Personal Protective Equipment for Infection Control in {{org_field_name}} (England) Policy

Policy Statement

This policy shows how {{org_field_name}} prevents and controls the spread of infection among staff, people who use the services and the local community through the correct wearing of protective equipment and related procedures.

The aims are to ensure that people, their families and staff are as safe as possible from acquiring infections and care home staff are aware of and put into practice the basic principles of infection control.

Infection control is the name given to a wide range of policies, procedures and techniques intended to prevent the spread of infectious diseases among staff, people who use the services and communities. All of the staff working in a care home are at risk of infection or of spreading infection, especially if their role brings them into contact with blood or bodily fluids like urine, faeces, vomit or sputum. Such substances may well contain pathogens which can be spread if staff do not take adequate precautions.

Adherence to strict guidelines on infection control is of paramount importance in ensuring the safety of both people who use the services and staff. Also, good, basic hygiene is the most powerful weapon against infection, particularly with respect to cleaning, the wearing of protective clothing and hand washing.

Legislation and Guidance

The policy is in line with the requirements of Regulation 12: Safe Care and Treatment of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and the corresponding Code of Practice for Health and Adult Social Care on the Prevention and Control of Infections and Related Guidance.(The Hygiene Code).

Other infection control legislation, which {{org_field_name}} must observe include:

the Health and Safety at Work, etc Act 1974 and the Public Health Infectious Diseases Regulations 1988 which place a duty on the organisation to prevent the spread of infection
the Reporting of Incidents, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR), which places a duty on the organisation to report outbreaks of certain diseases as well as accidents such as needle-stick accidents
the Control of Substances Hazardous to Health Regulations 2002 (COSHH) which places a duty on the organisation to ensure that potentially infectious materials within the home are identified as hazards and dealt with accordingly
the Environmental Protection Act 1990, which makes it the responsibility of the organisation to dispose of clinical waste safely

In addition, the home will comply with all other relevant best practice infection control guidance.

For instance, applicable guidance from the National Institute for Health and Care Excellence (NICE) includes:

CG139: Healthcare-associated Infections: Prevention and Control in Primary and Community Care (updated February 2017)
PH36: Healthcare-associated Infections: Prevention and Control (November 2011)

Guidance is also available from the Department of Health and Social Care (DHSC) and from the Health and Safety Executive (HSE) in the form of:

Infection Prevention and Control (IPC) Resource for Adult Social Care (2022) DHSC
Infection Prevention and Control in Adult Social Care: COVID-19 Supplement (2022) DHSC
Prevention and Control of Infection in Care Homes: An Information Resource (2013) DHSC
HSG220 Health and Safety in Care Homes (2nd edition) (2014) HSE.

Specialist advice and support will be obtained from the local public health protection team and from relevant primary healthcare teams.

The Use of Personal Protective Equipment

In consultation with staff and their representatives, the organisation will:

identify, as part of its risk assessment programme, the need for any Personal Protective Equipment (PPE)
carry out an assessment of proposed PPE to determine whether or not it is suitable
take any necessary measures to remedy any risks found as a result of the assessment
replace, modify or repair PPE to meet statutory obligations, as necessary and at no cost to the employee
inform every employee of any risks that may remain
ensure that staff are trained to use PPE correctly
reassess, as necessary, any substances used, or work processes that have changed.

Disposable gloves and aprons

The effective use of personal protective equipment (PPE) and effective hand hygiene in relation to infection control and prevention is a vital area in preventing the spread of healthcare-associated infections and is essential in complying with the Hygiene Code.

The hands of staff are likely to be the most common means of transmission of infection from one person to another unless basic precautions are taken, ie careful handwashing between contacts and the correct use of protective clothing such as disposable gloves (sterile and non-sterile) and disposable aprons.

Disposable gloves and disposable aprons are provided for staff who are at risk of coming into direct contact with body fluids, or waste such as faeces.

Sterile gloves are provided for clinical procedures such as:
a. applying dressings
b. wound care
c. catheterisation
d. suturing
e. working with MRSA.
Non-sterile gloves are provided for non-clinical procedures such as:
a. washing dirty or used instruments
b. clearing up blood or bodily fluids or spillages
c. handling disinfectants
d. inserting suppositories or enemas
e. PR examinations/procedures
f. emptying catheter bags
g. venepuncture
h. performing mouth care.
Gloves should be worn at all times during these procedures and disposed of immediately after the procedure or contact is finished.
Gloves should always be changed between people who use the services.
On no account should staff attempt to wash and reuse gloves.

Plastic disposable aprons are also provided for use by nursing care staff, care assistants and domestic staff. Aprons should be used in all of the above procedures and should be changed between contacts with individuals, especially where people are known to be colonised or infected with MRSA.

The responsibility for ordering and ensuring that supplies of gloves and aprons are readily available and accessible lies with __________________________.

In {{org_field_name}}, gloves and aprons are supplied by ___________________________.

Covid-19 infection and prevention measures

{{org_field_name}} will comply fully with all official public health guidance and restrictions introduced as part of the national response to the Covid-19 coronavirus pandemic. The organisation is aware that a range of infection prevention and control measures have been required.

In {{org_field_name}}, during the current phase of the Covid-19 pandemic, all use of PPE for infection prevention and control purposes will be based on the latest guidance, from the UK Health Protection Agency, including their Infection Prevention and Control in Adult Social Care: COVID-19 Supplement (DHSC 2022). The guidance sets out PPE requirements in a variety of common scenarios in different care settings, including residential care.

