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The Gwent Health Community Clinical Governance Collaborative


Infection Prevention and Control Audit Tool for Care Homes

Page1of 28 Final Version 1 Produced: 07/01/2009


Content

1. Guidelines for Using the Tool

2. Audit Programme Template

3. Audit Tools:

3.1 Infection Control Management

3.2 Environment 3.3 Kitchen

3.4 Hand Hygiene

3.5 Personal Protective Equipment

3.6 Disposal of Waste and Spillage Management 3.7 Prevention of Sharp Injuries

3.8 Specimen Handling

4. Feedback / Action Plan Template 5. Evaluation Form

6. Appendix 1 – Sources of further information



INFECTION CONTROL AUDIT TOOLS 1. Guidelines for Using the Audit Tools These audit tools are intended for use by care home managers and staff (As appropriate to their function) who are engaged in providing high standards of infection control practice, thereby reducing the risk of healthcare associated infections(HCAIs) and ensuring patients/clients are cared for in a safe environment. They are designed to enable care home staff to monitor their compliance with infection control standards and policies. Planning the Audit Programme The audit tool is intended for use as a guide to review the care environment and infection control practices through the application of an audit programme and the production of an audit report and action plans. Time Required It is envisaged that the audits contained in this audit pack may be carried out at one time. The time required to complete a specific audit will vary according to the standards being audited. Scoring All criteria should be marked either Green if the criteria is met in full Amber if the criteria is met in part Red if the criteria has not been met Non applicable (N/A) where appropriate Comments Comments should be written on the form for each of the criteria at the time of the audit clearly identifying any issues of concern and areas of good practice. These comments may then be incorporated into the action plan. Comments made can indicate where some compliance has been observed e.g. ‘eight out of ten sharps boxes are labelled’. However, if one out of eight sharps boxes are not labelled for example, then the answer should be “No” (i.e. not all boxes are compliant). Practice Related Elements of the Tool When asked to observe practice e.g. hand hygiene, then a minimum of five practices should be observed. If one or more staff member/s fails to comply then the audit response should be “No”



Example Clinical staff nails are short, clean and free from nail extensions and varnish. If one healthcare worker has nail varnish then the response should be “No”. Action Plans An action plan must be generated for each audit completed (unless all criteria have been met in full during the audit. An action must be documented for all criteria scoring amber or red. Feedback of information and report findings It is advised that the auditor should verbally report any areas of concern and of good practice to the person in charge of the care home being audited prior to leaving work. A written action plan must also be developed by the auditor and should be discussed with the care home manager and staff for action. The manager/auditor should re audit the care home if there are concerns and to assess progress with the action plan.

Care Homes should use the audit results as the basis of a discussion within the care home team Sources of Information and Guidance When the audit highlights practices which require review staff can use the resource guide listed in Appendix 1 for sources of further information and guidance.



2. Audit Programme Template

Audits for Completion (i.e. full or environmental)

Date Responsible Person Date Action plan completed



3.1 Infection Control Management Standard: Infection Prevention and Control is an integral part of the culture within the care home

Evidence Green Amber Red N/A Comments 1 A lead for Infection

Prevention and Control has been identified within the Care Home

Ask for evidence

2 The nominated lead has received relevant infection control training

Ask for evidence

3 Staff have access to Infection Control Policies such as the NPHS Care Home Guidelines and the Department of Health Infection Control Guidance for Care Homes (2006)

Look for evidence

4 A training programme for Infection Control is in place

Look at the training log and training materials

5 The infection control training programme includes induction of all staff

Look at the training log

6 The infection control training programme includes the management of patients with infections e.g. patients with diarrhoea, infected wounds etc

Ask for evidence

7 The infection control training programme includes ongoing updates

Look at the training log

8 A programme of audit of infection control practices is in place

Ask for evidence

9 A policy relating to the management of patients who are admitted with or develop an infection in the home is available

Ask for evidence

10 A policy is in place to ensure staff assess patients prior to or on admission for any current infections

Ask for evidence

11 A written and verbal communication procedure is in place to ensure care home staff are informed of the infection status of those transferred out of

