Manual Handling and Other Emergency Procedures

Submitted by Jacky.Kohunui@… on Thu, 12/07/2023 - 13:47

Follow safe work practices for manual handling.

In this topic you will learn about:

  • Safe work practices
  • What makes manual handling hazardous
  • Manual handling 
  • Manual handling techniques
  • Reducing manual handling risks
  • Risk assessment and risk management 
  • Client behaviours that can increase risk
  • Infection Control
Sub Topics

Manual handling refers to movement that involves force or changes in posture. Nearly every task you perform in an aged care or disability setting will include manual handling of some type.

You might be required to:

  • Help a person to walk
  • Use a computer
  • Take part in an activity session such as yoga or dancing
  • Help a person to shower
  • Transfer a person using a hoist
  • Clean a bathroom and toilet.

Any type of activity that involves movement puts you at risk of injury from falls, sprains, damage to your spine or muscles, stiffness and pain. Manual handling injuries cause significant risks to workers in your sector.

Key statistics

According to the Australian Bureau of Statistics, in the period of 2021-2022 there were 497,300 people had a work-related injury or illness (3.5% of people who worked at some time during the year). The most common cause of injury or illness was 'Lifting, pushing, pulling or bending' (24%). 66% had time off as a result of the injury or illness. 31% received workers compensation for the injury or illness.(Australian Bureau of Statistics, 2023).

There are various common injuries associated with manual handling and include:

  • injuries to muscles, ligaments, intervertebral disc and other structures in the back
  • injuries to soft tissues such as nerves, ligaments and tendons in the wrist, arms, shoulders, neck or legs
  • abdominal hernias
  • chronic pain.

What Makes Manual Handling Hazardous?

Four key risk factors that can make manual handling tasks hazardous include:

  • Task
  • Individual
  • Load
  • Environment

These risk factors can be easily remembered as "TILE":

Task
Sub-factors Description

Task is too strenuous

  • Tasks undertaken too frequently with insufficient rest breaks
  • Tasks undertaken for long periods of time / long distance
  • Imposed working speed process unable to be altered

Awkward postures or movements

  • Bending backwards, forwards or sideways
  • Twisting the back
  • Raised arms above shoulder height
  • Working with bent wrists
  • Looking down for long periods of time
  • Looking to the side for long periods of time
  • Squatting or kneeling for long periods of time.
Individual
Sub-Factors Description
Work familiarity / experience
  • Undertaking a task where you are not familiar with the movements, expectations and muscular effort required
Training / supervision
  • Training received prior to undertaking the task
  • Management / peer expert supervision
Individual Physical capacity
  • Strength of individual
  • Age of individual etc.
Previous known injuries
  • Previous and/or existing injuries
Load
Sub-factors Description
Too large
  • Loads that are unable to be held close to the body (e.g. arms outstretched more than 30cm from body). This increase the potential for overexertion and muscle fatigue.
Too heavy
  • There is no legislative weight limit that is considered ‘safe’ for manual handling and/or lifting. Individuals have different capabilities that must be considered when taking into account when lifting and moving a load
Difficult to grasp
  • Loads may be slippery
  • Use of Personal Protective Equipment e.g. gloves may make gripping the load difficult
  • Unsuitable handles or broken handles
  • Surface textures
  • Load is too small (e.g. having to pinch to pick something up)
Unstable unbalanced or contents can move
  • Moving water/chemical container
  • Moving half-filled box
  • Having to lift a person or animal
Difficult to reach.
  • Loads that are stored above shoulder height
  • Loads that are stored below knee height
Environment
Sub-factors Description
Available space
  • Having enough space to manoeuvre items or stand straight
  • Walkways and entry/exit points are free from obstacles
  • Enough clearance under desks to ensure workstation is set-up correctly
Floor surface
  • Working in areas where there are changes in levels e.g. navigating stairs
  • Undertaking a task where there may be surface cracks, dips or holes
  • Working where there is the potential to have a slippery floor e.g. spilt water or working outside
Climate (heat, cold, ventilation, humidity)
  • Working in hot conditions
  • Undertaking tasks where there may be exposure to radiant heat e.g. welding
  • Working in cold conditions
  • Working in humid conditions
  • Working in areas with a lack of ventilation
Vibration
  • Undertaking tasks using plant or equipment e.g. use of a power tool
Lighting
  • Adequate lighting to enable employees to see without squinting or leaning forward to see

