Guidance

Essential IPC considerations for clinical interventions and procedures in adult social care​ 

Published 28 October 2026

This section outlines the infection prevention and control (IPC) principles for common clinical procedures and medical devices used in adult social care settings. It highlights key measures to reduce the risk of infection and support safe care, while recognising that staff should continue to follow their training, local policies, and guidance where applicable.

Key summary

• clinical procedures (for example wound care, catheters) can increase infection risk
• good IPC helps prevent harm, outbreaks, and antibiotic resistance
• aseptic technique keeps wounds and devices clean and safe
• people with wounds or devices are at higher risk of infection
• some procedures can increase spread through the air
• safe handling of equipment, medicines, and samples is important

Call for action

• spot signs of infection early (for example redness, swelling, fever)
• follow IPC guidance and aseptic technique for all procedures
• clean hands before and after care tasks
• use the right PPE for the task
• keep equipment clean, safe, and ready to use
• check for signs of infection and report concerns
• provide safe care for devices (for example catheters, feeding tubes)
• give medicines safely and complete the full course
• collect and handle samples correctly and send quickly
• work with healthcare professionals and follow advice
• keep clear records and care plans

This explains the IPC principles for common clinical procedures and medical devices used in ASC settings. It does not replace training, local policies or professional guidance. Registered nurses and other healthcare professionals should continue to follow their professional standards and local procedures when carrying out clinical procedures.

Below are key considerations and proactive measures for the most common clinical interventions carried out in ASC settings.

Safeguarding statement

In keeping with the Mental Capacity Act 2005, care and support workers must presume capacity unless assessed otherwise, provide tailored support to enable understanding, and document any capacity assessments clearly. Where a person lacks capacity, decisions or protective measures must be made in their best interests and be proportionate, necessary, and least restrictive, with involvement from relevant professionals and those close to the person wherever appropriate.

Always ensure any information sharing about a person who is infectious is done so in a compassionate but proportionate way.

Aerosol generating procedures

Only a small number of procedures in adult social care are classed as aerosol generating. This section introduces aerosol generating procedures (AGPs) to signpost care and support workers in ASC settings to obtain advice if this is needed. Where these procedures are undertaken, care and support workers should follow national or local guidance.

Aerosol generating procedures are clinical procedures that result in the production of airborne or respiratory particles that come out of a person’s mouth, nose, or lungs (respiratory tract). Examples of these include any procedure that can cause the person to cough or procedures that use a suction catheter to clear a person’s airway below the oropharynx (the middle part of the mouth directly behind the mouth).

If a person has a suspected or confirmed respiratory infection, some clinical procedures can increase the risk of infection spreading. Follow local guidance and seek advice from an ASC manager, IPC lead or healthcare professional if unsure whether a procedure is an aerosol generating procedure (AGP) or whether respiratory protective equipment (RPE) is needed. See the aide memoire for advice on where the person accessing care should be cared for and the PPE that may be required.

If a care and support worker is not sure whether a clinical procedure is an AGP, always ask the ASC manager or their nominated deputy.  

Examples may include airway suctioning and use of respiratory support devices such as Continuous Positive Airway Pressure (CPAP) or cough assist.

When carrying out an AGP it is important to wear the correct RPE which protects against pathogens that transmit through the air.

Always ventilate the area before carrying out the AGP.

Respiratory protective equipment includes:

• Filtering Face Piece class 3 (FFP3) respirator (must be fit tested and used in line with HSE guidance)
• eye protection
• gown or apron

Continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP)

CPAP is a treatment for obstructive sleep apnoea (OSA), a condition that can be life-threatening.

CPAP and BiPAP treatment must be given as prescribed and by a care and support worker who is trained to use it. 

Clear guidance from NICE and NHS England is available to support and encourage people that need to use this treatment regularly.

These procedures can spread infection. Use appropriate RPE, including FFP3 respirators where indicated by risk assessment and guidance. The risk assessment should consider the procedure being carried out, whether the person has a suspected or confirmed respiratory infection, and advice from IPC teams or healthcare professionals.

Ventilate the room during and after the procedure where possible, by opening windows where it is safe to do so.

Seek advice from local IPC teams whether the room needs to be left empty for a period of time before it can be used again. Opening windows can reduce the need for this.

