This document provides information on infection control and universal precautions for healthcare workers. It defines key terms, describes modes of transmission and portals of entry for infections. It explains universal precautions and proper hand hygiene techniques. The document outlines when gloves should be used and changed, and how to properly put on and remove gloves. It also provides guidance on cleaning spills and what to do following an exposure incident.

1. INFECTION CONTROL &
UNIVERSAL PRECAUTIONS

2. OBJECTIVES
▶ At the end of this session, you participants will be able to:
◦ Verbalize definitions related to infection control
◦ List modes of transmission of infections and portals of entry of bacteria
◦ Explain universal precautions
◦ Explain the worker’s role in preventing spread of infections
◦ Demonstrate proper hand washing techniques, application and removal of gloves
◦ Describe appropriate techniques for cleaning up spills

3. DEFINITIONS
▶ Infection control – the set of methods used to control and prevent the spread of
disease
▶ Infections - are caused by pathogens (germs)
▶ Communicable disease – disease spread from one person to another
▶ Infectious disease – disease caused by a pathogen (germ or bacteria)

4. DEFINITIONS
▶ Contaminated – means dirty, soiled, unclean
▶ Disinfection – cleaning so that germs (pathogens) are destroyed
▶ Mode of transmission – the way germs are passed from one person to another
▶ Mucous membranes – membranes that line body cavities that open to the
outside of the body

5. MODES OF TRANSMISSION
▶ Body fluids – tears, saliva, sputum (mucus coughed up), urine, feces, semen,
vaginal secretions, pus or other wound drainage, blood
▶ Touching the infected person or their secretions
▶ Touching something contaminated by the infected person.
▶ Droplets – coughing, sneezing, laughing, spitting, talking

6. PORTALS OF ENTRY
▶ Any body opening of an uninfected person which allows pathogens to enter
▶ Nose, mouth, eyes, rectum, genitals and other mucous membranes
▶ Cuts, abrasions or breaks in the skin

7. WHO IS AT RISK??
▶ Anyone whose resistance to disease decreases
◼ Reasons for lowered resistance: age, existing illnesses, fatigue and stress
◼ The elderly have weaker immune systems and a lower resistance to
pathogens
◼ Elderly are hospitalized more often, increasing the chance for hospital-
acquired infections
◼ Recovery longer in the elderly

8. WHAT RISKS ARE WITHIN MY ORGANIZATION?
Each year, your Organization will publish an Infection Plan and Risk Assessment. This Assessment will prioritize
the types of Infections most commonly found within your patient population, and determine what
characteristics increase or decrease the likelihood of risk. The Assessment will establish goals and strategies to
prevent the spread of these infections. If you have not see a copy of the the Infection Plan and Risk Assessment,
please ask your supervisor.

9. UNIVERSAL PRECAUTIONS
▶ Universal precautions are infection control guidelines designed to protect
workers from exposure to diseases spread by blood and certain body fluids.
▶ Always treat blood, body fluids, broken skin and mucous membranes as if they
were infected
▶ Always follow Universal Precautions because you cannot tell by looking at a
person whether they have a contagious disease

10. UNIVERSAL PRECAUTIONS
▶ Use practical, common sense
▶ Wash your hands before putting on gloves and immediately after removing
gloves
▶ Do not touch clean objects with contaminated gloves

11. UNIVERSAL PRECAUTIONS
▶ Wear gloves if you may come in contact with blood, body fluids, secretions and
excretions, broken or open skin, human tissue of mucous membranes
▶ Bag all disposable contaminated supplies
▶ Clean all surfaces that may be contaminated with infectious waste, such as beds,
wheelchairs and shower chairs

12. WHAT CAN I DO??
▶ Good hand washing is the most effective method to prevent the spread of
infection
▶ May use an alcohol-based hand cleaner in place of washing with soap and water
▶ Avoid touching eyes, nose or mouth

13. WHAT CAN I DO??
▶ Cover your nose and mouth with a tissue every time you cough or sneeze
▶ Throw used tissue in a wastebasket
▶ If you don’t have a tissue, sneeze or cough into your sleeve
▶ Always clean your hands after coughing or sneezing

14. HAND WASHING
▶ Remove any jewelry or watch
▶ Wet hands with warm, running water
▶ Add soap
▶ Rub hands vigorously for 20 seconds, washing all surfaces (about the time it
takes to sing “Happy Birthday” twice)
▶ Rinse, keeping fingers pointing down
▶ Dry with paper or clean cloth towel
▶ Turn off faucet with towel and open door with towel

15. WATERLESS HAND SANITIZER
▶ Make sure all visible dirt is removed from your hands
▶ Apply a dime sized amount of waterless hand sanitizer to the palm of one hand
or use a waterless hand sanitizer wipe
▶ Rub hands together covering all surfaces of hands and fingers
▶ Rub until waterless hand sanitizer is absorbed
▶ Remember, waterless sanitizers are not effective if dirt is visible on your hands

16. HAND HYGIENE VIDEO
▶ View these videos on hand hygiene:
http://www.cdc.gov/CDCTV/HandsTogether/
http://www.publichealthgreybruce.on.ca/Communicable/Handwashing/
Application of learning – Staff Return Demonstration

17. WHEN SHOULD I USE GLOVES ?
▶ When you may come in contact with blood or any body fluids, open wounds, or
mucous membranes
▶ Performing or helping with mouth care
▶ Performing or helping with perineal care
▶ Performing care on a patient who has broken skin

