Infection Control

All NHS organisations must ensure that they have systems in place to minimise healthcare associated infections and ensure that adequate resources are in place to protect patients, their relatives, staff and visiting members of the public from the risk of infection when they attend our sites and when they use our services.   The Trust must comply with the Health and Social Care Act 2008: Code of practice on the prevention and control of infections, known as the Hygiene Code (updated 2022).     

The Trust has a dedicated Infection Prevention & Control Team which is headed by the Director of Infection Prevention & Control who is also the Chief Nurse.  There is a Consultant Medical Microbiologist who is the dedicated Infection Control Doctor and a team of Infection Prevention & Control Specialist Nurses, who are all committed to preventing and minimising the spread of infection at our Trust.  This includes:

• Constantly improving practice to reduce the incidence of infections that could be acquired in hospital
• Surveillance of infections that occur with support for frontline staff so they can take action to ensure the patient is nursed appropriately for their needs and to prevent spread of infection
• Education and training for staff via the Trust’s mandatory training programme and bespoke training for specific groups of staff when the need arises
• Producing Infection Prevention & Control policies in line with national guidelines which are available to staff via the Trust’s intranet
• Audit of policies in practice to ensure compliance with best practice and the Hygiene Code

The Infection Prevention & Control Team bases much of its advice on the National Infection Prevention & Control Manual for England which can be found here: NHS England » National infection prevention and control manual (NIPCM) for England

Trust Annual Infection Prevention & Control Annual Report

The Director of Infection Prevention & Control produces an annual report of Infection Prevention & Control performance and activity.  The report for 2022-23 can be found here: IPC Annual Report 2022-3 V1

How you can help us

Hand hygiene

Hand hygiene is the single most important and effective action to take that reduces the spread of pathogens and prevents infection from occurring.  Conducting hand hygiene at the right time, using the right technique, with either alcohol-based hand rub or sanitiser, or soap and water is critical.  The NHS provides the following video on the best way to wash your hands:      

How to wash your hands – NHS (www.nhs.uk)

When you visit our sites, you are also encouraged to use the sanitiser stations which are situated at the entrance to wards and departments.   Our staff are required to clean their hands before and after direct patient contact, before an aseptic task, after exposure to blood or body fluids and after contact with a patient’s immediate surroundings. They are also required to clean their hands when entering and leaving the hospital and ward areas.  We will always welcome and support patients and visitors to challenge our staff if they see them not cleaning their hands appropriately.         

Click the following link to find out more about visiting: www.swbh.nhs.uk/patients-visitors/while-you-are-here/visiting/

Norovirus

Norovirus, sometimes known as the winter vomiting bug, is the most common stomach bug in the UK.  It is highly contagious and can affect people of all ages and causes vomiting and diarrhoea.  It can cause outbreaks in hospitals.

The main symptoms of Norovirus are:

• Feeling sick (nausea)
• Diarrhoea
• Being sick (vomiting)

You may also have:

• A high temperature
• Headache
• Aching arms and legs and generally feeling unwell

Treatment:

• You can usually treat yourself or your family member at home
• The most important thing to do is to rest and take fluids to avoid becoming dehydrated
• You will usually start to feel better in 2 to 3 days

How to limit the spread of Norovirus:

• Stay at home and get plenty of rest. Don’t return to work, visit the hospital to see relatives or friends, or send children back to school until 48 hours after symptoms have resolved
• Wash your hands thoroughly and often with soap and water. Alcohol hand sanitisers don’t kill Norovirus
• Use bleach-based household cleaners to disinfect hard household surfaces and commonly used objects and remember to include touchpoints such as light switches, remote controls, and when cleaning toilets, include the flush mechanism
• Don’t cook or prepare meals for other people
• Wash contaminated bedding and clothing on the hottest temperature the fabric can withstand

Flu during winter (influenza) 

The flu vaccine is the best defence we have against the spread of flu so please have yours if you are entitled to a flu vaccine.  It can also be purchased for a small fee from some high street pharmacies.

Please help us to protect our patients and staff by not attending A&E or visiting relatives or friends if you are unwell with flu like symptoms.

Flu symptoms:

• A sudden high temperature
• An aching body
• Feeling tired or exhausted
• A dry cough
• A sore throat
• Headache
• Difficulty sleeping
• Loss of appetite
• Diarrhoea or tummy pain
• Feeling sick and being sick

The symptoms are similar for children, but they can also get earache and be less active.

Pharmacists can help with flu and can offer treatment advice and flu remedies.       

Services

What to expect if you are admitted to one of our hospitals

MRSA Screening

Meticillin resistant Staphylococcus aureus is a bug that is resistant to some of the commonly used antibiotics used to treat infection.  Due to this it is sometimes referred to as a ‘superbug’.

