Risk definitions

Our patients can be categorised as 'confirmed risk' patients, 'suspected risk' patients or 'no known risk' patients when it comes to infectious disease.

Confirmed risk

A ‘confirmed risk’ patient is one who has been confirmed to have an infectious disease (e.g., COVID-19, MRSA, MRDOs, TB, scabies, seasonal influenza and enteric infections ((diarrhoea and/or vomiting) including Clostridioides difficile (formerly known as Clostridium difficile)) by a laboratory test or clinical diagnosis.

Suspected risk

‘Suspected risk’ patients include:

• Those awaiting laboratory test results or clinical diagnosis to identify infections/organisms
• Those who have had recent contact/been in close proximity to an infected person

No known risk

A ‘no known risk’ patient is one who doesn't fit into either the 'confirmed risk' or 'suspected risk' category

Booking an appointment

• If a known/suspected risk patient calls the practice, book them in for a virtual appointment (e.g., via phone, tablet or computer, in their own home) at the end of the shift
• If the patient requires a face-to-face appointment, add a comment in the appointment book (e.g., please isolate patient - suspected measles/chickenpox)

Isolating a patient

If a known/suspected risk patient is due to come into the practice for an appointment, they should be isolated by following these steps:

1. Accompany the patient to an empty room or designated area immediately upon their arrival
2. Make sure that the door of the room stays closed at all times
3. Tell the clinician that the patient has arrived so that they can see them as soon as possible

4. When a room is unavailable, the infection's epidemiology should be considered to help you determine where to place the patient

Requirements for isolation

The empty room or designated area used for isolation must:

• be separate from other patients in waiting/communal areas
• have a notice on the door stating ‘Isolation Area - No Unauthorised Entry’
• be free from clutter, and where possible, equipment not required for the consultation should be removed before the patient enters
• have appropriate 😷Personal protective equipment (PPE)and 👋Hand hygienefacilities available

• contain a foot-operated lidded and lined waste bin, for disposal of all waste as infectious waste
• contain disposable medical devices, care equipment and couch roll

After the appointment

After the appointment and before leaving the isolation room, please do the following:

• dispose of any PPE worn in the room in that same room
• clean and disinfect the room using a top-to-bottom, clean-to-dirty approach, including reusable medical devices and care equipment, such as couches, chairs, work surfaces, and stethoscopes

• clean all large and flat surfaces using an ‘S-shaped pattern' from clean to dirty, top to bottom, overlapping slightly, but do not go over the same area twice. This cleaning motion reduces the amount of microorganisms that may be transferred from a dirty area to a clean area

Minimising risk of transmission

Further steps which we can take to prevent transmission of infectious disease in the practice include:

• Follow Infection Prevention & Control SOPs at all times
• If a patient has a suspected blood-borne virus (BBV), follow the extra precautions found in our 🩸Blood borne viruses (BBV) page
• If any patient blood and/or body fluid samples are spilled, clean as described in the procedure on our💧Body fluid spillage protocol page

Referral or transfer to another health or social care provider

NOIDS

In all cases, we must refer patients with suspected/confirmed infectious disease to Notifable diseases and causative organisms (NOIDS). Referrals are made via EMIS (create a letter > search 'notification of infectious disease').

Any other referral/transfer

If referring to any other health or social care provide (e.g. ambulance service, hospital), be sure to inform them of the patient’s status prior to the transfer. This will allow them to perform a risk assessment so that they can determine the appropriate infection prevention and control (IPC) measures needed (e.g. transportation without other patients, isolated on admission).