CORE SKILLS FRAMEWORK

Transcription

1 CORE SKILLS FRAMEWORK INFECTION PREVENTION AND CONTROL: LESSON NOTES & TIPS FOR A SUGGESTED APPROACH These notes are designed to be used in conjunction with the Infection Prevention & Control training powerpoint slides. The purpose of the session is to provide basic/induction level training in infection prevention and control. The content of the slides relates to the general information that all employees should be presented with. How you choose to present this information is up to you you know your own training style and have better insight into what your audience wants and needs. It is anticipated that this core skill will be supported with a practical skill development session on hand hygiene technique that will be separately assessed such as Glo Germ hand hygiene assessment. If you have the time, feel free to add exercises, games, video clips, etc. In keeping with the guidance offered in the Core Skills Framework, it is anticipated that this session should last for 45mins to 1hour.

2 SLIDE 1 This is an opportunity for you to introduce yourself and explain how you intend to run the session. This will depend on your own training style, but you should consider: when and how you will take questions? E.G. Do you want these as you proceed through the presentation or at the end? what activities will you use? In addition to presentation, will you have exercises, activities, assessment, etc what happens next? E.G. how will their attendance and any subsequent assessment be recorded? Please remember to update this slide to reflect local information.

3 SLIDE 2: What you will learn in this session This effectively relates to the learning outcomes that have been defined as part of the core skills project. To make this more user-friendly, these are articulated as what participants will learn and have been mapped to the Core Skills Framework learning outcomes as indicated below:

4 What participants will learn The importance and general principles of infection prevention and control The nature of Healthcare Associated Infections Factors that may increase an individual s susceptibility to infection Be aware of how individuals can contribute to Infection Prevention & Control. Where to find information, including legislation, national guidance and local policies The role of hand hygiene in preventing transmission of infection Local infrastructure, initiatives and reporting procedures Core skills framework learning outcome Understand the and general principles of infection prevention and control Appreciate the nature of Healthcare Associated Infections Recognise factors that may increase an individual s susceptibility to infection. Individual responsibility contributing to infection prevention & control Know where to find information about Infection Prevention & Control, including relevant national legislation or guidance and local policies. Describe the role of hand hygiene in the prevention of transmission of infection Describe the basic local infrastructure, initiatives and reporting procedures for Infection Prevention & Control

5 SLIDE 3: Why is this so important? Participants need to recognise the importance of this issue. Clarify that there is a legal responsibility to address infection prevention and control issues. The Health and Social Care Act (2008) and associated Code of Practice sets out criteria by which organisations have a statutory obligation to ensure that the risk of infection is kept as low as possible and patients are cared for in a clean, safe environment. In addition to this, use the slide to present an argument that will persuade your specific audience. There are some examples provided on this slide, but please bear in mind that text should be 28 or 24 font size, so only select what you think is most suitable. In addition, you may wish to highlight that there has been lots of publicity surrounding drug-resistant infections such as Meticillin-resistant Staphlococcus aureus (MRSA) and many newspapers focus on these. Although MRSA and other drug-resistant infections are currently a major problem for many healthcare services you can stress that there are many other infections that are just as harmful and just as important to control. For example, Clostridium difficile is a common cause of diahorrea in hospitals, Acinetobacter causes HCAI particularly in patients in intensive care units, and noravirus causes sickness and vomiting.

6 Other key points you may wish to emphasise include: increase the hospital stay of a patient by an average 7-11 days major impact on the availability of beds Cost the NHS more than 1billion per a year 15% of current HCAI s are preventable releasing 150 million infections are often difficult to treat and they can complicate illnesses, cause distress to patients and their family, and in some cases may even lead to death infected patients cost 3 times more to treat than uninfected patients infections are becoming difficult to treat because of an increase in antimicrobial resistance

7 SLIDE 4: What are Healthcare Associated Infections (HCAI)? This slide can be used to explain what HCAIs are in straightforward, simple terms. Build on the simplicity by stressing that Healthcare Associated Infections (HCAI) are those infections that develop as a direct result of any contact in a healthcare setting. People often believe that they only occur in hospital wards and after surgery so it is important to stress they also occur in outpatients departments and in community settings. Explain how they can affect both patients and healthcare workers. Highlight the many causes of HCAI, but that they are most commonly caused by the contaminated hands of healthcare workers, contaminated medical devices, and a failure of staff to comply with local policies, procedures and guidelines. It s also worth reminding your audience here of the human cost of an HCAI. If a patient gets an HCAI, it may: Make their existing medical condition worse; Make their stay in hospital longer; Cause them pain, depression and stress Lead to a loss of earnings; Reduce their chances of successful recovery.

8 SLIDE 5: Infection versus colonisation? This is an opportunity to explain to non-clinical staff the difference between infection and colonisation. You may want to discuss the clinical signs and symptoms of infection, and explain how they may vary depending on the infection but that generally infections can be localised (in one place, such as an infected wound) or systemic (affecting the blood stream or the whole body, such as septicaemia or flu). However, the message in this slide is that the identification of a micro-organism in an individual does not necessarily indicate that they are, or will become ill.

