A graze. A minor wound in which the surface of the skin or a mucous membrane has been worn away by rubbing or scraping.
- Acute care setting/Acute hospital
This is a unique, demanding and fast-paced environment designed to accommodate a wide variety of urgent, or emergent patient care needs.
- Aerosol Generating Procedures (AGPs)
Certain medical and patient care activities that can result in the release of airborne particles (aerosols). AGPs can create a risk of airborne transmission of infections that are usually only spread by droplet transmission.
See Appendix 11, footnote 3 for further information
- Airborne (aerosol) transmission
The spread of infection from one person to another by airborne particles (aerosols) containing infectious agents.
- Airborne particles (aerosols)
Very small particles (of respirable size) that may contain infectious agents. They can remain in the air for extended periods of time and can be carried over long distances by air currents. Aerosols can be released during aerosol generating procedures (AGPs).
- Airborne precautions
A group of transmission based precautions to prevent the spread of airborne pathogens
- Alcohol based hand rub (ABHR)
A gel, foam or liquid containing one or more types of alcohol that is rubbed into the hands to inactivate microorganisms and/or temporarily suppress their growth.
- Alert organism
An organism that is identified as being potentially significant for infection prevention and control practices. Examples of alert organisms include Meticillin Resistant Staphylococcus aureus (MRSA), Clostridioides difficile (C.diff) and Group A Streptococcus.
Refers to the alveoli which are the small air sacs in the lungs. Alveoli are located at the ends of the air passageways in the lungs, and are the site at which gas exchange takes place.
An area with a door from/to the outside corridor and a second door giving access to the patient area (where both doors will never be open at the same time).
An agent that kills microorganisms, or prevents them from growing. Antibiotics and disinfectants are antimicrobial agents.
- Antimicrobial hand wipes
Hand wipes that are moistened with an antimicrobial solution/agent at a concentration sufficient to inactivate microorganisms and/or temporarily suppress their growth.
- Antimicrobial resistance
The ability of a microorganism to resist the action of an antimicrobial drug/agent which previously could treat the infection caused by that microorganism.
The process of preventing infection by inhibiting the growth and multiplication of infectious agents. This is usually achieved by application of a germicidal preparation known as an antiseptic.
- Aseptic Technique
A healthcare procedure designed to minimise the risks of exposing the person being cared for to pathogenic micro-organisms during simple (e.g dressing wounds) and complex care procedures (e.g. surgical procedures).
Not showing any symptoms of disease but where an infection may be present.
Machine used for sterilising re-usable equipment using superheated steam under pressure.
A partly enclosed area within a ward containing one bed (single bay) or multiple beds (multi-bed bay).
- Blood Borne Viruses (BBV)
Viruses carried or transmitted by blood, for example Hepatitis B, Hepatitis C and HIV.
- Body Fluids
Fluid produced by the body such as urine, faeces, vomit or diarrhoea.
- Carbapenemase Producing Enterobacteriaceae (CPE)
A group of bacteria that have become extremely resistant to antibiotics including those called carbapenems.
- Care setting
Includes but is not limited to general practice, dental and pharmacy (primary care), acute-care hospitals, emergency medical services, urgent-care centres and outpatient clinics (secondary care), specialist treatment centres (tertiary care), long-term care facilities such as nursing homes and skilled nursing facilities (community care), and care provided at home by professional healthcare providers (home care).
- Care staff
Any person who cares for patients, including healthcare support workers and nurses.
- Central Decontamination Unit (CDU)
A large, centralised facility for the decontamination and re-processing of re-usable medical equipment e.g. surgical instruments.
- Central Venous Catheter (CVC)
An intravenous catheter that is inserted directly into a large vein in the neck, chest or groin to allow intravenous drugs and fluids to be given and to allow blood monitoring.
A chemical that is used for disinfecting, fumigating and bleaching.
The removal of any dirt, body fluids (blood, vomit) etc by use of an appropriate cleaning agent such as detergent.
