This is part in our series on professional infection control in eldercare. In today’s blog, we discuss decontamination prevention and procedures, including barrier precautions, the appropriate disposal of contaminated materials and equipment, and preparing soiled linens for laundry.
The need for protective gloves, gowns, and masks.
Often throughout your day, you will need to use personal protective equipment such as protective gloves, gowns, and masks to assist you with infection control & prevention. Wearing glovesGloves allow you to create a barrier between you and the germs. So, let’s discuss tips for wearing gloves. First, you should wear single, disposable gloves when:
touching blood or body fluids
you or the the care recipient has broken areas of skin
you are assisting with personal care, such as cleaning stool or urine
you are handling soiled clothing or linens
the older adult has an indwelling device that you are helping to care for, such as a tracheostomy, central line, or indwelling urinary catheter
the older adult’s hands, clothes and home environment are not generally clean
cleaning the bathroom
Remove gloves prior to touching non-contaminated objects. Remove gloves promptly after use and wash hands thoroughly. Do not reuse or wash gloves for any reason! Before putting on gloves, wash your hands, then make sure the gloves do not have any tears or holes.Taking off gloves tips for easy infection control
Use gloved [right] hand to hold the [left] glove, near the wrist. Do not touch bare skin.
Peel the left glove off from the wrist. It should now be inside out.
Balled up the left glove in their right hand. Left it inside out
Put two fingers of their left hand inside the right glove. Did not touch the outside of the glove with their bare hand.
Peeled the right glove off from the wrist. It should now be inside out, over the left glove.
Threw away the gloves in the proper place.
Appropriate disposal of contaminated materials and equipment Syringes or needles are called “sharps” and need to be disposed properly:
Do not touch sharps with your bare hands. Use gloves and if possible, use a tool to pick them up
Sharps containers can be purchased from a pharmacy or healthcare provider and should be used to dispose of sharps
Fill the sharps container to approximately ¾ full, use heavy duty tape to secure the lid, and throw away with regular trash
Keep out of reach of children and pets
Always wash your hands after handling any medical sharps
Handling other wastes
Body wastes such as urine need to be flushed down the toilet
Soiled incontinence pads or disposable gloves need to be placed in plastic bags, tied and taken out to trash Immediately so that they do not create odors or grow bacteria in the home
Mop water needs to be flushed down the toilet or thrown outside – never put it down the kitchen sink
Properly Caring For and Decontaminating Equipment
Make sure that you don’t reuse equipment that is only meant for single-use, and ensure you dispose of it as per the directions. Properly clean reusable equipment. Clean and disinfect surfaces that are likely to be contaminated with microorganisms, including those that are close to the older adult (e.g., bed rails, overbed tables) and frequently-touched surfaces (e.g., door knobs, surfaces in and around toilets) frequently.
Cleaning the Environment
Mop up any spills with paper towels or other absorbent material
You can use either a bleach solution (1 part household bleach and 10 parts water) or an Environmental Protection Agency approved disinfectant (eg. accelerated hydrogen peroxide) and wash the area well. If you are a professional caregiver, you agency may have specific guidelines about what to use.
The amount of time needed for the bleach to work is the amount of time it takes the surface to air dry after you have washed it with the bleach solution
Bleach solution needs to be put into a spray bottle, labeled, and a fresh supply made every 24 hours
Dispose of gloves, soiled towels and other waste in sealed double plastic bag
Preparing soiled linens for laundry
If you have linens that are soiled with body fluids, such as feces, urine, vomit, you should take the following steps to ensure infection control:
put on gloves before handling soiled linens and carry at arms’ length (not against your clothing)
put linens in a plastic bag, NOT on the floor, and take them to the bathroom
rinse the large solids out in the toilet and place the soiled linens back in the plastic bag
launder immediately, using bleach if linens are white. If the sheets are colored, make sure they are dried completely in the dryer (the heat is as effective as bleach in killing the bacteria). Hanging clothes out on a clothesline will also kill the bacteria.
To become certified in professional sanitation and environmental infection control in eldercare,
check out the CareAcademy class!
