Patients must be promptly assessed for infection risk on arrival at the care area (if possible, prior to accepting a patient from another care area) and should be continuously reviewed throughout their stay. This assessment should influence patient placement decisions in accordance with clinical/care need(s).

 

Patients who may present a particular cross-infection risk should be isolated on arrival and appropriate clinical samples and screening undertaken as per national protocols to establish the causative pathogen. This includes but is not limited to patients:

• With symptoms such as loose stools or diarrhoea, vomiting, fever or respiratory symptoms. 
• With a laboratory confirmed or suspected infection or colonisation for which appropriate duration of precautions as outlined in A-Z pathogens are not yet complete.
  
• Known or suspected to have been previously positive with a
  Multi-drug Resistant Organism (MDRO), for example MRSA, CPE.
• Who have been a close contact of a person who has been colonised or infected with CPE in the last 12 months.
• Who have been hospitalised outside Scotland in the last 12 months (including those who received dialysis).

When assessing neonates for infection risk, the mother’s status should be taken into consideration if the mother has:

• been hospitalised outside Scotland in the previous 12 months
• had no antenatal care
• been previously positive with an MDRO, for example Meticillin Resistant Staphylococcus Aureus (MRSA) or Carbapenemase Producing Enterobacterales (CPE)

For further assessment and management of patients who are a potential infection risk, refer to Chapter 2: Transmission Based Precautions.

Resources

The Neonatal Assessment for Infection Risk should be used at point of entry or transfer before placement of neonate. The 'Healthcare infections in neonatal units: information for parents and guardians' information leaflet is available. 

Further information regarding general respiratory screening questions can be found within the resources section of the NIPCM.

Further information can be found in the patient placement literature review.