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Induction for departmental staff

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1 Induction for departmental staff
Infection Control Induction for departmental staff Suggested Speaking Notes: This presentation aims to provide information about infection related hazards that potentially exist in the workplace. This also directs staff to the resources, information and strategies needed to manage the risks. Workplace infectious diseases can impact on workplace operations e.g. absenteeism and disruptions to service delivery. It is also more efficient for all workplaces (and especially schools) to manage day-to-day staffing needs if staff are not away because they have contracted an infectious disease. E.g. In schools it is also easier to maintain the continuity of a students’ education if it is not disrupted by an avoidable disease outbreak. Note to Trainers: A hand out of slides as well as relevant documents may assist learners and facilitate discussion. Time out poster: A selection of Queensland Health Fact Sheets: e.g. chicken pox, whooping cough, measles. Hand washing poster: Other brochures: Safe handling and disposal of needles and syringes - Public Health Act 2005 –Contagious Conditions Fact Sheet for Schools and Education and Care Services Link: Information for Schools, Education and Care Services and Child Care Services Contagious conditions - Public Health Act 2005, Chapter 5 Part 2 Link: This is a comprehensive presentation. Presenters are encouraged to tailor the content to suit specific needs while covering relevant content.

2 Click on the picture to play the animation.
Instructions to Trainers: When this presentation is in “slide show” view, click on the image to automatically run the animation. **You will also need to be connected to the internet** This animation is a quick overview of infection control in the workplace. The web link for this animation is: Other animations are available on health and safety related topics at:

3 Overview Infection control is important in departmental workplaces.
There are specific diseases that can spread easily in our workplaces if controls are not in place. To protect your own health as well as the health of those around you, an understanding of infectious diseases, how they are spread and how to control them is fundamental. Suggested Speaking Notes: This slide provides a general overview of the contents of this presentation. This presentation provides background information, departmental protocols (what you are expected to know about and what you are expected to do - to stop yourself and others from getting sick). Why is this presentation important? Staff are entitled to be aware of the hazards they are potentially exposed to, at work, what the controls are, how to implement those controls and what to do if those controls are not working. As an employer, the department has a duty to advise staff of these potential hazards. In our workplaces, infection and infectious diseases are an identified hazard. Example to promote discussion: Teacher aide who is required to assist with toileting of students in a special needs environment. Note: some infectious disease are spread via the faecal/oral route (microscopic amounts of faecal matter are inadvertently ingested) e.g. Hepatitis A. The teacher aide should know: Hazards, risks, modes of infectious disease transmission and prevention. Standard precaution of correct hand washing and the proper way to wash hands The required facilities (hand basin, running water, soap, paper towels) and personal protective equipment (e.g. gloves) – and have access to these. There is a vaccination for Hepatitis A, and their duties entitle them to workplace funded vaccination. Note: The enterprise bargaining agreement for Teacher Aides, School Cleaners and Schools Officers (J/G) includes Hepatitis A&B vaccination for “at risk” staff. “At risk” means that their work duties require them to be exposed to the infectious agent i.e. faecal matter.

4 Infectious diseases are diseases you can “catch”.
Humans are susceptible to a wide range of diseases that can be contracted from: Other people (e.g. measles) Insects (e.g. mosquitoes) Animals = zoonosis (e.g. bats, horses, cattle) The environment (e.g. contaminated water, waste). Suggested Speaking Notes: The Work Health and Safety Act 2011 recognises the general duty for the workplace to be safe from harm. The Public Health Act 2005 has a specific section that applies to the powers and responsibilities of providers of services (e.g. school principals) to act in the event of a prescribed contagious condition. This is to prevent the particular condition e.g. measles, from spreading through the school and into the community. The Department has specific procedures and detailed guidelines to assist schools and other workplaces. The development and adoption of an effective infection control program in a workplace aims to prevent the introduction and spread of infectious diseases in the workplace. Note: Zoonosis – is a disease that can be caught by a human from an animal. i.e. it “jumps species”. Recent examples are “swine flu” (H1N1), “bird flu” (Avian Influenza), Lyssavirus from bats (flying foxes), Q fever (from sheep, cattle, goats, camelids etc). Animals i.e. zoonosis (e.g. bats, horses, cattle) Qld Health - Animal Contact Guidelines – Reducing the Risk to Human Health

