Overview

• a source of the infectious agent
• a mode of transmission, and
• a susceptible host.

• Common modes of transmission include contact, droplet and airborne. Some diseases can spread by multiple modes of transmission, e.g. influenza can be spread by droplet or contact.
• When supporting our clients, PPE is often used and, depending on the support needed, can include:
  • gloves
  • gowns or aprons
  • face masks
  • face shields or protective eyewear.

• Standard infection control precautions apply at all times
• to all HWH staff, including key managers, home support workers and contractors

• HWH Infection Prevention and Control Policy 
• Pandemic training - e.g., COVID-19- all staff will complete.
• Antimicrobial Stewardship

• Before putting on gloves
• After removing gloves
• Before touching food and eating
• After going to the toilet
• After lunch breaks or other breaks
• After blowing your nose or coughing
• After handling waste
• After handling unwashed linen or clothing
• After handling animals
• When your hands are visibly dirty 

1. Before touching a person or their surroundings
2. Before a procedure or where there is a risk of being exposed to body fluids
3. After a procedure or body fluid exposure risk
4. After touching a client
5. After touching a client's surroundings (e.g. bed, linen, personal items)

Respiratory hygiene/sneeze and cough etiquette

• Covering sneezes and coughs prevents infected people from dispersing droplets into the air, where they can spread to others. 
• Practising good respiratory hygiene means:
  • Covering your nose and mouth with a tissue when you cough, sneeze, wipe or blow your nose
  • If no tissues are available, cough or sneeze into your elbow rather than your hand
  • Encouraging clients to use tissues when they sneeze or cough
  • Providing the means for the prompt disposal of used tissues in general waste
  • Encouraging clients to practise hand hygiene
  • making alcohol-based hand rub available. 

PPE - gloves

• For procedures with a risk of exposure to blood or body substances, i.e. assisting a client with toileting, urinary catheter care or when dressing wounds
• When touching or cleaning equipment or surfaces that may come into contact with blood or body substances
• When performing blood glucose monitoring
• When performing oral suctioning,
• When caring for clients who have an infection spread by contact
• If the worker has broken skin
• When preparing food.

• Gloves are not used instead of hand hygiene
• perform hand hygiene before and after using gloves
• Remove gloves when a care activity is finished, and change gloves before starting a different care activity
• Dispose of used gloves immediately
• Do not use multiple gloves at the same time
• Cover any broken skin with a waterproof dressing

• sterile—used for procedures where there is contact with susceptible sites (urinary catheter care) or where an aseptic technique is required (wound care or managing a tracheostomy)
• non-sterile—used when emptying a urinary catheter bag or assisting a client with toileting
• Reusable utility—used for non-care activities such as cleaning.

• Sterile wound dressing change is completed by a person trained to undertake sterile treatments, usually a Registered Nurse (RN).

• Perform hand hygiene before and after using them
• Gowns must fully cover the torso from neck to knees, arms to end of wrists and adequately wrap around the back with all tie fastenings tied at the back
• Remove and dispose of gowns as soon as care is completed
• Elastic aprons can be used: 
  • When clothes may be exposed to blood or body fluids, but a low risk thatthe  arms will be contaminated 
  • when the worker’s clothes might get wet (e.g. showering a client) 
  • only once and then disposed of as soon as care is complete.

• Face masks protect us when caring for clients with an infection spread by droplet or airborne route. They protect the nose and mouth from exposure to many infectious agents and are used if there is a risk of:
  • droplets or aerosols (e.g. from coughs or sneezes)
  • splashes or sprays of blood or body fluids (e.g. when providing complex wound care or urinary catheter care).
• Coughing clients can also wear face masks, especially if they cannot cover their mouths (you can use both only if wearing the face mask will not cause the client distress).
• When using face masks:
  • Check the manufacturer’s instructions before use
  • Don’t touch the front of the mask with your hands once your mask is in place
  • Use the mask for the care of one person only, and change if a care activity is taking a long time
  • Don’t leave the mask dangling around your neck
  • When the activity is complete, discard the mask and perform hand hygiene.

• Protective eyewear protects our eyes from exposure to infectious agents when there is a risk of:
  • droplets or aerosols (e.g. from oral suctioning)
  • splashes or sprays of blood or body fluids (e.g. when emptying urinary catheter bags).
• Protective eyewear protects us when caring for clients with an infection spread by droplet or airborne route.
• When using protective eyewear:
  • Remember that the outside of the eyewear is contaminated
  • When care is complete, remove eyewear using the headband or earpieces
  • clean the eye shield after each use with detergent and water, and allow it to dry
  • If eyewear is single-use, dispose of it after completion of the care activity.

• When supporting clients with urinary catheters or tracheostomies, good practices are vital to protect both the client and you from risks of infection. When supporting clients with medical devices:
  • Always perform hand hygiene before any contact with the device or where the device enters the client's body
  • Wear PPE if there is a risk of exposure to blood or body fluids
  • touch the device as little as possible
  • Remember that the longer a device is in place, the greater the risk of infection.
  • Medical devices designed for single use must not be used multiple times—always follow the manufacturer’s instructions.

• Cleaning is essential to stopping the spread of infection and depends on the objects involved and the risk of contamination. 
• When cleaning:
  • Most surfaces can be adequately cleaned with warm water and detergent as per the manufacturer’s instructions
  • Allow cleaned surfaces to dry completely
  • A detergent solution followed by a disinfectant may be appropriate when an infection is known or suspected.

