Health Care Providers Reference Tool_E

7/30/2019 Health Care Providers Reference Tool_E

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inection preventionand control

reerence tool

for health care providers

in the community


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taBle o contentS

Itrducti . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1Glssary Terms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

H Iectis Spread . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Risk Assessmet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Routine Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Hand Hyiene. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8Usin PPE Propery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Ctact Precautis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

Methiciin Resistant Staphylococcus aureus(MRSA) . . . . . . . . . . . . . . . . . . . . . 15

Vancomycin Resistant Enterococci (VRE) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16

Clostridium difcile. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

17Scabies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18

Drplet + Ctact Precautis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19

Inuenza . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Common Cod . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21

Airbre Precautis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

Chickenpox. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

Tubercuosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

Emergig Issue Bedbus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

Priciples Cleaig . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

Hadlig Equipmet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

Useul Liks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28


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introdUction

Health care priders i the cmmuity eed t k thellig acts he it cmes t preetig ad ctrlligthe spread iectis.

Yu s sk s. Cients who have chronic diseases ike

diabetes or heart disease and those with inesses that compromise their immune

systems are at hih risk or a kinds o inections. Cients who have urinary

catheters or other ines enterin their bodies are aso at hih risk or inections.

Yu s mgsms m h u us

s. I you dont cean your hands, or dont cean and disinect the

equipment you use or mutipe cients, microoranisms can easiy spread.

i s fu h s s. Key concepts in

prevention incude ceanin your hands, wearin persona protective equipment

when appropriate and ceanin and disinectin equipment propery.

1

Thei p c r twas created to

provide you with inormation about the measures you can take in your work

with cients to prevent and contro the spread o inections.

We rateuy acknowede input rom our coaborators,the Community Care aencies in the Wateroo Weinton area and

the Wateroo Weinton Inection Contro Network

c v:

Dr. Martha Fuord, Medica Coordinator

Wateroo Weinton Inection Contro Network

Gh dsg:

Diese Desin Associates, Stratord, Ontario


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GloSSarY o terMS

a pus: Specifc precautions (Contact, Dropet, and Airborne),

which are carried out or specifc oranisms or cinica presentations, in addition toRoutine Practices. Additiona Precautions may incude the physica separation rom

other individuas and/or the use o persona protective equipment (own, oves, mask/

N95 respirator, eye protection) to prevent or imit the transmission o potentiay

inectious aent(s) rom coonized or inected individuas to others.

ab pus: A type o Additiona Precautions (neative pressure room withdoor cosed and possiby use o a ft-tested N95 respirator) used to prevent or imit the

transmission o potentiay inectious aents throuh airborne dropet nucei or sma

partices that may be dispersed over on distances by air currents. Neative pressurerooms are not used in community and home heath care settins.

c: Any person receivin heath care within a heath care or home care settin.

cz: The presence and rowth o a microoranism in or on a body butwithout tissue invasion or ceuar injury. The cient wi be asymptomatic.

c pus: A type o Additiona Precautions (oves and own) used toprevent or imit the transmission o potentiay inectious aents via contact with an

inected/coonized person, contaminated objects, or equipment.

cm: The presence o a potentiay inectious aent on a body surace,cothes, owns, oves, beddin, toys, surica instruments, dressins, or other

inanimate objects (bedrais, bedside tabes, bedpans, wakers, commodes, sins,

mechanica its).

d c: Providin hands-on care (e.., bathin, washin, turnin cients, chanincothes, continence care, dressin chanes, care o open wounds/esions, toietin).

dssm: Scattered or distributed over a considerabe area throuhout an oranor the body.

d pus: A type o Additiona Precautions (mask and eye protection)used to prevent or imit the transmission o potentiay inectious aents throuh

respiratory secretions by contact with the mucous membranes o the eye, nose, and

mouth when providin care within two metres o the cient.

em h c: The immediate space around a cient that may be touchedby the cient and may aso be touched by the heath care provider when providin care.

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GloSSarY o terMS3

H Hyg: A enera term reerrin to any action o hand ceanin. Hand hyienereates to the remova o visibe soi and remova or kiin o transient microoranismsrom the hands. Hand hyiene may be accompished usin an acoho-based hand rub or

soap and runnin water.

Hh c-ss i (Hai): A term reatin to an inection that isacquired durin the deivery o heath care (aso known as nosocomia inection).

