In 2015, we have had a bad flu season because of an unexpected strain of the flu virus. This strain was not included in the flu shot, and as a result, many more people have gotten the flu this year. There has also been a growing measles outbreak. At PHCS, we cannot emphasis more how important it is to get vaccinations, but that is for another article. As a home care provider, it is important that we teach our staff, our clients, and the general public about infection control in the home. In this article, we discuss some of the things that can be done to minimize infections in the home.
To start, our clients/patients receive care in their homes. Even at home, some people are at special risk for infections because their body’s natural defense against illness is weak. We should recognize these demographic groups: newborns, older people, people with diabetes, people with HIV or AIDS, people being treated for cancer, or people using catheters. Catheters are thin tubes that introduce fluids or medications into the body, or drain unwanted fluids away. The catheter insertion site can be an access point for infections.
Infections are spread through the Chain of Infection. There are 4 links in the Chain of Infection, and all 4 must be present for an infection to occur.
- A Germ – a virus, bacterium, fungus, or parasite must be present.
- A Place for the Germ to Live and Multiply – this can be a person, animal, plant, food, soil or water.
- A Susceptible Host – a person who does not have resistance to the germ.
- A Way for the Germ to enter the host’s body – different Germs have different routes. Some of these include:
- Direct Contact – when people touch each other, kiss, have sex, etc.
- Indirect Contact – when food, water, feces, bandages or other substances that are contaminated by the germ enter the host.
- Droplets – when a person sneezes or coughs
- Other particles carried in the air.
Removing any of these links will break the chain of infection. You can break the chain by having the right behavior and attitudes. You should practice good personal hygiene. You should treat all body substances (blood, feces, vomit, etc.) as if they could be infectious. You should practice good housekeeping. If you are providing home care for someone in the home, you may need to wear a mask, medical gloves, an apron, or goggles. You should get immunized. Many common immunizations will protect you from many common infections.
One of the most important infection control techniques we teach our caregivers is to wash your hands. Everyone including caregivers should wash their hands before preparing or eating food, before and after you change a diaper, after using the bathroom, after touching garbage and animals or animal waste, after coughing, sneezing or blowing your nose, whenever your hands are visibly dirty. Home care caregivers should also wash their hands before and after giving cares. Some examples include cleaning wounds or incisions, performing catheter cares, changing bandages and handling soiled linens, towels or clothing, giving mouth care or cleaning private parts. Always wash your hands before putting gloves on and after taking them off. To wash your hands properly, you should use warm water and lather them with soap. Scrub your hands including your wrists, palms, etc. for at least 20 seconds. Rinse your hands thoroughly using warm, running water. Dry your hands with a clean or disposable towel. Use the towel to turn the facet off after drying your hands. If soap and water are not available and your hands aren’t visibly dirty, use an alcohol based hand sanitizer.
As mentioned above, another important way to control infections is with good housekeeping. Cleanliness is the key. Make sure you have effective cleaning supplies. Stock up on disinfectants, especially chlorine bleach. Never mix bleach with other cleaning products, only water. Mix 1 part bleach to 9 parts water. Mix a fresh solution each time you clean. Use a separate sponge for the bathroom and kitchen. Have paper towels accessible. Use rubber gloves when cleaning, and replace them when they become warn out. You can disinfect your cleaning supplies by soaking the in bleach for 5 minutes after you are done cleaning.
Other ways to provide good infection control in your home is to make sure you have good ventilation. Make sure you clean up after pets daily. Don’t allow clients/patients in one of the above mentioned “at risk” demographic groups to touch pet waste or messes. Clean up all body fluids or substances right away. To do this, wear medical or utility gloves. Get a plastic bag to dispose of soiled paper towels as you go (old plastic grocery bags are great.) Wipe the spill with paper towels. Use more paper towels to clean the surface with hot water and soap or detergent, and rinse well. Apply a bleach and water solution if possible. Leave it on for 10 minutes, and then wipe up. Put used medical gloves in the bag, seal it and place it in a second plastic bad for disposal. Disinfect utility gloves with bleach and water before storing.
Specific ways to provide good infection control in the bathroom include using liquid soap instead of bar soap. Change towels regularly. If possible, change washcloths daily to prevent fungal infections. Change toothbrushes regularly. People with certain illnesses or infections may need to change them more often. Consult your Physician. Disinfect your toilet by pouring bleach into the bowl. Clean your tub, shower, and sink with a bathroom cleaning product or the bleach and water solution. Mop the floor at least once a week or more if needed. Do not share personal items like razors, toothbrushes, bathroom cups, combs and hairbrushes, and towels and washcloths.
Specific ways to provide good infection control in the kitchen include storing food carefully. Refrigerate leftovers immediately in covered containers. Throw out old stale or spoiled food. Check expiration dates. Clean the inside of the refrigerator out at least every week. Keep the refrigerator set at 40F or less, and the freezer at 0F or less. Always thaw food in the refrigerator or using the microwave. Serve food at the proper recommended temperature. You should take special care with meat, fish, and eggs. Never eat them raw. Don’t buy cracked eggs. Use an accurate meat thermometer to make sure foods are heated to a minimum internal temperature. This is usually 160F for ground beef and pork, 145F for fish, steaks and roasts, and 165F for poultry. Wash fruits and vegetables under running water. Use separate cutting boards, plates and utensils for raw and cooked foods. Clean the can opener after each use. Keep all work surfaces clean. Use a clean spoon if you sample food during preparation. Wash dishes and utensils in hot soapy water and air dry, or use a dishwasher. There is no need to wash a client’s/patient’s dishes separately, or use a separate set. Don’t share utensils during meals. Don’t pour the dirty mop water down the sink, use the toilet.
Lastly, infection control procedures need to be followed if you have sharps in the house. Sharps are defined as any needles, scalpels, or other articles that could cause wounds or punctures to personnel handling them. A special sharps disposal container should be used. Needles should never be recapped. When the container is full, it should be sealed and disposed of properly. Here is a link to the Sharps guidelines for the city of Milwaukee: http://city.milwaukee.gov/ImageLibrary/Groups/healthAuthors/DCP/PDFs/Env-health/sharpspamphletR12-10.pdf
In a nutshell, infection control really comes down to cleanliness and common sense. Infection control should be practiced in every home, but especially in a home health care client’s home.
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