Policy for the management and control of diarrhoea and vomiting

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Winchester & Eastleigh Healthcare NHS Trust POLICY FOR THE MANAGEMENT AND CONTROL OF DIARRHOEA AND VOMITING (NOROVIRUS) INFECTIONS his/her advice and agreement. If appropriate the Consultant Microbiologist will seek advice from the HPA. 11.7 All linen from isolation areas should be treated as infected linen and disposed off as per the infected linen policy. 12 Hand Hygiene 12.1 The hands of healthcare staff can provide the vehicle for the transmission of this infection. Furthermore a lack of hand hygiene among healthcare staff is a well recognised problem nationally. It is therefore essential that all staff wash their hands when required using the correct hand washing technique to help reduce the risk of transmission, as per CP073 Hand hygiene Policy. A 12.2 Alcohol gel is not effective against these viruses and therefore hands must be washed with soap and water before and after every patient contact and after contact with potentially infectious equipment, furnishings or other fomites. Please refer to CP073 Hand hygiene Policy for further details. 12.3 Wearing gloves do not obviate the need to wash hands. 12.4 Patients must be provided with the opportunity to wash their hands or use hand wipes after each toileting episode and also before each meal. Hand washing with soap and water is always preferable. 13 Personal Protective Clothing 13.1All staff must put on a yellow plastic apron and non-sterile gloves before entering an affected bay or side room. These should be removed and hands washed with soap and water before leaving the room or bay. Any failure to comply with the wearing of protective clothing and hand washing during an outbreak should be notified to the ward manager and the IPC team. Failure of compliance may constitute a clinical incident. Outbreaks of D&V can be contained if all staff follow these instructions. Refer to the CP076 Policy for the Standard Precautions and PPE (Personal Protection Equipment) for guidance. 13.2 There is currently no evidence to justify the wearing of face masks routinely for either patients or staff. 14 Movement of Affected Patients 14.1If a patient is symptomatic, his/her visit to another department should be delayed unless clinically urgent, as it will be distressing for the patient if an episode of diarrhoea or vomiting occurs during transit. Furthermore this will also unnecessarily expose more contacts to the infection and may result in Authorities Document Control Information Author: Dr Parnaby Type: Policy Consultant Microbiologist Sponsor: Members of the Infection Prevention & Scope: Major Control Committee Reference: CP101 Issue Number: 2 Date July 2011 Status: Published Page 12 of 26
Winchester & Eastleigh Healthcare NHS Trust POLICY FOR THE MANAGEMENT AND CONTROL OF DIARRHOEA AND VOMITING (NOROVIRUS) INFECTIONS the contamination of equipment e.g. radiological scanners. Alternatives should be considered such as portable X-ray. If clinically urgent the investigation or treatment should be discussed with the appropriate department in advance so that appropriate precautions can be undertaken. 14.2 Asymptomatic patients in a closed bay maybe able to visit other departments for tests etc. It is the responsibility of the nurse in charge of the ward to ensure that the receiving department is informed about the status of the patient, so they can ensure their visit is brief. 14.3 Patients in a closed bay or ward who require surgery should have their requirements discussed on a case by case basis between microbiologist, anaesthetist and surgeon. This will depend on clinical urgency as in 14.1. 14.4 Asymptomatic patients requiring social work / care home assessment can have their assessment carried out in a day room or another room off the affected ward so as to reduce the delay in discharge. 14.5 When Kingfisher ward or another satellite ward e.g. Melbury Lodge has norovirus there need to be contingency plans of where these patients will be accommodated if they are clinically too unwell to be accommodated on Kingfisher ward. The affected ward must discuss with the site coordinator, A/E, EMAU and the admitting doctor that the patient either has norovirus or is a contact prior to transfer to the RHCH site. 14.6 What to do if a visit to another department is essential for clinical care 14.7 Symptomatic and asymptomatic patients must not be transferred to other wards. However if the patient needs to be transferred to another ward for clinical reasons, this must be discussed with the IPCT on an individual basis, and they must be isolated for at least 72 hours following their transfer or until symptom free for 72 hours. Individual patients may be transferred to another ward to enable them to be isolated. However the nurse in charge or the bed manager must discuss this with the IPCT before the transfer takes place. 14.8 Affected patients must not be discharged to nursing or residential homes until they have been clear of symptoms for more than 72 hours. If their discharge is planned within this period it is the responsibility of the nurse in charge to contact the nursing or residential home to discuss their discharge arrangements. The local HPU may advise that a 48 hour interval is acceptable. 14.9 Affected patients may be discharged to their own homes once they are deemed fit for discharge. Authorities Document Control Information Author: Dr Parnaby Type: Policy Consultant Microbiologist Sponsor: Members of the Infection Prevention & Scope: Major Control Committee Reference: CP101 Issue Number: 2 Date July 2011 Status: Published Page 13 of 26
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Policy for the management and control of diarrhoea and vomiting

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