Module 4: Infection Control & Universal Precautions

Learning Objectives

• Apply universal precautions consistently in all client interactions
• Demonstrate proper hand hygiene technique
• Use personal protective equipment (PPE) correctly
• Implement cleaning and disinfection protocols
• Follow COVID-19 and influenza-specific precautions

Core Principle: Treat ALL clients as potentially infectious

Universal precautions protect both the caregiver and the client from spreading infection.

• Gloves: Any contact with blood, body fluids, mucous membranes, or non-intact skin
• Masks: During respiratory care procedures or when client has respiratory illness
• Eye Protection: When splashing of body fluids is possible
• Gowns/Aprons: When soiling of clothing is likely

⚠️ Key Rule: Never reuse disposable gloves. Change gloves between tasks and between different body sites on the same client.

✅ Proper Handwashing Steps (40–60 seconds total)

1. Wet hands with clean, running water (warm or cold)
2. Apply soap and lather all surfaces including backs of hands and between fingers
3. Scrub for at least 20 seconds (hum "Happy Birthday" twice)
4. Rinse thoroughly under running water
5. Dry with a clean towel or air dryer
6. Use towel to turn off faucet if in a client's home

Hand Sanitizer: Use with at least 60% alcohol when soap and water unavailable. Not effective against C. diff or norovirus — always use soap and water for those.

Donning (Putting On) — Order Matters

1. Wash hands
2. Put on gown (tie in back)
3. Put on mask or respirator
4. Put on goggles or face shield
5. Put on gloves (pull over gown cuffs)

Doffing (Taking Off) — Most Contaminated First

1. Remove gloves (peel off, avoid touching outer surface)
2. Remove goggles or face shield (lift from behind)
3. Remove gown (roll inward, touching only inside)
4. Remove mask (untie from behind, avoid touching front)
5. Wash hands immediately

📋 Scenario: PPE Use

Situation: Your client has diarrhea and you need to assist with personal care and laundry.

✅ Correct Action: Don gloves and gown before any contact. After care, place soiled laundry directly in a bag without shaking it (shaking spreads pathogens). Remove PPE properly, wash hands thoroughly with soap and water.

High-Touch Surfaces to Clean Daily

• Doorknobs and light switches
• Toilet handle, seat, and surrounding area
• Bathroom and kitchen faucet handles
• Phone and remote controls
• Bed rails and assistive devices
• Kitchen countertops and table surfaces

Cleaning vs. Disinfecting

Cleaning removes dirt and germs from surfaces (soap and water).
Disinfecting kills germs using chemicals (EPA-approved disinfectant).
Always clean before disinfecting — disinfectants work less effectively on dirty surfaces.

⚠️ Common Bloodborne Pathogens

• HIV – Human Immunodeficiency Virus
• Hepatitis B (HBV) – Much more infectious than HIV
• Hepatitis C (HCV) – Leading cause of liver disease

If you are exposed (needlestick, splash to eyes/mouth): Wash the area immediately, report to your supervisor immediately, and seek medical evaluation within 2 hours.

📋 Scenario: Sick Client

Situation: You arrive and your client is coughing and says she has a fever of 101°F.

✅ Correct Action: Don a mask immediately. Contact your supervisor to report the situation and get guidance. Document the client's symptoms. Increase frequency of surface disinfection during the visit. Advise family to contact the client's physician.