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You will have seen on the news that the UK is currently experiencing a measles outbreak. Our neighbours in the West Midlands currently have 75% of the measles cases identified in England. Within the past week Derbyshire Community Health Service have identified 2 potential measles cases in patients who have accessed our services. Measles is not just a rash, the virus can have serious health consequences. It is important that all colleagues across DCHS are aware of the signs & symptoms of measles, what to do if you suspect you or a family member has measles or you have been in contact with someone who is suspected/confirmed measles and how to manage any potential measles cases within our services. If you have any query, concerns or require any further information or advice, please do not hesitate to contact the IP&C Team. E: DCHST.infectioncontrol@nhs.net or T: 01246515870.

Changes in IP&C COVID Guidance (5 October 2023) - Click here for more information

Read more about this alert

Welcome

Our IP&C team has responsibility for advice information and support for staff, patients and vistors regarding our infection prevention and control policies and procedures.

IP&C Campaigns, Meetings & Events

Notifying cases of infectious disease has become easier thanks to a new online service launched by UKHSA.

Registered Medical Practitioners have a legal duty to notify any suspected or confirmed cases of any diseases included on the notifiable list. This information goes to UKHSA to make sure that the right public health action is taken quickly to protect patients, their families, and the wider community.

Until now, notification has been through a paper, telephone, and email-based system. However, on Thursday 12, UKHSA launched ‘Report a Notifiable Disease’ – a new online service which will mean notifications can be made quickly and easily via gov.uk.

On this new page, they will be able to access a simple form which will take them quickly and easily through all the information which needs to be entered for a case, and this will be sent directly to UKHSA.

Urgent cases will still need to be called through to UKHSA, particularly out of hours to ensure prompt response. A paper form is also available to download on the gov.uk page for any colleagues who are unable to access the new online service. Further information about the process and training videos can be found on the web page.

This is an evolving situation so please regularly check back here for updates.

What are we trying to accomplish?

1. Reduce procurement and waste costs.

Cost of couch roll throughout DCHS:

  • 22/23 - £18,163.57
  • 23/24 - £22,093.08

2. Reduce waste, conserve resources and landfill space, save energy and reduce emissions.

  • In 2022-2023 DCHS used 403.45 miles of couch roll. This is the equivalent of traveling from DCHS headquarters at Ash Green Learning Disability Centre to Londonderry via the Giant’s Causeway.
  • In 2023-2024 DCHS used 562 miles of couch roll. This is the equivalent of traveling from DCHS headquarters at Ash Green Learning Disability Centre to Malroy, France via Brussels and Luxemburg.

The IP&C team need our colleagues’ support to reduce the amount of couch roll we are using across the Trust. Couches should be cleaned between patients, regardless of whether they are covered or not. Couch covers don’t remove potential pathogens, they just cover them up.

What changes do we want to make?

To remove couch roll from examination couches where:

  • Patients are not having invasive procedures (i.e. gynaecological examinations)
  • Patients are not suspected or known to have an infection,
  • There is no risk of contamination with blood or bodily fluids
  • Patients do not need to be unclothed from the waist down.

To reduce the amount of couch roll used:

  • Where a patient is unclothed from the waist down - only cover the area of the couch where there is potential for contamination
  • For invasive procedures (i.e. gynaecological examinations), only cover the area of the couch where this is potential for contamination
  • Where patients are not suspected or known to have an infection, only cover the area of the couch where this is potential for contamination
  • Where there is no risk of contamination with blood or bodily fluids, only cover the area of the couch where this is potential for contamination.

What will we achieve by reducing the amount of couch roll used within the trust?

  • Projected cost savings - £12,218.67 per year
  • Projected reduction in waste – 380 miles less couch roll used per year.

The link below will take you to the risk assessment which will support you in making the decision to roll to not to roll.

Link to our Risk Assessment Flow Chart for the use of blue roll

Please help the Trust to reduce the amount of waste we send to landfill.

