How Compliant Is Your Sluice Room Practice?

We were at Caring UK Conferences Plymouth & Bristol, in March, where our Managing Director and Business Manager presented an interactive session about ‘How Compliant is your sluice room practice’. We wanted to share the details of this insight because we know that Infection control and prevention plays a huge part in the exceptional work caregivers provide.

An infection occurs when microorganisms, more commonly known as germs, enter the body, replicate and cause an infection. These infections can sometimes be unpleasant, very serious or even life threatening for vulnerable patients.

There are four well-known kinds of infection;

1. Bacterial – such as pneumonia or strep throat, commonly treated with antibiotics.
2. Viral – such as colds, flu and gastroenteritis.
3. Fungal – such as athletes foot or ringworm.
4. Parasitic – such as scabies or body lice.

Infections can be spread directly or indirectly:
Directly – Direct transmission happens when actual contact takes place. I.e. touching, kissing, sexual contact or contact with lesions or sores.
Indirectly – Indirect transmission can occur when there is no direct human to human contact. For example, when an infected person sneezes or coughs, sending infection droplets into the air to be ingested by people or to fall on surfaces or equipment, contaminating them.

A key way to prevent the spread of bacteria to other people or objects such as door handles, light switches and phones is to keep our hands clean. This means that hands should be washed before and after every episode of care.

There is a lot of science surrounding bacteria, how it grows and how it can replicate to cause infection. The are three things that bacteria need to thrive and multiply:

1. They need nutrients. These can be found on or in a human, on a surface or in matter such as excrement or food.
2. They need a source of water or moisture. Some can survive without water for considerable periods but can’t grow and multiply.
3. They need an ideal temperature. This varies from 1 type to another, but in general, they need an ambient temp; only a few can survive extreme heat or cold.

For an infection to occur, several things need to happen. This is referred to as the chain of infection.

1. An infectious agent needs to exist – this is the germ/micro-organism that can cause the infection.
2. The germ needs a reservior – where it can live and grow. This could be a human, food, water, or matter.
3. The germ needs a portal of exit – it needs to find a way out of the infected person to spread. This could be by coughing, sneezing, vomiting, touching or bodily fluids.
4. The germ needs a mode of transmission – to spread from one person to another. This can be person to person by germs and pathogens becoming airborne and ingested, or it can be passed on via contaminated surfaces or equipment.
5. Portal of entry – Bacteria needs to find their way into another person. For example, through eyes, mouth, hands or any tubes used in care such as catheters or feeding tubes.
6. A susceptible host – this is someone at risk of infection because they are unable to fight infection. It could be a resident, staff or even visitors.

Chain of infection diagram:

As well as taking care in carrying out procedures, it’s extremely important to maintain high levels of care when it’s finished. This includes making sure that all waste is disposed of in an appropriate and safe manner. All establishments should have strict waste disposal policies in place which are robust, accessible and not subject to misinterpretation.

Waste disposal can seem like a complicated business because there are different rules for different types, but once you are familiar with them, it becomes clearer. If you ever have any doubts about how to dispose of a particular type of waste, always ask a manager or supervisor. Never guess, as this could have serious consequences.

The full definition, which comes from the Controlled Waste Regulations 1992, states that clinical waste is:

any waste which consists wholly or partly of human or animal tissue, blood or other body fluids, excretions, drugs or other pharmaceutical products, swabs or dressings, or syringes, needles or other sharp instruments, being waste which unless rendered safe may prove hazardous to any person coming into contact with it; and SR2008 No25 v6

Ways of disposing of clinical waste include:

• Yellow and black striped bags are for non-infectious bandages, masks, and dressings.
• Orange waste bags are for infectious waste that is not chemically and/or medically contaminated, such as bandages and dressings.
• Yellow waste bags are for infectious clinical waste that is also chemically and/or medically contaminated.
• Sharp containers are used for needles and clinical waste.
• The sluice room is used to dispose of Human bodily waste.

Because of the high risk that fluids and matter in a sluice room may be contaminated. A sluice room should be solely for the disposal of human bodily fluids.

A sluice room should also have a good method or operation which all staff members are fully versant with. They will have clearly defined clean and dirty areas to prevent the risk of cross-contamination. The handwash basin should be as close to the exit as possible, enabling users to wash their hands immediately before leaving.

A compliant sluice room will also include the following equipment:

• Bedan washer/disinfector
• Waste bin
• Storage rack for clean utensils
• Hand wash basin

You can find out more about sluice room processes here.