The NHSScotland National Infection Prevention and Control Manual (NIPCM) was first published on 13 January 2012, by the Chief Nursing Officer (CNO (2012)1), and updated on 17 May 2012 (CNO (2012)1 Update).
The NIPCM provides guidance to all those involved in care provision and should be adopted for infection prevention and control practices and procedures. The national manual is mandatory for NHSScotland. In all other care settings to support with health and social care integration the content of this manual is considered best practice.
The manual aims to:
The NIPCM currently contains guidance on Standard Infection Control Precautions (SICPs), Chapter 1 and Transmission Based Precautions (TBPs), Chapter 2 and Healthcare Infection incidents, outbreaks and data exceedance - Chapter 3. It is planned to further develop the content of the manual.
Responsibilities for the content of this manual
HPS must ensure:
Responsibilities for the adoption and implementation of this manual
Organisations must ensure:
Managers of all services must ensure that staff:
Staff providing care must ensure that they:
Infection Prevention and Control Teams (IPCTs) and Health Protection Teams (HPTs) must:
Standard Infection Control Precautions (SICPs), covered in this chapter are to be used by all staff, in all care settings, at all times, for all patients1 whether infection is known to be present or not to ensure the safety of those being cared for, staff and visitors in the care environment.
SICPs are the basic infection prevention and control measures necessary to reduce the risk of transmission of infectious agent from both recognised and unrecognised sources of infection.
Sources of (potential) infection include blood and other body fluids secretions or excretions (excluding sweat), non-intact skin or mucous membranes and any equipment or items in the care environment that could have become contaminated.
The application of SICPs during care delivery is determined by an assessment of risk to and from individuals and includes the task, level of interaction and/or the anticipated level of exposure to blood and/or other body fluids.
To be effective in protecting against infection risks, SICPs must be used continuously by all staff. SICPs implementation monitoring must also be ongoing to ensure compliance with safe practices and to demonstrate ongoing commitment to patient, staff and visitor safety.
Further information on using SICPs for Care at Home can be found at http://www.nes.scot.nhs.uk/education-and-training/by-theme-initiative/healthcare-associated-infections/training-resources/preventing-infection-in-care-@-home.aspx
1The use of the word 'Persons' can be used instead of 'Patient' when using this document in non-healthcare settings.
Patients must be promptly assessed for infection risk on arrival at the care area (if possible, prior to accepting a patient from another care area) and should be continuously reviewed throughout their stay. This assessment should influence placement decisions in accordance with clinical/care need(s).
Patients who may present a cross-infection risk include those:
For assessment of infection risk see Section 2: Transmission Based Precautions.
Further information can be found in the patient placement literature review.
Hand hygiene is considered an important practice in reducing the transmission of infectious agents which cause HAIs.
Hand washing sinks must not be used for the disposal of other liquids. (See Appendix 3 of Pseudomonas Guidance http://www.hps.scot.nhs.uk/resourcedocument.aspx?id=6073)
Before performing hand hygiene:
To perform hand hygiene:
Alcohol Based Hand Rubs (ABHRs) must be available for staff as near to point of care as possible. Where this is not practical, personal ABHR dispensers should be used.
Perform hand hygiene:
Wash hands with non-antimicrobial liquid soap and water if:
In all other circumstances use ABHRs for routine hand hygiene during care.
(The video above demonstrating Hand Washing and Drying Technique was produced by NHS Ayrshire and Arran)
Hand wipes should not be used by staff in the hospital/care setting for hand hygiene unless there is no running water available. In this circumstance staff may use hand wipes followed by ABHR and should wash their hands at the first available opportunity.
Surgical Hand Antisepsis
Surgical scrubbing/rubbing: (applies to persons undertaking surgical and some invasive procedures)
Perform surgical scrubbing/rubbing before donning sterile theatre garments or at other times e.g. prior to insertion of vascular access devices.