Client Behaviours That Increase the Risk

People Unlike other types of loads you might lift or carry can be unpredictable. When a person needs help to transfer from bed to chair or from chair to wheelchair, they may use many different responses and behaviours that can put you at risk. The person might be frightened or anxious, and become rigid, making it more difficult to help them walk or move. They might have dementia and react aggressively because they are frightened or unsure of who you are and what you are trying to do. The person can hit out unexpectedly, causing you to move into an unnatural or dangerous posture. The person might stop helping you mid-way through the transfer and begin to fall. The natural reaction of most people would be to reach out and catch the person to prevent them from falling. This is one of the most dangerous reactions you can have. Let your supervisor know if a client uses a behaviour during a transfer that might put you at risk. Write down what happened using your workplace reporting forms, such as an incident form or near-miss report.

Note

Never attempt to stop a person from falling by reaching out to pull them up or by putting your weight against theirs as they fall. You could be seriously injured by this movement.

As difficult as it sounds, you must allow the person to fall to avoid putting yourself at risk. Your workplace will support you with training to help you understand this procedure's importance.

Reducing Manual Handling Risk

Your workplace must provide you with training in manual handling postures and techniques. During this training, you will learn certain universal rules that apply when transferring any load.

Here are some of these rules.

When working in the healthcare industry, employers often require proof of manual handling training. Manual handling is the use of force exerted by a person to lift, move, push, pull, or carry people and equipment. Due to the regular handling of patients, manual handling in healthcare is a common workplace injury. You can prevent manual handling injuries by identifying potential hazards, assessing risks, reducing risks, and regularly reviewing risk controls.

Risk Assessment

The health and safety risks associated with potentially hazardous manual handling tasks are to be assessed, considering:

  • If an individual is likely to be injured while carrying out the task?
  • What preventative measures have already been put in place, and are they adequately managing the risk?
  • What is the level of risk associated with undertaking the task?

The Department has developed some sample risk assessments that should be tailored to your workplace. These include:

  • Display of artwork
  • Stage set-up
  • Transporting and storage of heavy and unstable books
  • Transporting and storage of sporting equipment and transporting and storage of large boxes or containers
Risk Controls
Control Description
Do not undertake the tasks
  • Communicate to employees that they are not to perform the task
  • Re-design the task so that manual handling can be avoided completely
Change the environment (workspace)
  • Change the layout of the area e.g. create a clear pathway to the door
  • Store items close to where they are to be used
  • Adequate and accessible storage solutions (e.g. weight rated shelves, shelves are built fit for purpose, items can be stored between knee and shoulder height)
  • Lower the height of storage shelves to reduce the need to use a ladder or lift above shoulder height
  • Undertake the task in more suitable temperature conditions (Compliance Code for Workplace Amenities states that for sedentary work 20°C - 26°C depending on the time of year and clothing worn)
  • Allow enough space to conduct the task
  • Keep items to be used at the same level to reduce the need for lifting or lowering
  • Provide enough lighting
Change the nature of the work
  • Arrange for deliveries to be placed near area of use
  • Team lifting
  • Break down the task e.g. reduce the weight of object
  • Determine working position e.g. sitting or standing
  • Set realistic work rates/timeframes
  • Rotate tasks
Modify the load
  • Reduce the weight of the load to be carried e.g. take objects out of box to be moved
  • Place items in a smaller tub
  • Purchase items in smaller containers instead of bulk
Use mechanical aids
  • Use of slings/straps
  • Backpacks
  • Tool belts
  • Hoists
  • Trolleys
Administrative aids
  • Develop, display and communicate safe work procedures
  • Provide adequate supervision
  • Provide manual handling training
  • Display safety signage indicating the weight of the load is visible
Activity

Let's do a quick knowledge check by completing the quiz below, before you proceed further.

