How to Clean & Prevent Infection in GP Waiting Rooms

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Every year, the UK is hit by multiple viruses. Some of these are seasonal, including influenza A, influenza B, RSV, and rhinovirus. And of course, we must now live with Covid-19 alongside these common viruses.

GP waiting rooms can inadvertently help spread infection. Patients may visit their GP about an unrelated condition, but leave having caught a new infection.

In this post, we’ll explore some of the measures GP surgeries can adopt to prevent and control the risks of infection, through the winter months and beyond.

New IPC Guidance Policies for GP Surgeries

The NHS Infection Prevention and Control team (IPC) released a new set of policies in July 2021. For more information, you can read the latest IPC guidelines for general practice.

Some of the advised measures include:

  • Site specific policies. All GP surgeries should have effective infection prevention control policies relevant for their practice. It should be regularly updated and accessible to all. Also, all surgeries should appoint an IPC lead, who has the authority to implement change where it’s needed.
  • The IPC policy should cover staff training requirements, and specify how frequently staff should receive training updates.
  • Contractors should follow a general cleaning schedule. This should include detailed guidelines for specific areas, fixtures, and fittings, with priority given to high-frequency touch items including door handles and light switches.
  • The IPC policy should advise on what PPE to use, and when. It should also cover staff training in effective use and disposal of PPE.

Cleaning & Infection Control in GP Waiting Rooms

Cleaning Waiting Room Soft Furnishings

Viruses and bacteria can linger and spread in the fibres of carpets and curtains. For this reason, clinical areas should not have carpets. But there should be clear policies in place for the frequency of cleaning carpets, curtains, and other soft furnishings in waiting rooms. There should also be specific guidelines to follow should any item of furniture get contaminated with body fluids or spillages.

Hand Hygiene in GP Waiting Rooms

All staff and patients should have access to adequate handwashing facilities. Staff should follow standard hand hygiene protocols. All patients should be encouraged to wash their hands as frequently as possible, and ideally before and after they interact with doors, light switches, and other possible infection vectors.

Cough and Sneeze Etiquette Communication

Catch it, bin it, kill it. All staff and patients should cover their nose and mouth with a disposable tissue when sneezing, coughing, wiping or blowing. They should then immediately dispose of that tissue before washing their hands. GP surgeries can promote good cough and sneeze etiquette among their patients through making the guidelines clearly visible, and through providing tissues, plastic bags for disposal, and hand hygiene facilities.

Read our full guide to standard infection control precautions. These precautions are relevant to all healthcare settings, which of course includes GP surgeries.

Ventilation Concerns for Infection Prevention and Control

GP waiting rooms are enclosed spaces where infected patients can spend extended periods of time. And in the winter months, waiting rooms are less likely to be adequately ventilated. Surgeries will keep their doors and windows closed while running their central heating. These conditions can create a hotbed of infection.

A good air purifier can completely filter the air in a room, trapping and killing any viruses that might be lingering in the atmosphere. This, combined with an effective cleaning policy, can make a huge difference in reducing the risk of infection in GP waiting rooms.

The Blueair air purifier has a Clean Air Delivery Rate (CADR) that will completely filter the air in a GP waiting room 4.8 times an hour. It uses a series of filters to capture 99.97% of airborne particles as small as 0.1 micron – including many common seasonal viruses and bacteria.

You can browse our full range of air purifiers for healthcare settings.

Got some questions? Need some support? Get in touch to talk to our friendly team of expert air purification consultants.

How Many Dentists Have Left the NHS?

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In the past few years, thousands of dentists have left the NHS.

How Many NHS Dentists Are There?

According to one report, at the end of 2020 there were 23,733 dentists providing NHS care in England. By the end of January 2022, this figure had fallen to 21,544.

As each dentist manages a caseload of around 2,000 patients , this mass desertion has lead to the creation of “dental deserts”, leaving approximately four million people without access to dental care on the NHS.

It looks like the problem is only going to get worse, too. According to the British Dental Association (BDA), 75% of UK dentists are likely to reduce, or further reduce, their NHS commitment over the next 12 months. 45% claim they’re going to go fully private, and 47% suggest they’re either going to change career or seek early retirement.

Why Are So Many Dentists Leaving the NHS?

Shawn Charlwood, chair of the BDA’s General Dental Practice Committee, attributes the mass exodus to dentists feeling “overstretched and underfunded” during and after the recent Covid-19 pandemic.

According to BDA figures, 87% of UK dentists have experienced symptoms of stress, burnout and other mental health problems over the last 12 months. And it seems that patients, frustrated by the lack of available NHS dentist appointments, may be taking out their anger on staff. 86% of UK dentist report that colleagues in their practice have received physical or verbal abuse from patients.

What’s the Problem with the NHS Dental Contract?

The BDA argues that the current NHS dental contract, which has been in place since 2006, “puts government contracts ahead of patient need”.

For years, this contract set untenable incentives. For example, dentists would receive the same renumeration for doing one filling as they would for doing 10. It’s for such reasons that the Health Select Committee described the contract as “unfit for purpose”.

