As an employee it is our responsibility to take all precautionary measures to prevent and control the spread of infection in the workplace; this means working safely to protect myself, other members of staff, the patients and all other individuals from infection.
As a health worker we should;
Maintain high standards of personal health and hygiene, where possible we should avoid coming in to contact with pathogens, such as bacteria and viruses that cause illness.
Regular washing of uniforms and refraining coming into work when you are ill, as you may be putting others at risk. Not wearing anything below the elbow as jewellery can carry bacteria, and hinder the correct hand washing procedure.
Be aware of and follow the infection control policies and procedures that are used in your work area. Implement best practice in infection prevention and control by maintaining a clean, tidy and hygienic environment. Ensure all equipment used is cleaned properly. In our case all examination couches are cleaned down after each clinic and fresh paper is used for each patient.
It is our responsibility to use the Personal Protection Equipment (PPE) the employer provides correctly, and to attend all mandatory training relating to infection prevention and control, also to keep up to date with any changes in our work environment.
It is our duty to promptly report any risks and hazards to our line manager/employer that could result in the spread of infection.
Employers responsibility in the relation to the prevention and control of infection is to make the workplace a safe environment, not only safe for staff but for all individuals and visitors.
They have to produce and communicate a health and safety policy, by following current legislation, including an infection prevention and control policy, also to ensure that all safety procedures are followed.
Employers must carry out risk assessments to assess the dangers of certain work activities. They are then responsible for putting strategies in place for reducing or eliminating the risk. They have to provide a safe environment by maintaining equipment, providing suitable areas for food preparation, cleaning equipment and cleaning materials, washing and toilet facilities and the safe disposal of waste.
Under health and safety law and regulations employers have to provide a safe workplace for all staff and also to provide the required PPE free of charge.
They need to provide staff with adequate information, training and supervision. Keeping staff up to date with infection control policies, procedures encourages safe and best practice.
The employer should keep records relating to infection prevention and control in the workplace. They are legally required to keep records relating to accidents and infectious diseases in the workplace.
There are laws, legal regulations and standards relating to all aspects of infection prevention and control. They cover a number of different issues which are relevant to health and social care practice. These include health and safety at work, public health issues, environmental safety and food safety, most come under the Health and Safety at Work Act This act is about ensuring a safe work place for employers, employees and members of the public by minimising accidents at work.
The current legislation and regulatory body standards for prevention and control of infection are
Health and Safety at Work Act 1974 – this act is about ensuring a safe work place for employers, employees and members of the public by minimising accidents at work.
Public Health (Control of Disease Act 1984 (amended in 2010) .These amendments improved and extended the previous arrangements for statutory notification of infectious diseases in England.
Environmental Protection Act 1990.The Environmental Protection Act deals with issues relating to waste on land, defining all aspects of waste management and places a duty on local authorities to collect waste. And ensure that any waste is handled safely and within the law.
The Managing of Health and Safety at Work Act 1999 introduced the need for monitoring health and safety and risk assessment; including infection prevention and control.
Personal Protective Equipment (PPE) at Work Regulations 1992. Are set of regulations created under the HASAWA .The regulations place a duty on every employer to ensure that suitable personal protective equipment is provided to employees who may be exposed to a risk to their health or safety while at work.
Food Safety Act 1990. Provides the framework for all food legislation in Britain
Food Safety Regulations 1995. (Amended 1999, 2004) were brought in to ensure safe practices for food to avoid contamination and spreading of infection and includes handling, storing and disposal of food.
Reporting of injuries, Diseases and Dangerous Occurrences (RIDDOR) 1995. is relevant as it requires that any infection or disease that is work related
be recorded and reported.
The Control of Substances Hazardous to Health (COSHH) 2002 is relevant as it is concerned with the prevention and control of pathogens and managing the safe storage and use of hazardous substances.
Hazardous Waste Regulations 2005 (Amended 2009) if you produce, transport or receive hazardous waste you will be regulated by these regulations
Health and Safety Executive (HSE)
The HSE is an independent regulator for work related health, safety and illness. They provide information and advice to reduce risks of accidents occurring in the workplace including the spread of infections
National Institute for Health and Clinical Excellence (NICE). NICE is responsible for providing guidance on the most effective ways to prevent, diagnose and treat disease and ill health
The Food Standards Agency (FSA) The agency set standards to guide and inform infection prevention and control practices. The FSA is responsible for food safety and food hygiene and providing advice on food safety issues.
Code of Practice for the Prevention and Control of Healthcare Associated Infection (HCAI); Regulation 12; 2011 Following a referral from the Department of Health, NICE, in partnership with the Health Protection Agency (HPA), developed this quality improvement guide, to prevent and control healthcare-associated infections (HCAIs)
The Care Quality Commission (CQC) regulates all health and adult social care services in England, including those provided by the NHS, local authorities, private companies or voluntary organisation. It also protects the interests of people detained under the Mental Health Act.
