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CH31. Blood-borne Viruses in Care Homes

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Blood-borne Viruses in Care Homes (England) Policy

Policy Statement

{{org_field_name}} recognises that having effective infection prevention and control policies and procedures in place is of paramount importance in ensuring the safety of both people who use the services and staff from infectious organisms such as blood-borne viruses.

The policy shows how the home prevents the spread of blood-borne viruses among people who use the services, staff and visitors and how it deals with any outbreaks. It is written in line with Regulation 12: Safe Care and Treatment of the Health and Social Care Act 2008 (Regulated Activities) 2014, which includes requirements for the prevention and control of all infectious illnesses and related laws and guidance that include:

Under the above legislation, and associated codes of practice, {{org_field_name}} understands its legal and moral duty to ensure the health and safety of both staff and people who use the services and to protect them, wherever practicable, from dangerous substances in the workplace, including the risk of transmission of infections.

The policy aims to ensure that:

  1. people who use the services, their families and staff working at the home are as safe as possible from blood-borne viruses
  2. all staff at the home are aware of the causes of the spread of blood-borne viruses and are trained to avoid these
  3. people who are infected with blood-borne viruses receive the highest quality of care
  4. staff who are infected with blood borne viruses are not discriminated against and receive adequate adjustments and support.

Relevant Guidance

The home seeks at all times to comply with evidence-based best practice in infection control, particularly with the Health and Social Care Act 2008 Code of Practice on the Prevention and Control of Infection and Related Guidance published by the Department of Health and Social Care (the Hygiene Code). 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:

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:

The home might also seek specialist advice and support from the local public health protection team where necessary.

Background

Blood-borne viruses are microorganisms that cause disease and can be spread via infected blood and other bodily fluids. The most common blood-borne viruses which present a hazard to staff and people who use the services are the Human Immunodeficiency Virus (HIV), Hepatitis B and Hepatitis C.

HIV is the virus which can cause Acquired Immune Deficiency Syndrome (AIDS). It is transmitted through infection with bodily fluids, such as through unprotected vaginal or anal sex, through sharing injecting drug equipment, or from mother to baby.

Hepatitis is an inflammation of the liver which can be caused by infection with either the Hepatitis B or Hepatitis C viruses. Hepatitis B and C are easily transmitted through contaminated blood. Importantly, there is an effective vaccination against Hepatitis B but none against Hepatitis C, and current treatments for it are not effective in all cases.

Staff who come into contact with bodily fluids are potentially at risk from blood-borne viruses, particularly if their work also involves sharp or abrasive implements or substances that can break the skin, such as needles.

People undergoing aseptic techniques are also at risk if inadequate controls are in place to ensure that all equipment used is sterile and all procedures are effectively carried out with proper attention to infection control principles.

Preventing Blood-borne Viruses

{{org_field_name}} understands that in nursing or residential adult social care settings the implementation of sound infection control techniques, especially rigorous attention to handwashing, and a thorough cleaning of the environment and equipment are the most effective ways to control the spread of infection. Therefore, in {{org_field_name}} the following applies.

  1. The home has appointed an infection control lead who will carry out a risk assessment of the risks of blood-borne infection and will keep this assessment under regular review. The findings of each review will be recorded and control measures indicated by the assessment will be fully implemented and communicated to all staff.
  2. All staff who perform duties that might expose them to risk will be given adequate information about the risks and how to minimise them and ensure their own safety. The information will include the immediate steps to be followed upon contamination with blood or other body fluids.
  3. All staff must comply with all infection control policies and procedures and adhere to best practice in infection control at all times.
  4. All staff should comply with the home’s Handwashing and Hand Hygiene Policy at all times. Scrupulous handwashing before and after any contact with people who use the services and before and after any procedure is considered by the home to be the single most important infection control measure to prevent the spread of infection.
  5. Disposable gloves and aprons should always be worn when attending to dressings, performing aseptic techniques, dealing with blood and body fluids or assisting with bodily care. All gloves and aprons should be changed and disposed of after each procedure or contact and always between contacts with different people.
  6. Cuts, sores and wounds on staff and people who use the services should be covered with suitable impermeable dressings.
  7. Blood and body fluid spills should be dealt with immediately according to the home’s cleaning of spillages policy.
  8. Clinical waste containing blood or bodily fluids should be disposed of according to the home’s infection control policy.
  9. Sharps waste should be managed in compliance with the home’s disposal of sharps policy and disposed of into proper sharps containers. Where possible the use of sharps will be minimised and safer alternatives implemented.
  10. All aseptic procedures will be conducted by appropriately trained, qualified and competent staff using sterile equipment according to the Aseptic Techniques Policy. Wherever possible disposable single-use equipment should be used. Any reusable medium- or high-risk equipment used in clinical procedures should be sterilised according to the home’s Infection Control Policy. Low-risk equipment should be cleaned thoroughly with detergent and hot water after use.
  11. Clothes and bedding fouled with blood or body fluids should be machine-washed separately from standard laundry at a high temperature, in accordance with the home’s infection control and laundry policies.
  12. If a person’s wound does not respond to treatment then their GP should be advised.
  13. Blood-borne virus risks should be included in COSHH assessments and any appropriate control measures taken to reduce identified risks.
  14. The home should always inform the receiving hospital if a person from the home who is due to go into hospital is knowingly infected with a blood-borne virus.
  15. People with blood-borne viruses or diseases should be cared for appropriately in the home by:
    a. having all details of their condition entered in their individual plan of care; this should include, where appropriate, input from multi-agency teams and other healthcare professionals involved in their care as well as any specialist input
    b. being subject to regular review
    c. the hospital responsible for the discharge of the individual providing the home with all the necessary details of the infection and any treatment in advance of discharge in a formal discharge plan that the home is agreeable to.
  16. Where necessary, the home should seek and follow expert infection control advice from its local health protection team.
  17. Any incidents involving exposure to blood and other body fluids, or near-misses where exposure was narrowly averted, will be recorded using an incident form and reported. The infection control lead will investigate reports and complete an annual audit of incidents.
  18. Where necessary, reports will be made to the CQC or to the Health and Safety Executive under RIDDOR.
  19. Relevant nursing and care staff should be immunised against Hepatitis B. The need for a worker to be immunised should be determined by risk assessment and based upon advice from the home’s occupational health service provider. Such immunisation should only be seen as a supplement to reinforce other control measures and where assessed as necessary the home will arrange for immunisation free of charge to employees.
  20. Staff who are infected with a blood-borne virus, such as HIV or hepatitis, will be treated in accordance with the home’s AIDS/HIV Policy. This is designed to ensure that such staff are not discriminated against or treated less favourably than other staff and to ensure that “reasonable adjustments” are made to ensure that they can carry out their duties safely and effectively. The policy is also designed to ensure that such staff have access to sufficient occupational health support.
  21. Any incident where a member of staff has been or is suspected to have been exposed to possible infection from blood or other bodily fluids should be reported immediately to the person in charge who should refer the person to a GP, occupational health or Accident and Emergency Department as necessary based upon an assessment of urgency or severity. All incidents should be followed up by the occupational health service.

Contact Details (complete as relevant)

The infection control lead for the home is:

_________________________________

Local health protection team contact details are as follows:

_________________________________

_________________________________

_________________________________

_________________________________

_________________________________

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Training

New staff are given training in the home’s policies on infection control as part of their induction.

Infection control awareness and training is updated at least annually.

Clinical staff and those with special responsibilities for infection control and risk assessment are also provided with specialist training relevant to their roles and responsibilities.

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}}

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