NHS Dental Contract Changes in 2022/23

In July 2022, the government announced a number of changes to the NHS dental contract. These included:

  • A new minimum payment for hitting targets.
  • A higher reward for treating three or more teeth.
  • Dental therapists can now accept patients for certain NHS treatments, freeing up dentists’ time for more urgent and complex procedures.
  • New payment rates for more complex treatments.
  • Updates to the NHS website and directory of services to help patients find dentists in their local area.

The BDA argued that these new contractual arrangements “do not even begin to address the system’s fundamental flaws… this is another attempt to conjure up more capacity without adding any new investment.”

The Collapse of Dentistry on the NHS?

In September 2022, NHS England released on update on the reforms their dental contract changes for 2022/2023.

The BDA, who previously claimed that “dentists are simply not seeing a future in the NHS”, seems cautiously optimistic that these changes may make a difference. However, they’ve also described these changes as “modest and marginal”, claiming that dentistry needs an immediate funding injection of £880m to stabilise the situation in the short-term.

Eddie Crouch, chairman of the BDA, called for “real commitment; root-and-branch reform and adequate funding.”

And unless the government makes this “real commitment” soon, it seems that dentists will continue to leave the NHS, and those “dental deserts” will continue to grow.

A Message to Dental Patients

Despite the problems many are having seeing a dentist on the NHS, Chief Dental Officer for England Sara Hurley said that anyone experiencing tooth issues should contact their local dentist as usual.

She said: “Infection prevention and control measures to protect staff and patients were introduced during the pandemic. These limited the number of procedures NHS dentists could carry out.”

“However, these restrictions have now been lifted enabling practices to operate at full capacity for the first time in two years, so anyone with concerns about their dental health should contact their local dentist as they usually would or seek advice from NHS 111.”

A Message to Dental Surgeries

We know that the last few years have been difficult and that you’ve probably had to deal with higher levels of staff absences due to infection. We’d love you to see how,  by installing our Blueair air purifiers in your surgery, you can tacklethis issue and reduce illness. Why not get in touch with us to find out how we can support you?

Omicron BA.4 and BA.5: Transmissibility & Symptoms

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Omicron BA.4 and BA.5 are two of the most recent subvariants of Covid-19 to be detected.

These two subvariants were first detected in South Africa in the early months of 2022. Each variant appears to be an offshoot of the previous BA.2 variant.

How Transmissible are Omicron BA.4 and BA.5?

A virus’s basic reproduction number (R0) is the average number of people an initial case can infect in a population with no immunity, either from vaccines or previous infection. The original Omicron strain (BA.1) had an R0 of 9.5. BA.2, of which BA.4 and BA.5 appear to be offshoots, was estimated to be 1.4 times more transmissible than BA.1.

Studies from South Africa suggest that BA.4 and BA.5 may be more transmissible than BA.2. So BA.4 and BA.5 could be the most infections variants of Omicron yet.

On top of this, these variants appear to be good at evading immunity. This means there’s a greater chance of reinfection with these strains compared to previous strains.

What Are The Symptoms of Omicron BA.4 and BA.5?

Like previous Omicron variants, BA.4 and BA.5 brings numerous flu-like symptoms. These include:

  • Coughing, sneezing, and a blocked or runny nose
  • Aches, pains, and fatigue
  • Sore throat and a hoarse voice
  • Chills, shivers, and fever
  • Loss of smell, or an altered sense of smell
  • Tight chest and shortness of breath

Preventing and Controlling Omicron BA.4 and BA.5 Infection

Data from South Africa and the UK suggest that BA.4 and BA.5 waves may not be associated with an increase in severe disease and death.

Nonetheless, this highly transmissible strain may still pose a risk to elderly and immunocompromised people, and to people with certain underlying health conditions. On top of this, extensive infections may place a further strain on an already overburdened health service.

Strategies for Preventing the Spread of Covid-19 Variants in Healthcare Settings

We’ve put together an essential guide to preventing the spread of Covid-19 in hospitals and other healthcare settings.

Strategies include:

  • Standard infection control precautions, such as effective hand hygiene and good respiratory and cough etiquette.
  • Effective PPE use, including proper protocols for putting on and taking off equipment.
  • Cleaning for infection prevention and control, with specific procedures depending on the setting.

Read our full guide to preventing the spread of Covid-19 in healthcare settings.

Air Filtration for Effective Infection Control

Like the previous variants, BA.4 and BA.5 are airborne viruses. A recent report from the University of Cambridge demonstrated how an air filtration system in a Covid-19 ward successfully removed almost all traces of the airborne virus.

In public and communal areas of healthcare settings, including waiting rooms, canteens, wards and corridors, air filtration systems can make a huge difference in preventing the spread of BA.4 and BA.5. They trap and kill viruses, bacteria and other harmful particles while quietly filling rooms with cleaner, healthier air.

Our range of HealthProtect air purifiers can completely filter the air in a room as large as 62m² once every 12.5 minutes. The advanced filters can trap up to 99.97% of particles down to 0.1 microns, and up to 99% of viruses and bacteria – including the BA.4 and BA.5 Omicron variants.

We can help you in your fight against Covid-19 and other respiratory viruses this winter and beyond. Get in touch to talk to one of our infection control experts today.

