Home Care Aide Training Guide

HomeCareAide

TrainingGuide

InfectionControlandStandardPrecautions

Pre-ServiceTrainingCourse#1

HomeCareAideOrientation

TrainingManual:InfectionControl&StandardPrecautions Page2

TrainingManual:InfectionControl&StandardPrecautions Page3

TableofContentsCourseObjectives.........................................................................................................................................4

InfectionControl..........................................................................................................................................4

Germs...........................................................................................................................................................5

Infections......................................................................................................................................................6

HowCanYouHelpBreakTheChainOfInfection?...................................................................................8

StandardPrecautions...................................................................................................................................9

Compliance...................................................................................................................................................9

Handwashing..............................................................................................................................................10

HandwashingHowTo.............................................................................................................................11

ACTIVITY: PracticeProperHandwashing........................................................................................11

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CourseObjectives

Bytheendofthiscourseyouwillbeableto:

• Defineagerm

• Definetheenvironmentagermneedstoliveandgrow

• Explainthechainofinfection

• Explaintheimportanceofhandwashingininfectioncontrol

• Demonstrateproperhandwashingwithinandatappropriatetimes

• Defineinfectioncontrol

• Definestandardanduniversalprecautions

InfectionControl

Infectionsareamajorsafetyandhealthhazardtoboththecaregiverandtheirclient.Someinfectionsareminorandcauseshortillnesses.Othersareseriousandcancausedeath.Infectionscanbeespeciallyseriousforvulnerableinfantsandolderpersons.Caregiversandmedicalprofessionalshaveanimportantroleinprotectingpatients,residents,visitorsandthemselvesfrominfection.

Germsaresmall(micro)plantsoranimals(organisms)thatcanbeseenonlywithamicroscope.Germsareeverywhere:intheair,food,soil,andwater;andinthemouth,nose,respiratorytract,stomach,intestines,andskinofhumansandanimals.

Somegermscauseinfectionsandareharmful.Thesearecalledpathogens.Nonpathogensaregermsthatusuallydonotcauseaninfection.

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Therearethreetypesofgerms:

Bacteria–microscopic,onecell,plantlifethatmultiplyrapidly.Bacteriacancauseinfectioninanybodysystem.

Fungi–plantsthatliveonotherplantsoranimals.Mushrooms,yeastsandmoldsarecommonfungi.Inhumans,fungicaninfectthemouth,vagina,skin,feetandotherbodyareas.

Viruses–verysmallmicroscopicorganismsthatgrowinlivingcells.Theycausemanydiseasesincludingthecommoncold,herpes,diarrhea,acquiredimmunodeficiencysyndrome(AIDS)andhepatitis.

Germs

Germsrequireanenvironment(host)toliveandgrow.People,plants,animals,soil,foodandwaterarecommonplaceswheregermsgrow.Germsmustgetwater,oxygenandnourishmentfromtheirhost.Awarm,darkenvironmentisalsoneeded.

Mostgermsgrowbestatbodytemperatureandaredestroyedbyhighheatandultravioletlight.

Germsarefoundinmostorgansinthedifferenthumanbodysystems,i.e.,thelungs,theintestinesandontheskin.Thesegermsarecallednonpathogens(normalflora)whencontainedwithintheirownbodysystems.Whenanonpathogenistransmittedfromonesystemtoanotheritbecomesapathogen.

Forexample,Escherichiacoli(E.coli)isnormallyfoundinthelargeintestine.Feces(bowelmovements)containE.coli.Afterbowelmovements,alwayswipingfromfronttobackwillpreventE.colifromenteringtheurinarysystemandcausinganinfection.Whenwedon’twashourhandsaftergoingtothebathroom,orifthehandwashingispoor,theE.colicanalsospreadtoanythingthosehandstouch,i.e.,doorhandles,food,etc.Thisisoneexampleofhowinfectionscanbespreadtootherpeople.

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Infections

Aninfectionisadiseasestateresultingfromtheinvasionandgrowthofgermsinthebody.Alocalinfectionisinabodypart.Asystemicinfectioninvolvesthewholebody.