Please be aware we are seeing a rise in cases of Parvovirus which is a common and highly contagious childhood illness sometimes called slapped-cheek disease because of the distinctive rash that develops. Please be aware that it does present a risk to pregnant women, for more information please read the attached information sheet. Please contact the IP&C team for any support or guidance.

You can read more here.

Please be aware that the Hajj is taking place in the Kingdom of Saudi Arabia (KSA) from 14 June to 19 June 2024. This is the annual Islamic pilgrimage to Mecca and many pilgrims from around the world are expected to travel there including from the UK. Umrah pilgrimage also takes place to KSA throughout the year. Clinicians are reminded that travellers to the Hajj are exposed both to infections endemic to KSA, and infections associated with mass gatherings. Pilgrims returning from the Hajj may have respiratory symptoms after their visit. Some may therefore meet the case definitions for MERS. Please see the attached for further information. Please contact the IP&C team for any support or guidance.

You can read more here.

Below is linked a webinar created for health professionals responding to the rise in Pertussis (Whooping cough).

Click here for more information.

The overuse of gloves;

  • Reduces the opportunity to clean our hands.
  • Increases environmental contamination
  • Increases our environmental impact through the production and the disposal of gloves
  • Increases the risk of skin conditions, such as occupational dermatitis. 

Glove Awareness Week 2022 - Stop. Think. Make one change

The Life Cycle of Gloves

Click here to read more on our new Covid-related absence policies.

The Infection Prevention & Control Team are excited to announce that we are holding  several IP&C Face to Face sessions around the county in 2024-2025. We enjoyed engaging with our colleagues at our IP&C Face to Face sessions last year and would like to welcome all of our colleagues from across DCHS,  alongside our IP&C champions to join us again this year. Colleagues are not required to book in advance and will be provided with a certificate of attendance following the session. Please see location, dates and times below.

Date

Location

Wednesday 11th December 2024 (09:00hrs - 12:00hrs)

Repton Health Centre Meeting Room

Wednesday 11th December 2024 (09:30hrs - 12:30hrs)

Wednesday 22nd January 2025 (09:30hrs - 12:30hrs and 13:00hrs-16:00hrs)

Walton Hospital Committee Room

Wednesday 22nd January 2025 (09:30hrs - 12:30hrs)

Tuesday 18th February 2025 (09:30hrs - 12:30hrs)

St. Oswald’s Hospital

Small meeting room

Policies, guidance documents and information leaflets

Poster Name Link
DCHS Management of In-Patients with Diarrhoea or suspected Clostridioides Difficile (Cdiff) Link
Dry hands Link
Management of blood and body fluid spillages Link
Myth Busters - Hand hygiene Link
Myth Busters - Personal Protective Equipment (PPE) Link
Myth Busters - Standard precautions for infection control Link
Myth Busters - Uniform poster Link
Patient under barrier precautions poster Link
Sore red hands Link
Top tips for hand hygiene Link

 

Information for champions and students

Infection Prevention and Control Quality and Safe Care Champions (QSCC)

IP & C Quality & Safe Care Champions (QSCCs) are nominated members of staff who receive support to ‘embed’ best practice in relation to infection prevention and control within their clinical areas and support improvements to patient care within the Quality Always Clinical Assessment and Accreditation Scheme (CAAS) standards. The champions utilise the World Health Organisation's 5 moments of hand hygiene as the framework for the programme. Hand hygiene, including audit of practice, is a key focus for the champions.

Staff interested in becoming champions must read the agreement form with their manager. A QSCC nomination form must then be completed and submitted to Quality Always.

Please see Quality Always intranet page on MY DCHS for information on:

  • QSCC Role Overview
  • QSCC Agreement
  • QSCC Nomination Form
  • Support Sessions Timetable for Year
  • QSCC Register

IP & C Self-assessment Tool for Quality & Safe Care Champions

  • Inpatient Wards
  • Community
  • Out Patients/Planned Care

PPE – Gloves, aprons & masks

Question Answer

Do I need to wear gloves for venepuncture (taking blood)?

