INFECTION CONTROL REPORT
NPMC has policies for Infection Prevention and Control (IP and C). These policies are relevant to all employees of NPMC including non-clinical staff, trainees, visitors and observers. It is expected that the policies will be adhered to.
The policies are adapted for use at NPMC from the Joint Standard Infection Prevention & Control Guidelines and Manual March 2014 Dr Kakoli Choudhury, Milton Keynes Public Health. These are available in an electronic file in the staff handbook. All members of staff have access to the staff handbook. The policies are monitored by the Lead Nurse, updates are reported in the monthly newsletter “Surgical Spirit” and this is distributed to all staff.
The employers and staff of NPMC are committed to minimising the risk of infection and ensuring safety of patients.
Management Structure for Infection Prevention and Control
Managing Partner- Caroline Rollings
Infection Prevention and Control Lead - Debbie Hughes, Lead Nurse.
Telephone number 01908 611767
The CCG Patient Safety and Infection Control Lead for MK CCG is Jenny Brooks.
Training is offered in-house on infection prevention and control annually, this took place on May 19th 2015 and was delivered by ECG training.
This training forms part of mandatory annual training for clinical staff. All training is reviewed at annual appraisal by their Line Manager. Staff unable to attend training can access it online using Smartlog. All training is recorded on the central training log held at NPMC.
Infection Control training is discussed with all new members of staff at their induction meeting with the Lead Nurse and reviewed regularly.
Infection Control Audit
This takes place bi-annually and the last audit took place in August 2014.
It was conducted by the Lead Nurse and the Facilities Administrator. The main changes are:-
- A plan for Soap dispensers and glove holders to be fitted in in all clinical rooms
- Alcohol gel for use by the public in all waiting areas
- Upgrade of the nurses clinical rooms.
An action plan is in place to address areas in the building that need an upgrade, this is an ongoing process.
Infection Control Spot Checks
The Lead Nurse and Facilities Administrator perform these checks, the last one took place on 4th November 2015 it also included a review of the bi-annual audit that last took place in 2014.
The Domestic Cleaning Staff at NPMC
We changed our contract cleaning company to Clearwater early in 2015. Training for the staff is delivered by the British Institute of Cleaning Science Standards (BICS). The Area Supervisors train the cleaners and then assess them on their abilities and document this via the ‘Record of Induction and Training’. The cleaners are also trained in handling clinical waste. The cleaning team follow a cleaning specification document and audits are performed and fed back to us monthly.
Hepatitis B vaccination is offered to the cleaning team and a record is kept. The cleaning team has access to the policy relating to Sharps, Needlestick Injuries and Accidental Exposure to Blood/Bodily Fluids.
Spot checks on cleaning and hygiene are performed by the Area Supervisor from Clearwater. The Facilities Lead meets monthly to address any issues or concerns raised. These are escalated to the Lead Nurse, as appropriate. All team members at NPMC are encouraged to report any issues to the Facilities Lead.
Clostridium –Difficille (C-Difficille)
We investigate within the Practice any C Difficile infections notified to us by Milton Keynes laboratory using a pathway. The learning is then captured and shared. Antibiotics remain a key risk factor. All prescribers at NPMC continue to follow MKCCG Guidance on the Management of Infection in Primary Care. This minimises the risk of C Difficile to our patients by prescribing appropriately and avoiding broad spectrum antibiotics.
Methicillin Resistant Staphylococcus Aureus (MRSA)
We have a system in place at NPMC that will alert Clinicians of a diagnosis from the laboratory of MRSA and this will be actioned appropriately.
We have had no infectious outbreaks reported since November 2014.
EBOLA Virus 2015
NPMC had an emergency plan in place and we activated stage one, the risk decreased during the summer. The plan is still available should the risk re-occur in the UK again.
The influenza vaccine is offered to all our vulnerable patients as advised by Public Health and is available annually.
Dedicated Flu Clinics are opened on the first Saturday in October and the first Saturday in November. Additional clinics are put in place as required.
Vaccine is also routinely offered to patients in ‘at risk’ groups including ladies who are pregnant and for over 65 years when they present for a consultation during the flu season.
During the 2015 /2016 season nasal flu vaccination for children has continued. Children who are within the correct dates of birth have been invited for vaccination. The school nurses will be vaccinating the older children in the group at school.
Seasonal flu clinics are advertised on our website in the surgery and on social networks.
The clinical team at NPMC are committed to reducing the amount of antibiotics used and they are only used if appropriate. On November 18th 2014 Antibiotic Awareness Day was highlighted in the surgery with posters and invitations to all to become antibiotic guardians.
Prescribing of antibiotics at NPMC is lower than both the national average and the Milton Keynes average. Antibiotic prescribing is continuously monitored and appropriate updates are provided.
The prescribing team at NPMC performed an audit on the delayed prescribing of antibiotics for upper respiratory tract infections during 2014. The results are very positive, it showed that fewer prescriptions were exchanged for antibiotics compared to the year before. This means that:
- Infections were getting better without the use of antibiotics.
- Reduction in the use of inappropriate antibiotics helping to reduce antibiotic resistance.
- Reduces the incidence of infections.
Dedicated isolation facilities are not available in the Medical Centre, however, should we be made aware of a patient with a potential infection, a side room is made available. NPMC have an Isolation Policy available to all staff. Decontamination takes place before the room is reused. When possible, home visits and telephone consultations are offered.
Immunosuppressed Patients (Patient with Reduced Immunity)
Immunosuppressed patients acquire infections more easily and therefore there is a potential risk when they attend the surgery for appointments. Vulnerable patients, especially those receiving chemotherapy or radiotherapy are offered an alert card to carry in their purse or wallet. By presenting this card at Reception they will be offered the opportunity to wait away from the public waiting area. The receptionist will notify the clinician of their arrival in order to facilitate a timely consultation.
Occupational Health Vaccinations
All staff who are at risk of contracting Hepatitis B by the nature of their work, are offered vaccination against Hepatitis B and a blood test to confirm immunity. Records and immunisation status are kept and maintained. All the team are offered annual influenza immunisation during the special staff flu sessions held in the Medical Centre.
Staff Sickness Policy
NPMC has a Staff Sickness Policy. This ensures that members of staff when unwell do not attend work and spread infection. NPMC use a private Occupational Health facility in Milton Keynes should the need arise. Staff sickness is managed by the Team Leaders. All ‘return to work’ interviews are undertaken by the Team Leader to ensure staff are fit to return to their duties.
NPMC has a Uniform Policy. All health care professionals, where appropriate, are provided with and wear a uniform. Those clinicians who don’t need to wear a uniform wear clothing that is smart, clean and fit for purpose. Everyone is provided with a name badge and this should be visible when performing duties in the Medical Centre.
Sterilising of Equipment
Autoclaving of instruments does not take place at NPMC. The Medical Centre uses “single use” medical instruments which are then disposed of in an appropriate waste stream. When specialist instruments are required, in Consultant Clinics and Contraceptive Clinics, sterilising is outsourced to the Central Sterile Supplies Department at Milton Keynes Hospital.
A policy is available for all staff to access. All clinical waste is disposed of using the most appropriate waste stream. Orange bags and filled sharps bins are stored in an area away from the public and are collected twice weekly by SRCL, who have a contract to perform this work for MK CCG.
Reporting Notifiable Diseases
All notifiable diseases are reported following the Health Protection Agency’s guidance.
This infection control report is available in the Staff Handbook. It is also on the website and in the Patient Information Manual in both patient waiting areas.
Date for review
1st October 2013
25th November 2014
4th November 2015