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Infection Control

As a Trust, we are committed to having plans in place to minimise infections and ensure that we have the right resources 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 and Control team which is headed by the Director of Infection Prevention and Control who is also the Chief Nursing Officer.  The team is:

  • Constantly improving the way we work to reduce infections that could be acquired in hospital
  • Monitoring infections that happen, supporting staff so they can take action to ensure the patient is nursed correctly and to prevent spread of infection
  • Educating and training staff, with bespoke training when needed
  • Producing Infection Prevention and Control policies in line with national guidelines 
  • Auditing policies in practice to ensure compliance with best practice and the Hygiene Code.

 

How you can help us

Keeping your hands clean by washing them properly is the most important and best way to reduce the spread of infections.  It’s important to use the right technique, with either alcohol-based hand rub or sanitiser, or soap. Water is really important.  The video featured in the link below shows you 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/

 

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)  Screening

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. 

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.

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

CPE Q&A

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 four 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

Patient Information in Punjabi

Extended Spectrum Beta Lactamases (ESBL) PUNJABI ML5004
VRE PUNJABI ML5005
Group A Streptococcal Infection PUNJABI ML5295
Washing patients laundry at home PUNJABI ML5331
Tuberculosis (TB) PUNJABI ML5453
Norovirus PUNJABI ML5460

Patient Information Urdu

Extended Spectrum Beta Lactamases (ESBL) – Urdu ML5004
VRE – Urdu ML5005

Group A Streptococcal Infection – Urdu ML5295_
Washing patients laundry at home – Urdu ML5331
Tuberculosis (TB) – Urdu ML5453
ML5460 Norovirus – Urdu

Patient information in Romanian

Extended Spectrum Beta Lactamases (ESBL)_ ML5004
Vancomycin Resistant Enterococci (VRE)_ML5005
Group A Streptococcal Infection ML5295
Washing patients laundry at home_ML5331

Tuberculosis (TB)ML5453
Norovirus ML5460

 

 

Norovirus

You can read more about norovirus here: Norovirus (ML5460) or by going to www.nhs.uk/conditions/norovirus/

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

Surgical wound infections happen when germs enter the cut or incision the surgeon has made through the skin to perform your operation.  A surgical wound infection can happen at any time from two to three days after your operation until the wound has healed. On rare occasions a wound infection can occur several months after an operation.   

Most surgical wound infections are skin infections. Very rarely they can spread to deeper tissues.    

Before your operation

As part of the pre-admission process, you may be advised to ensure you have a shower with soap and water before you come into hospital.  You may also be given an antibacterial solution to wash with before you come into hospital or before you go for your operation.  As part of the pre-admission process you might be screened for MRSA (see above section on MRSA).  

Signs of a wound infection

In general surgical wound infections are quite rare and affect only a very small number of patients. 

How to recognise a wound infection:

  • The skin around your wound is red or sore, or feels hot and swollen
  • Your wound has liquid (often green or yellow pus) coming out
  • Your wound opens up in places
  • You feel generally unwell or have a temperature (fever)

Looking after your wound

While you are in hospital, the nurse who changes your dressing will check your wound for any signs of infection.  If the nurse or doctor looking after you thinks that you might have a surgical wound infection, they might take a sample from the surface of your wound using a swab (like a long cotton bud) and send it to the laboratory for testing.  If an infection is detected, you might be given antibiotics.

Try not to remove your dressing unless instructed, or touch you wound or drain, as you could accidentally spread bugs from your fingers onto your wound.  

If you are concerned about your wound, tell your doctor or nurse.

After you leave hospital

If you are concerned about your wound when you are already at home, contact your doctor or nurse using the contact details they have given you.  If not, inform your GP and request advice.  

Surveillance of surgical site infection

All surgical wounds are checked for signs of infection.  For some operations there is a national programme to monitor surgical site (wound) infections that covers all of England.  This means that hospitals can be compared with each other to ensure infections can be kept to a minimum. Typically, types of operations in this category include hip and knee replacements, or the repair of a fractured hip.  If you are having one of these procedures, you may get a follow up call or questionnaire at home up to a month after your operation to check if you have developed any signs of infection.   Further information can be found here.

 UKHSA Surgical site infection leaflet A4 (publishing.service.gov.uk)

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

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