• The risks of healthcare-associated infection (HCAI) and infectious diseases are greatly increased by extensive movement of patients within the hospital, by very high bed occupancy and by an absence of suitable isolation facilities (DH 2003).

• The Department of Health & Social Care’s programme to reduce HCAI, requires a review of the patient journey for both emergency and elective patients, to identify and reduce risks of infection transmission that are associated with movement of potentially infectious patients (DHSC 2022).

• These guidelines set out the infection prevention and control principles that should be applied to bed management, movement of patients, and discharge planning of patients, to minimise the risk of infection.

This is a controlled document. If you are using a printed copy, check it against the guidelines site to ensure you are using the latest edition. Print copies must be destroyed after use.

Abbreviations

The risks of healthcare-associated infection (HCAI) and infectious diseases are greatly increased by extensive movement of patients within the hospital, by very high bed occupancy and by an absence of suitable isolation facilities (DH 2003). The Department of Health & Social Care’s programme to reduce HCAI, including MRSA, requires a review of the patient journey for both emergency and elective patients, to identify and reduce risks of infection transmission that are associated with movement of potentially infectious patients (DHSC 2022).

These guidelines set out the infection prevention and control principles that should be applied to bed management, movement of patients, and discharge planning of patients, to minimise the risk of infection.

• Assess the need to transfer the patient. Patients may sometimes have to move beds or wards during their admission for reasons such as isolation, change in clinical condition or speciality. Non-clinical transfers should be kept to a minimum, as consistent care in one environment leads to better patient outcomes (DHSC 2022).

• Ward/ department staff must inform staff on the receiving ward/ department of any required infection prevention and control precautions and/ or treatment, prior to the transfer.

• For transfers to inpatient areas, staff from the sending ward must inform the Site/ Bed Manager of any infection prevention and control requirements prior to the transfer.

• Standard infection prevention and control precautions, and transmission-based precautions must be adhered to (including hand hygiene, and the appropriate use of personal protective equipment) during transfer.

• The trolley or wheelchair used for transportation should be decontaminated after use.

• For guidance on environmental decontamination post-transfer, please refer to IPC28b: Decontamination and Management of the Healthcare Environment.

• If the transfer is to a department for an investigation or procedure, please ensure that investigations are performed as soon as the patient arrives in the department, and that the patient is returned to the ward promptly after the procedure is complete.

• There is no requirement to empty the investigation/ procedure room of equipment/ consumables when investigating an infected patient. Instruments/ equipment/ consumables that are not in use should be kept covered or be stored in a cupboard, and equipment in rooms kept to a minimum, as for all patients.

• For details on precautions for specific infections, refer to the NIPCM (NHSE 2024) ‘A to Z of Pathogens’ resource.

• The sending healthcare provider must ensure that it provides suitable and sufficient information on each patient’s infection status whenever arranging for a patient to be moved from the care of one organisation to another. This will ensure that any risk to the patient and others from infection may be minimised (DHSC 2022).

• When patients are receiving treatment for a healthcare-associated infection, such as antimicrobial treatment, it is vital to communicate what treatment and follow-up is needed. This will ensure that treatment regimes can be completed and the outcome for the patient is optimised.

• Availability of appropriate facilities and care should be confirmed with the receiving hospital or care home prior to transfer of known or suspected infectious patients (DHSC 2022). Seek advice from the Infection Prevention & Control Team if required.

• Where patients with a healthcare-associated infection are being transferred or discharged to a nursing or residential home, hospice or another hospital, a transfer letter must be completed detailing the infection, treatment, and precautions required for care.

• Ward/ department staff should inform transport staff of any additional infection prevention and control precautions they need to take while the patient is in their care.

• When patients are receiving treatment for a healthcare-associated infection, such as antimicrobial treatment, it is vital to communicate to the patient, any treatment protocol and what follow-up is needed. This will ensure that treatment regimes can be completed and the outcome for the patient is optimised.

• Patients and carers should be informed of any specific infection prevention and control precautions they may need to take, to minimise risk of transmission on discharge.

• If follow-up is required by Community Care Teams/ Primary Care, detail of relevant infection, treatment and follow-up should be provided in any referrals made.

• Details of any new diagnosis of infection or multi-drug-resistant organism carriage (such as CPE, MRSA or C. difficile) must be included in the GP letter and on any transfer letters.

Monitoring of this guideline is through the Annual IPC Audit and Surveillance programme. An audit of communication of HCAI information is completed by the IPC Team a minimum of annually.

Department of Health (2003) Winning Ways: working together to reduce healthcare associated infections in England. Report to the Chief Medical Officer.

Department of Health & Social Care (2022) The Health and Social Care Act 2008: code of practice on the prevention and control of infections and related guidance.

NHS England (2024) National Infection Prevention and Control Manual (NIPCM) for England.

This guideline has been registered with the Trust. However, clinical guidelines are guidelines only. The interpretation and application of clinical guidelines will remain the responsibility of the individual clinician. If in doubt, contact a senior colleague or expert. Caution is advised when using guidelines after the review date. This guideline is for use in Frimley Health NHS Foundation Trust hospitals only. Any use outside this location will not be supported by the Trust and will be at the risk of the individual using it.

Version Control Sheet

Related Documents