Infection Control

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Infection Control

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Universal Precautions: Self-Learning Module

Module: Infection Control

Unit: Universal Precautions

Unit Overview: This Universal Precautions unit is a self-paced, self-administered learning module designed to educate and train child care employees on the correct technique for using universal precautions.

Pre-requisite	Handwashing Self Learning Module
Topic Completion Time	Approximately 30 minutes
Target Audience	Child Care employees
How to Use This Unit	Read all the material Complete the test Complete the course evaluation
When to Use This Unit	Initial orientation of new child-care employees Annual review of child-care employees

Learning Objectives

Following completion of the Universal Precautions unit, the child care employee will be able to meet the following program objectives:

	Discuss the importance of following universal precautions
	Describe the universal precautions for contact with blood, vomitus, feces, urine, tears, saliva, and nasal secretions.
	List the steps to safely remove disposable gloves.
	Explain the correct way to wash hands.
	Create an effective disinfectant solution.

Contents

What Are Universal Precautions?
Who Developed Universal Precautions?
Why Follow Universal Precautions?
Spills of Body Fluids
First Aid for Bleeding Wounds
Use of Gloves
Disinfection
Handwashing
Contaminated Clothing

What Are Universal Precautions?

Universal Precautions are a set of established procedures for infection control. They were developed to limit the spread of blood-borne diseases such as Hepatitis B and HIV. Guidelines for using Universal Precautions are based on the National Health and Safety Performance Standards Guidelines for Out-Of-Home Childcare.

Who Developed Universal Precautions?

Universal Precautions were developed by the Center for Disease Control (CDC) and the Occupational Safety and Health Administration (OSHA). Universal Precautions have been adapted for use in the child care setting.

Why Follow Universal Precautions?

Some bacteria and viruses that cause disease are carried in the blood or in body fluids that contain blood. Hepatitis B and HIV are two examples. Although your skin is an effective barrier against the spread of blood-borne diseases, skin that is broken by a cut, abrasion or chafing can provide an entry point.

You may care for a child with a blood-borne disease who does not yet show symptoms or who has a blood-borne disease that has not been disclosed or diagnosed.

Some viruses, such as Hepatitis B, can survive outside the body for a week (for example, on surfaces).

Although the disease-containing bacteria and viruses may be present in other body fluids, such as saliva, the concentration is low and no cases of blood-borne diseases transferred by direct contact with saliva have been reported. Urine, tears, vomitus, nasal drainage and feces, unless they contain visible blood, do not transmit blood-borne diseases. They can, however, transmit other types of disease, so you should use some precaution when in contact with these fluids.

Spills of Body Fluids

Urine, feces, blood, saliva, nasal discharge, eye discharge, and injury or tissue discharges should be cleaned up immediately, as follows:

	Remove spills of vomitus, urine, and feces from floors, walls, bathrooms, tabletops, toys, kitchen counter tops, and diaper-changing tables. Then clean and disinfect the area.
	Remove spills of blood or blood-containing body fluids and injury or tissue discharges. Then clean and disinfect the area. Wear gloves in these situations unless the amount of blood or body fluid is so small that it can easily be contained by the material used for removing it.
	When cleaning contaminated surfaces, wear gloves to protect your hands. Avoid exposing open skin sores or mucous membranes to blood or blood-containing body fluids or to injury and tissue discharges.
	Clean mops and rinse them in sanitizing solution. Then wring the mops as dry as possible and hang to dry.
	Place blood-contaminated material and diapers in a zip-lock plastic bag or a plastic bag secured with a twist tie. If a sharp item was contaminated, place it in a hard container before putting it into the plastic bag.
	After exposure to blood or blood-containing fluids and tissues, wash your hands properly even if you wore gloves.
	Wash your hands after drying tears or wiping discharge from the nose or mouth.

First Aid for Bleeding Wounds

Wear gloves when rendering first aid to any cut, scrape or wound, unless the amount of blood or body fluid is so small that the material used for cleaning can easily contain it. This includes wounds that have no visible blood. Bacteria and viruses can be carried in the watery discharge from wounds.

