Linda Segel
N47
November 22, 2012

The Home Front

1. Basics of Handwashing to Promote Infection Control

The number one intervention for prevention of infection and spreading of illnesses is proper handwashing.

The home care nurse should get into the habit of washing his/her hands * when arriving and leaving the patient’s home * before and after patient care * before using clean equipment * after handling dirty equipment * when touching food * when going off duty.

It is prudent for the home care nurse to bring his/her own dispenser of liquid soap and paper towels to each patient’s home. Liquid soap is definitely a better choice to bar soap because of bacteria growth. Even though soap and water are the best deterrent against disease, other alternatives such as antiseptic towelettes, antibacterial gets, etc are acceptable according to the CDC.

Handwashing in the home is so important and is by far the most vital teaching a nurse can convey to a patient and caregiver. The patient should get into the habit of washing hands with liquid soap several times throughout the day. The nurse should demonstrate that this should be done for at least 10-15 seconds using the method of rubbing the lathered hands together and then rinsing thoroughly under running water. The nurse should never assume that the patient is familiar with this technique.

2. The “Bag Technique” and use of personal protective equipment to reduce the spread of infection.

The “bag technique” is a tool by which the nurse minimizes and prevents the spread of any infection from one patient to another.

Basically, the bag should always be in view of the nurse, and never put down on dirty surfaces (floor, couches etc). Therefore it is best to place the bag on a hard surface, like a table or chair, with newspapers or paper towel underneath to create a barrier. It is a good idea for the nurse to be well organized and know in advance what will be needed in each home so as to minimize the amount of times the bag is open. The nurse should wash his/her hands before taking out any supplies so that the contents of the bag remain as clean as possible. The bag should be left in the car for long periods of time so as not to be exposed to extreme temperatures.
All PPE like gloves, gowns, goggles, masks and aprons are kept in the nurse’s bag for their protection against infection, as well as special respirator masks. In addition to this equipment, there are other safety measures to prevent spread of disease, which include, dating every opened bottle of solutions, placing caps face up while bottle isbeing used, pouring solution into another container, refrigerating if necessary and not using the solution if it has been contaminated.

Nurses are prepared in case of accidental needlesticks and splashes – they have routine occupational safety and infection control training specifically for these type of accidents.

3. Proper disposal of used dressing and sharps

Proper storage and disposal of used dressing will protect nurses and their patients from accidental injury.

The nurse will allocate each family their own sharps for needle disposal which they will need long after her/his nursing care is needed. Therefore the patients have to be well instructed how to dispose of these. It is important for the nurse and patient to remember not to recap the needles. Used dressings should be put in leak proof containers before being thrown in the patient’s garbage. In some instances a decontamination solution will be applied to the dressing before its disposal.

4. Way to reduce spread of antibiotic-resistant microorganisms

The following methods are advised so as to minimize spread of antibiotic-resistant microorganisms from one person to another, and from one house to another.

* Minimize number of staff entering house * Schedule patient visit for the end of the day * Take the least possible number of items into the home * Educate the family about sharing utensils and proper washing of these utensils * Whenever possible use disposable equipment * When disposable equipment not available, use proper disinfecting methods * Use the PPE and handwashing with antibacterial soap so as not to spread this infection to another home.