CLEANING & HYGIENE
The Hidden Dangers
Essity’s Ian Catchpole considers how an appropriate hand
hygiene regime can help to reduce cross-contamination and lower the infection risk in care homes.
It is a sad fact that the elderly are much more vulnerable to infections and viruses than the rest of us, and the risk to their health is greater when they are living in environments such as care homes.
It is all too easy for germs to spread in enclosed communities where residents have frequent contact with one another and with the staff who look aſter them. Care home illnesses are commonly caused by respiratory, urinary, skin and soſt tissue infections – all of which can be highly contagious. Gastric conditions and the norovirus can also have a huge impact on care homes.
Preventing infections and limiting their spread when an outbreak occurs is a real challenge for care and nursing home staff. The constant influx of visitors means that new pathogens are being brought in all the time, and these can spread rapidly.
And it is not only visitors who are to blame. In a study of 115 norovirus outbreaks in care homes, led by ET Curran in 2016, 12 cases were found to have been caused by care workers, only three of whom were symptomatic before coming on duty. So the threat could come from anywhere and some bugs linger in the environment for days – sometimes even for months.
A 2006 study, led by A Kramer, revealed that the influenza virus can survive on surfaces for up to two days whereas the norovirus can remain active for up to a week. And MRSA can survive for several months.
Care homes are obliged by the Care Quality Commission (CQC) to follow a basic code of practice relating to the prevention and control of infections. For example, they are required to report any outbreak to Public Health
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England. However, because an outbreak is defined as just two or more residents displaying the same symptoms, the signs can be all too easy to miss – particularly in a busy home where two sufferers may not be attended by the same member of staff.
Staff are told to look out for symptoms such as fever, diarrhoea, vomiting, unexpected falls and confusion. They should also take particular note if more people than usual are ill or if several residents appear to be displaying similar symptoms. Care workers are instructed to report these signs immediately to senior management who should have a documented outbreak plan detailing the actions that need to be taken in the event of an outbreak.
These might include restricting visitors, stepping up cleaning schedules, isolating symptomatic residents and postponing visits from outside service providers. And the HPA also advocates reinforcing the hand and respiratory hygiene messages for residents, staff and visitors.
Hand hygiene is crucial in helping to prevent outbreaks in care homes. The Health Protection Agency’s (HPA) advice to staff is to wash their hands thoroughly and dry them with a single- use towel before and aſter touching a resident, before carrying out any aseptic procedure, aſter any risk of exposure to bodily fluids and aſter any contact with the resident’s surroundings. Hands should also be washed before and aſter dealing with bed linen. And where gloves are worn, the hands should be thoroughly cleaned before putting them on and aſter taking them off again.
According to HPA guidelines, hand washing should also take place before
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