Management of In-patients with Loose Stools ... - NHS Lanarkshire
Management of In-patients with Loose Stools ... - NHS Lanarkshire
Management of In-patients with Loose Stools ... - NHS Lanarkshire
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Note: Completion<br />
<strong>of</strong> Review<br />
<strong>NHS</strong> <strong>Lanarkshire</strong><br />
Health Protection Committee<br />
Section E1<br />
Effective From Sep 2010<br />
Replaces Jun 2010<br />
Pages 6 <strong>of</strong> 31<br />
SECTION E 1 - <strong>Management</strong> <strong>of</strong> <strong>In</strong>-<strong>patients</strong> <strong>with</strong><br />
<strong>Loose</strong> <strong>Stools</strong>: Gastrointestinal Outbreak<br />
Review Date March 2013<br />
Health Protection Committee approved review date extension to March 2013<br />
If the diarrhoea ceases then the patient may, after being symptom-free for 48hrs, and following<br />
consultation <strong>with</strong> the <strong>In</strong>fection Control Team, be returned to their usual placement. This can be<br />
carried out prior to confirmation <strong>of</strong> the laboratory results, provided he/she is continent and can be<br />
relied upon to maintain good hand hygiene.<br />
If diarrhoea continues beyond 24hrs, and in the absence <strong>of</strong> any positive microbiology, two further<br />
specimens should be sent 24hrs apart, unless advised otherwise by a member <strong>of</strong> the <strong>In</strong>fection<br />
Control Team.<br />
If these three specimens are negative then, after consulting the <strong>In</strong>fection Control Team, the patient<br />
can return to their usual placement even if diarrhoea continues, provided that he/she can maintain<br />
good hand hygiene.<br />
If symptoms subside before further samples are obtained then, as above, the patient may return to<br />
their usual placement after consulting the <strong>In</strong>fection Control Team.<br />
If any <strong>of</strong> the samples test positive the patient may require treatment. Staff must contact the<br />
<strong>In</strong>fection Control Team who will give further advice as required. The patient where possible,<br />
should remain in isolation. <strong>In</strong> certain circumstances transfer to the <strong>In</strong>fectious Diseases Unit at<br />
Monklands Hospital may be indicated. This would only be undertaken after full consultation<br />
between the <strong>In</strong>fectious Diseases Physician and the Microbiologist.<br />
Follow-up (clearance) specimens are not usually required once the acute symptoms have resolved<br />
and the stool is formed. There are some exceptions to this. For further details please refer to<br />
Section F, Control <strong>of</strong> <strong>In</strong>fection Manual.<br />
If two or more <strong>patients</strong> <strong>with</strong>in the same clinical area develop loose stools <strong>with</strong>in 24hrs, <strong>with</strong> no<br />
obvious cause, such as laxative administration, suppositories, medicine administration, altered diet<br />
etc., then the possibility <strong>of</strong> an outbreak should be considered and must be reported to the <strong>In</strong>fection<br />
Control Team.<br />
CLEANING SPILLAGES OF VOMIT AND FAECES<br />
The following precautions should be followed by staff when cleaning vomit or faeces. Refer<br />
also to Section I, Control <strong>of</strong> <strong>In</strong>fection Manual Spillage Poster: -<br />
Wear disposable gloves and plastic aprons. A surgical type face mask may be worn to<br />
prevent inhalation <strong>of</strong> contaminated aerosols during this procedure, particularly where a<br />
patient has vomited.<br />
Use disposable paper towels to soak up any excess liquid. Transfer these and any soiled<br />
matter into a clinical waste bag<br />
Clean soiled area <strong>with</strong> a solution <strong>of</strong> detergent and chlorine e.g. Actichlor Plus<br />
E 6