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Diarrhoea and Vomiting Outbreak Management in Care Homes (England) Policy

Policy Statement

This policy describes the measures taken by {{org_field_name}} in the event of an outbreak of diarrhoea or vomiting, which might have various or unknown causes.

Any case of diarrhoea or vomiting in a community such as a care home is a cause for concern as it may, if caused by an infectious agent such as Clostridium difficile, be spread to other people and staff if urgent steps are not taken to prevent this. The spread of such an infection can easily lead to an outbreak which may have serious implications for the health of all people, especially elderly ones, and staff.

Legislation

{{org_field_name}} is aware that it must comply with all relevant legislation, including:

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 service and to protect them, wherever practicable, from dangerous substances in the workplace, including the risk of transmission of infections.

Regulation

{{org_field_name}} recognises that it must comply with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in order to meet its legal requirement for registration with the Care Quality Commission (CQC).

With respect to infection control, the home understands that a range of regulations may apply, including:

Guidance for Providers on Meeting the Regulations, published by the CQC in March 2015, provides guidance on how this service should comply with the regulations.

Guidance

{{org_field_name}} 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.

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:

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

Definition

In {{org_field_name}}, two or more unexpected cases of diarrhoea and/or vomiting occurring at the home within a few days of each other will be considered an outbreak.

The aim will then be to ensure that the event is appropriately managed and that effective precautions are taken to minimise the risks of cross-infection.

Indicators

{{org_field_name}} recognises key indicators of a viral outbreak as being:

  1. sudden onset of vomiting or diarrhoea with victims sometimes not having sufficient warning to reach a toilet
  2. a rapidly rising attack rate
  3. a high attack rate also affecting staff.

Procedures

Any cases of diarrhoea will be viewed as infectious until advised otherwise and the following actions taken.

  1. While a person has diarrhoea their contact with other people should be restricted. They should be cared for in their own room and designated a specific commode or toilet for their exclusive use.
  2. Faecal samples should be obtained from symptomatic people and the microbiology form accompanying the sample should clearly state it is part of an outbreak.
  3. Staff should wear disposable gloves and aprons when caring for people with diarrhoea and the need to observe careful hand washing practice should be stressed. Antibacterial alcohol gels should be used routinely during an outbreak by healthcare staff between attending to people using the services, but hands must always be washed very thoroughly with soap and water before attending to a person.
  4. Environmental cleaning should be increased, and particular attention should be paid to toilets, bathrooms, door handles, commodes and support handrails. For the duration of the outbreak, environmental cleaning should be performed using detergent and hot water followed by a chlorine-releasing solution at concentrations of 1000ppm. Disinfectants need to be used on surfaces and floors to ensure that the spread of infection is controlled.
  5. Soiled linen should be bagged and dealt with separately as potentially infectious according to individual care home policies and practices. Laundering of soiled bed linen or clothing should be on a hot cycle of the washing machine (at 71°C for three minutes or more where possible).
  6. People should be encouraged to wash their hands after using the toilet or commode, and before eating.
  7. Where required, the person’s GP should be called, and any prescribed treatment administered as per their instructions.
  8. Visitors should be informed of the outbreak and unnecessary visits should be discouraged. Those who choose to visit should wash their hands as they enter and leave the home and comply with all other hygiene practices in place. In the event of a serious outbreak all visitors should be discouraged.
  9. The local infection control team should be contacted, and any advice acted upon without delay.
  10. The home should be closed to admissions until 48 hours after the last symptomatic person has recovered.
  11. Symptomatic staff should go off duty immediately and go to see their GP. They should have a faecal sample taken and should remain off work until symptom free for 48 hours.
  12. If any infected person requires admission to hospital, the receiving unit should be informed of the outbreak so that they can institute appropriate measures.

{{org_field_name}} recognises that confirming the diagnosis as early as possible is essential in outbreak management. Stool samples should, therefore, be taken early in the course of illness as soon as possible after people develop symptoms. Stool specimen pots are kept readily accessible for use in emergencies. Samples should be appropriately labelled as “outbreak” to ensure it will be tested for viruses.

Training

All new staff receive training in this policy as part of their induction.

Staff with specific duties and responsibilities under the policy will receive appropriate additional training.

Clinical staff and those with special responsibilities for infection control and risk assessment will receive advanced training on infection control and the measures to be taken for controlling outbreaks.


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

Reviewed on: {{last_update_date}}

Copyright ©2024 {{org_field_name}}. All rights reserved

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