Pathogensdonotalwayscauseinfection.Thedevelopmentofaninfectiondependsonthefollowingconditionsbeingpresent:

- germ(source) -methodoftransmission- growth-producingenvironment -entrypoint- exitpoint -asusceptiblehost

Thesourceisagerm.Thegermmusthaveanenvironmentwhereitcangrowandmultiply.Humansandanimalsarecommonenvironmentsforgerms.

Althoughtheymaynothaveanysignsorsymptomsofinfection,humansandanimalsmaybecarriersandcanpassgermstoothers.Wherethegermleavesthehostenvironmentiscalledtheexitpoint.

Exitpointsincludetherespiratory,gastrointestinal,urinary,andreproductivetracts;breaksintheskin,theblood,andbodyfluids.

GERM

ENVIRONMENT

EXIT POINT

TRANSMISSION

ENTRY POINT

SUSCEPTIBLEHOST

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Whenagermleavesthehost,itmustbetransmittedtoanotherhost.Methodsoftransmissioncanbe,butarenotlimitedto:

• throughcontaminatedfood,wateranimals,personalcareitemsordirectcontact

• bydirectcontactwithbloodandbodyfluids,wounddressingsinsectbites“droplets”intheairfromcoughingorsneezing.

Thegermmustenterthebodythroughanentrypoint.Pointsofentryandexitarethesame.Asusceptiblehost(apersonatriskforinfection)isneededforgermstogrowandmultiply.

Thehumanbodycanprotectitselffrominfection.Aperson’sabilitytoresistinfectionisaffectedbytheirage,nutritionalstatus,stress,fatigue,generalhealth,medicationsandthepresenceofdiseaseorinjury.Vaccinationsalsohelptoprotectthebodyfromcertaininfections.

Remember,aninfectionisadiseasestateresultingfromtheinvasionandgrowthofgermsinthebody.Whenaninfectionoccursthebodytakesstepstofightitoff.

Someofthesignsandsymptomsofinfectionare:

• Fever

• Fastbreathingorfastheartbeat

• Painortenderness(canbespecifictotheinfectedareaorgeneralizedforsystemicinfections)

• Lossofenergy

• Lossofappetite

• Nausea

• Vomiting

• Diarrhea

• Rash

• Soresonmucusmembranes

• Rednessandswellingofabodypart

• Dischargeordrainagefromtheinfectedarea

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Peopleareindividualintheirresponsestoinfection.Notallpeoplewillexperienceallofthesesymptomsandsomewillexperiencetheseinvaryingdegrees.Careprovidersneedtoknowtheirclient’sbaselinehealthstatusandbeabletorecognizeanyofthesesignsandsymptoms.

HowCanYouHelpBreakTheChainOfInfection?Youcanpreventthespreadofgermsbyadoptingthefollowingpractices:

1) Washyourhandsafterurinatingorhavingabowelmovement.Alsowashyourhandsafterchangingfemalesanitaryproducts,children’sdiapersoradultincontinencepads.

2) Washyourhandsaftercontactwithyourownoranotherperson’sblood,bodyfluids,secretionsorexcretions.Theseincludesaliva,vomitus,urine,feces,vaginaldischarge,mucus,semen,wounddrainage,pusandrespiratorysecretions.

3) Provideallpersonswiththeirowntoothbrush,drinkingglass,towels,washclothsandotherpersonalcareitems.

4) Coveryournoseandmouthwhencoughing,sneezingorblowingyournose.

5) Bathe,washhairandbrushyourteethregularly.

6) Washyourhandsbeforeandafterhandling,preparingoreatingfood.

7) Washfruitsandrawvegetablebeforeeatingorservingthem.

8) Washcookingandeatingutensilswithsoapandwaterafteruse.Don’tforgetcuttingboards,countersandanythingtouchedbyrawmeat.

9) Usinggloveswhenhandlingobviouslysoiledmaterialandthenperforminggoodhandwashingwhenfinished.

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StandardPrecautions

TheCentersforDiseaseControlandPrevention(CDC)haveupdatedtheirguidelinesforprotectinghealthcareworkersfromexposuretoinfectiousdiseases.

Theguidelinesincludetwotiersofprecautions.