Information on MRSA can be found here  MRSA – NHS (www.nhs.uk)

When you are admitted to hospital as an emergency, you will probably be screened for MRSA.  A nurse will take a swab, which looks like a long cotton bud, and will gently insert into your nose and then send the swab to the laboratory for testing.  Other swabs may be taken from other parts of your body such as the groin or any damaged skin or wounds.  

If the MRSA is present, this does not mean you have an infection, it means only that you are carrying MRSA on your skin.  If MRSA is found, you will be given ointment for the inside of your nose and a body wash to help remove it or at least reduce it on your skin.  This helps to reduce the likelihood of the MRSA causing an infection for example getting into your blood stream or into a wound.

If you are having surgery that is planned, an MRSA screen is undertaken as part of your pre-assessment visit.  If MRSA is found, you will be given ointment for your nose and body wash to help reduce the presence of MRSA on your skin before your operation.   When you are admitted to hospital for surgery, you may be placed in a single room. This allows us to contain and control the bug and prevent them from spreading.      

Carbapenemase-producing Enterobacterales (CPE)     

What is CPE?

Carbapenemase-producing Enterobacterales (CPE) are a family of bacteria that usually live harmlessly in the gut.  This is known as colonisation and someone who is colonised is known as a carrier.  There is no way to know if you are colonised without being tested.  If you are colonised with CPE, it does not usually cause any problems.  However, if the bacteria move to the bladder or bloodstream, they can cause an infection and the risk is increased for those patients with a low immune system.  This can be a problem, as there are very few antibiotics available to treat an infection with CPE, making them difficult to treat. 

How does CPE spread?     

CPE can be spread from person to person, via the hands of staff, via other patients and visitors, and by touching surfaces and equipment around the bedside that might have CPE on them.  They are not spread through the air or by coughing or sneezing.

Preventing spread of CPE     

Everyone, including patients, staff and visitors can help prevent the spread of CPE by

• Having their sleeves rolled up above their elbows
• Washing hands with soap and water when entering and leaving wards at our hospitals
• Helping patients wash their hands with soap and water or use hand wipes before eating meals and after going to the toilet
• Washing hands with soap and water before and after helping a patient with their personal care

How do I know if I have CPE?

One of the main ways CPE is spread is when patients transfer between hospitals where CPE is present.

Therefore, we will screen (test) you for CPE when:

• You have been a patient staying at least overnight in another hospital in the UK in the last 12 months
• You have transferred from a hospital abroad or have been an inpatient in a hospital abroad in the last 12 months
• You are admitted to critical care
• We know already that you are colonised with CPE
• We know or suspect you have come into contact with someone who has had CPE.

This is why you are asked if you have been in another hospital in the UK or abroad in the last 12 months.  When you transfer into one of our hospitals from another hospital, this is also why you may be transferred into a single room to begin with while a test is taken.    

If you are an inpatient at one of our hospitals, it may be necessary to take a CPE screen (test) before you are transferred to another hospital for treatment.    

What is the CPE screen (test)

The test usually involves taking a sample from your rectum (the end part of your gut) where a swab (like a long cotton bud) is put just inside your bottom.  This is because CPE mostly live in your bowel.  We may also test a sample of your faeces (poo). We may also test any wounds or where you have had a drip or line fitted (intravenous line sites) for the presence of CPE.

Results of the CPE screen (test)

We usually have the results of the CPE screen (test) within 4 days.  

If the screening swab is negative, there will be no need to stay in a single room while in hospital.

If the screening swab shows you are a carrier of CPE, but you have no signs of infection, you will remain in a single room for the duration of your stay in hospital, with your own toilet or commode.   You won’t need to have any additional antibiotic treatment. 

If you are shown to have an infection with CPE, you will receive antibiotics under the guidance of a specialist doctor in Microbiology.

Do I need to tell anyone I have CPE?

Before you leave hospital, you will be given a leaflet that says you have been colonised with CPE, or a leaflet that says you have had an infection with CPE.  You can show this to your GP or when you go to another hospital.  

Patient Information

Clostridium difficile – Clostridium difficile (C. diff) – NHS (www.nhs.uk)

Meticillin resistant Staphylococcus aureus (MRSA) – MRSA – NHS (www.nhs.uk)

Influenza – Flu – NHS (www.nhs.uk)

Tuberculosis – Tuberculosis (TB) – NHS (www.nhs.uk)

Surgical wounds and preventing infections

Contacts

For more information please call the Infection Prevention and Control team on: 0121 507 5900, or alternatively contact our lead nurse or doctor below:

David Shakespeare
Deputy Director for Infection Prevention and Control
dshakespeare@nhs.net

Dr Mark Li
Consultant Microbiologist and Infection Prevention and Control Doctor
mark.li@nhs.net