Ask for a description of the process



hospitals/other care organisations

12 A written and verbal communication procedure is in place to inform receiving hospitals/organisations of the infection status of those transferred out of the home

Ask for a description of the process

13 Staff always inform the hospital (Royal Gwent and Neville Hall) if a patient develops a wound infection up to 30 days after a surgical operation

Ask staff. If no - advise to ring 01633 238058 if post operative infections are identified*

* This question is specific to Gwent



3.2 Environment Standard: The environment will be maintained appropriately to reduce the risk of cross infection

Evidence Green Amber Red N/A Comments1 The organisation has

comprehensive written cleaning standards and procedures (use national standards of cleanliness for Wales 2004 as a guide)

Ask for evidence

2 Organisational structures are in place to ensure standards of cleanliness are audited in accordance with national cleanliness standards as above

Ask for evidence

3 Overall appearance of the environment is tidy and uncluttered

Observe

4 Fabric of the environment and equipment smells clean

Observe

5 The allocation of rooms for clinical practice is fit for purpose (treatment/Pharmacy rooms)

Observe

6 Rooms where clinical practice takes place are not carpeted

Observe

7 Floor coverings in clinical practice/treatment rooms are washable and impervious to moisture and are sealed and clean

Observe

8 All floors, including edges and corners are visibly clean with no visible body substances, dust, dirt or debris

Observe

9 Furniture in patient areas e.g. chairs and couches are made of impermeable and washable materials

Observe

10 Furniture in patient contact that cannot be cleaned is condemned

Ask staff

11 Tables are tidy and uncluttered to enable cleaning

Observe

12 Chairs are free from rips and tears

Observe

13 Furniture, fixtures and fittings are visibly clean with no visible body substances, dust, dirt or debris

Observe

14 Pillows/mattresses are enclosed in a washable and impervious cover

Observe



15 All dispensers, holders and all parts of the surfaces of dispensers soap and alcoholic gels, paper towel/couch roll/toilet paper holders are visibly clean with no visible body substances, dust, dirt or debris

Observe

16 Toilets are visibly clean with no body substances, dust, lime scale stains, deposits or smears – including underneath the toilet seat

Observe

17 Hand wash basins are visibly clean with no body substances, dust, lime scale stains, deposits or smears

Observe

18 Facilities are available for the safe disposal of continence products

Observe

19 Baths and bath hoists are visibly clean and are cleaned between patients

Observe

20 All patients have individual toiletries which are stored in patient’s rooms and not in communal areas

Observe

21 There is a procedure in place for regular decontamination of curtains and blinds e.g. minimum of 6 monthly

Ask for evidence

22 Dressing trolleys are clean and in a good state of repair

Observe

Sluice 23 A sluice room is available

Observe

24 The integrity of fixtures and fittings is intact

Observe

25 Separate hand washing facilities are available

Observe

26 The room is clean and free from inappropriate items

Observe

27 The floor is clean and free from spillages

Observe

28 Floors including edges and corners are free from dust and grit

Observe

29 Shelves and cupboards are clean inside and out

Observe

30 A suitably located sluicing disinfector or other appropriate disinfection procedures are in place to maintain hygiene standards and infection control (CSSIW standard)

Observe



31 A separate dedicated sink is available for decontamination of patient equipment

Observe

32 A sluice hopper is available for the disposal of bodily fluids

Observe

33 Equipment in sluice room is visibly clean

Observe

34 There is sufficient provision of commodes and bedpans to minimise risks of cross infection. (CSSIW standard)

Observe and discuss

35 Commodes/Bedpan holders/urinals and jugs are disinfected after each use either in a washer disinfector or with general-purpose detergent and disinfectant solution, rinsed, dried and stored inverted or on racks

Observe/discuss

36 Commodes are clean and free from organic matter on all surfaces, are in a rust free condition and in a good state of repair.

