Nature CareSAFE PRACTICES
¦¦¦¦¦¦¦¦¦. 1INFECTION CONTROL ¦¦¦¦¦¦¦¦¦¦¦.¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦. 4Introduction to the course ¦¦¦¦¦¦¦¦.¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦.. 4HOW INFECTION IS SPREAD¦¦¦¦¦¦¦¦¦.¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦. 4The Microbial World ¦¦¦¦¦¦¦¦¦¦..¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦.. 4The Chain of Infection¦¦¦¦¦¦¦¦¦..¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦ 5Review Questions:¦¦¦¦¦¦¦¦¦¦¦.¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦. 9HYGIENE CONTROL ¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦.. 10Standard Precautions¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦. 10AIDitional Precautions¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦.. 11Handwashing ¦¦¦¦¦¦¦¦¦¦¦¦¦.¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦. 11Personal Protective Equipment (PPE)¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦.. 14Maintaining a Clean Workplace ¦¦¦¦¦¦¦.¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦.. 15Spills management¦¦¦¦¦¦¦¦¦¦¦.¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦.. 19Waste Disposal ¦¦¦¦¦¦¦¦¦¦¦¦.¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦. 21Review Questions:¦¦¦¦¦¦¦¦¦¦¦.¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦.. 23BLOOD BORNE PATHOGENS ¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦.. 25Infection Control Processes ¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦. 27Documentation¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦.. 29Good Housekeeping¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦. 31Review Questions:¦¦¦¦¦¦¦¦¦¦¦.¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦.. 33WORK HEALTH AND SAFETY ¦¦¦¦¦¦¦¦¦..¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦.. 34Introduction to the course ¦¦¦¦¦¦¦¦.¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦ 35Introduction to Work Health & Safety¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦ 35WORK HEALTH & SAFETY ACT, 2011¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦.. 36Workplace Injury Management and Worker’s Compensation ¦¦¦¦¦¦¦¦¦¦¦¦¦.. 41RISK MANAGEMENT ¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦. 43Risk Management Process¦¦¦¦¦¦¦¦¦.¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦.. 45Review Questions ¦¦¦¦¦¦¦¦¦¦¦..¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦.. 52WHS MANAGEMENT RISK TO HEALTH AND WELLBEING ¦¦.¦¦¦¦¦¦¦¦¦. 53WHS Management Risk to Health and Wellbeing¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦ 53Review Questions ¦¦¦¦¦¦¦¦¦¦¦..¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦.. 61WHS MANAGEMENT RISK OF ACCIDENTS OR INJURY ¦¦¦¦¦¦¦¦¦¦¦¦¦¦ 62Emergency plans¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦. 64Review Questions ¦¦¦¦¦¦¦¦¦¦¦..¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦¦.. 66©Nature Care CollegeSafe Practices Learning GuideSafe Practices Learning Guide V3/01/13Page 4 of 66INFECTION CONTROLIntroduction to the courseInfection control is an important part of any health practice. Exposure to infectious material,the spread of infection and the treatment of diseases resulting from infection is a big part ofpublic health. This course will introduce the Complementary Health Care Practitioner to allaspects of infection and infection control.Infection Control considers infection from micro-organisms, or microbes. Assessing the riskof infection in a clinic will help a practitioner avoid any dangers and be aware of properprotocols to follow in the event of exposure.HOW INFECTION IS SPREADThe purpose of this session is to give the studentsknowledge regarding the Microbial worldand how infection and disease results. The studentswill gain a detailed understanding of thechain model of infection.By the end of this lesson you should be able to:Discuss the Chain Model of InfectionDefine an agent, a reservoir, a place of exit andsusceptible hostExplain how a microorganism can enter a hostDiscuss the transmission of diseaseExplain the hygiene scaleThe Microbial WorldMany practitioners learn about microbes in Anatomy& Physiology and in Biochemistry.Although the vast majority of microorganisms do notcause disease (i.e. they are notpathogens) those which can are still responsible for much suffering and death.Microorganisms which can affect human health belongto one of four major groups viruses,bacteria, fungi and protozoa.