If gloves are not available, and it is necessary control life or limb-threatening bleeding from a wound, do not delay emergency treatment. Use a thick layer of paper towels or cloth to apply pressure. Put on gloves as soon as available.

Use of Gloves

Wear gloves if you are in known or anticipated contact with blood or blood-containing fluids or with any discharge from wounds. Unless otherwise specified by guidelines for your child care setting, gloves are not required for routine diaper changes, drying tears or wiping secretions from the nose or mouth. Wear gloves if the child has diarrhea or if you have open sores or lesions on your hands.

Single-Use (Disposable) Gloves

	Dispose of single-use gloves after each use. Blood-contaminated gloves should be disposed of in a plastic bag with a secure tie.
	DO NOT re-use disposable gloves.
	When removing the glove, do not touch the outside. Follow these steps to safely remove contaminated gloves: Use the fingertips of a gloved hand to grasp the other glove near the cuff. Slowly pull the glove down while removing your hand. Turn the glove inside out as you pull. Drop the contaminated glove into a plastic bag. Use the fingertips of the ungloved hand to grasp the INSIDE of the gloved hand near the cuff. Slowly pull the glove down while removing your hand. Turn the glove inside out as you pull. Drop the contaminated glove into a plastic bag.
	Wash your hands after removing the gloves.

Multi-Use Gloves

	After each use AND before removing, clean the gloves with soap and water, and then dip the gloved hands into a disinfectant solution up to the wrists.
	Remove the gloves and hang to dry.
	Wash your hands after removing the gloves.

Disinfection

Guidelines and procedures for disinfection solutions are based on the National Health and Safety Performance Standards Guidelines for Out-Of-Home Childcare and on information from the Center for Disease Control (CDC).

Disinfection kills most disease-causing organisms such as streptococcus, staphylococcus, E. coli, salmonella and the agents that cause HIV and hepatitis. A product that claims to be a disinfectant must be registered with the Environmental Protection Agency (EPA).

Disinfection Methods

Disinfection removes almost all germs from an object.

Bleach Disinfection Solution

A solution of 1/4 cup household, liquid chlorine bleach in one gallon of cool tap water (or 1 tablespoon of bleach to 1 quart of water), prepared fresh daily, is an effective disinfectant for environmental surfaces. An effective disinfection solution should have a faint chlorine smell. If the odor is not present, regardless of when the solution was made, discard the solution and prepare a fresh mixture.  Sun, evaporation and heat weaken the solution, so keep the solution covered, out the sun and away from heat sources.

Caution: Never mix bleach with any liquid other than water. Mixing bleach with a liquid such as vinegar or ammonia can cause a dangerous chemical reaction.

Note: Some germs, such as cryptosporidia, are not killed by a bleach solution.

Commercially Prepared Disinfection Solution

Commercially prepared disinfection solutions that have been approved by the Environmental Protection Agency and the state or local health department are available. These products are usually labeled as "germicide" or "hospital-grade."

Heat

Prolonged, intense heat, which occurs when using a dishwasher or hot cycle of a washing machine, is an effective disinfectant. Tap water is not hot enough to be an effective disinfectant.

Procedure

Bleach Solution

Clean the surface or object with soap and water to remove all visible dirt.
Wipe the object with a disinfectant solution or submerge the surface in the solution. If wiping, apply enough solution to wet the item thoroughly and allow the solution to remain on it for a few minutes; if submerging, allow the item to remain in the solution for a few minutes.
Partially dry the object (if desired) to remove most of the wetness, but leave a small amount of solution on the object or surface to air dry.

Commercial Solution

To ensure disinfection, follow the manufacturer's instructions.

Safety Precaution

Keep all disinfection solutions out of the reach of children.

Note: The bleach solution, if mixed as directed above, is not harmful if ingested.

Handwashing

Proper hand washing is essential to prevent the spread of disease. For more information, see How To Wash Hands.

Contaminated Clothing

Clothing (and cloth) contaminated with blood should be placed in a plastic bag and securely tied. The clothing should be washed in hot, soapy water.

Proceed to the Universal Precautions Post Test.

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