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Legisaltions related to Infection, Prevention and Control

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There is a wealth of legislation designed to prevent and control the spread of infection. Legislations, regulations and procedures are written into organisational policies, which set out the organisation’s responsibilities in ensuring that the law is obeyed. All organisations that provide health and social care services are legally required to have infection control policies and procedures.

The Health and Safety at Work Act (1974) states that “Employers are responsible for the health and safety of employees, workers from other organisations, and visitors while they are on the premises’ (Beryl Stretch, 2010). The Health and Safety Act (1974) applies to anyone working with people whether it be employees, self-employed business owners, those on work experience, apprentices, volunteers, mobile workers or even homeworkers. It is the workers responsibilities under the Health and Safety at Work Act is to take care of everyone who may be affected by their work. For example, workers should only do work that they have been trained to do (e.g. soiled laundry).

They should also be use and store equipment and materials properly (e.g. cleaning products). Workers must also ensure they are working safely at all time (e.g. working with sharps). It is the workers responsibility to report any health and safety hazards to the appropriate person without any delay. Faulty equipment, safety signs that have been tampered with and infectious diseases and accidents (biological spills, sharp injuries) should be reported immediately.

The Act also obliges workers to work closely with their employers to carry out their health and safety responsibilities. This includes following the workplace’s safe practice procedures at all times, not tampering with anything that has been provided for their health and safety, knowing what to do when in an emergency using PPE correctly.

The Management of Health and Safety at Work Regulations (1992) highlights what the employers are obliged to achieve under the Health and Safety at Work Act. Under the control of Substances Hazardous to Health Regulations (COSHH) employers are required to control substances that may be harmful to the health of their workers. Employers can promote this regulation by carrying out a thorough risk assessment before the setting is opened and updating regularly. They should also make sure there is a health and safety policy written for the setting and is easily accessible for everyone.

The employer should also appoint someone to be responsible for health and safety. A record should be kept of all the accidents and incidents that have taken place in the setting and be kept safe. Employers can also promote this regulation by provide equipment and training in infection prevention and control, safe food handling, the correct use of equipment, working with hazardous materials and first aid. Employers should be providing workers with health and safety information, such and information on effective hand washing technique, colour coding for waste disposal and soiled laundry, management and immunisation requirements.

Under the Public Health (Control of Diseases) Act 1984 and the Public Health infection Diseases) Regulations 1988, doctors in England and Wales have a legal duty to notify an appropriate person at the local authority if they are aware that, or have cause to suspect that, a patient is suffering from a notifiable disease. If it appears to be a case of two or more cases of patients and/or staff with the same infection, for example, diarrhoea and vomiting within the same unit or team, an outbreak must be suspected. The Line Manager and Infection Control Team must be informed.

If it is outside normal working hours then the Public Health Specialist must be informed. The doctor will need to complete a certificate stating – the patient’s name, age and sex, the address of the premises where the patient is, the notifiable disease from which the patient is, or suspected to be suffering, the date, or approximate date, of the onset of the disease. If the patient was at a hospital, the doctor will have to state the day on which the patient was admitted, the address of the premises from which they came, and whether or not they think the disease from which patient is, or is suspected to be, suffering was contracted in hospital.

There are many food safety legislations. The food safety legislations aims to ensure the maintenance of a high standard of – personal hygiene in food handlers and environmental hygiene in areas where food is stored, prepared, cooked and served.

The Food Safety Act 1990 was established as the main framework all food legislations in Britain. The act declares that it is illegal to sell food which is unfit for human consumption. The act allows environmental health inspectors to examine food and confiscate food which is unfit for human consumption. Employers have a legal liability to ensure employees have access to facilities and training to practice safe food handling techniques.

The Food Hygiene Regulations 2006 aims to improve food safety and reduce the incidence of food poisoning by outlining the hazards associated with food preparation and appropriate methods to ensure food safety.

The Food Safety (Temperature Control) Regulations 1995 identifies the temperature required to ensure food safety during storage, preparation and serving. Food safety (General Food Hygiene) Regulations 1995 aims to prevent cases of food poisoning. Employers can maintain food safety by making sure that all food areas are kept clean and there is a good standard of personal hygiene. The following points can help prevent food poisoning by good personal hygiene:

1. Washing hands thoroughly before handling food, and wash and dry them again frequently during work.

2. Drying hands with clean towels, disposable paper towels or under an air dryer.

3. No smoking, chewing gum, spitting, in a food handling or food storage area.

4. No coughing or sneezing over food or where food is prepared or stored.

5. Wearing clean protective clothing, such as an apron.

6. Keep spare clothes and other personal items away from where food is stored and prepared.

7. Covering or tying back long hair.

8. Keep nails short so they are easy to clean, and no nail polish as it can chip into the food.

9. Avoid wearing jewellery, or only wear plain banded rings and sleeper earrings.

10. Covering cuts and wounds by a waterproof wound strip or a bandage. Use brightly coloured wound strips, so they can be seen easily if they fall off.

