Health

Task 2A Basic procedures in personal hygiene Infections are a major cause of human suffering and premature death. It is essential that control of infection is issues of very great practical importance for every health care professional. To prevent and to help reduce the risks of infection, it is essential to follow certain basic procedures of cleanliness. Disease causing organisms live in and on the body and can affect others if a high standard of personal hygiene is not maintained. This is why attention to personal hygiene is important. Wearing clean clothes and regular washing helps to protect people against infection. Looking after self is a priority when caring for others which is why it is essential for all care workers to look after themselves. Wounds such as cuts, grazes scratches and boils can be very easily infected. Keeping the wounds properly covered with a suitable waterproof dressing is the best way to prevent it from happening. By doing this, it would make both the care worker and service user protected from infection. Cleanliness for care workers must be applied to; * Self for example personal hygiene which consists of keeping nails and hair short, showering or bathing daily, wearing clean clothes, keeping hair clean and having clean teeth. * Equipment for example the items used to provide care and to treat service users * Environment for example the floors, furniture * Food preparation for example preparing, cooking and serving meals. When considering personal cleanliness care workers should pay attention to all parts of the body. These factors are Cleanliness, dress, protective clothing, hand washing, hair care, footwear and oral hygiene. Personal cleanliness also includes keeping nails and hair short, showering or bathing daily, wearing clean clothes, keeping hair clean and having clean teeth. Hair care Hair care is vital because disease causing organisms can live in hair and on the scalp. Unwashed hair can carry many bacteria that can easily fall onto service users head or their food or into a wound if hair is not correctly managed. A type of bacteria or infection is head lice. Long hair should always be kept under control and shouldn’t be let loose. If a care worker keeps touching their hair then there is a risk of transferring bacteria to the service user.to practise correct hair care; shampoo hair frequently, keep hair tied back or covered if necessary, avoid touching hair, never comb hair in the presence of others especially service users and don’t comb hair in food preparation and cooking areas. Hair that is left hanging and not tied back could become caught up in equipment and cause injury. Once children are older they should be told how to shampoo their hair wash and rinse it properly to avoid any problems. Before washing a child’s hair they should detangle their hair. It is also important to get them into a routine for washing their hair. Some children don’t like going in the bath so make it fun for them. Use a mild shampoo for children so it does not sting their eyes. In nurseries the teachers should make sure the children don’t have head live because it can spread and go into other peoples hair. If they notice head lice in any child’s hair then they should send letters home so parents can check if they have. They need to wash their hair at least 4 times a week to avoid it getting dirty and greasy because it can also cause an infection on the scalp. When you comb a child’s hair use a good hairbrush. Also in nurseries when the children are baking the teachers need to make sure their hair is tied up because hair can fall into the food. The correct way in which hair should be cleaned properly is; * Get your hair completely wet with water by rinsing your hair for about a minute. * Then put some shampoo in your hand and rub in your hair and scalp with the palms of your hand. * Massage the shampoo in your hair with your finger tips. Make sure you scrub all your hair properly. * After shampoo completely rinse your all your hair until all the shampoo has been washed out. * Then repeat If hair care is done correctly then it is much less of a risk to get any types of bacteria Hand washing A very large population and variety of germs are carried on people’s hands everyday. A few of these can cause illness like diarrhoea, colds and other, more serious and occasionally even life threatening diseases. When people forget to wash their hands, or don’t wash their hands correctly they can spread these germs to others. Hand washing, when done correctly, can help everyone stay healthy and avoid spreading and receiving germs. Hands should be washed when: * Preparing or eating food * Treating a cut or wound or tending to someone who is sick * Inserting or removing contact lenses * Cleaning after using the toilet * Handling uncooked foods, particularly raw meat, poultry or fish * Changing a nappy * Blowing the nose or coughing or sneezing * Playing with or touching a pet * Handling rubbish How hands are washed is just as important as when they are washed. Especially when it comes to getting rid of germs. Just rinsing them quickly is not enough. When care workers wash their hands, they should: * Massage palm to palm * Rub right palm over back of left hand and vice versa * Rub palm to palm * Massage backs of fingers in opposing palm * Rotate right thumb clasped in left palm and vice versa * Rotate fingers of left hand in right palm and vice versa * Rinse hands with water The hand washing process should take no longer than 30 seconds If hand washing is not possible whilst travelling, going out somewhere where you can’t find a sink then it is important that you carry wipes or anti bacterial gel to wipe your hands. In a school there should be located place where there is a hand wash basin so the children can reach the tap. There should be hot running water and also soap or running liquid to wash hands with. By the sink there should also be disposable soft paper towels to dry hands with and a bin to chuck it into. Staff should make sure the children wash their hands before and after eating and also when going to the toilet for hygiene reasons. It is important staff make sure they wash their hands properly and make sure the children wash their hands before having lunch for example. Children might have touched dirty surfaces and may get infected by bacteria and germs if they don’t wash their hands it could spread over the body. They could also get a virus to prevent the cause of infections is crucial that everyone wash their hands regularly. Staff should make sure the children go through the right technique of washing hands and should make them practice so they get the hang of washing their hands correctly. Hand washing is one of the most important ways of controlling the spread of infections. It can cause infections and spread diseases. It is also important that in nursery’s teachers should wash their hands after changing a child diaper. It is important that young children are taught how to wash their hands correctly. If children are out then teachers should carry anti bacterial gel because they might not be able to find a hand wash basin. Dress When working with service users it is appropriate to wear clothing that has been provided or approved by the care setting. Clothing provided often takes the form of a uniform. Besides providing protection from the spread of infection, a uniform makes care workers easily recognised. In the ideal situation, work clothing should not be worn outside of the care service as this helps stop the spread of any infection from one place to another. It’s best not to where any jewellery like rings, bracelets or watches while working in any care environments. This is because it would encourage the growth of infectious organisms, increasing the risk of infections that can be passed on as the skin underneath where the jewellery is would be warm. It is important that a care worker wears clothing that is suitable for the tasks that have to be carried out. For example: * Trousers would more appropriate for a nursery teacher as a lot of bending down is acquired in a nursery * Trainers or flat shoes for a nursery teacher because they would be accepted to run about a lot. Protective clothing As well as wearing a uniform in care settings, care workers should also be supplied with other forms of protective clothing. These are there to help protect care workers as well as service users. Protective clothing can include; * masks (paper masks help to prevent the spread of infection through the respiratory route) * aprons (barriers to infection made out of latex so can be disposed after each use) * gloves (excellent barriers to infection made of latex, so they can be disposed after each use * overshoes (used for one area only, in order to prevent the spread of infection from one room to one area to another) * theatre hoods or caps (to contain hair when in the operating theatre) * theatre greens (these are now not always green and are used to perform or assist surgical procedures) An example of when protective clothing should be worn is In a residential home if a care worker is helping an elderly service user to get bathed they will need to wear disposable gloves for hygiene purposes so no bacteria is spread. They will have to wear aprons because it is a barrier which prevents infections. In a residential home the care worker who prepares the food will have to wear a cap or hat so hair does not fall in the food they make. Caps are also used in hospitals when surgeons are in theatre operating for health reasons so hair does not fall when they are operating. Over shoes are used for when someone is in one area only and if they want to go somewhere else they will have to change their shoes to prevent the cause of infection. Care workers may wear overshoes when they are cleaning mess up in a residential home so germs and bacteria does not get on to their shoes and spread when they go elsewhere. They must remember to take them off one they have finished. Care workers might also wear over shoes whilst they are helping an elderly service user to have a wash because the service user may have a problem like arthritis. Also in hospitals overshoes may be worn in theatre. In care settings all staff has appropriate and protective clothing to wear for their job which they can take off before they go