Infection Control and Personal Care 1

WELCOME Introductions House keeping Breaks Location of washrooms 2

Learning Objectives What are microorganisms/types? ARO’s How do they spread? How to stop them? Hand washing Use of gloves Skin/pressure sores Prevention of pressure sores Personal care- tenets of personal care Appropriate touch Perineal (pericare care) 3

Are everywhere! They live on our skin and in our bodies, on surfaces and in contaminated food and water. Most are not harmful to humans. Some are useful to humans. Can cause infections, illness, disease and death. Grow more easily in wet/moist dark places than dry and light areas. 4

Some have become resistant to antibiotics (called ARO’s, antibiotic resistant organisms)  MRSA (methicillin resistant staphylococcus)  Also known as the “superbug” strain of Staphylococcus.  VRE (vancomycin resistant enterococcus)  Enterococci, including VRE, are normally found in the human bowel and are shed from the body through stool.  Clostridium difficile ( C diff)  is a bacterium that causes infectious diarrhea and other serious intestinal conditions. 5

ARO’s Antibiotic Resistant Organisms Are caused by: Not finishing antibiotic prescriptions, lack of effective hand washing skills and using antibacterial soaps. Bacteria and virus’s mutate and are able to counteract the strength of current antibiotics. 6

Types Types of microorganisms: (germs) ◦ Bacteria ◦ Viruses ◦ Fungi ◦ Parasites (protozoa) 7

Germs are spread by coughing, sneezing, talking. People inhale germs by droplets in the air expelled by an infected person. Germs are also spread by touching objects that are infected by a person with an illness (cold, flu). 8

Stopping the spread of Germs Cover your nose and mouth with a tissue when you sneeze, throw the tissue out. The proper way to sneeze is into your elbow if you do not have a tissue. Keep hands away from you eyes, nose and mouth. 9

Achoo! 10

Wash hands frequently - hand washing is the best way to stop the spread of germs. Alcohol based hand sanitizers can be used (Must be at least 60% alcohol). 11

When to Wash Your Hands Wash hands after using the washroom. After sneezing, coughing, blowing your nose. After contact with an ill person. Before and after you handle food or beverages. After you touch door knobs telephones handrails or things that have many people touching them. 12

How to Wash Your Hands Wet hands under warm water and apply soap remove jewelry, rings, watches. Scrub between fingers front and back of your hands. Scrub finger nails. Continue washing for seconds (or sing happy birthday twice). Rinse well and dry you hands thoroughly. 13

How to Use Alcohol Based Hand Cleaner Dispense sanitizer (use about the size of a quarter). Rub hands together working the gel between fingers under nails and back of hands. Continue rubbing until your hands are dry. Hands must be dry before they are considered clean. 14

Blood and Body Fluid All body fluids are considered potentially infectious. Use non-latex gloves to protect yourself from diseases such as HIV, hepatitis B or C. Never share razors or toothbrushes or personal items. 15

Skin Care 16 Our skin weighs about 1kg and if intact is our first line of defense against infection. The skin is the largest organ of the body. The outermost layer of the skin is called the epidermis.

Functions of the Skin Protects us from hot or cold. Protects us from chemicals, UV radiation and bacteria. Helps to regulate our body temperature The production of sweat evaporates on the skin helps to keep us cool. Our skin protects us from impacts such as pressure. 17

Functions of the Skin Our 5 th sense. The sense of touch is one of the body’s important functions. Without it we would not be able to feel the breeze against our face a gentle touch of loved ones or sense hot and cold. 18

Preventing Skin Breakdown or Pressure Sores Intact skin is essential for health. This keeps out germs that can create an infection or illness. 19

What is a Pressure Sore A pressure sore is breakdown of skin due to staying on one position without shifting your weight. This may happen if you are bedridden, or in a wheel chair. The pressure against the skin causes lack of circulation to the area. 20

Without adequate blood flow to an area of the body breakdown will occur. 21

Pressure sores can start as a change in color (paleness or redness) of the skin and continue to progress to huge gaping wounds that are deep enough to see muscle and bone. The most common place for pressure sores to develop are bony prominences( bones close to the skin). Prevention is most important. 22

The susceptible areas are the heels, elbows, ankles, hips, shoulders, back and ears and the tailbone. 23

Causes of Pressure Sores Shear is caused when tissues and bone slide against each other in a bed or wheelchair. Friction is caused by repeated movements over surfaces such as bedding or wheel chair arm resulting in local heat and scraping of the skin. Moisture from urine, stool, sweat or poor hygiene makes skin weaker causing skin breakdown. 24

Poor nutrition makes people more venerable to skin breakdown. 25

Keeping Skin Healthy Use non-scented products to moisturize skin after bathing. Keep skin clean, avoid hot water, do not scrub skin when washing, pat skin dry with a clean towel. Use mild soap. Do not rub skin over boney areas. Avoid talc or powders. 26

Healthy Skin Adjust clothing or bedding to avoid pressure from wrinkles or seams. Keep clothing next to skin dry. Change attends keep skin free from urine and stool. Use gloves when giving personal care. Allow or help to toilet frequently. Change position every 2 hours or encourage person to change position. 27

Mobility Be active as possible. Activity helps with circulation and muscles strong. Consult school physiotherapist or parent for specific activities for children with developmental disabilities. 28

Eating for Healthy Skin Ensure a healthy diet. Protein is needed for tissue growth and repair. The sources are meat, fish, poultry, eggs, nuts beans. Fluids are required to keep the body and skin hydrated. Consult with parent dietitian or health care professional. 29

Personal Care for Children Children that require assistance with personal care (toileting, change of depends or diapers) are at an increase risk for inappropriate touching, physical and sexual abuse. It is important to treat a child with respect dignity and privacy when assisting with personal care. 30

Basic Tenets of Personal Care Caring Warmth Empathy Safety Rights of participation 31

Appropriate Touch Children with disabilities are still children and are deserving of compassion, warmth, and empathy and boundaries. Acceptable touch for children when trying to convey compassion is on the arm between elbow and shoulder. Light touch on the child’s shoulder is also acceptable. 32

Pericare Ensure that you have the parents permission to change or toilet their child. When toileting a child or changing attends please ensure the privacy of the child. Ideally the change of attends should be in a room with a door & change table. The same caregivers or EAs should provide the care. This contributes to a trusting relationship. 33

Pericare Ask permission before change or tell the child what you are going to do. Include the child in their care. Talk to the child as the change progresses. Ensure that the child’s skin is free of urine or stool. Remember not to rub skin, pat dry. This is the ideal time to assess the skin looking for open, bruised or red areas. 34

When cleaning of the child’s perenial area please use warm water or a wipe that parents have agreed to. Wipe the perenial area from front to back. Ensure all stool is removed from folds or scrotum. 35

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