Observe

37 There is evidence of a planned maintenance schedule (regular service contract) for macerators and/or washers disinfectors within the nursing home

Ask for evidence

38 There is evidence within the nursing home of a ‘contingency plan’ in the event of the macerator and/or washer disinfector breaking down.

Ask for evidence/discuss

39 Cleaning equipment is colour coded to denote specific areas (refer to NPSA national colour coding)

Observe

40 Mops and buckets are stored clean, dry and inverted

Observe

41 Mop heads are laundered daily or are disposable

Observe /Discuss

Pets 42 Pets which live in the home have

evidence that all appropriate worming and vaccinations are up to date and have a flea management programme

Ask for evidence

43 Pets which are resident in the home are well trained (do not soil the environment)

Observe

44 Staff wash their hands after handling pets

Observe

45 Clients are able to wash their Observe



hands after handling pets, prior to eating

Linen 46 Clean linen is stored in a clean

designated area separate from used linen (not in the sluice or bathroom)

Observe

47 Clean linen is free from stains Randomly check linen

48 Clean linen store is clean and free from dust

Observe

49 Clean linen store is free from inappropriate items

Observe

50 Linen is segregated in appropriate colour coded bags according to policy

Observe

51 Bags are less than 2/3 full and are capable of being secured

Observe

52 Bags are stored correctly prior to disposal

Observe

53 Linen skips and the appropriate bags are taken to the area required (staff are not carrying soiled linen or leaving it on the floor)

Observe

54 Gloves and apron are worn when handling contaminated linen

Observe

55 Any washing machines used are situated in an appropriate designated area

Observe

56 There is written guidance regarding how to use the washing machine

Observe

57 There is evidence that the guidelines are being adhered to

Ask staff and observe

58 If a washing machine is in use a tumble dryer is also available which is externally exhausted

Observe

59 There is evidence that the washing machine and tumble drier are on a pre-planned maintenance programme

Look for evidence

60 Facilities are available for staff to wash their hands in the laundry room

Observe



3.3 Kitchen Area Standard: Kitchens will be maintained to reduce the risk of transmission of infection in accordance with current legislation

Evidence Green Amber Red N/A Comments 1 The kitchen is subject to a regular

inspection from Environmental Health or other agency

Ask for evidence

2 The kitchen is free from infestation or animals

Observe

3 Fly screens are in place where required

Observe

4 The floor is clean and dry Observe 5 Cleaning materials used in the

kitchen are identifiable and are stored separately to other cleaning equipment and away from food

Observe

6 A dedicated hand wash basin with liquid soap and paper towels is available

Observe

7 Fixtures and fittings are in a good state of repair

Observe

8 Fixtures, surfaces and appliances are clean and dry

Observe

9 Shelves cupboards and drawers are clean and dry, free from dust and in a good state of repair

Observe

10 All cooking appliances are visibly clean

Observe

11 Refrigerators/freezers are clean and free from ice build up

Observe

12 A thermometer is observed in the Refrigerator and freezer

Observe

13 There is evidence that daily refrigerator temperatures are recorded and appropriate action is taken if standards are not met (refrigerator temperature must be less than 8 degrees c, freezer 18 degrees c)

Check records

14 Resident and staff food stored in the refrigerator is labelled and there is a system in place to determine when it was opened and/or when it should be used by

Observe

15 The refrigerator is free of Inappropriate items e.g. medications or specimens

Observe

16 Milk is stored in the refrigerator Observe 17 Bread is stored in a clean dry

container Observe

18 All food products are within their Observe



expiry date 19 Opened food is covered or stored

in containers Observe

20 Water coolers/ice machines are mains supplied, visibly clean and are on a planned maintenance programme

Observe/ ask for evidence

21 Ice machines dispense the ice from nozzles directly into a receptacle on demand

Observe

22 Ice making machines are visibly clean and are cleaned at least once weekly

Observe

23 A dishwasher is used to wash cutlery and crockery which is achieving disinfection temperatures evidenced by a maintenance programme

