Hygiene

Handling of drugs includes preventing the spread of infection. In order to protect residents from infection, special precautions should be used when providing medications. Fingernails should be kept short and clean. Artificial nails and fingernail polish are not recommended. Consult facility policy for guidelines.

Hand Washing

Hand washing is the single, most important way to prevent the spread of infection. Hands are exposed to germs continuously. Proper hand washing helps prevent the spread of germs from one resident to another, and to staff. After proper hand washing, hands are considered clean until they come in contact with someone or something else. When providing medications, wash hands between each resident unless no contact has been made with the resident or anything the resident has touched. If gloves are worn during a procedure, wash hands after removing the gloves. An alcohol-based hand sanitizer is used in some settings in areas where running water is not available. If hands touch the resident or anything contaminated, hand hygiene should be performed.

When should you wash hands? 

• At the beginning and end of each shift. 
• Before and after eating; after using the toilet, coughing, sneezing, or blowing the nose. 
• Before and after breaks and meals. 
• Before and after providing care to a resident or handling his or her belongings. 
• After removing disposable gloves.
• After handling soiled linen or equipment. 
• Anytime they are soiled.

Removing Gloves

For some procedures, disposable gloves are worn. Gloves should also be worn anytime there is a chance of coming in contact with body fluids. Medication aides may come into contact with body fluids when giving a medication under the tongue or to broken skin. Gloves should be removed after each procedure and between each resident. Hands should be washed each time gloves are removed. Use the following procedure to remove gloves so germs are not spread.

Guidelines for Putting on a Mask, Gown and Gloves

1. Wash and dry hands thoroughly before starting.
2. Unfold the mask and place it on the face. Adjust the nosepiece and ties behind the ears or neck.
3. Put on the gown with the opening at the back.
4. Be sure all clothing is covered, and fasten gown at neck and waist.
5. Put on gloves, pulling them up and over the cuffs of the gown.

Guidelines for Removing Mask, Gown, and Gloves:

1. The neck fasteners of the gown, the mask ties and the insides of the gloves and gown are considered clean. The rest of the gown, the mask, and the gloves are considered dirty.
2. Remove the gloves.
3. Remove the gown without touching any dirty surfaces with bare hands. 
4. With bare hands untie and unfasten the back of the gown.
5. Pull the gown off and invert it so the contaminated areas are turned inward.
6. Carefully contain the gown and place in the appropriate trash container.
7. Remove the mask by the ties.
8. Place all protective clothing in the appropriate containers as they are removed.
9. Wash and dry hands thoroughly immediately after removing protective clothing.
10. Laundry and/or waste containers and bags should be marked with biohazard labels and carried to the appropriately designated area in the facility.

Transmission-Based Precautions

Standard precautions are followed for all residents. Transmission-based precautions are used in addition to standard precautions. These precautions are based on how a particular pathogen is spread or transmitted.

There are three types of transmission-based precautions:

Contact precautions: For infections that are transmitted by contact.

• Use standard precautions.
• Wear gloves when in the resident’s room and for any contact with the resident or anything the resident has touched.
• Wear a gown if possible. Clothing may come in contact with the resident or items in the resident’s room.
• Wear a mask and eyewear if contact with body fluids is possible.
• Wash and dry hands thoroughly after removing barriers without touching surfaces or items in the resident’s room.
• Limit moving the resident out of their room when possible.
• Disinfect equipment if removed from the resident’s room.

Droplet precautions: For infections that are transmitted by droplets when residents are coughing.

• Use standard precautions.
• Wear a mask and eyewear when working within three feet of the resident.
• Wear gloves when in contact with body fluids.
• Wear a gown during procedures that may cause contact with body fluids.
• Wash and dry hands thoroughly before putting on gloves and after removing gloves.
• Put a disposable mask on the resident if they must leave their room.
• Disinfect equipment if removed from the resident’s room.

Airborne precautions: For infections that are transmitted by droplets that stay suspended in the air for long periods of time.

• Use standard precautions.
• Wear a mask if susceptible to the disease. A HEPA filter mask must be used if the infection is tuberculosis or another pathogen identified as requiring a HEPA filter mask.
• Keep the resident’s room door closed at all times.
• Use gloves or a gown when in contact with body fluids.
• Wash and dry hands thoroughly before and after using gloves, and any time skin is in contact with body fluids.
• Put a disposable mask on the resident if they must leave their room.
• Disinfect equipment if removed from the resident’s room.