Section 18 Infection Contro1

18.1　Infection ControI Policv

In general, infection control for any communicable disease is based on three principles:

l. The infectious agent is blocked from entering a potential host

2. The agent is physically removed before it causes ham

3. The agent is killed in a process of sterilization or disinfection

The Agency recognizes the need to protect bo血clients and empIoyees from the risk of infection・

1 8.2　　Proced ure§

A. Infection Control is practiced in accordance with the Agency’s Qunlity Management Plan and accepted

nursing practice.

B. Hand Washing Techniques

To prevent cross-COntamination and spread of infectious organism・

1. Wash hands before and after any client care.2・ Take equlPment tO WaSh hands to sink area and place items on clean paper towel.

3. Wet hands and foreams. Lather using vigorous friction’Sta血g at fin・geIlips and working toward

forearm.

4. Wash hands vigorously under stream ofwater for at least lO seconds. Ifruming water is not

avai賞able, then hands should be cleansed with an antiseptic hand cleauser.

5. Dry hands with a clean paper towel fom fingers to foream.

6. Leave water ruming during hand drying and tum off faucet with a dry paper towel.

7. Discard towel in trash.

8. Wash hands between procedures as applicable.

9. Ifwearing gloves, always wash hands after removal ofgloves.

C. Proper Handling, Cleaning, Disinfecting ofPatient Care Equipment, Supplies, and Linens.

1 ・ All equipment must be cleaned oforganic material before disinfection・

2. Cleaning agents that may be used in the home:

a, Bleach

b. Hydrogen Peroxide

C. Hot Soapy Water

d. White Vinegar

e. Isopropyl AIcoho1

3. Laundry should be handled as皿1e as possible to prevent cross-∞ntamination.

a. place linens soiled with body fluids in a large Plastic bag.

b. Linens are then washed in hot soapy water with bleach solution.

C. Linens should be kept separate from family wash.

d. Dirty linens should never be carried against cIothing wom by the empIoyee.

D. EmpIoyee Health:

l ・ All empIoyees providing direct client care must meet the health requirements listed in the Persomel

Policies,

2. All empIoyees having direct client ∞ntaCt will receive an amunl education on BIoodbome

Pa血ogens and Universal Precautions and Tuberculosis prevention in ac∞rdance with OSHA’State

and local standards.

3. EmpIoyees who are ill should notify′ their supervisor.

4. Job-related illnesses and a∞idents wi11 be reported immediately to their supervisor. The supervisor

wi11 complete an Incident Report form and follow the ∞mPany PrOCedure for Wokers’

Compensation Claim Reporting.

5. Exposure incidents will be handled in a∞Ordance with the federal, State’and local laws.

183　　ReDOrtin望Communicable Diseases

A. Reportable Diseases and Conditions

All new cases of reportable diseases, Whether client or empIoyee related, Shall be reported to the local

health o触ces, ifthe attending physician has not already done so, m ac∞rdance w地心e laws ofthe

state. Reported diseases and the time frane for repo血1g Will confom w地心e state and loca1 1aws. A

list of state specific reportable diseases can be found at the end ofthis section.

B. Report ofOutbreaks

All cases ofany outbreak or undue prevalence of infections or parasite disease or infestation shall be

reported to state or local hea皿departments in accordan∞ With the laws ofthe state.

18.4　Medical WasteHandIin箪

Medical waste handling is perfemed in accordance with the Exposure Control Plan and local laws. In血e

event that an o∞aSion should arise when we would need to utilize special waste handling, it is our intent to

use a reputable medical waste handling company on a per client contract basis.

18.7　　State SDeCi範c ReDOrtable Disease List

/、 Diseases and Conditions Reported to CoIorado Pubfro臨ealth Agencies by State Law

重mpo].tant nO缶oe for pa鯖ents receiving health care services in CoIorのdo!