Observe/ ask for evidence

24 The dishwasher is clean and well maintained

Observe

25 Disposable paper roll is available for drying equipment and surfaces

Observe

26 The kitchen is free from fabric tea towels or dish cloths

Observe

27 The kitchen is free from inappropriate items or equipment

Observe

28 Waste bins are foot operated and in good working order

Observe

29 Waste bins are clean Observe



3.4 Hand Hygiene Standard: Hands will be decontaminated correctly and in a timely manner using a cleansing agent to reduce risk of cross infection

Evidence Green Amber Red N/A Comments 1 The organisation has a policy for

hand hygiene Look for the policy

2 Organisational structures are in place to ensure that all staff are aware of the hand hygiene policy and procedures

Look for evidence

3 Hand hygiene is an integral part of induction for all staff

Look for evidence

4 Staff have received training in hand hygiene procedures

Ask a member of staff

5 Staff nails are short, clean and free from nail extensions and varnish

Observe all staff on duty

6 No wrist watches, stoned rings or other jewellery are worn during clinical procedures

Observe all staff on duty

7 Hand hygiene is actively promoted for example posters promoting hand hygiene are available and are on display

Look for posters

8 There is a dedicated hand wash basin in each treatment/clinical area

Observe

9 Hand washing facilities are clean and intact (check sinks, taps, splash backs, soap, and towel dispensers)

Observe

10 Hand wash basins are dedicated for that use only and are free from used equipment and inappropriate items

Observe

11 There is easy access to hand basins

Observe

12 Dedicated hand wash basins comply with HTM 64 i.e. no plugs, no overflows, water from taps not directly situated above the plug hole

Observe

13 Elbow operated taps are available at all hand wash basins in clinical areas

Observe

14 Liquid soap is available at each hand wash basin and is in the form of single use cartridge dispensers

Observe

15 Bar soap is not used for staff hand washing

Observe



16 Soft absorbent paper towels are available at all hand wash sinks

Observe

17 Re-usable terry cotton towels are not used by staff to dry hands

Observe

18 There are no re-usable nailbrushes used or present at hand wash sinks

Observe

19 There is a foot operated bin for waste towels in close proximity to the hand wash sinks which are lined and fully operational

Observe

20 Staff use the correct procedure for washing hands (observe staff i.e. use running water, soap, cover all area of the hands, rinse and dry on paper towels)

Observe

21 Alcohol hand rub is available for use where appropriate

Observe

22 Staff can indicate when it is appropriate to use alcohol hand rub i.e. on clean hands

Ask staff

23 Staff can indicate when it is inappropriate to use alcohol hand rub i.e. on physically contaminated hands, when caring for patients with diarrhoea (ask staff)

Ask staff

25 Clinical staff are encouraged to use hand moisturisers that are pump operated for personal use

Observe



3.5 Personal Protective Equipment Standard: Personal protective equipment is available and is used appropriately to reduce risk of cross infection

Evidence Green Amber Red N/A Comment 1 The organisation has a policy for the

appropriate use of personal protective equipment

Ask for evidence

2 Staff are trained in the use of personal protective equipment as part of induction

Ask for evidence

Gloves 3 Sterile and non-sterile gloves

(powder free) conforming to European Community (EC) standards are fit for purpose (no splitting etc) and are available in all clinical areas

Observe

4 Alternatives to natural rubber latex (NRL) gloves are available for use by practitioners and patients with NRL sensitivity

Observe

5 Powdered or polythene gloves are no longer in use

Observe/ discuss

6 There is an appropriate range of sizes of gloves available

Observe

7 Gloves are worn as single use items for each clinical procedure or episode of patient care

Observe

8 Hands are decontaminated following the removal of gloves

Observe

9 Gloves are stored appropriately away from the risk of contamination

Observe

Aprons 10 Disposable plastic aprons are worn

as single-use items for each clinical and environmental procedure or episode of patient care

Observe

11 Disposable plastic aprons are worn as part of food hygiene practices i.e. food preparation and serving meals

Observe

12 Aprons are stored appropriately away from the risk of contamination

Observe

Face and Eye Protection 13 Clean facemasks and eye protection

are worn when there is a risk of any bodily fluids splashing into the face and eyes (COSHH Control of Substances Hazardous to Health)

