JUNE 2019 Issue

SUMMER BBQ FOOD SAFETY

Practise safe Barbequing this summer When preparing to BBQ it is vital to remember the 4C's of food hygiene: Chilling

defrost food overnight in the fridge or if this is not possible, using a microwave on the defrost setting directly before cooking

store raw foods separately from ready-to-eat foods, covered on the bottom shelf of your fridge

keep chilled food out of the fridge for the shortest time possible during preparation

Cleaning

washing hands thoroughly with soap and hot water before cooking and eating, especially if you've been handling raw meat or things like firelighters

keeping utensils and serving dishes clean when preparing food and ensuring you don't mix those used to prepare raw and ready-to-eat dishes

never washing raw chicken or any other meat - as it splashes germs onto your hands, utensils and worktops

Cooking Always ensure that the meat is steaming hot throughout (burgers are not like steak and should always be served well done) There is no pink meat visible when you cut into the thickest part Meat juices run clear Don't forget, charred on the outside doesn't always mean cooked on the inside Cross-contamination is most likely to happen when raw food touches or drips onto ready-to-eat food, utensils or surfaces. Avoid by using different utensils, plates and chopping boards for raw and cooked food Washing your hands after touching raw meat and before you handle ready-to-eat food Further information available from www.gov.uk/safety-hygiene/barbecues

Breaking News !

Lorenzo alerts are there

to prevent the spread of

infection—staff can implement

the correct precautions

early—you must review

Lorenzo alerts on admission

work with your ward clerk/

admin teams to ensure you

know of any possible risks

and hand over to receiving

ward

X3 patients with CRE have

been admitted from ED to

ward areas without review of

alert causing unnecessary

anxiety to those patients that

have been followed up as part

of the contact tracing

process.

One positive patient has been

transferred from ward to ward

without precautions in place

causing unnecessary onward

risk of transmission

COMMUNICATION IS KEY

DO NOT PUT OUR STAFF

AND PATIENTs AT RISK

Ensure cleaning schedules

are up to date and all staff

know and understand where

the risks are

Infection Prevention

Newsletter

Lorenzo

Alert Icon

MRSA FEEDBACK: MANAGEMENT OF CENTRAL VENOUS LINES

2

Documentation — Communication is KEY

All venous access requires close monitoring and VIP scores must be recorded after use.

Blocked lumens should not be attempted to be unblocked unless you are competent to do

so — lumens must be labelled do not use and steps taken to remove the line and change

to PICC line if access still required.

Flushing — If we do not have the insertion information for PICC/CVL lines should be

removed and not accessed unless the patient can give you a coherent account, and the

line is being managed by another health care provider.

ANTT competencies — all staff that are up to date with ANTT will have a sticker, staff who

are not competent are required to complete competency prior to embarking on

procedures that require the use of ANTT — it is ok to CHALLENGE—BE A PATIENT

ADVOCATE AND PRACTICE SAFELY

RCA FEEDBACK RCA feedback; timely collection of stool sample and bowel management Root cause analysis themes from April/May 2019 have identified several clinical

areas not documenting actions taken when type 5 -7 stools are being recorded. Please remember to follow the SIGHT protocol. When patient’s have type 5 - 7 stools then there should be an associated action and infection considered if this is a change in the patient’s normal bowel habit.

If type5 -7 stools are normal for the patient ensure this is documented on the ad-

mission documentation and if stools change and become offensive or mucus like a sample would be indicated.

Management of constipation — please ensure that we document the effects of

administration of laxatives and enemas and we can easily see the nursing as-sessment of the efficacy of medication.

Bed movement — when patients are moved from bed space to bed space or to

another ward can we document the numbers of the beds, this would be really helpful when we assess onward risk of transmission of C difficile. Remem-ber also to use a inter healthcare transfer form to detail symptoms and sample dates if you know or suspect a patient to have a infection— http://tghwebapp/documents/SIGHTProtocol.pdf

Focus on waste and discarding CD drugs Please review pharmacy bulletin—

http://tghwebapp/documents/MedSafetybulletin24DenaturingControlledDrugs.pdf

3

DEHYDRATION Signs of dehydration include:

having a headache

feeling tired and weak

confusion

mood swings

dry lips

Urine 4 to 8

Why is water important? Your body uses water to help with many different processes, including: transporting nutrients and oxygen around your body getting rid of waste products controlling your temperature the function of your digestive system Drinking enough water will also help to keep your skin healthy.

What can you do ? Make sure patients have access to regular drinks Ensure assistance is given / offered if needed Consider the use of alternative cups e.g. beakers Document correct fluid balance Ensure you know what your patient likes to drink

Listeriosis is a rare infection caused by bacteria called listeria. It usually goes away on its own, but can cause serious problems if you're pregnant or have a weak immune system. Listeriosis is usually caught from eating food containing listeria bacteria.

