Known or Suspected Infections that Require Source Isolation - Management of Patients Requiring Rehabilitation with

Publication: 07/02/2019  
Next review: 01/02/2022  
Standard Operating Procedure
CURRENT 
ID: 5886 
Approved By: IPCT and Physiotherapy Clinical Governance 
Copyright© Leeds Teaching Hospitals NHS Trust 2019  

 

This Standard Operating Procedure is intended for use by healthcare professionals within Leeds unless otherwise stated.
For healthcare professionals in other trusts, please ensure that you consult relevant local and national guidance.

Management of Patients Requiring Rehabilitation with Known or Suspected Infections that Require Source Isolation

This SOP describes the actions required to ensure safe management of in-patients who require rehabilitation.

Background and indications for standard operating procedure/protocol

Patients who require therapy during their in-patient stay frequently need to access rehabilitation facilities and equipment to optimize their recovery. However, due to the potential for cross infection ‘source isolated’ patients may in certain circumstances be unable to leave their room for rehabilitation, or be transferred to an appropriate rehabilitation setting.

This SOP and attached guidance is intended to minimize these circumstances and provide a procedure for when source isolated patients can access rehabilitation facilities.

The principles described within this SOP should be applied to all patients who are source isolated and should be used for the management of patients in source isolation when access to rehabilitation resources is clinically indicated.

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Procedure method (step by step)

Risk Assessment

All patients should be screened according to the guidance attached (see appendix A: Flow chart for the management of patients with known or suspected infections who require rehabilitation).

For patients who require access to rehabilitation facilitates who  are in source isolation please refer to risk assessment in Appendix A

If you have a patient who, according to this guidance, you must treat in source isolation; but you consider that this is either an unsafe environment for rehabilitation, or may hinder the patient’s potential recovery - please contact the IPC team so that they can be risk assessed on a case by case basis.

Patients that do not require source isolation are not restricted  in terms of access to rehabilitation facilities and staff  should always maintain standard precautions.

For those patients who are source isolated but are in a category that means they may leave their room for therapy the following should be adhered to.

Where possible, the patient should be treated at the end of the clinical session. Morning session or afternoon session.  It is recognised this may not always be feasible. If it is necessary to treat a patient before the end of the clinical session they must be the only patient in the rehabilitation room.

1. Before entering the patients side room, or having any interaction with the patient, staff must decontaminate their hands. See LTHT IPC Hand Hygiene policy. A clean white apron and gloves must be placed on the apron dispenser for each physiotherapist in preparation for leaving the room. Therapists should then don yellow apron and gloves to enter the room, along with any equipment required to transport the patient to the rehabilitation facility.

2. Once the patient has been hoisted to a chair, or prepared to be transported to the rehabilitation facility on their bed, they should be helped to wash hands where feasible. Equipment being removed from the room should be cleaned with a chlorine based product and pushed into the corridor. Physiotherapists should then remove aprons and gloves, wash their hands, leave the room and don the white aprons to take the patient  to the rehabilitation room. NB: gloves should not be worn to allow the therapists to attend to ‘normal’ hand hygiene procedures. If there are two or more therapists, the therapists pushing the chair/bed can remain in contact with the chair/bed, and the accompanying therapists can operate doors etc., washing hands as per protocol.

3. Where possible, remove all unnecessary equipment from the rehabilitation room. If this is not possible, place equipment away from the patient to prevent potential contamination.

4. If the patient vomits or is incontinent of loose stools during the therapy session, ensure that the curtains in the rehabilitation area are changed.

5. Once in the therapy room therapist should decontaminate hands wear gloves and apron.

6. After the therapy session, the therapists should remove aprons and gloves, wash their hands, don clean white aprons, and return the patient to their room.

7. Again, if there are two or more therapists, the therapists pushing the chair/bed can remain in contact with the chair/bed and the accompanying therapists can operate doors etc., washing hands as per protocol.

8. After therapy, the rehabilitation room, any equipment and all contact points should be cleaned using a chlorine releasing agent or an approved cleaning product (following decontamination advice from IPC Team or the manufacturer’s recommendations).

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Provenance

Record: 5886
Objective:
  • To standardize and optimize the rehabilitation of patients who require source isolation in an in-patient setting.
  • To minimize the potential for cross infection.
Clinical condition:
Target patient group: Patients who require rehabilitation and physiotherapy care but have infections that require source isolation.
Target professional group(s): Secondary Care Nurses
Adapted from:

Evidence base

LTHT IPC Isolation guidelines

Approved By

IPCT and Physiotherapy Clinical Governance

Document history

LHP version 1.0

Related information

Appendix A

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Equity and Diversity

The Leeds Teaching Hospitals NHS Trust is committed to ensuring that the way that we provide services and the way we recruit and treat staff reflects individual needs, promotes equality and does not discriminate unfairly against any particular individual or group.