Clinical procedures - best practice

Ensuring healthcare providers do the right thing to patients every time is fundamental to reducing infection. This applies in all care settings. The Essential Steps are straightforward tools which support staff in doing the right thing every time. Used correctly these tools bring high reliability to key clinical procedures by reducing the risk of infection and increasing safety.  Strict attention to hand-hygiene and keeping key parts of equipment aseptically clean is important. 

An Aseptic Non-Touch Technique is the method employed to help prevent contamination of wounds and other susceptible sites by organisms that could cause infection, by ensuring that only uncontaminated equipment and fluids come into contact with sterile/susceptible body sites during certain clinical procedures. It should be used during any procedure that bypasses the body's natural defences.  Organisms can be transferred from one person to another if techniques to prevent such spread are not adopted. 

Guidance on clinical procedures and good practice is downloadable here:

Catheter use (PDF, 431Kb)

Enteral feeding (PDF, 350Kb)

Peripheral intravenous cannula care bundle (PDF, 88K)

Reducing spread of infection (PDF, 311Kb)

Source: Essential Steps, Department of Health

Inter-healthcare infection control transfer policy

The purpose of a transfer policy should be to ensure appropriate communication, placement and safe patient transfers for the prevention and control of healthcare associated infections.

A patient or client who has been confirmed as being colonised or infected with Meticillin-resistant staphylococcus aureus (MRSA), Glycopeptide-resistant enterococci (GRE), Extended Spectrum Beta Lactamase (ESBL), Pulmonary Tuberculosis (TB) and gastrointestinal infections with diarrhoea and/or vomiting including Clostridium difficile, should have these details recorded and passed on at transfer.

Patients or clients awaiting laboratory test results to identify infections and/or organisms or who have been in recent contact or close proximity to an infected patient case, should also have these details recorded at transfer.

When transferring patients or clients in either of the above risk groups between wards and departments or to another care setting it is essential to inform the infection control team at the receiving ward or care facility of any infectious conditions, within working hours before the transfer is carried out and before arranging an appointment or ordering transport.

A transfer form must also be completed for all transfers whether the patient presents an infection risk or not, (DH 2008).  Essential Steps offers a model risk assessment form and gives scenarios in which it would be used.

Examples of good practice in the North East

North Yorkshire and York Primary Care Trust Infection Control Transfer Form

The Lincolnshire Care Pathways Partnership Integrated Care Pathway, and pictorial guide for patients. A form is also available for patients or residents who transfer between healthcare providers in Lincolnshire and North Yorkshire to pass on important information about their infection status and can be downloaded here

The Care Quality Commission will assess compliance with the requirements set out in the Regulations made under section 20(5) of the Health and Social Care Act 2008 and provides guidance on how providers can meet the registration requirements relating to healthcare associated infections set out in the Regulations, effective from 1 April 2009.

An inter-healthcare infection control transfer policy will help meet criterion 3 of the Regulations "Provide suitable and sufficient information on HCAI to patients and the public and to other service providers when patients move to the care of another healthcare or social care provider"