what to do in the event of contamination.
Regulatory body standards are:
7 NICE guideline 2003
The National Institute for Health and Care Excellence (NICE) delivers national guidance, standards, information and advice to improve health and social care. It also guides how to encourage healthy living and prevent ill health.
• to help practitioners deliver the best possible care
• to give people the most effective treatments based on the latest evidence
• to provide value for money
• to reduce inequalities and variation
NICE guidelines also set the standards for infection control, there are standard principles and general advice. Everyone that is involved in providing care should be:
• Educated about the standard principles of infection prevention and control.
• Trained in hand decontamination, use of personal protection equipment and safe use and disposable of sharps.
Whenever care is delivered the healthcare workers should have available appropriate supplies of:
• Materials for hand decontamination.
• Sharps containers.
• Personal protective equipment.
Educate the patients and cares about:
• The benefits of effective hand decontamination.
• The correct techniques and timings of hand decontamination.
• When it is appropriate of using liquid soap and water or hand rubs.
To make sure that there is the availability of hand decontamination facilities.
• The role of maintaining standards of healthcare workers’ hand decontamination.
Skills for Health Infection Control workplace competencies are a good thing because it will help employers to gain the skills and knowledge and understanding that is needed to undertake a particular task or jobs to a recognised level of competence.
The quality standards for health and social care 2006 This quality standard covers the prevention and control of infection for people receiving healthcare in primary, community and secondary care settings. Settings include hospitals, general practices, dental clinics, health centres, care homes, the person’s own home, schools and prisons providing healthcare, and care delivered by the ambulance service and mental health services. A number of factors can increase the risk of acquiring an infection, but high standards of infection prevention and control practice, including providing clean environments, can minimise the risk.
The quality standard is expected to contribute to improvements in the following outcomes:
• infection rates
• avoidable deaths from healthcare-associated infections.
Government and health department standards and guidelines This guidance updates and replaces NICE guideline CG2 (published in June 2003). It suggests evidence-based advice on the prevention and control of infections that are associated in healthcare and community care. These new and updated approvals that address areas that the clinical practices for preventing healthcare-associated infections in the primary and community care that have changed. This guideline was formerly called infection: prevention and control of healthcare-associated infections in primary and community care.
Under the requirements of the National Minimum Care Standards, the workers in any care sectors are required to be properly trained in Infection Control.
Good infection control is key to preventing the spread of MRSA, Clostridium Difficile and other harmful bacteria.
Infection control measures:
• Isolating infected patients where appropriate.
• Effective cleaning and sanitization.
• Effective personal hygiene including hand washing.
• Linen and textile disinfection.
• Barrier protection-masks, glove, aprons and other PPE.
Our objectives should be to break the chain of infection.
2.2 Describe local and organisational policies relevant to the prevention and control of infection
Describe your organisations policies and procedures regarding prevention and control of infection and any local policies you are aware of:
My organisation will have policies and procedures about the use of protective equipment and how you must use them and when, cleaning routines to follow, how to uphold clean environments. This is in relative to different areas and activities such as in bathrooms and toilets where body fluids are present, disposing of hazardous waste, preparing, handling, cooking, serving and clearing food. PPE is vital when working with hazardous activities.
There are regularities and procedures that aid the preventing and controlling of spreading infection. Getting regular information at work and attending training educates everyone’s understanding about infection prevention and control.
Also the public health departments make certain that safety of local communities such as the facility of sewerage systems, clean water, safe waste disposal, the monitoring of pollution and clean air are all taken care of. Environmental health also consists of making sure that food outlets meet the mandatory food safety standards and that they are regularly inspected. Training and information is also available for infection control teams.
Health and Social Care Act 2008 – this is a code of practice on the prevention and control of infections and is related guidance the document that is commonly referred to as the hygiene code. This requires someone to be responsible for infection prevention and control to act as a source of authority to set and monitor practice standards.
Health and Safety policies for United Response is that the staff undertake monthly Health and Safety audits where the cleanliness and hygiene/safety of the service and equipment are inspected. Copies of these will be found in the Health and Safety file.
At United Response all staff receive training on minimising the likelihood of infection and controlling its spreads.