5 Departmental Workplaces
Infectious diseases spread easily in our workplaces - why? Groups of people, in close contact, for extended periods & on a daily basis e.g. classrooms Culture of attendance (staff/students/others) Even when sick. Possible contact with asymptomatic carriers e.g. contagious before the symptoms show. Non-vaccinated populations Environmental e.g. Returning to workplaces that may have been flooded, contaminated with waste water/surface water. Suggested Speaking Notes: Our workplaces are diverse locations where groups congregate for various reasons e.g. staff, students, public, parents, grandparents, babies etc. In this way our workplaces are different from typical office, factory or industrial workplace. Diligence regarding infection control is therefore needed. Consider some examples: school assembly, classroom activities, prep, special schools, open day, parent/teacher interviews. Each of these factors needs to be considered when attempting to address infection control. Consider some behaviours: Staff tend to “soldier on” even when they are unwell and potentially infectious to others. Parents may inadvertently send unwell students to school or are unable to collect unwell students due to work commitments. Example: consider a year 6 student with early symptoms of influenza, gastroenteritis or measles the day before leaving for a one week trip to Canberra. Teachers on the excursion may be unaware of the student’s condition until day 2 at which time, everyone is getting sick.

6 Departmental Workplaces continued…
Hygiene issues e.g. poor cough & sneeze etiquette, hand washing Workplace activities e.g. contact sports / special education / first aid Work duties e.g. cleaning & maintenance, toileting Community engagement e.g. Visitors & volunteers Curriculum e.g. Handling animals, food preparation and food consumption, science activities. Locations e.g. Mosquito borne diseases (Ross River, Dengue, Japanese Encephalitis) Suggested Speaking Notes: Day to day activities at a departmental workplace can potentially place us in contact with blood and body fluids. E.g. a head clash in the playground or on the sports field, an unwell student that vomits in the classroom. Our schools and other workplaces often have others who’s immunity and/or wellness is unknown e.g. an open day, fete, conference, excursion, diagnosed – but undisclosed condition e.g. hepatitis C. Consider some other reasons that a workplace may be a “amplifier” of disease. Conditions Behaviours Cohort Non-vaccinated staff/students Staff or students undergoing cancer treatment (immunosuppressed)

7 How are infectious diseases transmitted – modes of transmission
Contact transmission – direct contact with infectious blood or body substances. Droplet transmission – infectious agent in large droplets (respiratory secretions / splash / splatter). Airborne transmission – infectious agent in aerosols and are inhaled. Food-borne transmission – consumption of contaminated food. Water-borne transmission – consumption of contaminated water. Vector-borne transmission – carried by a vector e.g. mosquito bites etc. Suggested Speaking Notes: If we know how an infectious agent enters the body, then we and devise strategies to prevent infection. How are different disease transmitted: You can “catch” the ‘flu’ from someone’s nasal secretions (sneezing etc.) Transmission is therefore breathing in infectious airborne droplets. You can “get” gastroenteritis if someone with unwashed hands prepares food. Transmission in this case is faecal/oral – Indirect Transmission. Before rigorous blood bank screening, you could “catch” blood borne diseases e.g. hepatitis C, HIV etc., from a blood transfusion. Transmission in this case is Direct Contact transmission (infected blood enters the blood stream) Access Queensland Health Factsheets to find the answers by looking at the “transmission” and “prevention” sections for each disease. Qld Health Fact Sheets web page: Modes of Transmission – the common ways diseases spread are: Contact transmission – when a person is exposed to an infectious agent from direct contact with infectious blood or body substances e.g. blood, urine, faeces, saliva, nasal secretions, or from indirect contact with contaminated items such as surfaces and equipment e.g. door handles. Infectious agents can then enter the person’s body via broken skin e.g. cuts, the mucous membranes of the person’s eyes, nose or mouth, by ingestion e.g. the ‘faecal-oral route’ or by a sharps e.g. needle stick injury. Droplet transmission – when infectious agents contained in large droplets e.g. splash, spray, spatter of blood or body substances are deposited on the mucous membranes of the eyes, nose, mouth etc. Airborne transmission – when infectious agents contained in aerosols and dust are inhaled. Food-borne transmission – when infectious agents are spread through consumption of contaminated food. Water-borne transmission – when infectious agents are spread through consumption or contact with contaminated water. Vector-borne transmission – when insect vectors such as mosquitos and ticks transmit infection to a person via bites e.g. Dengue Fever

