A statement updated yearly to summarise:
- Any infection transmission incidents and actions taken, which are also reported in accordance with our Significant Events Reporting Procedures.
- Details of infection control audits and any actions taken.
- Details of any infection control risk assessments undertaken.
- Details of staff training.
- Reviews and updates of any policies, procedures and guidelines.
Solent NHS Trust Infection Prevention and Control Team flagged up one of our patient’s who contracted Clostridium Difficile June 2015. The GPs discussed the patient’s medications, at the monthly staff meeting, and could justify the reason’s for this patient being prescribed them.
The Solent NHS Trust IPC team check any health care associated infection results from pathology departments and follow them up by informing and speaking to the surgery involved to ensure clinical staff are aware and can justify their actions and possibly learn from mistakes.
Annual infection prevention and control audit was carried out by the current IPC (infection prevention and control) lead for Park Lane Medical Centre Sonia Barton, in January 2016.
Actions taken as a result of 2016 audit:
A formalised cleaning rota of the washable toys in the waiting area and the patient touch screen was introduced. The responsibility falls to one of the late duty receptionists at the close of surgery each day, and they must sign the cleaning log.
Lights and fittings throughout the surgery were in need of cleaning. This was carried out by receptionist Michael Miller 02/02/16.
Patient chairs in treatment rooms and Drs rooms were all old and the covers were split. These were all replaced with new chairs 03/02/16.
The covering on the couch in treatment room one is split. The practice manager is looking into costs of either recovering the couch or replacing it.
The sharps injury/significant exposure policy was out of date. The practice manager has sourced the up to date policy from Portsmouth hospitals NHS trust, including posters for clinical areas and personal cards for medical staff.
Domestic waste bins in both treatment rooms were open topped. The guidelines advise pedal non touch metal bins. The bins were replaced with new metal pedal bins 03/02/16.
The sharps boxes were only changed when full. They are now checked every 3 months and any that have dates of 3 months old are changed regardless whether they are full or not.
The cleaners mops were left wet in the cleaning buckets which is a hazard. The cleaners were made aware this is unacceptable and hangers were brought and fixed to the wall to hang the mops upside down after cleaning is completed.
Drivers who deliver vaccinations are asked to provide proof that the cold chain while transporting vaccinations has not been broken. Reception staff obtain a temperature slip from the driver, providing proof that the vaccinations, the surgery are accepting, have been kept at required temperatures to keep them safe for use.
External Audit 2016
An external infection control audit was carried out on 08/02/16 by Solent Infection Prevention & Control Speciality Nurse Anne Bishop. This audit was carried out with Nurse Sonia Barton IPC lead and Nurse Anne Pearce and Receptionist/phlebotomist Lorraine Nicholson.
The audit is designed to assist practices using an IPC tool which can be used to measure baseline compliance with standards and identify areas in need of improvement. The opportunity to take part in an IPC treatment room audit supports our clinical team in ensuring that evidence based “best practice” is consistently applied when performing clinical procedures which help to prevent health care associated infections.
Actions to be taken as a result of audit:
Plugs in sink in treatment room one should not be there and there is an overflow.Action – plugs were removed 08/02/16. IPC lead looking into finding a cover for overflow.
Flooring in treatment room one is showing signs of age, the tiled floor is not most suited for healthcare. It was suggested a steam clean would improve the condition in the interim. Action – the practice manager has requested that the company who have been contracted to clean the carpets, steam clean the treatment room floor also.
The covering on the couch in treatment room one is old and splitting making cleaning difficult. Action – recovering of the couch has been arranged with an appropriate water repellent vinyl 09/02/16.
Two handwashing basins in non-clinical rooms have been identified as low use outlets and as a result should be on a flushing regime. Action – a flushing regime poster was sent and placed above the two sinks and evidence of flushing will be documented.
Some hot water taps in consultation rooms have poor flow which needs addressing for water safety purposes. Action – practice manager is looking into this problem.
Skin cleansing wipes used prior to venepuncture did not contain chlorhexidine 0.5% in addition to the alcohol content. Action – the correct wipes were ordered 08/02/16.
Window blinds in treatment rooms need to be cleaned six monthly. Action – blinds will be cleaned every six months and evidence documented on the regular cleaning rota.
Over all compliance score is 100% for sharps handling and disposal, and 94% for all other improvements.
Clinical staff were made aware of the new needle stick/contamination incidents policy and given personal cards with contact details of where to report to 04/02/16. Old posters were replaced in treatment rooms with up to date ones.
All staff were updated with hand hygiene and a light box was used to enlighten all staff on their own hand washing performance. Clinical staff were advised competencies will be checked. Non clinical staff were reminded where to find bodily fluid spillage kits and procedures for cleaning and instruction in specimen handling was updated 09/02/16.
Policies Procedures and Guidelines
Solent NHS Trust Infection prevention and control policy is followed at Park Lane Medical Practice and includes: hand hygiene, cleaning and decontamination, safe handling and disposal of waste, sharps safety, personal protective equipment (PPE), safe handling of blood and body fluid spillage, respiratory hygiene and asepsis.
Next review: Feb 2017