Standard Operating Procedure Bio-security Policy

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1 Standard Operating Procedure Bio-security Policy Also refer to: 1. Risk assessment & Local Rules Cleanliness and tidiness 2. Risk Assessment & Local Rules - Disinfection 3. Risk Assessment & Local Rules - Infectious disease and zoonosis 4. Risk assessment & Local Rules - Protective clothing 5. Reception manual Dress and tidiness code 6. SOP - Disposal of waste, clinical waste, medicines and cadavers 7. SOP - Environmental hygiene 8. SOP - Hazardous waste spillages 9. SOP - Isolation of infectious animals 10. SOP - Maintenance of a surgically clean environment 11. SOP BSAVA Are you protecting your antibacterials? 12. FECAVA Recommendations for Hygiene and Infection Control Poster Background information Infectious disease outbreaks between animals can have serious consequences and, additionally, a variety of antimicrobial resistant and zoonotic bacteria such as MRSA are of increasing concern in veterinary healthcare. Many organisms can cause serious or life threatening infections; can readily colonise veterinary premises and can spread by direct contact or poor hygiene. Colonisation of in contact humans can pose a public health risk and may result in dissemination in to the wider community. Effective infectious disease control methods are therefore vital. Examples of biological hazards that may be pertinent to animals and / or humans include: Kennel Cough, Parvovirus, Feline Viral Enteritis, Ringworm, MRSA, and Salmonella. Routes of transmission may include: direct animal contact, contact with body fluids or excretions, by inhalation of aerosols or by indirect contact between humans, animals and the environment. Local Rules In addition to the standard procedures and risk assessments mentioned above and in order to help prevent transmission of infectious disease between humans / animals and animals / animals this practice adheres to the following control measures: 1) Major contamination risk pathways a. Hand washing is the single most effective hygiene measure - hands must be washed with an antibacterial hand wash solution before and after each consultation or on handling any in-patient or it s environment using the hand washing facilities provided (available in consulting rooms, prep room and kennels).

2 b. Hands should be dried using disposable paper towel which should then be disposed of immediately in the appropriate waste stream bin. c. Contact with animals during prep room procedures and / or entry or exit from kennels / cattery should be followed by hand washing or the use of alcohol hand gels. d. Alcohol gel dispensers are available at reception and in prep room they provide convenient and simple disinfection and should be used after animal contact but it should be noted they are only effective if hands are clean and dry soiled hands must be washed first. e. Physical contact by staff with animals in reception / waiting area should be kept to a minimum and alcohol hand gel used after any contact. f. Owners should be encouraged to control their animals whilst in waiting areas keeping dogs on leads and cats in baskets. 2) Cleaning and disinfection a. The building layout and surface finish takes in to account the need to be able to easily clean and disinfect surfaces, whilst every effort is made to ensure access to hand-washing facilities without having to touch anything. If it is noted that handles, doors, floor, wall or door surfaces have become damaged to the extent that they are a malfunctioning, are a hazard or prevent easy cleaning please inform the Practice Manager in order that the issue can be promptly addressed. b. Consultation room examination tables / prep room table / x-ray table should be sprayed with the appropriate disinfectant spray (at the correct dilution) after each animal handling episode (using the spray bottle dedicated to each room set to spray not mist to minimise aerosol production) and dried with disposable paper towel which should be disposed of immediately in the appropriate waste stream bin. c. All kennels should be disinfected with the appropriate disinfectant spray (at the correct dilution and set to spray not mist to minimise aerosol production) after discharge of each occupant (using the spray bottle dedicated to each kennel room set to spray not mist to minimise aerosol production) and any bedding thoroughly cleaned (appropriate to the level of contamination). All soiled bedding should be put straight into the container provided and transported directly for laundering, do not leave soiled bedding unattended. d. The use of disinfectants (type and appropriate dilution for each disinfection scenario) is described in Disinfection - Local Rules. e. Plastic keyboard covers should be in place on all computer keyboards in clinical areas (consulting rooms, prep room, x-ray room) and should be cleaned as part of standard room cleaning procedures. f. All notices and posters in clinical areas should be laminated to facilitate easy cleaning; white boards in consulting rooms and prep room should be cleaned as part of standard room cleaning procedures. g. Impervious plastic seating in consulting rooms and reception should be cleaned immediately if soiled and should be cleaned as part of standard room cleaning procedures.