home. In all care settings hygiene is very important because bacteria and infections can be spread very quickly from one person to another so care workers need to make sure all service users stay clean and also because some have allergies to prevent that protective clothing should be worn. All protective clothing should be changed when moving from interactions from one service user to the other especially in a hospital. This reduces the risk of cross infection. Care workers may often find that they have to change their apron or gloves part way through a task. It is important that they do this especially if that garment has become highly soiled. It should be done as a matter of safety and good practice. Task 2B Conditions that require reporting When working in a care setting conditions like diseases, illness and other environmental conditions will need to be reported to prevent the cause of infections Disease Nursery’s, hospitals and other residential health care settings have specific problems which relate to infection control. There are few reasons as to why this is: * they have a high density of people who are susceptible to infection because of illness or debilitation * they have many sources of infections because people with severe infection are often hospitalized * there is a high level of close interpersonal contact between care professionals and service users For these reasons most care providers now pay particular attention to control of infection. In care environments there is always a need to be constantly aware of the effects of disease. A few examples of diseases are: * malaria * measles * plague * rabies * rubella * salmonellosis (other than typhoid or paratyphoid) * smallpox * sexually transmitted diseases * tetanus * tuberculosis * typhoid and paratyphoid * typhus Under the regulations, medical practitioners are obliged, as soon as they become aware or suspect that a patient is suffering from, or is a carrier of an infectious disease, to notify in writing the local medical officer ASAP. However, immediate notification is obligatory in the case of certain infectious diseases such as cholera or where a serious outbreak of infectious disease is suspected. At the end of each week, returns of all diseases notified are sent to the department of health and children. It is important that care workers play their part in making sure that their mangers are made aware of any disease outbreaks. Illness The illness could be of either the service user or the care worker, regardless of which they are, the correct people need to be aware. If the child at the nursery does develop a new illness then their medical practitioner needs to know. This is always done for the sake of the service user and in confidence. If a nursery teacher develops an illness then it is their personal responsibility to notify the appropriate people. This may be their GP and their manager. This is because they have a duty to the children and others. Conditions Environmental conditions need to be reported in the interest of public safety. Overflowing sewer’s and drains should always be reported as soon as possible in order to limit the spread of infection. Unsanitary conditions in general should always be reported anyway, if necessary to the environmental drains health department of the local council. Environmental health officers have far reaching powers that allow them to shut down offending environments, especially where they think there is a serious danger to public health. Airborne pollutants can also be a problem, and include escaping chemical gasses can be toxic and can cause asthma and bronchitis. They may also carry disease causing agents such as bacteria or viruses. Task 2C. Universal precautions Universal precautions are those taken by clinical staff to limit the risk of the spread of infectious diseases. Universal precautions are infection that controls guidelines which is designed to protect people from the spread of infections and diseases. Such precautions mainly apply to blood and bodily fluids. To prevent diseases and infections transferring onto others. To avoid getting infections some guidelines should be followed whilst dealing with blood or other fluids from patient’s body. In the UK, the department of health regularly sets guidelines for health authorities to follow. Precautions have been established for limiting the risks associated with hepatitis C, and similar precautions are now taken for the control of human immunodefincey virus (HIV). The guidelines are safeguards aimed at reducing the risk of transferring infections from patient to practitioner, patient to patient, or practitioner to patient. The universal precautions for care workers are: * Wash hands before and after contact with every service user and before removing and wearing gloves. * Changing gloves when in contact with each service user * Cover any wounds with waterproof bandage. * Wear gloves when coming in contact with blood or other bodily fluids * Exercise care in handling disposable sharp instruments * Wear foot wear with enclosed feet as wearing open footwear would be hazardous because blood or other bodily fluids could be spilt or sharp