Local and organisational policies should incorporate all of the current laws, regulations and standards relating to infection prevention and control. All local authorities have infection control policies and procedures that have been developed to protect their local communities.
The borough I work in has Environmental and Public Health Policies that safeguard the community’s right to having clean air, safe and clean water, ensuring sewerage is managed safely, rubbish and waste disposed of, Food safety and food standards to control outbreaks of food poisoning. Infection prevention and control teams carry out routine inspections too to different settings to ensure safety. See leaflet for information re Borough Public Protection Unit.
My Hospital Trust has policies and procedures which can be found on the Trusts Intranet. These cover topics such as when and how to use protective equipment, cleaning routines to follow to maintain a clean and safe environment. How to handle laundry that may be contaminated with body fluids, disposing of hazardous waste, preparing, handling food. How to dispose of sharps, How to deal with biohazards such as blood and soiled dressings. Also provides guidance for using the PPE, and how to report any incidents or hazards.
Health care providers are responsible for providing systems and procedures for preventing and controlling infection in terms of monitoring any infection outbreaks, providing immunisation programmes and using barrier nursing in care settings to contain and prevent the spread of infection. If there is an epidemic of say the flu virus they would have to work closely with Public Health staff.
Receiving regular Information updates at work and attending training raises everyone’s awareness about infection prevention and control. Posters reminding people to wash their hands in key areas act as a reminder to staff and the public how important prevention is.
The media and different health campaigns organised to raise awareness amongst the general public about infection prevention and control. For example in relation to swine flu and to the MRSA bug and other superbugs. Subject lines are commonly used in soaps to highlight things like safe sex, as with the HIV and Chlamydia campaigns in the past.
The public health departments, now placed with our local authorities ensure the safety of local communities. They keep a check on the provision of sewerage systems, water quality, safe waste disposal, the monitoring of pollution and clean air. Environmental health enforces the required food safety standards. Food outlets and suppliers are routinely inspected by them. Training and information is also available from the local authorities and their infection control teams.
The outbreak of infection can be potentially fatal, especially for vulnerable groups. For example babies, children, elderly and people with existing conditions.
Prevention is always better through things like immunisation programmes. But if an infection takes hold it can be very difficult to contain and treat. All healthcare providers and local authorities should have an emergency plan in place for such eventualities, as not only the public become infected the staff will too especially in the case of virus such as swine flu.
There may be repercussions of any disease, leaving the sufferer with long term conditions such as breathing problems after the flu or in the case of MRSA wounds that never heal and are resistant to most antibiotics, all can prove fatal. The outbreak of an infection such as food poisoning has a wider impact for the families of the individuals affected. They may not be aware that the condition is contagious and not implement the necessary hygiene protocols. Very quickly the infection can be spread to a wider and unrelated group, from the original source.
The organisation or care provider could be closed down or fined by not complying with the standards and law; this will damage their reputation and
could incur considerable financial cost.
The definition of the word risk is to highlight a potential hazard or something that is very likely to cause harm.
There are many opportunities for the risk of infection when working in any area that involves dealing with body fluids, soiled or contaminated laundry, and clinical waste or in any personal care or close contact situation. Food preparation and disposal is a high risk area too. If work areas are not kept clean, hand washing regimes adhered too or soiled items disposed of correctly, pathogens can flourish and infections will be easily spread. This all increases the risk of infection or infestation.
There are five main stages to carrying out a risk assessment: 1) Identify the hazard – this involves identifying what the hazards are and how they might cause harm. We would observe the place or activity, talk to all individuals concerned and learn about their experience of using piece equipment or working in a particular area for example.
2) Evaluate the risks – We now look at who might be harmed and how. We have to considering everyone using the workplace; this includes all individuals, staff and visitors. Then work out the likelihood of an incident occurring
3) Take precautions – Using past experience and knowledge of health and safety we now have to make the judgment on what needs to be done. Assessing which actions and precautions must be taken to remove or reduce the hazard. Wearing appropriate PPE for example
4) Review the risks – Checks on the effectiveness of the precautions put in place should be carried out at regular intervals. This an opportunity to revise them if necessary.
5) Report and record outcome – the findings of the risk assessment must be recorded. Everyone involved, and those who need to be made aware, are given the report and education on how the risks can be prevented and or controlled.
Risk assessment is a very important process as it helps to reduce or remove the risk of accident or illness to all parties concerned. By doing a risk assessment an organisation can identify any potential dangers and can protect their workforce or users of the service. It also shows that they are responsible employers.