This includes lots of types of food, but it's mainly a problem with:

unpasteurised milk

dairy products made from unpasteurised milk

soft cheeses, like camembert and brie

chilled ready-to-eat foods, like prepacked sandwiches, pâté and deli meats

You can also catch listeriosis from: someone else who has it – for example, if you eat food they have handled when they have not washed their hands, close contact with farm animals – especially sheep and cows that are giving birth

Symptoms In most people, listeriosis has no symptoms or only causes mild symptoms for a few days, such as:

a high temperature of 38C or above

aches and pains

chills

feeling sick or vomiting diarrhoea If you have these symptoms, you can usually look after yourself at home. The best way to prevent listeriosis is to practice good food hygiene. Chilled food should be put in a fridge or other suitable equipment as soon as you get it home. Observe the use by date on food packaging For further advice contact the infection prevention team or visit; https://www.nhs.uk/conditions/listeriosis/

Great opportunity to support carers week and our carers.

Making infection prevention everyone's business.

MUMPS (PERTUSSIS)

MOST OLDER HEALTH CARE WORKERS (BORN

BEFORE 1980) ARE LIKELY TO BE

NATURALLY IMMUNE TO MUMPS, BUT MAY

REQUIRE MMR VACCINE TO

ENSURE THAT THEY ARE COVERED FOR

MEASLES AND RUBELLA. THOSE BORN

AFTER 1980 ARE AT HIGHER RISK OF BEING

SUSCEPTIBLE AND SHOULD BE

OFFERED MMR IF THEY HAVE NOT ALREADY HAD 2 DOSES. KNOW YOUR VACCINATION

STATUS.

PROTECT

YOURSELVES Risk of Respiratory

splash—mask, gloves and apron

Increase in measles cases call for improved MMR vaccination

Public Health England (PHE) is calling for all parents to get their children vaccinated against measles, mumps and rubella (MMR) when the vaccine is offered, or for them to take it up now if they didn’t have it at the scheduled time. In the first quarter of 2019, there were 231 confirmed cases of measles.

As measles is highly infectious, anyone who has not received 2 doses of MMR vaccine is at risk, particularly unvaccinated people travelling to countries where there are currently large outbreaks of measles and those who are likely to be attending festivals this summer.

Seasonal influenza

It may seem a little early to be once again talking about staff flu vaccination, but now is the time to plan!

Last year we only achieved an uptake of 61% vaccination in front line staff. This is below the 75% target set by NHS England, but more worrying, this means we are not protecting ourselves, patients and those whose health conditions put them more at risk from influenza.

The Trust flu group are finalising the 2019-20 flu plan with key actions to meet the 80% target; we need all of our staff to help us reach this goal.

All wards and departments across the Trust will need to nominate staff to support a programme peer vaccination, these staff will need to attend both flu and anaphylaxis training (these will be advertised shortly, please also contact education Werneth House).

The infection prevention and communications teams are working together to improve access to information for staff to myth bust and help us all make more informed decisions. A new flu page will be accessible via TIS.

Please remember the vaccine cannot give you flu, and usually the worst side effects are a sore arm or feeling ‘achy’, these symptoms should pass in a few days.

Read more about flu and the myths that surround vaccination at:

https://www.nhs.uk/live-well/healthy-body/facts-about-flu-and-the-flu-vaccine/

If you are concerned about having the flu vaccination please contact the infection prevention team on 0161 922 6194.

What you

need to

know!

Look up Infection Pre-

vention data for your

ward on the TIS page or

see the poster in your ar-

ea

Getting It Right First Time - GIRFT

GIRFT (Getting It Right First Time) is a national programme designed to improve medical and surgical care by reducing unwarranted variation.

Following a national review of all surgical departments across England,

findings indicated that many trusts had a lack of awareness of their own

surgical site infection (SSI) rates. Consequently, a GIRFT SSI

programme has now been set up to review SSI rates in surgical units in

England and to review the current practice in prevention of SSIs.

The trust is participating in this programme of work and therefore all cases of surgical site infection occurring within 30 days of surgery (or 1 year for orthopaedic or breast implants) must be uploaded to the GIRFT site, along with details of their treatment and outcomes. The survey information gathered will ensure the trust has improved information on infection rates and it is therefore vital that we have clinical engagement for identification of cases.

How can you help?

The poster below sets out the criteria for a SSI and notes the contact details of the specialist leads who should be notified to undertake further investigation. If have not seen this poster and would like a copy to place in your office, base or department, please contact the infection prevention team and a poster will be sent to you.

POLICY CHANGES

THE NEW

PATHOLOGY

SPECIMEN

PACKAGING AND

TRANSPORT

POLICY IS NOW

AVAILABLE ON THE

TIS INTRANET.

