Nature Care
SAFE PRACTICES
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INFECTION CONTROL …………………………….
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…………………. 4
Introduction to the course …………………….
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HOW INFECTION IS SPREAD……………………….
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…………. 4
The Microbial World …………………………..
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………………….. 4
The Chain of Infection………………………..
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…………………… 5
Review Questions:…………………………….
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……………………. 9
HYGIENE CONTROL ………………………………
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…………….. 10
Standard Precautions
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. 10
Additional Precautions
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1
Handwashing ………………………………….
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Personal Protective Equipment (PPE)
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…………………….. 14
Maintaining a Clean Workplace ………………….
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………….. 15
Spills management…………………………….
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Waste Disposal ……………………………….
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……………………. 21
Review Questions:…………………………….
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BLOOD BORNE PATHOGENS …………………………
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…….. 25
Infection Control Processes ……………………
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Documentation
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……….. 29
Good Housekeeping
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…. 31
Review Questions:…………………………….
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………………….. 33
WORK HEALTH AND SAFETY ………………………..
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Introduction to the course …………………….
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………………… 35
Introduction to Work Health & Safety
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WORK HEALTH & SAFETY ACT, 2011…………………
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.. 36
Workplace Injury Management and Worker’s Compensati
on ………………………………….. 41
RISK MANAGEMENT ………………………………
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……………. 43
Risk Management Process……………………….
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…………….. 45
Review Questions ……………………………..
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………………….. 52
WHS MANAGEMENT RISK TO HEALTH AND WELLBEING …….
………………………. 53
WHS Management Risk to Health and Wellbeing
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……… 53
Review Questions ……………………………..
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………………….. 61
WHS MANAGEMENT RISK OF ACCIDENTS OR INJURY ………
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Emergency plans………………………………
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Review Questions ……………………………..
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………………….. 66
©Nature Care College
Safe Practices Learning Guide
Safe Practices Learning Guide – V3/01/13
Page 4 of 66
INFECTION CONTROL
Introduction to the course
Infection control is an important part of any healt
h practice. Exposure to infectious material,
the spread of infection and the treatment of diseas
es resulting from infection is a big part of
public health. This course will introduce the Compl
ementary Health Care Practitioner to all
aspects of infection and infection control.
Infection Control considers infection from micro-or
ganisms, or microbes. Assessing the risk
of infection in a clinic will help a practitioner a
void any dangers and be aware of proper
protocols to follow in the event of exposure.
HOW INFECTION IS SPREAD
The purpose of this session is to give the students
knowledge regarding the Microbial world
and how infection and disease results. The students
will gain a detailed understanding of the
chain model of infection.
By the end of this lesson you should be able to:
Discuss the Chain Model of Infection
Define an agent, a reservoir, a place of exit and
susceptible host
Explain how a microorganism can enter a host
Discuss the transmission of disease
Explain the hygiene scale
The Microbial World
Many practitioners learn about microbes in Anatomy
& Physiology and in Biochemistry.
Although the vast majority of microorganisms do not
cause disease (i.e. they are not
pathogens) those which can are still responsible fo
r much suffering and death.
Microorganisms which can affect human health belong
to one of four major groups – viruses,
bacteria, fungi and protozoa.
©Nature Care College
Safe Practices Learning Guide
Safe Practices Learning Guide – V3/01/13
Page 5 of 66
The word infection is used to describe situations w
here pathogenic microorganisms are
established in the body. It is important to underst
and the difference between infection and
disease in relation to organisms such as the Human
Immunodeficiency Virus (HIV) and
hepatitis B and C viruses, all of which people may
be infected with without having the
corresponding disease (AIDS, acute or chronic hepat
itis B or C).
The Chain of Infection
To cause disease these microorganisms must spread f
rom their living and/or non-living
sources, i.e. reservoirs, to a host susceptible to
their pathogenic abilities, and so must exit
from their sources then is transported to and enter
s a suitable host. This process is described
as the “chain of Infection”. If any link in the cha
in is broken then the Chain of Infection is
halted.
A
reservoir
is a source that provides the microorganisms with c
onditions for survival and
multiplication. A reservoir can be human, animal or
nonliving.
The Human reservoir is the main living reservoir of
human disease. Diseases such as AIDS,
typhoid fever, hepatitis, diphtheria, dysentery, go
norrhoea and streptococcal infections are all
from human carriers.
Animal reservoirs can be from both wild and domesti
c and carry microorganisms that can
cause human diseases. For example, Rabies, Lyme dis
ease, Salmonellosis and Malaria.
Soil and water are two major non-living reservoirs
of microorganisms (however, some might
debate that water is actually living). The microorg
anisms that cause botulism and tetanus are
found in soil and water can be a reservoir for micr
oorganisms that cause cholera and typhoid
fever.
In general
portals of exit
are related to the part of the body that is infect
ed. The most
common are the respiratory tract and the GIT. For e
xample, through coughing and sneezing
many microorganisms that live in the respiratory tr
act can exit in the
discharges. The microorganisms that cause disease s
uch as tuberculosis,
whooping cough and influenza have the respiratory t
ract as the portal of exit.
Microorganisms that use the GIT as a portal of exit
can leave the body through
the faeces, such as salmonellosis and typhoid fever
or through saliva such as the rabies
virus.
©Nature Care College
Safe Practices Learning Guide
Safe Practices Learning Guide – V3/01/13
Page 6 of 66
Microorganisms responsible for sexually transmitted
diseases use the urogenital tract as a
portal of exit.
There are other portals of exit that can be linked
to the method of transmission of many
pathogens. For example, blood that is infected can
be removed and reinjected by
contaminated needle, as in HIV and hepatitis B or b
iting insects, yellow fever and malaria.