Learning outcome 3 Understand systems and procedures relating to the prevention and control of infections
3.1 Describe procedures and systems relevant to the prevention and control of infection
You may have already met this within the last task
Procedures and systems that are applicable to the prevention of control infection are to follow the establishments’ policies and procedures these are the correct hand washing, wearing the correct PPE for example, gloves, aprons and protective clothing, the right way of disposing of waste and using the right cleaning equipment and accurate way of cleaning spillages, surfaces and equipment.
recording and reporting systems this is important These \’responsible persons\’ must record and report certain incidents, injuries, diseases and dangerous occurrences involving employees, self-employed workers and members of the public.
The information provided through recording and reporting enables the enforcing authorities (either Health and Safety Executive (HSE) or local authority Environmental Health), to identify where and how risks arise, and to investigate serious accidents.
Important of risk assessments The importance of risk assessment in relation to the prevention and control of infection is that, through risk assessment, you will be able to found or to uncover the factors that may cause infection and also the things that will contribute to its factors. Through uncovering the factors of infection through risk assessment, you will be able to prevent and control infection if it appears.
health and safety management The need to comply with Health and Safety regulations is law. They are there to protect your business, employees and you.
Infection control policies and procedures are recommended for any business where body spillages pose a risk to staff, clients or visitors. These include: schools, child day care centres, care homes, hotels, coach and public transport operators. (coach, rail, tram, and aircraft). Any business which sees high levels of the public entering, visiting or waiting will benefit from infection control procedures. The procedures will reduce the threat of cross infection of communicable disease, and reduce staff absences through sickness.
Immunisations of staff may reduce the transmission of influenza to vulnerable residents.
3.2 Explain the potential impact of an outbreak of infection on the individual and the organisation
If one of your service users contracted flu it could make them very poorly can you explain how please:
It may cause further illness, this can also lead to a serious disease and difficulties such as Bronchitis and Pneumonia, and this is more likely in the elderly and those with underlying diseases such as heart disease and respiratory problems. The infection can be more life-threatening than seasonal flu. Flu casualties can be infectious for up to 24 hours before any symptoms show. family members and friends will be upset and angry if not treated properly.
There are other symptoms and someone may suffer from flu will be dehydrated, sweaty, cold, be shivering, the individual will have a fast pulse rate or a chesty cough. This would cause prolonged incapacity and distress to the individuals, family members and friends.
What effect could this have on the rest of the service users, the staff and the home?
This can cause distress, disruption and added workload for staff; increased costs because some members of staff may have caught it and will have to get agency workers in short notice to cover shifts; there will be disruption to routines and the services; they may have to cancel services for the residents; and can damage to reputation of the care home if this is not treated properly.
Learning outcome 4 Understand the importance of risk assessment in relation to the prevention and control of infection
4.1 Define the term risk:
A risk is the likelihood of a hazard causing harm; any action, situation or circumstances which cause the spread of infection. Also may apply to situations with property or equipment loss.
4.2 Outline potential risks of infection within the workplace
1 Poor hygiene habits of vulnerable service users this is a potential risk because they can pass on infection to other residents or staff if they are not being washed or taken care of their hygiene.
2 Reusable, multi-patient use equipment such as commodes, beds, pressure relieving mattresses and blood pressure cuffs, requires sanitization after each episode of use by a patient. This must be commenced in line with local policies in suitable services. This is a risk if it is not decontaminated properly because it will spread germs and infections to others.
3 Poor maintenance if items like mattresses or pillows are infected it can become contaminated. Cleaning the environment is important if not done can transfer infectious materials.
4 Additional risks in areas of food production for example kitchen, there could be a risk of contamination, food poisoning, illnesses if food is not being prepared properly, or the temperature of the food isn’t right.
5 Risks of collection and disposal of hazardous waste, this can be a risk as the staff could be at risk of injury or exposure to blood borne viruses, or infection from PPE or waste not being disposed of properly.
6 Risk of illness to staff especially where involved in high risk activities, they can pass it on to the residents who are more likely to get other illnesses and get worse.
4.3 Describe the process of carrying out a risk assessment
Step 1: identify dangers by visible examination of the workplace, ask employees, observing the manufacturer’s instructions or data sheets, consider records relating to accidents, near misses and ill health.
Step 2: determine who may be harmed and how, consider everyone in the workplace not just the employees.
Step 3: evaluate the risks occurring from the hazards, and decide if the existing precautions are satisfactory, or if there should be more done. If something needs to be done, take steps to remove or control the risks.
