Infection Prevention and Control
Infection Prevention and Control is a top priority at the Royal Surrey County Hospital. We understand that coming into hospital can be a very stressful time for both patients and their relatives without the additional worry of picking up an infection. At the RSCH we do everything we can to keep our hospital clean and you safe.
Our staff are committed to reducing infections and this is included in the Trusts values and behaviours and all job descriptions. We have seen significant reductions in our rates of both MRSA bacteraemia (blood stream infection) and Clostridium difficile cases. (See graphs below)
The risk of getting an infection whilst in hospital is low, but this does not mean there is room for complacency.
Our Director of Infection Prevention and Control (DIPC) is Medical Director Dr. Marianne Illsley.
Role of Infection Prevention & Control Team
The risk of getting an infection whilst in hospital is rare but this does not mean there is room for complacency. The Royal Surrey takes the prevention and control of infection very seriously and has a dedicated infection control team who work closely with all staff to advise where and how people with specific infections should be cared for, depending on the type of infection concerned.
The Infection Prevention and Control Team not only aim to provide day to day advice for health care staff and patients, but also provide a co-ordinated approach to infection prevention and control across the Trust. There is great emphasis on education and the provision of policies and procedures which aim to prevent the spread of infection within the hospital. Audits are regularly undertaken by both the Infection Prevention and Control Team and ward staff to ensure clinical practices are in line with Infection Control standards. The team are also responsible for the management and control of any outbreaks of infection which occur within the hospital.
What can you do to help?
- Keeping your hands and body clean is important when you are in hospital; make sure that you bring toiletries, including soap, into hospital with you.
- Do not share or borrow toiletries.
- Please wash your hands – especially before eating and after using the toilet. There are sinks available in all patient areas and alcohol sanitising foam at the end of the beds. If there is no sanitising foam at the end of your bed or the bottle is empty, please inform the nursing staff.
- Wear slippers when walking around the wards. This keeps your feet clean so that bacteria or other germs cannot be transferred from your feet to the bed.
- Please do not sit on other patients’ beds – this provides an ideal opportunity for bacteria to spread.
- Help us with our cleaning by keeping your locker top and bed table free of clutter to assist the housekeeping staff
- If you see any dirt, dust or mess either around your bed or in the toilets or bathrooms please inform a member of staff.
- Please tell staff immediately if your dressing becomes loose or wet or a wound or intravenous drip site becomes sore or painful.
- If a member of staff needs to examine you, please do not be afraid to ask them if they have washed their hands or used the sanitising foam. If they are wearing gloves you can ask if they have changed them since examining the last patient. If you do not feel able to do this please tell the ward sister or matron.
- Please ask staff whether equipment has been cleaned between use e.g., blood pressure machine.
- Ask visitors to avoid coming to see you if they are suffering from a cold, diarrhoea or vomiting, have a fever, a rash or any other infection.
Help us to prevent the spread of Infection; three simple things:
- Do not come to the hospital if you are ill e.g. please do not visit if you have had diarrhoea and / or vomiting or symptoms of flu within the last 48 hours
- Clean your hands before and after leaving the ward. The sanitising foam is sufficient for most situations. Please use soap and water if visiting someone with diarrhoea and /or vomiting or symptoms of flu within the last 48 hours.
- Do not eat at the bedside or sit on the bed whilst visiting patients
We must all take responsibility to reduce the risk of infection. Germs can be brought into wards and units by anyone and they can be spread to other people.
Infection control is everyone’s responsibility; we need your commitment to help us protect our patients.
Other things to remember
- If you are visiting a patient with an infection then always check with ward staff that it is okay to do so and what you can do to reduce the spread of the infection. You should clean your hands before entering and on leaving the isolation room.
- Please do not use the patients’ toilets, there are separate public toilets available for your use.
- Please do not bring or send flowers to patients.
- If children are visiting, please ensure they are supervised at all times so that they do not touch equipment or dressings. Please do not bring children under 10 years old without prior discussion with the nurse in charge. It is not recommended to bring babies under 1 year old into the hospital environment.
Patients and Relatives/Friends Bringing Food into Hospital
The wards do not have provision to store patient food.
The Royal Surrey County Hospital (RSCH) NHS Foundation Trust has a legal obligation to comply with the requirements of the Food Safety Act 1990 and associated legislation regarding the composition, safety, handling, labelling and hygiene of food provided to people in its care.
The Catering Department provides meals to patients that have been stored, cooked and served following the Food Safety Laws.
If a patient chooses to have food brought in / stored in ward fridge it may not have been prepared / stored / transported following food safety guidelines. The Trust cannot accept any responsibility for untoward effects resulting from eating or drinking brought-in items. Please do not bring in any perishable foods which require refrigeration or freezing. Staff are not allowed to store or reheat any foods. Ward staff will document in notes if food is being brought in.