Hand Hygiene posters/leaflets can be found at http://www.washyourhandsofthem.com/home.aspx
Further information can be found in the Hand Hygiene literature reviews:
(The video above demonstrating Surgical Scrubbing using ABHR was produced by Golden Jubilee National Hospital)
Respiratory and cough hygiene is designed to minimise the risk of cross-transmission of respiratory illness (pathogens):
Staff should promote respiratory and cough hygiene helping those (e.g. elderly, children) who need assistance with this e.g. providing patients with tissues, plastic bags for used tissues and hand hygiene facilities as necessary.
Further information can be found in the cough etiquette/respiratory hygiene literature review.
Before undertaking any procedure staff should assess any likely exposure and ensure PPE is worn that provides adequate protection against the risks associated with the procedure or task being undertaken.
All PPE should be:
Reusable PPE items, e.g. non-disposable goggles/face shields/visors must have a decontamination schedule with responsibility assigned.
Gloves must be:
Double gloving is recommended during some Exposure Prone Procedures (EPPs) e.g. orthopaedic and gynaecological operations or when attending major trauma incidents.
For appropriate glove use and selection see Appendix 5.
Further information can be found in the Gloves literature review.
Aprons must be:
Full body gowns/Fluid repellent coveralls must be:
Further information can be found in the Aprons/Gowns literature review.
Eye/face protection (including full face visors) must:
Further information can be found in the eye/face protection literature review.
Fluid Resistant Type IIR surgical face masks must be:
Further information can be found in the surgical face masks literature review.
Footwear must be:
Further information can be found in the footwear literature review
Headwear must be:
For the recommended method of putting on and removing PPE see Appendix 6.
Further information can be found in the headwear literature review
2Scottish National Blood Transfusion Service (SNBTS) adopt practices that differ from those stated in the National Infection Prevention and Control Manual.
Care equipment is easily contaminated with blood, other body fluids, secretions, excretions and infectious agents. Consequently it is easy to transfer infectious agents from communal care equipment during care delivery.
Care equipment is classified as either:
Before using any sterile equipment check that:
Decontamination of reusable non-invasive care equipment must be undertaken:
Adhere to manufacturers’ guidance for use and decontamination of all care equipment.
All reusable non-invasive care equipment must be rinsed and dried following decontamination then stored clean and dry.
Decontamination protocols should include responsibility for; frequency of; and method of environmental decontamination.
An equipment decontamination status certificate will be required if any item of equipment is being sent to a third party e.g for inspection, servicing or repair.
Guidance may be required prior to procuring, trialling or lending any reusable non-invasive equipment.
Further information can be found in the management of care equipment literature review.
For how to decontaminate reusable non-invasive care equipment see Appendix 7
It is the responsibility of the person in charge to ensure that the care environment is safe for practice (this includes environmental cleanliness/maintenance). The person in charge must act if this is deficient.
The care environment must be:
Staff groups should be aware of their environmental cleaning schedules and clear on their specific responsibilities.
Cleaning protocols should include responsibility for; frequency of; and method of environmental decontamination.
Further information can be found in the routine cleaning of the environment in hospital setting literature review
Linen used during patient transfer
For all used linen (previously known as soiled linen):
For all infectious linen (this mainly applies to healthcare linen) i.e. linen that has been used by a patient who is known or suspected to be infectious and/or linen that is contaminated with blood and/or other body fluids e.g. faeces:
Local guidance regarding management of linen may be available.
Further information can be found in the safe management of linen literature review and National Guidance for Safe Management of Linen in NHSScotland Health and Care Environments For laundry services/distribution http://www.hps.scot.nhs.uk/haiic/ic/resourcedetail.aspx?id=1542 .
Further information about linen bagging and tagging can be found in Appendix 8.
Spillages of blood and other body fluids may transmit blood borne viruses.
Spillages must be decontaminated immediately by staff trained to undertake this safely.
Responsibilities for the decontamination of blood and body fluid spillages should be clear within each area/care setting.
For management of blood and body fluid spillages see Appendix 9.
Further information can be found in the management of blood and body fluid in health and social care settings literature review.
