Infection prevention and control news

Glow gel activity

Our Infection Prevention team attended a ward to complete glow gel activity. The rational for the visit was to demonstrate and highlight areas of cleaning that may have been missed during routine cleaning.

This was supported by the ward manager.

IPC contaminated their hand with the glow gel and went onto the ward.

On return to the ward at a later date the glow gel was still evident this showing effective cleaning had not taken place.

Gloves Off campaign

The climate crisis is driving the breakdown of conditions that make good health possible, but we can play a role to help combat this.

In the UK the NHS alone contributes 4 – 5% of the country’s emissions, and plastic gloves, made using fossil fuels, are one of the most common single-use plastic items in healthcare.

By reducing unnecessary glove use, we can help reduce the impact of health and care systems on the environment.

A common misconception is that gloves should be used to prevent the spread of infection when providing care – in fact Hand-hygiene is the way to achieve this. As one element of personal protective equipment gloves protect the hands of nursing staff from harm when in contact with hazards such as blood and body fluids or chemicals – they are not generally needed for core nursing activities such as feeding or moving patients, administering medicines, or taking observations for example.

It's easy to forget to perform hand hygiene when wearing gloves. Reducing unnecessary glove use is not only better for our planet, but also safer for everyone.

Watch this anmation around how infections spread.

Nutrition and Hydration Week

Annie and Lucy from IPC spent time at Harry Blackman House discussing the importance of hydration & nutrition to help prevent urinary tract infections. They were able to talk to service users along with their families about drinking plenty of fluids and foods that contain high water content.

IPC Champions

The IPC Champion leads have set up a monthly drop in Q&A sessions via Microsoft Team. This is to allow the IPC champions to ask any questions they may have around infection control, ward assurances, AMAT etc.

Please note this is not a training session.

A direct Teams invite will be invited to the MHCD & MHSLD

Any further interest in this role please speak with your line manager, contact the IPC team if further information required: Infection.ControlTeam@merseycare.nhs.uk.

Group A Streptococcal (GAS) Infection:

Group A Streptococcus (GAS) - also known as Streptococcus pyogenes - are bacteria that can be found in the throat and on the skin. People may carry GAS and have no symptoms of illness or may develop infection.

How GAS is spread

Streptococcus bacteria survive in throats and on skin for long enough to allow easy spread between people through sneezing and skin contact.

People who are currently carrying GAS in the throat or on the skin with no symptoms of illness are described as colonised.

Kinds of illnesses caused by GAS

Most GAS illnesses are relatively mild such as ‘strep throat’, scarlet fever or a skin infection such as impetigo.

However, on rare occasions, these bacteria can cause other severe and even life-threatening diseases.

Invasive group A Streptococcal (iGAS) disease

Although rare, life-threatening GAS disease may occur when bacteria get into parts of the body where bacteria usually are not found, such as the blood or muscle. This may occur when a person has sores or other breaks in the skin that allow the bacteria to get into the tissue, a weakened immune system or some viral infections, such as a cold or flu. These infections are called invasive Group A Streptococcal (iGAS) disease.

Early signs and symptoms of invasive group A Streptococcal (iGAS) disease include:

• high fever
• severe muscle aches
• localised muscle tenderness
• increasing pain, swelling and redness at site of wound
• unexplained diarrhoea or vomiting

Good infection control measures such as effective hand hygiene, good general cleaning and careful handling of soiled household linens such as bedding and towels reduce the risk of cross infection.

Addition information can be found at:  Strep A - NHS

World AIDS Day (1 December 2024)

IPC specialist nurse Ann Irvine spent time with staff and service users at Broadoak reception promoting/discussing the facts around HIV/AIDS

Additional information on HIV/AIDS: HIV | Terrence Higgins Trust

Safe sharps

The has been an increase in RADAR reporting needle stick injuries following trust guidelines can help prevent such injuries.

Used sharps must be discarded immediately by the person generating sharps waste, into an approved container conforming to current standards.

Sharps containers must be located in a safe position to minimise the risk of spillage and at a height that allows the safe disposal of sharps. Ensuring temporary closure mechanism is utilised when sharps bin is not in use, preventing accidental spillage.

1. Containers must be disposed of when the fill line is reached.
2. Consequences of needle stick injury are potentially serious, carrying the risk of transmitting blood borne viruses such as Hepatitis B and C and Human Immunodeficiency Virus (HIV).

Risks are generated by unsafe practices, in particular re-sheathing needles and disassembling devices manually, not disposing of sharp items into a sharp’s container at point of use or unstable containers toppling over.

