published on
March 25, 2021

Care home infection prevention checklists to prepare for a second wave

WRITTEN BY
Amber Ainsworth
·
posted on
COVID-19: Care Settings


As you will be aware, there has been a significant increase in the number of Covid-19 positive cases across the UK recently. 

It’s more essential than ever to have infection prevention and control guidelines in place at your care home to prepare for a possible second wave. 

Here, we’ll provide checklists for the key areas to focus on.

1.Hand hygiene

Hand hygiene is one of the most effective actions you can take to reduce the spread of infections, including Covid-19.

There are five important moments for you to clean your hands - make sure these are always followed when providing care. 

5 times hands should be cleaned:

  1. Just before you provide care to a resident
  2. As soon as you have finished providing care to a resident
  3. Straight after you have been exposed to any body fluids
  4. Straight after touching the person’s surroundings (e.g. chair, door handle) if this may have contaminated your hands
  5. As soon as you take off protective gloves

To prepare for hand hygiene, it is recommended that you:

  • Expose your forearms so that they are bare from the elbows down
  • Remove all hand and wrist jewellery, a single plain metal finger ring is permitted; however, it should be removed or must be moved during hand hygiene
  • Ensure finger nails are clean, short and that artificial nails or nail products are not worn
  • Cover all cuts or abrasions with a waterproof dressing.

Hand sanitiser or soap and water?

In general, you can use a hand sanitiser as default to clean your hands. However, in these situations you must use liquid soap and water:

  1. When you can clearly see you have dirty hands
  2. When your hands may be contaminated with bodily fluids
  3. When you’ve provided care to residents who are coughing, vomiting or who have diarrhoea, even if you’ve worn gloves.

How to wash your hands effectively

Washing your hands should take 40-60 seconds. Here are the steps to follow to effectively wash your hands:

  1. Wet your hands with water
  2. Apply enough soap to cover both hands
  3. Rub your hands palm to palm
  4. Place your right palm over the top of your left hand, and interlace the fingers, and rub back and forth
  5. Do the same with your left palm over your right hand
  6. Rub your palms together with your fingers interlaced 
  7. Rub the backs of your fingers against the opposite palm
  8. Clasp your left thumb with your right palm and rotate your thumb
  9. Rub your left fingers against your right palm in a rotational motion
  10. Do the same two steps above with your right thumb and fingers
  11. Rinse hands with water
  12. Dry hands thoroughly 
  13. Use a towel to turn off the tap

You can find an illustration of the above steps from the World Health Organisation here. 

Cough hygiene - ‘Catch it, bin it, kill it’

To minimise transmission of Covid-19 through respiratory droplets, tissues and waste bins should be available to everyone. 

All staff, residents, users and visitors should:

  • Use disposable tissues to cover the nose and mouth when sneezing, coughing or wiping and blowing the nose
  • Dispose of used tissues immediately in the nearest bin
  • Clean hands after coughing, sneezing, using tissues, after any contact with respiratory droplets or objects contaminated with respiratory droplets
  • Not touch their eyes, mouth and nose
  • Help those people who may need help with containing their respiratory droplets such as the elderly
  • Provide those who are immobile with a bag close by for immediate disposal of tissues
  • Ensure common areas, or during transportation, that people with symptoms wear a fluid-resistant surgical face mask to minimise dispersal of their respiratory droplets or contamination of surfaces
  • Clean frequently touched surfaces.

2. PPE

Homes need to make sure there is an adequate supply of PPE available to all staff. 

PPE includes the use of masks, gloves and aprons - and generally, choosing the right protective equipment to use will require an assessment of the task and the risk to both yourself and the resident. 

For coronavirus transmission prevention, there are set guidelines in place for care homes to follow. 

In general, the rules for PPE are: 

  • Wear each item only once 
  • If gloves are needed, put them on just before providing care and take them off straight afterwards 
  • Change gloves between different care tasks for one person, for example, personal care and care that involves non-intact skin 
  • Change gloves between care tasks for different people Dispose of all used items correctly (see below)

PPE and coronavirus in care homes

Face masks must be worn in care homes at all times, whether there are suspected cases of coronavirus or not.

The recommended PPE in care homes includes:

  • Fluid repellent facemask 
  • Apron 
  • Gloves 
  • Eye protection if there is a risk of splashing or exposure to respiratory droplets (plastic eye protector reusable goggles may be suitable)

Public Health England have released guidance on the correct application of the above equipment, which can be accessed here.

Please find our full overview of advice for wearing PPE in care homes here

It may be worth using a PPE burn rate tool such as this, to calculate stocks required in general and if a second second wave were to occur.

3. Sharps

‘Sharps’ refers to the use of needles. Staff must always have the proper skills and experience in place before using needles for medical procedures in your home. 

To help prevent infection from sharps: 

  • Handle sharps as little as possible and don’t pass them from hand to hand 
  • Do not bend, break or recap a used needle 
  • Put used sharps in the right container straight away 
  • Don’t use sharps containers for anything else 
  • Dispose of sharps containers when the fill line is reached, or every three months – whichever occurs first

4. Waste disposal

All staff are responsible for the safe management and disposal of waste. Healthcare waste, such as dressings and disposable clothing, can spread infection.

To reduce the risk of this:

  • Put waste immediately into the right colour storage, bag or container 
  • Make sure you know how healthcare waste must be labelled and stored 
  • Make sure residents and their friends and family understand how waste must be handled, stored and disposed of

This document from the NHS explains the waste management approach for all healthcare facilities during the Covid-19 outbreak.

5. Visitor awareness

Residents and their friends and family can play a part in helping to prevent infection. 

Make sure they know about: 

  • The importance of clean hands 
  • How, when and where to clean their hands 
  • When to use hand sanitiser or soap and water 
  • What they can do to make sure care staff maintain clean hands

It is important to encourage and continue to educate good practice in your care setting. 

Here to help

Our Clinical Team is on hand to assist, monitor and process any incidents that may occur within your home. You can reach us on [email protected], or by calling 020 3911 2555

Join us

Get in touch and let us know If you’re not already working with Florence, and you need long-term staff to fill your rota gaps. Florence offers nurses and carers to fill multiple shifts over long-term periods.

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