Scottish Health Technical Note (SHTN) 3: NHSScotland Waste Management Guidance contains the regulatory waste management guidance for NHSScotland including waste classification, segregation, storage, packaging, transport, treatment and disposal.
The Health and Safety (Sharp Instruments in Healthcare) Regulations 2013 outline the regulatory requirements for employers and contractors in the healthcare sector in relation to the safe disposal of sharps.
Categories of waste:
For care/residential homes waste disposal may differ from the categories described above and guidance from local contractors will apply. Refer to SEPA guidance http://www.sepa.org.uk/waste.aspx.
Safe waste disposal at care area level:
Always dispose of waste:
Liquid waste e.g. blood must be rendered safe by adding a self-setting gel or compound before placing in a healthcare waste bag.
Waste bags must be no more than 3/4 full or more than 4 kgs in weight; and use a ratchet tag/or tape (for healthcare waste bags only) using a ‘swan neck’ to close with the point of origin and date of closure clearly marked on the tape/tag.
Store all waste in a designated, safe, lockable area whilst awaiting uplift. Uplift schedules must be acceptable to the care area and there should be no build-up of waste receptacles.
Sharps boxes must:
Local guidance regarding management of waste at care level may be available.
Further information can be found in the safe disposal of waste literature review.
3Not required for boards with an on-site incinerator facility. This applies only to NHS Borders.
The Health and Safety (Sharp Instruments in Healthcare) Regulations 2013 outline the regulatory requirements for employers and contractors in the healthcare sector in relation to:
Sharps handling must be assessed, kept to a minimum and eliminated if possible with the use of approved safety devices.
Manufacturers’ instructions for safe use and disposal must be followed.
Needles must not be re-sheathed/recapped.4
Always dispose of needles and syringes as 1 unit.
If a safety device is being used safety mechanisms must be deployed before disposal.
A significant occupational exposure is:
There is a potential risk of transmission of a Blood Borne Virus (BBV) from a significant occupational exposure and staff must understand the actions they should take when a significant occupational exposure incident takes place. There is a legal requirement to report all sharps injuries and near misses to line managers/employers.
For the management of an occupational exposure incident see Appendix 10
Further information can be found in the occupational exposure management (including sharps) literature review.
4 A local risk assessment is required if re-sheathing is undertaken using a safe technique for example anaesthetic administration in dentistry.
Standard Infection Control Precautions (SICPs) may be insufficient to prevent cross transmission of specific infectious agents. Therefore additional precautions (TBPs) are required to be used by staff. SICPs must still be applied with these additional considerations.
TBPs should be applied when caring for:
TBPs are categorised by the route of transmission of infectious agents (some infectious agents can be transmitted by more than one route):
Further information on Transmission Based Precautions can be found in the definitions of Transmission Based Precautions literature reviews.
Posters to display on the doors of patients being cared for under contact, droplet or airborne precautions and a TBP aide memoire are available in Resources.
The potential for transmission of infection or infectious agents must be assessed at the patient’s entry to the care area and should be continuously reviewed throughout their stay. The assessment should influence placement decisions in accordance with clinical /care need(s).
Patients who may present a cross-infection risk include those:
These patients should be prioritised for placement in a suitable area to minimise cross transmission pending investigation e.g.
Patients being transferred by ambulance should be transported in accordance with Scottish Ambulance Service (SAS) local guidance.
Isolation within a care home for a known/suspected infection may be necessary to prevent spread. In most cases this can be achieved in the persons’ bedroom.
The clinical judgement and expertise of the staff involved in a patient’s management and the Infection Prevention and Control Team (IPCT) or Health Protection Team (HPT) should be sought particularly for patient placement decisions such as the application of TBPs e.g. isolation prioritisation when single rooms are in short supply.
For patients with a suspected/known infectious agent. Appendix 11 provides details of the route of transmission, optimal patient placement, duration of isolation and type of precautions required.
If multiple patient cases of the same infection are confirmed or if single rooms are unavailable, cohorting of patients may be appropriate. Patients should be separated by at least 3 feet (1m) if cohorted.