The following list of di§easeS弧d conditions must be reported to st概e or county public hedth

ngencies by health care providers, ho§Pitals and laboratories, accOrding to CoIorado Board of

Health regulations &ttp :侮vw.cdphe,State.CO,uSんpんegs妃iseasecontrol胤dex.h粗l). By law,

血is repo血g doe§ nOt requlre patient consent or nodfication. The col血dentialrty ofpersonal

health iIlfomation reported to the CoIorado Depar血ent of Public Hea弛=弧d Environ皿ent

(CDPHE) is protected by law. If you have question§ regarding the§e rePOrting requke皿e創is,

please call CDPHE at GO3) 692-2700. Ifyo`】 have quesfrong aboIIt Whether you皿ight have a

COndition that must be r印orted, disc鵬this with your health care providen

重血健扇o櫨s Di§e猟銃

An瓜r紋

B〇億l壷皿

Br頃ce皿a

Ca皿pylo ac健r ‾

働孤croid

α劃しydia

α0工era,狐d o瓜釘Ⅴめ五〇血危c缶ons

C重os壷d止血d与脆鵡ile *

Cmtchfield-Jacob Disease (CJD) or vari如t CJD

(　CⅣptOSp〇五dⅧ皿

q℃lo寧pO拘

Di垂瓜e瓦a

E. °°櫨0157;櫨7 (狐d o瓜erめⅩ血や的d慣cぬg E, c串)

最強cep血孤itis

Gia舟ia

Go虹oⅡ血ea

G鶴Oup Ou餌eaks ind訪ねgあod poiso競止g

照紺地Ⅳin鳩

He皿Olydc ue重nic syndro皿e =1 8 years old

Hemophilus ducreyl

地軸Op址1購i血ue腹a

Hepa脱s A, B and C (and other viraD

ⅢV仏IDS (includes CD4+ count

棚tbe/OW脚es時ys胸s a勅e細Ca叩Viders L∂bo融es have sep細repO砺卿irements∵ A case鵬t be rapo舶f肋sfateorIocal煽筋d印a肋en聞○面g舶gわos府画的加的脱硫me ln脱融

〈棚S創。脆m 。apa同軸朋。m脚誌望伽a〃臆Suspe叩CapeS・ W申nerO手機of s撃PO噂鮒やo巾細臆a噂a鱒二二

2互・ Hou「 R印o昨a削es

血aI刷fes by dogs, Cats’bats,

諒unks or othe「 w肘camivores

tl:hrax

火ulis調

置oIera

中htheria

剛p ou伽eats - known or suSpeCted

of a岬ypes: iIlcluding foodbo叩e'

waterbome or Other胴ness

epat鵬B (了d)

仙enza ・ asSOCiated

h°Spita惟atl°n (7d〉

a蘭画oba債e面Sis (7d)

γptoSpo「棚osis (7d)

;yClospo胎(7d)

」 c°Ii O157:H7 & s輔ga tox面

上へ轟Cing E. co= (7d)

andHIVinfe融on(7d)

油ancroid (7d)

)「uceIl°Sis (7d)

ねn(avl「us 〈7d)

yme Disease (7d)

これceph尋鵬(7d〉

1epat鵬C, aCute (7d)

」epa珊S, othe「 >圃(7d)

ねwasak! Syndrome (7d〉

両ism spectrum diso「de「S SI O years

°Id 〈30d〉十

綱h defects, deve10Pmenfal disab猶ties

and risk factors (PregnanCy tO 3rd

胃’(ねy) (120d〉十

Haemoph軸S輔uenzae invasive disease

Hep競iti容A

Human Rabies (SuSPected)

Measles

Ne!sseria meningitidis invasive disease

Pe轟ussi s

plague

Diseas亘皇

lnfIuenza _ aSSOCiated deat掴fく18

yea「s (7d)

Mumps (7d)

旦墜車両e種両日両岸鴫馴書〇割塗室Giardぬsis (7d)

Hemo騨C uremic syndrome if s 18

yea「s (了d)

しiste「iosis (了d)

