TheatrePracticeStandardsGeneric1

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Generic Theatre Standard No 06 - Management of Patients with known Infections or carriers of Infectious Agents Standard Statement: All Theatre staff will have knowledge of the requirements for caring for patients with known Infections or carriers of Infectious Agents in the operating department to protect self, colleagues and patients from the risk of health care acquired infection. General considerations • Training all staff involved in the care of the patient must be aware of the specific precautions and have received adequate training. • Briefing should include a quick check to ensure all staff are aware of the specific precautions, patient’s position on the list, recovery time/place and sufficient environment/equipment cleaning time all should be highlighted and discussed. • Communication is absolutely essential prior to handover, so the next healthcare team have the ability to instigate isolation procedures, as necessary. • Flow The essence of this is maintaining adherence with infection control policy but also maintaining flow through our theatres. Sensible and thoughtful application with discussion between all care givers will allow for better flow. • In order to limit accidental exposure good theatre practice/technique includes keeping staff to a minimum, trying to reduce unnecessary movement of personnel from one zone to another, raising awareness and keeping only the equipment/items relevant for the surgery taking place in the theatre. Standard precautions must be adhered to. The theatre doors must be kept closed to aid the efficiency of the ventilation systems. As far as possible all personnel, surgical instruments and sundries must be sourced prior to the case being undertaken. • Recovery PACU Known infectious patients do not always need to be recovered in theatre. Safety gel, granules/sachets to be used when transporting possibly infected fluids, e.g. urine from the bay to the sluice. Appropriate communication with the recovery team must occur to ensure that they are informed of the patient’s status. The recovery bay and all equipment must be cleaned following transfer to the ward. Recovery staff must ensure that the receiving ward is fully aware of infectious status, in a timely manner to allow the receiving ward to make any necessary arrangements. • Waste Contaminated PPE and clinical waste disposed into yellow bags for incineration. Contaminated clothing and reusable bedding disposed into red bags for infected laundering. Safety gel/granules to be applied to spillages or when carrying possibly infected bodily fluids from theatre to sluice and when disposing, to prevent splash back. Please see individual standards for or specific guidance on • Staff risk • Patient position on list schedule • Hand Hygiene • Personal Protective Equipment (PPE) • Environment/equipment cleaning • Recovery PACU instructions Quick-view chart on list position and recovery placement for each infectious agent can be seen below. Compliance: 100% Exceptions: None 26
Quick-view chart on list position and recovery placement for each infectious agent Infection Place on List Recovery Clostridium difficile C.diff. and GDH Symptom free in last 72 hours DO NOT NEED to be last on list Symptoms present in last 72 hours Consider either allowing sufficient time between patients to clean AND recover OR placing patient LAST ON LIST Symptom free in last 72 hours DO NOT NEED to be recovered in theatre Symptoms present in last 72 hours SHOULD BE recovered in theatre Creutzfelt-Jacob Disease (CJD) SHOULD BE placed at the end of the list where possible DO NOT NEED to be recovered in theatre Extended-spectrum betalactamases (ESBLs) and Amp C Glycopeptide Resistant Enterococci (GRE) Diarrhoea symptom free in last 72 hours DO NOT NEED to be last on list Symptoms present in last 72 hours Consider either allowing sufficient time between patients to clean AND recover OR placing patient LAST ON LIST Diarrhoea symptom free in last 72 hours DO NOT NEED to be last on list Symptoms present in last 72 hours Consider either allowing sufficient time between patients to clean AND recover OR placing patient LAST ON LIST Symptom free in last 72 hours DO NOT NEED to be recovered in theatre Known ESBL patients SHOULD NOT BE RECOVERED NEXT TO a patient at high risk of contracting ESBL (for definitions please see the RCHT ESBL Policy). Symptom free in last 72 hours DO NOT NEED to be recovered in theatre Known GRE patients SHOULD NOT BE RECOVERED NEXT TO a patient at high risk of contracting GRE (for definitions please see the RCHT GRE Policy). MRSA DO NOT NEED to be last on list DO NOT NEED to be recovered in theatre Norovirus SHOULD BE placed at the end of the list where possible SHOULD BE recovered in theatre TB DO NOT NEED to be last on list DO NOT NEED to be recovered in theatre Patients with Diarrhoea If infection is suspected, these patients SHOULD BE recovered in theatre. 27