Consider assigning a dedicated team of care staff to care for patients in isolation/cohort rooms/areas as an additional infection control measure (staff cohorting). This can only be implemented if there are sufficient levels of staff available (so as not to have a negative impact on non-affected patients’ care).
Duration of isolation/cohort
Patient(s) should remain in isolation/cohort whilst they remain symptomatic and/or are considered infectious and the door must remain closed.
Before discontinuing isolation; individual patient risk factors should be considered (e.g. there may be prolonged shedding of certain microorganisms in immunocompromised patients); and the clinical judgement of those involved in the patient’s management should be sought.
Avoid unnecessary transfer of patients within/between care areas.
All patient placement decisions and assessment of infection risk (including isolation requirements) must be clearly documented in the patient notes.
Further information can be found in the Patient Placement (Isolation and Cohorting) literature review.
For how to decontaminate non-invasive reusable equipment see Appendix 7.
Further information can be found in the management of patient care equipment literature review.
5Scottish Ambulance Service (SAS) and Scottish National Blood Transfusion Service adopt practices that differ from those stated in the National Infection Prevention and Control Manual.
Routine environmental decontamination
Patient isolation/cohort rooms/area must be decontaminated at least daily using either:
Increased frequency of decontamination should be incorporated into the environmental decontamination schedules for areas where there may be higher environmental contamination rates e.g.
Equipment used for environmental decontamination must be either single-use or dedicated to the affected area then decontaminated following use e.g. mop and bucket.
Following patient transfer, discharge, or once the patient is no longer considered infectious:
Remove from the vacated isolation room/cohort area, all:
The room should be decontaminated using either:
The room must be cleaned from the highest to lowest point and from the least to most contaminated point. Manufacturers’ guidance and recommended product "contact time" must be followed for all cleaning/disinfection solutions .
Further information can be found in the environmental decontamination and terminal cleaning literature review.
6Scottish Ambulance Service (SAS) and Scottish National Blood Transfusion Service adopt practices that differ from those stated in the National Infection Prevention and Control Manual.
Where it is not reasonably practicable to prevent exposure to a substance hazardous to health (as may be the case where healthcare workers are caring for patients with suspected or known airborne micro-organisms) the hazard must be adequately controlled by applying protection measures appropriate to the activity and consistent with the assessment of risk. If the hazard is unknown the clinical judgement and expertise of IPC/HPT is crucial and the precautionary principle should apply.
Respiratory Protective Equipment (RPE) i.e. FFP3 and facial protection, must be considered when a patient is admitted with a known/suspected infectious agent/disease spread wholly or partly by the airborne or droplet route and when carrying out aerosol generating procedures (AGPs) on patients with a known/suspected infectious agent spread wholly or partly by the airborne or droplet route.
The decision to wear an FFP3 respirator/hood should be based on clinical risk assessment that includes e.g task being undertaken, the infectious state of the patient, the presenting symptoms, risk of acquisition and the availability of treatment.
For a list of organisms spread wholly or partly by the airborne (aerosol) or droplet routes see Appendix 11.
The following risk categorisation is the minimum requirement for staff groups that require FFP3 fit testing. NHS Boards can add to this for example where high risk units are present. This categorisation is inclusive of out of hours services.
National Minimum Risk Categorisation for fit testing with FFP3
Level 1 – Preparedness for business as usual
Staff in clinical areas most likely to provide care to patients who present at healthcare facilities with an infectious pathogen spread by the airborne route; and/or undertake aerosol generating procedures i.e. A&E, ICU, paediatrics, respiratory, infectious diseases, anaesthesia, theatres, Chest physiotherapists, Special Operations Response Team (Ambulance), A&E Ambulance Staff, Bronchoscopy Staff, Resuscitation teams, Mortuary staff.
