Essential Steps
A Simple Guide……..
Alison Harvey
Senior Infection Prevention and Control Nurse
What is it ?
A programme of observational audit to demonstrate compliance with good practice
Where did it come from ?
• A Department of Health (DoH) iniative
• Developed for the community i.e. Community nurses, Care homes, Podiatry etc
• For anywhere ‘hands on care’ is delivered
Why did the DoH do it ? Essential steps to safe, clean care aims to provide a framework to
support local organisations’ use of best practice to prevent and manage the spread of infections and ultimately improve patient and service user safety.
The framework is composed of a number of interlinked tools and products and can be used on an organisation-wide basis, as well as in individual departments, teams, care homes and so forth.
The idea is that organisations determine for themselves which of the elements they wish to use once they have assessed their current position in preventing and managing infections. Essential steps to safe, clean care is intended to be implemented and used in ways that will support local success. It is not expected that all organisations will involve the same staff grades or roles, as the tools are locally adaptable
What does it mean to me ?
• Part of ongoing personal development• Assists the appraisal process• Benchmarks standards of care• Part of the CQC’s assessment process
within care homes• Gives assurance to commissioners that
care provided is of a quality standard
What does it look like ?Tools and products provided in the pack include:
• self-assessment tool and future action;
• signposting to useful resources to inform users;
• three key Essential Steps that, if implemented within organisations, may impact significantly on reducing the level of infections;
• review tools to assist individuals/teams in monitoring compliance and to record continuous compliance or improvement;
• certificates for staff, to recognise their progress in performing safer practice;
Contents• Each audit typically contains 4 or 5 risk
elements
Typically Preventing the Spread of Infection has :-
-Hand hygiene
-Use of personal protective equipment
-Safe disposal of sharps
-Aseptic technique• -
Prompt Sheets for Assessors
• One is available for each audit
• Detailing each intervention
• Shows the criteria required
• And information on why the standard may not be met
Intervention Criteria required Standard not achieved if
Hand hygiene (prior to patient contact)
Suitable method chosen – soap and water or alcohol if hands visibly clean
Hands not washed.Nail varnishFalse nailsWrist watchWrist or hand jewellery (plain wedding band allowed)
Technique used for hand washing or alcohol rub effectively cleans hands (e.g. 6 steps see over)
Personal Protective equipment
Gloves, apron, face protection worn as appropriate. (See risk assessment over).
PPE not worn as required by procedure
Aseptic Technique Sterile equipment used Level of asepsis is not maintained/ breaks in asepsis not addressed.
Non-touch technique adoptedClean technique is only carried out if appropriate to the procedure/ patient.
Sharps Sharps container available – not overfilled
Failure to safely use sharps and dispose of at point of use. Sharps used safely e.g.
not resheathed/ passed hand to hand.Sharps disposed of intact by the user.
ESSENTIAL STEPSPrompts for assessorsAudit 1 Preventing the spread of infection
3 Wash/rub ALL surfaces of the hands. These six steps should take about 15 seconds
NO contact with body
fluids*
Contact with body fluids (incl. excessive
skin scales) but low risk of splashing
Contact with body
fluid and high risk of
splashing
No protective clothing required
Disposable gloves
and plastic apron
Disposable gloves, plastic
apron, face protection
Contact between
clothing and patient, and or
equipment (including laundry)
Disposable plastic apron
Risk assessment for asepsis.Aseptic technique to be used instead of a clean technique
if the patient falls into any of the following categories:Babies
Immunocompromised patientsPatients with diabetes Clients with chronic
disease Frail patients Patients in poor
nutritional state
Suggested hand washing and alcohol application technique
Risk assessment for the use of PPE.
*NB the term body fluids includes wounds.
Where can I find them?
• All the tools, assessor sheets and supporting information are available to download on the Infection Prevention and Control Website – in the care home section @
• http://www.kirklees.nhs.uk/your-health/infection-prevention-and-control/
Thanks for listening
• Any questions ?
• Next ….Essential steps workshops
Top Related