25 Infection Prevention and Safety in the Home 1. Discuss disinfection in the home REMEMBER: Infection control and safety guidelines were first covered.

25Infection Prevention and Safety in the Home

1. Discuss disinfection in the home

REMEMBER:Infection control and safety guidelines were first covered in chapters 5 and 6. This chapter contains information about these topics as they relate to home care.



This is a partial list of items in the home that are considered “dirty”: • The floor• Saliva and other discharges from mouth/nose; anything that comes into contact with these discharges

• Body wastes and anything that comes into contact with body wastes

• Drainage from wounds and items that come into contact with it

• Spoiled food and objects that come into contact with it



REMEMBER:Sterilization destroys all microorganisms, including pathogens, and disinfection kills some, but not all microorganisms.



Think about this question: • What other items or areas in the home would be considered dirty?

• What items or areas in the home might need to be disinfected?

Disinfecting using dry heat

Equipment: items to be disinfected, clean metal pan (cookie sheet, cake pan, etc.), timer or clock, oven, potholders

1. Wash your hands.

2. Place items in the pan.

3. Place sheet or cake pan in the oven.

4. Turn on oven to 350° F. Bake for one hour. Keep oven door closed while items are baking.

Disinfecting using dry heat (cont’d.)

5. Turn off heat. Allow items to cool.

6. After items have cooled, remove with the potholders.

7. Store the items.

8. Wash and dry the disinfecting equipment. Return to proper storage.

9. Wash your hands.

10.Document the procedure.

Disinfecting using wet heat

Equipment: items to be disinfected, clean pot with enough room to hold items, clean lid for pot, cold water, timer or clock, stove, potholders1. Wash your hands.

2. Place items in the pot and fill it with water. Make sure water covers all items, leaving enough room at the top for steam to escape.

3. Place lid on pot and place covered pot on burner on stove.

Disinfecting using wet heat (cont’d.)

4. Turn on heat and bring water to a boil. Do not open the lid at any time during boiling.

5. Boil for 20 minutes. You should see steam escaping from the sides of the pot.

6. Turn off heat. Allow items and water to cool.

7. After items have cooled, remove the cover with the potholders.

Disinfecting using wet heat (cont’d.)

8. Remove the items. Place on a rack or a clean towel to air dry.

9. Wash and dry the disinfecting equipment. Return to proper storage.

10.Wash your hands.

11.Document the procedure.

25Infection Prevention and Safety in the Home2. Describe guidelines for assisting a client when isolation precautions have been ordered

Remember these guidelines for isolation procedures in the home: • Use disposable dishes and utensils; discard in specially marked bags in covered garbage containers.

• Wear disposable gloves when handling soiled laundry and wash client’s laundry separately. Use hot water and detergent.

• Use bleach/water solution (1 part bleach/9 parts water) to clean up spills of blood or body fluids and to disinfect surfaces.

• Client should use separate bathroom if possible. If client shares the bathroom, disinfect it after each use by the client.


REMEMBER:Always reassure clients that it is the disease, and not the person, who is being isolated.


Remember this information about handling spills in the home: • Put on gloves before cleaning up a spill involving blood or body fluids.

• If blood/body fluids are spilled on a hard surface remove the spill first, then clean immediately with bleach/water solution (1:9). Be careful not to spill bleach or bleach solution on clothes, carpets, or bedding.

• If blood/body fluids are spilled on fabrics do not use bleach to clean the spill. If no bleach-free disinfectant is available, use soap and water, or regular carpet cleaner on a carpet.

25Infection Prevention and Safety in the Home3. List ways to adapt the home to principles of good body mechanics

REMEMBER:Chapters 6 and 10 contain more in-depth information about body mechanics.


Remember these strategies for applying the principles of good body mechanics in the home: • Have the right tools for the job.• Have footrests and pillows available.• Keep tools, supplies, and clutter off the floor.• Sit when you can.• Use gait or transfer belts when assisting clients with ambulation or transfers.


REMEMBER:It is essential that you immediately report any safety hazards in a client’s home to your supervisors.

25Infection Prevention and Safety in the Home4. Identify common types of accidents in the home and describe prevention guidelines

Falls

Causes: unsafe environment, loss of abilities; elderly clients are particularly at risk.

