Section A Environmental Health and Infection Prevention Control
- Nov 18, 2025
- 8 min read
In modern healthcare, environmental health and infection prevention and control (IPC) are not “nice to have” – they are the backbone of safe, effective clinical practice. This is true whether you’re working in a GP surgery, an acute hospital, or a challenging maritime or defence environment.
At Kraken Medical, we support clinicians to translate policy into practical action: from cleaning protocols and waste management to PPE decisions, outbreak recognition and antimicrobial stewardship.
Below is a structured overview of core competencies in Environmental Health and IPC (Section A), distilled from practice and aligned to real-world clinical work.
Index
The Foundations of Environmental Health & IPC
Decontamination and Cleanliness of Clinical Areas and Equipment
Safe Management of Clinical Waste and Sharps
Immediate Actions After Sharps or Splash Injuries
Selecting the Right Level of PPE
Surgical vs FFP3 Masks: Understanding the Difference
Decontaminating Biohazard Spillages
IPC Audits and Escalating Non-Compliance
Notifiable Diseases, Reporting and Safe Patient Transfers
Isolation Precautions: Standard, Contact, Droplet and Airborne
Recognising Infectious Disease Outbreaks and Coordinating the Response
Antibiotic Stewardship: Using Antimicrobials Responsibly
Key Practical Takeaways for Clinicians
1. The Foundations of Environmental Health & IPC
Environmental health and infection prevention are about more than checklists: they are a mindset. Every interaction, surface, instrument and clinical decision can either reduce or increase risk.
The themes that run through all of Section A are:
Reliable systems (cleaning, waste, audit, reporting)
Informed clinical judgement (risk assessment, PPE choice, antimicrobial use)
Clear communication (within the team, up the chain of command, between facilities)
The result is not just compliance, but safer patients, protected staff and resilient services.
2. Decontamination and Cleanliness of Clinical Areas and Equipment (A.1)
Maintaining a clean clinical environment is the first line of defence against infection.
Levels of decontamination
Clinicians must understand and apply three key levels:
Routine cleaning - Removal of visible dirt and organic material from surfaces and equipment using appropriate detergents and techniques.
Disinfection - Targeted reduction of pathogenic microorganisms on surfaces and equipment using approved disinfectants.
Sterilisation - Complete elimination of all forms of microbial life (bacteria, viruses, fungi and spores). Methods may include autoclaving, chemical sterilisation or gas sterilisation, used according to device type and material.
Clinical decision-making
Safe practice relies on assessing:
The risk associated with the procedure (e.g. invasive vs non-invasive)
The patient’s infection status (known, suspected, high-risk)
The type of equipment (single-use, reusable, critical, semi-critical, non-critical)
Sterilisation is prioritised where there is high risk of infection transmission; disinfection and routine cleaning are used in lower-risk contexts, always in line with local protocols and national guidance.
Skills gained:
Applying the correct level of decontamination for different scenarios
Judging risk and making defensible, protocol-based decisions
Embedding cleanliness as a non-negotiable patient safety habit
3. Safe Management of Clinical Waste and Sharps (A.2)
Clinical waste, particularly sharps, carries significant risk if mishandled. Robust waste management protects staff, patients and the wider environment.
Waste segregation, storage and transfer
Competent clinicians:
Segregate waste correctly at the point of generation (including sharps)
Use appropriate, clearly labelled containers
Store waste safely pending collection
Ensure transfer and disposal follow current policy and legislation
Documentation: waste log, consignment notes and pre-acceptance audits
Accountability is underpinned by good records:
Waste logs record type, quantity, dates and tracking details for waste generated and disposed of.
Consignment notes document the transfer of waste to authorised handlers.
Pre-acceptance waste audits assess whether waste meets disposal facility requirements and does not pose additional risks.
Sharps management
Key behaviours include:
Using puncture-proof, clearly labelled sharps containers
Disposing of sharps immediately after use, without recapping
Monitoring fill levels and replacing containers before they exceed the safe limit
Consistent use of appropriate PPE and safe handling techniques
Practical takeaway:
Good waste management is not merely administrative – it is a critical component of occupational health and environmental protection.
4. Immediate Actions After Sharps or Splash Injuries (A.3)
When sharps or splash incidents occur, the speed and quality of the response can significantly alter the outcome.