Madhuri ReddyTop Infection Control Tips for Eldercare
Handwashing Tips to Help You Prevent Infection from Spreading
This is part of a series about maintaining a clean and healthy environment in eldercare (but it’s great advice for anybody!) In today’s article, we will discuss infectious diseases spread by skin, and how you can use handwashing as an effective infection control procedure.
Infectious diseases spread by skin
Some germs live on the skin. These include head lice and scabies. What are they? Well, head lice are parasitic insects that live on a person’s scalp and hide in their hair. Scabies is a contagious skin disease caused by a type of small bug called an itch mite. People in group settings such as nursing homes are very likely to get these diseases, especially scabies. So in order to keep scabies from spreading, oftentimes all affected family members need to be treated at once, even if they’re not feeling itchy at the time. Their symptoms could appear much later if not treated, and they could also spread the disease to someone else!
Tips to Prevent Infection
Here are some additional tips you can use to prevent infection in the event that you come in contact with an infectious disease:
Keep yourself healthy
Keep up to date on Immunizations
Cover your mouth when coughing or sneezing
Stay home and rest when you are too ill to give someone else care. That is very important since illness can affect your ability to do your job on top of being very likely to spread disease
Infection Control Procedures
Hand hygiene (which includes handwashing and cleaning hands with antiseptic cleansers) plays a critical role in the spread of infectious diseases, even in an older adult’s own home.In fact, the most common way that infections are spread are by our hands!The reasons that most people claim that they don’t wash their hands regularly include:
causes dryness and irritation
sinks are not located in an easy space to get to
lack of soap or towels
simply too busy, or not not enough time
needs of the older adult are much more of a priority
belief that there is a low risk of catching an infection from the older adult
You should know that these are NOT good excuses! Most germs are very easy to pass on. By avoiding proper infection control, you are risking the safety of the older adult.
Proper Handwashing Technique
What should you use to clean your hands?
When hands are visibly dirty, contaminated or soiled, wash with soap and warm water. Either plain soap or antimicrobial soap work well.
If hands are not visibly soiled, use an alcohol based handrub for routinely decontaminating hands. Application is key – LET IT DRY! There is a “kill time” that refers to disinfectants – this is the time needed for the product to make contact with the surface being cleaned and remain wet. It is dependent on the microorganisms and also the manufacturer. Often handrubs may cause dry skin – it’s helpful to have moisturizer available, especially in the winter.
When should you wash your hands?
Before and after contact with the older adult’s skin, particularly if there are broken areas of skin
After contact with body fluids or excretions, wounds or wound dressings (whether or not gloves are worn)
After assisting the older adult with toileting or changing incontinence products
After you go to the restroom
Before preparing food
After wiping nose, sneezing or touching your face
When hands are visibly soiled
It may be necessary to perform hand hygiene between tasks and procedures on the same older adult to prevent cross-contamination of different body sites.
How do you properly clean your hands?
To correctly use a hand rub, you should:
apply it to the palm of one hand, rub hands together covering all surfaces until dry
the amount varies by manufacturer, but it is usually about 1 tablespoon (??)
For proper handwashing you should:
Get soap and towel before beginning; roll up sleeves
Take off your jewelry
Stand back from the sink
Clothes and hands should not touch the sink.
Turn on the water with a towel
Water should be warm but not hot
Wet hands. Fingertips point down.
Put liquid soap on hands and wrists.
Rub hands, fingers, and wrists. Rubbing helps loosen bacteria and dirt. Also, make sure to clean between fingers.
Rub hands under the water for at least 30 seconds (Sing “Happy Birthday” twice )
Dry hands with a clean towel. Do not shake water off hands.
Turn off the water with the towel
Don’t touch the sink, faucet, surfaces or doorknobs with hands after washing. This will re-contaminate your clean hands.
Put the towel in the hamper or laundry for cleaning
For Fingernail Hygiene
Keep fingernails short (¼ inch or shorter)
Artificial nails should not be worn when taking care of older adults
Additional Tips to Keep Hands Clean
keep a pocket-sized container of alcohol-based handrub on you
place alcohol-based handrubs in the older adult’s bedroom and bathroom
remember that alcohol is flammable so store these handrubs away from high temperatures or flames
There are several important things you can do when taking care of other people in order to help prevent infection from spreading – handwashing is easy and essential.