Observe/ discuss



3.6 Disposal of Waste and Spillage Management Statement: Waste is disposed of safely without the risk of contamination or injury and in accordance with legislation

Evidence Green Amber Red N/A Comment 1 The organisation has a

procedure/policy for the disposal of waste

Look for the policy

2 Audits are used to monitor waste procedures

Look for evidence

3 Staff have attended a training session which includes the correct and safe segregation and disposal of waste


4 There is evidence that the waste contractor is registered with valid carrier and management licences

Check records

5 If generating Clinical (Hazardous – DoH 2006) waste the care home is registered to do so

Check records

6 Clinical (Hazardous) waste is disposed of and transported in UN approved appropriate sharps containers OR suitable colour coded waste bags

Observe

7 All other clinical (non –hazardous – DoH 2006) offensive/hygiene waste (e.g. incontinence pads) is disposed of in tiger bags (yellow with black stripe)

Observe

8 There is evidence that staff are segregating waste correctly. (e.g. domestic and non-hazardous waste are not being placed in clinical waste bags)

Observe/ ask a member of staff

9 A waste disposal poster identifying waste segregation is available in the sluice

Look for posters

10 All plastic waste sacks are fully enclosed within bins to minimise risk of injury

Observe

11 All Clinical and Offensive waste bins are foot operated, lidded and in good working order

Observe

12 All waste bins are visibly clean – externally and internally

Observe

13 There is no emptying of waste from one bag to another

Observe/Discuss

14 There are no overfilled bags. Bags are no more than 2/3 full

Observe

15 Waste bags are removed from clinical areas daily

Observe/Discuss

16 Clinical (Hazardous) waste bags are Observe



labelled and secured before disposal

17 Waste awaiting collection is only stored in the designated area. (Check that waste bags are not being stored in corridors or in other inappropriate areas)

Observe

18 The waste storage area is clean and tidy

Observe

19 All Clinical (Hazardous) and offensive waste bins containers are kept secure and are inaccessible to the public

Observe

20 Waste storage bins in the outside compound (dedicated area for the safe storage of waste bins) are locked and secured.

Observe/Discuss

21 Clinical (Hazardous) and offensive waste is labelled and segregated from other waste for transportation

Observe

22 There is no storage of inappropriate items in the waste compound

Observe

23 The waste compound is kept clean and tidy

Observe

24 The organisation has a procedure for dealing with body fluid spillages

Ask for evidence

25 Staff have received training in dealing with body fluid spillages

ask a member of staff

26 Dedicated spillage kits/ or the necessary equipment is available for decontaminating and cleaning body fluids: Disposable apron and gloves Waste bags Paper towels Hypochlorite granules and or bleach/hypochlorite solution

Observe/Discuss

27 Equipment used to clear up body fluid spillage is disposable or able to be decontaminated

Observe/Discuss



3.7 Prevention of Sharp Injuries Statement: Sharps will be handled safely to prevent the risk of needle stick/inoculation injury

Evidence Green Amber Red N/A Comments 1 The organisation has a

procedure/policy for the management of sharps/needlestick injuries or splashes and bites

Look for evidence

2 Staff are aware of the policy Ask a member of staff

3 There are arrangements in place to ensure that hepatitis B immunisation is recommended for relevant staff

Discuss

4 There are arrangements in place that ensures staff are dealt with appropriately in the event of a needlestick or bite/splash

