Infection Prevention Control Infection Prevention and Control Section

Infection Prevention & Control Infection Prevention and Control Section 2 Infection Prevention & Control Datix Reporting Customer Service

Infection Prevention & Control Infection Control Contact Details Lesley Cullen Mobile: 07785267553 Kim Shaw Tel: 01268 739721 Mobile: 07814672247 Sian Olivo Tel: 01268 739752 Mobile: 07983986591

Infection Prevention & Control What is Infection Control? Infection control is an essential part of all health/social care practice

Infection Prevention & Control . Source Mode of Spread The Chain of Infection Portal of Entry Person at Risk

Infection Prevention & Control Sources of Infection Sources : • • • Patients Staff Equipment Environment Animals, insects

Infection Prevention & Control Modes of Spread • • • Direct contact Inhalation Ingestion Inoculation Indirect Fomite Hands Air Vectors

Infection Prevention & Control Person at Risk Elderly Very young Immuno-suppressed Chronic illness Medication Anyone undergoing a procedure which breaches the body’s defences

Infection Prevention & Control Portals of Entry Natural Artificial Mouth Catheters Nose Intravenous lines Ears Wounds And the less savoury! Feeding tubes

Infection Prevention & Control Standard Infection Control Precautions (SICP) Underpin routine safe practice by protecting both patients and staff from known or undisclosed infections. Applying standard precautions at all times and to all patients, best practice becomes second nature and the risks of infection are minimised

Infection Prevention & Control Hand Decontamination Hands MUST be decontaminated immediately before each patient contact and after any activity that potentially results in hands becoming contaminated

Infection Prevention & Control Your Hands Transient skin Flora Microbes acquired on the surface of the skin through contact with other people, objects or the environment. The antibacterial properties of the skin prevent the survival of these transient micro-organisms for more than a few hours, but within this time the organisms are readily transferred to other people or objects

Infection Prevention & Control Your Hands Resident Skin Flora Also known as ‘normal’ flora, they live deeply seated within the epidermis. They are not readily transferred to other people or surfaces. In most situations they are unable to cause disease and do not need to be removed from the skin during routine clinical care.

Infection Prevention & Control Hand Decontamination Methods Hand washing Removes soil and debris Abrasive action Alcoholic Hand Preparations Use of anti-microbial’s to destroy or suppress both transient and resident organisms. Wipes Ideal for Surface/equipment cleansing Also hand decontamination

Infection Prevention & Control Your 5 Moments for Hand Hygiene at the Point of Care *

Infection Prevention & Control When to wash your hands Hands that are visibly soiled or potentially contaminated with organic material must be washed with liquid soap and water

Infection Prevention & Control Alcohol Hand rub / Handel These only work if the skin is clean of organic matter They will remove both transient and resident organisms They are very useful to community staff, where access to hand-washing facilities may be difficult

Infection Prevention & Control Hand-washing Technique

Infection Prevention & Control Areas Missed During hand-Washing

Infection Prevention & Control Method for Application of Alcohol Hand Preparations

Infection Prevention & Control Personal Protective Equipment Used to protect both yourself and the patient from the risks of cross infection May also be required for contact with hazardous chemicals and pharmaceuticals

Infection Prevention & Control Gloves should be worn whenever there might be contact with body fluids, mucous membranes or non-intact skin

Infection Prevention & Control Plastic Aprons Are impervious to moisture and therefore provide a better barrier than cotton gowns

Infection Prevention & Control Masks, Visors & Eye Protection These should be worn when a procedure is likely to cause body fluid or substances to splash into the mouth or eyes Masks are necessary if infection is spread by the airborne route Masks are generally not required in community settings

Infection Prevention & Control Achieving & Maintaining a Clean Environment High standards of cleanliness will help reduce the risk of cross-infection Cleaning removes contaminants including dust and soil, large numbers of micro - organisms and the organic matter that shields them Cleaning schedules must be in place Do not send contaminated equipment elsewhere without decontaminating first Before dispatch, complete and attach certificate which states the method of decontamination used, or the reason why it was not possible

Infection Prevention & Control Challenge poor practice!

Infection Prevention & Control • Report the unclean environment

Infection Prevention & Control Decontaminating Equipment • Do not send contaminated equipment elsewhere without decontaminating first • Before dispatch, complete and attach certificate which states the method of decontamination used, or the reason why it was not possible • Certificate available in the Infection Control Guidelines.

