Reducing the risk of coronavirus in care homes
Care & Nursing Essentials’ round-up of news and advice on the coronavirus outbreak for those working in care homes, including a printable guide… Care homes urge visitors to stay away As coronavirus cases in the UK continue to rise, many care homes have now taken the decision to ban visitors unless absolutely necessary. Despite the government’s decision not to advise distancing, many care providers took the decision to reduce the number of people coming in and out of care home settings in order to help stem the spread of the virus. Pharmacist and NHS Digital adviser Mohammed Hussain tweeted that the move by care homes was “another example of organisations taking the lead where government guidance is behind the curve”. Meanwhile Mario Kreft MBE, the chair of Care Forum Wales and owner of eight care homes in Wrexham and Caernarfon, said: “In my organisation, Pendine Park, we’re already significantly reducing the number people entering homes and we’ve introduced washing stations outside each of them. “We’ve got to do everything that we can to ensure that people are safe, and I would say this to anybody who wants to visit a loved one in a care home to think very, very carefully because totally accidentally this virus could be transmitted. “Simply put, not visiting care homes is likely to save people’s lives. “I think it’s very important that we recognise that care homes will be a safe haven.” Spring Budget’s extra funding to tackle coronavirus As the coronavirus outbreak reaches epidemic level globally, the UK government has pledged funds to help stop the spread of the virus and to ease financial difficulty caused by Covid-19. During the Spring Budget, Chancellor Rishi Sunak pledged to make it easier for people to claim sick pay and outlined measures for self-employed people. He also announced extra funding to help public services cope. Mr Sunak stated: “I know how worried people are. What everyone needs to know is we are doing everything we can to keep this country and our people healthy and financially secure. This is an issue above party.” Despite the extra funds announced regarding the coronavirus outbreak, Siva Anandaciva, Chief Analyst at The King’s Fund said social care had been “overlooked” in the budget. He said: “The coronavirus outbreak has understandably altered the government’s priorities for this Budget so the extra £5bn announced for the NHS, social care and other public services to support their response to the coronavirus is very welcome. As the situation develops the government will need to keep under review how much funding public services need. “The Budget also included an additional £6bn for the NHS to deliver on some of the government’s headline manifesto commitments. Chronic workforce shortages remain the single biggest issue currently facing the NHS and social care, yet the Budget was light on detail of how it would boost recruitment and retention, and support under pressure staff. The publication of a long-term, comprehensive NHS People Plan has been repeatedly delayed and held back to allow for today’s Budget commitments, so it is now essential to get this published as soon as possible. “Adult social care remains a pressing and overlooked issue and despite the Prime Minister’s election commitment to ‘fix it once and for all’ the pressures have only increased in recent months. It is hugely disappointing that this Budget does not include an emergency cash injection to help local government to address social care needs beyond coronavirus. In writing to MPs and Peers last week, the government has still not come forward with any proposals for long term reform of social care.” Printable poster for your care home The team at Log my Care – a care management app provider – has created this poster with a list of handy information as well as a quick instruction set as to how to log a suspected coronavirus incident within the Carer App: Advice on reducing spread risk A scientist has published some useful advice on how to help prevent the spread of coronavirus which can help you prevent yourself and care home residents from catching the disease. Scientist James Robb (MD FCAP) was a professor of pathology at the University of California San Diego and one of the first molecular virologists in the world to work on coronaviruses in the 1970s. His tips are fairly self-explanatory but explain clearly why these precautions are needed – and his advice on stocking up on zinc lozenges has sparked a worldwide spike in sales of the product. Dr Robb said: “I was the first to demonstrate the number of genes the virus contained. Since then, I have kept up with the coronavirus field and its multiple clinical transfers into the human population (e.g., SARS, MERS), from different animal sources. The current projections for its expansion in the US are only probable, due to continued insufficient worldwide data, but it is most likely to be widespread in the US by mid to late March and April.” He said coronavirus is spread in large droplets by coughing and sneezing. This means that the air will not infect you but all the surfaces where these droplets land are infectious for about a week on average.Therefore, everything that is associated with infected people will be contaminated and potentially infectious. He added: “The virus is on surfaces and you will not be infected unless your unprotected face is directly coughed or sneezed upon.“The only way for the virus to infect you is through your nose or mouth via your hands or an infected cough or sneeze onto or into your nose or mouth. How to prevent the spread of coronavirus Dr Robb listed the precautions he was currently using as coronavirus said – adding that he took the same precautions during any flu season, except for the mask and gloves: 1) No handshaking! Use a fist bump, slight bow, elbow bump, etc.2) Use only your knuckle to touch light switches. elevator buttons, etc. Lift the gasoline dispenser with a paper towel or use a disposable glove. 3) Open doors with your closed fist
