TheatrePracticeStandardsGeneric1

Generic Theatre Standard No 06F - Management of Patients with
suspected/confirmed Norovirus in the Operating Theatre Department
Standard Statement: All Theatre staff will have knowledge of the requirements for caring for
patients with Norovirus in the operating department to protect self, colleagues and patients from
the risk of health care acquired infection.
Norovirus is a major cause of acute gastroenteritis and diarrhoea in children and adults. The cause
of illness, Norovirus (previously known as Norwalk-like or Small Round Structured Virus) was
described in 1968 in samples from an elementary school in Norwalk, Ohio. The disease is often
termed Winter Vomiting Disease because of the increased prevalence in the winter months;
however it can be detected throughout the year.
Norovirus is the most common cause of outbreaks of gastro-enteritis in hospitals and can also
cause outbreaks in other settings such as schools, nursing homes and cruise ships. Hospital
outbreaks often cause major disruption in hospital activity resulting ward closures, cancelled
admissions and delayed discharges which can significantly reduce clinical activity for the duration
of the outbreak. Failure to observe and comply with Infection Control guidelines/policy can lead to
further spread of infection and a delay in the hospital returning to normal activity. Outbreaks can
affect both patients and staff, sometimes with attack rates in excess of 50%. For this reason, staff
shortages can be severe, particularly if several wards are involved at the same time. It is therefore
essential that cases are detected early and isolated appropriately to prevent spread and major
outbreaks.
General Considerations
Please see Policy for the Management of outbreaks of suspected / confirmed Norovirus
Generic Theatre Standard 04 - Infection control in the Operating Department
• Staff risk Noroviruses are highly contagious. Noroviruses are transmitted primarily
through the faecal – oral route either by person to person spread or via contaminated
food or water. In addition Noroviruses can be spread via aerosol dissemination of
infected particles following vomiting. Transmission can also occur through hand
transfer of the virus to the oral mucosa following contact with environmental surfaces,
fomites and equipment which have been contaminated with either faeces or vomit.
Norovirus can survive for up to 12 days on some surfaces.
• Patient position on list schedule Preferably at the end of the list
• Hand Hygiene the hands of healthcare staff can provide the vehicle for the
transmission of norovirus. It is essential that all staff wash their hands when required
using the correct washing technique to help reduce the risk of transmission. 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 contact with potentially infectious
equipment, furnishings or other fomites. Gloves do not obviate the need to wash
hands.
• Personal Protective Equipment (PPE) aprons and gloves must be used appropriately
(single use items) and for each episode of care/treatment/examination on all patients
by all staff. These must be changed for each episode of care. There is currently no
evidence to support the wearing of face masks for either patients or staff.
• Environment/equipment cleaning All equipment that the patient has come in contact
with must be cleaned with a chlorine based disinfectant e.g. Actichlor plus, after the
patient has left the theatre.
• Recovery PACU instructions These patients SHOULD BE recovered in theatre.
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