Clean the area after the procedure, ensuring any surface or touch point has been cleaned with a detergent. If the person is suspected or confirmed of having an infection, disinfectant may also be required. This will depend on the type of infection. Follow the manufacturer’s instructions to ensure the equipment is cleaned regularly.

Aseptic technique

Most aseptic procedures are carried out by registered healthcare professionals. Care and support workers should only carry out aseptic procedures if they have been trained and assessed as competent.

Aseptic technique is a way of working that helps stop pathogens getting into wounds, contaminating medical devices or other parts of the body during care. It involves keeping equipment clean, cleaning hands correctly and avoiding contamination during procedures.

When using aseptic technique:

• clean hands, then clean and prepare the work surface or trolley
• clean hands thoroughly before starting the procedure
• avoid touching vulnerable body sites and sterile equipment where possible
• use sterile gloves if touching a vulnerable site (a part of the body where pathogens can get in and cause an infection (this can include wounds, cuts, surgical areas, and places where intravenous lines (IV) lines or catheters enter the body) or handling sterile parts of equipment or devices)
• only use sterile fluids and sterile equipment (any sterile equipment and fluids will state they are sterile clearly on the packaging)
• check sterile packs are within their expiry date and are intact with no sign of damage before use
• never place contaminated or non-sterile items in the sterile field
• never reuse single-use items
• minimise movement around the procedure area to reduce the risk of contamination

Managing invasive indwelling devices and wounds

People with wounds or an invasive device, are at a higher risk of infection.

Common invasive devices and wounds include:

• urinary catheters
• peripheral venous catheters
• enteral feeding tubes
• tracheostomies
• stoma care appliances
• chronic wounds
• surgical wounds

Care and support workers should follow their ASC settings policy for managing invasive devices and wounds and always follow evidence-based guidelines to ensure safe and effective care. EPIC3 and National infusion and vascular access society are evidence-based resources to support the safe management of invasive devices and wounds.

Health professionals often visit ASC settings to deliver clinical care such as inserting invasive devices and carrying out wound care. 

Care and support workers should be competent with the skills and knowledge to manage invasive devices and wounds safely in their ASC settings. They should be able to recognise signs of infection (high temperature, redness, swelling or pain) and know when to report concerns to healthcare professionals. 

Key IPC practices when caring for someone with an invasive device or wound include:

• assessing the risk of exposure
• use appropriate personal protective equipment (PPE)
• avoid unnecessary use of PPE
• follow risk assessment and care plans
• clean hands before and after contact with the person’s medical device or wound
• use aseptic technique for all medical device and wound care
• carry out a risk assessment to help decide whether sterile gloves are required during care
• only use sterile gloves if you are going to touch equipment that needs to stay sterile or touch non-intact or invasive parts of the body (wound bed, catheter that is being inserted into the body)
• use dedicated clinical spaces for wound/device care where possible in communal ASC settings
• carry out wound/device care in a person’s room when no dedicated clinical space is available (domiciliary care)
• do not carry out wound/device care in bathrooms as they may increase the risk of contamination
• clean the immediate surroundings such as worktops thoroughly before using as a medication or equipment preparation area
• protect equipment from contamination, and report or escalate if the environment does not allow safe care
• storing all equipment so it is clean, dry, and protected from contamination (for example store equipment in lidded, plastic boxes)
• when moving from one place to another always keep equipment clean, dry, and protected from contamination
• following the manufacturer’s instructions for using, cleaning, and storing equipment.
• checking equipment is safe and report any concerns, including for items owned by the person or provided by the NHS. providers should keep records for equipment they supply
• ensure each person has a documented care plan detailing their wound/device care needs and is review by a health care professional
• monitoring for signs of infection, prompting healthcare professionals to assess any ongoing need for devices, and documenting this clearly in the person’s care plan
• communicating and educating the person and their relatives about infection risks, the importance of hand hygiene, and what signs and symptoms to report (such as redness, swelling, pain, fever, or discharge)
• provide clear instructions on what to do and who to contact if concerns arise.  Where appropriate, share this information with family carers and those involved in the person’s care

These steps help prevent infection and keep people accessing care and support safe. Further information can be found in NICE guidance for prevention and control in community care. 

