The Standard Infection Control Precautions (SICPs) are a series of “must do” practices intended to reduce the risk of infection in care settings.
There are 10 standard infection control precautions. SICPS are for every patient, for every care setting, and for every time. And all members of staff should abide by them.
In this post we’ll list them, and explore how each SICP can help prevent infection.
Patient Placement, and Assessing a Patient’s Infection Risk
As soon as patients arrive at a care area, you must assess their infection risk. You must also continuously review their infection risk throughout their stay. Ideally, you should make this assessment before you accept a patient from another care area.
Your assessment should determine where you place patients in accordance with their clinical or care needs. For example, you should isolate patients who show a high risk of cross-infection as soon as they arrive. You should then work to establish the underlying cause of their infection through testing clinical samples, and through ongoing screening.
There are numerous protocols for good hand hygiene. It largely comes down to three things:
- What you use to wash your hands. Staff should have access to alcohol based hand rubs (ABHRs) as close as possible to the point of care. When your hands are visibly soiled or dirty, or when you’re caring for patients with conditions involving vomiting or diarrhoea, you should use water and non-antimicrobial liquid soap. When visiting patients in their own home, use whatever hand soap they have available, before applying some ABHR.
- How you wash your hands. It should take you at least 20 seconds, and there’s a specific technique to ensure you get as thorough a clean as possible. When visiting a patient in their own home, you should use your own supply of disposable paper towels to dry yourself. Surgeons and those who work in certain other clinical fields usually have to abide by even stricter hand hygiene protocols.
- When you wash your hands. There are five points at which you should perform hand hygiene: 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
Catch it, bin it, kill it. When sneezing, coughing, wiping or blowing your nose, you should cover your nose and mouth with a disposable tissue, before promptly disposing of that tissue in a waste bin. And immediately after this, you should follow the hand hygiene procedures outlined above.
If you don’t have any tissues to hand, use your elbow or sleeve to cover your nose and mouth when coughing or sneezing.
As for patients, if they’re showing any symptoms of respiratory illnesses, you should encourage them to wear a face mask. However, this must be a high-standard surgical face mask. Also, it must be clinically safe for the patient to wear a mask, and they must give their consent to wearing one.
In any case, you can help promote good respiratory and cough etiquette among your patients through providing tissues, plastic bags for disposal, and hand hygiene facilities.
Personal Protective Equipment
The personal protective equipment (PPE) you wear should provide adequate protection against the risks associated with whichever task or procedure you’re undertaking. So before any task or procedure, assess your likely exposure to blood, body fluids, and potentially harmful chemicals.
There are separate protocols for all the various different types of PPE, including gloves, aprons, gowns, masks, and goggles. But some protocols apply to all PPE:
- All PPE must be located close to the point of use.
- You must store PPE in a clean and dry area until you need to use it, and you must adhere to any expiry dates on the packaging.
- Unless specified by the manufacturer, all your PPE should be single-use only.
- You must change your PPE immediately after seeing each patient, and immediately following each task or procedure.
- You must correctly dispose of all PPE immediately after use.
Safe Management of Care Equipment
Most care equipment is reusable, and it can quite easily become contaminated with infectious agents including blood and other bodily fluids. This SICP is essentially all about ensuring that you keep all reusable care equipment clean and well-maintained.
There are also protocols for single-use care equipment – for example, you should never use the same needle or syringe on more than one patient. And before using any sterile equipment, you should check that the packaging is intact, with no obvious signs of contamination, and that the expiry date’s valid.
Safe Management of Care Environment
In short – keep your care environment clean and tidy. The care environment should be visibly clean. It should be well-maintained and kept in a good state of repair. There should be no non-essential items or equipment on the premises that could prevent effective cleaning.
On top of this, you must commit to a cleaning routine that meets the appropriate regulatory standards.
Safe Management of Linen
Keep your clean linen in a clean, designated area. If you don’t have a dedicated enclosed cupboard, then you can use a trolley – but only if the trolley is used strictly for this purpose, and only if it can be completely covered with an impervious covering that you decontaminate regularly.
You should immediately categorise any linen you use during patient transfer. And you should ensure a laundry receptacle is available as close as possible to the point of use for the immediate deposit of any used linen. Never overfill laundry receptacles, and never place used linen anywhere but in the receptacle. Also, never dispose of anything else in the laundry receptacle, whether it’s an empty drink can or a used needle.
There are specific protocols for safely handling “infectious linen” – that is, linen used by a patient who is known, or suspected, to be infectious. You should have a dedicated receptacle for infectious linen. But before you place this linen in a receptacle, you should put it in a water-soluble bag, then put this bag into a second, plastic bag. Make sure any receptacles or bags you use for infectious linen is clearly marked, and make sure you store any infectious linen in a designated, safe, lockable area.
Safe Management of Blood and Other Body Fluids
Any spilled bodily fluid can transmit viruses. So you should decontaminate any spillages immediately, ensuring that only staff with appropriate training undertake this task. In every care setting, it should be clear who’s responsible for decontaminating any blood or bodily fluid spillage.
Safe Disposal of Waste
In each care setting there are four separate “waste streams”, with a different colour coding for each:
- Black/Clear – This waste has trivial risk, and mainly includes domestic waste. The protocols specify that you must separate this waste at source into recyclable and non-recyclable waste.
- Orange/Light Blue – This is low-risk or “laboratory” waste – items that have been contaminated, or that you suspect to be contaminated, with blood and other bodily fluids. When it comes to liquid waste, such as blood, you must first add a self-setting gel or compound before you dispose of it.
- Yellow – High-risk waste that carries a risk of infection, contamination, or other forms of harm. For example, “anatomical and human tissue which is recognisable as body parts” must be placed in the yellow waste stream for “ethical” reasons. Sharps boxes – that is, boxes of used needles and syringes – are usually placed in the yellow waste stream. Their boxes must be clearly labelled with the date of assembly, the point of origin, and the date of closure.
- Red – The red waste stream is for “special waste”, including chemical waste.
The tenth SICP is all about prevention and exposure management. It’s all about taking immediate corrective action if you’re injured in the care setting, or if you’re exposed to blood and bodily fluids.
A lot of this comes down to effective disposal of sharps. Each care setting must have arrangements for the safe use and disposal of sharps, and they must provide appropriate training to all employees.
It’s also about understanding the risks of occupational exposure – when and how it might happen, and the steps you must take when an occupational exposure incident takes place.
We offer an expert workplace exposure monitoring service that will ensure you meet your COSHH obligations wherever your staff are exposed to hazardous substances in your care setting.
Our fully-accredited consultants will manage the work for you, eventually providing a comprehensive report that includes discussions and recommendations based on our findings.
Head here for more information on COSHH workplace exposure monitoring, to talk to an expert, or to get a quote.