HTTP://

TGHWEBAPP/

DOCUMENTS/

PATHOLO-

GY_SPECIMEN_PA

CKAGING_AND_TR

ANSORT.PDF

THE NEW POLICY

TARGET USERS ALL

STAFF WHO TAKE,

PACKAGE OR

TRANSPORT

SAMPLES FOR

PATHOLOGY

INVESTIGATIONS

Well done to

Stamford Unit for

their prompt and

efficient

screening for

MRSA and CRE

SURGICAL SITE INFECTION (SSI) SURVEY

GIRFT IS A NATIONAL PROGRAMME DESIGNED TO IMPROVE SURGICAL AND MEDICAL CARE BY REDUCING

UNWARRANTED VARIATIONS. SURGICAL SITE INFECTION IS CURRENTLY AN IMPORTANT FOCUS FOR GIRFT. IT IS

IMPORTANT THAT CLINICIANS ARE AWARE OF THEIR OWN SSI RATES.

T&G ICFT IS PARTICIPATING IN THIS SURVEY FROM 1/5/19 TO

31/10/19

IF YOU ARE CARING FOR A PATIENT WITH SSI WITHIN 30

DAYS OF SURGERY (OR 1 YEAR FOR ANY IMPLANT

INCLUDING ORTHOPAEDIC OR BREAST) PLEASE NOTIFY

DR FIONA NEW Fiona.new@tgh.nhs.uk

AND THE RELEVANT SPECIALTY LEAD AS BELOW:

TRAUMA AND ORTHOPAEDICS - MR NAIM - Soulat.naim@tgh.nhs.uk

GENERAL SURGERY - MR MIHAILESCU - Andrei.mihailescu@tgh.nhs.uk

ENT - MR THORLEY - Daniel.thorley@tgh.nhs.uk

BREAST SURGERY - MR ELLENBOGEN - simon.ellenbogen@tgh.nhs.uk

OBSTETRICS AND GYNAECOLOGY - DR ANIM-SOMUAH - ma.somuah@tgh.nhs.uk

New Pathology User

Guidance

Pathology testing is one of the core diagnostics in use within healthcare today, but the process doesn’t start in the laboratory, it starts with staff taking the right sample and sending it safely.

To help staff with this process pathology and infection prevention have revised and updated much of the guidance to help get the right specimen to the right place and safely to minimise the risk to patients (having to be re-bled etc.) and colleagues (potential for infection etc.). Getting this right the first time every time will also save the Trust money.

The new guidance incudes:

Pathology User Guide

Pathology Specimen Guide (a quick guide on how to label specimens, what specimen container to use and some common problems that can be avoided)

Pathology Specimen Packaging and Transport Guide -how to safely pack and transport specimens once they have been taken

The guidance contained in these documents is applicable to all areas (hospital, community and general practice) and are available from the Pathology Department pages via the TIS page –

http://tis/pages pathology.asp

7

TATTOOS AND BODY MODIFICATION

A report recently published by the Royal Society for Public

Health (RSPH) highlights the infection control risks

following special procedures – such as tattoos, piercing,

electrolysis and acupuncture, and a need for additional

procedures, such as dermal fillers, to be added into

legislation.

Across the UK there has been a big increase in the

numbers of people having tattoos, piercings, electrolysis

and acupuncture. This has highlighted concerns about the

practices surrounding these procedures, the infection risks

and the legislative environment.

Based on a national survey of people who had at least one

special procedure in

the previous five years,

of those who reported

having had a negative

side effect, one in ten

required medical

treatment.

Research by the RSPH

also found:

Anyone can

purchase specialist

equipment online to

carry out tattooing

or piercings without

the necessary

training or

qualifications in

how to use them.

Two fifths of people who had a special procedure did

not check whether the person carrying it out was

registered or licenced to carry it out

The most important factor that influenced where the

public had their special procedure was the skill of the

technician, followed by the cleanliness of the premises

and recommendations by previous clients.

You can read the report in full and find out what standards RSPH are asking to be improved by visiting the RSPH web site at: https://www.rsph.org.uk/

Every contact & every cup counts

Hydration Campaign – July –August 2019

Throughout the summer months, the infection prevention

team are supporting the community teams in encouraging pa-

tients to stay

hydrated and stay healthy. By providing an information leaflet

and a water calendar to encourage increased fluid intake,

these easy steps can help to reduce the risk of dehydration and

infection.

The elderly are most at risk as they lose their thirst response

increasing the risk of dehydration further.

Staff, Think ,Drink More Water check out the ‘refill app’

Need more advice? The infection prevention team are just a phone call or email away

Email: infectionprevention@tgh.nhs.uk Twitter: @IPTameside Tel: 0161 922 6194 Fax: 0161 922 6507

Infection Prevention

Environmental

Well Done Keep up the

good work

Our audit programme has

started really well with clinical

areas achieving a pass mark

>90%

W42

W45

EOU

POU

Children's OPD

A big thank you to all the

teams championing

Infection Prevention

URINE DIPSTICK

Diagnosis of lower UTI must be based on documented clinical signs and symptoms.

Diagnosis must NOT be based on urine dipstick analysis. Urine

dipstick analysis should NOT be carried out for patients who are 65 years and over without clinical symptoms. Empiric antibiotic treatment must be based on the Trust's antimicrobial guideline. A urine specimen must be submitted to the microbiology laboratory for culture and sen-sitivity.

Please click on the poster below for more information on Preventing Urinary Tract

Infections