Infection Prevention & Control Single Use Items Never re-process single use devices

Infection Prevention & Control Sharps A sharp is defined as anything which can puncture the skin and may be contaminated by blood, body fluids or drugs

Infection Prevention & Control Sharp Bin Lids

Infection Prevention & Control Safe Sharps Practice Dispose of sharps at point of use Do not pass from hand to hand Never re-sheath needles Keep handling to a minimum Do not dismantle by hand prior to disposal Use safety devices

Infection Prevention & Control Post Exposure Management Encourage bleeding Wash under running water Dry and apply waterproof dressing

Infection Prevention & Control Post Exposure Management Report incident to your line manager Contact occupational health department / A&E Complete datix incident form Inform infection prevention team Initiate investigation as to the cause of the incident and risk assessment

Infection Prevention & Control Waste Disposal Orange bag for hazardous (clinical) waste Black for household waste Cardboard boxes for glass and aerosols Approved rigid container for sharps disposal

Infection Prevention & Control Clinical Waste Dispose of waste carefully Do not over fill bags Close securely and label Hold bag by neck, keeping away from body

Infection Prevention & Control For More Information The Infection Prevention and Control policy and associated guidelines can be found On the intranet

Datix Reporting Datix Incident Reporting Section 2 Infection Prevention & Control Datix Reporting Customer Service Medicines Management

Datix Reporting Intranet Location The Datix Incident form is available to all staff via the Intranet. The next few slides will show you how to navigate to the incident form.

Datix Reporting Select Forms from the Home Page

Datix Reporting Select Incident Reporting

Datix Reporting Select the Datix Incident Reporting Link

Datix Reporting This will take you to the incident form.

DATIX Form Completion DATIX Forms are very easy to complete. A form should be completed immediately after an incident or accident happens and anyone can complete the report form. The DATIX form is completed on line via the intranet On the form all the areas marked with the red asterisk must be completed Datix Reporting

Datix Reporting Any witness statements, or other relevant documents, should be scanned and attached to the DATIX form. Ensure the documents are saved and are ready to be attached before completing the incident form. Enter all the details of those involved including Service Users, Staff, Visitors etc. By selecting the Add Another button you will be able to add all those involved in the incident/accident.

Datix Reporting Enter your details as the reporter of the incident Once the form is complete you finish by clicking on the “submit” box at the bottom. Once a DATIX form has been submitted the system automatically sends out any necessary alerts; the form is then available for the manager of the area identified to complete their part, this will include any investigations or reports.

Datix Reporting If you have any queries or require Datix training please contact The Risk Management Department on 01268 739731

Customer Service Section 2 Infection Prevention & Control Datix Reporting Customer Service Medicines Management

Learning Outcomes On completion of the Customer Service course you will: • • Understand what customer service is Understand why excellent customer service is important Be able to identify our customers Understand how to apply the Trust Service Standards Have learnt basic everyday skills in dealing with customers Understand how to give your best when dealing with difficult customer interactions Be equipped with strategies to protect your own wellbeing when dealing with customers who challenge us Customer Service Why is Customer Service important? The benefits of excellent customer service are: • Satisfied customers • Enhanced reputation of the organisation • Reduction in complaints • Trust Objectives are achieved • Improved working relationships • Increased job satisfaction • Our wellbeing is protected REMEMBER: Customers will tell 3 or 4 others about good service but will tell 9 about bad experiences Surveys have identified that our customers' impressions are registered within 60 seconds of the first meeting Therefore, as the 'face' of the Trust, it is essential that we promote the SEPT brand appropriately in that time span.

Our Customers Customer Service Who are our customers? • • Service users / clients / patients Relatives / carers Other Trust services / staff / colleagues Internal / external agencies: Other health organisations Local Authorities Voluntary sector General public EVERYONE! Trust Service Standards Positive hellos Be genuinely warm, welcoming and engaging, not cold and clinical; whenever you meet a customer, whether it’s for five minutes or five months. Positive goodbyes Customers leave every interaction 100% clear, and positive, about what will happen next, why and when and is never left wondering what's happening and what might happen next.

Trust Service Standards (cont) Customer Service Jargon free With customers we need to cut out jargon, buzzwords, acronyms, abbreviations and SEPTspeak so people know what we are talking about. Your choices Involve the customer in their own care and where possible give them choices they can make themselves about their treatment. Smooth handoffs Smoothest handoffs when customers move from one service to another (in SEPT and with partners) or stop receiving services. In the know Pro-active communication so the customer always knows where they are and is never left wondering what’s happening and what might happen next. Service basics we all need to get right Take the initiative We will take the initiative whenever something needs to happen. Keeping promises We will make commitments and keep our promises every time.

