Infections in the workforce

This action aims to minimise the risks of transmission of acute infections via workers, patients and visitors as well as disruptions to health service delivery where healthcare providers are unable to practise due to suspected acute transmissible infections. Processes should be risk-based and applicable in response to outbreaks and pandemics. In some instances, physical distancing and screening of staff and visitors may be appropriate.

While the healthcare service has a duty of care to the workforce, staff members also have a responsibility to protect themselves and to not put others at risk.

The healthcare service should identify or develop policies, procedures or protocols that respond to areas in which there is the greatest risk of infection transmission. Development of policies, procedures or protocols should include consultation with the workforce and relevant key stakeholders where risks have been identified, where changes need to occur or improvements can be made to respond to risks, and consider: 

• Identification of possible cases
• Implementation of other treatment options (for example, rescheduling procedures)
• Exclusion periods for elective services
• Suggested management options for suspected or confirmed infections that may be transmissible
• How impacts on treatment and recovery are minimised
• Workforce occupational risk.

Policies should be incorporated in workforce orientation and training programs to include key aspects of standard and transmission-based precautions. Evaluate attendance at, and content of, the orientation or induction programs for the workforce.

• What is your healthcare service’s process for preventing and managing infections in the workforce? 
• Who was consulted in the development of the process?
• How is service provision managed during outbreaks?

• Define and implement a process for preventing and managing infections in the workforce. This should include:
  • circumstances where members of the workforce should refrain from attending the healthcare service and interacting with patients, for example, when an infection is suspected or confirmed, or when they are at greater risk of infection or susceptible to adverse health outcomes
  • whether healthcare providers are able to work via remote-attendance and how this will be facilitated 
  • if and how service provision will continue during periods of outbreaks and pandemics, or events where there is an increased risk of transmission of infection is common, for example, seasonal influenza or local outbreaks of viral gastroenteritis
  • how the healthcare service will access or be alerted to local state or territory public health orders or guidelines for the requirements for workforce screening and exclusion periods. 
• Provide the workforce with training on preventing and managing exposure to infections.

The type and comprehensiveness of evidence used is dependent on each healthcare service context. The content and complexity of the policies and processes will likely depend on the size of the healthcare service, but could include:

• The healthcare service’s process for preventing and managing infections in the workforce
• Observation of how the healthcare service is alerted to, or can access local state or territory public health orders
• Business continuity plans. 

Commission resources

• Addendum NSQHS Standards Accreditation Workbook 2021 Infection Prevention and Control Standard – provides users with updated information on reflective questions and examples of evidence for the 2021 Preventing and Controlling Infections Standard within the NSQHS Standards. Principles and strategies are broadly applicable.
• Infection Prevention and Control eLearning Module: Preventing and managing occupational exposures to infectious agents in health care course – an eLearning module on hand hygiene and infection prevention and control.
• Communicable Diseases Network Australia – Series of National Guidelines (SoNGs) – provides nationally consistent advice and guidance to Public Health Units to help them respond to notifiable diseases using best practice. 

Other resources

• Australian Government Department of Health: Local state and territory health departments. 
• National Health and Medical Research Council in collaboration with the Commission: Australian Guidelines for the Prevention and Control of Infection in Healthcare – Section 4.2 (2019) – developed to specifically support improved infection prevention and control in acute health settings. Provides a risk management framework to ensure that the basic principles of infection prevention and control can be applied to a wide range of healthcare settings.