Hh c p: Any person conductin activities within a heath care orhome care settin that wi brin him/her into contact with cients or their environment,

not imited to but incudin emerency medica services, physicians, nurses, aied heathproessionas, students, support services, housekeepin, maintenance, vounteers,

contract workers.

immumms: The state o a person who has a defciency in the bodys normadeense mechanism that makes him/her more susceptibe to inections.

i: The entry and mutipication o an inectious aent in the tissues o the host.Asymptomatic or subcinica inection is an inectious process runnin a course simiar

to that o cinica disease but beow the threshod o cinica symptoms. Symptomatic orcinica inection is one resutin in cinica sins and symptoms (disease).

i p c (ipac): Evidence-based practices and proceduresthat when appied consistenty in the perormance o heath care activities, can prevent or

reduce the risk o transmission o microoranisms to heath care providers, other cients,

and visitors.

ps p equm (ppe): Cothin or equipment worn by heath careproviders or protection aainst hazards (own, oves, mask/N95 respirator, ace/eye

protection).

rsk assssm: An evauation by the heath care provider o the cient, theirenvironment, type o contact and the task or procedure to be perormed in order to

identiy hazards and risks associated with exposure to potentiay harmu inectious

diseases, bood, body uids, respiratory secretions, excretions, non-intact skin, mucous

membranes, body tissues, and contaminated equipment.

ru ps: The system o inection prevention and contro practices

recommended by the Provincia Inectious Diseases Advisory Committee (PIDAC) as weas the Pubic Heath Aency o Canada (PHAC) to be used by a heath care providers

with a cients durin a care to prevent and contro transmission o microoranisms.


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HoW inectionS Spread

The ch tsmss is the mdel used t describe hiectis me rm e pers t ather. It is a key ccepti iecti preeti ad ctrl. T stp a iecti rmspreadig, yu simply hae t break e lik i the chai.

INFECTIOUS

RESER

VOIR

SUSCEPTIBLE

MODE OF

PORTA

L

TRANSMISSION

PORTA

L

OFEXIT

OFEN

TRY

AGENT

H

OST

SUSCEPTIBlE HOST:

Any person who is

at risk o ettin an

inection rom theinectious aent.

Ae, chronic heath

conditions, iestye,

immune status,

and enetics a

contribute to an

individuas risk

o inection.

INFECTIOUS AgENT: A microoranism

that is capabe o producin an inection.

Exampes o inectious aents incude

bacteria, viruses, parasites and uni.

RESERVOIR:

Any pace where an

inectious aent ives.

Microoranisms canive in or on peope,

animas, insects, soi,

and water.

PORTAl OF EXIT:

The way the

inectious aenteaves the reservoir.

The nose and mouth

are exampes o

human portas o

exit rom where

secretions can

eave the body.

MODE OF TRANSMISSION:

The way the inectious aent traves rom

one person to another. Most commony,

inections spread by direct or indirect

c. Some inections can spread

throuh the d route and a ewinections spread by the ab route.

See ossary or urther inormation.

PORTAl OF ENTRY:

The way the inectious

aent ets into the nexthost. A host may inest

the inectious aent; the

inectious aent miht

et into a wound. The

host may breathe it in

or it coud be spashed

or sprayed into the

mucous membranes

on the hosts ace.

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riSK aSSeSSMent

rsk assssm ad ru pst be used r ALL cliets,

by ALL health care priders,

at ALL times

The key t implemetig ru ps is the assessmet

risk bere each cliet iteracti, takig it csideratieets, circumstaces ad practices t determie hichexpsure ctrls are required.

Ask the llig durig yur risk assessmet.

Doestheclientappeartobefeelingunwell?

Hastheclientbeendiagnosedwithaninfection?

Doestheclienthaveanysymptomsofaninfection(coughing,sneezing,fever,

diarrhea, vomitin, rash, drainin wound, enera maaise, conusion, redness,

swellingorpaininaspecicbodyarea)?

WhatcontactamIgoingtohavewiththeclient?

WhattaskamIgoingtoperform?

Whatismyriskofexposuretoblood,bodyuids,respiratorysecretions,

excretions, non-intact skin, mucous membranes, body tissues, and contaminated

equipment?

WilltheclientbecooperativewhileIperformthetask?