8 Airborne/Droplet Transmission
Large particles (droplets) can carry viruses and bacteria through the air which can then be deposited onto mucous membranes (eye, nose, mouth) of a susceptible person (e.g. via sneezing, coughing, talking). e.g. whooping cough, rubella, mumps, influenza, meningococcal disease. Small particles (aerosols) that are airborne, may also be deposited on mucous membranes or inhaled directly. e.g. tuberculosis, Q fever, legionella, chicken pox, measles. Suggested Speaking Notes: This picture clearly shows how a sneeze will impact on people and surfaces. This is why sneeze and cough etiquette are very important in the workplace. How could Standard Precautions address airborne/droplet transmission: Hand washing to prevent hand to mouth contamination Cleaning and disinfection to prevent indirect transmission e.g. wiping down surfaces, cleaning and disinfecting chopping boards. Respiratory hygiene, cough and sneeze etiquette. Cover the nose/mouth with disposable single-use tissues when coughing, sneezing, wiping and blowing noses Use tissues to contain respiratory secretions Dispose of tissues in the nearest waste receptacle or bin after use If no tissues are available, cough or sneeze into the inner elbow rather than the hand Practice hand hygiene after contact with respiratory secretions and contaminated objects/materials (wash/sanitise) If no tissue coughing or sneezing into your sleeve – see link: Q fever is primarily transmitted from the animal to humans via inhalation of the Q fever bacteria. Would hand washing be the most effective control? – No. The most effective control would be? – Elimination (do not expose unvaccinated people to high risk activity), Vaccination, PPE – level 2 respirator etc., i.e. controls that protect the mode of transmission of inhalation. Like a smoke particle, if you can smell it, then you can inhale it, Q fever bacteria are microscopic.

9 Contact Transmission - Direct
Direct contact When blood or bodily substances from a person or animal come in direct contact with another person in such a way that it can enter their body. e.g. Infected blood or other bodily fluid enters another person’s system directly, via a wound or via mucous membrane e.g. needle stick injury, diseases passed from mother to foetus, saliva exchange. e.g. Infected blood or other body fluid from an animal, enters another person’s system via a wound or via mucous membranes e.g. bat lyssavirus (scratch/bite), Ross River virus (mosquito). . Suggested Speaking Notes: Direct contact is when a person is exposed to an infectious agent from direct contact with infectious blood or body substances e.g. blood, urine, faeces, saliva, nasal secretions, or from indirect contact with contaminated items such as surfaces and equipment. Infectious agents can then enter the person’s body via broken skin e.g. cuts, the mucous membranes of the person’s eyes, nose or mouth, by ingestion e.g. the ‘faecal-oral route’ or by a sharps e.g. needle stick injury. When are we in direct contact with blood and/or bodily fluids? When blood and/or bodily fluids can penetrate your natural bodily protection mechanisms. e.g. Skin and Superficial Infections: impetigo (school sores), ringworm, conjunctivitis. e.g. Blood borne diseases: Hepatitis B and C, Diseases carried in saliva; bacterial meningitis, cytomegalovirus - science experiments using saliva or urine. e.g. Infectious diseases that are passed from mother to foetus during pregnancy i.e. congenital diseases (toxoplasmosis, chicken pox, human parvovirus, rubella, cytomegalovirus, herpes simplex virus)/ Direct contact disease transmission is addressed through adoption of Standard Precautions. This is the practice of assuming that all blood and bodily fluids are potentially infectious. Note: staff are not required to disclose medical conditions – including blood borne diseases. Parents are not to send a child to school if they know that the child has a prescribed contagious condition under the Public Health Act They do not have to disclose the student’s condition. Further blood borne diseases such as HIV and Hepatitis B and C are not prescribed contagious conditions under the Public Health Act Consider: how do we protect ourselves and others from direct contact? – vaccination, PPE, correct protocols (e.g. disposal of used/discarded syringes), covering open wounds, management of injury.

10 Contact Transmission - Indirect
Indirect Contact when germs from an infected host or other source are passively transmitted to another person e.g. via an inanimate object. Inanimate objects: e.g. surfaces, keyboards, mouse, telephone, iPad, utensils, cups, toothbrushes, razors, soiled linen, taps and sinks etc. Suggested Speaking Notes: Indirect Contact Transmission is why it is important to practice regular hand and respiratory hygiene, cleaning and disinfection of contaminated surfaces, washing of linen (e.g. sheets/blankets in first aid room), using disposable items when appropriate e.g. tissues, paper hand towels, and cleaning/sanitising of reusable items that may harbour infectious disease e.g. class sets of recorders, communal cutlery, coffee cups, shared head sets etc. A practical example would be the kitchen chopping board (Home Ec, tuckshop, work kitchen). Salmonella can be transmitted from raw chicken meat. Indirect contact occurs when raw poultry — or even just its juices — somehow come into contact with any other food products that will not be cooked e.g. if a cook were to cut raw chicken on a cutting board and then later slice fresh tomatoes on the same board without washing it first. Salmonella could be indirectly transmitted to a person. Trainers can use the images on the slide to promote discussion of other surfaces (e.g. tap handles, keyboards, mobile phones etc.

