Contents
Acknowledgements, ix
Foreword by Professor Janice Stevens CBE, MA, RGN, x
1 Introduction, 1
2 The Essentials, 2
The chain of infection, 2
Standard principles of infection prevention and control, 4
Hand hygiene, 5
When and how to clean the hands, 5
Hand hygiene equipment, 6
Gloves, aprons, visors and masks – personal protective equipment (PPE), 8
General principles, 8
Gloves, 9
Aprons and gowns, 10
Masks, 10
Visors and goggles (eye protection), headwear and footwear, 12
Summary of when to use PPE, 12
Decontamination, 14
Definitions and application of processes, 14
Decontamination of healthcare equipment, 15
Decontamination of the healthcare environment, 17
Managing blood and body fluid spillages and splashes, 19
Isolation and cohorting, 22
Use of isolation facilities, 22
Isolation precautions, 23
Cohorting, 25
Isolation priority and duration, 25
Respiratory precautions, respiratory hygiene and cough etiquette, 28
Preventing transmission of infection, 28
Respiratory hygiene/cough etiquette, 30
Enteric precautions, 31
Hand washing, 31
Disposal of items contaminated with vomit and faeces, 31
Soiled/contaminated clothing and bed linen, 31
Disinfection, 31
Other considerations, 32
Safe sharps practice, including sharps and splash injury management, 33
Safe sharps practice, 33
Sharps injury management, 34
Splash injury management, 34
Safe disposal of clinical waste, 35
Waste segregation and disposal, 35
Category A pathogens, 36
Cytotoxic/cytostatic drugs, 37
Cancer chemotherapy drugs, 38
Safe handling of linen and laundry, 40
Clean linen storage, 40
Used linen, 40

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vi CONTENTS
Infectious linen, 40
Storage of used linen, 40
Asepsis and aseptic non-touch technique, 41
Aseptic non-touch technique (ANTT), 41
Standard and surgical ANTT, 41
3 Wider Aspects, 42
Managing an outbreak of infection, 42
Definitions, 42
Patient management, 42
Communication, 44
Staff, visitors and others, 45
Isolation and screening of contacts, 46
Your health and wellbeing, 47
The Occupational Health and Wellbeing department, 47
The deceased, 48
Body bags, 48
Handling high-risk bodies on the ward, 48
Specimen collection and storage, 51
Audit, 52
The audit cycle, 52
Audit resources, 52
Department of Health, 52
The Infection Prevention Society (IPS), 53
Assistance dogs, ward pets and visiting animals, 55
Guide dogs, hearing dogs and assistance dogs, 55
Ward pets, 55
Visiting animals, 55
Notifiable diseases, 56
The healthcare environment, 57
Fixtures and fittings, 57
Control of substances hazardous to health (COSHH), 60
Hazard symbols, 60
Symbols used on medical devices, 61
Antibiotics, 63
Overview, prescribing, administration, side effects and toxicity,
penicillin allergy and antibiotic stewardship, 63
Classification and resistance, 65
4 A-Z of Infections, 67
Acinetobacter, 67
Adenovirus, 69
Anthrax, 70
Campylobacter, 72
Cellulitis, 73
Chickenpox, 74
Cholera, 76
Clostridium difficile, 77
Creutzfeldt–Jakob disease (CJD), 79
Cryptosporidiosis, 81
Cytomegalovirus (CMV), 82
Dengue fever, 83

CONTENTS vii

Diarrhoea, 84
Diphtheria, 86
Escherichia coli, 87
Extended spectrum beta lactamase (ESBL) producers, 89
Fleas, 90
Giardia, 91
Glandular fever (infectious mononucleosis), 92
Glycopeptide-resistant enterococci (GRE), 93
Group A streptococcus (GAS), 95
Group B streptococcus (GBS), 96
Group C and Group G streptococci, 97
Haemophilus influenzae type B (Hib), 98
Hand, foot and mouth disease, 99
Hepatitis A virus, 100
Hepatitis B virus, 101
Hepatitis C virus, 103
Hepatitis D virus, 105
Hepatitis E virus (HEV), 106
Herpes simplex virus, 107
Human immunodeficiency virus (HIV), 108
Impetigo, 110
Influenza, 111
Klebsiella, 114
Legionnaires disease, 115
Leptospirosis (Weil’s disease), 116
Lice – head, body and pubic, 118
Listeria, 120
Malaria, 121
Measles, 122
Meningitis, 124
Methicillin-resistant Staphylococcus aureus (MRSA), 126
Multiresistant bacteria, 129
Mumps, 131
Necrotising fasciitis, 132
Norovirus, 133
Panton–Valentine leucocidin (PVL), 135
Parainfluenza, 137
Paratyphoid, 138
Parvovirus, 139
Pests and vermin, 140
Pseudomonas, 141
Rabies, 142
Rash illness, 143
Respiratory syncytial virus (RSV), 144
Rotavirus, 146
Rubella (German measles), 147
Salmonella, 148
Scabies (Sarcoptes scabiei var. hominis), 149
Classical scabies, 149
Crusted scabies, 150

viii CONTENTS
Scarlet fever (scarletina), 151
Serratia, 152
Shigella, 153
Shingles (herpes zoster), 154
Staphylococcus aureus, 156
Stenotrophomonas, 157
Toxoplasmosis, 158
Tuberculosis (TB), 159
Typhoid, 161
Viral haemorrhagic fevers (VHFs), 163
Whooping cough, 165
5 Glossary, 167
6 Useful Resources, 172
7 References, Sources and Further Reading, 173

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