On competion o the risk assessment, use a appropriate strateies o ru

ps isted on the oowin paes to reduce transmission o microoranisms.

For urther inormation reer to the document Routine Practices and Additional

Precautions in All Health Care Settingsat www.oahpp.ca

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6

Hand HYGieneHand hyiene is perormed usin acoho-based hand rub

or soap and water.

onentrytoandonexitfromtheclientshome.

beforeprovidingdirectcaretotheclient.

beforeputtingonglovesforclean/asepticor

invasive procedures.

immediatelyafterremovinggloves.

afterprovidingcareinvolvingbodyuids,secretions,

excretions or bood.

beforepreparing,handlingorservingfood.

aftercontactwithitemsintheclientsenvironment.

GloveS*

arewornwhenthereisariskofcontactwith

bood, body uids, secretions, excretions, non-intact

skin, mucous membranes, or contaminated suraces

or objects.

are a substitute or hand hyiene.

m h hyg mg gs.

MaSK, eYe protection, or ace SHieldS*

protecteyes,nose,andmouthduringproceduresand

care activities ikey to enerate spashes or sprays

o bood, body uids, secretions, or excretions.

mustbewornwithintwometresofacoughingclient.

*risk assessment required

roUtine practiceS


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roUtine practiceS7

GoWnS*

shouldbewornifcontaminationofuniformor

cothin is anticipated.

environMent

Allequipmentthatisbeingusedtocareformorethan

one cient must be ceaned between each use.

Ensureanysurfacesusedtoprovidehealthcaretoa

cient are cean beore and ater the care is iven.

linen and WaSte

Handlesoiledlinenandwastecarefullytoprevent

persona contamination and transer o erms to

other cients.

SHarpS injUrY prevention

Usetheappropriatesafety-engineeredneedlesystem.

Alwaysdisposeofmedicalsharpsintheappropriate

sharps disposa container.

*risk assessment required


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4 MoMentS or Hand HYGiene8

Adapted with the permission o the government o Ontario.


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1

2

3

4

Beore i c / c em c

WHen? Cean your hands when enterin: beforetouchingclientor

beforetouchinganyobjectorfurnitureinthe cients environment

WHY? To protect the cient or cient environment romharmu erms carried on your hands.

Beore as pus

WHen? Cean your hands immediatey beoreany aseptic procedure.

WHY? To protect the cient aainst harmu erms,incudin the cients own erms, enterin his

or her body.

ater By u exsu rsk

WHen? Cean your hands immediatey ater an exposure riskto body uids (and ater ove remova).

WHY? To protect yourse and the cient environmentrom erms.

ater c / c em c

WHen? Cean your hands ater touchin cient or any objector urniture in the cients environment and ater eavin

the cients home.

WHY? To protect yourse and the cient environmentrom harmu erms.


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Hand HYGiene

Hand hyiene may be done usin acoho-based hand rub (ABHR) or soap and

runnin water. To be eective, the acoho content o ABHR used by heath care

providers shoud be at east 70%.

Hw hub(only i hands are not visibly soiled)

1. Appy 1 to 2 pumps o product into pams o dry hands.

2. Rub hands toether, pam to pam.

3. Rub in between and around fners.

4. Rub back o each hand with pam o other hand.5. Rub fner tips o each hand in opposite pam.

6. Rub each thumb casped in opposite pam.

7. Rub hands unti product is dry.

Do not use paper towes.

8. Once dry, your hands are sae.

Hw hwsh

1. Wet hands with warm water.

2. Appy soap.

3. lather soap and rub hands pam to pam.

4. Rub in between and around fners.

5. Rub back o each hand with pam o other hand.

6. Rub fnertips o each hand in opposite pam.

7. Rub each thumb casped in opposite hand.

8. Rinse thorouhy under runnin water.

9. Pat hands dry with paper towe.

10. Turn o water usin paper towe.

11. Your hands are now sae.

Heath care providers in the community shoud carry ABHR to use in case adequate

hand washin aciities are not avaiabe.

When soi is visibe on hands, wash with soap and water. I soap and water are not

avaiabe, cean soi o with a moist toweette and oow with appication o ABHR.

10

iStockphoto.com/Janine lamontane

iStockphoto.com/Robert gubbins


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USinG ppe properlY

Persona protective equipment (PPE) is meant to protect heath careproviders rom becomin contaminated. Improper use o PPE can actuay

ead to the spread o erms and increased risk o inection or you and

your cients. Foow the uideines beow or proper use o PPE.

