Infection prevention and control are critical in childcare settings. To maintain a safe and hygienic environment, you have to assess the level of risk you face, explains Laura West…
Infections are easy to contract and transmit. But it’s equally easy to avoid if everyone plays their part and puts into practice proper preventative actions.
First, let’s understand what an infection actually is. Bacteria, fungi or viruses entering the body are what cause infection. They can be minor and stay in one area, like an abscess or boil, or spread through the body, like flu or a blood infection.
It’s easy to deal with general infections, but sometimes they can cause more serious health problems. You can spread infections like flu or norovirus from person to person, but not all infections are transmittable.
There are many infections that people can pick up, at work, around the home and in public places. We can spread them by blood, bodily fluids, waste, skin contact or infectious aerosols such as sneezing, dust and water droplets.
The spread of infection is also known as the ‘chain of infection’. By breaking a link we can halt the process. There are six links to consider:
Infections generally enter the body via one of four routes:
Inhalation – meaning, we breathe it in.
Ingestion – entry through the mouth. This often occurs accidentally through hand-to-mouth transfer, when a person has a substance on their hand and then does something like bite their nails, smokes or eats lunch.
Injection – caused by sharp objects that penetrate the skin and allow harmful substances into the body. Particular hazards include discarded needles and syringes.
Absorption – this usually takes place through cuts or other breaks in the skin. However, other substances can penetrate and be absorbed by unbroken skin.
Infection can occur in a number of different ways within a childcare setting. The main way is putting contaminated hands, fingers or pens into the mouth, nose or eyes, or inhaling infectious aerosols or droplets from the air (eg breathing in after someone has sneezed).
Other ways include contamination via broken skin (a wound) or coming into direct contact with a microorganism or something contaminated by microorganisms.
More serious ways of contamination could involve splashes of bodily fluids such as blood or excrement coming into contact with the eyes, nose, mouth or open wound, or a skin-penetrating injury – eg being contaminated via a discarded needle or animal/insect bite.
In order to do effective infection prevention and control, you have to assess the level of risk. Once you’ve identified a source of infection, you must consider how likely it is that infection will occur.
In order to do this, think about how often your staff carry the task out, how many employees are exposed, and how much infectious material is handled. If you consider that there is a risk, decide whether existing infection prevention and control measures are sufficient or if you require more.
Within industries where people work with people (adults and children) or animals, the basic infection prevention and control principles of occupational hygiene should be applied in all situations. Occupational hygiene principles that all staff should follow include:
As well as occupation hygiene, good environmental hygiene and design are also essential. These principles include the following:
Cleaning products are the next area of infection prevention and control to consider. Disinfectants can be used to reduce bacteria to a safe level; this is achieved by using the disinfectant along with very hot water (82ºC or higher) for best effectiveness.
But remember, they must be diluted to the correct levels and left in place for the specified ‘contact time’ before rinsing. Disinfectants won’t break down grease and dirt. Detergents will, but will not kill bacteria, However, sanitisers are a combined detergent and disinfectant that will kill bacteria if left for the correct ‘contact time’.
Washing your hands regularly, effectively and thoroughly is the best way to keep the level of hand-based bacteria to a low or zero level.
As well as controlling the day-to-day risks it’s important to consider potential action that may be required in an emergency situation. If an employee is exposed to blood or potentially infectious materials, you will need to wash the exposed area thoroughly with soap and running water.
If blood or bodily fluids are splashed in the eyes or mucous membrane, flush the eye area with running water for at least 15 minutes.
Report the exposure to your supervisor, document the incident and investigate how this happened using health and safety procedures. It is also advisable to seek medical advice. It is a good idea to have a ‘clean up’ or ‘spill kit’ available.
Washing your hands is one of the most important aspects of infection prevention and control…
You need to wash your hands before and after:
Laura West is the childcare health and safety specialist at MCW Nursery Support Service Ltd, a family-run business specialising in health and safety, auditing and training for the childcare industry. Visit mcwnss.co.uk.