Immediate action drill
Clinicians should be drilled in:
Safely removing themselves from the source
Prompt wound care (e.g. encouraging bleeding, thorough washing with appropriate solution, covering with suitable dressings)
Immediate reporting through the correct chain (supervisor, occupational health, designated medical lead)
Risk assessment following exposure
Following exposure to blood or body fluids:
Assess the type of exposure (percutaneous, mucosal, non-intact skin, splash)
Consider the source risk (known infection status, likely pathogens, viral load if known)
Review the immunisation status of the exposed person
Decide on the need for post-exposure prophylaxis (PEP) and follow-up testing
Ensure accurate documentation and monitoring
Clinical reflection:
A competent clinician not only knows the algorithm but remains calm, systematic and supportive – especially when colleagues are the ones exposed.
5. Selecting the Right Level of PPE (A.4)
Choosing PPE is about matching protection to risk, in line with current policy (e.g. BR1991 Ch 13 and local equivalents).
Contact transmission
Low risk: routine care without significant exposure to body fluids → gloves and clean uniform/apron.
Medium risk: wound care or handling contaminated materials → gloves, fluid-resistant gown, eye protection as required.
High risk: heavy exposure to blood/body fluids or highly infectious conditions → full PPE (gloves, fluid-resistant gown, mask/respirator, eye/face protection).
Airborne transmission
When dealing with known or suspected airborne infections, use fit-tested respirators (e.g. FFP3-type), alongside hand hygiene and appropriate PPE.
Droplet transmission
For respiratory infections spread via droplets, use surgical masks, gloves and hand hygiene as a baseline, escalating to higher-level respiratory protection during high-risk or aerosol-generating procedures.
Skills gained:
Translating risk assessment into rational PPE choice
Avoiding both under- and over-protection, while adhering to local policy
6. Surgical vs FFP3 Masks: Understanding the Difference (A.5)
Not all masks are created equal. Understanding the difference is crucial for both personal safety and infection control.
Surgical masks
Designed mainly to protect others from the wearer’s respiratory droplets
Loosely fitting; limited seal around the face
Effective for large droplets and splashes but not designed to reliably filter fine airborne particles
FFP3 masks (filtering facepiece respirators)
Designed to provide high-level personal protection against airborne particles
High filtration efficiency, with a close-fitting seal
Used in high-risk environments where exposure to infectious aerosols or hazardous particulates is likely
Practical takeaway:
Use surgical masks for droplet protection and source control; reserve FFP3 (or equivalent) respirators for airborne risks and aerosol-generating procedures, in line with fit-testing and policy.
7. Decontaminating Biohazard Spillages (A.6)
Effective response to spills prevents incidents from escalating into outbreaks.
Tools and agents
Spill kits: Provide PPE, absorbent materials, waste bags and clear instructions for safe containment and cleanup.
Clinell pads and disinfectant wipes: Pre-impregnated with broad-spectrum agents for rapid disinfection of hard surfaces and non-invasive equipment.
Chlorine-releasing agents (e.g. hypochlorite solutions): Strong antimicrobial action, particularly effective against many bacteria and viruses, used at correct dilutions and contact times.
Best practice
Don appropriate PPE before approaching the spill
Contain and absorb before disinfecting
Apply the correct disinfectant with adequate contact time
Dispose of all materials as clinical waste, following local policy
Skills gained:
Systematic, safe management of biohazard spills
Confident use of disinfectants and spill kits according to protocol
8. IPC Audits and Escalating Non-Compliance (A.7)
Audit is not about blame; it is about assurance and improvement.
Conducting IPC audits
Using tools such as the Central Management and Audit Tool (CMaAT), clinicians:
Assess compliance with hand hygiene, PPE, cleaning, decontamination, waste management and other IPC policies
Use standardised checklists or digital tools for consistent data collection
Identify trends, gaps and training needs
Escalating and mitigating non-compliance (afloat and other settings)
When non-compliance is identified:
Immediate corrective action where possible (on-the-spot feedback, re-education, correcting minor process issues).
Report to supervisors or chain of command where issues are significant, recurrent or systemic.
Document findings and actions taken to support governance and learning.
Collaborate with senior staff and IPC leads to develop targeted interventions (training, policy review, resource changes).
Follow-up and re-audit to check that improvements are embedded.
Clinical reflection:
Effective clinicians see audit as part of professional practice, not as a tick-box exercise.
9. Notifiable Diseases, Reporting and Safe Patient Transfers (A.8)
Timely reporting and clear communication are central to public health protection.