Preventing Infections in Burns Patients

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All patients are at risk from infection in hospitals and healthcare settings. But the risks are particularly high for burns patients.

High Infection Risk in Burns Patients

This is for three reasons:

  • Burns patients invariably spend an extended period in the hospital. The longer any patient’s hospitalisation, the more frequently they’ll face common sources of nosocomial infections.
  • Burns patients frequently undergo invasive procedures as part of their treatment.
  • The nature of a burns patient’s injuries involves the loss of skin barrier protection against micro-organisms, and treatment often involves induced immunosuppression, which will only make them more vulnerable to infection.

So burns patients present a particular challenge for hospital staff.

In this post, we’ll explore some essential techniques and products that can help prevent infections in burns patients.

Standard Infection Control Precautions for Burns Patients

The Standard Infection Control Precautions (SICPs) are a set of practices that every member of staff in every healthcare setting must follow. They apply to every patient, every setting, every time.

For more information, you can read our full guide to SICPs. But a crucial consideration for burns patients is the first precaution: Patient placement, and assessing a patient’s infection risk.

Dedicated Burns Unit

The patient placement precaution involves placing patients in accordance with their clinical or care needs, while isolating patients who either have a high risk of infection, or who show a high risk of cross-infection.

It’s for this reason that hospitals should have dedicated burns units, where staff can take extra precautions to reduce the patients’ potential exposure to nosocomial infections.

Regular Hand Washing For Burns Patients

Hospital staff should wash their hands at five key points:

  • Before you touch a patient.
  • After you touch a patient.
  • After you touch a patient’s immediate surroundings.
  • Before you undertake any clean or antiseptic procedures.
  • After any body fluid exposure risk.

There’s also a specific technique you should follow to wash your hands. For most healthcare settings, it should take at least 20 seconds. But in a burns unit, where the risks of infection are higher than elsewhere, staff may have to commit to an even more thorough hand hygiene regime.

PPE For Treating Burns Patients

Burns patients often lose their skin barrier protection against micro-organisms. So when treating burns patients, the correct PPE is vital. It can create an effective barrier against many common sources of infection, which can help ensure that the healthcare worker does not pass on an infection to the burns patient.

You’ll find a number of guides to effective PPE use on our site:

Infection Control for Burns Patients with Sterile Mats

Burns patients often have to undergo frequent invasive procedures as part of their treatment. Alongside numerous other infection control measures, absorbent mats can help you reduce the risks of infection while also cutting down on your turnaround time between procedures.

Our DryMax Sterile Mats can absorb up to 6 litres of water or 2.4 litres of saline. Place the DryMax Sterile Mat next to the patient and it’ll effectively help to capture all the various drips and spills created by the procedure.

Not only will this keep both the patient and the surgeon drier and more comfortable during the procedure, it will also contribute to infection prevention and control while reducing the risk of slips.

Then, after the procedure, you can simply dispose of the mat, allowing for more faster and effective cleaning between procedures. So as well as making your procedure cleaner and safer, it can also help make your unit as a whole run smoother and more efficiently.

It’s completely latex-free and you can use it flat, folded or rolled, depending on your needs.

Head here to learn more about how our DryMax Sterile Mats can help with infection control for burns patients.

Want to discuss your theatre’s fluid collection requirements? Call 0333 015 4345 or email info@cairntechnology.com.

 

How UK Hospitals Can Stop the Spread of Covid to Inpatients

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A recent report found that more than 40,600 people were likely infected with Covid-19 while being treated in hospital in England for another reason.

What can hospitals do to protect their inpatients from infection?

In this post we’ll explore some of the measures hospitals can adopt to stop the spread of Covid, and other viruses.

Standard Infection Control Precautions

The Standard Infection Control Precautions (SICPs) are a series of practices every member of staff in every care setting must adopt to reduce the risk of infection.

SICPs include, but are not limited to:

  • Patient Placement – You must assess every patient’s infection risk as soon as they arrive, and continuously review their risk throughout their stay. You should isolate any patients who show a high risk of cross-infection as soon as they arrive.
  • Hand Hygiene – There’s a specific hand hygiene technique designed to clean your hands as thoroughly as possible. You should perform this technique before you touch a patient; after you touch a patient; after you touch a patient’s immediate surroundings; before you undertake any clean or antiseptic procedures; and after any body fluid exposure risk.
  • Respiratory and Cough Etiquette – All staff should adopt best practice techniques, and encourage patients to do the same through providing ample tissues, hand hygiene facilities, and plastic bags for disposal.
  • Safe Waste Disposal – Each healthcare setting should have four separate waste streams with a different colour coding for each. For example, you should use yellow bags to demarcate any waste that carries a risk of infection, contamination, or other forms of harm.

For more, read a full guide to all 10 SICPs.

Personal Protective Equipment (PPE)

PPE protects both staff and patients from infection. It does this through acting as a barrier against common sources of infection, including coughs, sneezes, and bodily fluids.

For effective infection control, you should follow certain PPE protocols:

  • Store all PPE in a clean and dry area that’s close to the point of use.
  • Ensure all PPE is single-use only, unless specified by the manufacturer.
  • Put on and take off PPE in a specific order, practicing best practice hand hygiene techniques between each step.
  • Change PPE immediately after seeing each patient. You should also change your PPE immediately after performing each task or procedure.
  • Correctly dispose of all PPE immediately after use in the correct waste stream.

