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OUTBREAK SCENARIO food poisoning

OUTBREAK SCENARIO food poisoning. Scenario 1 . You are in charge of a 34 bed, mixed age and mixed sex acute ward and responsible for infection control. The ward has 5 bays of 6 beds and 4 single rooms Members of staff on duty are 2 qualified, 2 students and 1 healthcare assistant

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OUTBREAK SCENARIO food poisoning

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  1. OUTBREAK SCENARIOfood poisoning

  2. Scenario 1 • You are in charge of a 34 bed, mixed age and mixed sex acute ward and responsible for infection control. The ward has 5 bays of 6 beds and 4 single rooms • Members of staff on duty are 2 qualified, 2 students and 1 healthcare assistant • You start work at 7am with the other staff to find that 3 patients have developed diarrhoea during the night and the isolation ward is full • List the managerial actions that you would take on starting duty

  3. Key points 1 • Managerial actions include: • Check the patients are isolated • Check specimens have been sent to the laboratory • Inform infection control team and line manager • Make sure there are adequate supplies, laundry, gloves, aprons, etc • Allocate a dedicated nurse to the isolated patients • Make sure menu cards have been saved from the previous day • Contact the catering department to save food samples

  4. Scenario 2 • What are the most important areas you will cover in your preliminary investigation?

  5. Key points 2 • Preliminary investigation includes: • The time symptoms started • Common factors amongst the infected patients, e.g. antibiotics, type of food eaten, geographical location of each patient

  6. Scenario 3 • Examine patient menu cards and preliminary investigation form to try to identify any common causative factor

  7. Key points 3 • Are there any common food sources in the menu cards? • Are there any similarities between cases from the information on the preliminary investigation form?

  8. Scenario 4 • The laboratory specimens have not shown a result. What specific precautions should be taken with the patients?

  9. Key points 4 • Hand hygiene • Disinfection • Cleaning • Waste disposal • Isolation precautions • Protective clothing • Visitors • Communication • Patient education • Psychological support

  10. Scenario 5 • You are to receive three new admissions to the ward, what are the implications?

  11. Key points 5 • Staff skill mix • Allocation of staff to isolated patients • Who decides to close the ward to new admissions?

  12. Scenario 6 • One of the student nurses tells you that the bedpan washer/disinfector has broken down, what are your alternatives?

  13. Key points 6 • Alternative methods for disposal of faeces • Hand hygiene • Protective clothing • Choice of disinfectant • Inform the estates department to prioritise the repair of the washer/disinfector

  14. Scenario 7 • At lunchtime, two nurses due to start the late shift ring in and report that they are sick with diarrhoea, what would you do?

  15. Key points 7 • Contact occupational health • Ask for faecal specimens • Investigation to include agency work, travel, food history • Line manager to maintain staffing levels • Use of agency staff

  16. Scenario 8 • Visiting starts at 2pm. What action is needed?

  17. Key points 8 • Speaking to relatives and visitors • Providing an explanation/reassurance • Information and education • Hand hygiene • High risk foods from visitors • Restricting visitors who are ill

  18. Scenario 9 • By 6pm two further patients have developed diarrhoea • What action is needed?

  19. Key points 9 • Isolate patients • Inform infection control of new cases as they occur

  20. Scenario 10 • The infection control doctor has visited the ward and decided to call a meeting of the outbreak group • Who should be members of this group?

  21. Key points 10 • ICD • ICN • Consultant in charge • Senior nurse • General manager • Consultant in communicable disease • Others as required

  22. Scenario 11 • The nurse in charge from ward 8 contacts you to say that Mrs Smith, who was transferred from your ward, has developed diarrhoea. • There had been a celebration party by one of the qualified nurses who was leaving and the sandwiches she had eaten tasted ‘strange’ • What action do you now take?

  23. Key points 11 • Establish a source • Investigate who brought food • Where was the food purchased, cooked and stored • Liaise with environmental health officer • List all the people who had eaten food at the party

  24. Scenario 12 • All those who were ill had eaten chicken sandwiches prepared some time before the party and brought into the ward by the nursing staff • Laboratory specimens showed that those with diarrhoea have grown salmonella • What recommendations will you now make?

  25. Key points 12 • Observe and adhere to food hygiene policy • Patients should only consume food provided by the hospital catering department • Staff food must be labelled and stored separately from patients food and not given to patients

  26. Action summary • Early identification • Correct management of patients, staff, resources • Investigation should be prompt, thorough, written/recorded • Clear communication to patients, staff, visitors • Outbreak team, lessons learned, recommendations

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