Infections can range from fairly minor, like coughs and colds, to more serious ones like septicaemia (blood poisoning) and wound infections.
About 10 per cent of people in hospital acquire an infection, although this figure may be higher so certain groups of people. Any patient that has had an operation or procedure where the skin is broken (such as an IV infusion) is at the risk of infection.
Patients with certain conditions are also more at risk of infection. For instance: people with heart, kidney, or skin disease, or those with low immune systems. Other patients at risk include very young babies or children who are not feeding well.
Infections tend to be more common for people in hospital because they are in close contact with other patients and staff, who themselves might have an infection.
The infection control team at Great Ormond Street Hospital (GOSH), like those at other hospitals in the UK, are specially trained in microbiology, biology, and infection control. They are responsible for advising staff about infection as well as monitoring all infections that are happening at GOSH, and responding to any outbreaks. They work closely with all wards and departments though a ‘link system’, and specifically with departments such as catering and laundry.
Regular checks are carried out on every ward to make sure the infection control standards are being met.
The infection control team is in tough with networks throughout the local area, the rest of the UK, and abroad, so that they are immediately aware of any alerts that could have an impact on our patients.
Infection and colonisation are two terms that you might hear mentioned, and the next section explains that difference between them.
Generally speaking, an infection is the illness caused by the growth of a germ on or in a person.
Sometimes infection does not show any symptoms, so we call it asymptomatic.
When the germ is found on our body without causing an illness we call it colonisation. Carriage may be very short term or transient – for example acquired by touching someone but quickly removed by hand wash. Alternatively it may be persistent with the germ multiplying on your body, this is also called colonisation.
In certain circumstances, the germs that colonise our bodies may go on to give an infection.
There are many different types of infection causing different symptoms and spreading in different ways.
The next section explains more about how infections can be spread.
The germs that cause infection can be spread in various ways.
- Airborne germs like the chickenpox virus are carried in the air.
- Other germs are spread though coughs or droplets breathed out when a person has the infection. These droplets settle on surfaces and may be transferred to another person’s eyes or mouth – usually by their hands.
- Germs can also be passed on through direct contact or touch, such as in the skin condition scabies.
Indirect contact means contact with dirty equipment or other materials. The infection control team at GOSH, and the infection control link nurses on the wards, are working hard to reduce the spread of infection, but we all have a part to play.
The following section explains what we would do to prevent infections and what we expect patients and families to do as well.
Hand washing is the easiest way that we can all reduce the spread of infection. Everyone coming into contact with your child, like doctors, nurses, other members of staff, and you and your family, should was their hands thoroughly before and after touching your child.
Liquid soap and water is available on every ward, as well as alcohol gel for when washing with soap and water is not possible, or hands are not visibly dirty. You can help us by asking members of staff who have come into contact with your child whether they have washed their hands, you should also ask your visitors to wash their hands and make sure that your own hands are clean too.
We try to make sure that all areas of the hospital are clean and have regular checks throughout the day to make sure that high standards are reached. We realise that sometimes we don’t manage to reach our high standards, but the senior nurses, managers, and infection control teams will try to resolve any problems quickly. If you feel that an area is not clean enough please tell us so that we can get it cleaned.
We clean each bed area once a day, usually between 10.30am and 4.30pm for around 20 minutes. As space is limited, please move away from the area when cleaning is happening. You can also help us by keeping the area tidy by removing dirty cups, used tissues, and leftover food. If the bed area is tidy it is easier for our domestics to clean.
All of our equipment like infusion pumps and ventilators are clean regularly, decontaminated between patients, and maintained so that they work properly. Every member of staff that is trained to use the equipment is also trained to repost any problems such as if it stops working or needs cleaning. All outside parts of the equipment are cleaned regularly, so tell us if you think that it needs to be cleaned.
Monitoring is very important in reducing the spread of infection because if we know that somebody has an infection then we can take precautions. When a new member of staff joins the hospital they are checked for immunity against certain disease and immunised if needed. They are also screened for infection which is then treated.
We also monitor children that are admitted to GOSH by taking a swab of their nose and throat and sample of faeces. These samples are sent to the laboratory and sent for certain germs so that doctors and nurses know whether precautions are needed to stop any infection from spreading.
Certain germs are becoming resistant to antibiotics, so children with these infections are nursed in a single cubical and staff may wear an apron and gloves.
We need your help with monitoring, so we ask you phone the outpatient department or ward before you come in if your child has been in contact with an infectious disease, like chickenpox or a tummy bug.
We also need to know if your child has been in contact with MRSA, hepatitis B or C or HIV. It will not make any difference to the quality of your child’s care but it gives us notice that your child might need to be seen separately from other children, or that our staff might need to wear protective clothing, or the appointment or admission may need to be rearranged for another time.
Our staff are advised to wear a protective apron and gloves if they’re likely to come into contact with bodily fluids such as; saliva, blood, vomit, urine, and faeces, or they are nursing a child colonised or infected with MRSA. We rarely advise our staff to wear masks unless there is a risk of breathing in an infection.
In certain circumstances, where there is a risk of bodily fluids being splashed into the eyes and mouth, we recommend our staff wear a visor or goggles.
On very rare occasions a ward may need to be closed because of an outbreak of infection such as vomiting. If this happens we will tell you as quickly as possible and we may need to restrict access to the area.
If an area is closed due to infection please keep your movements within the hospital to a minimum and avoid visiting other wards if possible. It would also help if you could restrict the number of people visiting your child let us know if a visitor develops any signs of infection once they are back home.
Infection control is the responsibility of all of us; whether a member of staff, a patient, or family member or visitor.
By taking simple measures and working together we can prevent infection developing and spreading.