9 SLIDE 6: Chain of Infection The focus of this slide is on the 6 links in the chain of infection and provides a pictorial view. The following slides can be used to assist you to discuss each link in the chain. Don t forget to provide examples relevant to your client group. SLIDE 7: Infectious Agent Explain that this is any disease-causing micro-organism (micro-organism).

10 SLIDE 8: The Reservoir This is the site where infectious micro-organisms reside and multiple. Discuss carrier hosts and that they are hosts that do not show any outward signs or symptoms of a disease but are still capable of transmitting the disease. SLIDE 9: Site of exit Clarify that this is the route of escape of the micro-organism from the reservoir. Use examples such as respiratory secretions from sneezing, blood exposure, breaks in skin, urine on hands.

11 SLIDE 10: Transmission This is the method of transfer by which the micro-organism moves or is carried from one place to another. Explain that the three principal routes of transmission are: Contact Droplet Airborne SLIDE 11: Site of entry This is the route through which the micro-organism enters its new host, such as inhalation (breathing in), ingestion, breaks in the skin, tubes placed in body orifices (eg urinary tract or airway).

12 SLIDE 12: Susceptible Host This could be any vulnerable individual (patients, staff or visitors). Discuss how the micro-organism s ability to reproduce depends on the degree of the host s resistance. Those with strong immune systems are better able to fend off microorganisms than those with weakened immune systems. Examples of susceptible hosts are the very young or old; poor nutritional status - obesity/malnutrition; poor personal hygiene; incontinence; recent antibiotic therapy; medical/surgical intervention; metabolic disorders or other underlying disease.

13 SLIDE 13: Standard precautions Explain how the term Standard Precautions is now used extensively as minimum set of infection control measures to be used for the care of all patients. Highlight how they are mandatory for ALL staff at ALL times in healthcare settings. Hand Hygiene Use of personal protective equipment Safe use and disposal of sharps Management of sharps injuries Safe disposal of clinical waste Safe management of laundry Cleaning and decontamination of re-usable equipment Maintenance of a clean clinical environment Safe management of body fluid spillages Respiratory Hygiene The following slides allow you to discuss how these relate to professional roles.

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15 SLIDE These slides focus on specific aspects of infection control procedures. Use this as an opportunity to clarify specific issues that would relate to the key role(s) of your audience.

16 SLIDE 19: Management of inoculation injuries The key purpose of this slide is to discuss how individuals should deal with potential inoculation injuries. You need to clarify the procedure within your organisation, making it clear what they should do and who they go to for advice &support. SLIDE 20: Hand decontamination Use this slide to stress how the chain of infection can be broken by good appropriate hand hygiene.

17 SLIDE 21: The 5 moments This slide refers to the World Health Organisation My 5 Moments for Hand Hygiene approach that defines the key moments when healthcare workers should perform hand hygiene. This evidence-based, field-tested, user-centred approach is designed to be easy to learn, logical and applicable in a wide range of settings. This recommends that health-care workers to clean their hands: before touching a patient, before clean/aseptic procedures, after body fluid exposure/risk, after touching a patient, and after touching patient surrounding

18 SLIDE 22: Barriers to hand hygiene Use this to stress how workers in healthcare often overlook how their personal jewellery and clothing can hinder effective hand hygiene.

19 SLIDE 23: How to wash your hands This explains the 7 Steps to Hand Hygiene: Apply hand hygiene rub or wash hands with liquid soap and water using the 7 Step Hand Hygiene technique to decontaminate hands between caring for different patients, or between different caring activities for the same patient. Cuts and abrasions and scratches must be covered with waterproof dressings. Promote skin integrity by drying hands properly after washing them and by using hand cream at regular intervals throughout the day. If a particular product irritates the skin contact Occupational Health. Hands that are visibly dirty must be washed with liquid soap and water. Use hand hygiene rub if hands appear clean. Sometimes the Infection Control Team may advise against using hand rubs as a first method of cleaning, for example rubs not effective against Norovirus or Clostridium difficile spores. Hand hygiene rub may be used as an additional step following hand washing to provide additional cleansing and residual disinfectant action (e.g. prior to clinical procedures).

20 SLIDE 24: Appropriate products With this slide, you can discuss or demonstrate the products that they should use to maintain good hand hygiene. This may be the first time that you refer to Dermal hydration and moisturisation, so the message is the importance of preventing dry skin and reducing the risk of dermal irritation and contact dermatitis. Skin moisturisers are used to help prevent skin from becoming dry and to restore dry skin to its normal condition. The HSE (2007) recommends that healthcare workers be provided with products that will minimise the occurrence of irritant dermatitis associated with hand decontamination.

21 SLIDE 25: Bare below the elbows All staff undertaking duties in clinical areas or with patient contact must comply with the Bare Below the Elbows dress code. You may wish to emphasis at this point where organisational codes and policies can be found. Discuss generally with participant

22 SLIDE 26 : Further Information Some suggestions for you to include here are: Your organisation s Infection and Prevention Control Resources Your organisation s Infection Prevention and Control Team details.

23 SLIDE 27: Summary The summary slide is an opportunity for you to reinforce messages regarding the importance of infection prevention and control and that everyone who works in the healthcare economy has some responsibility for this. SLIDE 28: Any questions Remember to leave some time at the end for questions and answers. Use this as an opportunity to remind them who you are and where they can go for extra information.