Infection Control

Doea the practice undertake minor surgery?

Does the practice undertake IUCD fitting?

1. Is there a named clinical lead person in the practice for infection prevention and control?

2. Does the practice have a policy on infection prevention and control? (please see the list in Appendix 2)

3. Is infection prevention and control included in all staff induction programmes?

4. Is there a process for reporting untoward incidents in relation to infection prevention and control (e.g. sharps and body fluid splashes)?

5. Is the practice aware of and know how to contact the following:

1. Have all staff at risk been immunised with hepatitis B ?

2. have they had their response to vaccination confirmed by serology for anti HBs antibodies?

3. Are all staff routinely advised regarding immunisation against seasonal influenza?

4. Are all staff routinely advised regarding immunisation against seasonal influenza?

5. Does the practice have access to Occupational Health service or access to appropriate occupational health advice? (This may include pre-employment checks to ensure appropriate immunisations have been given.)

6. Has the issue of immunity to Measles, Rubella and Varicella in clinical staff been considered in the practice?

1. Are all areas including clinical areas and equipment visibly clean and free from extraneous items?

2. Are there comprehensive written standards for cleaning the environment and equipment in the practice?

3. Are there up to date cleaning schedules which includes regular cleaning of clinical, admin and sanitary areas (e.g. toilets, fans, air conditioners, high areas, curtains, blinds, toys, computer keyboards, telephones and desks)?

4. Are walls in good condition (no cracked or peeling paintwork), intact and have smooth easy-to-clean surfaces?

5. Are floor coverings in a good state of repair, impervious to fluids and are they easy-to-clean?

6. Is the furniture in the Practice suitable for its use, (e.g. impermeable / washable materials)?

7. Are mops and buckets colour coded, clean, dry and stored appropriately?

8. Have cleaning staff received training in infection prevention and control and cleaning in a healthcare environment?

1. Does the practice have a Hand Hygiene Policy?

2. Are posters displayed adjacent to hand washbasins featuring the hand hygiene process?

3. Does your practice policy demonstrate an awareness of the DH uniform policy?

4. Are there wash basins dedicated to hand hygiene in each clinical and consulting room which can be easily accessed?

5. Do all hand wash basins for use in connection with clinical procedures have elbow/ foot operated or infrared electronic mixer taps?

6. Is the hot water thermostatically controlled?

7. Does the basin have sink plugs and overflows?

8. Is the tap off-set from the waste outlet?

9. Is liquid soap dispensed from single use cartridges or bottles? (I.e. no bar soap).

10. Are alcohol-based hand rubs available for clinical staff use during domiciliary visits?

11. Are paper towels available? (I.e. no cloth towels in use).

12. Are hand wash basins free from nail brushes and other extraneous items?

13. Are there separate arrangements to dispose of waste materials (e.g. urine) other than using the hand washbasin?

1. Does the practice have a policy to ensure that staff wear PPE appropriately?

2. Is the following PPE available for staff?

3. Is face and eye protection worn by staff if splashing of blood, body fluids or chemicals is anticipated?

4. Are staff aware of the principles of wearing and disposing of personal protection equipment (PPE) i.e. disposable gloves, aprons and additional availability of masks and goggles) – for example

4. Are staff aware of the principles of wearing and disposing of personal protection equipment (PPE) i.e. disposable gloves, aprons and additional availability of masks and goggles) – for example

1. Does the practice have a policy for managing spillages in healthcare premises?

2. Are all staff aware of the procedure for dealing with spillages of blood or other body fluids?

3. Is a spillage kit available for dealing with spillages of blood/body fluids (NB blood spills must always be cleaned using a kit that has disinfectant containing 10,000 ppm available chlorine (e.g. presept granules)?

4. Are disposable cloths or mop heads available for cleaning blood or other body fluid spillages?

1. Does the practice have a policy on safe handling & disposal of sharps?

2. Is there a sharps container conforming to BS 7320 and UN3291 available and is it positioned safely; out of reach of vulnerable people?

3. Are sharps containers discarded when two thirds full and stored in a secure facility away from public access until collected for disposal?

4. Is blood sampling undertaken by using a single-use vacuum blood collection system?

5. Are sharps used for taking blood from patients at home/care home, disposed of in to an appropriate sharps container which is returned to the surgery for safe disposal?

6. Are needles re-sheathed? (This carries a high risk of sharps injury).

7. Are the sharps containers assembled according to manufacturer's instructions and labelled in accordance with legal requirements?

8. Do practice staff wear gloves when undertaking venepuncture?

9. Are Staff aware of the correct procedure to follow after a needle stick injury, other sharps or blood splash exposure?

1. Does the practice have a policy on waste management?

2. Is the practice registered with the Environment Agency as a producer of clinical waste?

3. Is there documentary evidence to show that all clinical waste (including sharps containers) is disposed of by a registered waste collection company?

4. Are records of waste transfer and disposal arrangements kept and stored in accordance with the EPA 1990?

5. Are there easily accessible foot-operated clinical waste bins, with the appropriate colour coded bag (yellow or orange) available, in each clinical area? (e.g. is the foot operation in working order).