Level 2 – Preparedness in the event of emerging threat
Staff in clinical setting likely to provide care to patients admitted to hospital in the event of an emerging threat e.g. Medical receiving, Surgical, Midwifery and Speciality wards, all other ambulance transport staff. In the event of an ‘Epidemic/Pandemic’ Local Board Assessment as per their preparedness plans will apply.
All tight fitting RPE i.e FFP3 respirators must be:
Further information regarding fitting and fit checking of respirators can be found on the Health and Safety Executive website. Powered respirator hoods are an alternative to tight-fitting FFP3 respirators for example when fit testing cannot be achieved.
FFP3 respirator or powered respirator hood:
Powered hoods must be:
Further information can be found in the Respiratory Protective Equipment (RPE) literature review and the Personal Protective Equipment (PPE) for Infectious Diseases of High Consequence (IDHC) literature review.
Frameworks to support the assessing and recording of staff competency in PPE for IDHC are available in the resources section of the NIPCM.
The principles of SICPs and TBPs continue to apply whilst deceased individuals remain in the care environment. This is due to the ongoing risk of infectious transmission via contact although the risk is usually lower than for living patients.
Washing and/or dressing of the deceased should be avoided if the deceased is known or suspected to be harbouring invasive streptococcal infection, viral haemorrhagic fevers or other Group 4 infectious agents.
Details of pathogens can be found in Appendix 12. Key Infections from HSE Guidance “Controlling the risks of infection at work from Human Remains.
Staff should advise relatives of the precautions following viewing and/or physical contact with the deceased and also when this should be avoided.
Deceased individuals known or suspected to be harbouring a Group 4 infectious agent should be removed to a sealed double plastic body bag with absorbent material placed between each bag. The surface of the outer bag should then be disinfected with 1000ppm av.cl before being placed in a robust sealed coffin. This should be identified as a high risk and placed within a cold storage facility by mortuary staff whilst awaiting ongoing transport.
Further information can be found in the infection prevention and control during care of the deceased literature review.
The purpose of this chapter is to support the early recognition of potential infection incidents and to guide IPCT/HPTs in the incident management process within care settings; (that is, NHSScotland, independent contractors providing NHS services and private providers of care).
This guidance is aligned to the Management of Public Health Incidents: Guidance on the Roles and Responsibilities of NHS led Incident Management Teams (2017)
The terms ‘incident’ and ‘Incident Management Team’ (IMT) are used as generic terms to cover both incidents and outbreaks
A healthcare infection incident may be:
An exceptional infection episode
• A single case of any serious illness which has major implications for others (patients, staff and/or visitors), the organisation or wider public health e.g. infectious diseases of high consequence such as VHF or XDR-TB.
See literature review for Infectious Diseases of High Consequence (IDHC)
A healthcare associated infection outbreak
• Two or more linked cases with the same infectious agent associated with the same healthcare setting over a specified time period; or
• A higher than expected number of cases of HAI in a given healthcare area over a specified time period.
A healthcare infection exposure incident
• Exposure of patients, staff, public to a possible infectious agent as a result of a healthcare system failure or a near miss e.g. ventilation, water or decontamination incidents.
A healthcare infection data exceedance
• A greater than expected rate of infection compared with the usual background rate for that healthcare location.
Further information can be found in the literature review Healthcare infection incidents and outbreaks in Scotland.
An early and effective response to an actual or potential healthcare incident, outbreak or data exceedance is crucial. The local Board IPCT and HPT should be aware of and refer to the national minimum list of alert organisms/conditions. See Appendix 13.
The resources section is not mandatory but can be used as a supporting tool for the NIPCM .
Following detection/recognition of an incident a member of IPCT or HPT will:
The IPCT/HPT will establish an IMT if required.
o Generate hypotheses as to which cross-transmission pathways and clinical procedures may be involved.
o Determine whether additional case finding and control measures may be necessary.
o Confirm that all incident control measures are being applied effectively and are sufficient.
The IMT Chair, in discussion with the IMT, should determine whether further reporting on the incident and the incident management is required i.e. SBAR Report and full IMT report template are available in the resources section of the NIPCM website.
