Check out this universal precautions study packet

Aides might think the study packet created by Agene Parsons, RN, BSN, MPH, is designed primarily to help them become more competitive when they play her "Concentration" game at the universal precautions inservice. But the truth is, the packet - and the game - is a fun way to convince them to study infection control material.

Parsons, former director of quality improvement and education for Housecall Medical Resources of Atlanta, created the comprehensive study packet for aides to review before playing a universal precautions game she based on the old television game show. Here are some sample chapters of the study packet she devised:

Infection control: Infection control is the measure taken by health care professionals to remove one link in the chain of the infectious process to control infections.

    I. Measures to prevent the spread of infection to others:

    1. Wash hands immediately after contact with each patient and after every contact with material that may be contaminated and potentially infectious.

    a. Wash hands even if sterile gloves are used.

    b. Wear gloves for direct exposure to blood, drainage, or secretions.

    2. Plan what you are going to do before the initial patient contact.

    3. Carry out infection control precautions as required to prevent the spread of microorganisms among patients, caregivers, visitors, and agency personnel.

    4. Observe asepsis as indicated.

    5. Use high-efficiency disposable mask, covering nose and mouth, when indicated.

    a. Use mask only once and discard in appropriate receptacle.

    b. Refrain from handling mask while in use.

    6. Use gown when required to prevent soiling of clothing.

    a. Use gown once and discard in appropriate receptacle.

    b. Use sterile gown in certain instances (extensive burns, wounds).

    7. Use gloves when indicated by the patient's condition. Wear gloves when touching blood, body fluids, mucous membranes, or non-intact skin of all patients.

    a. Wear disposable, single-use gloves.

    b. Use once; discard in appropriate receptacle.

    8. Wear gloves, gowns, and masks during procedures that are likely to generate splashes of blood or other body fluids.

    9. Handle needles and syringes with extreme care because it is usually not known whether a patient's blood is contaminated with human immunodeficiency virus, hepatitis virus, or other microorganisms.

    a. Place used needles in a labeled, puncture-resistant container; do not bend, break, or recap by hand.

    b. Blood spills should be cleaned up promptly with a solution of 5.25% sodium hypochlorite solution diluted 1:10 with water.

    10. Disinfect and handle wastes with all due precautions.

    11. Handle bed linens and fomites with care.

    12. Carry out concurrent disinfection of fomites.

    13. Control dissemination of infectious droplets.

    a. Encourage the patient to cover nose and mouth when coughing or sneezing.

    b. Wrap contaminated tissues and articles in paper before disposal.

    14. Control dust.

    a. Avoid creating aerosols (e.g., shaking bed linens).

    b. Require damp dusting of furniture and wet vacuum cleaning of floors.

    c. Maintain cleanliness of surroundings; wash soil from walls as soon as it appears.

    d. Reduce to a minimum the activity of caregivers in the patient's room.

    15. Ventilate the patient's room properly with a system that directs room air to the outside. Keep the door to the room closed.

    II. Prevention of overwhelming infection in the immunosuppressed patient:

    1. Use meticulous hand-washing techniques before each patient contact, as well as between patient care activities to different body sites.

    2. Tell patients to request all personnel/visitors to wash their hands before touching them.

    3. Give prompt attention to fever.

    4. Use a private room; persons with known infections should not enter.

    5. Do not use invasive devices unless absolutely necessary; use only under aseptic conditions.

    6. Control water supplies (pitcher, sink) and ice. Dispose of open containers on a periodic basis; remember that every item in the room is potentially dangerous.

    7. Teach the patient about personal hygiene and the signs and symptoms of infection.

    8. Bathe the patient with antiseptic solution, paying special attention to axillary and perineal areas.

    9. Attend to proper housekeeping procedures.

    10. Offer low microbial foods and beverages when indicated: fresh fruits and vegetables; cold-sliced meat (rare meat can increase bacterial colonization).

    11. Be aware of the patient's emotional state.

HIV/AIDS facts:

Cause. The agent that causes AIDS is the human immunodeficiency virus (HIV).

Transmission. HIV can be transmitted by any type of sexual contact (rectal, vaginal, or oral), by blood-to-blood contact (most often by shooting drugs and sharing needles), or by a woman to her unborn or newborn baby perinatally or through breast-feeding. HIV is not transmitted through any type of casual contact, by insects, or by animals.

Infection. A person can be exposed to HIV and not become infected. It is possible to have sex with an infected individual and not get infected. Infection also can occur from a single contact with an infected person. Everyone is different. Enough virus must get into the bloodstream for infection to occur, and this happens most often through sexual and blood-to-blood contact.

Disease process. When HIV enters the body and the bloodstream, it attacks certain cells. Its favorite targets are the T-4 helper lymphocytes (also known as T-cells). T-cells are a critical part of the immune system. Without T-cells, the body cannot effectively fight off most diseases and infections.

Opportunistic diseases and infections. About the time an HIV-infected person is diagnosed with AIDS, one or more opportunistic diseases or infections will appear because the immune system can no longer protect the body from these diseases. An individual with a healthy immune system does not usually get opportunistic diseases.

Time. The time from infection with HIV until opportunistic diseases and infections appear is, on average, about 10 years. Since each individual is different, and people get infected with varying amounts of virus during exposure, this "incubation" period may be as short as about two and as long as 15 years. Once diagnosed with AIDS, an individual usually survives two to five years.

Testing. Anyone can get a blood test for antibodies to HIV. The body produces antibodies to destroy a foreign invader; in this case, HIV. Antibody blood tests are done confidentially at any County Public Health Unit or can be done anonymously at many. Individuals also can be tested at their doctor's office and at other testing sites.

Prevention:

    · Abstinence. No drugs and no sex means no infection.

    · Mutual monogamy. Having sex with only one person who is not infected means no infection.

    · Drugs. If needles are not shared during drug use, no infection will occur. If needles must be shared, ordinary bleach will disinfect them before sharing. Bleach should be drawn into the needle and syringe three times and shaken each time, then water should be drawn in three times to rinse the bleach.

    · Condoms. Since abstinence and mutual monogamy are not prevention options for some people, latex condoms must be used correctly, consistently, and responsibly. Condoms can only be used once. They must be used from start to finish. They must be used during every sexual encounter; and, only water-based lubricants must be used with latex condoms.