Chapter 3 Identifying causes of infection and reducing the risk of infection

1. Chapter 3Identifying causes of infection and reducing the risk of infection

2. What is an infection? An infection is when a person gets sick from germ or virus. Germs or viruses may come from another person, an animal or insect or from food. When a person has an infectious condition, there is a risk they may pass it on to another person. Infections can seriously affect your health and your client's health. Stopping the spread of infection is called infection control.

3. What is an infection? It is against the law to discriminate and not provide a service to people who are sick. In your work, you need to treat all your clients as potentially infectious. In some cases, you may need to use special procedures to care for a particular client. Any extra care requirements should be outlined in the care plan.

4. In this chapter you will learn about: 3.1 Identifying risks of infection 3.2 Applying safety precautions to prevent the spread of infection 3.3 Recognising when additional infection control is required 3.4 Applying additional safety precautions Identifying other sources of infection

5. 3.1 Identifying risks of infection Infection is a medical condition that is caused by micro-organisms. These are very small particles that lodge in the human body and multiply causing disease. A disease is an illness, sickness or medical condition. One of the most common infections is the common cold. Infection is a risk for everybody. A variety of organisms cause infections.

6. The following table outlines the most common ones.

7. Other organisms, such as the flu virus, are highly contagious. This means they can spread very easily from one person to another. You don’t have to be in contact with the virus for long to catch it and get sick. Most people have an immune system that helps to prevent infections. Your immune system is your natural defence against illness. However as people get older their immune system is less effective due to the ageing process. The older person may be less able to fight infection. They may get sicker and take longer to get better.

8. How infection can happen • Infection can occur in a number ways including through: • body fluids, such as blood, tears, saliva, urine, faeces and semen, which can contain harmful viruses, diseases and organisms • objects that have come into contact with viruses, diseases and organisms

9. How infection can happen • food and drink that has come into contact with viruses, diseases and organisms • flies or other insect bites • linen with body fluids on it, including blood, tears, saliva, urine, faeces and semen • clients, residents, visitors or staff with infectious diseases such as influenza (the flu)

10. Bacteria, viruses and other micro-organisms can enter the body in several ways. They can enter through the: • mucous membrane- the moist lining of the orifices(holes) of the body; for example, the nose, mouth, eyes, anus, genitals • nasal passages in the nose and lunges during the act of breathing • mouth into the throat, stomach and digestive system • skin by needle puncture, cut or gaze.

11. How people are infected Support workers, clients and other staff may be exposed to infection during personal care tasks, when handling food or soiled clothing or linen or by just being near people with infections.

12. Personal care tasks When performing personal care tasks, the risk of infection increases because the support worker is in closer contact with the client and at risk of being exposed to body fluids or other infectious material.

13. For example, you may need to: • assist a client who has the flu and is coughing continuously • change the bed linen of a client who has an infectious skin disease • assist a client with a salmonella infection with their bowel movements • assist a client with a nosebleed and you have broken skin. • Another example of where you may be exposed to infection is if you fail to use, or use in the wrong way, personal protective equipment (PPE) such as gloves or waterproof aprons.

14. Food handling • There is a risk of infection from food because food may have unsafe levels of bacteria. It may also be because an infected person has handled the food and infected it. When preparing or serving food, there are some steps that you should follow: • Wash your hands correctly. • If you have a cut, you need to have it covered by a band aid. • If you are touching food, you need to wear gloves; for example, if you are preparing sandwiches. • You should always wear an apron.

15. Foodhandling (continued) • Youshould always use clean utensils. • Food must be stored at the correct temperature because bacteria may multiply and cause infection- hot food should be kept hot and cold food should be kept cold.

16. Handling soiled clothing or linen Linen from beds, bathrooms and clothing can be infectious. Every piece of used linen and clothing you handle should be treated as infectious. You must wear PPE when handling these items such as disposable gloves. Your workplace will have policies and procedures that explain how to handle used linen and clothes.

17. When changing bed linen and clothing, there are steps you need to follow: • The linen should be put directly into a linen skip (or bin). • Infectious linen should go into a specially marked skip so it can be identified at the laundry and washed appropriately. • Linen contaminated with body fluids needs to go into a specially marked skip. • Hold soiled linen away from your body- do not hug the soiled linen. • Do not put soiled linen on the floor. • Do not shake linen when making the bed- this can spread micro-organisms.

18. People with infections Being with people who are infectious increases your risk of infection. For example, if someone who has a cold or the flu coughs or sneezes on you, their infection might pass to you. If a person who has a skin infection holds your hand when you have an uncovered cut, their infection might be passed to you.

