To make sure that your health and care area is ready for winter you should have the correct products, procedures and communications in place to stop infections spreading.
At all times Standard Infection Control Precautions (SICPs) should be followed. SICPs are the basic infection prevention and control measures necessary to reduce the risk of transmission of infectious agents from both recognised and unrecognised sources of infection.
SICPs may be not be enough to prevent cross-transmission of specific infections so you might need to also use additional precautions known as Transmission Based Precautions (TBPs) when caring for patients with a known or suspected infection or colonisation.
Further information on SICPs and TBPs can be found in the NIPCM and CHIPCM.
Make sure that you have the contact details for your local infection prevention and control (IPC) team and NHS board health protection (HPT) team so you can easily get advice and support on infection control and outbreak management during the winter season.
Communications
- Ensure key messages around respiratory hygiene, and norovirus are effectively communicated to staff, service users and the public.
- Ensure that all national and local winter planning communications are available and circulated to staff.
- Provide appropriate communications on IPC and winter planning in in the care area. For example posters and signage in wards and staff kitchen areas promoting hand hygiene and cough etiquette.
- Hand hygiene posters - Appendix 1 - How to hand wash and Appendix 2 - How to hand rub.
- Use infection alert posters to provide information on precautions to be taken when entering an area or visiting a service user.
- Have a supply of HAI and disease specific information leaflets to give to service users and visitors.
- Work with local communications team or staff to issue winter planning communications based on national messaging. This can include social media, websites, staff newsletters, infographics, posters, email signatures, videos and animations.
- Promote seasonal vaccinations for flu and COVID-19 to eligible groups using a range of communications materials, messaging and assets and NHS Inform.
- Remind staff:
- not to attend work until 48 hours after their last symptom of diarrhoea and/or sickness
- not to come into work if unwell and to use NHS Inform for further information on norovirus or respiratory infections
- about their eligibility for seasonal vaccinations
- to access training to ensure their IPC knowledge is up to date for example from NHS Education Scotland
- Remind visitors that they shouldn't visit if they:
- are feeling unwell
- have symptoms of a respiratory infection
- are not yet 48 hours symptom free of sickness and/or diarrhoea
- Direct the public to NHS Inform for further information on norovirus or respiratory infections.
Assessment of infection risk
- Infections can spread easily in busy areas so try to ensure that shared areas, for example waiting areas, are not overcrowded.
- Assess service users for infection risk on arrival to the care area (if possible, before transferring from another care area) and review throughout their stay.
- Service users who present a particular cross-infection risk, for example with symptoms such as diarrhoea, sickness, fever or respiratory symptoms, should be isolated on arrival with appropriate clinical samples and screening undertaken as per national protocols to establish the causative pathogen.
- Ensure sure staff have access to appropriate training on patient placement and assessment for infection risk.
- Make sure that care areas are well ventilated where possible and if safe to do so.
Hand hygiene
- Make sure there is an adequate supply of hand rub, soap and paper towels available to ensure hand hygiene can be correctly undertaken by service users, staff and visitors.
- Ensure ordering of supplies takes into account potential increase in product demand over winter period as well as seasonal holiday period and closures.
- Hand hygiene using soap and water should be used where a service user has symptoms of a gastro-intestinal infection (vomiting and/or diarrhoea).
- Remind visitors to use appropriate hand hygiene.
- Put up hand hygiene technique posters in areas where they are required for example hand rub dispensers at entrance to care area and above hand wash basins.
- Remind staff to undertake hand hygiene at the 5 moments or 4 moments in care homes.
- Make sure staff have access to appropriate training on hand hygiene
Respiratory and cough hygiene
- Ensure ordering of supplies takes into account potential increase in product demand over winter period as well as seasonal holiday period and closures.
- Staff should promote respiratory and cough hygiene helping those who need assistance with this, for example elderly and children.
- Provide service users with tissues, plastic bags for used tissues and hand hygiene facilities as necessary.
- Encourage service users showing symptoms of respiratory illness to wear a surgical (TYPE II R FRSM) face mask where it is clinically safe and tolerated by the wearer.
- Note: FRSM is not required when service user in their room on their own.
- Dispose of used tissues and face masks promptly into a waste bin.
- Wash hands with non-antimicrobial liquid soap and warm water after coughing, sneezing, using tissues, or after contact with respiratory secretions or objects contaminated by these secretions.
- Make sure staff have access to appropriate training on respiratory and cough hygiene.
Personal Protective Equipment (PPE) and Respiratory Protective Equipment (RPE)
- PPE and RPE are required to minimise the risk of cross-transmission of infection to yourself and others when providing care.
- PPE and RPE should be single-use items unless specified by the manufacturer whose decontamination procedures should be followed.
- Follow appropriate guidance for when and what PPE and RPE to wear when an infection is known or suspected.
- Make sure there is an adequate supply of all PPE and RPE that it is close to the point of use.
- PPE and RPE should be changed immediately after each service user and/or following completion of a procedure or task.
- PPE and RPE should be disposed of after use into the correct waste stream which is healthcare waste or domestic waste.
- Perform hand hygiene after removing PPE and RPE.
- Advise visitors to wear PPE if they are performing direct care.
- Ensure ordering of supplies takes into account potential increase in product demand over winter period as well as seasonal holiday period and closures.
- Make sure staff have access to appropriate training on PPE.
Care equipment and environment
- Environmental and equipment decontamination may need to be increased when there is a known or suspected infection in the care area.
- Make sure staff are aware of their environmental and equipment cleaning schedules and know their specific responsibilities.
- Routine environmental cleaning should follow the guidance in the NHSScotland National Cleaning Specification and Cleaning Specification for Care Homes.
- There may be a need to update local cleaning schedules where increased frequency of environmental cleaning is required.
- Terminal cleans of service users rooms should be undertaken following transfer or discharge, or once the service user is no longer considered infectious.
- Make sure staff have access to appropriate training on management of equipment and environment.