Infection Control

Universal Precautions

Universal Precautions are standardized actions that caregivers take to protect themselves and others from the spread of infection. They create a physical barrier between you and potentially infected body fluids.

The four basic Universal Precautions are:

• 🤲 Hand Washing — the single most important act to prevent infection
• 🧤 Gloves — worn when there is risk of contact with body fluids
• 😷 Masks — worn when there is risk of airborne or splashed body fluids
• 🥼 Gowns — worn when there is risk of contamination to clothing

The Chain of Infection

For an infection to develop and spread, a chain of five links must remain connected. Breaking any one link stops the infection.

1. Infectious Agent — the bacteria, virus, or pathogen causing disease
2. Reservoir — where the pathogen lives and grows (person, surface, water)
3. Portal of Exit — how the pathogen leaves the reservoir (cough, wound drainage, urine)
4. Mode of Transmission — how the pathogen travels (direct contact, droplets, airborne)
5. Portal of Entry — how it enters a new host (mucous membranes, broken skin, mouth, nose)

Proper Hand Washing

Hand washing is the primary act that prevents infection. You must wash your hands:

• Before and after administering any medication
• Before and after wearing gloves
• After contact with any body fluids or contaminated surfaces
• Before and after client care activities

Correct Hand Washing Technique

1. Wet hands with warm running water
2. Apply soap and lather vigorously for at least 20 seconds (sing "Happy Birthday" twice)
3. Scrub all surfaces: palms, backs of hands, between fingers, under nails
4. Rinse thoroughly under running water
5. Dry with a clean disposable paper towel
6. Use the towel to turn off the faucet

Alcohol-based hand sanitizers are acceptable when hands are not visibly soiled, but they do not replace proper hand washing for all situations.

Personal Protective Equipment (PPE)

Gloves

Select gloves that match your hand size (XS, S, M, L, XL). Inspect gloves for damage before use — the material should be intact.

When to wear gloves:

• When there is redness, drainage, or possibility of infection at an administration site
• When administering controlled drugs via skin contact (creams, patches)
• When administering medications that may splash (liquids, eye/ear/nose drops)
• Whenever handling body fluids or contaminated materials

Important: Gloves do NOT replace hand washing. They are made of semi-permeable materials that can still allow some microbes to pass through.

Donning (Putting On) Gloves

Select the correct size. Inspect gloves for damage. Pull them over your hands ensuring no gaps at the wrists.

Doffing (Taking Off) Gloves

1. Grasp the outside of one glove with your opposite gloved hand
2. Peel the glove off and hold it in your still-gloved hand
3. Slide your ungloved fingers under the remaining glove at the wrist
4. Peel it off inside-out, enclosing the first glove inside
5. Dispose of both gloves immediately — outside of gloves is contaminated!
6. Wash hands immediately after removing gloves

Gloves Must Be Changed When:

• Moving from one client to another
• Moving from a contaminated body site to a clean site on the same client
• The glove is torn or damaged
• After handling contaminated materials

Masks

Use a mask when there is likely risk of coming into contact with splashed body fluids, sprayed oral secretions (sneezing, coughing), or when handling/administering medications that may splash or cause coughing/sneezing.

Face Shields

Cover from the forehead down below the chin. Can be sanitized and reused after each use with appropriate disinfectant.

Infection Control in the Care Setting

In addition to PPE and hand washing, good infection control practice in residential care settings includes:

• Wiping down handles and surfaces where hand washing occurs
• Using disposable cups, straws, and tissues when feasible
• Wiping up spills promptly
• Managing garbage containers throughout the day — avoid overflow
• Using designated containers labeled for Biohazards when body fluid contact has occurred
• Storing medications properly (cool, dry, limited light, locked)

Safety & Emergency Situations

QMAPs should monitor for signs of adverse medication reactions. If a resident emergency requiring immediate action occurs:

• Stay calm and call 911 if needed
• Follow your facility's emergency procedures
• Notify your supervisor immediately
• Document the incident completely

Seizures

Most seizures end within a few minutes. General steps:

• Stay with the person until the seizure ends and they are fully awake
• Help them sit in a safe place once alert
• Comfort the person and speak calmly
• Tell them what happened in very simple terms
• Do NOT restrain them during the seizure
• Call 911 if the seizure lasts more than 5 minutes or if this is their first seizure