©Nature Care CollegeSafe Practices Learning GuideSafe Practices Learning Guide V3/01/13Page 5 of 66The word infection is used to describe situations where pathogenic microorganisms areestablished in the body. It is important to understand the difference between infection anddisease in relation to organisms such as the HumanImmunodeficiency Virus (HIV) andhepatitis B and C viruses, all of which people maybe infected with without having thecorresponding disease (AIDS, acute or chronic hepatitis B or C).The Chain of InfectionTo cause disease these microorganisms must spread from their living and/or non-livingsources, i.e. reservoirs, to a host susceptible totheir pathogenic abilities, and so must exitfrom their sources then is transported to and enters a suitable host. This process is describedas the chain of Infection. If any link in the chain is broken then the Chain of Infection ishalted.Areservoiris a source that provides the microorganisms with conditions for survival andmultiplication. A reservoir can be human, animal ornonliving.The Human reservoir is the main living reservoir ofhuman disease. Diseases such as AIDS,typhoid fever, hepatitis, diphtheria, dysentery, gonorrhoea and streptococcal infections are allfrom human carriers.Animal reservoirs can be from both wild and domestic and carry microorganisms that cancause human diseases. For example, Rabies, Lyme disease, Salmonellosis and Malaria.Soil and water are two major non-living reservoirsof microorganisms (however, some mightdebate that water is actually living). The microorganisms that cause botulism and tetanus arefound in soil and water can be a reservoir for microorganisms that cause cholera and typhoidfever.In generalportals of exitare related to the part of the body that is infected. The mostcommon are the respiratory tract and the GIT. For example, through coughing and sneezingmany microorganisms that live in the respiratory tract can exit in thedischarges. The microorganisms that cause disease such as tuberculosis,whooping cough and influenza have the respiratory tract as the portal of exit.Microorganisms that use the GIT as a portal of exitcan leave the body throughthe faeces, such as salmonellosis and typhoid feveror through saliva such as the rabiesvirus.©Nature Care CollegeSafe Practices Learning GuideSafe Practices Learning Guide V3/01/13Page 6 of 66Microorganisms responsible for sexually transmitteddiseases use the urogenital tract as aportal of exit.There are other portals of exit that can be linkedto the method of transmission of manypathogens. For example, blood that is infected canbe removed and reinjected bycontaminated needle, as in HIV and hepatitis B or biting insects, yellow fever and malaria.Theroute of transmissionof a microorganism from a reservoir to a susceptible host can bein the form of contact, vehicle or vector.Contact transmission can be direct contact personto person physical contact such astouching, kissing, and sexual intercourse or indirect contact through anonliving object such as tissues, towels, eating utensils and toys.Droplet transmission is also considered to be a type of contact transmission since thedroplets travel short distances. For example, influenza, pneumonia and pertussis.Transmission of a microorganism via a medium such as water, food, air, blood, body fluids,drugs or intervenous fluid is known as vehicle transmission.Microorganisms transmitted via a vector refers to animals that carry pathogensfrom one host to another. For example, houseflies can transfer dysentery fromfaeces of infected people to food.©Nature Care CollegeSafe Practices Learning GuideSafe Practices Learning Guide V3/01/13Page 7 of 66Flow chart: Chain model of infectionTheportals of entryfor pathogens areomucous membranes, through the lining of the respiratory tract, gastrointestinaltract, genitourinary tract and conjunctiva.Most common is the respiratory tract where microorganisms are inhaled into the nose ormouth in drops of moisture or as dust. Common diseases are the influenza, pneumonia,tuberculosis, measles, smallpox and the common cold.The next common site is the GIT; microorganisms enter via food and water and throughcontaminated fingers. Common diseases include hepatitis A, dysentery, giardiasis, choleraand poliomyelitis.Pathogens that enter via the genitourinary