Ask a member of staff to describe the procedure

5 All staff receive training in sharps/splash/bites management and are aware of the actions to take following an injury


6 All needlestick/sharps/bites/splash injuries are recorded

Look for evidence

7 There is signage (e.g. a poster) displayed for the management of needlestick/sharps injuries and/or bites and splashes

Look for a poster

8 Sharps containers comply with BS 7320 (1990)/UN 3291

Observe

9 Sharps containers are correctly assembled

Observe

10 All sharps containers in use are labelled with date, locality and signed prior to disposal

Observe

11 Sharps containers are available at the point of use

Observe/Discuss

12 Sharps containers are visibly clean with no body substances, dust, dirt or debris

Observe

13 Sharps containers are stored safely away from the public out of the reach of children

Observe all boxes in use

14 Sharps containers are not filled beyond the indicator mark i.e. 2/3 full


15 The temporary closure mechanism is used when the

Observe all boxes



sharps container is not in use in use 16 There are no inappropriate items

e.g. packaging or swabs in the sharps containers


17 Needles and syringes are discarded as a single unit

Observe/Discuss

18 Inappropriate re-sheathing of needles does not occur (ask a member of staff)

Observe

19 Sharps boxes with residue of prescription only contained within are disposed of by incineration

Observe/Discuss

20 Full sharps containers are sealed with the integral lock – tape or stickers are not used

Observe

21 When full and ready for disposal all sharps containers are dated and signed

Observe

22 Sharps containers are not placed in waste bags prior to disposal


23 Sealed and locked sharps containers are stored in a locked facility away from public access

Observe




3.8 Specimen Handling Standard: Specimens are handled in a way that negates the risk of cross infection to all staff

Evidence Green Amber Red N/A Comments 1 The organisation has a policy for

Specimen Handling Look for the policy

2 All staff handling specimens, including reception staff, are trained to do so

Ask a staff member

3 Specimens that are to be sent to the microbiology laboratory are in appropriate containers

Observe

4 Specimens are sealed in designated plastic transit bags

Observe

5 Request forms are not in the same section of the bag as the specimen

Observe

6 Specimens awaiting transit are kept in a designated area, away from the public and staff rest areas

Observe

7 Refrigeration for specimens is available where required

Observe

8 Specimens are not stored with food

Observe

9 Specimens are transported in leak-resistant boxes with lids that can be fastened

Observe/Discuss

10 Specimen transport boxes are visibly clean

Observe

11 There is no evidence of leaking or externally contaminated specimen containers being sent to the laboratory

Observe/Discuss


4. Feedback Report / Action Plan Date: Care Home: Areas of non compliance Action Required Responsible Person Target Date Review Date



Date: Care Home: Areas of non compliance Action Required Responsible Person Target Date Review Date




Date: Care Home Areas of non compliance Action Required Responsible Person Target Date Review Date


5. Evaluation Form Please complete this evaluation form to enable an assessment of the suitability of the audit tools to be undertaken 1. Grade of staff completing the Audit (please circle) Manager Registered Nurse Support Worker Other Please state 2. Time taken to complete the audit …………………………………………. 3. How useful did you find the audit in identifying infection control issues within the care home Please circle (1 = not useful 3 = useful 5 = very useful) 1 2 3 4 5 4. Please comment on any specific questions which you felt were difficult to assess

7. Any other comments regarding the audit tool Please return this form to your Governance Facilitator within your Local Health Board



Appendix 1

Sources of Information

Useful Websites National Public Health Service for Wales www.nphs.wales.nhs.uk NPHS Welsh Healthcare Associated Infection Programme (WHAIP). http://www.wales.nhs.uk/sites/home.cfm?OrgID=379 Infection Prevention Society (previously the Infection Control Nurses Association) www.ips.uk.net Hospital Infection Society www.his.org.uk Healthcare A-Z information on Healthcare Associated Infections http://healthcarea2z.org/index.aspx National Electronic Library of Infection www.neli.org.uk National Resource for Infection Control www.nric.org.uk Health Protection Agency www.hpa.org.uk Strategy Documents in Wales Healthcare Associated Infections, A Community Strategy for Wales http://new.wales.gov.uk/dphhp/publication/protection/communicable-disease/haistrategy/hia-strategy-e.pdf?lang=en Healthcare Associated Infections A Strategy for Hospitals in Wales http://www.wales.nhs.uk/documents/healthcare-associated-infections-e.pdf National Standards for Cleanliness: http://new.wales.gov.uk/about/departments/dhss/publications/health_pub_index/guidance/national_standards_cleanliness?lang=en