11 The department therefore requires a tailored
Controlling Infectious Diseases Controlling infectious diseases requires a “multi-faceted” approach considering: Modes of transmission Evolving diseases and germ resistance People’s behaviour, knowledge & beliefs Environment (where we work, learn & play) Changing circumstances & emergencies Individual requirements & group requirements The department therefore requires a tailored Infection Control Program be implemented Suggested Speaking Notes: The information provided so far should increase awareness of potential diseases in the workplace and how they can be transmitted. It should also increase the awareness that there are many unknowns. An infectious disease could enter the workplace at any time. The workplace needs a consistent continuous process to account for the ever present risk and the things that are unable to be controlled e.g. new diseases, people’s behaviour. This environment drives the concept of an Infection Control Program, which is a multifaceted approach in an effort to cater for each mode of transmission and all individual circumstances.

12 Infection Control Program
Key elements of and effective Infection Control Program Suggested Speaking Notes: Workplaces are best to use the broad elements of an infection control program to develop their own specific workplace practices or protocols. In order to cater for the gambit of infectious diseases, not only acquired from humans but also potentially acquired from animals (zoonoses), the infection control program needs to be multifaceted with all components working in a complementary manner. E.g. Infection Control as it applies to rendering first aid to demonstrate how the facets of the Infection Control Program complement each other. Training – first aiders should know about infection control when rendering first aid Standard precautions – first aiders will have been trained to treat all blood and bodily fluids as if they are infectious. Vaccination - first aiders should consider ensuring all relevant childhood illness related vaccinations up to date as well as hepatitis A and B. Waste Management - the first aid room should have a sharps container and appropriate disposal of contaminated items (e.g. swabs, bandaids, etc) Cleaning and disinfection – surfaces should be routinely cleaned and disinfected. Linen should be laundered. Safe use of Sharps – sharps disposal bin (previously mentioned), training in handling and disposal of syringes, arrangement for disposal and replacement of full sharps containers. Personal Protective Equipment – disposable gloves, plastic apron etc. Hand /Respiratory Hygiene – hand basin with mild liquid soap, running water and paper towels, masks, tissues. Communal towels not to be used. Consider how the elements of an infection control program could be applied to another activity. Reminder: What is meant by the term “Standard Precautions”? Standard precautions is a term used in health sectors and describes the assumption that all blood and bodily fluids / substances are potentially infectious and therefore all blood and bodily fluids/substances should be treated accordingly. If standard precautions and the Infection Control Program is rigorously applied, it should follow that most infectious diseases can be contained as routes of transmission will be blocked. For example: if first aid is being applied, we assume that the blood and bodily substances of both parties is infectious, i.e. the person providing first aid AND the injured person. The standard precautions apply to both people in order to protect both people.

13 How to implement infection control
Promote infection control as standard practice Know the risks in your workplace, how diseases are transmitted and how to implement controls. Have processes and protocols in place Have appropriate facilities and consumables (allocate funds) Signage e.g. correct hand washing technique Provide and take part in training sessions Maintain records of training Promote vaccination Adopt a risk management approach to infection control Suggested Speaking Notes: Infection control should become standard practice and “second nature” to staff and students. The importance of effective hand washing cannot be overemphasised. Refer to Hand Washing Technique Poster Drying hands is important as wet hands may also be “better” at picking up contaminants. An infection control program need not be expensive, however, workplaces should have funds allocated to these proactive programs e.g. for upkeep of facilities, paper towels, soap, soap dispensers. Some locations have benefited from relocating their hand washing facilities and changing the type of soap that they use. Example of thinking laterally when faced with an infection control issue. Issues: Soap creating slip hazard in toilet block, students not washing hands, vandalism (soap down the S bend) Initial response: Removed the soap and hand towels. This option is unsatisfactory for infection control. Novel control: Hand basins moved to exterior of the toilet block. Foam soap dispensers were attached over the sinks. Area “caged” to prevent evening and weekend access. Positive outcome 1. No vandalism – outside hand washing area could be observed by staff (e.g. on duty) and students. Positive outcome 2. behavioural change – evident to all if a person did not wash their hands. Other blocks updated. Idea shared with other schools and the Facilities Branch for improved future design. Risk Management: Health and safety risk management is a process where we do what we can to minimise the risks associated with health and safety hazards at our workplace. The aim is to identify and control hazards so that people are not injured and do not become unwell due to work. Reviewing infection control measures examples e.g. if there is a new hazard – immuno-compromised staff / student e.g. if current controls are not working – student behaviour e.g. PPE is not suitable for the task – causes allergic reaction for user More information: Health and Safety Risk Management – Creating Healthier Workplaces Website: Managing Health and Safety Risks: Health and Safety Risk Assessment Template: l