You should also ensure that the PPE you use is suitable for the task at hand. You can read our full guide to when and what type of PPE to use.

We also have a detailed guide to the factors you should consider when choosing PPE for your healthcare setting.

Cleaning for Infection Prevention and Control

Surgical site infections (SSIs) account for around 20% of total hospital-acquired infections. The risk of infection is at its highest during the operative procedure when the patient’s wounds are still open.

Common sources of infection include members of the operating team, the clothes they wear, the operating theatre environment, and the equipment used during the procedure.

All hospitals should have clear guidelines in place for keeping operating theatres aseptic, sterile, and restricted. These guidelines might include:

  • Thoroughly cleaning any reusable surgical instruments before use, and storing them in a sterile environment until they’re required.
  • Regular floor and surface cleaning – including the use of absorbent mats to capture fluids for safe disposal after procedures.
  • Effective zoning of the operating theatre complex based on the levels of cleanliness, the presence of microorganisms, and the types of procedures carried out.

You can read our complete guide to cleaning for infection control in operating theatres.

Air Filtration for Infection Control

A recent University of Cambridge study found that an air filtration system in a Covid-19 ward successfully removed almost all traces of the airborne virus.

Different areas of a hospital will have different air filtration requirements. Waiting rooms and other public areas will need a good supply of clean air to prevent the spread of infection among staff and inpatients, for example. And as we’ve seen, operating theatres and other treatment areas will have much more substantial air filtration needs, with a set number of air changes per hour (ACH).

You can read our full guide to air filtration systems in hospitals.

We Can Help You Control and Prevent Infection in Your Hospital

Our range of HealthProtect air purifiers are specifically designed for hospitals and other healthcare settings.

The BlueAir HealthProtect 7740i Air Purifier can deliver complete filtration every 12.5 minutes in rooms as large as 62m². Its filters can trap up to 99.97% of particles down to 0.1 microns, and up to 99% of viruses and bacteria – including the Covid-19 virus.

We also provide air purifiers for larger areas and smaller rooms.

Want to talk about how we can help reduce air pollute and improve the air quality in your hospital? Get in touch to talk to one of our air purification experts today.

Why Is PPE So Important in Healthcare?

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Personal protection equipment (PPE) is vital for effective infection prevention and control in healthcare. PPE protects both staff and patients from infection through acting as an effective barrier against common sources of infection such as coughs, sneezes, and bodily fluids.

PPE Protocols

But it’s not just the PPE itself that works to prevent infection. There are also key protocols associated with PPE, all of which are designed to reduce the risks of contamination. These include:

  • Storing all PPE in a clean and dry area, close to the point of use.
  • Ensuring all PPE is single-use only, unless specified by the manufacturer.
  • Putting on and taking off PPE in a specific order, with thorough hand-washing between each step.
  • Changing PPE immediately after seeing each patient, and immediately after each task or procedure.
  • Correctly disposing of all PPE immediately after use.

An Essential Introduction to PPE in Healthcare

Though certain medical procedures will call for specialist protective equipment, usually when we talk about PPE we’re referring to the following:

  • Scrubs
  • Gowns and aprons
  • Gloves
  • Footwear
  • Head covers for facial and head hair
  • Masks and face shields

There are specific guidelines for what type of PPE to use for each task. And as we mentioned above, there are separate guidelines for storing PPE, disposing of it, and putting it on and taking it off.

You’ll find many guides to PPE and its related protocols on our site:

What Is The Most Important PPE?

As different types of PPE are designed for different tasks, then really, no single piece of PPE is more or less important than any other. Some might argue that masks and face shields are the most important, as they can protect you from accidently ingesting bodily fluids during certain procedures, which can be a key source of infection. But if you’re handling caustic chemicals in the lab, a face covering won’t be as immediately useful as a good pair of gloves. So who’s to say which is the most important?

The importance of any given piece of PPE depends entirely on the task at hand. It’s also fair to say that any piece of PPE is only as good as the person using it.

If the equipment doesn’t fit properly, or if the person doesn’t follow the essential infection control protocols, then they might as well not have bothered wearing any PPE in the first place.

How Effective is PPE for Healthcare Workers?

In December 2021, the UK’s National Institute for Health Research released the results of a study into the effectiveness of PPE for healthcare workers.

The study specifically looked at PPE’s effectiveness in reducing the transmission of Covid-19 in health and social care settings. PPE might offer different levels of effectiveness when used to reduce the transmission of other pathogens.

The study accounted for numerous variables, including full-PPE use compared to partial use, the frequency and consistency of PPE use, and the impact of infection control training and education on transmission rates.

You can read the key findings of the study.

How Else Can You Prevent Infection in a Healthcare Setting?

PPE, and the protocols associated with its use, is just one of many standard infection control precautions in a healthcare setting. Other vital precautions include good hand hygiene, respiratory and cough etiquette, patient placement, and the correct management of equipment, linen, and waste.

You can read our complete guide to the standard infection control precautions.

How to Manage Infection Control

We offer many services and solutions that can help you manage infection prevention and control in your healthcare setting.