objects may be dropped * Clear up any spills and disinfect the area * Wear gloves when cleaning equipment, before sterilizing or disinfection and when clearing up spillages * Follow any safety procedures for the disposal of contaminated waste * Where there is a possibility for blood to splatter, wear protective eyewear such as goggles. Eye wash should be available and should be used ASAP if there are any accidents. Task 2D Cleaning and sterilizing Cleaning Removing micro organisms and dirt or other objects from surfaces or equipment is the purpose of cleaning. Cleaning is usually done by using water or with or without detergents. The first stage of making sure that the environment or surroundings are free from dirt and micro organisms is cleaning. Areas which are used by the children of the nursery and for the treatment for the children should be cleaned daily or more frequently if there are any spillages. At times different equipment is used for different areas in a care setting. For example: * Red buckets are used for cleaning away blood or bodily fluids such as urine etc. * Green buckets are used to mop corridors and floors * White buckets are used in play areas For most cleaning, a detergent solution is adequate for surfaces and furniture. Basins and taps should be cleaned after use with a detergent solution. Bins should not become overfull and should be cleaned daily with a detergent solution. The carpets should also be vacuumed daily. The cleaning cloths such as the dusters should be disposable so they can be chucked away at the end of each day. Furniture and other hard surfaces should be damp dusted daily with disposable cloths. It is best that the cloths are colour coded so then it could be easily organised and so the can make sure that there is no repetition of using the same cloth. Mops should have detachable heads so that they can be washed after each use in hot, soapy water, then wrung out and stored, mop upside down. Table tops and feeding trays must be cleaned immediately prior to serving food. The air filters of vacuum cleaners should be changed regularly according to the manufactures instructions. Detachable tools should be wiped with a detergent solution. Disinfecting Basically, Disinfectants are substances that are applied to objects and surfaces to reduce the number of micro-organisms. A disinfectant is a chemical used on objects and surfaces to reduce the number of pathogenic micro organisms. However an over use of antibacterial agents is an important cause of some kinds of hospital acquired infection. This is because the causes of some infections slowly become more resistant to its effects. Disinfection’s does not mean that all micro organisms are killed and in particular, bacterial spores are frequently not killed. Disinfection is not an alternative to cleaning. Disinfectant should be applied where it is specifically indicated by the policy of the setting to do so. Floors and ceilings are cleaned with hydrochloric which is otherwise known as bleach, or sodium dichorisocyanurate. In some care settings alcohol wipes are used to disinfect equipment that comes into contact with service users. An example of where disinfectant would be important is the disinfections of toilet seats and handles when there is an outbreak of diarrhoea. Care workers must make sure; however, that disinfection solution’s are rinsed and dried off the seats and handles of toilets, in case service users rub the excess fluid into their eyes or in case the disinfectant irritates their skin. In residential home care workers need to make sure they clean everything properly and disinfect with the right substances. They should also that disinfected solutions are rinsed and dried off the seats and handles of toilet and doors and wash their hands after because there will be bacteria everywhere as well. Sanitizers can also be used because it will disinfect and clean so if there is no hand washing basin people should have hand sanitizer with them for hygiene purposes. In some care settings alcohol may be used to disinfect equipment that comes into contact with service users. Normal detergents can also disinfect and they may be used in care settings to clean the tables after eating. Hot water can also be used to clean surfaces with detergents and you don’t always need to use other chemicals. Surfaces need to be thoroughly scrubbed before disinfecting and need to be wiped with sponges, brushes and sprays. Dealing with sterilizing All spillages of bodily fluids, blood, urine and vomit should be cleaned immediately to prevent risk of getting infections. When cleaning disposable gloves should be worn and the spillage should be mopped up with absorbent paper towels or toilet tissues. If there is only a small amount, then these can be disposed of into a plastic waste sack or flushed down the toilet. The disposable gloves should also be binned. For spillages which are inside, then the affected areas should be cleaned with detergents like washing up liquid or an anti bacterial spray to kill any bacteria and germs. After cleaning then the area should be rinsed and dried. In a nursery if a child falls outside and there is blood on the