14 Potential Infectious Diseases in the workplace
The Queensland Health “Time Out” poster is an excellent quick reference resource. Download this poster for ready reference. Teachers/school staff and managers should model the recommended exclusion periods when they are unwell. Suggested Speaking Notes: The Queensland Health “Time Out” poster is an essential resource to access, it can be stuck up on the wall in office for example. It is recommended it be downloaded as a resource. This is an excellent first reference when the office is advised of a staff member or student with an infectious disease or other condition. It provides some additional information about the condition as well as the period of time that the person should be away from work/school and any impacts on close contacts e.g. people exposed to the person with the infection. The list above shows some of the most commonly encountered conditions. For more information on each of these a Queensland Health factsheet can usually be “googled” e.g. google search “Queensland health measles factsheet” would be the easiest way to find more information in print - example diseases. Chickenpox (varicella) Cold sores (herpes simplex) Conjunctivitis Cytomegalovirus (CMV) Diarrhoea and/or Vomiting Diphtheria Enterovirus 71 Glandular Fever (EBV) Hand, foot and mouth disease Hepatitis A Hepatitis B, Hepatitis C HIV/AIDS Influenza and Flu-like illness Measles Meningitis (bacterial) (viral) Meningococcal infection Parvovirus Pertussis (whooping couth) Poliomyelitis Ringworm/tinea/scabies Rubella School sores (impetigo) Strep. throat including scarlet fever Tuberculosis Typhoid, paratyphoid

15 Protocol for managing infectious diseases
If a staff or student/parent advises of an infectious disease…. 1. Maintain confidentiality, but inform the appropriate person at your location (e.g. school admin/workplace manager) 2. Actions for School Admin/ Management Determine the nature of the disease? (measles, chickenpox) Confirm diagnosis (i.e. was a the disease diagnosed by a doctor?) If confirmed by a doctor, seek relevant information from Qld Health. d) When confirmed, the school / workplace may provide information to staff/school community to be aware of symptoms and recommended actions e.g. using a link to a Qld Health Fact Sheet. Suggested Speaking Notes: Schools and other workplaces may like to keep a folder of instructions (physically or electronically) for ready access in this situation. A range of standard letters e.g. to parents, co-workers etc. can be handy as it is usually important to have any necessary communication strategies in place before the end of school or the end of the work day. Immunocompromised and non-immune staff or students, may need to be identified and advised appropriately. Ready reference information: Departmental Infection Control Page: Time Out Poster Access to Queensland Health Fact Sheet Access to contact: Regional Senior Health and Safety Consultant, Local Public Health Unit Procedures – Managing Prescribed Contagious Conditions, Infection Control Infection Control Procedure: Infection Control Guideline: Management of Prescribed Contagious Conditions Procedure: Queensland Health Public Health Units: Sample Letters/ s/newsletter articles.

16 Protocol for managing infectious diseases continued: Schools / workplaces do not notify Qld Health, but can call them for advice if needed. If a prescribed contagious condition has been diagnosed the doctor or laboratory will notify Qld Health. Queensland Health will only notify a school in particular circumstances. e.g. a community cluster/outbreak. Suggested Speaking Notes: Refer to departmental procedure: Management of Prescribed Contagious Conditions for details - Children are at considerable risk of being exposed to a contagious condition when an infectious child attends school or child care as these are places where close and prolonged contact often occurs between children through playing, eating and classroom situations. The Management of Prescribed Contagious Conditions procedure relates only to schools and services covered by the Public Health Act 2005: The provisions of the Public Health Act 2005 (Qld) (http://www.legislation.qld.gov.au/LEGISLTN/CURRENT/P/PubHealA05.pdf) include minimising the spread of vaccine preventable contagious conditions in schools. Although there are many medical conditions that are contagious, not all childhood infectious diseases are prescribed in the Public Health Regulation 2005 (Qld) (http://www.legislation.qld.gov.au/LEGISLTN/CURRENT/P/PubHealR05.pdf). The responsibilities outlined below apply only to the specific conditions which are prescribed under the Public Health Act 2005 (Qld) (http://www.legislation.qld.gov.au/LEGISLTN/CURRENT/P/PubHealA05.pdf). - A listing of prescribed contagious conditions are on the next slide….

17 Preventing the spread of infection
Hand Washing is one of the most important measures in preventing transmission of infection. Hands should be washed using soap, water and then dried: before handling, preparing or eating food before and after assisting students with eating/meals assisting students with toileting providing first aid or medication contact with an ill or injured person after contact with blood or body fluids (this includes your own e.g. sneezing/coughing) removal of protective gloves using the toilet; and after contact with animals. Suggested Speaking Notes: There are many posters and instructional videos on hand washing. But ideally, when should you wash your hands? This slide provides the information. Think about the number of times a day that you do NOT wash your hands when you probably should. Many people now have alcohol based hand rubs / sanitisers on their desk at work. It is becoming commonplace to see hand sanitisers at the counter of many businesses, particularly, doctors surgeries, gyms, veterinarians, pet stores and chemists. https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/ch55g_how_to_wash_hands_poster_ pdf You could get the group to speak about examples in every day working life and in home life.