Notifiable diseases and FMed85 (Defence context)
Clinicians in defence or similar structured systems must:
Know which diseases are legally notifiable
Recognise their clinical presentation and diagnostic criteria
Complete the appropriate reporting form (e.g. FMed85) accurately and promptly
Ensure key details are included (demographics, symptoms, lab results, relevant exposure or epidemiological information)
Report to designated public health leads (e.g. SO2 Public Health) as required
Communicating isolation requirements during transfers
When transferring patients between Medical Treatment Facilities (MTFs):
Clearly communicate the patient’s infectious status and required isolation precautions
Ensure documentation accompanies the patient (isolations orders, key lab results, relevant clinical notes)
Support the receiving team to implement isolation promptly on arrival
Practical takeaway:
Good reporting and handover protect not just one patient, but entire units, ships, wards or communities.
10. Isolation Precautions: Standard, Contact, Droplet and Airborne (A.9)
Isolation precautions are applied according to transmission risk.
Standard precautions
Used for all patients, regardless of diagnosis:
Hand hygiene
Appropriate PPE use
Safe injection practices
Safe handling of blood, body fluids, non-intact skin and mucous membranes
Contact precautions
For infections spread by direct or indirect contact:
Enhanced hand hygiene
Gloves (and gowns where indicated)
Meticulous environmental cleaning
Single-room isolation or cohorting where possible
Droplet precautions
For infections spread via respiratory droplets:
Surgical masks for close contact
Eye protection where splashes are likely
Respiratory hygiene and cough etiquette
Preferably single rooms or cohorting by pathogen
Airborne precautions
For pathogens transmitted via airborne particles:
Fit-tested respirators (e.g. FFP3-type)
Airborne isolation rooms or negative pressure areas where available
Strict control of room entry and PPE protocols
Skills gained:
Matching the level of isolation to the mode of transmission
Communicating rationale to patients and colleagues to improve adherence
11. Recognising Infectious Disease Outbreaks and Coordinating the Response (A.10)
Early recognition and decisive action are key to outbreak control.
Recognising an outbreak
Possible indicators:
A cluster of patients with similar symptoms
An unexpected rise in cases of a particular infection
Multiple linked cases confirmed by laboratory testing
Actions within clinical remit
Implement appropriate isolation and infection control measures immediately
Treat and support affected patients
Maintain accurate records of cases and clinical details
Communication and escalation
Notify Environmental Health, IPC teams and the wider command structure as appropriate
Share clear, factual updates, including suspected pathogen, case numbers and control measures in place
Follow established outbreak protocols and contribute to coordinated response efforts
Clinical reflection:
Recognising when “this is not normal” and escalating appropriately is a hallmark of a safe, mature clinician.
12. Antibiotic Stewardship: Using Antimicrobials Responsibly (A.11)
Antibiotic stewardship is now a core professional responsibility.
Rational antibiotic use
Clinicians should:
Base prescribing on accurate diagnosis and appropriate investigations
Choose agents that target likely pathogens, considering local resistance patterns and guidelines
Prescribe correct doses and durations, avoiding unnecessarily prolonged courses
Review therapy regularly and de-escalate or stop when appropriate
Governance, monitoring and education
Effective stewardship also involves:
Ongoing education on resistance and prudent prescribing
Collaboration with pharmacists, microbiologists and infectious disease specialists
Participation in surveillance and resistance monitoring
Explaining to patients why antibiotics are (or are not) needed and the importance of completing prescribed courses
Practical takeaway:
Every prescription is an opportunity either to preserve or to
undermine the future usefulness of antibiotics.
13. Key Practical Takeaways for Clinicians
Treat cleanliness and decontamination as core clinical skills, not housekeeping.
Manage clinical waste and sharps with the same care you give to medicines and devices.
Rehearse and internalise immediate action drills for sharps and splash injuries.
Match PPE and mask type to the specific transmission risk, not habit or convenience.
Use spill kits and disinfectants confidently and systematically when managing biohazards.
Engage positively with IPC audits; use them to drive improvement, not just compliance.
Report notifiable diseases accurately and on time, and never transfer a patient without communicating isolation needs.
Understand and apply isolation precautions tailored to standard, contact, droplet and airborne risks.
Be alert to early signs of outbreaks and escalate promptly through the correct channels.
Practise antimicrobial stewardship every day; your prescribing decisions have population-level consequences.
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