Step 4: record any findings and say how they can be controlled to avoid harm. in effect the employees should be informed about the outcome of the risk assessment.
Step 5: review the assessment from time to time and study it if needed for example if work activities change.
4.4 Explain the importance of carrying out a risk assessment
A risk assessment is to protect your workers and your business, as well as fulfilling with law. As for when to do a risk assessment it must basically be performed before you or any other employees conduct some work which exposes a risk of injury or ill-health.
A risk assessment can help tackle dilemma between rights and health and safety concerns as the risk assessment looks after the individuals to have their choices met in the safest possible way.
The importance of a risk assessment is that it is a legal requirement of a health and safety legislation that needs to be carried out and documented in a risk assessment document; this has been proven to be a safe way to control infection if it is applied properly by all staff members. Risk assessment is about identifying the risks and putting things in place to reduce or remove the risks.
Learning outcome 5 Understand the importance of using Personal Protective Equipment (PPE) in the prevention and control of infections
5.2 Describe the different types of PPE and 5.3 explain the reasons for each
Aprons and gloves are commonly used types of PPE.
1. Heavy duty – reusable e.g., Marigolds that are used generally for cleaning the environment and equipment, washing up and handling laundry, dry and hang up ready for next use. This would never be used for patient care.
2. Thin polythene disposable gloves are for food preparation and food handling. This should never be used for patient care, as they can split easily, leak and can slip off hands easily.
3. Single use non sterile vinyl gloves. When a carer or patient has a latex sensitivity. this has contact with spilt body fluids likely they are not as protective as latex with blood contact. They are used mainly for changing pads, wiping bottoms, etc. dressing dirty wounds, leg ulcers, etc. when carer’s skin is damaged.
4. Single use powder free latex gloves. When the hospital staff use their skills is in the use of operation. The procedure is likely to come in contact with blood.
5. Nitrile gloves use is similar to latex gloves. This is when carer or patient are latex sensitive. It is better than vinyl when used in operation. It is important because it has more protection than vinyl for blood contact.
6. Sterile/surgical gloves. Sterile gloves should be used for disease-free and intrusive procedures.
7. Face shields or goggles. This is worn when there is a risk of extensive splashing of blood or other body fluids for example in operating theatre, and if changed between patients and immediately after completion of a procedure or a task.
8. Respirators: this is a dust masks, a ½ face respirators. This is worn to protect the wearer from breathing in any hazardous substances.
9. Protective suits, shields, knee-pads. face shields should wrap around the sides of the face to protect splashes from all angles. Gowns/ aprons are to be worn to protect clothing and/or skin from becoming contaminated, soiled or wet from splashes or contact with blood or body substances, or during cleaning and disinfection
Plastic not reusable aprons should be worn every time there is a possibility of contact with blood/body fluids.
A separate one should be worn for each circumstance of care given to each individual resident.
Change aprons involving in care for different residents, and between different tasks for the same resident, to prevent cross-contamination.
1 white apron is used for personal care
2 blue apron is used for handling food
PPE is used to decrease the risk of pathogens being transferred from the support worker to the individual. PPE forms a physical barrier from infections and protects staff from infection that is carried by others.
5.5 Describe employees’ responsibilities regarding the use of PPE
Employees’ responsibilities on the subject of how to use PPE is to attend training about PPE how to put them on and take them off and the use of PPE properly and dispose of PPE safely. Employees must report straightway if they are out of any PPE and not to use any PPE that is torn or has a fault.
5.6 Describe employers’ responsibilities regarding PPE
Employers’ responsibilities about the use of PPE include providing the accurate PPE in relation to the particular task that is been carried out by the staff members. Have the right fitting of PPE; this must be provided free of charge. Employers need to have preparations in place to make sure PPE is put in storage correctly and is accessible when needed. It is the obligation of the employer to evaluate the need of PPE in the work environment. The employer should train staff and be responsible for information and guidance on how to use PPE.
5.7 Describe the correct practice in the application and removal of PPE
With the reference to the policies and procedures of the organisation and manufacturer’s guidelines we must follow the correct methods of using and removing PPE. But before putting on any PPE you would wash your hands and put some gel on also you would do the same after removing the PPE.
Order of putting PPE on:
Gown or apron
• Fully cover your torso from neck to knees, arms and to end of your wrists, and wrap around the back.
• Fasten at the back of neck and waist.
• Secure the ties or elastic bands at the middle of you head and neck.