S堅型型Iv Trans臆mi脆d Dis皇室連星

G°n〇両ea, any S請e (7d)

三重皇聖ptle駆sea麹宣

Ps舶c°Sis (7d)

Q戸eve「 (7d〉

Relapsing Fever (7d)

蛙血腫垂壁nce畦e蝿S圭」虫y争S ive Dj謹皇整

心e函c me面g鵬(了d)

生唾里中関山請Re関山bh D加重圏はLegionellosis (7d)

Lep「OSy (7d)

Maぬ「ia (7d)

Po陸o調ye潤s

Rubeila

SARS

S調ailpox

SyphiIis, ea「書y (1O, 2o, earIy Iafent)

TubercuIosis (active disease)

TypIIOid Fever

RubeIla. congenital (7d)

Tetanus (7d)

Va「icella (7d)

Sa血onellosis (了d)

S涌gellosIs (7d)

Trichinosis (7d)

Lymphog削uloma venereum (7d)

Rocky Mountain Spotted Fever (7d)

丁ula「e請ia (7d〉

Transmissible spongiform

enceph亀lopathy (7d)

Toxic Shock Syndrome (7d)

Pos粗Ve TB s軸test in wo「kers

exposed to active disease (7d)

Environ調皇nt連Pccupa唾堕L and Chronic Cond随里芋MuscuIar Dystrophy (120d)+

Sp圃c○刷れ申南S (120d)十Fetal AIc°hoI Synd「ome if SIO years

°ld 〈30d)

Head injuries (hosp闘Zed

○○繍al) (120d〉十

u_L REPORTS MuST INCしUDE:

. The disease O「 COnd牝ion being 「ePOrted

」 Patient's name, date of b柵, SeX, 「aCe・. ..　　　. ●　　　臆　′・○　○I‥」:__　_;き、,

TO REPORT A CASE /随QuEST FORMS, CONTACT:

The Loca岨ea船Depertment Or

coIorado Depar血ent of Public Hea帆and Envi「Onment

Division of Disease Contnof & E nvironmental Epidemiology

Exposure Contro賞Plan

血accordance with也e OSHA BIoodborne Pa血ogens Starrdard’29 CFR 1910. 1030’the

剛owing expos鵬plan has been developed・

Exposu職Detcmina伽n

The exposure dctermination is made without re ard to the use ofpersonal

protective equip重neu唖.e. exployees are considered to be exposed even if they鵬紺

personal protec。ve equipme叫This exposue dete馳血ation is required to list all job

classifications in which all empIoyees may be expected to i調r such occupa魁onal

印osure, regardless of frequency. Ai tlris agency,也e脚owing job class亜cE血ons ae m

血is c如egO坤:

l. RN SxpervlSOr

2. RN, LPN, CNA, PCP field staff

3. Ad皿i血s寄如O重

4. Br狐ch M細胞g繍

5. Care Coordinator(S)

6. Hum狐Resource Mannger(S)

General Pr血ciples

l. Consider all patieut’s blood狐d body fluids as infe{誼ous皿ate固s.

2. Equipmen扉instrments and utensils w腿com誼contact w池patieut

excredons, SeCrctious and body fl融s are considered contaminated.

3.血fe血us wa如e includes’but in not lin宙ed to, the following:

a A皿d記SS血gs

b. Used so孤ed pads価apers

c.工n競Ⅳe皿OuS血b血かa血統e購

d. Used foleys and drainage bngs

e. A皿used needles and sha呼s

f Thsh,如ves, gOWnS,皿aSks’chlⅨ, d印ends’etC’Contaminated with

clie皿ts blood or body餌ds

g・ S料地呼皿坤龍腿

Standard Precau慣ons

A皿healthcare workers sho山d rou血ely use a押ropriate bar血preca血ous to

prevent skin and則COuS-membrane exposure w血en contact wi也blood or other body

餌ds of any padentis anticipated. The puxpose ofprotective equip鮒証e to keap blood

and o也er potentia11y infe鎚ous皿aterial fro皿∞utacting skin’eyeS,狐d n鵬OuS

membr弧es. But this does not皿ean血at you皿ust be wxpped in a headtotoe cocoon・

血some cases, adequate protection is provided solely by givves・血o也er cases,皿aSks

and eye protection融also be needed. And in sti皿other §ituatious, gOunS’apronS狐d

head covering皿ay be requlred.