The use of the word 'Persons' can be used instead of ‘Patient’ when using this document in non-healthcare settings.
A graze. A minor wound in which the surface of the skin or a mucous membrane has been worn away by rubbing or scraping.
Certain medical and patient care activities that can result in the release of airborne particles (aerosols). AGPs can create a risk of airborne transmission of infections that are usually only spread by droplet transmission.
See Appendix 11, footnote 3 for further information
The spread of infection from one person to another by airborne particles (aerosols) containing infectious agents.
Very small particles that may contain infectious agents. They can remain in the air for long periods of time and can be carried over long distances by air currents. Airborne particles can be released when a person coughs or sneezes, and during aerosol generating procedures (AGPs).
A gel, foam or liquid containing alcohol that is rubbed into the hands as an alternative to washing hands with soap and water.
An organism that is identified as being potentially significant for infection prevention and control practices. Examples of alert organisms include Meticillin Resistant Staphylococcus aureus (MRSA), Clostridium difficile (C.diff) and Group A Streptococcus.
Refers to the alveoli which are the small air sacs in the lungs. Alveoli are located at the ends of the air passageways in the lungs, and are the site at which gas exchange takes place.
An agent that kills microorganisms, or prevents them from growing. Antibiotics and disinfectants are antimicrobial agents.
Hand wipes that are moistened with an antimicrobial solution/agent at a concentration sufficient to inactivate microorganisms and/or temporarily suppress their growth.
A healthcare procedure designed to minimise the risks of exposing the person being cared for to pathogenic micro-organisms during simple (e.g dressing wounds) and complex care procedures (e.g. surgical procedures).
Not showing any symptoms of disease but where an infection may be present.
Machine used for sterilising re-usable equipment using superheated steam under pressure.
Viruses carried or transmitted by blood, for example Hepatitis B, Hepatitis C and HIV.
Fluid produced by the body such as urine, faeces, vomit or diarrhoea.
A group of bacteria that have become extremely resistant to antibiotics including those called carbapenems.
Any place where care is carried out. This includes hospital wards, treatment rooms, care homes and care at home.
Any person who cares for patients, including healthcare support workers and nurses.
A large, centralised facility for the decontamination and re-processing of re-usable medical equipment e.g. surgical instruments.
An intravenous catheter that is inserted directly into a large vein in the neck, chest or groin to allow intravenous drugs and fluids to be given and to allow blood monitoring.
A chemical that is used for disinfecting, fumigating and bleaching.
The removal of any dirt, blood, sickness, etc by use of an appropriate cleaning agent such as detergent.
Any area where a patient is observed or treatment is carried out such as a treatment room or hospital ward.
A sink designated for hand washing in clinical areas.
An infectious agent (bacterium) that can cause mild to severe diarrhoea which in some cases can lead to gastro-intestinal complications and death.
A bay or ward in which two or more patients (cohort) with the same confirmed infection are placed. A cohort area should be physically separate from other patients.
A dedicated team of healthcare staff who care for a cohort of patients, and do not care for any other patients.
Placing a group of two or more patients (a cohort) with the same confirmed infection in the same room or area.
The presence of bacteria on a body surface (such as the skin, mouth, intestines or airway) that does not cause disease in the person or signs of infection.
Mucous membranes that cover the front of the eyes and the inside of the eyelids.
The spread of infectious agents from one person to another by contact. When spread occurs through skin-to-skin contact, this is called direct contact transmission. When spread occurs via a contaminated object, this is called indirect contact transmission.
Dirty, soiled or stained.
Spread of infection from one person to another.
Removing, or killing pathogens on an item or surface to make it safe for handling, re-use or disposal, by cleaning, disinfection and/or sterilisation.
A chemical cleansing agent that can dissolve oils and remove dirt.
3 or more loose or liquid bowel movements in 24 hours or more often than is normal for the individual.
Spread of infectious agents from one person to another by direct skin-to-skin contact.
A chemical used to reduce the number of infectious agents from an object or surface to a level that means they are not harmful to health.