Injuries are far more likely to occur where there is no opportunity to dispose of items immediately after use.

Information available for the safe handling of sharps and disposal of sharps items with the IPC Manual which can be found in the attached document.

IPC Link Practitioners

Please visit the IPC champion YourSpace page. 

Any further interest in this role please speak with your line manager, contact the IPC team if further information required: Infection.ControlTeam@merseycare.nhs.uk

HIV

HIV (human immunodeficiency virus) is a virus that damages the cells in your immune system and weakens your ability to fight everyday infections and disease.

AIDS (acquired immune deficiency syndrome) is the name used to describe a number of potentially life-threatening infections and illnesses that happen when your immune system has been severely damaged by the HIV virus.

While AIDS cannot be transmitted from one person to another, the HIV virus can.

There's currently no cure for HIV, but there are very effective drug treatments that enable people with the virus to live a long and healthy life. 

With an early diagnosis and effective treatments, most people with HIV will not develop any AIDS-related illnesses and will live a normal life.

• HIV and AIDS - NHS (www.nhs.uk)

Scabies

Scabies is an itchy rash caused by mites. Scabies is contagious from the point of infestation, its spread through close skin contact and anyone can get it. It should be treated quickly to stop it spreading.

Symptoms include severe itching, usually most severe at night, rash and shallow burrows on the skin. This generally begins three to six weeks after infestation.

The scabies rash usually spreads across the whole body, it often affects skin between fingers, around the wrists, under the arms, around the waist, groin and bottom.

Among elderly patients, the clinical presentation may be very different. Burrows and rashes may affect parts of the body typically covered by clothing, for example, the torso or legs, therefore careful and thorough examination is required.

Treatment:  Apply the prescribed cream/lotion to all part of the body including scalp and face and particular attention should be paid to toes and finger or where the rash is seen. The application should be left on for 8 to24 hours depending on manufacturer’s instructions. Reapply on hands and other areas of the body if washed during contact period. Always repeat the treatment a week after the first application.

Crusted scabies

Crusted scabies is a presentation which most commonly occurs in elderly, immunocompromised or malnourished people. This form of scabies is characterised by a scaly rash and thickened crusts of skin containing many mites, alongside heavy skin shedding. Itching may be absent. It is harder to treat and may contribute disproportionately to transmission.

Please inform the IPC team of any service users/patients diagnosed with Scabies to enable the team to offer further guidance and support.

For further information regarding scabies please see below links

• Scabies - NHS (www.nhs.uk)
• UKHSA guidance on the management of scabies cases and outbreaks in long-term care facilities and other closed settings - GOV.UK (www.gov.uk)

Please see scabies care plan link: Scabies_Care_Plan-__.docx (live.com)

All care plans are available on the IPC tiles on YourSpace.

IPC Champions

The IPC Champion leads have set up a monthly drop-in Q&A sessions. This is to allow the IPC champions to ask any questions they may have around infection control, ward assurances, AMAT etc.

The next session will be Thursday, 14 November from 11am to 12pm. Please note this is not a training session. A direct Teams invite will be invited to the MHCD and MHSLD.

If you have any queries or further interest in link persons’ role please speak with your line manager and contact us on 0151 295 3036 or e mail infection.controlteam@merseycare.nhs.uk

Whooping Cough (Pertussis)

Whooping cough (pertussis) is a bacterial infection of the lungs. It spreads easily and can sometimes cause serious problems. It’s important for Babies and children to get vaccinated. Unvaccinated pregnant women will also be offered a vaccine . The first signs of whooping cough are similar to a cold, these include runny nose and sore throat (Pyrexia is an uncommon symptom).

After about a week, symptoms can be:

• Coughing bouts that last a few minutes and are worse at night
• A whooping sound-gasp for breath between coughs. Young babies and adults may not make this noise
• Difficulty in breathing after coughing and may look cyanosed (blue/grey colour)
• May bring up thick mucus which can lead to vomiting
• May become very red in the face (more common in adults)
• The cough may last for weeks even months

Whooping cough is contagious from about six days after the start of cold like symptoms to three weeks after the coughing starts.