According to the supplementary guidance, in situations when caring for a person who is not suspected or confirmed to be infected with Covid-19, the following is advised.

During social contact with clients, other staff or visitors, staff are advised that no PPE is required. They are also not required to wear PPE for tasks not involving contact with blood or body fluids (eg moving clean linen, tidying, giving medication, writing in care notes, etc).
During care or domestic tasks involving likely contact with blood or body fluids (eg giving personal care, handling soiled laundry, emptying a catheter or commode) staff are advised to wear gloves and an apron. They should also risk assess the situation and wear a mask as required. A Type IIR mask should be used where splashing is likely, as well as eye protection.
During general cleaning with hazardous products (disinfectants or detergents) staff are also advised to carry out a risk assessment and to wear the PPE indicated. Staff should wear a mask, eye protection, gloves and an apron if indicated in the risk assessment or if recommended by the cleaning product manufacturer. A Type IIR mask should be used where splashing is likely.

The guidance states that staff should change PPE between tasks and between caring for different care recipients.

In situations when caring for a person who is suspected or confirmed to be infected with Covid-19 (symptoms may include coughing, sneezing, diarrhoea, vomiting, shortness of breath, temperature), the guidance states the following.

When giving personal care to a person with suspected or confirmed Covid-19 staff are advised to wear a type IIR mask (which they should remove on leaving the area) and disposable gloves, a disposable apron and eye protection.
During general cleaning duties in the room where a person with suspected or confirmed Covid-19 is being isolated or cohorted (even if more than 2m away) staff are advised to wear a type IIR mask (which they should remove on leaving the area) and disposable gloves, a disposable apron and eye protection.
For tasks other than those listed above, when within 2m of a person with confirmed or suspected Covid-19, staff are advised to wear a type IIR mask (which they should remove on leaving the area), disposable gloves (if contact with blood or body fluids is likely), a disposable apron (if contact with blood or body fluids is likely) and eye protection.

When undertaking Aerosol Generating Procedures (AGP) the guidance states the following.

When undertaking an AGP on a person who is not suspected or confirmed to have Covid-19 (or any other infection spread by the airborne or droplet route) staff should wear a type IIR mask (to be used for the single task only), and gloves, and apron and eye protection. A fluid-repellent gown should be considered if there is a risk of extensive splashing.
When undertaking an AGP on a person who is suspected or confirmed to have Covid-19 or another infection spread by the airborne or droplet route staff are advised to wear an FFP3 RPE respirator (for the single task only), disposable gloves, a disposable apron (consider a gown if risk of extensive splashing) and goggles or a visor.

Note the following.

Aerosol-generating procedures (AGPs) are medical procedures that can cause the release of virus particles from the respiratory tract and can increase the risk of airborne transmission to those in the immediate area.
Type I and type II masks are not considered PPE and are worn to provide “source control” — that is, to protect others from the wearer’s respiratory droplets should they have asymptomatic Covid-19 infection.
Type IIR fluid-repellent surgical masks protect the wearer by providing a fluid repellent barrier between the wearer and the environment — this protects the wearer against blood or body fluid splashes and against the respiratory droplets of others reaching their mouth and nose.
Face masks of all types can be used for “source control” and can be worn “sessionally”, that is for a maximum of four hours, unless the worker is providing personal care or cleaning the room of someone with suspected or confirmed Covid-19 or is carrying out an AGP.

For PPE to be effective, it is important that staff use it properly and follow instructions for putting it on (donning) and taking it off (doffing). These will be explained in training and displayed around the home.

All used PPE should also be disposed of appropriately according to the homes waste management policy.

All staff are required to comply with formal Covid-19 restrictions and to keep themselves updated with changes as they occur.

Maintenance

All PPE should be adequately maintained by the home. PPE will be repaired, replaced or modified as required.

Where a problem arises with the use of PPE, staff must inform a responsible person immediately, ie a supervisor, line manager or {{org_field_name}} manager. The manager will take immediate steps to investigate. In all such cases, the risk assessment will be reviewed and the PPE replaced, repaired or modified.

Latex allergies

Some people can develop allergic reactions to the latex within disposable gloves. Any member of staff who suspects that they might be suffering from an allergic reaction to the latex gloves provided should stop using them immediately and inform their line manager or supervisor. They should then consult their GP.

Charges

In {{org_field_name}}, there will be no charges to staff for using PPE.

Where an assessment of risks has taken place under the Management of Health and Safety at Work Regulations 1999 and residual risks exists after control measures have been applied, then the provision of PPE will be a specific requirement for employees and in these circumstances no charge will be made for the PPE.

Personnel

______________ is the infection control lead for the organisation.
Other infection control personnel are:
a. ______________ who is responsible for infection control risk assessment and staff training
b. ______________ who is responsible for the cleaning and hygiene of the home.

Training

All new staff should be encouraged to read the organisation’s health and safety policies as part of their induction process. Where new staff are required to use specific items of PPE they should be trained in all aspects of its use.

All care staff will be trained in the effective use of PPE at the point of care as part of their infection control training.

Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}

Reviewed on: {{last_update_date}}

Next Review Date: {{next_review_date}}

CH230. Personal Protective Equipment for Infection Control in the care service