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 :
directly from person-to-person;
indirectly through equipment and supplies, and
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
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:
Hand hygiene – demonstrating proper hand washing techniques
Protective barriers – including gloves, gown, mask, eye protection, or face shield.
Dispose of laundry and hazardous waste properly – use towels only once after contact, and wash linens routinely and when soiled.
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:
If possible, encourage the older adult to cover the mouth/nose with the elbow rather than the hand.
Place surgical masks on the coughing person when tolerated and appropriate.
Maintain hand hygiene after contact with respiratory secretions.
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:
try and avoid direct contact with the older adult if possible
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!
Madhuri ReddyPreventing Infection: Maintaining A Clean and Healthy Environment
This is a multi-part series to help in-home professional, non-medical caregivers learn some practical, non-clinical skills on how to approach their day to day professional life. In Part I, we will focus on the definition and responsibilities of a professional caregiver and explore how to approach your first day on the job. Whether you’re an experienced caregiver or brand new, your clients always present new challenges to grow and learn.
Professional Caregiver Definition
Let’s start with defining what exactly it means to be a professional in-home, non-medical caregiver.A professional caregiver is someone whose career is to assist another person in a way that enables them to live as independently as possible. Professional caregivers can go by many different job titles. Home health care refers to care provided in the home by a licensed medical professional, such as a nurse or physical therapist. Non-medical in-home care focuses on helping older adults with the daily activities they need to engage in life and remain safe and healthy. Professional caregivers who do not have a medical license generally can perform these tasks like feeding, bathing, and have an extremely important job since they are on the front lines and provide direct care. Being a professional caregiver can be a rewarding career, but is also heavy and hard work, tiring and lonely if you are not prepared. Our goal is to help you learn professional skills so that you can feel confident whether you’re a veteran refreshing your skills or you’re new to caregiving.
Profesional Caregiver Responsibilities
What you can and cannot do as a professional caregiver depends on two main factors: The first, who your employer is, and the second being the setting where you are working. Remember that each agency has its own policies and procedures, so what you do when working for one agency may not be the same as what you are allowed do for another agency; and always refer to your handbook or your hiring manager when you run into those gray areas. Your responsibilities are different depending on the care setting where you are providing care: a private home, assisted living, or a skilled nursing facility. In a home, you will usually be helping with personal care (such as grooming and bathing) and helping the older adult remain as independent as possible (by helping with such things as meal preparation and light housekeeping).Being a professional caregiver means having high professional standards. Your behavior, professionalism and boundaries affect your relationship with your clients. Let’s take a look at everything that you can do to make the first best impression with the a day in the life of a caregiver.
AppearanceLet’s say that it’s your first day of meeting a new client. As professional caregivers, every meeting of a new client is like a new job interview. Make sure to maintain a high standard of personal health, hygiene and professional physical appearance. This can mean different things for different people but for a caregiver it generally means: keep your hair kempt, wear small or no jewelry, wear clean and professional clothes (for example, slacks and a shirt or sweater that isn’t tight or revealing) and closed toes shoes. Packing an extra set of clothes for the day is often a good idea – there are so many things that may happen throughout the day with your clients and you want to be prepared to stay clean and comfortable.
Arriving in Your Client’s HomeOn the first day, think about how to make the situation as comfortable for the client and yourself as possible. Try and arrive 10 to 15 minutes early to get a chance to meet anyone at the home whether it is someone from the agency or a family member. Typically, someone will be there to meet you and get you started. If you have personal items like purses and backpacks, you might want to leave them in your car or in the client’s front closet to avoid forgetting anything or any confusion between your things and the client’s personal things.
Washing Your Hands The importance of washing your hands can never be overstated and it is something you should be prepared to do throughout the day. Before you start your first day, take 30 seconds to wash your hands before you begin working with your client. By the time you arrive at the home, you’ve touched a lot of surfaces and your clients who are often older may be at risk for infection. Wash your hands to make a first strong impression and also to keep you and the older adult healthy. Make sure that you get underneath those fingernails too!