Hydration

With the warmer weather hopefully upon us staff need to be aware of good hydration for patients it helps prevent urinary tract infections among many other health benefits. It’s recommended that adults drink at least eight cups of fluid a day (unless they have been advised to reduce fluid intake by a medical professional) Any fluid except alcohol counts tea coffee milk etc. Foods such as soups ,iced lollies, fruit and milk puddings can count to your fluid intake. Drinking regularly throughout the day  prevents dehydration

Hydrating fruits and vegetables include

• Cucumber-96%
• Pineapple-95%
• Lettuce-95%
• Celery-95%
• Tomato-94%
• Watermelon-92%
• Grapefruit-90%
• Pear-84%

https://www.nhs.uk/conditions/urinary-tract-infections-utis/ 

PPE – Using gloves appropriately

Using gloves appropriately animation - HIS (Healthcare Infection Society) in conjunction with IPS (Infection Prevention Society) have launched a new animation for their ‘Gloves off’ campaign highlighting the critical importance of hand hygiene and proper glove usage in healthcare - complementing the getting back to basics theme.

Any further interest in this role please speak with your line manager, contact the IPC team if further information required: Infection.ControlTeam@merseycare.nhs.uk

Measles

Measles is not just a childhood disease; it can make adults seriously unwell too. Across the North West, there has been an increase in the number of positive cases.

Measles is a highly infectious viral infection. Symptoms include a runny nose, cough, conjunctivitis (sore, itchy, watery, red and sticky eyes), high fever, rash (maculopapular) and feeling generally very unwell.

The spots of the measles rash are sometimes raised and join together to form blotchy patches. The rash starts on the face and behind the ears before spreading to the rest of the body. The incubation period is between 10 to 12 days but can vary from 7 to 21 days. For additional information, visit the NHS website.     

How we can assist: ensuring staff remain vigilant for possible cases, ensure anyone who presents at a health care setting is isolated appropriately at the earliest opportunity and MMR vaccination is arranged when appropriate.  

Measles is not just a childhood disease; it can make adults seriously unwell too. The best way to protect yourself, your family, friends, our patients and service users, is by having the MMR vaccination. you can have your MMR at the vaccination centre in Maghull Health Park by booking a slot on YourSpace.

To view the recording of the North West Primary Care Webinar update and advice on Measles from Wednesday 6 March 2024, visit YourSpace.

For Measles Information and Guidance please visit the IPC Tiles on YourSpace.

IPC Link Practitioners

Link Champions have you completed your survey and returned it to the Infection Prevention and Control Team? If not please ensure it is returned by the 31 May 2024 to: Infection.ControlTeam@merseycare.nhs.uk

World Hand Hygiene Day is the 5 May 2024. IPC will be visiting the below areas on the 1 May 2024 -come and meet the team!

• Ashworth Reception - 1.30pm to 3.30pm 
• Hollins Park Reception 1.30pm to 3.30pm 
• Clock View Reception 1.30pm to 3.30pm 

IPC will be visiting the below areas on the 3 May 2024:

• Goodlass Road Reception - 9am to 11am
• Longmoor House Reception - 1pm to 3pm

Please visit the IPC champions tile on YourSpace

Any further interest in this role please speak with your line manager, contact the IPC team if further information required: Infection.ControlTeam@merseycare.nhs.uk

PPE – Using gloves appropriately

Using gloves appropriately animation - HIS (Healthcare Infection Society) in conjunction with IPS (Infection Prevention Society) have launched a new animation for their ‘Gloves off’ campaign highlighting the critical importance of hand hygiene and proper glove usage in healthcare - complementing the getting back to basics theme.

Mouth Care Matters

Please see the below link to the website for Health Education England Mouth Care Matters programme, setting out to improve oral health.

Home - Mouth Care Matters (hee.nhs.uk)

The Mouth Care Matters programme aims to create a healthcare team that is more responsive and personalised for patients and delivers better clinical outcomes, bringing an increased awareness of the importance of good mouth care and how it impacts on general health and quality of life. 

The initiative is relevant for all people who provide personal care to patients be that in an acute, care home or community setting. The website offers a wealth of training materials, posters and resources.

Influenza

Influenza is an acute viral infection of the respiratory tract.  Influenza is highly infectious with a usual incubation period of one to three days. Flu is easily spread to other people. You're more likely to give it to others in the first five days.

Transmission is by droplets, aerosol, or through direct contact, spread by germs from coughs and sneezes, which can live on hands and surfaces for 24 hours.

To reduce the risk of spreading flu:

• wash your hands often with warm water and soap
• cover your mouth and nose with a tissue when you cough or sneeze (if you do not have a tissue, cough or sneeze into the bend of your elbow, not into your hand) bin used tissues as quickly as possible
• stay at home and avoid contact with other people if you have a high temperature or you do not feel well enough to do your normal activities. Find out more in the attached document.

