Concordia Home Care and Nursing Services LLC Concordia Health Mobile Lab
Infection Control: Guidelines for Standard and Additional Precautions
Participants will be able to:
• Identify that each agency has an infection control program
• Understand the four disease transmission categories
• Understand standard precautions and how and when they should be used
• Understand additional precautions and how and when they should be used
• Be able to apply this understanding at work
There are four ways diseases are passed around.
Airborne germs can travel long distances through the air and are breathed in by people. Examples of diseases caused by airborne germs are tuberculosis, chickenpox, influenza, and certain types of pneumonia.
The blood of an infected person comes in contact with the bloodstream of another person, allowing germs from the infected person into the other person’s bloodstream. Blood and bloodborne germs are sometimes present in other body fluids, such as urine, feces, saliva, and vomit. Examples of diseases caused by bloodborne germs are HIV/AIDS and viral hepatitis.
Touching certain germs can cause the spread of disease. Sometimes you touch an infected person, having direct contact with the germ. Sometimes you touch an object that has been handled by an infected person, having indirect contact with the infection. Examples of diseases caused by contact germs are pink eye, scabies, wound infections, and methicillin-resistant Staphylococcus aureus (MRSA).
Some germs can travel only short distances through the air, usually not more than three feet. Sneezing, coughing, and talking can spread these germs. Examples of diseases caused by droplet germs are flu and pneumonia.
You should wash your hands with soap and warm water, especially if visibly soiled, or with an alcohol-based hand rub if not visibly soiled.
Guidelines on hand washing:
• Wash your hands upon entering the home and/or prior to reaching into your nursing bag.
• Wash your hands after touching blood, body fluids, or objects contaminated by blood or body fluids. Do this even if you were wearing gloves.
• Wash your hands after removing gloves.
• Wash your hands between each patient’s care.
Guidelines on wearing gloves:
• Wear gloves whenever you touch or potentially could come in contact with blood, body fluids, or contaminated objects.
• Wear gloves before touching a patient’s broken skin or mucous membranes (mouth, nose). Put on clean gloves if you already have a pair on.
• Change gloves between tasks. Dirty gloves spread germs, just like dirty hands!
• Remove gloves immediately after use and discard them before touching noncontaminated items or other surfaces.
• Always wash hands after removing gloves.
Guidelines on wearing personal protective equipment:
• Wear a gown, mask, and goggles If there is a potential for you to get splashed with blood or body fluids.
• Use a waterproof gown if you might get heavily splashed.
• Personal eyeglasses and contact lenses are not considered adequate eye protection.
• Remove protective clothing as soon as you can and wash your hands afterward.
• Dispose of protective equipment per agency policy. Gowns should not be worn for more than one patient.
As a last precaution, keep everything clean and clean up spills as soon as possible.
Standard Precautions for Handling Objects
• Clean any equipment that has been used by one patient before giving it to another patient. You should wear gloves when cleaning contaminated equipment. Follow your agency’s cleaning procedures.
• Use disposable equipment only once.
• Dirty linens should be rolled, not shaken, and should be held away from your body. Linens soiled with body fluids can be washed with another laundry, using your agency’s procedures.
• No special precautions are needed for dishes or silverware. Normal dish soap and hot water (water temperature must be hot enough to meet state requirements) will kill germs.
• Change cleaning rags and sponges frequently.
• Stethoscopes, blood pressure cuffs, and thermometers should be cleaned between each use, using your agency’s procedures.
• Dispose of dangerous waste, such as needles, very carefully. Needles and other sharp devices should go into clearly marked puncture-proof containers, not the regular trash container! Do not recap used needles—put them in the puncture-proof container without the cap on.
• Trash that is contaminated with germs, such as wound dressings, should be disposed of according to your agency’s procedures.
• Any container marked “biohazard” is only for discarding contaminated waste; don’t remove anything from it! If you must handle anything in the container, always use gloves. Don’t put your hand in anything that contains needles or other sharp objects.
• Check your gloves and other protective clothing frequently. If you see tears or holes, remove the gloves, wash your hands, and apply clean gloves.
Use additional precautions in addition to standard precautions when a patient has an illness requiring extra infection control measures. If you know that a patient has a disease that is spread in one of the following ways, use these extra precautions:
• The patient should have a private room, possibly one with a special air filter.
• Keep the patient’s room door closed.
• Wear a mask. If the patient has or might have TB, wear a special respiratory mask (ask your supervisor). A regular mask will not protect you.
• Remind the patient to cover the nose and mouth with a tissue when coughing or sneezing.
• Dispose of the tissue in the nearest waste receptacle and wash your hands immediately. Ask the patient to wear a mask if he or she wants or needs to be around others.
• If the patient is cognitively impaired, is unable to follow standard precautions, or has open draining wounds, then the patient should be encouraged to stay in one room (the door may stay open). Encourage at least daily cleaning of the patient’s room and disinfect frequently touched surfaces and equipment.
• Gloves should be worn prior to entering the room.
• Change gloves after touching a contaminated object (bed linens, clothes, wound dressings).
• Remove gloves right before leaving the room. Don’t touch anything else until you wash your hands. Wash your hands ASAP!
• Wear a gown in the room if the patient has drainage, has diarrhea, or is incontinent. Remove the gown right before leaving the room.
• Limit the amount of nondisposable equipment bought into the home.
• Utilize disposable equipment or patient-dedicated equipment if at all possible.
• If equipment cannot remain in the home, then clean and disinfect items per agency policy.
• Patients that are cognitively impaired or noncompliant with covering their mouth when sneezing or coughing should be maintained in one room, but the door may stay open.
• Wear a mask when working close to the patient (within three feet) and follow standard precautions.
• Instruct the patient on using a tissue when coughing and disposing of it in a waste receptacle immediately.
• Ask the patient to wear a mask if he or she wants or needs to be around others.