Essential Steps
A Simple Guide……..
Alison Harvey
Senior Infection Prevention and
Control Nurse
What is it ?
A programme of
observational audit to
demonstrate compliance
with good practice
Where did it come from ?
• A Department of Health (DoH) iniative
• Developed for the community i.e.
Community nurses, Care homes,
Podiatry etc
• For anywhere ‘hands on care’ is
delivered
Why did the DoH do it ?
Essential steps to safe, clean care aims to provide a framework to
support local organisations’ use of best practice to prevent and manage
the spread of infections and ultimately improve patient and service user
safety.
The framework is composed of a number of interlinked tools and
products and can be used on an organisation-wide basis, as well as in
individual departments, teams, care homes and so forth.
The idea is that organisations determine for themselves which of the
elements they wish to use once they have assessed their current
position in preventing and managing infections. Essential steps to safe,
clean care is intended to be implemented and used in ways that will
support local success. It is not expected that all organisations will
involve the same staff grades or roles, as the tools are locally
adaptable
What does it mean to me ?
•
•
•
•
Part of ongoing personal development
Assists the appraisal process
Benchmarks standards of care
Part of the CQC’s assessment process
within care homes
• Gives assurance to commissioners that
care provided is of a quality standard
What does it look like ?
Tools and products provided in the pack include:
• self-assessment
tool and future action;
• signposting to useful resources to inform users;
• three key Essential Steps that, if implemented within
organisations, may impact significantly on reducing
the level of infections;
• review tools to assist individuals/teams in monitoring
compliance and to record continuous compliance or
improvement;
• certificates for staff, to recognise their progress in
performing safer practice;
Contents
• Each audit typically contains 4 or 5 risk
elements
Typically Preventing the Spread of
Infection has :-Hand hygiene
-Use of personal protective equipment
-Safe disposal of sharps
-Aseptic technique
Prompt Sheets for Assessors
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•
•
•
One is available for each audit
Detailing each intervention
Shows the criteria required
And information on why the standard
may not be met
ESSENTIAL STEPS
Prompts for assessors
Audit 1 Preventing the spread of infection
Intervention
Criteria required
Standard not
achieved if
Hand hygiene (prior to
patient contact)
Suitable method chosen –
soap and water or alcohol
if hands visibly clean
Hands not washed.
Nail varnish
False nails
Wrist watch
Wrist or hand
jewellery (plain
wedding band
allowed)
Technique used for hand
washing or alcohol rub
effectively cleans hands
(e.g. 6 steps see over)
Personal Protective
equipment
Gloves, apron, face
protection worn as
appropriate. (See risk
assessment over).
PPE not worn as
required by
procedure
Aseptic Technique
Sterile equipment used
Level of asepsis is
not maintained/
breaks in asepsis
not addressed.
Non-touch technique
adopted
Clean technique is only
carried out if appropriate
to the procedure/ patient.
Sharps
Sharps container available
– not overfilled
Sharps used safely e.g. not
resheathed/ passed hand
to hand.
Sharps disposed of intact
by the user.
Failure to safely use
sharps and dispose
of at point of use.
Suggested hand washing and alcohol application technique
3 Wash/rub ALL surfaces of the hands.
These six steps should take about 15 seconds
Risk assessment for the use of PPE.
*NB the term body fluids includes wounds.
NO contact
with body
fluids*
No
protective
clothing
required
between clothing
and patient, and
or equipment
(including
laundry)
Contact
Contact with
body fluids
(incl. excessive
skin scales) but
low risk of
splashing
Contact with
Disposable
plastic
apron
Disposable
gloves and
plastic
apron
Disposable
gloves, plastic
apron, face
protection
body fluid and
high risk of
splashing
Risk assessment for asepsis.
Aseptic technique to be used instead of a clean technique if the
patient falls into any of the following categories:
Babies
Immunocompromised patients
Patients with diabetes
Clients with chronic
disease
Frail patients
Patients in poor
nutritional state
Where can I find them?
• All the tools, assessor sheets and
supporting information are available to
download on the Infection Prevention
and Control Website – in the care home
section @
• http://www.kirklees.nhs.uk/yourhealth/infection-prevention-and-control/
Thanks for listening
• Any questions ?
• Next ….Essential steps workshops