Low risk foods which can be brought in freely
- Fresh fruit, washed or wrapped fresh fruit and fruit products (e.g. dried fruit tubs of pre-packed fruit)
- Commercial chocolates and confectionery
- Pre-packed cakes not containing fresh or artificial cream (e.g., cake bars, cereal bars, muffins, scones, pancakes)
- Pre-packed commercial Sandwiches, (which do not contain fillings from the Prohibited Foods opposite) and eaten on the day
- Canned and small bottles (plastic only) soft drinks
- Small bottles (plastic only), cartons of fruit juice or smoothies
- Tinned food products which do not require heating, i.e: rice pudding, custard.
- Pre-wrapped biscuits, crackers, crackerbreads, crispbreads, breadsticks
Individual packets of crisps, popcorn, pretzels
- Pre-wrapped nuts and seeds (provided patient does not have allergy to these)
Foods that have a high risk of carrying food borne organisms – if not stored / transported at correct temperatures
- Food products with a high meat, fish or dairy content, i.e.: any fresh cream product/cake, flans/quiches, sandwiches with those items as fillings, custards, mousse, yogurts, ice creams.
- Any take away foods, i.e.: burgers, pizza, kebabs and products from any take away outlet.
- Raw or undercooked animal foods, i.e.: paté, eggs, unpasteurised dairy products (milk, cheese, cream, ice cream, custard, mousse, yoghurt).
Raw, undercooked or inappropriately thawed meat
- Fresh meat products e.g., soups, stocks or gravies
- Cooked meat or poultry
- Raw fish and shellfish, i.e.: sushi and sashimi.
- Any other foods requiring refrigeration or heating/re-heating, e.g., sausage rolls, pies, pasties, scotch eggs
- Any foods which are stale or past their sell by/use by date.
- Pick ‘n’ mix
- Full boxes of crisps or sharing packs
- Large cartons of fruit juice, grapefruit juice (which can interact with some medications) or milkshakes
- Items with added alcohol, e.g., chocolate liqueurs, Christmas cake, stolen or similar festive foods
- Any home produced food items
Infections at Royal Surrey
Infections that occur in a hospital or healthcare environment are called healthcare associated infections (HCAI). The most well-known HCAI is Meticillin Resistant Staphylococcus aureus (MRSA). Staphylococcus aureus (SA) is a type of bacteria that can cause infection when it gets in a patient’s wound, lungs or bloodstream, but it is normally sensitive to an antibiotic called meticillin and related antibiotics such as flucloxacillin. MRSA is a particular type of SA which is resistant to this group of antibiotics.
Another well-known HCAI is caused by Clostridium difficile or C. difficile for short. This causes an infection of the bowel, which then causes patients to have diarrhoea. It’s something that is more likely to affect elderly patients who have been taking antibiotics.
For further information please refer to the Patient Information Leaflets A to Z (look under I for Infection control)
Who gets these infections?
At any one time, approximately 7% of all patients in hospitals across the country have a HCAI.
What causes infection?
Infection can happen when bacteria enter part of the body :
- through a wound or cut (including a cut made during an operation);
- through a medical device that is inserted into the body – such as a drip into a vein or a catheter into the bladder;
- when we breathe (in the same way as when you catch a cold);
- when we swallow them, if the bacteria are on our fingers or in food – which can then result in food poisoning.
Why does infection happen in a healthcare environment?
Healthcare associated infections (HCAIs) can occur in any healthcare environment including acute hospitals and long-term care facilities such as nursing homes. These infections happen because people who are in healthcare facilities are usually more vulnerable to infection due pre-existing disease, surgical procedures, medical treatments, indwelling medical devices (e.g., urinary catheters, intravenous infusions, implants) or a weakened immune system due to disease or treatment. As people age and become frail they also become more likely to pick up infections. Patients can also come into hospital with pre-existing infection.
What if I get an infection?
If you get an infection staff will advise you what they will do to treat the symptoms and help you recover. This may mean that you are moved to a side room or that staff will wear aprons and or gloves when treating you. This is to prevent other patients getting the infection. Hand hygiene is paramount.
Can I still have visitors?
Yes, visitors are still allowed. MRSA or other antibiotic resistant infections don’t normally harm healthy people.
Where can I find more information on this or similar issues?
There are lots of different sources of advice. You can ask a nurse or doctor on the ward who will be able to answer your questions.
You can also visit http://www.nhs.uk/conditions/mrsa/pages/introduction.aspx or contact NHS Choices by phoning 111.
The Health and Social Care Act 2008 – Code of Practice on the Prevention and Control of Infections and related guidance (see link below) has 10 criteria that all registered health care providers will be assessed on. These criteria include:
- Appropriate management arrangements to monitor the prevention and control of infection
- Providing and maintaining the environment and patient equipment to prevent and control infections
- Provision of information on infections to patients, visitors and staff
- Ensuring that appropriate policies and guidelines are in place e.g. Hand Hygiene
- Staff responsibilities in relation to infection prevention and control
- Surveillance processes to monitor infection and implement strategies to prevent the spread of infection
The Infection Prevention and Control Team provide regular updates to the Trust Board on all 10 criteria.