Thefirstandmostimportanttiercontainsthoseprecautionsdesignedtodecreasetheriskoftransmissionofdiseasetothehealthcareworkerthroughbodyfluids.Thistieriscalled“StandardPrecautions.”Standardprecautionsareusedwhencaringforanyperson,regardlessoftheperson’sdiagnosisandwhetherthepersonisknowntohaveaninfectiousdisease.

“StandardPrecautions”applytosituationswhencaregiversareincontactwith:

1) Blood

2) Allbodyfluids–secretionsandexcretions–except

sweat.

3) Brokenskin(opensores,cuts,etc.)

4) Mucusmembranes

Compliance

Tocomplywiththesestandardprecautionsthe

followingpracticeisexpected.

Gloves—Mustbewornwhencontactwithblood,allbodyfluids,secretionsandregardlessofwhethertheycontainvisibleblood,brokenskin,andmucousmembranes.

Gownsoraprons—Mustbewornduringproceduresorsituationswhenyouanticipatesubstantialsoiling,exposuretobodyfluidsblood,drainingwounds,ormucusmembranes.,

Maskandprotectiveeyewear—Mustbewornduringproceduresthatarelikelytogeneratedropletsofbodyfluidsorbloodorwhenthepersoniscoughingexcessively.They

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mustbewornwhenyouaregoingtobewithinthreefeetofexposuretotheanticipateddroplets.

Handwashing—Handsmustbewashedbeforeglovingandafterglovesareremoved.Handsandotherskinsurfacesmustbewashedimmediatelyandthoroughlyifcontaminatedwithbodyfluidsorbloodandafterallclientcareactivities.Caregiverswhohaveopencuts,soresontheirhandsmustwearglovesforallclientcontactorberemovedfromclientcontactuntilthehandsarehealed.Alcoholhandrinsesmaybeusedif:

1) thehandsarenotvisiblysoiled

2) asinkisnotreadilyavailable

Multiple-useclientcareequipment—Whenusingequipmentoritemsthataresharedbymorethanoneclientitmustbeadequatelycleanedanddisinfectedafteruseorwheneveritbecomessoiledwithbloodorotherbodyfluids.Youmaywipethepersonalcareitemswithanydisinfectant,includingalcohol.

Healthcareprofessional,includingcaregivers,areatanincreasedriskoftransmittingandhostinginfections.Howevertheseriskscanbegreatlyminimizedoreveneliminatedbyunderstandingsimpleinfectioncontrolconcepts.

Itisyourresponsibilitytodoallyoucantopreventinfectionsinyourclientsandyourself.

Handwashing

Handwashingwithsoapandwateristheeasiestandmostimportantwaytopreventthespreadofinfection.Youuseyourhandsinalmosteverytask.Theyareeasilycontaminated.Withouthandwashing,germsonthehandsspreadtootherpersonsoritems.

Washyourhandsbeforeandaftergivingcare!!

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HandwashingHowTo1) Makesureyouhavesoap,papertowels,orangestickornailfileandawastebasket.

Arrangetohaveallitemseasilyavailable.

2) Pushyourwatchorsleevesfourtofiveinchesupthearms.

3) Standawayfromthesinksoyourclothesdon’ttouchthesink.

Standsothesoapandfaucetareeasytoreach.

4) Turnonthefaucet.Adjustthewateruntilitfeelswarmandcomfortable.

5) Wetyourwristsandhandsthoroughlyunderrunningwater.

Keepyourhandslowerthanyourelbowswhilewashing.

6) Applyaboutateaspoonofsoaptoyourhands.

7) Rubyourpalmstogetherandinterlaceyourfingerstoworkupagoodlather.

Thisstepshouldlast15-20seconds.

8) Washeachhandandwristthoroughly.Cleanwellbetweenthefingers.

Cleanunderthefingernailsbyrubbingthetipsofyourfingersagainstyourpalms.

9) Useanailfileororangesticktocleanunderthefingernailsifnecessary.

10) Rinseyourwristandhandswell.Watershouldflowfromthearmstothehands.

11) Repeatstepssixthroughtenifneeded.

12) Dryyourwristsandhandswithpapertowels.Patdrystartingatyourfingertips.

13) Discardthepapertowels.

14) Turnofffaucetswithcleanpapertowelstoavoidcontaminatingyourhands.

15) Discardpapertowels.

ACTIVITY: PracticeProperHandwashing