• Prompt clean-up of spills (e.g., vomit or diarrhoea) helps prevent infectious agents from spreading from the environment to people. 
• When managing spills:
  • Select the appropriate PPE (e.g. gloves and other equipment) depending on the size of the spill
  • Immediately wipe up spots and spills smaller than 10cm or cover larger spills with absorbent material
  • Dispose of contaminated cleaning materials
  • clean with a detergent solution and consider following with disinfectant for infectious or larger spills
  • Always perform hand hygiene.

• Advise the office or the client's Care Manager: 
  • If you are suffering from diarrhoea, vomiting, fever, sore throat with fever or jaundice, seek medical advice and do not return to work until free of symptoms for 48 hours
  • You have infected skin lesions (e.g. infected skin sore, boil, acne or abrasion, or any discharges from the ears, nose or eyes) and seek medical advice
  • If you believe any food is unsafe to eat
• perform hand hygiene before handling food or putting on gloves
• perform hand hygiene after using the toilet, smoking, coughing, sneezing, blowing nose, touching face, nose, ears or mouth, handling rubbish or after cleaning
• Avoid unnecessary contact with ready-to-eat foods
• cover hair and tie back long hair
• secure hair clips, hairpins, buttons on clothes, jewellery and bandages
• ensure bandages or dressings on any exposed open cuts or lesions on the body are covered with a waterproof covering
• not sneeze, blow, or cough over unprotected food or surfaces likely to come into contact with food
• not eat over unprotected food or surfaces likely to come in contact with food
• not spit, smoke or use tobacco or similar preparations in areas where food is handled
• not touch food after touching earrings, body parts (hair, nose, ear, eye), skin lesions, saliva, mucus, sweat, blood or money without first performing hand hygiene
• not wear gel, acrylic or false fingernails, jewellery or lanyards that may come into contact with food.

• Keep hot food hot and cold food cold
• Use separate storage, utensils and preparation surfaces for cooked and uncooked foods
• Wash all utensils and preparation surfaces thoroughly with hot water and detergent.

• Wear gloves and a disposable gown/apron when handling the linen of clients who have an infection
• Take a laundry basket to the bedside and put the linen directly in the basket
• Place linen soiled with blood or urine, or other body fluids, into leak-proof laundry bags—do not carry soiled linen
• Don’t sort or rinse used linen in areas used to provide support to clients 
• perform hand hygiene after handling any linen
• Store the clean linen in a clean, dry place, separate from the used linen.

• Perform hand hygiene before and after transport and
• If a client has a respiratory illness, encourage them to wear a mask and to perform respiratory hygiene/cough etiquette, also
• contain and cover any infected areas of the person’s body.

• Flush the area with running water
• Wash the area with soap and water
• Report the incident to the client's Care Manager
• Raise an Incident Report
• Seek medical advice.

• Practising hand hygiene at all times
• Practising respiratory hygiene/cough etiquette
• Ensuring home support workers are trained in the correct practices to reduce the risk of infection
• Ensuring appropriate PPE is available to home support workers when required
• Auditing of infection control policy and practices.
• CCM to complete the WHS document inside the client's care instructions, which details infection risks to the support worker team, and infection prevention processes to use when care is transferred between clinicians or other health services
• CCM will instruct support staff on infection prevention and control practices.
• CCM should contact other health service clinicians to advise if a client has a confirmed infection that is contagious. 
• CCM to report communicable diseases to the Department of Health and Aged Care 
• CCM is to be an antimicrobial steward advocate for clients who have been overprescribed antibiotics, which may potentially create infection risks.
• Undertake Infection Prevention and Control (IPC) Training at Induction and complete the annual Hand Hygiene - IPC - Refresher course. 

• Practising hand hygiene at all times
• Practising respiratory hygiene/cough etiquette
• Wearing PPE when required
• Support staff to follow infection prevention and control instructions from CCM 
• advising the office and seeking medical advice if you are suffering from diarrhoea, vomiting, fever or have infected skin lesions
• advising the office if you notice anything that might increase the risk of infection, e.g. inadequate cleaning or an unwell client.
• Advise the office if the client has had a visitor who presented with symptoms of unwellness or illness, such as cough, wheeze, fever, chills, skin rash, etc.
• Advise the CCM when the client is prescribed antibiotics by a medical professional. 
• Undertake Infection Prevention and Control (IPC) Training at Induction and complete the annual Hand Hygiene - IPC - Refresher course. 

• Talent LMS - 4.1.5 Infection Prevention and Control course 
• Talent LMS - 4.6.1 Hand Hygiene course 
• Infection Control - Policy
• Hand Hygiene - Policy
• Hand Hygiene - Processes 
• National Hand Hygiene Initiative 2019
• COVID-19 training
• Sneeze and cough etiquette YouTube video 2.13 mins

• Infection Control Policy
• Pandemic Management Policy
• Hand Hygiene Policy
• Hand Hygiene Processes
• Antimicrobial Stewardship

• NDIS - Practice Standards and Quality Indicators Guidelines 2018 (Cth Legislation)
• NDIS Practice Standards and Quality Indicators, Nov.2021 v.4 
• NDIS Quality and Safeguards Commission
• NSW Health cough etiquette 
• Aged Care Quality Standards
• Infection Control Processes
• COVID-19 training
• ACSQHC - Principles for aseptic technique 
• Department of Health and Aged Care - Communicable Diseases