GLovES

glovesarenotrequiredforroutinecareactivitiesthatinvolvecontactwith

intact skin.

glovesarenotasubstituteforhandhygiene.Cleanyourhandsy time you

remove oves.

glovesaresingleuse.Donotwashglovesanddonotre-usethem.Disposeof

them in the arbae ater one use.

putonanewpairofgloveswhenyourriskassessmentofthetaskyouwillbe

perormin requires oves to be used. Remove oves as soon as the task is

compete and cean your hands. I there is another task that requires ove use

then a new pair o oves shoud be put on rather than movin rom one body siteto another with the same pair o oves.

glovesmustthandswell.Sandwich-makingstyleglovesarenotappropriate.

Gown

putonimmediatelybeforestartingthetaskyouneedtoperformifyouthink

your cothes coud become soied.

removegownassoonasthetaskisnished,disposeofitandcleanyourhands.

FACE PRoTECTIon (Mask ad Eye Prtecti)

putonimmediatelybeforestartingthetaskyouneedtoperformifyouthink

your ace coud be spashed or sprayed.

removeassoonasthetaskisnished,disposeofthemaskandcleanyourhands.

eyeprotectionmaybedisposedoforcleanedanddisinfectedasper

manuacturers instructions.

as muh s ssb, yu my w mk y m yu

wh h us a pus s qu .

th my shu s yu wh m bu hw us

hs us y.

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pUttinG on ppe

1. Perorm hand hyiene.

2. Put on own.

3. Put on procedure mask or

N95 respirator (i required).

4. Put on eye protection or

ace shied (i required).

5. Put on oves.

Helpul Hits: Keepglovedhandsawayfromface.

Removeglovesiftheybecometorn.

Performhandhygienebeforedonningnewgloves.

Avoidtouching/adjustingPPE.

Limitsurfacesanditemstouched.

Adapted rom CDC Inection Control Home

12

or


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taKinG o ppe

1. Remove oves.

2. Remove own.


4. Remove eye protection or

ace shied (i required).

5. Remove mask or

N95 respirator.


13

Adapted rom CDC Inection Control Home

or

or


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contact precaUtionS

c pus are used in addition to Routine Practices or microoranisms

where contamination o the environment or intact skin is a particuar consideration,

such as:

contaminationoftheclientenvironment.

infectiousagentsofverylowinfectivedose(e.g.Norovirus,rotavirus).

clientsinfectedorcolonizedwithantibioticresistantorganismsthatmaybe

transmitted by contact with intact skin or with contaminated environmenta

suraces.

There are t kids ctact trasmissi.

direct smss occurs when microoranisms move rom one person

to another directy, usuay on hands.

indirect smss invoves the movement o microoranisms rom

a person to an object or surace and then to another person. Contact Precautionsare used by heath care providers to stop the spread o microoranisms that trave

by the contact route (e.. MRSA, VRE, C. difcile, and scabies).

Addig c pus t ru ps icludes:

Glovesandgownusedifcontactwithaclientoracontaminatedenvironmentis

required. Contact Precautions are appropriatey appied or situations incudin,

but not imited to, contact with diarrhea or uncontained wound drainae.

Handsmustbecleanedafterremovalofpersonalprotectiveequipment.

Use c pus i the llig circumstaces:

Acutediarrhea

Knownorsuspectedinfectionorcolonizationwithanantibioticresistantorganism

Skinrash

Draining,infectedwoundwhendrainagecannotbecontainedbydressing

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15

Mh rssStaphylococcus aureus(MrSa)

The Basics:

MRSAisabacteriathatisresistanttosomeantibiotics.

MRSAlivesontheskinandinthenasalpassages.

MRSAmovesfrompersontopersonbydirectcontactbetweenpeople

usuay on hands. It can aso move indirecty on heath care equipment.

PeopleatriskforMRSAcolonization/infectionincludetheelderly,those

with repeated contact with the heath care system and those with chronic

heath conditions.

Mde Trasmissi:

Directcontact

Indirectcontact

H t Preet Spread:

Usec pus or direct care activities.

Followthe4 Moments or Hand Hygiene.

Encourageclientstocleantheirhands.

Cleananddisinfectequipmentbetweenuses.