1.塑吐哩過重g: Strict hand washing technique is to be used in all in§tanCeS Of

cou同t with狐y Patient’s blood or o血er potentially infectious餌ds. Wash

harrds froquerty and always betvreen clieu朗融ents and after glove r弧oval.

Exposure ControI Plan

GIoves should be ch孤ged after contact with each patieut and immediately if

they’re to皿Or Pur調tured. Refer to励新海脇ng Procedre蹄関わ妬めr虎細線・

2.製唾Si Wear gloves when exposed to any patient’s blood劃d body secretio髄

including cont訓鴎with any moist body site, fluids or solids’including劇eous

men心ranes or non-i劃act skin, h組d血g soiled equipme競and/or linens’紐ger

sticks and/or a叫y皿vaSrve PrOCedures, and a11 client care.3・器鵜磐繋灘灘誤認霊謹dpass血ou釦to or reach the empIoyee’s wo血cIothes under nomal con{髄ons of

us。. AII PPE will be provided by facility, family or clie血as deemed appr垂uate.

R鴫r研]切so桝l Pro嬢かe軸碕桝ent Ch釘やr 。寂菰

4・曖柴慧警譜驚狐掘s叫S融n彊両軸叩r鋤。融

from diaposめle sy血ges. After use, items will be placed in puncture

resisf狐t COutainers. These corf血IerS Shndd be: Prac缶cal to也e use area’

be leak proof on血e sides and bo請Om・ be k印t cIosed, nut OVer帥ed.

when the co血er is %餌珂W軸心e securely sealed and placed in the

household trash.

b. M独融w紬〇両也諒sk ofpu鵬唾, e・g・, ga昭e血ess立鴇C地軸S,

gloves’d印ends, etC.’Will be place。fu leak proofplastic b鍵翫也en

securely蝕tened and disposed ofin也e clieut,s household tl aSh.

5.遡哩的珪壁婆a. Eating, drin血ng, aPPlying cosmedcs or lip bal皿, arrd handling contact

leuses are pro肋ited in work areas where blood or oth餅POte融a11y

血姑誼ous皿軸瓦血s狐e肱ely to be p鯵S鎖血

b. Ma血t‘血a clean che競eAVironment with e皿Phasis on the baぬroo皿弧rd

軸櫨cle秘虹l血ess.

c. Kieep su押lies offぬe floor and out ofreach ofc鮒dren.

d, Bngs used by則rses証me he地aide狐d other sta鯖w址ch are t]rought

into the ho皿e are Class競ed as clean o阻血e inside. The outside of也e bag’

becanse it is磯posed to all environments, is considered代soiled." The

iuside and outside ofthe bag whl be cle紬ed wl].en Visibly soiled. A barier

皿ay be used urker the bag as needed. For RN几PN“ disciplines’Please

refer細棚融暗B優姥e脇que Proceゐ鳩

e.血dividuals w地Iesions or exposed skin surfaces may require removal

from wo出血clieI鵬homes. Sma皿cuts and scrapes should be covered

wi血an adhesive dress血g or bandnge and皿Onitored cIosely for integrfty

血止血g c騰血C狐e孤誼Ⅴ迫es・

6.堕ds ofDis追触垂塑a. Reusable articles in the client,s home cont劃血ated with blood or body

餌ds wi11 be washed with soap狐d water. If a d狐ger Of contanin証on of

body parts or a砧aceut areas exists, item win be washed in a spe髄c

container and瓜e subseque血sohtion discarded in the toilct bowl. F皿

strength disinfectaut will be used to cle狐t{胤ct bowl勧rd seat.