Extra considerations for home care

In a person’s own home or in extra care housing it can be much harder to find a clean space. Keep equipment for care off anything visibly dirty and take in equipment such as sterile sheets that are often in dressing packs to cover any areas that are dirty, and place equipment on that instead. Clean kitchen roll can also be a good alternative if the area doesn’t need to be sterile.  

Urinary catheter care

If a person has a urinary catheter, they are at higher risk of infection because bacteria can enter where the catheter goes into the body.

The GP or district nurse should regularly review whether the catheter is still needed and remove it as soon as possible.

Always record the date of catheter insertion where known, the indication for catheterisation and the date of next review or change.

Preventing catheter-associated urinary tract infections (CAUTIs)

To prevent CAUTIs:

• encourage the person to drink enough fluids
• clean hands and put on disposable gloves before touching the catheter or drainage bag
• after handling the catheter, remove gloves and immediately clean hands again
• clean the catheter entry point daily with non-perfumed soap and water
• keep the catheter and drainage bag connected at all times (closed system) to reduce infection risk. Only disconnect when changing the catheter bag
• attach a night bag (if used) to the leg bag without breaking the closed system and ensure it is stored appropriately between uses in the person’s own room if they are not single use
• keep the drainage bag below bladder level, to allow urine to drain properly
• avoid letting the bag touch the floor; use a catheter bag stand
• empty the bag at regular intervals, such as when it is two-thirds full, or as advised by the healthcare professional and use a clean container to empty the bag
• avoid touching the drainage tap to the container
• dry the tap after emptying with a clean tissue or toilet paper to reduce contamination
• in a care home, use a sluice or toilet to dispose of urine
• in a home setting, use the toilet to dispose of urine
• clean the container used to empty the catheter bag after use and let it air dry until next needed
• ensure the catheter is well secured to reduce movement and prevent injury

More information on urinary catheter care and preventing infections is available in the NICE infection prevention and control guidance for urinary catheters and  Device Related Infection Prevention Practice (DRIPP) - Infection Prevention Society

Enteral feeding

Enteral feeding is used when a person cannot eat by mouth. Liquid feed is given through a tube that enters the body in one of three ways:

• naso-gastric (NG) – through the nose into the stomach
• percutaneous endoscopic gastrostomy (PEG) – directly into the stomach
• jejunostomy – directly into the small intestine

Preventing infection

To prevent infection:

• store feed exactly as the manufacturer instructs
• clean hands thoroughly before preparing feed or touching equipment
• handle equipment as little as possible
• clean and dry the tube entry site every day using the method recommended in the person’s care plan and or by a healthcare professional
• flush the tube with fresh water before and after feeding or giving medications to prevent blockages
• use clean equipment and ensure equipment is cleaned after each use
• if the person is immunosuppressed, use cooled freshly boiled water or sterile water from a freshly opened container (not tap, bottled, or table water)
• use minimal handling and aseptic technique when connecting the feed to the tube
• pre-packed feeds may be used for up to 24 hours if stated by the manufacturer
• always check the manufacturer instructions for feeds prepared on site, these should be used within 4 hours
• after each session, dispose of feed bags and administration sets according to local waste rules
• do not dispose of unused feed in sinks
• always follow the person’s care plan and risk assessment

Antimicrobial administration   

An antimicrobial is a medicine or substance that kills pathogens or stops them growing. These medicines are called antibiotics, antivirals, antifungals or antiparasitic medicines.

Correct administration ensures antimicrobials work properly and reduces the risk of antimicrobial resistance (AMR).

Gloves and aprons are not required for the administration of most antimicrobials unless there is a risk of blood or body fluid exposure. However, gloves should be worn when applying antimicrobial creams or ointments, when there is a risk of contact with body fluids, or when handling medicines that are identified as hazardous in the manufacturer’s instructions or local medicines policy. Face protection may be required for administering antimicrobials for people with respiratory infections and/or respiratory symptoms.

Under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and Regulation 12: Safe care and treatment - Care Quality Commission every antimicrobial administered should have a printed label showing:

• person’s name
• date of administration
• name and strength of antibiotic
• dose and frequency to be administered

Capsules should be swallowed whole. If a person has difficulty swallowing, contact the prescriber for an alternative formulation.