Trust Service Standards (cont) Customer Service Common courtesies Every interaction is focused 100% on the customer. From simple courtesies like opening doors for people to difficult interventions. Active listening Valuing listening over speaking. Use active listening to find out all we need to know about the individual and not jump to conclusions. Ears open All the world’s a stage and we should listen out for appropriateness of conversations we have when customers are around. Also listen out for ringing phones – it’s likely to be a customer needing help. Eyes open Be aware of the spaces we work in. Demand they are safe, calm and physically and emotionally comfortable. Do something about it if they aren’t. Revealing great service Say why When you do something to help a customer, let them know you’ve done it and why it’s helpful to them. “If they don’t know it, you haven’t done it”.

Our values Customer Service

Basic Customer Service Skills Customer Service STOP! • Always stop what you are doing and talk directly to the customer • Give the customer your full attention • Don't write whilst they are talking to you - if possible stop the conversation to write down the information and then start again LOOK! You can learn a lot about your customer just by looking. There are two important aspects to focus on: 1. Eye contact 2. Mood assessment • • Be aware of your eye contact with the customer: Appropriate eye contact - demonstrates interest Too little eye contact - might suggest you are anxious or uninterested Too much eye contact - might suggest you are hostile, threatening or confrontational • Assess the customer's mood - anxious, impatient, embarrassed, angry. Having this understanding will help you respond appropriately to the customer and to provide the right level of service.

Basic Customer Service Skills Customer Service LISTEN! 1. Put yourself in the customer's shoes - how might you feel in this situation? 2. Concentrate on what is being said 3. Show you are listening - body language (e. g. nod your head), use appropriate facilitators (e. g. "uh-huh", "I see") 4. Paraphrase what the customer has said - to demonstrate understanding 5. Ask questions, if in doubt 6. Be aware of what is being missed out by the customer 7. Write down important details 8. Ask for correct spelling of names etc. 9. Listen to what is being said, - and what isn't!

Asking Questions Customer Service When assisting customers, asking clear and concise questions can help you: • Understand the exact meaning of what you're being told • Find out the real needs of the customer • Check that the customer has understood the information • Check that the customer agrees with the suggested course of action There are two types of questions you can use to resolve a problem: 1. Closed questions 2. Open questions. Closed questions are short and normally just require a yes / no answer. For example, "Do you have any allergies? ". They are helpful when dealing with customers who are: • Anxious • Distressed • Distracted • Talkative Open questions usually prompt a more detailed and informative response. For example, "Can you tell me what allergies you have and the accompanying symptoms? ". These questions are helpful when dealing with customers who are: • Reserved • Uncertain • Reluctant to engage in discussion

Telephone Customers Customer Service The big difference when using the phone is that you cannot see the customer and they cannot see you. Therefore vital information is missing, for example: • Facial expression • Eye contact • Gestures • Reduced ability to demonstrate listening skills • Use of diagrams / objects to explain what you mean Remember - you have to work harder when you are dealing with customers by phone: You can't look - you must listen There is no eye contact - you must smile (honestly - it shows in your voice) Focus on the positives It is important to use positive language when helping customers. Even if you are not able to resolve the problem yourself immediately, focus on what you can do for the customer. "I am sorry but I do not have the information you want. However I will contact the person who does and get back to you tomorrow. Will that be alright? "

Difficult Customer Interactions Customer Service Remember a customer is usually upset with the organisation or the situation - they are less likely to be upset with you personally. When the customer is challenging your customer service skills, accept the challenge and work out a solution. DO DON’T • Work with the customer and offer a problem solving approach • Return anger with anger • Take control and assert yourself • Promise what you can’t deliver • Let them express their frustration or anger • Pass the buck • Show concern and empathy • Blame colleagues • Apologise personally, where • Apologise automatically/ responsible, or say “I’m sorry you feel unnecessarily this way. ”

Service Giving your best - dealing with Thinking. Customer Traps Dealing with challenging customers and difficult situations can be very frustrating and in the longer term have a negative effect on our emotional wellbeing. Unfortunately sometimes the person who makes life most difficult for us is ourselves – although we think we are focused and actively listening to someone, we are also busy listening to the voice in our own heads: we hear something and react to it with our own running commentary. Sometimes this is referred to as our ‘journalist’. This internal commentary is often negative and unhelpful to us in dealing with difficult situations and challenges. Whilst we are being a ‘journalist’, we are not being an effective ‘player’. To help us to give our best, and to protect our wellbeing, we need to be aware of and manage this internal commentary. When we are emotionally upset, anxious or angry we tend to think about our experiences in a distorted way that reinforces our present mood. All of us can at times fall into ‘thinking traps’. Next are 9 of the most common thinking traps and examples of how to deal with them.

