Infection prevention and control is the name given to a wide range of policies, procedures and techniques intended to prevent the spread of infectious diseases amongst staff and patients. All of the staff working at Wisbey Osteopathy are at risk of infection or of spreading infection due to close contact with patients and hands-on manual therapy techniques being used. Pathogens may be present on clothes, skin and within droplets in the air, particularly if aerosol-producing techniques (APT) are used, which can be spread if staff do not take adequate precautions.
Wisbey Osteopathy believes that adherence to strict guidelines on infection control is of paramount importance in ensuring the safety of both patients and staff. It also believes that good, basic hygiene is the most powerful weapon against infection, particularly with respect to hand washing. Wisbey Osteopathy adheres fully to Outcome 8: of the Essential standards of quality and safety: Cleanliness and infection control and Regulation 12: of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which relates to the effective operation of systems designed to assess the risk of and to prevent, detect and control the spread of a health care associated infection.
Basic Principles of Infection Control
The aim of Wisbey Osteopathy is to prevent the spread of infection amongst staff, service users and the local community.
The goals of Wisbey Osteopathy are to ensure that:
(a) Patients, their families and our staff are as safe as possible from acquiring infections through work-based activities.
(b) All staff at Wisbey Osteopathy are aware of and put into operation basic principles of infection control.
Wisbey Osteopathy will adhere to infection control legislation:
(a) The Health and Safety at Work Act 1974 and the Public Health Infectious Diseases Regulations 1988, which place a duty on Wisbey Osteopathy to prevent the spread of infection.
(b) The Reporting of Incidents, Diseases and Dangerous Occurrences Regulations 1995, which place a duty on Wisbey Osteopathy to report outbreaks of certain diseases as well as accidents.
(c) The Control of Substances Hazardous to Health Regulations 2002 (COSHH), which place a duty on Wisbey Osteopathy to ensure that potentially infectious materials within the organisation are identified as hazards and dealt with accordingly.
(d) The Environmental Protection Act 1990, which makes it the responsibility of Wisbey Osteopathy to dispose of clinical waste safely.
(e) The Food Safety Act 1990, to ensure that all food prepared in staff members homes for staff member consumption is prepared, cooked, stored and presented in accordance with the high standards required by the Food Safety Act 1990 and the Food Hygiene (England) Regulations 2005.
Infection Control Procedures
At Wisbey Osteopathy:
- All staff are required to make infection control a key priority and to act at all times in a way that is compliant with safe, modern and effective infection control practice.
- The principle osteopath of Wisbey Osteopathy will make every effort to ensure that staff will have access to sufficient facilities and supplies of appropriate equipment to ensure that they can implement effective infection control procedures and techniques at all in times, including when working in the homes of patients, if applicable.
- Any staff who does not feel that they have access to sufficient facilities and supplies of appropriate equipment to ensure that they can implement effective infection control procedures and techniques have a duty to inform their principle osteopath.
Effective Hand Washing
The majority of cross-infection in a manual therapy environment is caused by unwashed or poorly washed hands which provide an effectivetransfer route for micro-organisms.
Regular, effective hand washing and drying, when done correctly, is the single most effective way to prevent the spread of communicable diseases. Staff and patients who fail to adequately wash and dry their hands before and after contact with each other may transfer micro-organisms from one to another and may expose themselves and the public to infection.
At Wisbey Osteopathy:
• All staff should, at all times, observe high standards of hygiene to protect themselves and their patients from the unnecessary spread of infection.
• All staff should ensure that their hands are thoroughly washed and dried:
– Between seeing each and every service user where direct contact is involved, no matter how minor the contact
– After handling any body fluids or waste or soiled items, including PPE, clinical waste, or patients
– After using the toilet
– Before and after handling foodstuffs
– After smoking
– Before and after any clinical activity
– Upon entering and leaving the premises
• Hands should be washed thoroughly — liquid soaps and disposable paper towels should be used rather than bar soaps and fabric towels (whenever possible).
• All cuts or abrasions, particularly on the hands, should be covered with waterproof dressings at all times.
• Ordinary soap is considered to be effective for routine use in removing dirt and reducing levels of transient micro-organisms on the skin to acceptably safe levels.
• Antiseptic hand washing solutions may also be used in situations where effective hand washing is not possible.
• The use of alcoholic products for hand decontamination is not intended to replace washing hands with soap and water but rather to supplement hand washing where extra decontamination is required or to provide an alternative means of hand decontamination in situations where standard facilities are unavailable or unacceptable.
• Patients and chaperones will be required to wash their hands thoroughly upon entering the building.
• To be effective hands should be thoroughly washed before the use of an alcoholic rub and again after the procedure or patient contact has ended. Please see the correct hand washing technique attached to this policy.