- Clinical wash hand basin
A sink designated for hand washing in clinical areas.
- Clostridioides difficile (C.diff)
An infectious agent (bacterium) that can cause mild to severe diarrhoea which in some cases can lead to gastro-intestinal complications and death.
- Cohort area
An area (room, bay, ward) in which two or more patients (a cohort) with the same confirmed infection are placed. A cohort area should be physically separate from other patients.
The presence of microorganisms on a body surface (such as the skin, mouth, intestines or airway) that does not cause disease in the person or signs of infection.
Mucous membranes that cover the front of the eyes and the inside of the eyelids.
- Contact precautions
Series of procedures/interventions used in addition to routine practices to prevent transmission of infectious agents that spread by direct or indirect contact
- Contact transmission
The spread of infectious agents from one person to another by contact. When spread occurs through skin-to-skin contact, this is called direct contact transmission. When spread occurs via a contaminated object, this is called indirect contact transmission.
The presence of an infectious agent on a body surface; also on or in clothes, bedding, surgical instruments or dressings, or other inanimate articles or substances including water and food.
- Cough etiquette/respiratory hygiene
Measures that are taken to minimise the spread of respiratory infections to others.
Spread of infection from one person, object or place to another.
The process of removing, or killing pathogens on an item or surface to make it safe for handling, re-use or disposal, by cleaning, disinfection and/or sterilisation.
A chemical cleansing agent that can dissolve oils and remove dirt.
3 or more loose or liquid bowel movements in 24 hours or more often than is normal for the individual.
- Direct contact transmission
Spread of infectious agents from one person to another by direct skin-to-skin contact.
A chemical used to reduce the number of infectious agents from an object or surface to a level that means they are not harmful to health.
The treatment of surfaces/equipment using physical or chemical means, for example using a chemical disinfectant, to reduce the number of infectious agents from an object or surface to a level at which they are not harmful to health.
- Domestic waste
Waste produced in the care setting that is similar to waste produced in the home.
A small drop of moisture, larger than airborne particle, that may contain infectious agents. Droplets can be released when a person talks, coughs or sneezes, and during some medical or patient care procedures such as open suctioning and cough induction by chest physiotherapy. It is thought that droplets can travel around 1 metre (3 feet).
- Droplet transmission
The spread of infection from one person to another by droplets containing infectious agents.
An agent used to soothe the skin and make it soft and supple.
- Enhanced single room (with en-suite facilities and ventilated lobby)
This is a single room with space for one patient and contains a bed; locker/wardrobe; clinical wash-hand basin, en-suite shower, WC and wash-hand basin and has a ventilation system that prevents uncontrolled escape of infectious aerosols from the room to adjacent areas and a lobby with positive pressure ventilation.
It can also provide a degree of dilution of infectious aerosols in the room for the safety of staff and visitors.
The room should have extract ventilation that exceeds its supply, such that gaps in its fabric leak inwards not outwards.
- Enhanced single room (with en-suite facilities)
This is a single room with space for one patient and contains a bed; locker/wardrobe; clinical wash-hand basin, en-suite shower, WC and wash-hand basin and has a ventilation system that prevents uncontrolled escape of infectious aerosols from the room to adjacent areas.
It can also provide a degree of dilution of infectious aerosols in the room for the safety of staff and visitors.
The room should have extract ventilation that exceeds its supply, such that gaps in its fabric leak inwards not outwards.
A room containing a sink and toilet and sometimes a shower/wetroom or bath.
- En-suite single-bed room
A room with space for one patient and containing a bed; locker/wardrobe, clinical wash-hand basin, en-suite shower, WC and wash-hand basin.
- Exceptional infection episode
A single case of an infection that has severe outcomes for an individual patient OR has major infection control/public health implications e.g. infectious diseases of high consequence such as extensively drug resistant tuberculosis (XDR-TB).
