World class training suite provides education to NHS staff
Infection prevention and control specialist GAMA Healthcare, best known for hospital disinfectant range Clinell, has built-in a state-of-the-art training facility, which is supporting healthcare professionals on the frontline. GAMA Healthcare has provided complimentary training to over 32,000 NHS healthcare professionals since 2016 and hopes to reach a further 10,000 NHS staff over the next 12 months. The training suite was the brainchild of the company’s clinical directors, who are passionate about improving quality in the NHS. GAMA Healthcare has a strong heritage in education, guided by its four clinical directors who are all internationally renowned lecturers in infection prevention, allied with esteemed global Academic Institutions and involved in advising governments in infection prevention and control policy. During COVID-19, the team were released back to the NHS, helping to guide infection prevention and control protocols at the height of the pandemic. “We welcome NHS staff working in infection prevention and control into our training suite. GAMA Healthcare is passionate about preventing infections and has provided healthcare training for over a decade; As Clinical Directors, with nearly 100 years combined IPC experience, we share knowledge and skills both in the UK and abroad. This makes the clinical team a valuable resource when it comes to healthcare professional education,” comments Yvonne Carter, Clinical Director at GAMA Healthcare and previously Head of Infection Control at Royal Free London NHS Foundation Trust. Find out more at www.gamahealthcare.com
New approaches to hand hygiene
The importance of hand hygiene has been understood and accepted for a long time. The majority of infections – around 80 per cent according to studies – are passed by hand to hand contact or by touching a contaminated surface. This is why hand hygiene and surface disinfection are critical to infection prevention in hospitals, care homes and other settings. One would imagine that hand hygiene would be the easiest of everyday activities to get right. We all learn at an early age to wash our hands before eating and after going to the toilet. But studies have shown that relatively large numbers of people forget – or refuse – to do this. Even in settings such as hospitals, where poor hand hygiene can have serious consequences, studies suggest that processes can be improved, compliance rates increased and infection rates reduced. Despite established and robust infection prevention procedures, studies show that infection rates in hospitals run at around 10 per cent – that is one in ten – of all patients. While this is far lower than the past, many facilities have found it difficult to reduce the rate further. This is why current thinking is towards more effective hand hygiene processes and focusing on critical tasks. The recommended procedure for using hand rubs, for example, proscribes six separate steps. This is a tried and tested technique that is known to be effective at reducing infection rates when followed correctly. However, following all six steps correctly in the real world can sometimes be difficult. Researchers wanted to test if alternative, simpler techniques could be just as effective. One study compared the WHO’s current six-step hand rub method with a three-step method that involved covering the entire hand with alcohol rub and then focusing on the fingertips and thumbs. The results were significant and, to many, surprising. The three-step method was more effective at reducing the levels of bacteria on the subjects’ hands. A separate study focused on the fingertips because these are generally accepted to be the most contaminated part of the hand – this intuitively makes sense because it is quite possible to touch and hold all manner of surfaces and objects with the fingers alone. Trials of a fingertip-first method of hand hygiene demonstrated a greater reduction in the number of bacteria than the existing six-step methodology. Alongside new and improved hand hygiene techniques like these, attention has turned to when health workers should clean their hands. The World Health Organisation’s “Five Moments of Hand Hygiene” initiative has helped reduce infection rates in healthcare settings. These recommend healthcare workers wash their hands: before touching patients; before clean/aseptic procedures; after body fluid exposure; after touching patients; after touching patient surroundings. But despite progress, studies suggest between 20 and 40% of healthcare associated infections arise when a healthcare worker passes pathogens from one patient to the next. The latest thinking is for a more targeted approach that encompasses hand hygiene and surface disinfection. All areas in care settings are cleaned and disinfected daily, as before, but additional attention is paid to frequent touch and high-risk surfaces. In practice, this has been distilled into five critical points: before placing food/drink on over-bed tables; after procedures involving faeces or respiratory secretions within the patient bed-space; before/after any aseptic practice; after patient bathing (within bed-space); after any object used by/on a patient touches the floor. For its part, the cleaning and hygiene industry continues to develop innovations that help to make processes simpler, safer and more sustainable while improving performance and infection rates. Diversey offers a wide range of hand hygiene and surface disinfection products for healthcare and other settings. As a leading supplier with years of experience, the company can advise on the right combination of products for every setting and situation. Further information in the UK on 0800 525525 or http://www.diversey.com Further information in Ireland on 01 808 1808 or http://www.diversey.com