The
route of transmission
of a microorganism from a reservoir to a susceptib
le host can be
in the form of contact, vehicle or vector.
Contact transmission can be direct contact – person
to person physical contact such as
touching, kissing, and sexual intercourse or indire
ct contact – through a
nonliving object such as tissues, towels, eating ut
ensils and toys.
Droplet transmission is also considered to be a typ
e of contact transmission since the
droplets travel short distances. For example, influ
enza, pneumonia and pertussis.
Transmission of a microorganism via a medium such a
s water, food, air, blood, body fluids,
drugs or intervenous fluid is known as vehicle tran
smission.
Microorganisms transmitted via a vector refers to a
nimals that carry pathogens
from one host to another. For example, houseflies c
an transfer dysentery from
faeces of infected people to food.
©Nature Care College
Safe Practices Learning Guide
Safe Practices Learning Guide – V3/01/13
Page 7 of 66
Flow chart: Chain model of infection
The
portals of entry
for pathogens are
o
mucous membranes, through the lining of the respir
atory tract, gastrointestinal
tract, genitourinary tract and conjunctiva.
Most common is the respiratory tract where microorg
anisms are inhaled into the nose or
mouth in drops of moisture or as dust. Common disea
ses are the influenza, pneumonia,
tuberculosis, measles, smallpox and the common cold
.
The next common site is the GIT; microorganisms ent
er via food and water and through
contaminated fingers. Common diseases include hepat
itis A, dysentery, giardiasis, cholera
and poliomyelitis.
Pathogens that enter via the genitourinary tract ar
e contracted sexually, either through the
mucous membranes or through cuts or abrasions. Exam
ples are HIV, genital warts, herpes,
syphilis, Chlamydia and gonorrhoea.
o
Skin; unbroken skin is impenetrable by most microo
rganisms.
Microorganism
Agent
Reservoir
Portal of Exit
Portal of Entry
Susceptible host
Route of Transmission
Indirect Contact
Direct Contact
©Nature Care College
Safe Practices Learning Guide
Safe Practices Learning Guide – V3/01/13
Page 8 of 66
However, some microorganisms gain access to the bod
y through openings in the skin, for
example, hair follicles, sweat gland ducts. Some la
rvae of the hookworm can bore through
intact skin.
o
Direct deposition beneath the skin or membranes –
this is called the
parenteral route. For example, injections, bites, c
uts, wounds, surgery,
punctures and splitting.
Many microorganisms have a preferred portal of entr
y and it is only then that they can cause
disease. Disease may not occur if they enter via an
other portal, for example, Streptococci
can cause pneumonia if inhaled, but do not produce
any signs or symptoms if swallowed.
Some microorganisms can cause disease form more tha
n one portal of entry.
Resistance to infection varies depending upon the m
any factors of a person’s immune
system that will make them a
susceptible host
. Trauma, surgical procedures, therapeutic
procedures may render a person more susceptible to
infection. Immunocompromised
clients/patients are at an increased risk of infect
ion.
The hygiene scale
The hygiene scale goes from sewage to sterile. A Co
mplementary Therapies Clinic can sit
anywhere on this scale depending on the modalities
that are offered. For
example, a life coach or counselling clinic would b
e closer to standard
house cleaning, whereas an acupuncturist or a pract
itioner who takes
blood and urine samples would be higher on the scal
e.
©Nature Care College
Safe Practices Learning Guide
Safe Practices Learning Guide – V3/01/13
Page 9 of 66
Review Questions:
1. What is the meaning of the word infection?
2. Briefly explain the difference between the term
s infection and disease.
3. Name the stages of the chain of infection model
– Draw a diagram of the chain model
4. In relation to the “chain of infection” provide
definitions of the following terms
i. an agent:
ii. a reservoir
iii. a place of exit
iv. a susceptible host
5. List four common ‘portals of exit’ and list a m
icro-organism known to use each ‘portal
of exit’
6. Briefly describe how a micro-organism can enter
a host via the following routes of
transmission?
i. contact transmission
ii. droplet transmission
iii. vehicle transmission
iv. vector transmission
7. Define the differences between direct and indi
rect transmission
8. List three common ‘portals of entry’ for pathog
ens, giving examples of each, and
describe how each portal of entry could be used by
a micro-organism.
9. What occurs if any one link in the “Chain of in
fection” is broken?
©Nature Care College
Safe Practices Learning Guide
Safe Practices Learning Guide – V3/01/13
Page 10 of 66
HYGIENE CONTROL
The purpose of this session is to ensure that candi
dates are familiar with Standard
precautions and Additional Precautions and obtain k
nowledge and skills regarding
handwashing, waste disposal and spills management.
By the end of this lesson you should be able to:
Define Standard Precautions
Define Additional Precautions
Describe and perform correct hand washing techniqu
es
Explain waste disposal
Discuss handling of sharps
Identify areas using Colour Coding
Discuss spills management
Standard Precautions
Standard precautions are standard operating procedu
res that apply to all clients/patients
regardless of their perceived infectious risk. Thes
e precautions are required for the basic
level of infection control and are recommended for
the treatment and care of all patients.
They are designed to reduce the risk of transmissio
n of microorganisms from all sources of
infection to a susceptible host.
The principle underlying Standard Precautions assum
es that all patients/clients and
practitioners are potentially infected with blood-b
orne or other communicable diseases.
Standard Precautions include:
o
Hand washing
o
Use of personal protective equipment (PPE)
o
Aseptic practices
o
Appropriate reprocessing of instruments and equipm
ent following use
o
Safe handling and disposal of potentially infectio
us material and
o
Environmental controls
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