6. Is clinical waste and domestic waste correctly segregated (clinical waste in yellow or orange bags, according to waste regulations and domestic waste in black bags)?

7. Are clinical waste bags marked with the practice code when securing for disposal?

8. Are waste bags less than 2/3 full and securely tied?

9. Is clinical waste stored in a separate, secure storage area for waste which is kept clean and tidy and secure from vermin and/or other inappropriate/extraneous items?

10. Are staff encouraged to report all incidents (including near misses) to the designated infection control lead at the practice?

1. Does the practice have a policy or procedure for specimen handling?

2. Are specimens stored in a dedicated refrigerator (not with food, vaccines or medicines)?

3. Are arrangements for specimen testing appropriate in consulting rooms?

4. Are staff aware of the appropriate way to handle and transport specimens?

1. Does the practice have a policy which outlines the decontamination processes the GP Practices use for all medical devices?

2. Does the practice use an external sterile supply service for re-usable devices that need to be sterile at the point of use?

3. Are medical devices stored appropriately and above floor level to avoid being contaminated?

4. Are items of sterile equipment within their use-by date?

5. Are all items of equipment that come into contact with patients cleaned or decontaminated according to guidelines or disposed of after each use? (E.g. all tubing and the mask of the nebuliser should be treated as single use and disposed of as clinical waste after use. Nebuliser machines must be cleaned, spirometer mouthpieces disposed of and spirometers cleaned, ear syringing tips disposed of and the ear syringing machine cleaned?)

6. Is there a cleaning schedule/check list maintained for all items requiring cleaning?

1. Is the room and all work surfaces uncluttered?

2. Are there soft toys, soft furnishings or linen in the room? (No is the correct answer)

3. Is the flooring impervious to liquids, non-slip, intact and clean?

4. Does the flooring form a coved skirting (i.e. uplifted at the edges on to the walls) OR is the gap between the floor and the skirting sealed and is the seal maintained?

5. Are the walls and ceilings clean, dry and free from cracks or visible defects?

6. Is there an examination couch with an intact, impervious cover and single use roller paper towelling available?

7. Are there sufficient work surfaces and dressing trolleys of smooth, impervious and cleanable material?

8. Are all treatment surfaces in the room cleaned every working day with hot water and detergent, in accordance with written practice cleaning schedules?

1. Are sterile packs and other equipment stored appropriately?

2. Are the walls intact, free from visible cracks or visible defects, washable and easy to clean?

3. Is the flooring impermeable, intact with coved edging up the walls?

4. Are the ceilings intact and free from visible cracks or visible defects?

5. Is the ceiling light protected / enclosed from potential contamination?

6. Has the room adequate ventilation - natural or mechanical (not desktop fans)?

7. Is the heat source and pipe work in the room enclosed to prevent accumulation of dust and dirt?

8. Is the treatment couch protected with disposable paper towel that is changed after each patient?

9. Are skin antiseptics (e.g. chlorhexidine) and paper towels available for aseptic hand washing?

10. Are single use sterile gloves available in latex and non-latex (e.g. nitrile) material?

11. Is there a designated stainless steel trolley available for use in this room only?

12. Is there a clean clinical waste bin with a foot pedal that is in operation and is hands free?

13. Does the GP Practice audit post-operative wound infections?

1. Does the GP Practice follow the standards set out in the Green Book (DH, 2010)?

2. Is there a designated person in the practice responsible for the ordering, delivery and storage of vaccines?

3. Are there measures in place to prevent the fridge from being turned off (switch-less socket or warning label on plug)?

4. Is the temperature of the vaccine fridge monitored continually with a min/max thermometer and are the temperatures recorded each working day to ensure vaccines are maintained at 2-8OC? (min, max and actual fridge temperatures should be recorded.

5. Is the min/max fridge thermometer calibrated annually and are records retained?

6. Is the fridge either self-defrosting or is it defrosted monthly or sooner if needed and is a validated cool box then used to maintain the cold chain?

7. Is the fridge serviced annually?

8. Is there a process in place for safe disposal of expired, damaged or surplus vaccines?

9. Does the practice have records of vaccines received, batch numbers, expiry dates, fridge temperatures, servicing and defrosting of the fridge?

10. Is the practice aware of what they should do in the event of a power cut or a temperature reading outside the required range?

1. Does the practice have a policy on managing patients with communicable diseases?

2. Do you notify all reportable infectious disease on suspicion to the proper officer at the local borough?

3. Do you have access to notification forms, provided by Environmental Health, to notify infectious diseases to the proper officer? (Electronic via secure email in Bromley practices, or fax/post, Bexley, Greenwich, Lambeth, Lewisham and Southwark practices)

4. When do you notify gastro intestinal disease (food poisoning)?

Are you aware of the Health Protection (Notification) Regulations 2010?

Are you aware of the new requirements to notify cases of contamination and other diseases which may have public health significance that are not listed in the regulations?