18 Vaccination Vaccination not mandatory for staff or students of the department. However where a vaccination exists, this is the highest order of protection from the infectious disease. Vaccination boosts the immune system and creates immunity that protects from an infection without causing the suffering of the disease itself.   Most vaccines contain a little bit of the disease germ that is weak or dead. Vaccines do NOT contain the type of germ that makes you sick. Getting the vaccine is a much safer way to make antibodies without having to suffer the disease itself. Suggested Speaking Notes: This slide provides factual information regarding vaccinations and how they work. As there are many people who are concerned about vaccination, this information may be of assistance and allay their fears. The Australian Immunisation Handbook 10th Edition contains a table that compares the effects of disease vs the side effect of the vaccine. This has been made into a handout and can also be viewed at: Vaccine Side Effects vs Disease Symptoms.

19 Occupation Specific Vaccination
Recommended Vaccinations for: Persons who work with children Influenza MMR (measles, mumps, rubella) Pertussis (whooping cough) Varicella (chicken pox) Staff working in early childhood education and care All of the above plus hepatitis A. Source: Australian Immunisation Handbook 10th Edition Suggested Speaking Notes: With respect to immunisation, the Australian Government publishes an Immunisation Handbook which, amongst other information, makes recommendations for the vaccination requirements for specific work groups. Note: these are not mandatory but recommended. Trainers may discuss the benefit of vaccination compared with actually getting the disease, or passing the disease onto another person.

20 Vaccination Funding Staff Type Disease Funding Source
School Cleaners School’s Officers Teacher Aides Hepatitis A Hepatitis B Workplace Living and working in outer islands of Torres Strait Japanese Encephalitis At risk of acquiring TB Tuberculosis Workplace – check with TB Control unit Ag studies – with risk of exposure to Q fever Q fever All staff participating in Annual Flu Program Seasonal Influenza Funding determined locally All staff National Immunisation Program vaccinations/boosters Self funded. Suggested Speaking Notes: When workplaces and individuals are reviewing immunisation status, consider the funding needed. Principals/Managers can utilise this guide when budgeting form the vaccination component of their infection control program. E.g. annual influenza vaccination program is approximately $25/person. The program offers the convenience of the vaccinator coming to the work location as well as removing the cost of a doctor consultation. Staff type *at risk staff Risk Infectious disease Funding source School Cleaners, Schools Officers, Teacher Aides, Staff working in early childhood education and care, Special Education settings. Staff that may come into contact with faecal matter. Hepatitis A Funded locally by school / workplace. Note: Enterprise Bargaining agreements for Schools Officers Teacher Aids School Cleaners include this vaccination. Staff working in Special education settings Staff that may come into contact with blood and body substances, infectious waste, discarded syringes. Hepatitis B Staff who live with, or make frequent visits to, remote Indigenous communities Increased risk of exposure to hepatitis A Staff living and working in the outer islands of the Torres Strait Staff that may be exposed to Japanese Encephalitis which is transmitted via mosquitoes. Japanese Encephalitis Staff recognised as being at risk of acquiring Tuberculosis (TB) Check with local Tuberculosis (TB) Control Unit Tuberculosis Agriculture Studies Staff involved in activities that are likely to expose them to the Q fever bacteria Airborne inhalation of Q fever bacteria from at-risk animals (e.g. cattle, sheep, goats and camelids), birthing products, excreta, abattoirs, tanneries, stockyards etc. – see Q fever in Schools Fact Sheet. Q Fever