Our services include:

  • Air purification
  • Face-fit testing for PPE effectiveness
  • Workplace exposure monitoring services
  • Washroom hygiene solutions
  • Fluid management solutions
  • Cleaning equipment, disposal containers, and sanitising chemicals

So if you’d like some guidance on infection control, or a free quote for any of our services, get in touch to talk to an expert today.

 

When & What Type of PPE Should Be Used: NHS & Healthcare

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The NHS introduced new guidelines for personal protective equipment (PPE) in April 2020. They said:

“Any clinician working in a hospital, primary care or community care setting within two metres of a suspected or confirmed Covid-19 patient should wear an apron, gloves, surgical mask and eye protection.”

The guidelines also stipulated that clinicians should wear “a higher level of protective equipment” when carrying out aerosol generating procedures (AGPs).

These guidelines stipulated that healthcare workers essentially wore personal protective equipment round the clock. But this was during a global pandemic, when people from all walks of life took special measures to reduce the risk of infection.

So what are the PPE guidelines for NHS and healthcare workers during “normal times”, when we’re not fighting to contain a new virus?

A Brief Introduction to PPE

When we talk about PPE, we’re mainly referring to the following equipment:

  • Head covers, for facial and head hair
  • Masks and face shields
  • Scrubs
  • Gowns and aprons
  • Gloves
  • Footwear

All PPE fulfils the same essential function: to prevent the spread of viruses and bacteria, and to protect both staff and patients from contamination and infection.

Certain specialist procedures might call for specialist PPE precautions. For example, many healthcare settings have specific PPE guidelines for staff involved in chemotherapy treatments.

But by and large, when we refer to PPE, we’re referring to the above equipment.

When & What Type of PPE Should Be Used – Latest NHS Guidance

The NHS published the latest National Infection Prevention and Control (IPC) manual in June 2022. Though these guidelines apply to healthcare settings in England, the guidelines in Scotland, Wales and Northern Ireland will be broadly similar.

These guidelines reinforce the important role PPE plays as a standard infection control precaution (SICP).

Healthcare workers should assess the risks associated with any procedure before deciding what PPE to use:

“Before undertaking any procedure, staff should assess any likely exposure to blood and/or other bodily fluids, non-intact skin or mucous membranes and wear personal protective equipment (PPE) that protects adequately against the risks associated with the procedure.”

Basic PPE Principles in Healthcare

Regardless of the patient and the procedure, the latest NHS guidelines say that all PPE must be:

  • Stored close to the point of use in a clean, dry area
  • Single-use only, unless specified by the manufacturer
  • If reusable, decontaminated after use according to the manufacturer’s instructions
  • Changed immediately after seeing each patient, or after completing a procedure or task
  • Disposed of immediately after use in the correct waste stream – domestic, non-infectious, or clinical
  • Discarded immediately if it gets damaged or contaminated.

Read our full guide to the factors to consider when choosing PPE.

Beyond this, there are specific guidelines for each type of PPE.

NHS Glove Guidelines

The NHS advises that gloves must be worn when there’s any chance that a procedure will involve exposure to blood, other bodily fluids, non-intact skin or mucous membranes. Though it’s not recommended for routine clinical care, some exposure-prone procedures may require double gloving – such as gynaecological or orthopaedic operations, and major trauma incidents.

Do I Need to Wear Gloves When Using the Phone or Computer in a Hospital?

Gloves are not necessary for administration tasks, even if you perform them near patients – such as using telephones or computers, distributing or collecting food, writing in the patient chart or giving oral medication.

When to Change Gloves in Healthcare?

You must change your gloves immediately after seeing each patient, and after performing any task or procedure – even if it’s with the same patient. You must also change your gloves immediately if you suspect they have a perforation or a puncture.

NHS & Healthcare Apron and Gown Guidelines

Wear aprons to protect your uniform or clothes when you anticipate contamination – such as when in direct care contact with a patient. And like gloves, you must change your apron after seeing each patient, or after completing each task or procedure.

When to Wear Gowns instead of an Apron?

Wear gowns or coveralls instead of aprons when there’s a risk of extensive splashing of blood or bodily fluids, such as in the operating theatre or the intensive care unit. Gowns too must be changed between patients and procedures. And any gowns or coveralls worn in an operating theatre must be sterile.

NHS Face Protection Guidelines

You must wear eye or face protection, such as a full-face visor, whenever you anticipate any blood or bodily fluid contamination to the eyes or face. This includes during surgical procedures, and “always during aerosol generating procedures.”

The guidelines stipulate that regular corrective spectacles do not count as eye protection, and that any protection you wear should not be impeded by piercings, false eyelashes or other accessories.

NHS Mask Guidelines

When it comes to masks, the guidelines only cover fluid-resistant surgical face masks (FRSM). They recommend using these as a means of source control – to protect the patient during sterile procedures, such as surgery. They also recommend using them whenever there’s a risk of splashing or spraying of blood or other bodily fluids.

Like all PPE, the guidelines stipulate that you should remove or change your mask regularly – at the end of each task or procedure, and if the mask’s integrity gets breached (by moisture build-up, for example).