18. WHEN SHOULD I USE GLOVES ?
▶ When you have open sores or cuts on your hands
▶ In procedures that involve touching a patient; this also includes handling items
that belong to a patient.
▶ When disposing of soiled bed linens, gowns, dressings and pads

19. WHEN SHOULD I CHANGE GLOVES?
▶ When touching surfaces that may be contaminated
▶ Right before contact with mucous membranes or broken skin
▶ Immediately if they become wet, worn, soiled or torn

20. GENERAL GUIDELINES
▶ Wear gloves when handling soiled linens or patient items.
▶ Fold or roll linen so that the dirtiest area is inside
▶ Hold and carry dirty linen away from your body
▶ Do not shake dirty linen or clothes

21. GENERAL GUIDELINES
▶ Use appropriate receptacles for disposal
▶ Do not touch the inside of any disposal container
▶ Do not use “reusable” equipment again until it has been properly cleaned and
sanitized
▶ Never use disposable equipment more times than recommended by the
manufacturer

22. PUTTING ON GLOVES
▶ Remove any sharp jewelry
▶ Remove glove from box. Gloves come in small, medium and large. Most are
rubber latex and are pre-powdered. Those who are allergic to latex should use
vinyl gloves.
▶ Hold glove with your thumb and forefinger and insert hand into gloves
▶ Work fingers into proper places

23. PUTTING ON GLOVES - VIDEO
▶ http://www.uams.edu/csc/programs/orientation/gloves/glovesOn.mov
▶ Application of learning – Staff Return Demonstration

24. REMOVING GLOVES
WITHOUT CONTAMINATING YOUR HANDS
▶ Pinch the palm of one glove and pull away from the palm.
▶ Push the fingers of the pinching hand up inside the other glove, stretching the
material of the glove towards the cuff of the other glove until it emerges by the
wrist.
▶ Pull the fold down until the glove is almost off (you will be pulling the glove
inside-out).

25. REMOVING GLOVES
WITHOUT CONTAMINATING YOUR HANDS
▶ DO NOT take the glove completely off.
▶ Hook the ungloved thumb between the wrist and the skin of the other gloved
hand and pull down, pulling both gloves off. (Both gloves will now be inside out.)
▶ Dispose of the gloves properly.

26. REMOVING CONTAMINATED GLOVES - VIDEO
▶ Click for video instruction for removing contaminated gloves:
http://www.hse.gov.uk/mvr/myths/video/video9.htm
Application of learning – Staff Return Demonstration

27. SPILLS
▶ Put on clean gloves
▶ Wipe up immediately by cleaning from the outside (cleanest) to the inside
(dirtiest)
▶ Use the appropriate cleaning agent
▶ Never pick up glass, even with gloved hands
▶ Dispose of gloves and cleaning equipment and supplies

28. ASK YOURSELF-
▶ Do you know which infections are most common to the population you serve?
▶ Have those risks been identified, prioritized, and communicated to you?
◼ Are there any infection risks that have not been addressed?
▶ Do you know where the hand-washing/hand-sanitizing stations are located?
▶ Where can you find PPE in your facility?
◼ Note: If PPE is difficult to access, request to keep some near your workstation.
▶ If observed, would you improve your hand-washing techniques?
▶ What are some ways your hand hygiene program can improve?

29. REPORTING AN EXPOSURE INCIDENT
INCIDENT REPORTING:
Exposure incidents should be reported immediately since they can lead to infection with hepatitis
B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), or other
bloodborne pathogens. Early reporting is crucial for beginning immediate intervention to address
possible infection of the worker and can also help the worker avoid spreading bloodborne
infections to others. Furthermore, the employer is required to perform a timely evaluation of the
circumstances surrounding the exposure incident to find ways of preventing such a situation
from occurring again.
Reporting is also important because part of the follow-up includes identifying the source
individual, unless the employer can establish that identification is infeasible or prohibited by state
or local law, and determining the source’s HBV and HIV infectivity status.

30. EMPLOYEE EXPOSURE AND EVALUATION
When an employee experiences an exposure incident, this Organization will ensure there is an
immediate and confidential medical evaluation and follow-up available to the employee. This
evaluation and follow-up will be made available at no cost to the employee, and at a reasonable time
and place; performed by or under the supervision of a licensed physician or other licensed
healthcare professional; and provided according to the recommendations of the U.S. Public Health
Service (USPHS) current at the time the procedures take place.

31. EMPLOYEE EXPOSURE AND EVALUATION
In addition, laboratory tests will be conducted by an accredited laboratory and also will be at no cost to the
employee. An employee who participates in post-exposure evaluation and follow-up may consent to have his or
her blood drawn for determination of a baseline infection status, but has the option to withhold consent for HIV
testing at that time. In this case, the Organization will ensure that the employee's blood sample is preserved for
at least 90 days.
The Organization will obtain and provide the employee with a copy of the evaluating healthcare professional’s
written opinion within 15 days of completion of the evaluation. According to OSHA’s standard, the written
opinion should only include: whether hepatitis B vaccination was recommended for the exposed employee;
whether or not the employee received the vaccination, and that the healthcare provider informed the employee
of the results of the evaluation and any medical conditions resulting from exposure to blood or OPIM which
require further evaluation or treatment. Any findings other than these are not to be included in the written report.

32. ADDITIONAL INFORMATION
For more information, go to OSHA’s Bloodborne Pathogens and Needlestick Prevention Safety
and Health Topics web page at: https://www.osha.gov/SLTC/bloodbornepathogens/index.html.
To file a complaint by phone, report an emergency, or get OSHA advice, assistance, or
products, contact your nearest OSHA office under the U.S. Department of Labor website or call,
800-321-OSHA.