The Handling and Disposal of Clinical or Soiled Waste
• All clinical waste should be disposed of in sealed yellow plastic sacks and each sack should be clearly labelled with the clinic address.
• Non-clinical waste should be disposed of in normal black plastic bags.
• When no more than three-quarters full, yellow sacks should be sealed and stored safely to await collection by an authorised collector as arranged.
• Staff should alert the principle osteopath if they are running out of yellow sacks, or any protective equipment so that more than be ordered.
The Use of Personal Protective Equipment (PPE)
• Adequate and suitable personal protective equipment and clothing should be provided for all staff by Wisbey Osteopathy. All staff who are at risk of coming into direct contact with patients should use disposable glove, disposable masks and disposable aprons when indicated; for example, during a pandemic.
• PPE should be worn at all times during practitioner-patient contact and should be changed between patients. On no account should staff attempt to wash and reuse the gloves.
• The responsibility for ordering and ensuring that supplies of PPE are readily available and accessible lies with the principle osteopath.
• At times patients may be asked to wear a mask during their appointment, refusal to wear a mask when asked will result in immediate termination of the appointment with the appointment still being billable. Please note: masks worn by the patient will be a requirement during pandemics, Wisbey Osteopathy can provide masks for a small fee but we ask that patients bring their own mask if they have one.
• Once removed, PPE should be immediately placed in a bag and sealed for 72 hrs before being disposed of.
Procedures for the Cleaning of Spillages
• Staff should treat every spillage of body fluids or body waste as quickly as possible and as potentially infectious.
• When cleaning up a spillage staff should wear protective gloves and aprons provided, disposing of them as detailed in this policy.
The Disposal of Sharps (e.g. Neurotips and Medical Acupuncture Needles)
• Sharps — should be disposed of in proper, purpose-built sharps disposal containers.
• Sharps should never be disposed of in ordinary or clinical waste bags.
• Staff should never re-sheath sharps iteams.
• Boxes should never be overfilled.
• When full, boxes should be sealed, marked as hazardous waste and clearly labelled with the clinic details.
• Staff should never attempt to force sharps wastes into an over-filled box. Used, filled boxes should be sealed and stored securely until collected for disposal according to clinic arrangements.
In the event of an injury with a potentially contaminated needle staff should:
• Wash the area immediately and encourage bleeding if the skin is broken.
• Report the injury to their principle osteopath immediately and ensure that an incident form is filled in.
• Make an urgent appointment to see a GP or, if none are available and it is appropriate, Accident and Emergency.
• All staff should ensure that all food prepared at home for their own or staff consumption is prepared, cooked, stored and presented in accordance with the high standards required by the Food Safety Act 1990 and the Food Hygiene (England) Regulations 2005.
• The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 (RIDDOR) oblige Wisbey Osteopathy to report the outbreak of notifiable diseases to the HSE. Notifiable diseases include: cholera, smallpox, typhus, dysentery, measles, meningitis, mumps, rabies, rubella, tetanus, typhoid fever, viral haemorrhagic fever, hepatitis, whooping cough, leptospirosis, tuberculosis and yellow fever.
In an osteopathic setting, an example would be if a patient that has recently been seen in the clinic and the subsequently diagnosed with a notifiable disease.
• Records of any such outbreak must be kept specifying dates and times and a completed disease report form must be sent to the HSE.
• In the event of an incident, The Registered Manager is responsible for informing the HSE.
In regards to COVID-19, a report under RIDDOR must be made when one of the following applies:
• A person at work (a worker) has been diagnosed as having COVID-19 attributed to an occupational exposure to coronavirus. This must be reported as a case of disease.
• A worker dies as a result of occupational exposure to coronavirus. This must be reported as a work-related death due to exposure to a biological agent.
Staff at Wisbey Osteopathy will not knowingly treat anyone diagnosed with a notifiable disease, including COVID-19, and will not treat anyone while knowingly infected with a notifiable disease. Any patients they have been in recent contact with (7 days) will also be called and notified of their potential exposure. The clinic will also follow disease exposure protocol.
Disease Exposure Protocol
• If a patient has recently entered our building and then we are told they have subsequently been diagnosed with a notifiable disease within the incubation period for that disease the clinic they visited will be closed temporarily.
• The clinic will be professionally disinfected before reopening.
• Any staff that came into contact with the patient will be required to isolate at home for the incubation period specific to the disease they were exposed to and notify their GP for information on the next steps to ensure their health is appropriately monitored.
All new staff will be required to read the policy on infection control as part of their induction process. Existing staff will be given the opportunity for refresher training which will cover basic information about infection control.
Record of induction and ongoing training in infection control will be kept in the staff personal files. Samantha Wisbey is responsible for organising and co-ordinating training.