All residents are required to be regularly monitored for infection throughout their stay for the correct IPC precautions to be put in place to minimise the risk of infection being spread. 

Residents may be an infection risk if they have:

• diarrhoea, vomiting, an unexplained rash, fever or respiratory symptoms
• a known (laboratory confirmed) or suspected infectious pathogen for which appropriate duration of precautions, as outlined in A-Z of pathogens are not yet complete
• been previously positive with a Multi-drug-Resistant Organism (MDRO) for example Meticillin-resistant Staphylococcus aureus (MRSA); Carbapenemase Producing Enterobacterales (CPE)*

Further information regarding general respiratory screening questions can be found within the resources section of the NIPCM.

*CPE should be considered if the resident meets any of the following criteria within the 12-month period before admission:

• been an inpatient in a hospital outside of Scotland
• received holiday dialysis outside of Scotland
• been a close contact of a person who has been colonised or infected with CPE.

See the CPE toolkit for non-acute settings for further information and requirements. 

 

Staff should do the following if any resident displays signs and/or symptoms of infection:

• obtain advice on the resident’s clinical management from their GP and advice on appropriate IPC management from either the local HPT or IPCT (dependant on local processes) 
• make resident placement decisions based on advice received or sound judgement by trained clinical staff who are involved in the resident’s management
• if transport to hospital is required, advise the ambulance service of the resident’s infectious condition. Residents should not be moved within the care home if they have signs and symptoms of infection unless essential.

Resident isolation requirements within the care home

Residents may be required to isolate in their own room because of a known or suspected infection. During this time, it is important that: 

• residents remain in their rooms whilst considered infectious and the door should remain closed. If it is not possible for safety reasons, for example, the resident has dementia, an individual risk assessment should be carried out, and any decisions or actions should be documented. The local HPT or IPCT should be contacted for advice
• suitable discrete signage is placed on the resident's room door advising others not to enter the room
• there should be as much consistency in staff allocation as possible to care for residents in isolation room areas as an additional IPC measure. This is known as ‘staff cohorting’
• resident isolation requirements should remain under continuous review considering individual risk factors and the impact on the resident. The local HPT or IPCT (dependant on local processes) should be contacted for advice in these circumstances

Note: If a resident requires isolation because of infection or in an outbreak situation, this should be individually risk assessed to ensure the safety and health and wellbeing needs of the resident. Isolation must be for the minimum period specified and the resident must be monitored daily.

 

For more information read the patient placement, isolation and cohorting literature review.