Waste products produced by the body such as urine and faeces (bowel movements).
The condition of being exposed to something that may have a harmful effect such as an infectious agent.
- Exposure Prone Procedures (EPPs)
Certain medical and patient care procedures where there is a risk that injury to the healthcare worker may result in exposure of the patient’s open tissues to the healthcare worker’s blood e.g the healthcare worker’s gloved hands are in contact with sharp instruments, needle tips or sharp tissues inside a patient’s body.
- Face covering
A term that applies collectively to items used to cover the nose and mouth. Also referred to as a face mask.
These should not be confused with items of PPE.
- Fallow time
The period of time required for droplets and/or aerosols to settle and be removed from the air following a procedure. It is also known as settle time.
Respiratory protection that is worn over the nose and mouth designed to protect the wearer from inhaling hazardous substances, including airborne particles (aerosols). FFP stands for filtering facepiece. There are three categories of FFP respirator: FFP1, FFP2 and FFP3. An FFP3 respirator or hood provides the highest level of protection, and is the only category of respirator legislated for use in UK healthcare settings.
- Fit Testing
A method of checking that a tight-fitting facepiece respirator fits the wearer and seals adequately to their face. This process helps identify unsuitable facepieces that should not be used.
- Fluid resistant surgical mask (FRSM)
A term applied to fabrics that resist liquid penetration, often used interchangeably with 'fluid-repellent' when describing the properties of protective clothing or equipment.
General practitioner (your family doctor)
- Group 4 Infections
Definition taken from the HSE Approved list of biological agents www.hse.gov.uk/pubns/misc208.pdf
Group 4 infections cause severe human disease and are a serious hazard to employees; they are likely to spread to the community and there is usually no effective prophylaxis or treatment available.
- Hand Hygiene
The process of decontaminating your hands using either alcohol based hand rub or liquid soap and water.
- Hand wash station
A wash hand basin with mixer tap, paper towels and non-antimicrobial liquid soap in a single use container designed for hand washing use only.
- Health Protection Team (HPT)
A team of healthcare professionals whose role it is to protect the health of the local population and limit the risk of them becoming exposed to infection and environmental dangers. Every NHS board has a HPT.
- Healthcare Associated Infection (HAI)
Infections that occur as a result of medical care, or treatment, in any healthcare setting.
- Healthcare associated infection outbreak
Two or more linked cases associated with the same infectious agent, within the same healthcare setting, over a specified time period; or a higher than expected number of cases in a given healthcare area over a specified time period.
- Healthcare infection data exceedance
A greater than expected rate of infection compared with the usual background rate for the place and time where the incident has occurred.
- Healthcare infection exposure incident
An exposure of patients, staff, or the public to a possible infectious agent, as a result of a healthcare system failure or near misses e.g. ventilation, water or a decontamination incident.
- Healthcare Waste
Waste produced as a result of healthcare activities for example soiled dressings, sharps.
- Hierarchy of controls
This is a systematic process which provides a consistent approach to minimizing or eliminating exposures to hazards in the workplace.
- Hospital infection incident assessment tool (HIIAT)
Used by the IPCT or HPT to assess every healthcare infection incident i.e. all outbreaks and incidents including decontamination incidents or near misses in any healthcare setting (that is the NHS, independent contractors providing NHS Services and private providers of healthcare).
- Hygiene Waste
Waste that is produced from personal care. In care settings this includes feminine hygiene products, incontinence products and nappies, catheter and stoma bags. Hygiene waste may cause offence due to the presence of recognisable healthcare waste items or body fluids. It is usually assumed that hygiene waste is not hazardous or infectious.
A chlorine-based disinfectant such as bleach
To provide immunity to a disease by giving a vaccination.
- Immunocompromised patient/individual
Any person whose immune response is reduced or deficient, usually because they have a disease or are undergoing treatment. People who are immunocompromised are more vulnerable to infection.
Cannot be penetrated by liquid.