floor then water should be used to clean it and also gloves should be worn and disposed after and hands should be washed. In a nursery if a child has an accident and there is urine on the floor the cleaner should get it cleaned straight away and must remember to wear protective clothing. Also if a child vomits it should be cleaned straight away because other children may walk over it There are different types of disposable waste to prevent any infections then waste should be disposed. Yellow bags are used for clinical waste and should be disposed quick. Black bags are used in residential homes and hospitals and other settings for domestic waste. Nurseries use black bags to throw waste away that has been used. In a nursery the staff should make sure the nursery is cleaned regularly and properly because sometimes if it is not cleaned properly germs can be spread very quickly. For spillages which are outside, for example in the playground, sluice the area with water. Gloves should be disposed of and hands washed after taking off the gloves. Spillages on carpets and upholstery should be cleaned with warm soapy water or an appropriate carpet shampoo. Sterilizing Sterilization is a process of killing all microbes including spores. There are many methods available for sterilization. Sterilization may use exposure to, heat, radiation and chemicals. The most common way of heat sterilizing is autoclaving or moist heat. Autoclaving involves exposure of objects to superheated steam. Water boils at 100ºc when at atmospheric pressure giving steam at 134ºC, which achieves sterilization in about 3 minutes. Items for autoclaving are cleaned and wrapped in porous paper. The paper is then sealed with sticky tape; this tape has pale white diagonal stripes. The stripes change to a dark brown colour at high temperature so this allows the operator to see easily that the wrapped instrument has been in the autoclave. Only materials which can withstand exposure to steam at high temperatures are suitable for autoclaving. High temperatures without steam can achieve sterilization, but much higher temperatures and longer periods of exposure are required. Equipment that is used to penetrate the skin or to enter the body must be sterilized. Such instruments can be reused many times as long as they have been through the sterilization process each time. In care settings if they have any plastic equipment such as a baby’s bottle then they will not be able to sterilize it because the temperature would cause them to melt. However some can be sterilized by chemicals and gas but it depends what you are sterilising. The chemicals may be used in combination with temperatures of 50 ºC to 70 ºC. Baby’s bottles and other feeding equipment need to be sterilised but before they are they need to be washed in hot soapy water. If the bottles come up with cracks then they need to be disposed. There are different sterilising methods such as: * Boiling – This is a traditional method and you need to use a saucepan which has not been used for anything else. * Steaming - Steam sterilises are available to use and it ensures that bottle feeding equipment is safe to use. * Sterilising solutions - These often come on tablets which you can dissolve in cold water * Microwave sterilisers – Microwaves are available although you can not use them to clean with metal equipment. Task 2E Cares setting are required to send specimens to the laboratory for testing There should be procedures in place, for sending specimens to the laboratory in every care setting. The reasons for this are to ensure that the specimen: reaches the laboratory in a testable condition is labelled with the correct service users details and it is packaged in a manner that makes it safe to transport and handle. For these reasons specimens should be placed in the correct container. The specimen should be labelled so that it accurately identifies the service user and where they are located. The contained specimen should then be placed in the appropriate transportation packaging. This should carry a biohazard warning to allow it to be recognised. Specimens should always be placed in the correct container and labelled with the service user’s name. It should also carry biohazard which is a warning to allow it to be recognised. It should be sent by the correct courier service to the laboratory in the shortest time possible so it can be tested as soon as possible. If the specimen can’t be taken the same day then it should be put in the fridge until departure. It is important that they do not put the specimen in the fridge with food and drinks and also medication and need to be put in a different fridge so germs are not spread. Their can be confusion so it is vital it is stored properly because it could get mixed up and their could be dangerous consequences. In care setting they must also be aware that it is illegal to send infected and toxic substances through the postal system. They also need to follow the correct procedures and if they have any doubt about anything then ask for professional advice. In hospitals there are bags and container to put patient’s fluids, tissue or any other materials for testing.