How To Manage an Outbreak of Infection in a Care Home

Any outbreak of infection in a care home must be considered a high-priority issue. Infections can easily spread in any location where people share facilities, and care home residents are high-risk groups: If they develop an infection, they’re more likely to experience severe symptoms.

What is an Outbreak?

The NHS defines an infectious disease outbreak as “when there are more people with the disease than you might normally expect.” There may be a different criteria for declaring an outbreak depending on the setting. When it comes to COVID-19 in a care home setting, for example, the NHS recommends declaring an outbreak when “there are two or more staff, residents, or visitors testing positive within 14 days of each other.”

If you don’t take steps to control an outbreak, the number of people infected could increase rapidly. This will have a huge impact on staff and resident wellbeing, and on the quality of care you’re able to deliver.

When is an Outbreak Over?

The NHS advises that you can declare an outbreak as over when 28 days pass without any new cases of the infection. Again, this advice is specific for COVID-19, but you can use a similar criteria for other infectious diseases in a care home.

What Are The Most Common Infections in Care Homes?

COVID-19 remains a major risk for care homes. But you must treat any outbreak of any infection just as seriously.

More than 50% of all care home infections can be linked to:

• The influenza virus
• Norovirus
• Salmonella
• Streptococcus Pyogenes

Read our full guide to the most common infections in care homes.

How To Manage an Outbreak of Infection in a Care Home

You should have dedicated policies and procedures covering your response to infection outbreaks in your care homes. These documents should be easily accessible for all staff, and you should review them periodically to ensure they reflect current risk levels and best practice guidance.

Your policy should include:

• A list of the most common infections in care homes, along with some of the symptoms to look out for.
• A definition of an “outbreak”. At what point will your outbreak response plan come into effect? Also define at what point you can declare that the outbreak’s passed.
• Immediate response – what are the most critical steps to take once you’ve declared an outbreak? Think about who you’ll inform, how you’ll inform them, and what you’ll tell them. You’ll have to brief staff, inform residents, and contact their relatives too.
• High-risk residents – some residents might have existing conditions that make them particularly vulnerable to infection, or they might be immunosuppressed or immunocompromised.
• Your outbreak response policy should outline how you’ll shield your most high-risk residents, such as through zoning infected residents elsewhere in the care home and temporarily restricting any time spent in shared spaces.

Staff Training for Managing Outbreaks

Your staff should receive specialist training in managing outbreaks. The training should include:

• Understanding the most common infections in a care home, and what sort of symptoms to look out for. They should also learn how infections spread, as this will help them better understand how infection prevention and control strategies work.
• Understanding what counts as an “outbreak”, and what their immediate response should be. For instance, if they suspect a patient’s showing symptoms of a particular infection, who should they inform, and what should they do?
• Hand hygiene. Staff should learn the correct hand-washing technique, and the key moments when they should practice hand hygiene (such as before and after touching a resident or their surroundings).
• PPE use. Staff should understand how to use the right PPE for the right purpose. But they should also receive training on storing, handling and disposing of PPE for optimum infection control, including the correct procedures for putting equipment on and taking it off.

Resident Zoning and Isolation

Throughout the COVID-19 pandemic, it became common practice to isolate any patients who might be carrying an infection risk, to reduce the chances for the infection to spread from person-to-person. Similarly, any staff members testing positive were advised to self-isolate.

Your care home infection outbreak response policy should consider resident zoning and isolation. Ideally, you should have single rooms available for emergency quarantine. And in the event of an outbreak, you should carry out an infection risk-assessment for every resident, reserving your emergency isolation and zoning procedures for the most high-risk individuals.

At the same time, you need to consider your residents’ physical and psychological wellbeing. How can you continue to deliver a high quality of care even while they’re in isolation? How will you keep the resident and their visitors informed throughout their quarantine? And crucially, how long will the isolation last? At what point will they be able to safely mix again with the rest of the care home population?

For more information, and for actionable tips for managing outbreaks in your care home, be sure to read the latest Department of Health and Social Care and Public Health England guidance on infection control in care homes.

Cleaning

Cleaning is an essential part of infection prevention and control. Pathogens can survive on surfaces for hours, or even days. So regularly cleaning your care home environment can significantly reduce the risk of cross-infection.

You should already have cleaning policies and procedures in place for your care home, outlining where to clean, how to clean it, what products to use, and how often to do so. Your cleaning policy should pay particular attention to any area of your care home where residents share facilities, along with any area where food is prepared or consumed.

In the event of an outbreak, you should implement even more robust cleaning procedures. This might involve carrying out more regular cleaning or switching to using specialist cleaning products that can kill viruses and bacteria on surfaces.

Be sure to read our full guide to effective environmental decontamination for infection control.

Air Purification

As well as lingering on surfaces, the viruses and bacteria that cause infections and outbreaks in care homes can also be airborne.

Good air filtration can actively contribute to infection prevention in care homes, while helping to prevent the spread of infection during an outbreak. Air filtration can even help prevent the spread of COVID-19. One study found that an air filtration system successfully removed almost all traces of the airborne virus in a quarantine ward.

Our range of HealthProtect air purifiers are specifically designed for healthcare facilities such as care homes. They can deliver complete air filtration every 12.5 minutes, trapping and killing up to 99% of viruses and bacteria – including those responsible for all of the most common outbreaks in care homes.

We can advise on effective infection outbreak management in your care home. As well as supplying specialist healthcare air purifiers, we also stock a full range of infection control products, including the Virusolve+ range of one-step cleaner, sanitiser and disinfectant solutions.

Get in touch to discuss care home infection outbreak management with one of our friendly experts.