19. Common infections The following table describes some common infections.

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25. 3.2 Applying safety precautions to prevent the spread of infection Support workers can help clients recover more quickly from infection by helping to prevent the person becoming infected again or infecting others. Community services organisations have procedures to manage infections and to control the spread of infection. Support workers receive regular training about infection control. It is important to find out about your workplace procedures and how to apply them.

26. Standard precautions for infection control Many workplaces use standard precaution control or have plans to prevent infection. These precautions have been developed nationally and internationally to stop infection. Standard precautions are developed to reduce passing the infection on. Employers are required by the state or territory governments to use these precautions.

27. Complying with standard precautions means treating everyone as potentially infectious because: • infectious people may not show any signs of infections • infections are often only determined by laboratory tests • infections can be transmitted to others before being detected.

28. All this means is that you may not know when a person has an infection so you should always act as though they do. The main standard procedure include: Washing hands regularly Maintaining skin care Wearing gloves Handling and disposing of sharps effectively

29. Each of these points are explained below. Washing hands regularly Effective hand washing is the main way to protect you from infection. Keeping your hands clean reduces the chance of spreading infection. Your workplace will have a hand-washing policy and procedure. Make sure you read it and understand what you need to do. You can check your understanding with your supervisor.

30. How you wash your hands and how often you have to wash them will depend upon the work environment and the type of task you are doing. Plain soap is usually right for most hand washing. You need to use an antiseptic soap to clean your hands before and after you do some tasks

31. STANDARD PRECAUTION PROCEDURES should be adopted such as hand washing techniques

32. The aim of routine hand washing is to remove any bacterial infection that comes from another person’s skin or from objects in the environment. • Routine hand washing is important for support workers to maintain hygiene: • after contact with an older person • after body substance exposure; for example, being in contact with blood • after removing gloves- gloves are not an alternative to hand washing • after touching things that are likely to be infected; for example, bed pans, urinals, bedding

33. after using the toilet • before eating • in between tasks • before handling foods • after handling refuse(rubbish) • after handling soiled linen • after blowing their nose. • Clients should use routine hand washing: • after using the toilet • before eating • when hands are soiled or dirty.

34. Antiseptic hand wash An antiseptic hand wash is needed if you are going to do an aseptic task. You need to make sure your hands are germ free before you do the task. You also need to use an antiseptic hand wash when your hands have been in contact with body fluids.

35. Antiseptic hand washing should take at least one minute and includes these steps: Wet hands thoroughly. Lather hands with antiseptic soap and vigorously rub together, making sure all surfaces of the hands are covered. Rinse under a moderate stream of water. Dry thoroughly.

36. Maintaining skin care Your skin is a barrier that can protect you from infection. Skin can become dry and cracked due to lots of hand washing. These cracks can allow infection to pass through the skin. Make sure you dry your hands thoroughly after you wash them. Use a moisturiser to keep your skin healthy. If your skin does have a cut or abrasion then you need to make sure it is covered by a waterproof dressing during work time. The waterproof dressing will protect your damaged skin from infections.

37. 3.Wearing gloves • In normal practice there is no need to wear gloves • when caring for older people. Sometimes, if there is a risk to the support worker, gloves need to be worn. • You need to wear gloves when: • cleaning up body fluids • there is a risk of exposure to body fluids; for example, when showering a person who is incontinent of urine (can’t control their urine flow) • you have a cut or abrasion on your hand

38. Handling and disposing of sharps effectively Needles and blades are called sharps in community services and other health-related industries. Used sharps are needles and blades that have been used. Used sharps are medical waste. There are special rules about how medical waste must be thrown out. Used sharps must be placed in a container that meets the requirements of AS/NZS 4261:1994 reusable container for the collection of sharp items used in human and animal medical applications. This is a national standard that all health care organisations must meet.

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40. 3.3 Recognising when additional infection control is required Sometimes extra precautions against infection need to be taken. These are to protect clients, workers and others. The next table outlines the sources of infection that need extra infection precaution.

42. The next table describes some medical conditions that may require extra infection control precautions.

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46. 3.4 Applying additional safety precautions When extra infection control precautions are required, support workers need to know what to do. There may be additional instructions workers need to follow to control an infection. These should be outlined in the client’s care plan. Or a registered nurse or doctor may give you instructions about extra steps you need to take.

49. All those involved in the client’s care must know and understand extra infection control methods. This information should be in the client’s care plan and any additional information must be provided at handover meetings. Details of extra infection control precautions will be in the infection control manual, which may be part of the OHS or workplace policies and procedures manual. The supervisor may organise a training session for staff; for example, you may need to understand special ventilation requirements for a client. This would require special training.

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