3 h. All waste should be disposed of in the correct waste stream as described in SOP - Disposal of waste, clinical waste, medicines and cadavers. i. Urine / faeces or any other bodily fluids or spills should be cleaned up immediately with an appropriate disinfectant, using the cleaning materials / mop for the appropriate area; any waste should be disposed of in either hazardous or non-hazardous waste streams as deemed appropriate by a veterinary surgeon. j. Spills or breakages of medicines or hazardous substances should be cleaned up with the medicines spillage kit located in the pharmacy and should follow procedures outlined in SOP Hazardous waste spillages. k. Routine cleaning should be performed according to the cleaning rota detailed in the Cleanliness and tidiness - Local Rules. l. Care should be taken to use the appropriate cleaning equipment for the area to be cleaned - mops and buckets are colour coded (front of house / back of house / toilet & bathroom / isolation). m. High risk areas such as door handles and light switches should not be forgotten during routine cleaning (the use of room occupancy sensors in consulting areas / pharmacy / prep room negates the need for light switches in these areas). 3) Personal cleanliness and aseptic technique standards a. The Dress and tidiness code (Reception Manual) describes practice policy with regard to personal dress and hygiene standards and should be adhered to by all members of staff - aspects of the code important for maintaining practice hygiene include: tying back long hair, rolling up long sleeves, avoiding wearing ties and covering wounds or skin lesions immediately with water proof dressings. b. Clothes worn to the practice should be changed on entry in to the practice for the appropriate scrubs / uniform, which should be laundered at the practice at least daily. Soiled scrubs or uniforms should be changed at the earliest opportunity. c. Disposable gloves / aprons should be used whenever it is deemed necessary to prevent contamination of an animal handler with body fluids, lesions or contaminated materials or to help prevent cross contamination by handlers between animals as described in Protective clothing - Local Rules. d. Prep room, kennels and theatre staff should work according to their rota, helping to prevent cross contamination between areas. e. Theatre hygiene should be maintained as described in SOP - Maintenance of a surgically clean environment which includes protocols concerning theatre cleaning, theatre staff clothing and location / method of pre operative animal preparation. f. Antibiotics should not be routinely prescribed to prevent post-operative infection and all antibiotic use should follow the Practice antibiotic prescribing policy poster available in the pharmacy BSAVA Are You Protecting Your Antibacterials? g. Animals should not be allowed in the staff room and hand washing rules should be observed before break periods / eating.

4 4) Training and monitoring a. All protocols and local rules referred to above form part of the staff induction procedure, it is the Practice Manager s and / or Head Nurse s ultimate responsibility to ensure that staff understand the procedures for cleaning, personal appearance, disinfection, waste disposal, barrier nursing (isolation) and responsible antimicrobial use and that staff are aware how to locate these protocols. b. The daily / weekly / monthly cleaning schedule audit sheet (located in the waiting area) should be kept updated and will be regularly inspected by the Practice Manager. c. It is important that the cleaning schedule audit is visible to clients in the waiting area; it provides reassurance that the practice takes hygiene and antibiotic resistance issues seriously it is available in human healthcare settings and clients will expect to see similar standards. 5) Surveillance a. Active screening of animals, staff and the environment is rarely necessary, veterinary environments are not sterile and contamination with opportunistic pathogens is common and expected, the protocols described in this policy are designed to reduce the environmental burden, not to achieve sterility. Active surveillance must have clear aims, a defined protocol and specific action to be taken in light of findings. b. This practice has chosen to conduct regular environmental swabbing and environmental surveillance under the guidance of an external laboratory as described in SOP Environmental hygiene. The purpose of the protocol is to identify quantitatively and qualitatively evidence of unexpected levels of bacterial burden and the presence of antibacterial resistant bacteria, with results that can be used to establish the efficacy of cleaning and bio-hazard control protocols. 6) Animals with infectious disease, MRSA or other antimicrobial resistant bacteria a. Animals identified as potential sources of infection to humans and / or other animals should be prevented as reasonably as possible from coming in to contact with other animals and all members of staff should be made aware of their condition. Control measures may include: appointments made at the end of a consulting session to allow appropriate disinfection and minimise risk of animal contact in the waiting area admittance directly in to a consulting room to avoid contamination of the waiting area ensuring admitted animals are allocated space in isolation rather than dog or cat wards ensuring movement and procedures are scheduled for the end of the day b. All animals considered as known or potential sources of infection to other animals or humans should be subject to the isolation and barrier nursing protocols as described in SOP Isolation of infectious animals which includes procedures demarcating the isolation area, barrier nursing, disinfection, identification of personnel involved, waste disposal and references to COSHH and Health and Safety. c. Screening all cases for infections with antimicrobial resistant bacteria prior to admission is not usually feasible however specific risk factors (which may raise clinical suspicion) include: animals from known positive households or with owners that have frequent healthcare contact animals with non-healing wounds

5 animals with antibiotic resistant infections post operative or practice acquired secondary infections d. In cases of known or suspected antibiotic resistant infection and in addition to the routine protocols described above, all discharging wounds should be covered with an impermeable dressing, animals should (where possible) be transported on trolleys to minimise corridor contamination and clinical rooms and equipment should be cleaned and disinfected before further use.

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