Page 1:
New Bookmark Drugs Table of Content
Page 4 and 5: MEMBERSHIP OF THE WORKING PARTY Dr
Page 6 and 7: SECTION I - SUMMARY AND RECOMMENDAT
Page 8 and 9: SECTION III - INTRODUCTION Patients
Page 10 and 11: purchase these services. They must
Page 12 and 13: SECTION VI - PREPARATION FOR THE TR
Page 14 and 15: A patient who remains hypotensive d
Page 16 and 17: A patient who has been made physiol
Page 18 and 19: 4. Other equipment • suction •
Page 20 and 21: important to involve those who take
Page 22 and 23: REFERENCES 1. Association of Anaest
Page 24 and 25: APPENDIX II TRANSFER CHECKLIST FOR
Page 26 and 27: 21 Portland Place, London W1B 1PY T
Page 28 and 29: Storage of Drugs in Anaesthetic Roo
Page 30 and 31: Generic Theatre Standard No 08 - Ca
Page 32 and 33: 6.2. Overall performance against th
Page 34 and 35: • Clean theatre clothing should b
Page 36 and 37: • Protective face shields must be
Page 38 and 39: Generic Theatre Standard No 02 - Op
Page 40 and 41: • Please read NJR Manual and Trai
Page 42 and 43: 13. Positioning of the Patient •
Page 44 and 45: Generic Theatre Standard No 04 - In
Page 46 and 47: Example of Environmental Theatre Cl
Page 48 and 49: 3. Between case cleaning procedures
Page 50 and 51: 6.1. Floor scrubbing machines • C
Page 52 and 53: • Personnel participating within
Page 56 and 57: Generic Theatre Standard No 06A - M
Page 58 and 59: Generic Theatre Standard No 06B - M
Page 60 and 61: lood, CSF or brain tissue, should b
Page 62 and 63: Exceptions: None References: • Af
Page 64 and 65: • Environment/equipment cleaning
Page 66 and 67: Generic Theatre Standard No 06F - M
Page 68 and 69: Generic Theatre Standard No 06G - M
Page 70 and 71: Generic Theatre Standard No 06H - M
Page 72 and 73: Generic Theatre Standard No 07 - De
Page 78 and 79: • The deceased patient should be
Page 80 and 81: 11 Leakages from the oral cavity, v
Page 82 and 83: • Mormonism o It is essential tha
Page 84 and 85: FAITH CONTACT ADDRESS TELEPHONE NO
Page 86 and 87: • The active electrode must alway
Page 88 and 89: Generic Theatre Standard No 11 - De
Page 90 and 91: Generic Theatre Standard No 13 - Ma
Page 92 and 93: • The labelled container must be
Page 94 and 95: • Staff Responsibility • All st
Page 96 and 97: • It is the responsibility of the
Page 98 and 99: 6. Induction of anaesthesia • See
Page 100 and 101: 4. Time Out - Before start of surgi
Page 102 and 103: • The registered anaesthetic prac
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• The Senior Surgeon/Operating Cl
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Generic Theatre Standard No 16 - St
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Generic Theatre Standard No 18 - Us
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Generic Theatre Standard No 20 - Ma
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Generic Theatre Standard No 22 - Ma
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3. Planned over-running sessions
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Generic Theatre Standard No 23 - Bo
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Generic Theatre Standard No 25 - Co
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Generic Theatre Standard No 27 - Ph
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Generic Theatre Standard No 29 - Vi
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Generic Theatre Standard No 31 - Th
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• Advice should be obtained from
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8. Harassment and Bullying • Dign
Page 130 and 131:
Appendix 1. Governance Information
Page 132 and 133:
Appendix 2. Initial Equality Impact
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