TheatrePracticeStandardsGeneric1

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Exceptions: None References: • AfPP Principles of Safe Practice in the Perioperative Environment 2011 • Public Health England (2014) https://www.gov.uk/government/collections/extendedspectrum-beta-lactamases-esbls-guidance-data-analysis [accessed 12/03/15] • RCH Trust PolicyPolicy on precautions to be observed when caring for patients colonised or infected with extended Spectrum Beta - Lactamase producing organisms • RCHT Decontamination Policy RCHT IPAC Decontamination Policy 34
Generic Theatre Standard No 06D Management of Patients with Glycopeptide Resistant Enterococci (GRE) in the Operating Theatre Department Standard Statement: All Theatre staff will have knowledge of the requirements for caring for patients with GRE into operating department to protect self, colleagues and patients from the risk of health care acquired infection. Enterococci are Gram positive bacteria that are commonly found in the bowel of humans and animals. They rarely cause infection. They are occasionally responsible for urinary tract infections (UTIs), often related to the use of indwelling catheters, and more rarely cholangitis, endocarditis and gut-related sepsis. Two main types are associated with human diseases: Enterococcus faecalis and Enterococcus faecium. Enterococcus faecium is more common to cause bacteremic infections. Glycopeptide resistant enterococci (GRE) are resistant to vancomycin, usually teicoplanin and often other antibiotics. During mid 1980s enterococci resistant to vancomycin emerged and therefore often termed as Vancomycin Resistant Enterococci (VRE). GRE usually tend to cause colonisation rather than infection but when they cause serious infection, they are difficult to treat because of less therapeutic option. Hospital outbreaks of GRE have been reported mainly from renal dialysis, transplant, haematology and intensive care units. Risk factors for colonisation and infection with GRE include previous antibiotic therapy (especially with glycopeptides, cephalosporins, or carbapenems), immunosuppression, prolonged hospital stay, and admission to intensive care, renal, haematology or liver units. Once gut colonisation has occurred, carriage can be prolonged and there is no effective means of eradication. General Considerations Please see the Glycopeptide Resistant Enterococci (GRE) Policy Generic Theatre Standard 04 - Infection control in the Operating Department • Staff risk Effective hand decontamination is the most important measure to prevent and control the spread of GRE. Portering staff do not need to wear protective clothing whilst transporting patients. They only need to wear protective clothing if there is any possibility of having close contact with the patient and they must decontaminate their hands after removal. • Patient position on list schedule DO NOT NEED to be last on list, however, to ensure robust cleaning, adequate, non-pressured time be allowed to the staff to clean effectively. • Hand Hygiene Effective hand decontamination is the most important measure to prevent and control the spread of GRE. Alcohol gel is effective on GRE, so should be used in all potential situations as recommended in the Standard Precautions policy. Hands must be decontaminated between each patient contact whether or not the patient is known to be colonised with GRE. • Personal Protective Equipment (PPE) Staff should use standard precautions after contact with urine or faeces to prevent spread. Staff must put on gloves when entering the theatre and wear a plastic apron if substantial contact with the patient or environmental surfaces is anticipated. PPE must be removed followed by hand washing before coming out of the patient zone 35
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New Bookmark Drugs Table of Content
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MEMBERSHIP OF THE WORKING PARTY Dr
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SECTION I - SUMMARY AND RECOMMENDAT
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SECTION III - INTRODUCTION Patients
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purchase these services. They must
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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
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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
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Page 40 and 41: • Please read NJR Manual and Trai
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Page 46 and 47: Example of Environmental Theatre Cl
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Page 60 and 61: lood, CSF or brain tissue, should b
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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
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Page 86 and 87: • The active electrode must alway
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Page 92 and 93: • The labelled container must be
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Page 100 and 101: 4. Time Out - Before start of surgi
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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
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Appendix 1. Governance Information
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Appendix 2. Initial Equality Impact
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