Management of In-patients with Loose Stools ... - NHS Lanarkshire

More documents

Recommendations

Info

Note: Completion of Review NHS Lanarkshire Health Protection Committee Section E1 Effective From Sep 2010 Replaces Jun 2010 Pages 6 of 31 SECTION E 1 - Management of In-patients with Loose Stools: Gastrointestinal Outbreak Review Date March 2013 Health Protection Committee approved review date extension to March 2013 If the diarrhoea ceases then the patient may, after being symptom-free for 48hrs, and following consultation with the Infection Control Team, be returned to their usual placement. This can be carried out prior to confirmation of the laboratory results, provided he/she is continent and can be relied upon to maintain good hand hygiene. If diarrhoea continues beyond 24hrs, and in the absence of any positive microbiology, two further specimens should be sent 24hrs apart, unless advised otherwise by a member of the Infection Control Team. If these three specimens are negative then, after consulting the Infection Control Team, the patient can return to their usual placement even if diarrhoea continues, provided that he/she can maintain good hand hygiene. If symptoms subside before further samples are obtained then, as above, the patient may return to their usual placement after consulting the Infection Control Team. If any of the samples test positive the patient may require treatment. Staff must contact the Infection Control Team who will give further advice as required. The patient where possible, should remain in isolation. In certain circumstances transfer to the Infectious Diseases Unit at Monklands Hospital may be indicated. This would only be undertaken after full consultation between the Infectious Diseases Physician and the Microbiologist. Follow-up (clearance) specimens are not usually required once the acute symptoms have resolved and the stool is formed. There are some exceptions to this. For further details please refer to Section F, Control of Infection Manual. If two or more patients within the same clinical area develop loose stools within 24hrs, with no obvious cause, such as laxative administration, suppositories, medicine administration, altered diet etc., then the possibility of an outbreak should be considered and must be reported to the Infection Control Team. CLEANING SPILLAGES OF VOMIT AND FAECES The following precautions should be followed by staff when cleaning vomit or faeces. Refer also to Section I, Control of Infection Manual Spillage Poster: - Wear disposable gloves and plastic aprons. A surgical type face mask may be worn to prevent inhalation of contaminated aerosols during this procedure, particularly where a patient has vomited. Use disposable paper towels to soak up any excess liquid. Transfer these and any soiled matter into a clinical waste bag Clean soiled area with a solution of detergent and chlorine e.g. Actichlor Plus E 6
Note: Completion of Review NHS Lanarkshire Health Protection Committee Section E1 Effective From Sep 2010 Replaces Jun 2010 Pages 7 of 31 SECTION E 1 - Management of In-patients with Loose Stools: Gastrointestinal Outbreak Review Date March 2013 Health Protection Committee approved review date extension to March 2013 If visible blood is present, disinfect as per guidelines within Section I, Control of Infection Manual Clean and rinse off disinfectant with warm water Dispose of paper towels, gloves and aprons into the clinical waste bag SIGNIFICANT EXPOSURE/CONTAMINATION TO VOMIT/FAECES Any member of staff who has had a significant exposure to faecal matter, either by the definition below or by having their clothing grossly contaminated, must fill out a DATIX form. A significant exposure/contamination to blood/body fluid is defined as a contact of broken skin, mucous membrane or eyes with another person’s blood or body fluid. 2. GASTROINTESTINAL OUTBREAK BACKGROUND Gastrointestinal symptoms can be caused by numerous factors. Outbreaks within healthcare settings are generally caused by viral pathogens most commonly Norovirus, however they can be caused by bacterial infections. Outbreaks of viral disease, in particular Norovirus are more common during the winter months, they have a short incubation period and usually cause vomiting and/or diarrhoea. Other clinical features consist of abdominal pain and a low-grade fever. A viral gastrointestinal illness is highly transmissible and is usually passed from person to person often by vomit/faecal contamination and is the main cause of outbreaks within healthcare settings. RECOGNITION OF AN OUTBREAK Early evidence of outbreaks of infection may be detected by nursing/medical staff, the Infection Control Team or by the Microbiology Laboratory It is recognised that there cannot be absolute criteria for defining an outbreak or problem and in certain circumstances staff may have to act on the grounds of 'reasonable suspicion'. Staff should act promptly and seek advice where there is concern rather than worry about 'false alarms'. It is much better to be cautious, and to report early, rather than to wait until a major problem is evident ANY OF THE FOLLOWING IS SUGGESTIVE OF A PROBLEM: Any patient with a confirmed laboratory report of a gastrointestinal pathogen such as salmonella Unexplained diarrhoea in two or more patients within the same 24hr period Unexplained vomiting in two or more patients within the same 24hr period E 7
Page 1 and 2: Note: Completion of Review NHS Lana
Page 5: Note: Completion of Review NHS Lana
Page 11 and 12: Note: Completion of Review Bankaid
Page 19 and 20: Note: Completion of Review 3. BIBLI

Management of In-patients with Loose Stools ... - NHS Lanarkshire

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?