For liquid antimicrobials:

• shake the bottle well before use to ensure even concentration
• use a medicinal measuring spoon or oral syringe to measure the dose accurately. Do not use household spoons as they are less accurate
• medicinal oral syringes and spoons should be cleaned after each use using the same process used for normal cutlery

Give antimicrobials according to the dosing schedule:

• give antimicrobials at the prescribed times and in relation to food, if indicated
• if a dose is missed, give it as soon as possible unless it’s almost time for the next dose
• do not double dose to catch up
• ensure the full course is completed to prevent AMR
• record start and stop dates in the care plan
• seek medical advice if the person is not improving or symptoms worsen

Adverse effects

Mild side effects such as diarrhoea can occur. Contact the GP if symptoms are severe, persistent, or may indicate Clostridioides difficile infection (C. difficile )  

Suspected side effects can be reported through the Yellow Card Scheme.

Allergic reactions should also be reported immediately to the person’s GP, or NHS 111 if the GP is unavailable. If symptoms are severe (for example swelling of the face, lips, or difficulty breathing), call 999.

Expiry and storage

Please ensure the following measures are followed:

• check the expiry date before giving antimicrobials; return expired medicines to the pharmacy or using usual disposal processes
• store medicines away from heat, moisture, and sunlight. Follow local guidance for safe storage temperatures
• store antibiotic liquids in the refrigerator (+2°C to +8°C), where indicated
• monitor and record fridge temperatures daily in care homes; take action if temperatures are outside the safe range
• in someone’s own home, fridge temperature monitoring is not required
• reconstituted powders and leftover liquids deteriorate quickly so discard any partially used medicines by returning them to a pharmacy for disposal

Pathology specimens: collection, handling labelling, transport and result follow up

Providers should have a policy for specimen collection, handling, labelling, and transport.

Pathology specimens are clinical specimens, swabs or samples (solid or liquid) taken from a person to check for infection or other conditions, for example sputum, blood, urine or wound swab.

Specimens may be hazardous, so it is important that they are handled and transported safely to prevent spreading infection. If samples get contaminated, they can give incorrect results, leading to unnecessary antimicrobial prescribing and laboratory work. This can also cause delays in treatment.

It is important that specimens are only taken when there are clear signs of infection and when clinically indicated. Always check with a healthcare professional and do not test if there are no signs of infection, unless otherwise advised.

The following information will help care and support workers to carry out correct processes for collecting the sample, completing the microbiological forms and follow up.

Follow your provider’s local process. Only collect or transport samples if this is part of your role.

Before collecting a specimen:

• check with the local laboratory or GP for guidance on containers and transport requirements
• follow laboratory instructions carefully to avoid errors

When collecting the specimen:

• use a leakproof container that is approved by the laboratory receiving the sample. The laboratory can advise if it is not clear which container to use
• label the container clearly with
• person’s first and last name
• person’s date of birth
• the date of collection
• place the container inside a designated microbiology seal-able polythene bag
• put the request form in the side pocket of the polythene bag and not with the specimen itself
• do not use clips or staples as they can puncture the polythene bag

When completing the request form, include:

• the patient identifier (usually an NHS number, name and date of birth)
• the test required
• specimen site or type
• relevant clinical details, including medications- the more information the better
• date and time specimen was taken
• include relevant clinical details such as suspected infections or possible outbreaks where known

Incomplete forms, labels or specimen containers may cause the laboratory to reject the sample.

Where possible, samples should be sent to the laboratory on the day they are collected. If a delay is unavoidable, follow local laboratory advice on storage and transport requirements.

When handling or transporting the specimen:

• keep the outside of the container and bag clean and free from blood or body fluids
• use a UN3373 compliant container for transport by car or courier
• for postal samples, use an approved Post Office container with absorbent material, and send it first class

ASC setting should have a process in place to ensure specimens are always followed up and acted upon. When following up the specimen result:

• always note the expected date and time for result return and who will be reviewing them
• review test results promptly upon receipt and follow instructions for action
• communicate all results immediately to the person and/or their family

There is information available on packaging and transport requirements for patient samples including sending by post and general information about pathology testing.

Useful information about urinary tract infection: diagnostic tools can be found here