Nospeciallaundrypracticesareneeded.

Encourageregularcleaningintheclientshome,withspecialattentiontoitems

that are requenty touched such as iht switches and door knobs.


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vmy rsse (vre)

The Basics:

VREisabacteriathatisresistanttosomeantibioticsandcanliveoutside

o the body or on periods o time.

VRElivesinthebowelandfecalmatterofapersonwhoiscolonizedor

inected with it.

VREmostcommonlymovesfrompersontopersonbydirectcontactbetween

peope usuay on hands. It can aso move indirecty on heath care equipment.

PeopleatriskforVREcolonization/infectionincludetheelderly,thosewith

repeated contact with the heath care system and those with chronic heath

conditions.

Mde Trasmissi:

Directcontact

Indirectcontact

H t Preet Spread:

Usec pus or direct care activities.





Encourageregularcleaningintheclientshome,withspecialattentionto bathrooms and to items that are requenty touched such as iht switches

and door knobs.

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Clostridium difcile

The Basics:

Clostridium difcile(C. difcileor C. di) is a bacteria that ives in the bowe

and eces.

Itcausesdiseasewhenthenormalbacteriainthebowelaredisruptedas

a resut o antibiotic use.

SomestrainsofC. diproduce toxins that cause severe diarrhea. Other

compications can occur such as pseudomembranous coitis, toxic meacoon,sepsis, and death.

Noneedtosendfollow-upspecimenifclienthasreturnedtonormal

bowe unction.

Mde Trasmissi:

Directcontact

Indirectcontact

H t Preet Spread:

Usec pus unti norma stoos resume or at east 48 hours

and a thorouh ceanin has been competed.





Encourageregularcleaningintheclientshome,withspecialattentionto bathrooms and to items that are requenty touched such as iht switches

and door knobs.

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ScaBieS

The Basics:Scabiesiscausedbymitesthatburrowintoskinandlayeggs,andcausean

itchy rash.

Areasbetweenngers,foldsofwrist,elbowandknee,genitalia,breastsand

shouder bades are most commony inested.

Mitesdonotsurviveawayfromthehumanbodyformorethanthreedays.

Aninfestedpersoncanspreadscabieseveniftheydonthavearash.

Mde Trasmissi:

Directcontact

Indirectcontact

H t Preet Spread:

Usec pus or contact with cient and their environment unti

24 hours ater prescribed treatment has been appied.

Encourageclientstocleantheirenvironmentthoroughlyfollowingapplication

o treatment.

Mitesonfabricsaredestroyedbywashinginhotsoapywateranddryingon hot dryer cyce.

Itemsthatcannotbelaunderedorcleanedshouldberemovedfromuseand

stored in a seaed pastic ba or at east three days.

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19

droplet + contactprecaUtionS

d pus are used in addition to Routine Practices or cients

known to have or suspected o havin an inection that can be transmitted by

are respiratory dropets.

Some erms are abe to spread in more than one way. Additionay, whie you miht

be abe to te that a cient is sick, you may not know what oranism is makin them

sick. When this is the case, it is important to consider usin more than one type o

precaution to protect yourse.

The use o combinations o additiona precautions is not unusua and is oten

needed in order to adequatey protect ourseves and others rom disease spread.

d + c smss is e the mst cmmcmbiatis ad refects h germs like ifueza ad thercmm respiratry iectis spread.

Addig d c pus t ru psicludes:

Maskandeyeprotectionwhenwithin2metresoftheclient.

Glovesandgownusedifcontactwithaclientoracontaminatedenvironment

is required.Handsmustbecleanedafterremovalofpersonalprotectiveequipment.


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20

inlUenZa

The Basics:Inuenzaiscausedbytheinuenzavirus.

Inuenzaisasevererespiratoryinfectionwithsymptomsoffever,achesand

pains, weakness, atiue, runny nose, sore throat and couhin.

Complicationscanbeseriousandlife-threatening,especiallyinpopulations

such as chidren and the edery.

Mde Trasmissi:

Droplet

Directcontact

Indirectcontact

H t Preet Spread:

Receiveannualinuenzavaccination.

Used c pus within 2 metres o the cient and or

direct contact with the cient and the cient environment.

Wearagownifyouanticipatethatyourclothingwillbesoiled.