Yes, Royal Marsden Manual recommends wearing well‐fitting gloves during venepuncture and cannulation to prevent contamination from potential blood spills.
Do I need to wear gloves for giving injections? No, World Health Organisation guidance - gloves should not be worn for routine intradermal, subcutaneous, or intramuscular injections providing your skin is intact.

Do I need to change my gloves & apron between wounds or tasks on the same patient?

Yes, you need to change your gloves, but you do not need to change your apron unless it is contaminated or damaged.
Do I need to wear a sterile apron for wound care? No, as the apron should not come into contact with key parts.

When do I need to wear a visor/face protection?

 Where there is a risk of splashing to the face/eyes with blood or body fluids and for patients on the respiratory pathway or patients with Monkey Pox or Chicken Pox.
When do I need to wear and FFP3 mask? You only need to wear an FFP3 mask when carrying out an Aerosol Generating Procedure (AGP) on patients on the respiratory pathway and when caring for patients with Monkey Pox or Chicken Pox.
When do I need to wear a long-sleeved coverall/gown?

You only need to wear a long-sleeved gown/coverall when carrying out an Aerosol Generating Procedure (AGP) on patients on the respiratory pathway and when caring for patients with Monkey Pox or Chicken Pox.
Patient Care
Question Answer
Can I use Clinell Universal Wipes on patient’s skin?

No, Although Clinell Universal wipes are dermatologically tested and are “skin kind” they are designed to be used for cleaning surfaces and equipment. Other more suitable skin cleansing wipes are available from Clinell.

Do I need to clean patient’s skin prior to venepuncture?

Yes, in line with the Royal Marsden Manual of Clinical Nursing Procedures - Chapter 10.1 "Clean the patient's skin carefully for 30 seconds using an appropriate preparation, such as skin cleansing wipes containing “Chlorhexidine 2% and alcohol 70%”, and allow to dry. Do not re-palpate or touch the skin” “This is to maintain asepsis, minimize the risk of infection and to prevent pain on insertion.”

A link to suitable products available on NHS Supply Chain can be found here. For further information contact E: DCHST.infectioncontrol@nhs.net.

Cleaning equipment and the environment

Question Answer
Can I use Clinell Universal Wipes for cleaning surfaces/ equipment between patients?

Yes, as long as surfaces are not visibly dirty, contaminated with blood or body fluids or the patient has a known or suspected infection.

Do I need to wear gloves when using Clinell (green) universal wipes?

 Yes, the manufacturers of Clinell recommend wearing gloves when using the wipes as the products used in their manufacture may over time lead to irritation, allergies and skin conditions.
When do I need to use chlorine base solutions e.g. Actichlor? You need to use chlorine based solutions as part of the “5 step cleaning process” if equipment or surfaces are visibly dirty, contaminated with blood or body fluids and for patients with gastrointestinal infections such as Norovirus or C. Diff.

How often do fabric and disposable curtains need to be changed in DCHS?

 Every 3 months, curtains should be dated when the next curtain change is due.

Do the Laerdal pocket masks in rigid plastic containers have an expiry date?

Yes, the expiry date is recognised to be 5 years after manufacture.  

However masks should be checked regularly and if they look old, worn and out of date then they should be replaced.

Can portable be fans be used in clinical and non-clinical areas?

 Yes, portable fans may be used in both clinical and non-clinical areas but must not be allowed to blow air directly onto areas where clinical procedures such as wound care are taking place. They must also be on regular cleaning schedules and have a cage surrounding the blades that can be unclipped for cleaning.
Can portable air conditioning units be used in any areas of DCHS?

No, due to the risk from Legionella and issues around maintenance DCHS do not support the use of portable air conditioning units. Contact Estates for further information - dchst.estateshelpdesk@nhs.net.

Sharps and sharps containers

Question Answer

How long may sharps containers be used for once started?

Once opened sharps containers may only be used for 3 months. This does not apply to sharps containers on the resus trolley, these should be closed, disposed of and replaced once used.

Hand hygiene, Uniform & Bare Below the Elbows

Question Answer

Can I wash my hands with cold water?