Prevention: • Clear walkways. • Avoid waxing floors, and use non-skid mats. • Clients should wear non-skid shoes with tied laces. • Clients should wear clothing that fits properly. • Keep frequently-used personal items close.


Falls

Prevention (cont’d.): • Clean up spills. • Mark hazardous areas. • Improve lighting. • Lock wheelchair wheels. • Return beds to lowest position after care. • Offer frequent trips to bathroom. • Leave furniture in same place.


Look at Figs. 25-1 and 25-2 on p. 421 in the textbook. What changes have been made to prevent falls?


Burns/Scalds

Causes: dry heat (iron, stoves, other electric appliances), wet heat (hot water or other liquids, steam), or chemicals (lye, acids); small children, older adults, and people with loss of sensation are particularly at risk.

Prevention: • Roll up sleeves. • Check that stove and appliances are off. • Suggest the hot water heater be set at 120-130°F.


Burns/Scalds

Prevention (cont’d.):• Check water temperature. • Be careful with space heaters. • Report frayed cords. • Let clients know if you are about to pour or set down hot liquid.

• Pour hot drinks away from clients and keep away from edges of tables.

• Make sure clients are sitting down before serving hot drinks.


Look at Figs. 25-3 and 25-4 on p. 422 in the textbook. What changes have been made to prevent burns and other injuries in the kitchen area?


Poisoning

Causes: ingesting harmful substances; clients with limited vision, confused clients, children, and those with diminished sense of taste or smell are at greatest risk.

Prevention: • Lock cabinets. • Post Poison Control Center number. • Check refrigerator for spoiled food.


Cuts

Cause: sharp objects; children and confused clients are at greatest risk.

Prevention: • Keep sharp objects away from children. • Lock sharp objects away. • Cut away from body while preparing food. • Know first aid for cuts (see Chapter 7).


Choking

Cause: babies putting objects into mouth, unconsciousness, weakened clients

Prevention: • Keep small objects out of reach. • Cut food. • Position infants on their backs for sleeping. • Ensure that clients eat sitting up. • Provide thickened liquids if ordered.


For each of the following transparencies, think about these questions:

• What kind of hazards can you see in this picture (fall, burns, etc.)?

• What would you do to make this room safer?

25 Infection Prevention and Safety in the Home

Transparency 25-1: Hazards





25Infection Prevention and Safety in the Home5. List home fire hazards and describe fire safety guidelines

Remember these guidelines for reducing fire hazards in the home: • Never work wearing loose or flowing clothing, especially around the stove.

• Store potholders, dish towels, and other flammable kitchen items away from the stove.

• Don’t store items attractive to children above or near the stove.

• Discourage careless smoking and smoking in bed.

25Infection Prevention and Safety in the Home5. List home fire hazards and describe fire safety guidelines

Guidelines for reducing fire hazards in the home (cont’d.): • Stay in or near the kitchen when cooking/baking.• Do not leave the clothes dryer on when you leave the house. Lint can catch fire.

• Turn off space heaters when no one is home or everyone is asleep.

• Be sure that smoke alarms work. Check monthly and replace batteries when needed.

• Have fire extinguishers on hand. Keep one in the kitchen but not near the stove.

25Infection Prevention and Safety in the Home6. Identify ways to reduce the risk of automobile accidents

Keep these tips in mind to stay safe on the way to and from clients’ homes: • Plan your route.• Minimize distractions.• Use turn signals.• Use caution when backing up.• Drive at a safe speed.• Always wear your seat belt.


7. Identify guidelines for using your car on the job

Remember these points when using a car on the job: • Park in safe, well-lit areas.• Lock doors when driving and when you leave your car.• Do not leave valuables in car.• Have valid insurance and carry the card with you.• Keep proof of registration with you, not in the car.• Keep track of the miles you drive for work. Lying about mileage is the same as stealing.

• Keep your car in good working order. Get it serviced at appropriate times.

• Make sure you have good tires. Keep the gas tank full.


8. Identify guidelines for working in high-crime areas

REMEMBER:An assignment may take you to an area where crime is a problem. HHAs who use public transportation should remain alert at all times.



These tips can help you avoid trouble in high-crime areas: • Park in well-lit areas as close as possible to client’s home.

• Try to leave valuables at home.• If possible, do not carry purse with you. If you must take it, hold close to body.

• Lock car and do not leave valuables in it.• Walk confidently.• Try to avoid unsafe areas after dark.



