IPC 4.3 Transfer of patients with a known/suspected infection

Contents

  1.0 Introduction
  2.0 Duties 
  2.1 IPC Transfer infection control risk assessment (Appendix 1) 
 2.2 Admission to Trust inpatient facilities
 3.0 References / Source documents 
 Appendix 1

 

1.0 Introduction 

This guideline has been developed to provide clear operational guidance for the transfer of patients/clients both within hospital, Trust sites and to external organisations. This will enable the admitting health care facility/nursing service to make a risk assessment and instigate appropriate infection prevention and control precautions. This will be based on the transmission route of each Healthcare Associated Infection (HCAI) and the clinical environment in which the patients/clients will be cared for, whilst maintaining as much individualised care as possible. By identifying potential exposure risks posed by HCAIs and their causative organism, the provision of a safe environment for staff, visitors, and patients can be maintained. 

 

2.0 Duties      

Any member of staff involved in the transfer of service users have a responsibility to ensure that patient placement/assessment for infection risk has been undertaken NHS England » Chapter 1: Standard infection control precautions (SICPs) 

Accurate information on the service user’s infection status is communicated in an appropriate manner. The Infection Prevention and Control Transfer Infection Control Risk assessment (see Appendix1) must be completed for all patients/clients: 

For internal transfers i.e., from ward to ward

For external transfers i.e. to acute care facilities, care homes, external agencies and to patient/clients own homes where input from community healthcare services is required 

This information should facilitate the provision of optimum care, minimising the risk of inappropriate management and further transmission of infection.

 

2.1 IPC Transfer infection control risk assessment (Appendix 1)  

This form should be completed for all transfers to prevent the spread of HCAIs such as Methicillin Resistant Staphylococcus aureus (MRSA), Multi-Drug Resistant Organisms (MDRO), Group A streptococcus and enteric infections e.g., Clostridioides difficile (Clostridioides), Carbapenemase-producing Enterobacteriaceae (CPE) and Norovirus, as follows: 

To identify and inform of colonised or infected patients/clients with an organism or with have a history of a previous infection. 

To other hospitals: the transferring units should liaise with the receiving area regarding the current infection status of the patient. 

To care homes: the discharging unit must ensure that the care home is informed of the infection status of the patient/client prior to discharge. 

To the patients/client’s own home: if input is required from community services the discharging unit must liaise with the community services prior to discharge. If the service user is being discharged home with a care package, the carers must be informed of the patient’s/client’s infection status. 

From the community to a health care facility: the community services must complete an Infection Prevention and Control Discharge/Transfer Form for all patients with a confirmed or suspected history of infection. 

Patients with diarrhoea/enteric infection such as Clostridioides difficile (Clostridioides), Norovirus, or unexplained diarrhoea

These patients/clients should not be transferred / discharged until they have been free of diarrhoea for 72 hours and have passed a stool that is normal for that patient, unless clinically indicated. e.g. medical collapse requiring secondary care. For confirmed Norovirus infection patients/clients should not be transferred/discharged until they are free of symptoms for 48 hours unless clinically indicated e.g. medical collapse requiring secondary care.

If the patients/clients have been in a healthcare facility where there has been a suspected/confirmed outbreak of enteric infection, the admitting healthcare facility or community service must be informed even if the patient was asymptomatic during the outbreak period. 

For patients/clients with any other known / suspected infection, currently managed with Transmission-based precautions NHS England » Chapter 2: Transmission based precautions (TBPs) and advice from the IPCT is advised before transfer / discharge is arranged.

 

2.2 Admission to Trust inpatient facilities

The receiving facility must ensure that an HCAI risk assessment (Appendix 1) is undertaken prior to admission. This is to identify the patients Infection status to ensure that the service user is appropriately managed and placed in accordance with the National Infection Prevention and Control Manual to reduce HCAI risks NHS England » Chapter 2: Transmission based precautions (TBPs). 

When admitting a patient from another Trust /Organisation the receiving facility must ensure where relevant a transfer/discharge form is received with the appropriate infection status information.  Where this is not available an incident report must be completed highlighting any concerns relating to the discharge of patients with an infection from another healthcare organisation. These will be 3rd party incidents.

  

3.0 References / Source documents          

3.1 The Health and Social Care Act 2008: Code of Practice for the NHS on the prevention and control of healthcare associated infections and related guidance (Department of Health Revised Edition 2022) 

3.2 The National Infection Prevention and Control Manual 

 

Caption

Date	Author	Policy / procedure	Details of change
September 2010	N Murphy/B Pryse	18.09	Added section in Section 4.9 and new Appendix 1
January 2013	J Patrickson-Daly/D Churchill-Hogg	18.09	Changes throughout to include HP Division
August 2021	J Patrickson-Daly	18.09 (Issue 3)	Minor changes throughout
June 2020	Carol Evans	18.09 (Issue 5)	Minor Changes throughout including: Removal of POSITIVE logo; Change of details of DIPC / Exec Nurse; Consultation with IPC Group and Committee; 3.3.2 With an infection from another healthcare organization; 3.2.1 Clostridioides - the new name for Clostridium difficile; 8.0 Deletion of Tuberculosis Prevention and Control Policy 18.15
April 2021	L West	18.09 (Issue 5)	Reference number changed to 07.08
June 2023	IPC Team	Issue 6	Amended title and some minor word changes. Appendix 1 changed
June 2024	IPC Team	Issue 7	Change to guidance in line with the new IPC policy

 

Appendix 1

Trustwide intra / inter-healthcare IPC transfer / admission form (The document is available on the Connect site)

This form must be completed in conjunction with other discharge/transfer documentation and kept with multi-disciplinary confidential notes.