21 Prescribed Contagious Conditions
Prescribed Contagious Conditions as defined by Queensland’s Public Health Act Chapter 5 Part 2 chickenpox (varicella) diphtheria enterovirus 71 gastroenteritis german measles (rubella) haemophilus influenzae type b (Hib) hepatitis A influenza measles meningococcal disease (bacterial) poliomyelitis typhoid and paratyphoid tuberculosis whooping cough (pertussis) Suggested Speaking Notes: Public Health Act 2005 The Public Health Act is Legal framework to support schools when a child has or may have a contagious condition prescribed under the Regulation. Such contagious conditions are considered to be serious illnesses that may put children and staff at risk. Two useful links follow: These would also be good hand outs for participants. Public Health Act 2005 –Contagious Conditions Fact Sheet for Schools and Education and Care Services Link: Information for Schools, Education and Care Services and Child Care Services Contagious conditions - Public Health Act 2005, Chapter 5 Part 2 Link: Legislated definition of work caused “serious illness” – complete definition Infection arising out of work is a significant contributing factor, including any infection that is reliably attributable to carrying out work: with micro-organisms; or that involves providing treatment or care to a person; or that involves contact with human blood or body substances; or that involves handling or contact with animals, animal hides, skins, wool or hair, animal carcasses or animal waste products. The following occupational zoonoses contracted in the course of work involving the handling or contact with animals, animal hides, skins, wool or hair, animal carcasses or animal waste products: Q fever, Anthrax, Leptospirosis, Brucellosis, Hendra virus, Avian influenza, Psittacosis.” The Infection Control Procedure: describes the requirements expected by the Department of Education, Training and Employment (DETE) for the health, safety and wellbeing of staff, students and others with regard to infection control through both preventative and management strategies. Infection control practices are to be implemented at all departmental workplaces. This procedure and the Infection Control Guideline (http://ppr.det.qld.gov.au/corp/hr/workplace/Procedure%20Attachments/Infection%20Control/guideline.doc) have been established to provide a minimum standard to be implemented.  A worker who contracts an infectious disease due to the workplace (e.g. whooping cough from another staff member or student) has contracted a workplace “serious illness” and this must be notified to Workplace Health and Safety Queensland. See: Fact Sheet for Schools and Education and Care Services Public Health Act 2005 – Contagious Conditions Information for Schools, Education and Care Services and Child Care Services

22 Protocols for prescribed contagious conditions
Under the Public Health Act 2005 children with a prescribed contagious condition should not attend school or childcare until well and non-infectious. Unvaccinated children may need to stay away during a measles outbreak if they are at risk of infection or infecting others. following consultation with Qld Health , school Principals can require children to stay away for a specified period if they have or are suspected to have a contagious condition. Staff are expected to model appropriate behaviour and stay away from the workplace if they are unwell or infectious. If a staff member contracts a work caused serious illness as defined by Work Health and Safety Legislation, this is to be notified to Workplace Health and Safety Queensland by the workplace. Suggested Speaking Notes: If you are unsure, you can generally get a lot of information from the internet and/or Phone your local regional health and safety consultant Contacting Queensland Health on their general 13HEALTH number to speak to a nurse and/or doctor. Contacting your local Queensland Health Public Health Unit Schools should refer to the procedure – Management of Prescribed Contagious Conditions Procedure: Staff often become unwell from a bug that is “going around” however it is usually not possible to determine that it specifically came from work as it could also have been contracted in the general community e.g. on the bus, at a shopping centre. However, in specific circumstances, e.g. when a student with measles infects their teacher, or a staff member in an office infects other staff with chicken pox, or if a teacher contracted a disease from an animal while at school e.g. Q fever. Then the illness is a work cause serious illness and this must be reported to Workplace Health and Safety Queensland – in the same way as a Serious Injury would need to be reported to Workplace Health and Safety Queensland e.g. MyHR WHS.

23 Diseases related to pregnancy
Our departmental workplaces have a large number of females on site. Infectious diseases that could impact on pregnancy should be highlighted and precautions noted. Those considering pregnancy or who are pregnant should tell their doctor about their work requirements, seek advise about any recommended vaccinations / precautions and know your immunisation status. Refer to the procedure Pregnancy in the Workplace Any issues with regard to work placement or leave should be discussed with your Officer-in-Charge. Infectious Diseases that can impact on pregnancy. Measles Mumps Rubella Influenza Chickenpox (Varicella) Cytomegalovirus (CMV) Parvovirus Suggested Speaking Notes: Owing to the department’s demographics, it is important to advise of diseases that may be relevant to pregnancy. Information provided by the workplaces may assist in an individual’s discussions with treating medical practitioners. This information is also important to all who may have a pregnant contact e.g. spouse. The department has a large percentage of female staff and there are female students and parent volunteers. These women may or not know that they are pregnant, and there is no requirement for this to be disclosed to the workplace. Therefore staff / volunteers and students who are pregnant, should speak with their doctor about the work that they do and where they work to ensure that they have appropriate vaccination and/or know what infectious diseases can impact on their pregnancy in order to implement appropriate standard precautions. E.g. there is no vaccine for CMV (cytomegalovirus) which is common in children. When they are infectious it is shed in their urine and saliva. Children sometimes show no symptoms at all or the symptom (e.g. a rash on the cheek) does not appear until after the infectious period is over and they are no longer infectious. If contracted by a woman during her pregnancy, CMV can impact on the unborn child. This may be an issue in child care centres, where pregnant staff/volunteers may be changing nappies/toileting in contact with potentially infectious urine/saliva. Strict adherence to infection control procedures, specifically standard precautions is imperative in these environments. Some consideration should be given to removing these staff from high risk activities.