A process, for example using a chemical disinfectant, to reduce the number of infectious agents from an object or surface to a level that means they are not harmful to your health.
Waste produced in the care setting that is similar to waste produced in the home.
A small drop of moisture, larger than airborne particle, that may contain infectious agents. Droplets can be released when a person talks, coughs or sneezes, and during some medical or patient care procedures such as open suctioning and cough induction by chest physiotherapy. It is thought that droplets can travel around 1 metre (3 feet).
The spread of infection from one person to another by droplets containing infectious agents.
An agent used to soothe the skin and make it soft and supple.
A room containing a sink and toilet and sometimes a shower/wetroom or bath.
Waste products produced by the body such as urine and faeces (bowel movements).
The condition of being exposed to something that may have a harmful effect such as an infectious agent.
Certain medical and patient care procedures where there is a risk that injury to the healthcare worker may result in exposure of the patient’s open tissues to the healthcare worker’s blood e.g the healthcare worker’s gloved hands are in contact with sharp instruments, needle tips or sharp tissues inside a patient’s body.
Respiratory protection that is worn over the nose and mouth designed to protect the wearer from inhaling hazardous substances, including airborne particles (aerosols). FFP stands for filtering facepiece. There are three categories of FFP respirator: FFP1, FFP2 and FFP3. An FFP3 respirator or hood provides the highest level of protection, and is the only category of respirator legislated for use in UK healthcare settings.
A method of checking that a tight-fitting facepiece respirator fits the wearer and seals adequately to their face. This process helps identify unsuitable facepieces that should not be used.
A term applied to fabrics that resist liquid penetration, often used interchangeably with 'fluid-repellent' when describing the properties of protective clothing or equipment.
General practitioner (your family doctor)
Definition taken from the HSE Approved list of biological agents www.hse.gov.uk/pubns/misc208.pdf
Group 4 infections cause severe human disease and is a serious hazard to employees; it is likely to spread to the community and there is usually no effective prophylaxis or treatment available.
The process of decontaminating your hands using either alcohol based hand rub or liquid soap and water.
Health Protection Team (HPT) – A team of healthcare professionals whose role it is to protect the health of the local population and limit the risk of them becoming exposed to infection and environmental dangers. Every NHS board has a HPT.
Infections that occur as a result of medical care, or treatment, in any healthcare setting.
Waste produced as a result of healthcare activities for example soiled dressings, sharps.
Waste that is produced from personal care. In care settings this includes feminine hygiene products, incontinence products and nappies, catheter and stoma bags. Hygiene waste may cause offence due to the presence of recognisable healthcare waste items or body fluids. It is usually assumed that hygiene waste is not hazardous or infectious.
A chlorine-based disinfectant such as bleach
To provide immunity to a disease by giving a vaccination.
Any person whose immune response is reduced or deficient, usually because they have a disease or are undergoing treatment. People who are immunocompromised are more vulnerable to infection.
Cannot be penetrated by liquid.
A multidisciplinary group with responsibility for investigating and managing the incident.
The spread of infectious agents from one person to another via a contaminated object.
Invasion of the body by a harmful organism or infectious agent such as a virus, parasite or bacterium.
Any organism, such as a virus, parasite, or bacterium, that is capable of invading body tissues, multiplying, and causing disease
An Infectious Disease of high consequence (IDHC) typically causes severe symptoms requiring a high level of care and a high case-fatality rate, there may not be effective prophylaxis or treatment. IDHC are transmissible from human to human (contagious) and capable of causing large-scale epidemics or pandemics.
A device which penetrates the body, either through a body cavity or through the surface of the body. Central Venous Catheters (central line), Peripheral Arterial Lines and Urinary Catheters are examples of invasive devices.
A medical/healthcare procedure that penetrates or breaks the skin or enters a body cavity.
Physically separating patients to prevent the spread of infection.
An isolation suite comprises a single-bed room, en-suite facilities and a ventilated entry lobby.