Tips to avoid trouble in high-crime areas (cont’d.): • Leave area immediately and report to supervisor if you are concerned about your safety.

• Do not approach a home where strangers are hanging around. Call your supervisor.

• Call your client before your visit so they know when to expect you.

• Never enter a vacant home.• If necessary ask your supervisor to arrange for an escort or another care provider to go with you.

• Be sure someone knows your schedule. Call the office at the end of the work day.


Chapter Exam1. Which of the following items in the home is considered “dirty?”(A) The floor(B) Boiling water(C) New gloves(D) Soap

2. What is the proper ratio of bleach to water in a disinfecting solution?(A) 2 parts bleach to 5 parts water(B) 1 part water to 9 parts bleach(C) 1 part bleach to 9 parts water(D) 1 part bleach to 1 part water


Chapter Exam (cont’d.)3. What should be done with eating utensils used by a client when employing isolation procedures in a home?(A) They should be cleaned by being placed in the microwave for

45 seconds.(B) They should be thrown away in specially marked bags or washed

thoroughly in very hot water with detergent and bleach. (C) They should be thrown away in specially marked bags or soaked

overnight in undiluted bleach.(D) They should be soaked in vinegar and then washed in soapy

water.

4. What is one way to make any position safer and more comfortable?(A) The HHA should keep her legs crossed. (B) The HHA should stand while doing most jobs. (C) The HHA should keep her back bent or in a curve. (D) The HHA should use pillows to keep the body in alignment.


Chapter Exam (cont’d.)5. Which of the following statements is true of preventing falls? (A) Walkways should be cleared of clutter. (B) Keep lights low in the house. (C) Older people are not usually injured in a fall. (D) Use wax on floors to keep them easy to walk on.

6. Which of the following statements is true of preventing burns or scalds? (A) Put space heaters close to beds and chairs. (B) Keep hot drinks away from the edges of tables. (C) Wear loose clothing when working at the stove. (D) Clients should be standing up when being served a hot

drink.


Chapter Exam (cont’d.)7. Toddlers should not be given(A) Bottles(B) Foods cut into bite-size pieces(C) Popcorn(D) Pureed food

8. Which of the following poses a fire hazard?(A) Any space heater, regardless of where or how it is used(B) Computers and other electronics plugged into a power

strip(C) Vented heaters(D) Pain thinner stored next to a hot water heater


Chapter Exam (cont’d.)9. How often should smoke alarms be checked to ensure they are in working condition?(A) Weekly(B) Monthly(C) Quarterly (every three months)(D) Daily

10. If you must leave something in your car when using your car for work, which of the following is the best place to leave it?(A) On the driver’s seat(B) In the trunk(C) On the passenger’s seat(D) On the floor of the backseat


Chapter Exam (cont’d.)11. How can you reduce the risk of an automobile accident when driving to a client’s home?(A) Stay on your cell phone with the client as you drive so

he can give you directions.(B) Plan your route in advance.(C) Keep your map in one hand as you drive so you can refer

to it frequently.(D) Drive a bit faster than usual so you can shorten the

trip.

12. Where should a child not sit when riding in a car?(A) In the front seat of a car with dual airbags(B) In the middle of the backseat(C) Directly behind the driver’s seat(D) Directly behind the passenger seat


Chapter Exam (cont’d.)13. Where should you keep your car insurance card?(A) In the glove compartment of your car(B) In the console of your car, under the radio(C) Under the driver’s seat(D) In your wallet or purse

14. What should you do if you reach a client’s home and find nobody is there?(A) Let yourself in and start housekeeping tasks.(B) Call your supervisor and do not enter the home.(C) Let yourself in but don’t do any work until the client

arrives.(D) Let yourself in and start cooking lunch or dinner.


Chapter Exam (cont’d.)

15. Which of the following is a tip to avoid trouble when working in a high-crime area?(A) If strangers are hanging around a client’s home, move

past them quickly.(B) Refuse all assignments to areas you consider unsafe.(C) Be sure someone knows your schedule and call the office

at the end of your work day.(D) Carry a map and walk slowly so you are sure not to miss

the client’s house.

25 Infection Prevention and Safety in the Home 1. Discuss disinfection in the home REMEMBER: Infection control and safety guidelines were first covered.

Documents

place items

home think

home care

partial list of items

dry heat equipment

infection prevention

disinfecting equipment

clean pot