Ensuring effective hygiene and infection control in care
Trish Smith is general manager at Red Roofs Residential Care Home, part of Red Homes Healthcare. Trish joined the home in 1988, moving through the ranks to her current position. Here Trish discusses the key elements of ensuring effective hygiene and infection control in a care setting. As the manager of a busy care home it’s my job to make sure that my residents and staff are safe, which includes preventing and managing the outbreak of infection. This is a key element of safety in any care setting. Being responsible for hygiene and infection control means ensuring that all staff, residents and families are aware of their responsibility in keeping our care home clean and safe as part of their everyday routine. As with any care setting, regular contact with staff, family and friends means that infections are easily spread, so its important to eradicate any contamination from the outset and that any outbreaks are reported. It’s crucial this is properly managed and maintained as the repercussions can, in some cases, be life-threatening. Education around infection control First and foremost, education is key. Everyone involved giving care should know the basic standards for preventing and controlling infection. This involves being properly trained in hand sanitisation, using and disposing of sharps safely, and the role of personal protective equipment. If my staff know how to keep those in our care safe and understand the risks surrounding infection, then we’re all on the same page. Education doesn’t stop with caregivers – with many relatives visiting their loved ones throughout the day, it’s important that they, too, are aware of the benefits of handwashing in keeping us all safe. Handwashing Washing our hands correctly is possibly the easiest way to avoid cross-contamination and all staff should be aware of the guidelines. These principles outline when hands should be cleansed, whether to use hand rub or liquid soap, as well as the three stages of an effective handwashing technique. Personal protective equipment Personal protective equipment (PPE) also plays a vital role in our daily practices. This includes equipment such as gloves, goggles, visors, aprons and masks, which should all be readily available for staff to access. Staff should be trained to know when gloves are appropriate – as they should only be worn when necessary and are not a substitute for effective hygiene. It’s also important to use the correct type, depending on any allergies, or if working with high-risk substances. Similarly, aprons should also be worn only when necessary and disposed of once the task is completed. Sharps To reduce the risk of harm, it’s crucial that sharps are used safely and are disposed of in line with workplace policies. It’s my job as a manager to ensure any treatment requiring the use of injection or venepuncture is carried out by trained staff, who are fully aware of the risks, including the spread of infection, exposure to viruses and injury. Caregivers dealing with sharps should be aware of the guidelines surrounding sharps containers and the disposal of sharps following a procedure, as well as how to effectively deal with any injuries that may be incurred. Waste disposal Education is again, key, in ensuring the correct disposal of waste. All carers and patients should be aware of the procedures involved in handling, storing and disposing of waste to keep contamination to an absolute minimum. Colour-coded storage bags or containers, which are compliant with policy and legislation, should be used to segment healthcare waste immediately after it is produced. It must then be adequately labelled before transportation and disposal. What to do in the event of an outbreak If an outbreak of infection is to occur in a care setting, its important to recognise the symptoms swiftly to minimise the risk of other residents and staff becoming ill and to keep the occurrence under control. Depending on the level of severity, an effective policy should be followed, which outlines the assessment, communication, management, organisation and investigation involved in any infection found within the home. We also have a responsibility to inform Public Health England once an outbreak of infection has been identified. This is a not an exhaustive list of the procedures involved in maintaining a safe and clean environment for our residents and staff to live and work in. However, with the right policies and training in place we can empower ourselves with the confidence that those in our care are looked after safely and with dignity.