Any living thing (organism) that is too small to be seen by the naked eye. Bacteria, viruses and some parasites are microorganisms.
The way that microorganisms spread from one person to another. The main modes or routes of transmission are airborne (aerosol) transmission, droplet transmission and contact transmission.
Strains of the infectious agent (bacterium) Staphylococcus aureus that are resistant to many of the antibiotics commonly used to treat infections.
An incident in which the mucous membranes (e.g mouth, nose, eyes) are exposed to blood/other body fluid
The surfaces lining the cavities of the body that are exposed to the environment such as the lining of the mouth and nose.
Any device designed to reduce the risk of injury from needles. This may include needle-free devices or mechanisms on a needle, such as an automated resheathing device, that cover the needle immediately after use.
A synthetic rubber material used to make non-latex gloves.
Skin that is broken by cuts, abrasions, dermatitis, chapped skin, eczema etc.
An incident in which non-intact skin is exposed to blood or body fluids.
Care procedure that does not need to be undertaken in conditions that are free from bacteria or other microorganisms.
Exposure of healthcare workers or care staff to blood or body fluids in the course of their work.
Any living thing that can grow and reproduce, such as a plant, animal, fungus or bacterium.
When two or more people have the same infection, or more people than expected have the same infection. The cases will be linked by a place and a time period.
Any disease-producing infectious agent.
An injury caused by a sharp instrument or object such as a needle or scalpel, cutting or puncturing the skin.
Equipment a person wears to protect themselves from risks to their health or safety, including exposure to infections e.g. disposable gloves and disposable aprons.
A group that is convened by IPCT/HPT to determine and assess if further action relating to a Healthcare Incident/Outbreak/Data Exceedance is required i.e IMT.
The outcome may be:
Fever. Rise in body temperature above the normal level >37.2°.
To put a needle or other sharp object back into its plastic sheath or cap. Also known as ‘re-sheathing’.
A small droplet, such as a particle of moisture released from the mouth during coughing, sneezing, or speaking.
There are two main types of RPE: respirators and breathing apparatus.
A medical sharps device which has been designed to incorporate a feature or mechanism that minimises and/or prevents the risk of accidental injury. Other terms include (but are not limited to) safety devices, safety-engineered devices and safer needle devices.
Pieces of furniture that are in a bathroom, such as a toilet, bath etc.
Any body fluid that is produced by a cell or gland such as saliva or mucous.
Physically separating or isolating from other people.
A ‘sharp’ is a device or instrument used in healthcare settings such as needles, lancets and scalpels which are necessary for the exercise of specific healthcare activities and are able to cut, prick and/or have the potential to cause injury.
A type of percutaneous injury caused by a sharp instrument or device which cuts or penetrates the skin.
A percutaneous, mucocutaneous exposure or non-intact skin (abrasions, cuts, eczema) exposure to blood/other body fluids from a source that is known (or later found to be) positive for a bloodborne virus infection.
An incident which involves a used needle that has exposed, or may have exposed, the employee to blood/body fluids.
A form that some types of bacteria take under certain environmental conditions. Spores can survive for long periods of time and are very resistant to heat, drying and chemicals.
Free from live bacteria or other microorganisms
Care procedure that is undertaken in conditions that are free from bacteria or other microorganisms.
The procedure of making some object free of all germs, live bacteria or other microorganisms (usually by heat or chemical means).
A disposable fluid-resistant mask worn over the nose and mouth to protect the mucous membranes of the wearer’s nose and mouth from splashes and infectious droplets and also to protect patients. When recommended for infection control purposes a 'surgical face mask' typically denotes a fluid-resistant (Type IIR) surgical mask.
Way of closing bag by tying in a loop and securing with a zip tie to make a handle.
Cleaning/decontamination of an area or room following transfer/discharge of patient or when they are no longer considered infectious to ensure the area safe for the next patient or for the person to go back into their room in a care home setting
Any medical instrument used to access a patient’s veins or arteries such as a Central Venous Catheter or peripheral vascular catheter.