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
Mepilex dressings use state-of-the-art technology
To promote efficient healing Care & Nursing Essentials editor Victoria Galligan heard three different views on the new Swedish-deigned dressing Mepilex, which promise to decrease healing time and reduce infection… DEVELOPER – Molnlycke How and where were the dressings developed? Mepilex dressings were developed by Molnlycke, we are a Swedish-based leading medical solutions company that equips healthcare professionals to achieve the best patient, clinical and economic outcomes. Mepilex Border Comfort was developed with proprietary Flex Technology – the benefits of which have been analysed using an established method called finite element modelling. They also incorporate the new Exudate Progress Monitor – a dot pattern that allows you to easily track and record fluid as it spreads, without disturbing the wound. Which features make the dressings so effective? Mepilex Border Comfort addresses the challenges that many patients with chronic wounds face. The Cutting-edge Flex Technology means that the dressing can adapt to every day movement, allowing it to stay in place for longer and making wear more comfortable. Not only that, but superior exudate management means the dressing more effectively handles fluid and traps bacteria, reducing concerns about infection and meaning that dressings need to be less frequently changed. PATIENT –Nicholas Booth How long have you had the wounds for, are they new wounds or have you been suffering for a while? There have been two wounds, the first on my right leg and the second on my left. Both are on the Achilles tendon (pictured). I picked up the first wound in about April last year. It was my own fault. I wore some weights around my ankle in order to exercise my legs more while walking my dog. These was some abrasion to the back of my leg but I ignored it as cuts always heal up. This time the cut didn’t. I didn’t notice at first, but pain started to build up. By May, it was hurting enough to make me go to a drop-in centre. I thought it might be too trivial to bother them with but the nurse said: “You’ve got an ulcer. You must get this properly treated.” She told me to go down to my GP personally and make sure I got an appointment to see the practice nurse. Ever since that day I’ve been in pain. I have oedema, which makes the legs swell up, and if you have a cut that forces your wound, however tiny, to swell up too. When I used to take bandages off I used to dread looking at the results. It’s like watching your leg slowly burst open. How did the Mepilex dressings help? At one stage the bandages I was using (bought from supermarkets) were roughing up the skin around the wound, which effectively spread the area of pain. I never had that problem with the Mepilex bandages. They stay on too, which is a massive relief, as some of my bandages were coming off. The padding is brilliant too. At one stage, when I was cycling, I accidentally clunked the back of my ankle against the spiky bike pedal. I was in the middle of Richmond Park, swearing like hell and wailing, because the bandage I had on that day had given me no protection. The Mepilex give you a bit of protection. They stick to you like limpets too, without being uncomfortable. They also seem fairly absorbent and are very comfortable. It’s a shame I didn’t discover them earlier. Would you recommend them to a friend over other dressings, and if so, why? Oh absolutely. The application of the dressing, and keeping it in place, is crucial and the Mepilex is easily the best bandage for holding everything in place. At times, when I (or the medics) used other bandages, I was in agony when the bandage or the dressing slipped. I think Mepilex is great, used in conjunction with a support stocking. DOCTOR –Dr Paul Chadwick What are the common issues with regular dressings? There a lots of issues related to conformability and adhesion particularly on difficult to dress areas such as the feet. This leads to slippage and trauma to the wound and periwound and can prolong treatment time and increase risk of complications such as infection. With dressings that you can leave on for a week, isn’t there an increased risk of infection? There is no increased risk of infection providing the wound dressing is designed to be in place for that period. The risk is the development of infection which can occur whether the dressing is on for two days or seven and it is undetected. This is a particular issue in patients who have neuropathy (loss of feeling commonly seen in people with diabetes) where pain may not be present. In all cases patients should be encouraged to check the surrounding area and report any signs of heat, redness, swelling, odour and pain. Equally the patient should report urgently if they have any flu-like symptoms such as temperature. It is recognised in other areas of practice that things remain undisturbed for a week. For example in diabetic foot management gold standard treatment for a non-ischemic non-infected foot ulceration a total contact cast is used which remain undisturbed for a week. Are there cost savings to be made with Mepilex? Considering they require fewer changes, this will no doubt reduce staffing costs, and the reduction of secondary complications such as trauma associated with continually removing dressings will reduce costs. For more information on Mepilex dressing, see molnlycke.co.uk
