Infection Prevention and Control

Jun 26, 2023

Infection Prevention and Control

The definition of Infection Prevention and Control (IPC)

Infection prevention and control (IPC) is a practical, evidence-based approach preventing patients and health workers from being harmed by avoidable infections. Effective IPC requires constant action at all levels of the health system, including policymakers, facility managers, health workers and those who access health services. IPC is unique in the field of patient safety and quality of care, as it is universally relevant to every health worker and patient, at every health care interaction. Defective IPC causes harm and can kill. Without effective IPC it is impossible to achieve quality health care delivery.

Infection prevention and control affects all aspects of health care, including hand hygiene, surgical site infections, injection safety, antimicrobial resistance and how hospitals operate during and outside of emergencies.

World Health Organisation

In this article we are going to be concentrating on the therapy outpatient clinic setting and the measures you need to take to ensure you and your patients are treated in a safe, clean environment

Standard infection control precautions

To ensure safety, standard infection control precautions (SICPs) are to be used by all workers for all people whether infection is known to be present or not. SICPs are the basic IPC measures necessary to reduce the risk of spreading pathogens.

These basic IPC measures are:

  • hand hygiene
  • respiratory and cough hygiene
  • PPE
  • safe management of care equipment
  • safe management of the environment
  • management of laundry
  • management of blood and body fluid spills
  • waste management
  • management of exposure

Infection prevention and control: resource for adult social care – GOV.UK

Hand hygiene.

The 5 Moments for Hand Hygiene approach was designed by the World Health Organization to minimise the risk of transmission of microorganisms between a healthcare worker, the patient, and the environment. Make sure you are aware of the 5 Moments of Hand Hygiene and the correct way to wash your hands. There is lots of information around this on the NHS and Gov UK websites

Respiratory and cough hygiene

Good respiratory hygiene reduces the transmission of respiratory infections. Being alert to people with respiratory symptoms is important as this may indicate infection.

To help reduce the spread of infection:

  • cover the nose and mouth with a disposable tissue when sneezing, coughing, wiping and blowing the nose – if unavailable use the crook of the arm to catch a sneeze or a cough
  • ensure a supply of tissues is in reach of the person or those providing care
  • dispose of all used tissues promptly into a waste bin, which should be provided
  • clean hands after coughing, sneezing, using tissues, or after contact with respiratory secretions or objects contaminated by these secretions
  • keep contaminated hands away from the eyes, nose and mouth
  • support people who need help with respiratory hygiene where necessary


Risk assess whether you need to be using PPE. There is no government requirement now to use PPE for COVID19. 

Safe management of equipment

Pathogens may be transferred between people through the use of equipment if it is not properly stored and cleaned,

Gym equipment /machines and couches  must be decontaminated ideally after each use. It must be clear who is responsible for decontaminating the equipment, the frequency, and method of decontamination which conforms with the manufacturer’s instructions.

Poorly maintained equipment can also increase the risk of infection.

There are 3 categories of decontamination processes:

  • cleaning – a process that physically removes contamination but does not necessarily destroy pathogens
  • disinfection – a process that reduces the number of viable pathogens, but which may not necessarily inactivate some pathogens such as certain viruses and bacterial spores
  • sterilisation – a process used to make an object free from all viable pathogens including viruses and bacterial spores

The choice of decontamination process for reusable equipment depends on the assessment of risk. Risks fall broadly into 3 categories: high, medium and low.

Level of risk





Items that come into contact with intact skin. Items that do not come into contact with people.

Cleaning. Disinfection if an increased infection risk is suspected.


Items that come into contact with intact mucous membranes or items contaminated with particularly virulent or readily transmissible pathogens. Items used with people who are immunocompromised. Low risk items contaminated with blood or body fluids.

Cleaning (followed by disinfection or sterilisation if being used for more than one client).

Respiratory equipment, thermometer, commodes, urinals, bedpans.


All reusable medical devices that are used in close contact with a break in the skin or mucous membranes, and devices that enter a sterile area of the body.

Follow manufacturer’s instructions. This may include chemical disinfectant methods or sterilisation through an authorised sterilisation centre.

Wound dressing – sterile and single use.

Cleaning of the environment

It is important those carrying out cleaning duties understand their responsibilities as required under the Health and Safety at Work etc Act 1974 and associated regulations including COSHH. Workers should be provided with the PPE required to safely undertake cleaning tasks. See HSE advice on carrying out COSHH assessments.