b. Wk姐it is I]eeeSSary to uSe equlp皿eut Which皿st be disinfected after use

狐d whch will be used by or for a patient over a period oftime’e.g.:

Exposure ControI Plan

bedya購, u血als, bedside co皿mOdes, etC・,ぬe famdy will provide this

e哩岬皿e血・

c, BIood glueose m血tors wi皿be cleaned when visibly soiled or according

め皿融,s鯵cO棚血脂孤d貌ions.

d AII solutions will be checked for expira高m date prior to use. Use a

spec迅c so舶on such as aloohol or CIorox l : 10 if coⅡtaninated with

blood or body餌ds fro皿a Chent. R帥r to Proce働脚部乃r #鍬m

Cbn打Ol押切雇7拶hanわ汝

e. Themom如rs will be wiped w池alcohoI or an alcohol pad’SuPPlied by

c比重舐鑓ea心鵬e.創lowめ壷血y・

f S悔めoscopes and blood pressure oof穏wm be cleaned w血en Visibly soiled

by the employee who has possession of也e equlPme加.

g.餌clien証amdy is to be handled mini血ly and not shaken or placed

ngainst the e叩loyee’s cIo亜ng or body. Contemina鵬d laundry will be

placed immediately in也e clieut’s washing皿achine to m血imize e劃PIoyee

狐d魚皿i中exposu騰・

h. Broken如vsware will mt be pided xp directly by harrd. Wear gloves to

scoop up theわsoめed spⅢ and broken glass・ D垂鵬e血container arrd

pla∞ COutainer into household garbage.

取posure

A sig血飼cant exposure is defined as a needle stick or cut cansed by needle or

sha呼也at was act脇寒ily or p疎加ially coutaninated融blood or body餌ds, a muCOus

ne皿brane expo§ure (i.e. splash to血e eye or r調Eth) to blood or body fluids, a Cut狐eOus

expos耽invoiving large anoulits of blood or prolonged contact with blood - eSPeeially

Ⅵ血en也e exposed skin was cha押ed・ al’陶ded, Or a蝕icted with dem劇輯s.

If you are dire鎚y exposed, rapOrt it血mediately to your Supervisor. You wi11

be directed to a physician for ay treatmeut and剛ow-xp required as a result of狐y

exposure you encounteL R帥r to Cbmm棚融b朋穣cめ郷創se倣e #,r棚碗極地ble・

l. D鏡血道0鄭:

a. An i確C#0郷disease results fr(m也e iAVaSion ofa host by disease-

producing onganisus, SuCh as bacteria, Vi関ses,允mかr parasites.

取ample‥ Salmom批is a highly血fectious disease usua11y transmitted

from poo轟y pr印紬e{i允ods co血劃inated w池salmone皿bacteda and is

血ot ∞鴫ious.

b. A co朋muni倣ble (or contagious) disease is one that can be transn諦ted

from one person to ano也er. Not a皿infectious diseases are co皿m脚icable.

Exarxple: Chictrenpox is an infec屯ous disease w出ch is also co皿murde甜e

and can be eas叫y trans血tted from one person to ano血er.

2. Modes of Transnrission: Communicめle disease can be箪脂ねd#’eC姫y or

i融かec動bわ0めorne or a訪ome・

a. Direct龍阻Smission occurs也rough direct co競act wi吐血e blood or o血er

body subst狐CeS Of an infected individual.

b.血direct龍皿Smission occurs w池out person巾irerson CO劇act・珊e

disease-Produeing onganism passes fron the infected individual to an

Exposure Control Plan

inan血ate object. (The person comes into ∞utact wi也a conta皿inated

oセject and come§ down with也Le disease.)