mikrozid® universal – tough on germs, gentle on equipment
mikrozid® universal from schülke UK – experts in infection prevention – has a unique low alcohol formulation, with a dual action. Offering both cleaning and disinfection of surfaces in a single product, mikrozid universal is ideal where short contact times are required and prolonged exposure to moisture could cause damage. Effective against bacteria including TB, and viruses like norovirus, mikrozid universal is compatible with a wide range of materials including keyboards, touch screens, leatherette furniture, surfaces of medical equipment and work surfaces. mikrozid universal is fast acting (bactericidal in 15 seconds), has excellent material compatibility and contains added surfactants to boost cleaning performance. It is available in both liquid with integrated spray and high quality fleece wipes for enhanced coverage. To find out more about how schülke’s extensive infection prevention and control range can help your care home, contact:schülke UK, Cygnet House, 1 Jenkin Road, Meadowhall, Sheffield, S9 1AT0114 254 3500 / www.schuelke.com / email: mail.uk@schuelke.com
Three Key Tenets of Outstanding Infection Control
Ben Kilbey, Business Development Manager at Spearhead Healthcare, on achieving outstanding infection control procedures in your care home… Every care manager knows that a systematic, structured approach to cleaning is the only way to keep infections at bay and to protect residents and carers effectively – as well as your own reputation. Based on our extensive experience of helping hundreds of care homes like yours implement a best-practice infection control programme, here are our three guiding principles to set you on the right course. 1. Don’t cut corners with products It’s simply not possible to cut corners in infection control especially when it comes to the products you choose. Relying on domestic cleaning products, like furniture polish and bleach, is poor practice in care homes. It’s imperative to use BS EN1276-certified specialist products, like the ones included in our Platinum Plan, which are designed for the care environment and kill bacteria such as MRSA, Salmonella, E.Coli and the flu virus. Daily use of bactericidal and sporicidal cleaning products should be combined with a monthly deep clean, and a different set of chemical-based products are required to get an infection outbreak under control. That said, there are sensible ways of saving money without compromising on quality. For instance, providers can keep ‘cost-in-use’ to a minimum by purchasing products as concentrates, and training staff to use specialist diluting equipment correctly. As one of our customers Sophie Parker, Head Housekeeper at Dalawoodie House Nursing Home in Dumfries, reminds us: “Product overuse is as bad as underuse!” You can also take steps to consolidate chemical products, which is a key COSHH stipulation. For instance, our Multi-Surface Spray Polish is ideally suited for use on mirrors, furniture and metal surfaces such as stainless steel. 2. Get your infection control processes in shape Every process involved in cleaning the care home should be underpinned by a clearly thought-out and consistent strategy. This is where we often step in, helping homes to create and implement best-practice routines and procedures for staff, residents and visitors alike. This includes detailed guidelines for product usage and storage, usage of personal protective equipment (PPE), cost sheets, template cleaning schedules, logs and risk assessments. Delivering expert COSHH training for staff is also a core part of this. We’re strong advocates of colour-coding products, equipment and even paperwork to ensure that staff have clear visual reminders of which item to use where and which guidelines to follow. I can’t emphasise enough how important it is to include every area of the care environment in your cleaning strategy, from handwashing and laundry to fabrics (even curtains) and moving and handling equipment. 3. Take the lead on compliance Regulatory compliance in the care sector is not to be taken lightly. Thorough documentation demonstrates your commitment to maintaining the highest possible cleaning standards, strict accountability, transparency and willingness to communicate openly with all stakeholders. Indeed it will ensure peace of mind during any inspection. Rigorous documentation isn’t just for when an outbreak strikes or when you are under particular scrutiny. It may sound gloomy but it is really true that those providers who prepare for disaster will recover faster! In the event of an outbreak, you’ll need to show regulators, families and local authorities that you followed the correct procedures and did all within your means to contain it. Also, compliant record-keeping reassures everyone that you are doing everything possible to prevent it from reoccurring. Our documentation package for Platinum Plan customers provides useful templates, logs and records that all help reduce the compliance burden for busy care managers. See spearheadhealthcare.com for more advice on infection control
Implementing effective infection control
Clare Long, business account manager for care at the Professional Division of Miele, discusses effective infection control for care facilities… An infection control plan is a series of policies and procedures that every care home should have in place to ensure hygienic standards, prevent the spread of infection and keep residents, staff and visitors safe in the care environment. Even the most conscientious team can struggle to control infectious diseases if they don’t have guidelines to follow, and this is where your documented infection control plan comes in really useful. Here are some of the factors and regulations to take into account when introducing or revising your infection control plan for laundry procedures: 1. Hand hygiene This is the single most important factor for preventing the spread of infection and should underpin the rest of your policy. It’s vital for staff, visitors and residents to effectively wash and disinfect their hands to ensure they’re not transferring harmful germs or micro-organisms to other people, equipment or surfaces. Your individual policy should define the process that should be followed and when, for example after ‘hands-on’ contact with a resident. 2. Personal protection Your plan needs to define if and when staff should use personal protection. Carefully consider all the instances where personal protection measures may need to be taken and define the process. For example, an employee may need to use gloves and an apron to load soiled laundry into the washing machine. They should remove these and dispose of them safely before handling clean laundry at the end of the cycle or moving onto a different task. 3. Effective decontamination Dealing with waste and potentially infectious substances as a carer is often inevitable, but it’s vital to make sure that any soiled items are effectively decontaminated. Consider a sluice sink to remove as much residue as possible from soiled materials before entering the washing cycle. Ensure you’re equipped with quality commercial machines that are capable of handling larger loads and consistently washing to a safe standard. Once the washing cycle has finished, take care to prevent cross-contamination by ensuring clean washing does not come into contact with dirty items. 4. Regulation of infection control It’s vital to ensure industry guidelines and regulations are being met across different operations and the infection control plan is an effective way of ensuring your processes comply. The NHS infection control guidelines (HTM 01-04) define the decontamination of linen for health and social care. Your appliances should be tested and approved as being able to meet these conditions and be able to hold washing at either 10 minutes at 65⁰C or over, three minutes at 75⁰C or over or one minute at 85⁰C or over. 5. Brief staff Employees need to be thoroughly briefed and up-to-date with the correct procedures, particularly in the operational areas that might experience higher-than-usual staff turnover, like the laundry room. Ensure your infection control plan is properly communicated, easy to understand and accessible at all times. See miele.co.uk for information on cleaning products, domestic appliances and infection control.