The guidelines also make it clear that face protection is only effective it it’s well-fitting. A specialist face-fit testing service will help you ensure that all of your PPE is fit for purpose.

NHS Footwear Guidelines

While the guidelines don’t specify what specific type of footwear to use for general clinical work, they do stipulate that all footwear must be “visibly clean, non-slip, and well-maintained.” What’s more, any shoes you wear must be supportive, and they must cover the whole foot to avoid contamination and injury.

In areas where dedicated footwear is required, such as the operating theatre, you must remove the footwear before leaving the designated care area.

NHS Headwear Guidance

Unlike most PPE, headwear is not routinely required in clinical areas. It’s only required when it’s necessary to prevent contaminating the environment, such as in operating theatres, central decontamination units, and clean rooms.

But like all PPE, any headwear must be changed or disposed of between clinical procedures or tasks. And it must be removed before leaving the sterile environment. The headwear must completely cover the hair, and if you have any facial hair, you must cover this too, with a snood.

There are separate guidelines for headwear worn for religious regions, including turbans and headscarves. While staff do not have to remove this headwear, they must ensure they do not compromise patient care and safety. So any headwear must be washed or changed daily, and removed immediately if it gets contaminated. And staff must still comply with additional attire in operating theatres and other controlled environments.

Other Standard Infection Prevention Procedures

PPE is vital, but it’s just one part of the infection prevention jigsaw. Other important factors include hand hygiene, cough and respiratory hygiene, waste disposal, and fluid management.

You can read the latest NHS national IPC manual for England.

You can also read our guide to cleaning for infection control in operating theatres.

If you need extra advice and support, we specialise in infection prevention and control.

Our services include:

  • Air purification consultations and solutions
  • Face-fit testing
  • Fluid management and washroom hygiene solutions
  • Comprehensive infection control solutions, such as cleaning equipment and sanitising chemicals

Get in touch to talk to our friendly team of expert infection control consultants and we’ll help you find a solution that works for you.

Health & Safety in Operating Theatres – Hazards & Precautions

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Just like any other working environment, working in an operating theatre comes with numerous occupational hazards. However, in an operating theatre, these hazards can mean life or death. Even the smallest accident could seriously jeopardise the patient’s safety.

The question of health & safety in operating theatres is a deep one. Organisations such as the National Institute for Health and Care Excellence (NICE) regularly produce extensive documents advising on theatre safety on both an operational and a managerial level.

So in this post, we’ll provide an essential overview of the sort of hazards theatre staff may face, and the sort of precautions that could help them manage risk. Please note that in this post we’ll focus on staff safety rather than patient safety.

Also be sure to check out our introduction to improving quality and efficiency in operating theatres.

Common Hazards in Operating Theatres

Speaking as broadly as possible, we might categorise the common hazards staff face in operating theatres as follows:

  • Accidents, including slips, trips, and falls.
  • Exposure to hazardous substances.
  • Contamination and infection.

Let’s look at each of these hazards in turn, along with some of the precautions that could help prevent accidents.

Accidents in Operating Theatres – Slips, Trips and Falls

Just like in any other workplace, operating theatre staff can slip on spilled fluids, or trip and fall on a loose wire or a misplaced bit of equipment.

One of the many recommendations made in the NHS Productive Operating Theatre strategy concerns the layout of operating theatres. They advise removing any non-essential items from the area, and assigning each object a set place in the room.

These recommendations are primarily in place to ensure operational efficiency. If everyone knows where everything is, then operations can proceed with fewer interruptions.

But a well-ordered operating theatre is also a much safer operating theatre. If there are no non-essential items in the area, and if everything is in its right place, then in theory there’ll be no obstacles for theatre staff to trip over as they carry out their work.

The Importance of Good Theatre Hygiene

The guidelines also recommend regularly cleaning and maintaining the operating theatre environment. This is mainly for patient safety, to reduce the risks of infection. But it can also contribute to staff safety. Promptly cleaning any fluids spilled on the floor makes it less likely that anyone will slip and fall.

The right equipment can make a huge difference here. For example, non-drip absorbent operating theatre floor mats can soak up any spilled fluids before they become a health and safety hazard. Then, after the operation, they can simply be picked up, discarded and replaced. This will reduce the turnaround time between operations while also removing the need to mop, so staff won’t have to worry about wet and slippery surfaces.

Exposure to Hazardous Substances

Operating theatre procedures make use of a number of substances which can pose a health hazard  if staff are exposed to them for long periods.

A key culprit in the operating theatre is Isoflurane, which anaesthetists use to maintain a state of general anaesthesia. If inhaled in its vapor form, Isoflurane can cause headaches, dizziness, and fatigue. But long-term exposure can lead to chronic health conditions, including renal, hepatic, and reproductive disorders.

Like all potentially hazardous substances, so long as it’s properly stored, and so long as your equipment is properly maintained, then Isoflurane should pose no problems. But as the substance is so volatile, even the smallest spillage or leak poses a health hazard.

Prevention, and the Cure

Another key recommendation in the NHS Productive Operating Theatre strategy is to stay on top of your equipment maintenance. Again, this is primarily to ensure patient safety, as you cannot depend on faulty equipment to do the job you need it to do. But it’s also to ensure staff safety, to ensure that, for example, any leaks are fixed before they pose a problem.