c. BIoodbo虹Le diseases are spread by direct contact w池the blood or o血er

body sul)sta鵬eS Of狐infected pe購on.僻loodbome diseases of mst

concem include HIV, H唾atitis B and Hapatitis)・

d. Ai血ome diseases are spread by droplets of也e diseasei)rOducing

org狐ism be血g expelled i血o the air by a productive cough or sneeze or by

direct contact with infected body secretious. Ones of concem include

tut)erCulo§is, meningitis, mumPS, rubena and chickenpex・

3.旦xposure to BloQ4bo鱒e臆P鎚麹塾墜Hu皿an ``expsure” is de鋸ned as co血ct

wi血blood or body紐uids to which Standard Precautious apply. Exposure can

occur via needlestick, 1aceration or bite, Cor虹act w地an apen wourd, nOn-intact

skin or mueous me血brane during也e perfemance ofnomral job duties.

4.堕dy F担ds Expo型喧しExposures餌e也ose identified by也e CDC to which

Standard Precautious a押ly血cluding, wi血out lin融on,也e fo皿owing body

細血ds: blood, Se皿en, Va車血secrctions, CSF, SynOvial fluld, Pleural鳳rid,

peritoneal鳳rid’Pericardial餌d’am血otic froid, laboratcny坤ecim釦s也at

contain HrV or o也er body皿uids w址ch co劇ain visible blood, §uCh as vo皿itus or

u鵬ne.

Health Guidelines for EmpIoyees

珊e agency will dete龍血r弛e work sta加s of狐emPIoyee diagnosed wi血certain

diseases. R窮r扉Ziea協G協de搬esJar EJ呼lめ彫s and E即砂ee砕ya融%棚めn

上級e(紘

l.血fectious Dise謡es: Work status of emptryees with infec血ous diseases will be

dete皿ined by co腿ultation with the Director ofNursing甜rd也e e皿PIoyee, s

physician. Re∞mmendatious will be based on g竜delines from CDC’伽町ent

Practice and state law.

2. Communicあle Diseases‥ Any employee who has exposure to or is diagnosed

with a r印or劇ole co皿蘭皿icable disease w田mt be a1lowed to wo血Nb龍icafron

will be made ofexposure or diagnosis to all contacts.皿e client’s physician will

be櫨o髄ed,謡坤や抑p壷抽e・

a.珊e employee will紐st be suapended岨om whk. The er坤loyee wiu be

required to r印ort to his or her physician・

b. To retum to work, the empIoyee must present a written statement虚om

empIoyee,s physician indicating ptrysici狐’s pemission to r卸m to wok

wi血no restriく舟ons.

c. Reportable co皿mu血oable diseases are de缶ned by local healぬ

dep軸血e加S ・

Exposure ControI Plan

List of R印ortable Diseases

皿ess p扇0鵬中書や融, Clie鵬証吐血Ⅷ餌馳p劇証印0融脆

coⅢ血c貧b融se謎eS融職印0励め鵬S臓D印劃虹廠0馳狙R紳祝融

QfR儲タO汚ab le D言seases

l. Ahiepo融le co関unicable diseases調be reported to the State Department Of

Health, according to guidelines est融shed by the State Departmeut of Hedth.

2. Re∞rds win be kapt to identify any patte鵬Or trends of co皿皿unicable diseases.

Data regar(血g co皿unicable diseases皿be reviewed and analyzed on狐

ongoing basis to identify any trends.

Communicable/In蛤ctious Disease Information Th址皇

Disease/Infection �Modeof �重富Vaooi皿e �Si弧Sand

Tr種ns皿issio皿 �Av郷頒ab賞e? �Sy皿pto皿s

AIDS/HIV �Needlesticks,bloodsplashesintomu- cousmembranes(eyeormou也)or bloodcontactwithopenwounds �NO �Fever,nightsweats,Weight loss,○○u鴻

Anthrax �Cutaneous:SPOresenterOPenareaS Pulminary:inhalationofspores �YES �Cutaneous:PuStules,1esion§, edema Pulminary:fever,f轟igue, heacぬche,rapidoasetof acute respiratorydistress