 Yes, although it is preferable to use warm water, if this is not available then cold water may be used. It is the use of liquid hand soap and the mechanical action of hand washing that loosens dirt and microorganisms and allows them to be removed.
When can I use alcohol hand gel? When hands are not visibly contaminated or when patient has a known or suspected infection, including diarrhoeal infection.
When do I need to wash my hands with soap and water?

When hands are visibly soiled, when caring for patients with a known or suspected infection, when there is an obvious build-up of alcohol hand gel on hands, when caring for patients with diarrhoea and/or vomiting.

What can I do if I have dry or sore red hands?

 See DCHS leaflets on “dry hands” and “sore red hands” and if necessary contact Occupational Health dchst.occupationalhealth@nhs.net for advice and support.

Do I need to wash my uniform separate from other laundry and at 60 degrees?

Yes, extensive literature searches and research has concluded that washing uniforms at 60 degrees is the safest option as it removes all microorganisms, including Clostridioides difficile (C. diff) to as safe level.

What jewellery can I wear as part of DCHS Uniform and Dress Code Policy?

 You may wear one plain, smooth wedding band and one pair of plain stud earrings.
Can I wear a bangle e.g. Kara for religious reasons?

Yes, in agreement with your line manager, however you must remove it or ensure it is secured up your arm to enable effective hand hygiene to take place.

Can I wear an SOS medic alert bracelet?

 Yes, in agreement with your line manager, however you must remove it or ensure it is secured up your arm to enable effective hand hygiene to take place.

I work in the community can I use patient’s own fabric towels or kitchen roll for drying my hands?

 No, to standardise practice and minimise the risk of infection you should use your own stock of paper hand towels. These can be obtained for your service via the NHS Supply Chain.
Can I use patients own liquid hand soap or bar of soap when carrying out hand hygiene?

No, to standardise practice and minimise the risk of infection you should use your own stock of liquid hand soap or alcohol hand gel. These can be obtained for your service via the NHS Supply Chain.
Can I work clinically if I have a wound with a dressing on my hand or arm below the elbows?

No, if the dressing is not waterproof then you would be unable to carry out effective hand hygiene in order to minimise the risk of cross infection.

Can I work clinically if I need to wear a splint, brace or support to the hand or arm below the elbow for clinical activities?

No, unless the appliance can be removed to enable you to carry out effective hand hygiene and is fully wipeable to reduce the risk of cross infection.

Diarrhoea & vomiting

Question Answer

 What type of stools on the Bristol Stool chart do I need to send for testing if a gastro-intestinal infection such as Norovirus or Clostridium difficile is suspected?

True diarrhoea consists entirely of liquid/water and takes the shape of the container it is in and a pipette used to obtain a sample for testing, Type 5, 6 and 7 on the Bristol Stool Chart.

How long do patients with diarrhoea and vomiting need to remain isolated following symptoms of diarrhoea and vomiting?

Patients need to remain isolated for 48 hours after symptoms have subsided.

How long do I need to stay off work if I have symptoms of diarrhoea and vomiting?

 You need to be free of symptoms for 48 hours before returning to work.

Can I come into work with symptoms of diarrhoea and vomiting if I am not working clinically or work in an office environment?

No, you must not attend work with symptoms of diarrhoea and vomiting whatever environment you work in.

Specific infections & barrier nursing

Question Answer

Do patients with shingles or chickenpox need barrier nursing?

Yes, until blisters/spots have scabbed over and are dry.

Do patients with scabies need barrier nursing?

No, patients may be nursed in an open ward however linen should be treated as infectious until all treatment is completed. Standard precautions apply for use of gloves and apron.

MRSA swabbing

Question Answer
Do we routinely swab patients for MRSA within DCHS?

No, only patients having podiatric surgery or nail surgery where the nails appears to be infected or patients have a history of MRSA and have not been swabbed within the last 6 weeks are swabbed for MRSA within DCHS.

AMaT Audits and IP & C Champions

Question Answer
How often do AMaT audits need to be carried out?

