Appendices
Section 1
Policy Statement (Word)
Section 4
Bristol Stool Chart
D&V Weekly Record (Word)
D&V Investigation Record (Word)
Section 9
How to handwash – best practice
How to handrub – best practice
5 moments – chair
Handwash areas missed
Section 10
Glove chart
PPE donning and doffing
Section 12
Waste disposal flow chart
Waste disposal colour coding
Section 14
Colour coding cleaning equipment
Section 15
Spillage cleaning
Section 19
Decontamination declaration (Word)
Section 27
Sharps injury prevention
Sharps injury action (Word)
Checklist following sharps injury (Word)
Introduction
An outbreak of communicable disease/infection can be defined as the incidence of disease above that normally expected. Usually this means that there are two or more linked cases with the same illness/symptoms. In some instances, only one case may be sufficient to instigate investigation as an Incident e.g., meningococcal meningitis. Outbreaks in hospice care settings will be similar to those experienced in acute hospital settings e.g., viral gastro-enteritis, influenza etc.
Outbreaks of infection may vary in extent and severity, ranging from a few cases of infestation to food poisoning, affecting hundreds of people. Recognition of an outbreak in the early stages may be difficult therefore all staff must remain vigilant.
The Consultant in Communicable Disease Control (CCDC) at the local Health Protection Unit (HPU) at UK Health and Security Agency (UKHSA) has overall responsibility for outbreaks of infection in all health and social care provider settings (both NHS and independent sector) and the designated infection prevention & control advisor / senior manager on call must inform the local UKHSA HPU of any suspected outbreak of infection. An on-call service is provided by the local HPU of (UKHSA) outof-hours and at weekends.
Individual staff – particularly senior clinical staff and senior managers should be able to recognise a potential outbreak of infection or food poisoning
Staff should be familiar with the reporting system when they suspect an outbreak of infection and should report their concerns promptly to the line manager for investigation and, if necessary, reporting.
Staff have a duty of care to prevent further transmission of the outbreak by implementing appropriate IPC measures as advised by Infection Prevention & Control Advisor/HPU.
Staff have a responsibility to maintain communication with interested parties, especially service users and visitors as well as other clinical staff/areas which may be affected.
Senior Manager / Lead Nurse / Clinician /Occupational Health Adviser (Identifying possible/probable outbreak)
Infection Control Advisor
Health Protection Unit on call team
All outbreaks of suspected or confirmed infection must be reported through the line manager and to the designated infection prevention & control advisor (if in post). Once an outbreak is suspected then the first step is to liaise with the local HPU who will provide guidance on the appropriate steps to be taken. Local arrangements for ongoing support and guidance vary. All senior staff should have easy access to local phone numbers which should be documented. Local teams contact details can be obtained here:
Contacts: UKHSA health protection teams - GOV.UK (www.gov.uk)
Only large outbreaks (or those involving more than one facility) will require an outbreak control team to be convened. If convened, membership of the Outbreak Control Team will usually include the following:
• IPC Advisor / IPC lead / Registered Manager
• HPU Consultant in UK Health Security Agency (UKHSA) (usually the Chair)
• Environmental Health if required (food poisoning only)
• HPU health protection nurse
• Communications Manager if required
• Relevant physician/GP/health care professional
• Senior manager of area(s) concerned
• Pharmacist if required
• Estates and Facilities
• Housekeeping
• Occupational Health Advisor
• Other members as deemed appropriate
The function of the team will be to:
• review the problem
• decide on appropriate action
• specify tasks and responsibilities for team members
• communicate required action to affected care staff
• ensure all affected staff are aware of their responsibilities
• ensure appropriate supplies are available
• institute further investigation
• evaluate progress
• agree media statements and communication to service users/visitors/general public
• ensure communication with senior managers, local Integrated Care Service (ICS) / acute NHS Trusts, ambulance Trust etc
• agree report of outbreak and future recommendations to prevent similar recurrences
• prepare a final report at the end of the outbreak.
At the first meeting of the team an interim report of the outbreak will be prepared for senior management. The nominated lead person will inform all relevant external parties as appropriate. The team may also draw up a draft press release, as necessary.
A root cause analysis of the outbreak may be undertaken to systematically review all aspects of the management of the outbreak and to provide evidence for a final report including a review of actions taken, lessons learned and changes to be made to practice preventing a similar occurrence.
YES
Two or more service users and/or staff symptomatic with vomiting and/or diarrhoea / influenza etc.
NO
Less than 2 residents and/or staff symptomatic
If NO
Observe for further cases
If YES
Contact Senior Manager immediately
Arrange for samples to be taken from service users and staff who have symptoms if requested by IPC Advisor or HPU / GP
Document all symptomatic service users/staff
Secure communication daily to IPCA / HPU or as advised
Complete Incident Report Form