Encourageclientstocovertheirmouthandnosewhentheycoughorsneeze

and cean their hands requenty.


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coMMon cold

The Basics:

Coldsaretypicallylessseriousthaninuenzaandcausesymptomsofsneezing,

runny nose, watery eyes, chis and maaise. Fever is uncommon.

AvarietyofdifferentvirusescausethesymptomsthatwecalltheCommonCold.

Mde Trasmissi:

Droplet

Directcontact

Indirectcontact

H t Preet Spread:

Used c pus within 2 metres o the cient and or

direct contact with the cient and the cient environment.

Wearagownifyouanticipatethatyourclothingwillbesoiled.


Encourageclientstocovertheirmouthandnosewhentheycoughorsneeze

and cean their hands requenty.


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airBorne precaUtionS

ab pusare used in addition to Routine Practices or cientsknown to have or suspected o havin an iness transmitted by the airborne route

(e.. partices that remain suspended in the air and may be inhaed by others).

Addig ab pus t ru ps may iclude:

Fit-tested,seal-checkedN95respiratorworntoentertheclientsenvironment

(e.. cients with pumonary tubercuosis).

Handsmustbecleanedafterremovaloft-testedN95respirator.


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cHicKenpoX

The Basics:ChickenpoxiscausedbytheVaricella-ZosterVirusandisnormallyspread

throuh the air or rom direct contact with the uid in the chickenpox bisters.

Onceapersonhashadchickenpox,theywillnotgetitagain(theyareimmune

to chickenpox) but they coud deveop shines (herpes zoster) ater in ie

because the virus remains in their body.

Apersonwhoisnotimmunetochickenpoxcouldgetchickenpoxbydirect contact with the virus that is present in the bisters o the shines rash.

PersonswithDisseminatedHerpesZoster(shinglesspreadoveralargearea

o their body) may aso be abe to spread the virus by the airborne route.

Mde Trasmissi:

Airborneanddirectcontact

H t Preet Spread:

Healthcareprovidersmustknowtheirimmunestatusforchickenpox.

Achickenpoxvaccineisavailableforstaffwhoarenotimmune.

ImmunestaffdonotneedtowearanN95respirator.

HealthcareprovidersshoulduseRoutinePractices,includingariskassessmentprior to each cient interaction. I direct contact with a rash is expected, oves

and own may be worn.


Cleananddisinfectequipmentbetweenusesonclients.

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tUBercUloSiS

The Basics:TuberculosisiscausedbyabacteriacalledMycobacterium tuberculosis.

Transmissionrequiresprolonged,closecontactwithanindividualwhois

activey inected with TB in the uns.

Mostpeoplewhobecomeinfectedneverdevelopactivediseasebuthave

atent inection that coud become active i not treated.

Mde Trasmissi:

Airborne

H t Preet Spread:

Consultwithlocalpublichealthunitaboutclientsreceivingcareathomeand the precautions needed.

WhenAdditionalPrecautionsareneeded,wearat-tested,seal-checked

N95 respirator to enter the cient environment, in addition to Routine Practices.

Suggesttheclientwearaproceduremaskwhiletheyareinfectious.

Encouragetheclienttocontainrespiratorysecretionsbycoveringtheirmouth

or nose durin couhin or sneezin.UseRoutinePracticesforcare,includingfollowingthe4 Moments or Hand

Hygieneand ceanin equipment accordin to manuacturers instructions in

between uses on cients.

Consultwithlocalpublichealthunitaboutdiscontinuationofprecautions.


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eMerGinG iSSUe BedBUGS

The Basics:Bedbugsaresmall,red-browninsects(6mminlengthwhenfullgrown

are enouh to be seen by the naked eye). They are at and ova shaped.

Bedbugsfeedonhumanbloodatnight,indarkness.Theyareunlikelytobe

active durin the day.

Bedbugshideinsmallspacesusuallynearthebedorwheretheclient

normay seeps.Bedbugscannotyorjump.

Bitescausedbybedbugsoftenappearasitchy,redweltsontheskin.

Bbugs s ss but scratchin itchy bites may ead to

skin inection.

Mde Trasmissi:Hitchhikingwhenbugsclimbintooronbags,clothingorotheritems.

Migrationwhenbugsmovebywalkingintootherroomsorunitsinabuilding.