11. Wearing disposable gloves over the top of the wound strip if you have wounds on your hands.

12. Change disposable gloves regularly.

13. Advising the supervisor if you feel unwell and avoid handling food.

Hazard Analysis Critical Control Point or HACCP is an official documented system where employers must recognize potential risks to food in their workplace and put measures in place to avoid those risks. Employers and all of its employees must follow the laws concerning food safety or face potential prosecution. . The Act covers all workplace food preparation including Care homes and care provided in individual’s homes.

The Act and the Agency are a key reference point in all training, policy and procedural decisions in food preparation. HACCP guidelines also state that employers have to devise, maintain and follow policies and procedures to reduce risks. They must also ensure that their employers and they are kept clean, the workplace is kept place, food is protected to reduce the risk of harming others and good habits (especially washing hands) are kept. Policies and procedures involved in Food Safety are concentrating on keeping the consumer safe and healthy especially when in a place of work where vulnerable people are living.

Control of Substances Hazardous to Health Regulations (COSHH) 2002 involves employers to control the exposure to hazardous – toxic, harmful, irritant, corrosive or flammable substances, to avoid putting people’s health at risk or the risk of injury as much as possible. COSHH states that employers need to assess the risks to health from exposure to hazardous substances, and employees must carry out the necessary measures to control their exposure.

The aim is to reduce the number of accidents or incidents as a result of exposure the hazardous substances, and eventually attain an accident free workplace. Objectives stated in this policy to achieve this include having the suitable equipment, information, training and supervision required to carry out the policy. It also stressed the importance of risk assessments, safety systems – such as personal protective equipment, and excellent organisation.

Employers can maintain COSHH by assessing the risks posed by hazardous substances (e.g. bodily fluids, sharps). They should devise procedures that will prevent or control the exposure to the hazardous procedures and ensure that the procedures are followed. Employers should ensure health surveillance is carried out if employees are exposed to harmful substances in their work, to identify early stages of diseases. They should also prepare plans to deal with accidents, incidents and emergencies. COSHH can also be maintained by ensuring staff are adequately trained and supervised.

Reporting of Injuries Diseases and Dangerous Occurrences Regulation (RIDDOR) is a regulation that notifies employees and their staff what they need to report, and what to do if there are justifying circumstances such as prolonged illness. According to RIDDOR, deaths, major injuries, accidents resulting in over three day injuries, diseases, dangerous occurrences or events that has the potential to cause and spread infection, such as sharps and contamination injuries, notifiable diseases and biological spills need to be reported. When these situations do happen, the employer must report it to the local council or the HSE.

They will then look into what happened and then may be able to inform companies and employers on how to prevent or reduce the risk of the incidents reoccurring. Deaths or major injuries must inform the HSE or local council immediately; however injuries that causes staff or others to be incapacitated for over three days then the incident must be reported within 10 days. Health and Safety Executives will go into a workplace and inspect it to ensure that they are following RIDDOR. Work places can show that they are following RIDDOR by completing accident books. It is the responsibility of the workers to know and follow the relevant procedures.

The environmental Protection (Duty of Care) Regulations 1991 apply to organisations that produce and store waste (e.g. household waste, used disposable equipment and contaminated material). Employers have a responsibility or a “duty of care” to ensure a safe and healthy environment by making sure that there is no unauthorised, harmful treatment or disposal of the waste. They should also ensure that the waste is transferred to an authorised person and that the transfer note describes all aspects of the waste given. Employers should be keeping records of waste transfers and associated transfer notes for two years.

The Hazard Waste Regulations 2005 sets out to ensure that waste is dealt with without putting human health at risk and without using methods that could be harmful to the environment or cause a nuisance through noise or colours.

The Health Protection Agency (HPA) was set up in 2003 as a Special Health Authority (SHA). It functions include responding to and co-ordinating control measures in the event of outbreak of an infectious disease, providing training and expert advice to those responsible for controlling infectious disease and working with other organisations to deliver protection against infection. In 2004 changed the HPA from an SHA to a mom departmental public body. As a result, the HPA is now able to provide an improved health protection system with a wide range of functions, including working with Primary, NHS hospital trusts and local authorities in each part of the UK.

The National Institute for Clinical Excellence (NICE) 2003 recommends that hands be decontaminated immediately before every episode of direct patient contact or care, and after any activity or contact that could result in the hands becoming contaminated. The method of hand decontamination used will depend on what is practical, available and appropriate for the care or treatment being undertaken. NICE recommends that visibly soiled or potentially contaminated hands must be washed with liquid soap and water and less visibly soiled hands should de decontaminated prefer ably with an alcohol based hand rub, between caring for different patients and between different care activities for the same patient.

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