AMaT audits need to be carried out on a quarterly basis, the number of returns depends on the size of the team and refers to the number for the whole quarter. “One audit cycle” refers to a quarter.

Why do AMaT audits need to be carried out even in non-clinical areas/teams?

We need to ensure work areas and teams are working safely and correctly to minimise the risk of infections and outbreaks. The AMaT audits provide evidence that staff are complying with local and national guidance and this in turn provides assurance for the Trust board and external bodies such as NHSEI in the event of any outbreaks.
What can we do if it difficult to observe members of our team e.g. due to remote working?

In this case a scenario based observation can be completed e.g. at a base for example at handover, team meetings or time out days.
Can non-clinical staff become IP & C Champions?

Yes, non-clinical staff can receive information and training by contacting the Quality Always Team -  dchst.qualityalways@nhs.net.
How can I receive training, advice or support on using the AMaT tools?

Training, advice and support, including the answers to queries related to the AMaT can be obtained via the Improvement, Innovation and Effectiveness Team - dchst.cet@nhs.net.

Equipment and supplies

Question Answer

Do the IP & C Team carry supplies that other staff can access e.g. Lateral Flow Tests (LFT), gloves, aprons, hand wash and gel?

No, the IP & C Team only have a small supply of resources for their own use and order their own supplies via the PPE Team as all other areas - dchst.covid19ppe@nhs.net.

Is the IP & C Team able to provide product information or order codes for equipment and supplies such as gloves, wipes, masks etc?

No, the IP & C Team do not have access to information on products or order codes. Staff need to access the PPE Team dchst.covid19ppe@nhs.net or Procurement Queries - dchst.procurementqueries@nhs.net.

March

20th March - World Oral Health Day

The current 3 year campaign running until 2026, focuses on the link between good oral health and good general  health because “A HAPPY MOUTH IS….A HAPPY BODY”

May

5 May - World Hand Hygiene Day

Lead by the World Health Organisation (WHO) as part of the SAVE LIVES: Clean Your Hands campaign. The campaign aims to improve hand hygiene in healthcare workers and support the prevention of healthcare acquired infections.

September

All September - Sepsis Awareness Month

Aims to educate as may people as possible about this medical emergency to help them recognise the signs and symptoms to help save lives.

15 September - World Sepsis Day

Part of the above campaign

October

1 Week in October - International Infection Prevention Week

International Infection Prevention Week (IIPW), established in 1986, aims to shine a light on infection prevention each and every year. Each year has a different theme.​​​​​​​

19 October - International Stop Wound Infection Day

Aims to reduce wound infections in acute surgical wounds and non-healing chronic wounds, The site encourages the showcasing of research, technologies and initiatives using social media and has campaign resources to assist with this.

20 October - Clean Hospitals Day

Aims to raise standards in hospital cleanliness to protect patients and staff and bring international awareness to the importance of hospital cleanliness.

November

18 - 24 November - World Antimicrobial Awareness Week (WAAW)

Lead by the World Health Organisation (WHO).Aims to improve awareness and understanding of antimicrobial resistance. Encourages the appropriate use and correct disposal of antimicrobials.

December

1 December - World Aids Day

Aims to bring people together worldwide in the fight against HIV, to support those living with HIV and to commemorate those who have died from AIDS-related illnesses. The UK government has set a goal of ending HIV transmissions by 2030

Information for ALL staff

Anybody that needs to report an absence of any sort must contact their manager in the first instance, as soon as they are aware that they cannot attend work, so that they can make arrangements for covering the gap that you will leave. Click here for more information.

Managers

If you have a member of staff off sick with Covid-19, you would need to complete this form and return to the IP&C inbox - E: DCHST.infectioncontrol@nhs.net.

You also need to report as normal on ESR using this as reference:

Manager Self Service - Absence                        

  • Absence Type - Sickness                                           
  • Level 1 reason - S27 Infectious diseases                                 
  • Level 2 reason - S27998 Other infectious disease                                                               
  • Related reason - Coronavirus (Covid-19)

Information for patient facing colleagues