Customer Service 1. All-or-nothing thinking………seeing events in extreme terms without recognising that there is a middle ground. Sometimes this will involve imposing rigid rules on yourself and others. When these rules are not obeyed, you are likely to condemn yourself or others. A feature of this type of thinking is the use of 'Shoulds' and Musts'. Example: “I must have the holiday I want and if I don’t get it, I can’t stand it. ” Adaptive response: making a balanced assessment that gives you more options to choose from; accepting that things are the way they are and there is no reason why they should be different. Example: “I would rather have that holiday as my first choice but if I can’t have it, I’m sure I can enjoy myself somewhere else. ” 2. Catastrophizing………assuming the worst and, if it happens, that you won’t be able to cope with it. Example: “If I get a poor mark for my assignment, I am bound to fail the course and I'll never be able to live with the humiliation. ” Adaptive response: ask what is the probable outcome versus the possible outcome? The odds are that the outcome you fear will not actually happen. Example: “I might get a poor mark for my assignment but that doesn't mean that I'll be thrown off the course and even if it did happen, I would still be able to cope with it. ”

Customer Service 3. Discounting the positive………positive qualities or experiences are disregarded, leaving your life feeling one-sided – negative. This maintains your negative feelings. Example: “My colleagues said that my report was interesting but they are just trying to make me feel better because they know it was boring. ” Adaptive response: include positive qualities and experiences in order to make a more balanced assessment. Example: “It’s true that the report could have been more thought-provoking but it is very unlikely that my colleagues are all banding together to tell me a lie. ” 4. Fortune-telling………believing you can predict the future accurately and consistently. Sometimes you will be right but at other times, particularly when you are feeling low or worried, you might well be wildly inaccurate. Example: “I just know that I am going to fail this test. ” You act in ways to make your predictions come true by telling yourself that it is not worth spending much time revising, as you are bound to fail. Adaptive response: look at the evidence Example: write down some of your predictions and look at them again a few months later to see how accurate they were.

Customer Service 5. Labelling………attaching a general and negative label to yourself based on specific behaviour; assuming that a specific behaviour reflects you as a whole. Example: “I didn’t handle that problem very well, so I must be an idiot. ” Adaptive response: attach the label to the behaviour not yourself; focus on changing the behaviour to be more successful next time. Example: “I didn’t handle that situation very well so I’ll discuss it with my colleague who has dealt with these kinds of problems before. ” 6. Magnification / minimization………exaggerating negative information and minimising positive information. Example: “I couldn’t answer all of the questions raised, so my presentation was a complete disaster. A couple of people said they enjoyed it but they were just being kind. ” Adaptive response: maintaining a sense of proportion Example: “I couldn’t answer all of the questions raised but I was able to deal with most of them easily. Some people said they enjoyed my presentation, so it must have gone quite well. ”

Customer Service 7. Mind-reading………believing that we know what other people are thinking without communicating with them. Often negative thoughts are in our own minds, so we assume that these thoughts must be shared by others. Example: “He hasn’t said anything but I know my manager thinks I did not handle that situation very well. ” Adaptive response: ask for feedback or wait until you have firm evidence to support your beliefs – until then these are only YOUR thoughts. Example: “I think maybe I didn’t handle that situation very well, so I’ll ask my manager for some feedback. ” 8. Overgeneralization………drawing sweeping conclusions based on insufficient information or a single event. Example: “Because the magazine hasn’t replied to me about my article, it’s obvious that I can’t write and that I’ll never get anything published. ” Adaptive response: examine the evidence and then put forward alternative arguments. Example: “Well, maybe they take longer to respond than I thought. It will be hard to get something published if all I do is moan but I’m much more likely to get something published if I analyse articles that do get published and then keep practising. ”

Customer Service 9. Personalisation………blaming yourself for things that you are not responsible for. Example: “I made my partner give up his course. ” Adaptive response: distinguishing between actual and presumed responsibility Example: You have contributed to the disagreement by complaining about the time he spent studying but your partner decided to respond to this by giving up his course rather than managing his time differently.

Summary Customer Service Remember - we are all Customers! STOP - pay attention to all requests for assistance. LOOK - at your customer's requests to see how you could make their life easier you never know when you will need help. LISTEN - to your customer's needs, as they are as important as your own. Recognise and acknowledge their feelings and collect all the details. LEARN - use questions to get to the heart of the matter and work to find a solution. NEVER - blame colleagues, take things personally or argue with the customer. ALWAYS - assume the problem is solvable, even if it cannot be solved by you. RECOGNISE YOUR THINKING TRAPS - AND DEAL WITH THEM