http://www.nphs.wales.nhs.uk/

http://www.wales.nhs.uk/sites/home.cfm?OrgID=379

http://www.ips.uk.net/

http://www.his.org.uk/

http://healthcarea2z.org/index.aspx

http://www.neli.org.uk/

http://www.nric.org.uk/

http://www.hpa.org.uk/

http://new.wales.gov.uk/dphhp/publication/protection/communicable-disease/haistrategy/hia-strategy-e.pdf?lang=en

http://new.wales.gov.uk/dphhp/publication/protection/communicable-disease/haistrategy/hia-strategy-e.pdf?lang=en

http://www.wales.nhs.uk/documents/healthcare-associated-infections-e.pdf

http://new.wales.gov.uk/about/departments/dhss/publications/health_pub_index/guidance/national_standards_cleanliness?lang=en

http://new.wales.gov.uk/about/departments/dhss/publications/health_pub_index/guidance/national_standards_cleanliness?lang=en


Care Home Guidelines

NPHS Wales Infection Control Guidelines for Care Homes http://www2.nphs.wales.nhs.uk:8080/WHAIPDocs.nsf/61c1e930f9121fd080256f2a004937ed/5523c78f45f742ce80257305003d0e71/$FILE/Guidelines%20for%20Care%20Homes%20FINAL%20V9.doc.pdf

Department of Health Infection Control Guidance for Care Homes http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4136381 Education

HAI Champions Infection Control E-Learning Package for Wales http://www.wales.nhs.uk/sites3/page.cfm?orgid=379&pid=24141 Guidelines/Standards Evidence Based Practice in Infection Control (EPIC) guidelines http://www.epic.tvu.ac.uk/ World Health Organization (WHO): WHO guidelines on hand hygiene in healthcare (advanced draft): summary - clean hands are safer hands http://www.who.int/patientsafety/events/05/HH_en.pdf Infection Control in the Built Environment http://howis.wales.nhs.uk/sites3/Documents/254/InfectControl2nded.pdf

NICE Infection control, prevention of healthcare-associated infection in Primary and Community care 2003 http://www.nice.org.uk/guidance/index.jsp?action=byID&r=true&o=10922 DoH HTM 07 – 01 Safe Management of Healthcare Waste (Nov 2006) http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_063274 The Hazardous Waste (England and Wales) Regulations 2005 http://www.opsi.gov.uk/SI/si2005/20050894.htm The Waste Management (England and Wales) Regulations 2006 http://www.opsi.gov.uk/si/si2006/20060937.htm Healthcare Waste Strategy for Wales Guidance (Nov 2006) http://www.wales.nhs.uk/documents/WHC_2006_043.pdf


http://www2.nphs.wales.nhs.uk:8080/WHAIPDocs.nsf/61c1e930f9121fd080256f2a004937ed/5523c78f45f742ce80257305003d0e71/$FILE/Guidelines for Care Homes FINAL V9.doc.pdf



http://www.wales.nhs.uk/sites3/page.cfm?orgid=379&pid=24141

http://www.epic.tvu.ac.uk/

http://www.who.int/patientsafety/events/05/HH_en.pdf

http://howis.wales.nhs.uk/sites3/Documents/254/InfectControl2nded.pdf

http://www.nice.org.uk/guidance/index.jsp?action=byID&r=true&o=10922

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_063274

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_063274

http://www.opsi.gov.uk/SI/si2005/20050894.htm

http://www.opsi.gov.uk/si/si2006/20060937.htm

http://www.wales.nhs.uk/documents/WHC_2006_043.pdf


This Audit Tool has been developed by the Gwent Health Community Clinical Governance Collaborative. If you would like to use the tool in a

care home in Gwent contact the local Governance Facilitator within your Local Health Board

For further General Information on the Audit Tool Contact Dawn Hill Nurse Consultant Welsh Healthcare Associated Infection Programme [email protected]