- Incident Management Team (IMT)
A multidisciplinary group with responsibility for investigating and managing an incident.
- Indirect contact transmission
The spread of infectious agents from one person to another via a contaminated object.
Invasion of the body by a harmful organism or infectious agent such as a virus, parasite, bacterium or fungus.
- Infection Prevention and Control Team (IPCT)
A multidisciplinary team responsible for preventing, investigating and managing an infection incident or outbreak.
- Infectious agent
Any organism, such as a virus, parasite, bacterium or fungus, that is capable of causing an infection or infectious disease.
- Infectious Diseases of High Consequence (IDHC)/High Consequence Infectious Disease (HCID)
An Infectious Disease of high consequence (IDHC) typically causes severe symptoms requiring a high level of care and a high case-fatality rate, there may not be effective prophylaxis or treatment. IDHC are transmissible from human to human (contagious) and capable of causing large-scale epidemics or pandemics.
- Infectious period
The time when an infectious agent may be transmitted directly or indirectly from an infected person to another person. Also known as “period of infectiousness” and “communicability”.
- Invasive device
A device which penetrates the body, either through a body cavity or through the surface of the body. Central Venous Catheters (central line), Peripheral Arterial Lines and Urinary Catheters are examples of invasive devices.
- Invasive procedure
A medical/healthcare procedure that penetrates or breaks the skin or enters a body cavity.
Physically separating patients to prevent the spread of infection.
- Isolation Suite/Room
An isolation room/suite consists of enhanced en-suite single bed rooms:
An en-suite single bed room is defined as: consisting of a bed; locker/wardrobe; clinical wash-hand basin and en-suite shower, WC and wash-hand basin. (In new build, space for a social support zone for overnight stay and a clinical support zone is also provided).
- Enhanced single room (with en-suite facilities), also called isolation room, is the same as an en-suite single-bed room but with a ventilation system that prevents uncontrolled escape of infectious aerosols from the room to adjacent areas. It can also provide a degree of dilution of infectious aerosols in the room for the safety of staff and visitors. The room should have extract ventilation that exceeds its supply, such that gaps in its fabric leak inwards not outwards.
- Enhanced single room (with en-suite facilities and ventilated lobby), also called isolation suite, is the same as an enhanced single room (with en-suite facilities) but with a lobby having positive pressure ventilation.
- Lateral Flow Device (LFD)
A test carried out using a small medical device that tests whether or not there is a particular substance, gene, etc. in a sample. For example, to identify those who have COVID-19 but are not presenting symptoms.
- Long Term Care Facility (LTCF)
Long term care facilities provide a variety of services, both medical and personal care, to people who are unable to live independently.
- Mechanical Ventilation
Mechanical ventilation brings fresh air into a building from outside via a controllable method. Basic systems consist of a fan and either collection, (extraction) or distribution (supply) ductwork.
- Microorganism (microbe)
Any living thing (organism) that is too small to be seen by the naked eye. Bacteria, viruses and some parasites are microorganisms.
- Mode of transmission
The way that microorganisms spread from one person to another. The main modes or routes of transmission are airborne (aerosol) transmission, droplet transmission and contact transmission.
- Mucocutaneous exposure
An incident in which the mucous membranes (e.g mouth, nose, eyes) are exposed to blood/other body fluid.
- Mucous membranes/mucosa
The surfaces lining the cavities of the body that are exposed to the environment such as the lining of the mouth and nose.
- Multi-bed room
A room that contains more than one bed.
The acceptable maximum number of beds in a multi-bed room is four. Multi-bed rooms require two clinical wash-hand basins and must have en-suite sanitary facilities. Ideally, an assisted shower room (with WC, shower and general wash-hand basin) and a separate semi-ambulant WC (with general wash-hand basin) both en-suite.
- Needle safety device
Any device designed to reduce the risk of injury from needles. This may include needle-free devices or mechanisms on a needle, such as an automated resheathing device, that cover the needle immediately after use.