Where cleaning is the responsibility of the worker it is important all understand their responsibilities such as:

  • whose responsibility it is for cleaning different areas of the environment
  • the frequency of cleaning the different areas of the environment
  • the method of cleaning, including the products to use
  • the method, frequency and responsibility for cleaning equipment which includes reference to the manufacturer’s guidance for cleaning
  • the training required for cleaning
  • how cleaning standards will be monitored
  • arrangements for cleaning outside of usual frequencies
  • arrangements to prevent cross contamination – for example colour coding of cleaning materials
  • how to safely dispose of items such as cleaning cloths and gloves

Principles of waste management:

  • systems should be in place to ensure that waste is managed in a safe manner and expensive (infectious) waste streams used only where indicated
  • all outer packaging should be removed and recycled, where possible
  • waste involving sharps such as needles should always be disposed of in a sharps box designed for this purpose
  • waste should be placed in an appropriate waste bag, no more than three-quarters full and tied. Sharp items should not be disposed of into waste bags
  • hands should be cleaned after handling waste
  • waste bins should be foot operated, lidded and lined with a disposable plastic waste bag
  • collection of medical waste should be arranged through a licensed waste contractor

The widest used Infection Control wipe in the NHS is Clinell wipes

Why Clinell?

Clinell products are the only products proven to reduce the spread of pathogens that cause healthcare associated practice in the UK. Clinell wipes are proven to reduce the risk of MRSA by 55% and VRE by 97%. Clinell products are approved by medical device manufacturers for many different pieces of equipment. This is essential considering how often these devices are used and how often they require cleaning to ensure no long-term damage is created by this. Clinell wipes are also dermatologically tested and shown not to induce skin irritation.

Management of exposure (including sharps injuries)

There should be a plan to minimise the risk of exposure to potential pathogens. Examples of exposure include sharps injuries, human bites, failures in PPE, splashing of blood or body fluids into eyes. Where sharps are used a risk assessment should be carried out, and a safe system of work developed. Sharps should not be passed directly from hand to hand.

Needles must not be bent, broken, dissembled or recapped, and should be disposed of by the person generating the sharps waste into a sharps container.

Sharps containers must be located in a safe position which reduces the risk of spillage. Containers should be taken to the point of use, and the temporary closing mechanism used when not in use.

Only sharps waste should be disposed of in a sharps container, and it must not be filled above the fill line.

If an incident occurs, such as a staff member is injured by a sharp object, or there is a risk of contamination, medical attention should be sought without delay, and there should be an immediate assessment of any exposure. Immediate actions should be taken to reduce risks, including reporting the incident to an appropriate person.

Investigation to understand the circumstances of the incident should be undertaken and any identified actions to prevent similar incidents should be taken. Sharps handling should be eliminated or reduced, and approved safety devices used where appropriate.

Uniforms and workwear

. All workwear and uniforms should be clean and appropriate for the role and environment.

When providing direct, hands-on care, workers should be ‘bare below the elbows’ (see earlier section on hand hygiene for details). Long hair should be tied up and off the collar. If wearing a head scarf, it should be unadorned and tied neatly. Lanyards and neckties should not be worn during personal care.

Workers should wear clean clothes at the start of each shift, and change immediately if clothes become visibly soiled or contaminated. To enable this, workers may wish to consider storing spare, clean clothing at their workplace or in their vehicle.

To avoid risk of injury, workers should not carry pens, scissors or other hard or sharp objects in the pockets.

All elements of the laundry process contribute to the removal of infectious agents from fabrics. The washing process includes use of detergent, agitation and rinsing.

Uniforms and workwear should be washed at the hottest temperature the fabric will tolerate. Heavily soiled items should be washed separately to eliminate the risk of cross contamination.

Training and education

Training and education are essential to protect people from the risks of infection, along with maintaining competence in applying the principles of IPC. Each service should have a policy which sets out the training required and the frequency, along with how ongoing competency will be assured.

Usual topics included in IPC training include:

  • understanding how infections are spread and how to prevent it
  • when and how to effectively perform hand hygiene
  • how to risk assess and use PPE
  • how to identify and respond to someone with a confirmed or suspected infection to prevent transmission
  • how to respond to an outbreak of infection
  • how to manage waste (including sharps) and laundry safely
  • the importance of cleaning of equipment and maintaining the care environment
  • prevention and management of exposure to infection (including sharps injury)

A number of organisations provide support and advice for IPC training and education, both nationally and regionally. Nationally, Skills for Care and the Social Care Institute for Excellence provide resources.

If you have any questions we would love to hear from you

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