24 What are your key responsibilities? Know your immunisation status - Review your immunisation records. If you don’t have any, consider a a blood test to confirm your existing immunisation status. You may find you need a “booster”. Keep this information handy. Stay home when unwell - staff are expected to model appropriate behaviour and stay home when they are unwell or infectious. Promote and follow Standard Precautions for Infection Control – good hygiene practices, hand washing, cough and sneeze etiquette etc. Suggested Speaking Notes: Healthy and safe workplaces are everybody’s responsibility. This slide provides some ways that each of us can contribute on an individual level. Inevitably, people will get sick, despite the best intentions of the workplace. e.g. Staff member diagnosed with measles after a trip overseas. It is important for the staff member to understand the gravity of the situation and for management to know what to do if: The staff member is infectious while at work e.g. open plan office, school. There are protocols in place for managing these situations. Each situation needs to be managed on a case by case basis however the general processes are described in the next slides. Infection control guideline (http://ppr.det.qld.gov.au/corp/hr/workplace/Pages/Infection-Control.aspx) Management of prescribed contagious conditions procedure (http://ppr.det.qld.gov.au/education/community/Pages/Management-of-Prescribed-Contagious-Conditions.aspx)

25 Prevent the spread of infectious diseases
What are your key responsibilities? Prevent the spread of infectious diseases Understand and adhere to procedures Infection Control and the Infection Control Guideline Understand and adhere to procedure Management of Prescribed Contagious Conditions Implement and follow an Infection Control Program that has been developed for your workplace Seek advice if required. Suggested Speaking Notes: We all have a role to play in health and safety, this includes infection control to prevent the spread of infection diseases. While infectious diseases are potentially present in most locations e.g. shopping centre, movie theatre, markets etc. we can become complacent in the workplace. The workplace also has it’s own infectious disease risks e.g. sharing utensils, cups, glasses, working in close proximity to another person etc. An example: put yourself in the following situation. The person you work next to every day phones in to say that their doctor has told them they have chicken pox. They have been at work for the last two weeks continuously and have been suffering some “flu-like” symptoms but they became much worse over the weekend. They believe they contracted the virus while at a shopping centre as their own children are vaccinated but they themselves had never had the illness. Think about how often you have potentially been exposed to their respiratory secretions e.g. meetings, using the same phone, snacking from a communal lolly jar etc. Would you know what to do? Do you know your immunity status to Chicken pox? Have you been at risk? What about others at your workplace ?

26 All government departments then take direction from this team.
Pandemic Planning Interdepartmental protocols are in place for managing a pandemic or other health threat. Queensland’s Chief Health Officer establishes a State Health Emergency Coordination Centre. All government departments then take direction from this team. Health threat responses will be tailored to the disease type.

27 Remember Take Home Message Workplaces may harbour infectious diseases.
There is relevant legislation (WHS Act 2011 and Public Health Act 2005) There are Departmental procedures and guidelines to follow: Infection Control Management of Prescribed Contagious Conditions Prevent the spread of infectious disease following an Infection Control Program including Standard Precautions Be aware of your own immunity status to common infectious diseases. Some infectious diseases can be harmful during pregnancy. Seek advice if required. Suggested Speaking Notes: Through viewing this presentation and accessing further information such as the procedure and guidelines, it is hoped that you will be armed with and understand the above TAKE HOME MESSAGES. Adherence with departmental procedures and guidelines Appropriate facilities and supplies to support infection control A culture that encourages staff and students to stay at home when unwell Support for “at risk” staff e.g. Hepatitis A&B vaccination for school cleaners, schools officers, teacher aides, other “at risk” staff) Workplace protocols that support standard precautions for infection control e.g. adherence to Queensland Health “Time Out” exclusions. Availability of information e.g. Queensland Health Fact Sheets Regular training Risk management approach to infection control A protocol for managing infectious diseases and contagious conditions.

28 Further Resources Queensland Health – Phone: 13HEALTH (13432584)
Queensland Health Fact Sheets Departmental Policy: Infection Control Departmental Policy: Management of Prescribed Contagious Conditions Infection Control Guideline Creating Healthier Workplaces – Infection Control Regional Senior Health and Safety Consultant Key Health and Safety Tips for Teachers Local Qld Health Public Health Unit Suggested Speaking Notes: Use the links on this slide to develop an Infection Control folder in your Internet “Favourites”

29 Questions?

30 Click PLAY to run the department’s infection control animation.
Web address: Suggested Speaking Notes: Run the video again to reinforce the message. Any questions?


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