- Negative pressure room
A room which maintains permanent negative pressure i.e. air flow is from the outside adjacent space (e.g. corridor) into the room and then exhausted to the outside.
The room should be used to accommodate a patient known or suspected to be infected with a microorganism spread by the airborne (aerosol) route whilst the patient is considered infectious.
A synthetic rubber material used to make non-latex gloves.
- Non-intact skin
Skin that is broken by cuts, abrasions, dermatitis, chapped skin, eczema etc.
- Non-intact skin exposure
An incident in which non-intact skin is exposed to blood or body fluids.
- Non-sterile procedure
Care procedure that does not need to be undertaken in conditions that are free from bacteria or other microorganisms.
An infection occurring in a patient during the process of care in a hospital or other health care facility, which was not present or incubating at the time of admission.
- Occupational exposure
Exposure of healthcare workers or care staff to blood or body fluids in the course of their work.
Any living thing that can grow and reproduce, such as a plant, animal, fungus or bacterium.
When two or more people have the same infection, or more people than expected have the same infection. The cases will be linked by a place and a time period.
A disease outbreak that occurs over a wide geographical area (such as multiple countries and/or continents) and typically affects a significant proportion of the population.
Any disease-producing infectious agent.
- Patient cohorting
Placing a group of two or more patients (a cohort) with the same infection/strain in the same bay/ward. Cohorts are created based on clinical diagnosis, microbiological confirmation, epidemiology, and mode of transmission.
- PCR test
Highly accurate tests used to diagnose certain infectious diseases.
- Percutaneous injury
An injury caused by a sharp instrument or object such as a needle or scalpel, cutting or puncturing the skin.
- Personal Protective Equipment (PPE)
Equipment a person wears to protect themselves from risks to their health or safety, including exposure to infections e.g. disposable gloves and disposable aprons.
The time period when someone has the infection but has not yet developed symptoms but does go on to develop symptoms later in the disease.
- Primary Care Setting
These provide the first point of contact in the healthcare system and includes general practice, dentistry, community pharmacies etc
- Problem Assessment Group (PAG)
A group that is convened by the Infection Prevention and Control Team (IPCT)/Health Protection Team (HPT) to assess a healthcare incident/outbreak/data exceedence and determine if further action is required.
The assessment and outcome may be:
- HIIAT Green - continue to monitor
- HIIAT Amber/Red - IMT required
Fever. Rise in body temperature above the normal level >37.2°.
A period of isolation to prevent spread of a contagious disease.
To put a needle or other sharp object back into its plastic sheath or cap. Also known as ‘re-sheathing’.
- Respiratory droplets
A small droplet >5 μm in diameter, such as a particle of moisture released from the mouth during coughing, sneezing, or speaking.
- Respiratory Protective Equipment (RPE)
Respirators are devices that cover the nose and mouth and are designed to filter the air breathed in to protect the wearer from inhaling hazardous substances.
They provide respiratory protection from infectious agents transmissible by the airborne (aerosols) route. FPP3 respirators are recommended for use in UK health and care settings when exposure to aerosols is anticipated.
- Respiratory/non-respiratory pathways
Terms used to describe the placement of patients during periods of high prevalence of respiratory viruses/infection. This is determined by the presence of respiratory symptoms or risk factors associated with respiratory viruses.
Further details can be found in the Winter (21/22), Respiratory Infections in Health and Care settings Infection Prevention and Control Addendum.
- Safer sharp
A medical sharps device which has been designed to incorporate a feature or mechanism that minimises and/or prevents the risk of accidental injury. Other terms include (but are not limited to) safety devices, safety-engineered devices and safer needle devices.
- Sanitary fittings
All sinks and furniture in a bathroom, such as a toilet, bath, shower etc.
Performing a test or enquiry to identify individuals at risk of a specific disorder or infection to warrant further investigation or direct preventive action.
