Norovirus scenario and related SICPs
The following scenario offers learning opportunities related to the application of the Standard Infection Control Precautions (SICPs) outlined in this pocket guide. The SICP icons that appear throughout the scenario will include links to the chapter of the guide where you can access further knowledge and guidance.
The scenario takes place in a care home setting, however, throughout the scenario it is encouraged that you relate the key learning points to your own practice setting and note any points for discussion within your care team.
Clear View Care Home – Evening handover
Mrs Brown has had a very unsettled evening; she has not eaten her dinner and has had three episodes of sudden vomiting tonight. She is also complaining of stomach pains and has been up to the toilet on three occasions with loose, watery stools. She has had no history of loose stool or vomiting until today, and has had no recent change in diet or medication.
Mrs Brown has gone to her room and has asked to go to bed earlier than normal as she feels so unwell. Until we can prove otherwise, we will treat Mrs Brown with possible Norovirus. We have contacted her family and advised them of her condition and ask that they restrict their visiting at least for now and that they will have to carry out hand hygiene with soap and water if they wish to visit.
We have requested that no more than two people visit at any given time. Please alert visitors that if they have any underlying illness not to visit, or if they are showing symptoms do not visit until they have been clear of symptoms for at least 48 hours.
We have explained to Mrs Brown that she requires to be separated from the other residents and remain in her room until 48 hours after her symptoms subside to prevent further spread of the Norovirus infection, and she has been reassured that we will be able to visit her room regularly to look after her and provide her some company. There is also a call bell provided should she require assistance.
PPE is available for any staff entering the room. There is a soap dispenser and paper towels at Mrs Brown’s handwashing facilities for all staff and visitors to use on entry and on leaving her room. Please remember that Alcohol Based Hand Rub (ABHR) is not effective against hands contaminated with the Norovirus infection therefore please use the soap and water provided.
We ask that restricted staff on each shift take care of all Mrs Brown’s needs and that we clean and remove any unnecessary clutter, furniture or equipment. Please ensure minimal movement in and out of her room but do take the opportunity on each visit to provide company if required.
With Mrs Brown’s daughters’ permission we have agreed to launder all Mrs Brown’s clothes and her bed linen. We should do this by washing them separately from our other residents’ linen and at the hottest temperature the garments allow. If any linen or clothing is soiled they must be treated as infected, therefore please use the water-soluble bags provided and insert into a clear bag to be taken to the laundry room. If possible, please tumble dry and iron the items as indicated on the garment labels.
If Mrs Brown’s vomiting and/or diarrhoea persist please use the paper towels to soak up any spillages andclean using a disinfectant solution of chlorine releasing agent 1000ppm following manufacturer’s instructions. Place all infected waste into the plastic bags that have been left in her bathroom before removing and discarding your PPE and performing hand hygiene. Also refer to safe management of care equipment.
For Mrs Brown’s comfort and convenience we have provided a commode by her bed. After use, please clean it thoroughly with the disinfectant provided and rinse it thoroughly before drying. Do not remove it from the room. Use the same procedure for all the sinks and toilet, and as normal practice, use a separate disposable cloth for each piece of equipment/furniture/ surface and dispose as above after use.
Monitor and record Mrs Brown’s symptoms for signs of her condition worsening or improving so that once she has been 48 hours free of symptoms we can ensure she joins in with the other residents.
Finally, if you begin to feel any symptoms of Norovirus or any other transmissible infectious such as flu please let the duty manager know as you should not be at work. If you suspect you may have the symptoms of Norovirus you must refrain from returning to work until you are 48 hours free of any symptoms. Refer to prevention and exposure management and respiratory and cough hygiene.
Reflecting on the scenario, please consider any points for discussion within your care team.