Latest news from BBI LLC, pressure ulcer detection experts
The latest news from BBI LLC, the pioneers in biometric-sensor based medical devices… September 2019 BBI LLC boosts its global team with appointment of Zoe Wood as Senior Clinical Manager Zoe Wood has joined BBI LLC in the new position of Global Senior Clinical Manager. As BBI’s Global Senior Clinical Manager, Zoe’s primary role will be to develop and manage BBI’s clinical and health economics research, post market studies and publication plan. She will also support the marketing team in developing evidence-based claims and messaging for BBI’s SEM Scanner, and the global sales organisations in presenting clinical and HE data to expert groups, customers and other commercial organisations. Kate Hancock, Global Vice President of Marketing and Communications at BBI said: “A Senior Clinical Manager is essential for BBI’s increased growth and focus in furthering our clinical and health economic data. Zoe brings a great deal of experience and is a welcome and important addition to our team.” Zoe joins BBI LLC with more than 20 years’ experience in clinical care, having a Clinical Nursing Master’s Degree – Wound Healing and Tissue Repair and holding positions at high profile organisations including Healogics, Archimed and BUPA. Commenting on her appointment, she said: “I have seen first-hand the impact of pressure ulcers on two members of my family, yet these could so easily have been prevented. BBI’s technology has the potential to help all healthcare professionals revisit their current pressure ulcer prevention strategies, and I am very excited to join this innovative company.” September 2019 BBI LLC extends its partnership with RCSI on diabetic foot ulcer prevention research Manchester, UK, and Dublin, IRELAND, – BBI LLC (Bruin Biometrics), a developer of innovative sensor-based diagnostic products, and the Skin Wounds, and Trauma (SWaT) Research Centre at RCSI (Royal College of Surgeons in Ireland), announced today that they have agreed to extend their partnership to undertake a number of collaborative projects that will employ BBI’s proprietary biocapacitance technology, the SEM Scanner. The research programme will continue to explore biocapacitance science as a novel methodology supporting Diabetic Foot Ulcer (DFU) prevention. It seeks to radically alter the progression of the disease while contributing to the biological understanding of DFU development, the underlying pathophysiology and biomarkers, such as sub-epidermal moisture (SEM). The ultimate aim is to prevent Diabetic Foot Ulceration and reduce the prevalence of this significant public health problem. The planned study includes the use of BBI’s SEM Scanner to identify Diabetic Foot Ulceration before it is visible. This clincial research will enable the translation of evidence into contempoaray clinical decision-making, and those at risk of developing DFUs will ultimately benefit from this approach, improving thier quality of life, and saving services money. Highly significant clinical data has been found in the area of pressure ulcer prevention “The team at the Skin Wounds and Trauma (SWaT) Research Centre at RCSI is delighted with the opportunity to extend our partnership with BBI LLC. Our research collaboration to date has yielded highly significant clinical data mainly in the area of pressure ulcer prevention. The planned study will extend our research relationship into the area of Diabetic Foot Ulceration and how it can be prevented through earlier identification by the analysis of the role of biocapacitance technology in DFU prevention. At the heart of our research are patient outcomes that will improve patient quality of life. Our aim is that this study will continue to make a significant mark on the area of earlier identification of Diabetic Foot Ulceration with the resultant outcome that the lives of patients and their families are improved ’ said Professor Zena Moore, Director, SWaT Research Centre. RCSI. “I am delighted to extend the partnership with the RCSI and I look forward to the new advances our continued collaboration will bring in the prevention of this pernicious clinical problem,” said Martin Burns, CEO, BBI LLC Diabetes is a growing epidemic, with associated complexity of treatment and management from a wound care perspective, prevalence of foot ulceration reaches as high as 10%. Diabetes is the leading cause of non-traumatic limb amputation in the world. Within 18 months following amputation, almost 50 percent of individuals will develop ulceration on the other limb and of these, 58% will have further amputations within three to five years. It’s worthy of note that the three-year mortality rate after the first amputation is between 20 and 50 percent. This is down to the motor and sensory neuropathy associated with diabetes, resulting in damage to the foots nerve supply. This chain of events leads to further bone, joint and soft tissue damage, which can lead to irreversible cell destruction. Quality of life is threatened through mobility loss, subsequent social functioning and intractable pain experienced in almost 50% of these patients. Within healthcare, diabetic foot ulceration