H t Preet Bedbug Hitchhikers:

Whenvisiting,bringinasfewitemsaspossibleandavoidplacingbagsclose

to urniture and was. When this cannot be avoided, pace items in a pastic bathat can be cosed and inspect items or bedbus on eavin.

Avoidsitting,especiallyonfabric-coveredfurniture.Ifpossible,sitonwoodor

meta chairs as they are ess ikey to harbor bedbus.

Inspectshoes,clothinganditemstakenintothehomeafterleaving.

Ifyoundanybedbugsoninspection,killthemimmediately.

Whenyouarrivehome,placeyourclothinginthedryeronthehotcyclefor 30 minutes to ki any bus that miht be hitch hikin.

Followanyagencypolicyandprocedure.


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principleS o cleaninG

Keepig the eirmet ad cliet-care equipmet cleais a imprtat part preetig the spread iectisi cmmuity settigs.

Cleaningreferstotheremovalofmicroorganismsfromanobjectorsurfaceand

requires riction to remove microoranisms rom the environment and equipment.

Whencleaning,startwithcleanestareasandnishwithmostcontaminated

areas (or exampe, when ceanin a bathroom, start at the sink and counter,

then cean the tub/shower, then fnish ceanin with the toiet it is the most

contaminated area).

Tocleaneffectively,itisimportanttousematerialsandequipmentthat

are cean.

Surfacesintheclientshomeshouldbecleanedregularly.

I yu uld like mre irmati cleaig addisiecti i health care settigs, please isit the RICn likat www.h. r additial resurces.

visit www.h.t access the Pricial IectiusDiseases Adisry Cmmittees Best Practices for Cleaning,Disinfection and Sterilization in All Health Care Settingsas ell

as the Best Practices for Environmental Cleaning for Preventionand Control of Infections In All Health Care Settings.


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HandlinG eQUipMent

Hands shoud aways be cean beore touchin cean equipment in a nursin ba.Used or soied items shoud never be paced back into the ba unti they have been

propery ceaned and disinected. Where possibe, minimize the amount o equip-

ment carried into the home and ensure the ba is paced in an area that reduces

the chance o contamination.

Proceduresforcleaningandreprocessingofmulti-usehealthcareequipment

shoud be estabished and monitored.

Keepdirtyequipmentseparatefromcleanequipmentuntilitcanbecleaned and disinected appropriatey.

Underidealcircumstances,equipmentusedonclientswithinfectiousdiseases

shoud be sine use or dedicated to them unti they are no oner inectious.

When equipment cannot be dedicated to a cient, it must be ceaned and

disinected/steriized between uses.

Pleaserefertoyouragencyspoliciesandproceduresforspecicinstructions.

Appropriate ceanin and disinection o equipment depends on what the

equipment is used or and the potentia risk o inection invoved with its use.

The oowin tabe provides uideines:

cssf equm/d

df l pssgrqu

exms hm s ss

Critica Enters sterie tis-

sues incudin thevascuar system.

Ceanin oowed

by steriization.

Steriization may be achieved usin an

autocave or other approach; process mustbe monitored and verifed.

Semi-Critica Comes into contactwith non-intactskin or mucousmembranes butdoes not penetratethem.

Ceanin oowedby hih evedisinection(as a minimum).Steriization ispreerred.

Hih eve disinection may be achievedwith chemicas or pasteurization; timino process is critica to eectiveness.

Non-Critica Touches onyintact skin andnot mucous mem-

branes, or doesnot directy touchthe cient.

Ceanin oowedby ow evedisinection

(in some cases,ceanin aoneis acceptabe).

Acceptabe ow eve disinectantsincude acohos, chorines, 0.5 per centacceerated hydroen peroxide, 3 per cent

hydroen peroxide, iodophors, phenoicsand QUATs. Monitorin o process is notrequired. Must oow manuacturersdirections or use.


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USeUl linKS

The rg i c nwks uld like taser yur questis. Please call us ith yur IectiPreeti ad Ctrl questis r yu may brr itemsrm ur ledig library.

rg i c nwks (ricn):www.oahpp.ca

pub Hh o:www.oahpp.ca

th p ius dsss asy cmm (pidac):www.oahpp.ca

th pub Hh agy c (pHac):

www.phac-aspc.c.ca

jus c Yu Hs pgm:www.oahpp.ca

th cs dss c, a, Gg (cdc):www.cdc.ov

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