Wearing adequate PPE when handling or cleaning substances will also help you manage this hazard. But for total peace of mind, get a workplace exposure monitoring report for any area of your hospital where staff are exposed to hazardous substances.

A comprehensive report will include clear and actionable recommendations, so you’ll know exactly where the risks lie and exactly what to do to protect your staff.

Contamination and Infection in Operating Theatres

Infection control measures in operating theatres put the patient’s needs first, as surgical site infections (SSIs) account for around 20% of all hospital-acquired infections.

But of course, any measure that protects patients from infection will also protect staff from infection.

Operating theatres must be aseptic, highly-sterile, and restricted environments. Achieving this requires good air ventilation, strategic zoning, and numerous infection control precautions.

You can read our full guide to cleaning for infection prevention and control in operating theatres here.

PPE also plays a huge part in protecting both staff and patient from infection. It’s not just a question of selecting the right PPE for the task at hand. Just as important is applying and removing the PPE in the correct order.

Health and Safety in Operating Theatres – Essential Support, Solutions, and Guidance

We offer many services and solutions that can help you stay on top of health and safety in the operating theatre.

Our services include:

  • Air purification
  • Face-fit testing for PPE effectiveness
  • Workplace exposure monitoring services
  • Washroom hygiene solutions
  • Fluid management solutions, including absorbent floor mats
  • Cleaning equipment, disposal containers, and sanitising chemicals

Our experts are always on-hand to discuss your needs. So if you’d like some guidance health and safety in operating theatres, get in touch to talk to an expert today.

 

How to Remove PPE in the Correct Order

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Personal Protection Equipment (PPE) is an integral part of effective infection control in all healthcare settings.

We covered the various types of PPE that exist in our guide to infection control in operating theatres. We also explored some of the protocols concerning PPE in our guide to standard infection control precautions.

In this post we’ll explain how to remove PPE in the correct order to help prevent and control infection. Please note that we intend for this to act as a general introduction to the guidelines, and why they exist. For a complete guide to how to remove PPE in the correct order, please consult your hospital’s infection control protocols.

How To Remove PPE in the Correct Order

You should remove PPE in an order that minimises the risks of cross-contamination. You should remove PPE in a designated area, and dispose of it using designated receptacles.

For this guide, let’s assume you’re wearing the standard PPE healthcare workers used for infection control throughout the COVID-19 pandemic: an apron or gown, a visor (or goggles) for eye protection, a face mask, and gloves.

The Order For Removing PPE

  • Start With The Gloves. First, grasp the outside of one glove with the opposite gloved hand. Peel it off slowly, holding the removed glove in your other gloved hand. Then slide the fingers of your ungloved hand under the remaining glove at the wrist, before peeling it off. Discard of the gloves as orange clinical waste, then perform the standard hand hygiene protocol.
  • Next comes the gown. Break the straps at the neck, allowing the gown to fold forward on itself. Then break the waste straps at your back. Fold the gown in on itself, then fold or roll it into a bundle before discarding. Take care not to touch the outside surface of the gown, and clean your hands again having discarded it.
  • Eye protection comes next. Don’t touch the front of the eye protection. Only touch it by the headband, or the sides. If your eye protection’s disposable, place it in the orange clinical waste receptacle. If it’s reusable, place it in the appropriate receptacle for decontamination. Having disposed of the eye protection, clean your hands again.
  • Finally, your face mask. If you’re wearing an elasticated mask, remove it by pulling the loops over your ears. If you’re wearing a tied mask, untie or break the lower straps first, then the upper straps. In either case, only hold the mask by the loops or straps, and discard them as orange clinical waste. After this, wash your hands once more.

Please note – these are general guidelines for general health practitioners. Different healthcare settings, such as operating theatres, require different types of PPE, and there will be different protocols for both applying and removing this PPE.

Best Practice for Infection Control in Healthcare Settings

PPE is only effective if it fits correctly. We offer a specialist face fit testing service to help you ensure that your entire healthcare team can depend on their facial coverings for maximum protection. Head here for more information about Face Fit Testing.

We also stock a comprehensive range of infection control products for hospitals and other healthcare settings. Head here to browse our range of infection control solutions.

Improve Quality & Efficiency in Operating Theatres

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Improving quality and efficiency in operating theatres brings a range of benefits in both the short-term and the long-term:

  • Reduced turnaround time between procedures.
  • Improved patient care and infection control.
  • Happier and more motivated staff.
  • Huge financial savings – The NHS Institute for Innovation and Improvement estimates that a more productive operating theatre can help the average trust save more than £7 million.

How Much Do Operating Theatres Cost to Run?

Various sources suggest that operating theatres cost between £560 and £1,200 an hour to run. However, there is no recent data available and most sources date back to around 2015. Costs are likely to have risen significantly since then, especially when you take increases in energy costs into account. Improving quality and efficiency in operating theatres comes down to making the absolute most out of all available time and resources. It’s also about understanding the costs associated with downtime.

