CareAcademy Blog

Preventing Infection: Maintaining A Clean and Healthy Environment

Our multi-part series about Maintaining a Clean and Healthy Environment discusses what infection control is and why it is important. This article addresses standard precautions to prevent influenza.

What is infection control and why is it important?

Germs such as bacteria, viruses and fungi are everywhere!  Some are actually helpful, like the ones living in our own bodies. There are many that are harmful and can cause serious disease or death.  Infections can be transmitted in three main ways :
  1. directly from person-to-person;
  2. indirectly through equipment and supplies, and
  3. through the air.
The goal of infection prevention and control is to prevent the transmission of infection, and to keep both the older adult and their caregivers safe.

A Caregiver’s Work Saves Lives

As a caregiver, you have an important role to play in preventing illness. Basic infection control procedures can literally save lives. Maintaining a clean and healthy environment is one way to do that. Healthy people with healthy immune systems can fight off germs. However, people that are old or unwell may be more likely to develop infections and diseases. Older adults have a three-fold increased risk for pneumonia and a 20-fold higher risk for urinary tract infection than younger people do.

Risks and Standard Procedures

Some common risk factors for infection in older adults include:
  • malnutrition from not eating healthily or not eating enough food
  • certain medicines that weaken the immune systems
  • weakened immunity because of illnesses
  • urinary catheters
  • feeding tubes
  • pressure ulcers
  • long-term limited mobility
There are a few standard methods you can use to reduce the spread of infectious diseases.  These include:
  • hand hygiene, such as washing your hands
  • covering your nose and mouth when coughing or sneezing
  • having good personal hygiene yourself
  • making sure you provide the older adult with good personal hygiene
  • using proper food preparation and storing food
  • keeping dishes and utensils clean

Standard Precautions Maintain a Healthy Environment

Infectious diseases spread through blood or other bodily fluids. Standard precautions are a set of rules designed to prevent the transmission of disease through blood and body fluid when providing care. These precautions are meant to protect you as the caregiver. They are based on the principle that all blood, body fluids, secretions, broken skin and mucus may contain infectious germs. Infectious diseases can spread through blood or other bodily fluids.  Common blood-borne diseases include Hepatitis B, Hepatitis C and HIV. Older people cared for at home are often colonized or infected with multi-drug resistant organisms, or MDROs. MDROs are bacteria and other germs that have developed resistance to antimicrobial drugs. One example of an MDRO is a type of Staph infection which is resistant to many antibiotics, called Methicillin-Resistant Staphylococcus Auresu (MRSA). Your hands and clothing can become contaminated by having contact with the older adult and their immediate environment. Unless the older adult has been diagnosed with an MDRO or bloodborne infection, they and you as the caregiver will not know. That is why it is important to use Standard Precautions to prevent the transmission of these infectious diseases.

Importance of Handwashing in a Healthy Environment

The good news is that getting these diseases is preventable. The most important way to prevent the transfer of germs is hand hygiene. Every person should be treated as though they have an infectious disease.  An eldercare giver looking to maintain a clean and healthy environment will use:
  1. Hand hygiene – demonstrating proper hand washing techniques
  2. Protective barriers – including gloves, gown, mask, eye protection, or face shield.
  3. Dispose of laundry and hazardous waste properly – use towels only once after contact, and wash linens routinely and when soiled.
  4. Proper handling of contaminated areas and devices – clean the client’s environment routinely and when soiled with body fluids.
If you are a professional caregiver, standard precautions for maintaining a healthy environment should be used for all the adults you work with. In some cases, you will need to use additional precautions, called “contact precautions.” Check with your agency about specific guidelines you need to use for specific older adults. If you are a family caregiver, ask your loved one’s healthcare provider when you should use a specific set of precautions, and tell any healthcare providers that provide care for your loved one if the older adult has an MDRO.

Tips to Prevent Infectious Diseases Spread Through the Air

Infectious diseases can also be spread through the air, such as a cough or sneeze.  These diseases include influenza and the common cold. When caring for an older adult with signs and symptoms of a respiratory infection (such as fever, cough and/or sneezing) and whose health care provider has allowed them to remain at home, you should remember the following tips:
  1. If possible, encourage the older adult to cover the mouth/nose with the elbow rather than the hand.
  2. Place surgical masks on the coughing person when tolerated and appropriate.
  3. Maintain hand hygiene after contact with respiratory secretions.
  4. If at all possible, avoid close contact (anything less than 3 feet) . This is probably not easy to do while working.  So, if the older adult cannot wear a mask for some reason, you should.
If you have a respiratory infection:
  1. try and avoid direct contact with the older adult if possible
  2. if this is not possible, wear a mask while providing care

Flu Vaccines Keep Adults Healthier

It is very important that both the older adult and you, the caregiver, receive your annual influenza vaccine, or “flu shot.” Influenza is a serious disease that can lead to hospitalization and sometimes even death. Every flu season is different, and influenza infection can affect people differently. Even healthy people can get very sick from the flu and spread it to others. Older adults and people with medical illness are at particularly high risk for developing flu-related complications.
During recent flu seasons, between 80% and 90% of flu related deaths have occurred in people 65 years and older.
“Flu season” in North America can begin as early as October and last as late as May. During this time, flu viruses are going around at higher levels in the U.S. population. An annual seasonal flu vaccine (either the flu shot or the nasal spray flu vaccine) is the best way to reduce the chances that you will get seasonal flu and spread it to others. When more people get vaccinated against the flu, less flu can spread through that community. When you as a caregiver get the flu shot, you can help prevent the care recipient from getting the flu. If you or the older adult you care for cannot get the flu shot for some reason, speak to your health care providers. You may need to wear a mask when providing care.  

Eldercare professionals can get certified in maintaining a clean & healthy environment for clients. Get yours!

Dr. Reddy is a specialist in Internal Medicine & Geriatric Medicine. She holds appointments at Harvard Medical School & Hebrew SeniorLife in Boston, MA. She has seen the struggles that families and caregivers go through when caring for adults. Through CareAcademy, she intends to improve people's lives. Dr. Reddy's research is published as journal articles and book chapters. She has also authored a book for family caregivers.

Madhuri ReddyPreventing Infection: Maintaining A Clean and Healthy Environment

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