Chickenpox �Respiratorysecretionsandcontactw池 moistvesicles �YES �Fever,raSh,blisters

Di軸心ea: Campylo耽0ら C喜押toporidium’Gardia Salmonella,ShigellaViral, Yersinia �Fecal′0r種I �NO �L○○se,W訪eヴS約〇Is

GemanMeasles(Rube11a) �Respiratorydroplet§andcontactw粗 respiratorysecredous �YES �Fever,raSh

HepatitisA (InfectiousHepatitis) �Fe○al/Oral �Y臼S �Fever,1ossofappetite,fa一 tigue,jaundice.Incubation Periodis]5-50days(28avg)

Hepat鵡B (Se調mHep如tis) �Needlesdcks,bloodsp]achesintomu- cousme皿branes(eyeormouth)or bloodoontactwithopenwounds �YES �Fever,fatigue,lossofappe一 tite,n餌§ea,headacheうj劉m- dice.Incubationperiodis 45-160days(120av妙’

櫨ep沸i債sC �SameasHepatitisB �NO �S糾虹eaSHep融債sB

Hep都債sD �ameasHepatitisB;dependenton HBVOastorpresent)tocause 工n危ction �NO �AcomplicationofHBVin- fectionandc劃increasethe §eVerityofHBVinfection

Othernon-A,non-B �Severalvin章SeSWithdi飾erentmodesof �NO �Fever,headache,fむigue,

Hep融償s �transmission(Non-A&non-Bbec餌se 血erearenotteststoidentify血em) ��」a肌髄ce

HerpesSinplex (ColdSo鵬) �Contactofmucousmembranewith �NO �SkinlesionsIocatedaround

moistlesions.Fingersareatp弧でicular rickforbecominginfected ��血e血outh

H印eSZoster(Sh血gles) �Contactwi也moistlesious �NO �S貼nlesions

賞n組uenza �Aめome �Y巳S �Fever,fatigue,lossof appetite,n餌Sea’headache

commu皿icable鵬Ctious Di§eaSe I融mation Thble

Si糾S狐d Sy皿pto血S

D亀se的eI工融0Ⅱ �Modeof Tnsmis§ion �� �重sVacc皿c Avさ胤みb霊e? � 富a �� �NO �S ぬ め も 健 �ev餌e劃血g狐d8償細山 も0紙皿読めseco櫨d坤 霊誌。‡警寵呼 cted.Eggsofheadfroe 枇a血的ha遼asⅡ購曲 調曲直餌や書u車型 �

Lice:Head,Body・Pul)ic �cIoseheadtobeadcontact.Bo血body 皮p融鵬坤血e出血贈晦c○職場t餌 ぬ紺血go餌血虜eCl唾

Measles �R印触0Ⅳ血吋廊COO: 皿s独億也的沈SeC頑io皿s・唖車重y∞皿‾ 皿un鵡able �� �YES ��Fever,競鯵心,心憎n融魅 　h誕‡劇場S組

M餓血豆tis: Me血却COcC血 蹟e皿o垂加S血的e種後 ViralMeningitis �contactw組respintoryseCretious c側線購W虹e§p心気働ySe慨e瓦oos co同actwithrea車atoryseCretions �� �NO YBS NO ��京ev餅,SeV敬やe, ne〇七s働e也でo如 くS劃ne) (S劃腿〆 也かo垂励鼻糾e

Morormroleosis　:誓Wt崎ir坤SeC陶ti_調 ����NO ��Fev鋒,SO職 �

YES ��FeⅥ瓢,SW班血gofs捉Ⅴ狐y 頭狐ds(p紬宛の 　粛

M噌S　　　　軸ir坤や1総出co血露融 �������

軸皿ooe皿OSis　　　　F○○的伽e ����NO ��Suddenons鏡Ofev餌, めdo調i脚1paぬ,髄如 nausea&frequentVOmiting � 臆喜喜題エコ==こ ��愉出血g,t吋拉庶狐bu調WS or・調鳩鳴,,v節icle㌻-- p劃鵬まc心細y餌o皿d語孤教導S, w五節S,的州S皮衣血剣確 　心血班s出血