Ventilation is an important IPC measure. Letting fresh air from outdoors into indoor spaces can help remove air that contains virus particles and prevent the spread of COVID-19 and other respiratory conditions.

Inpatients - always contact the infection prevention and control team if you suspect you have any service users displaying symptoms of flu. Telephone: 0151 295 3036, email: infection.controlteam@merseycare.nhs.uk

Please see the attached document for the influenza checklist to be used within community settings.

Covid vs Influenza list

Disease Characteristics as per UKHSA Acute Respiratory Infection Resource Pack for Care Homes.

Influenza

Influenza is an acute viral infection of the respiratory tract.  Influenza is highly infectious with a usual incubation period of one to three days. Flu is easily spread to other people. You're more likely to give it to others in the first five days.

The risk of serious illness from influenza is higher in people with low immunity.

Transmission is by droplets, aerosol, or through direct contact, spread by germs from coughs and sneezes, which can live on hands and surfaces for 24 hours.

To reduce the risk of spreading flu:

• Wash your hands often with warm water and soap
• Cover your mouth and nose with a tissue when you cough or sneeze (if you do not have a tissue, cough or sneeze into the bend of your elbow, not into your hand) bin used tissues as quickly as possible
• Stay at home and avoid contact with other people if you have a high temperature or you do not feel well enough to do your normal activities.   

Find out more in the attached policy.   

Vaccines

Flu viruses can change year on year. Consequently, vaccines are made each year to provide protection against the flu viruses that are predicted to circulate, and therefore the vaccine needs to be given on an annual basis.

Find out more about our COVID-19 and flu campaign on YourSpace. Book your vaccines today!

How effective is the flu vaccine?

The flu vaccine will help prevent you getting flu and is your best protection against the virus. It will not stop all flu viruses but if you do get flu after vaccination, it’s likely to be milder and shorter-lived than it would otherwise have been. It takes between 10 and 14 days for your immune system to respond fully after you’ve had the flu jab.

IPC Link Practitioners

IPC have relaunched the IPC link practitioner role now known as IPC Champions.

Any further interest in this role please speak with your line manager, contact the IPC team if further information required: Infection.ControlTeam@merseycare.nhs.uk

Secondment opportunity within the Infection Prevention and Control Team

IPC Band 6 secondment Opportunity

An exciting development opportunity has come up within the Trust IPC team. The IPCT are looking for 2 candidates to join the team for an 18-month secondment.

The successful candidates will work with the IPC team to prevent and control health care associated infections for service users, carers, staff and visitors to the Trust and we work with all Trust staff and in partnership with other local NHS trusts, non-NHS bodies, the local authorities, and the public to achieve this.

If interested, please contact:

Gillian Verdin- gillian.verdin@merseycare.nhs.uk

Moira Brown- moira.brown@merseycare.nhs.uk

Infection.controlteam@merseycare.nhs.uk

Bare Below the Elbow (BBE)

Bare below the elbows is a term used to how staff should present themselves when in a clinical environment. This reduces the risk of infection and increases effective handwashing.

To be compliant with bare below the elbow in line with the Uniform and work ware attire policy staff should:

• Wear short sleeves
• Remove hand and wrist jewellery
• Ensure fingernails are short and natural- no false nails
• Ensure nails are free from nail varnish
• Cover cuts and abrasions with waterproof dressings.

What does it look like?

NO                            YES

The Facts

Staff not adhering to BBE are more likely to carry harmful bacteria and viruses under artificial nails, around and under watches and in stoned rings and on cuffs of long sleeved garments, which then are easily transferred to patients, themselves or other colleagues

• Cuffs become heavily contaminated with Staphylococcus aureus inclusive of MRSA and are more likely to come into contact with patients.

(Treakle, 2009).

• Healthcare workers who wear artificial nails are more likely to harbour Gram- Negative pathogens such as E. Coli on their fingertips. (World Health Organisation [WHO], 2009).
• Rings and watches are known to be associated with high numbers of bacteria on the hands and wrists (Salisbury ,1997)
• Bare below the elbow is supported globally, nationally and within local policy

Why is it so important?

Our patients may be more vulnerable to infection than the general population Bare below the elbow, helps with effective hand washing, which in turn helps to reduce the spread of infection.

Key points:

• Enables staff to wash their hands and wrists thoroughly
• Reduces the transmission of infection
• In the United Kingdom, improving hand hygiene in health-care settings can help prevent more than 1 300 deaths annually between 2015 and 2050
• Helps to keep our patients safe
• Keeps yourself and other staff safe.