represents estimated costs of €4–6 billion in light of a 1-1.4 million prevalence, placing a significant burden on resource. The SEM Scanner received European CE Mark approval in 2014 and Health Canada clearance in 2016 and is in full commercial use in Australia, New Zealand, Canada and the European Union including the UK, Belgium and Spain with additional markets expected to be opened in 2019. Additionally, FDA Authorisation to market the SEM Scanner in the USA was received in December 2018. December 2018 SEM Scanner detects pressure sores before they’re visible Care and Nursing Essentials editor Victoria Galligan spoke to the team at Bruin Biometrics, who are behind the SEM Scanner. The scanner can detect pressure damage before it is visible to the naked eye… Could you outline the workings of the SEM Scanner – how does it detect the moisture under the skin? The SEM Scanner is a, hand-held portable device that has been designed to measure sub-epidermal moisture (SEM) (also known as localised oedema) which is an invisible precursor to the development of incipient pressure damage. The analogy we like to use is one of an oil tanker moving through water. The oil tanker is the actual damage to the skin and tissue, but the big wave in
How hygiene can make up for funding cuts
Steve Nurdin, marketing manager at Cannon Hygiene, explains how an effective hygiene strategy can help care homes providers achieve positive customer feedback and attract new business. The UK social care system is facing a crisis and care homes will be hit the hardest. Spending cuts and unsustainably low budgets – on average £620 a week – have led to care home providers not being able to cover day-to-day costs, according to the Competition and Markets Authority (CMA). The Guardian also recently reported that social care spending has decreased by £7bn since 2010 and English councils plan to push through another £700m in social care cuts by the end of 2019. Care homes increasingly rely on the ability to attract and retain business to survive as a result. Clients expect nothing but excellence from care facility providers and poor high hygiene conditions are usually the main area for complaints and negative customer perceptions. But faced with decreasing budgets many care home owners face staff shortages and cleaning tasks often slip to the bottom of priority lists. Especially with cold and flu season just around the corner, excellent hygiene is crucial to avoid falling below standards and facing mounting customer complaints. Infections such as the common cold and flu are highly contagious and can spread like wildfire through any facility if no precautions are taken. The best defence is introducing a consistent hygiene strategy which can work in the background and take the pressure off already busy staff. Good hand hygiene is the single most important factor which can help prevent a seasonal outbreak of viruses. Hands are responsible for the spread of 80 per cent of infectious diseases and effective hand hygiene is one of the best and most cost-effective ways to kill bacteria before it can spread. Automatic hand sanitiser dispensers should be provided in key areas such as communal spaces and near entrances and exits. In washrooms – if en-suite or shared – proper hand-washing facilities are vital. No-touch solutions, such as automatic taps, soap dispensers and hand driers, can reduce the transfer of germs from the washroom into the wider care home, while also saving staff resources. Airborne germs are some of the easiest to transmit but hardest to prevent. While it is common practice, many people do not cover their mouth when sneezing or coughing. This can quickly spread bacteria between care home residents. The good news is that recent advances in technology means care home operators can now manage indoor air quality effectively and automatically. Air filters can kill bacteria, neutralise pollen and dust and fragrance the air to keep premises smell fresh throughout the day. The key to success lies in the detail, and special attention should be paid to areas where dirt and bacteria can settle and collect unnoticed. Vacuuming doormats may seem sufficient as the surface appears clean, but it only removes the top 10 per cent of the dirt, for example. Instead, they should be professionally laundered on a regular basis. Equally as important are door handles as bacteria can spread through hand to surface touch within hours throughout an entire building. In fact, a study conducted by The University of Arizona found that traces of a harmless virus placed on a door handle spread to half of the surfaces in the same building within just four hours. To tackle this issue there are solutions available that automatically spray an antibacterial mist on door grips and effectively neutralise bacteria. Managers should identify germ hotspots and develop a consistent hygiene strategy that can work in the background without much assistance. Automatic no-touch solutions will provide peace of mind for care home providers that an effective hygiene strategy is in place to protect residents and save resources. See cannonhygiene.com for more details on hygiene and infection prevention