scabies　　　　　Closebodycoutact ����NO ���

YES ��Severeh鈎dace,c,g 誌鰯n§, � S皿塊lPox ��耽S中細吋的p煽S&co劃幽CtⅥ nasalor請oa陸eCr鎚ons・Directcou-

tactw組PuStule§・Highlycorrm狐lca- bl ����血atbeeo皿eblisters

Gen細皮c庇皿eOuSl錐io皿s・ 櫨。Ⅳed鮮血e頑ioo囲め

帥皿秘中§e測狐co田圃的甜e重y throu執blood髄nsfusion ��NO ��� S押出脆

聯Ⅳ執心か押e躯,Wei卵: loss,cOu弧 二1‡00u直鵡細時的 �

Tuberculosis)Pu血OOary ��Aifbo皿e ��NO ���

詣議00直　篤註伽舶tW軸 ����YBS ��V章0eⅡ Ⅵ心0坤孤gso調速W心細 ○○職如Sめs鵬3 �

看鵜喜鵜鵜賀賀田 ���� ��

NO冊陳謝師直抽出餌lo融弧d印抑e帥餌制約卿適creportable’CO皿nunicable diseases

M耽b201W噌

圃囲田園圃間圃圏圃

E叩ipme巾●　Bacteriostatic fo餌可eel/liquid/wipes

. si通読侃調nn血gw沈er

●　Soap -Preferably liquid

●　P坤erTowels

●　Disposable plastic bag or WaSte Can

Proced∬e

l.血dication for handwashing are:

'　Before and after direct patient c紺e

●　Before and after each procedure舶丸-

●　A角錐uS血g也eb抽○○皿・

'　After blowing or Wiping nose"

'　Before and程er food prep or eating‘

●　Whenh狐ds are sOiled.

● A船的00虹紺融融抑摘edm勧請粗s・

● Before re-ente血g e岬loyee’s bag or clieutis supplies.

2. A11 empIoyees are reSPOnSible for inxplementing handwashing procedures in an

ongoing attemPt to Preveut andfor coutain in観ous proCeSSeS and communical’le

3. Bacteriesta。c ft融aniquid柾pes are the preftrable handwashing method

Ⅶm using Bactedosta龍c foandgeMiquid/wipes, 。坤ocedure is as fofrows :

' Place adequate anOuut Offoan or liquid on hands

● Using frction南m between fingers, arOund and under融Palms and

4. The proper ProCedure for handvrashing when using soap and融is as follows:

●　Tm water tO a COmfortable wam temPerature

● Hold hands under nming water SO they get COmPletdy wct.

● Lather hands融with soap: use fiiction; Wash between血gers, Wach area

狐0皿d弧d皿der租劃s・

● Using s clean toW。 dry hands thoroughly.

●　Tum offwaterぬucet using towel・

● Discard paper toWels in a disposalale bag or WaSte Can.

Nurs血g Bag Technique

1. Before entering the home’m放e sure血e bag is stocked w池bacteriostatic

foanAIquid佃ipes and plastic trash bags (Preferable in a side pocked)

2. Upon eutering the home’Place the bag on a cle狐Sur離e; Paper towels or plastic

bag may be used to create a cle紬area ifindicated. Open也e bag near the care

area and証POSSible, near the water s岬Iy.

a. wash hands thoroughly with bacteriostatic foa血liquid佃ipes.

b. Remove all items which will be needed for也e visit.

'　Place iteus on one ofthe Paper towels' CIoseぬe bag and give

ぬe client care.

' If additional items are needed after care has started, WaSh hands

before re・eutering bag.

' Cle狐any Visibly soled items which融I be retu皿ed to the t)ag'

●　Wash hands狐d retun equipme加to血e bag; CIose bag.

. Tidy up the work area disposing ofwastes.