- Secondary care setting
Provided by health professionals who generally are not the first point of contact for a patient. These settings are usually hospitals but can also be community based.
Any body fluid that is produced by a cell or gland such as saliva or mucous, for a particular function in the organism or for excretion.
Physically separating or isolating from other people.
A life threatening condition that arises when the body’s response to a severe complication of infection e.g. pneumonia (lung infection) injures its own tissues and organs. This can lead to multiple organ failure and death. Early recognition, treatment and management is key to successful patient outcomes.
A ‘sharp’ is a device or instrument used in healthcare settings with sharp points or edges, such as needles, lancets and scalpels which have the potential to cause injury through cutting or puncturing the skin.
- Sharps incident
A type of percutaneous injury caused by a sharp instrument or device which cuts or penetrates the skin.
- Sharps injury
- Significant occupational exposure
A percutaneous, mucocutaneous exposure or non-intact skin (abrasions, cuts, eczema) exposure to blood/other body fluids from a source that is known (or later found to be) positive for a bloodborne virus infection.
- Significant sharps incident
An incident which involves a used needle that has exposed, or may have exposed, the employee to blood/body fluids.
- Single-bed room
A room with space for one patient and usually contains as a minimum: a bed; locker/wardrobe; clinical wash-hand basin.
Single-bed rooms should also have en-suite sanitary facilities comprising of a shower, WC and a general wash-hand basin.
A reproductive cell produced by fungi and some types of bacteria under certain environmental conditions. Spores can survive for long periods of time and are very resistant to heat, drying and chemicals.
- Staff cohorting
A dedicated team of healthcare staff who care for a cohort of patients, and do not care for any other patients.
- Standard infection control precautions (SICPs)
These are a group of basic infection prevention and control practices that need to be adopted by all staff in health and care settings, irrespective of infectious status of patient.
Free from live bacteria or other microorganisms
- Sterile procedure
Care procedure that is undertaken in conditions that are free from bacteria or other microorganisms.
The procedure of making some object free of all germs, live bacteria or other microorganisms (usually by heat or chemical means).
- Surgical face mask
A disposable fluid-resistant mask worn over the nose and mouth to protect the mucous membranes of the wearer’s nose and mouth from splashes and infectious droplets and also to protect patients. When recommended for infection control purposes a 'surgical face mask' typically denotes a fluid-resistant (Type IIR) surgical mask.
- Surgical scrubbing
The process of removing debris and sterilizing hands prior to performing a sterile or surgical procedure.
- Surgical site infection
This is an infection which occurs after the surgery at the site of the surgical incision due to introduction and multiplication of pathogens at the surgical site.
Way of closing bag by twisting the top of the bag (must not be more than 2/3 full), looping the neck back on itself, holding the twist firmly, and placing a seal over the neck of the bag (such as with a tag).
- Terminal decontamination
Cleaning/decontamination of the environment following transfer/discharge of a patient, or when they are no longer considered infectious, to ensure the environment is safe for the next patient or for the same patient on return.
- Touch surfaces
These are surfaces that are frequently touched by different people throughout the day and are therefore more likely to be contaminated with bacteria or viruses for example doorknobs, tables, phones etc. which can then easily transfer to the user.
- Transmission-based precautions (TBPs)
These are additional measures that are used in conjunction with SICPs when caring for patients with a known or suspected infection or colonisation.
A suspension that is administered in order to stimulate the immune response of the body against an infectious agent.
- Vascular access devices
Any medical instrument used to access a patient’s veins or arteries such as a Central Venous Catheter or peripheral vascular catheter.
Ventilation is a means of removing and replacing the air in a space. In its simplest form this may be achieved by opening windows and doors.
- Viral load
The viral load or viral burden is a numerical expression of the amount of virus present in biological fluids or environmental specimens.
An area forming a division of a care setting (or a suite of rooms) shared by patients who need a similar type of care.