tract are contracted sexually, either through themucous membranes or through cuts or abrasions. Examples are HIV, genital warts, herpes,syphilis, Chlamydia and gonorrhoea.oSkin; unbroken skin is impenetrable by most microorganisms.MicroorganismAgentReservoirPortal of ExitPortal of EntrySusceptible hostRoute of TransmissionIndirect ContactDirect Contact©Nature Care CollegeSafe Practices Learning GuideSafe Practices Learning Guide V3/01/13Page 8 of 66However, some microorganisms gain access to the body through openings in the skin, forexample, hair follicles, sweat gland ducts. Some larvae of the hookworm can bore throughintact skin.oDirect deposition beneath the skin or membranes this is called theparenteral route. For example, injections, bites, cuts, wounds, surgery,punctures and splitting.Many microorganisms have a preferred portal of entry and it is only then that they can causedisease. Disease may not occur if they enter via another portal, for example, Streptococcican cause pneumonia if inhaled, but do not produceany signs or symptoms if swallowed.Some microorganisms can cause disease form more than one portal of entry.Resistance to infection varies depending upon the many factors of a person’s immunesystem that will make them asusceptible host. Trauma, surgical procedures, therapeuticprocedures may render a person more susceptible toinfection. Immunocompromisedclients/patients are at an increased risk of infection.The hygiene scaleThe hygiene scale goes from sewage to sterile. A Complementary Therapies Clinic can sitanywhere on this scale depending on the modalitiesthat are offered. Forexample, a life coach or counselling clinic would be closer to standardhouse cleaning, whereas an acupuncturist or a practitioner who takesblood and urine samples would be higher on the scale.©Nature Care CollegeSafe Practices Learning GuideSafe Practices Learning Guide V3/01/13Page 9 of 66Review Questions:1. What is the meaning of the word infection?2. Briefly explain the difference between the terms infection and disease.3. Name the stages of the chain of infection model Draw a diagram of the chain model4. In relation to the chain of infection providedefinitions of the following termsi. an agent:ii. a reservoiriii. a place of exitiv. a susceptible host5. List four common portals of exit’ and list a micro-organism known to use each portalof exit’6. Briefly describe how a micro-organism can entera host via the following routes oftransmission?i. contact transmissionii. droplet transmissioniii. vehicle transmissioniv. vector transmission7. Define the differences between direct and indirect transmission8. List three common portals of entry’ for pathogens, giving examples of each, anddescribe how each portal of entry could be used bya micro-organism.9. What occurs if any one link in the Chain of infection is broken?©Nature Care CollegeSafe Practices Learning GuideSafe Practices Learning Guide V3/01/13Page 10 of 66HYGIENE CONTROLThe purpose of this session is to ensure that candidates are familiar with Standardprecautions and AIDitional Precautions and obtain knowledge and skills regardinghandwashing, waste disposal and spills management.By the end of this lesson you should be able to:Define Standard PrecautionsDefine AIDitional PrecautionsDescribe and perform correct hand washing techniquesExplain waste disposalDiscuss handling of sharpsIdentify areas using Colour CodingDiscuss spills managementStandard PrecautionsStandard precautions are standard operating procedures that apply to all clients/patientsregardless of their perceived infectious risk. These precautions are required for the basiclevel of infection control and are recommended forthe treatment and care of all patients.They are designed to reduce the risk of transmission of microorganisms from all sources ofinfection to a susceptible host.The principle underlying Standard Precautions assumes that all patients/clients andpractitioners are potentially infected with blood-borne or other communicable diseases.Standard Precautions include:oHand washingoUse of personal protective equipment (PPE)oAseptic practicesoAppropriate reprocessing of instruments and equipment following useoSafe handling and disposal of potentially infectious material andoEnvironmental controls
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