How to Create a More Productive Operating Theatre

A productive operating theatre is optimised to improve a patient’s experience and outcomes. There are three key areas to focus on to achieve this:

  • Team performance and staff wellbeing
  • Safety and reliability of care
  • Value and efficiency

First, you need to assess how your operating theatre is managing right now.

How to Audit your Current Operating Theatre Practices

Start with a comprehensive audit of your operating theatre practices. The NHS Productive Operating Theatre strategy recommends that financial leaders should commit to a walk-around of their operating theatres to better understand the issues that frontline staff face every day.

The aim is to assess the operational status of each theatre in your trust. Here are some areas to focus on:

  • Is all the necessary equipment available and working?
  • Are the right staff in the right place at the right time?
  • Do operating lists start on time? If not, how often are they delayed, and by how much time are they delayed on average?
  • How often does the theatre face cancellations and delays?
  • Do operating lists finish on time?

Obviously, all theatres will encounter unexpected issues from time to time. But when they do, the operating team should be equipped to identify and escalate issues in a timeless and efficient manner. And when faced with a problem, all plans should be flexible enough that you can make small adjustments to get the day back on schedule.

What Does a Well-Organised Theatre Look Like?

In a well-organised operating theatre, everything and everyone is in the right place at the right time, and ready to go whenever needed.

To work towards a well-organised theatre, the NHS Institute for Innovation and Improvement recommends a system called 5S: Sort, set, shine, standardise, sustain.

  • Sort – Remove any non-essential items from the area.
  • Set – Assign each object an ideal area in the room and organise all the necessary materials and equipment so that it’s easy to access.
  • Shine – Regularly clean and maintain the operating theatre environment.
  • Standardise – Once you establish procedures for maintaining orderly, clean and functional work areas, decide how similar areas can be arranged in the same way.
  • Sustain – Commit to regular audits to ensure that everyone maintains the high standards you set.

How to Reduce Waste in Operating Theatres

The NHS Institute for Innovation and Improvement identifies seven key sources of waste in operating theatres:

  • Defects and rework. If you don’t provide the correct information in the first place, or if your processes are faulty, the operating team will have to repeat certain procedures to ensure they’re done right.
  • If things are not within easy reach, or if they’re not easily accessible, operating teams will have to spend more time than necessary searching for what they need. Also, if the operating theatre isn’t properly organised, people will have to move, walk, and travel much more than necessary.
  • Either people produce more than what is needed, or they produce things earlier than necessary for the next process.
  • Are you moving any materials that really don’t require moving?
  • If staff don’t get the equipment, information, or support they need when they need it, they’ll have no choice but to wait. And when they’re waiting, they’re not working.
  • In an inefficient operating theatre, there’ll be more stock than necessary, too many processes taking place at once, and too many patients waiting in a queue.
  • Over-processing. Everything every member of the team does in an operating theatre should add value. In an inefficient operating theatre, there’ll be an excess of unnecessary steps that don’t add value, they only serve to waste time, motion, and resources.

Improving Patient Preparation and Turnaround

Poor patient preparation can cause a lot of stress, anxiety and uncertainty for both the patient and their relatives. But on an operational level, poor patient preparation can also result in late starts, costly changes to the list order, multiple delays, and even potentially harmful errors and mistakes.

In a well-organised operating theatre, every patient will arrive in the theatre prepared for surgery:

  • At exactly the right time.
  • With an identity band in place, and with all their notes complete and accessible.
  • Fully-informed and consented.
  • With their operation site marked.

Efficient patient turnaround means that not a single second is wasted between the end of one surgical procedure and the start of the next. This can involve several processes occurring at the same time, including:

  • Handing over the patient to recovery staff.
  • Clearing away instruments and cleaning the operating theatre environment.
  • Setting up all instruments and equipment for the next procedure, including the anaesthetic equipment.
  • Performing the check-in and sign-in procedures for the next patient.

Operating Theatre Consumables and Equipment

As we’ve seen, a crucial aspect of a productive operating theatre is that everyone needs to be able to access the equipment they need, when they need it. Nobody should ever have to stop a process to search for the necessary equipment, and nobody should ever find that their equipment is broken, faulty, or out of date just when they’re about to use it.

Also, the theatre team should always have all the equipment they need to cover the number of scheduled procedures. And there should never be any issues concerning skills and competency when using new equipment.

The choice of equipment in an operating theatre can also make a huge difference to efficiency. For example, the right sort of absorbent operating theatre floor mats can help manage health and safety risks while simultaneously improving operational efficiency. As non-drip mats can be picked up and discarded, doing away with the need to mop floors, operating teams can significantly reduce the turnaround times between procedures without compromising on hygiene standards.

Improving Quality and Efficiency in Operating Theatres – Full Guidance

The Productive Operating Theatre is a series of modules designed to help theatre teams work together to improve the quality of the patient experience and the safety of surgical services. The resource outlines ways in which theatres can make best use of available time and expertise.

You can download a suite of modules covering every aspect of a productive operating theatre, including equipment and consumables, patient preparation and turnaround, the handover procedure, and effective teamwork and procedure scheduling.

Head here to access the full suite of Productive Operating Theatre resources.

Whether you want a consultation on effective infection control, or some advice on improving operational effectiveness in the theatre, our experts are here to help.

Get in touch to talk to one of our experts today.