Protective eyewear or shield
• Place these over your face and eyes and then adjust to fit.
How to remove PPE
• Outside of gloves will be contaminated!
• Grip the outside of the glove with your opposite gloved hand; and peel off the glove.
• Hold the removed glove in the gloved hand.
• Slide your fingers of ungloves hand under the remaining glove at the wrist.
• Then you will peel the glove off over the first glove.
• Throw away the gloves in waste container.
You must remember that you will need to Carry out hand hygiene.
Protective eyewear and shield
• The outside of the eye protection or face shield is contaminated!
• So to remove these, it should be handle by head band or ear pieces.
• You will place these in the labelled container for recycling or in the waste container.
Gown or apron
• The front of the gown and sleeves or apron are contaminated!
• You must first unfasten the ties.
• You must pull away from the neck and shoulders, but touching the inside of gown only.
• Then you turn gown inside out. Fold it or roll it into a bundle and then dispose of in the correct waste container or bin.
• Front of mask is going to be contaminated — DO NOT TOUCH!
• Grasp the bottom, then the top of the ties or elastics and remove.
• Throw these away in waste container.
You must remember to carry out hand hygiene straightway after removing any PPE.
5.8 Describe the correct procedure for disposal of used PPE
It is essential to know about waste streams in any place of work and follow them. it’s our obligation to separate items and dispose of them in the accurate waste stream. Placing items into the wrong waste streams will put your organisation at risk of breaking the law or pose a risk to waste handlers. All waste streams follow a colour-coded system with different-coloured bags and containers for various kinds of waste. It’s necessary that you get to know this colour-coding system and identify the right containers for the right waste.
Orange: is an infectious waste that is sent for treatment to make it safe prior to disposal. Waste that is contaminated with bodily fluids may pose a possible infection risk. There are Orange bag, orange-lidded boxes and rigid yellow sharps receptacles.
• Protective clothing (for example, gloves or aprons).
Learning outcome 6 Understand the importance of good personal hygiene in the prevention and control of infections
6.1 Describe the key principles of personal hygiene
1 Wash your hands before and after tasks.
2 Bath frequently to stop the spread of infection and body odour.
3 Keep your hair clean and tied back.
4 Wear clean clothing and make certain your uniforms worn and washed often and only wear in the workplace to avoid the spread of infection.
5 Keep your nails trimmed and clean.
6 Not to wear jewellery at work as this can be a way of transferring pathogens.
7 Restriction on how much makeup you wear.
8 Have regular health checks.
9 When you return to work; report any illness that you may have had abroad and vaccinations.
6.3 Describe the correct sequence for hand-washing
1. You must wash hands carefully using warm water and liquid soap.
2. Work up to a leather and make sure you wash your wrists, hands, fingers, thumbs, fingernails and between the fingers.
3. Rinse the soap off your hands and dry them thoroughly and use disposable towels.
6.4 Explain when and where hand washing should be carried out
Hand washing has to be carried out frequently to prevent and control the spread of infection.
1 should be washed before starting work and putting on a clean uniform
2 before and after the use of PPE.
3 before and after particular tasks such as after using the toilet.
4 before and after handling and serving food.
5 after handling waste.
6 before and after supporting individuals with activities.
We wash hands to reduces the risks of cross contamination or infection via microorganisms that are carried on hands and transferred to and from items, individuals or the environment.
6.5 Describe the different types of products that should be used for hand washing
There are different types of products that would be used for hand washing and these comprise of soap, antiseptic gels and alcohol-based hand rubs.
• Liquid soap from a dispenser have to be used for hand washing in public areas as these will have less pathogens whereas bars of soap which are shared between different people will have more pathogens.
• Antiseptic gels contain chemicals that terminate pathogens and these are used in a higher risk of infection area.
• Alcohol-based hand rubs must be used in add-on and not in its place of hand washing with soaps and antiseptic gels and they add an added protective barrier against pathogens.
6.6 Describe correct procedures that relate to skin care
It is essential to take care of our skin as it guards against pathogens; if the skin is not taken care of it could become dry and cracks will develop which can become the course of pathogens. It is therefore significant that hand cream is to help keep your skin moisturised so that it doesn’t get dry. Looking after your hands and keeping good condition of your skin; whereas grazed, chapped, scratched or dry flaking skin has a greater infection risk. Where the surfaces can harbour microorganisms.
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