Two employees moving personal belongings

What is the maximum weight employees are allowed to lift? No legislated weight limit is considered “safe” for manual handling. Individuals have different physical capabilities, which must be considered when taking into account any manual handling task. The weight of an object is not necessarily the only thing that makes a task hazardous.

What techniques can I use to help prevent an injury?

  • S.M.A.R.T Lifting Technique
  • Team Lifting
  • Pushing or Pulling Techniques when using mechanical aids

Smart Lifting

Read more to learn about SMART LIFTING TECHNIQUES

Team Lifting

Team lifting can be an effective way of moving objects. However, it is important to consider:

  • Whether there are enough people?
  • Does anyone have a known pre-existing injury?
  • Who will be coordinating the lift?
  • Whether has a lifting plan been established and communicated to those involved?
  • Whether all persons of the same size with similar strength?
Lifting of Persons

A ‘no lift policy’ is best. If a student is required to be lifted, employees should use available equipment (e.g. hoist, wheelchair etc.) and the student's own ability to avoid unnecessary manual handling. Where it has been identified that a student will be required to be lifted, guidance should be sought from the Regional Office. Where there are behaviours of concern, a Behaviour Support Plan should be developed in consultation with Student Support Services, parents or carers or specialists.

Pushing and Pulling Techniques When Using Mechanical Aids

The use of mechanical aids can assist in eliminating or reducing the need to lift, carry items/objects/persons in the workplace; however, it is important to consider:

  • when pushing, lean forward
  • when pulling, lean backwards (pushing is preferable as it involves less work by the lower back muscles and allows for maximum use of body weight). It allows employees to adopt a forward-facing posture, providing clearer vision in the direction of travel
  • ensuring you have a good grip
  • avoiding twisting and turning
  • checking that the handle height is between shoulder and waist height
  • checking that the handles or grips are in good condition
  • checking that the wheels on trolleys are in good condition
  • checking that the floors are free from obstacles and rubbish
Examples of mechanical aids include:
  • Flatbed trolleys
  • Upright trolley
  • Laptop charging trolley
  • Gym mat trolley
  • Shelf trolley
  • Wheelchair
  • Chari trolley
  • Sports equipment trolley
  • Wheelie bin trolley
  • Clax trolley
  • Library book trolley
  • Mobile hoist
Watch

Watch the following video from WorkSafe Victoria: Manual Handling 101: A guide for employers and workers in every industry

Safe Storage and Housekeeping

Items should be stored safely with work areas are kept free from obstacles and debris. This can be done by:

  • Storing frequently used and heavy items between waist and shoulder height.
  • Storing smaller, lightweight or infrequently used items in lower or higher areas.
  • Removing all obstacles and/or obstructions in pathways or in front of storage areas.
  • Knowing shelving weight limits. (see label)
  • Having access to a step-ladder to raise the employee to the best working zone.
  • Testing the weight of the object before picking it up.
  • Conducting quarterly workplace inspections using the relevant Workplace Inspection Checklist or equivalent.

Training

employees group discussing work plan with coach mentor at corporate office meeting

All Department employees should complete the Manual Handling eLearning module. The Department has also made available a manual handling presentation that can be used during a staff meeting or other forum to assist in building capability and raising awareness of potentially hazardous manual handling tasks.

Discussing Unsafe Manual Handling Practices

If you feel that a manual handling task poses too much risk for you, let your supervisor know. They have the responsibility to help you and other workers find safer ways to perform the task, such as using aids for cleaning or transferring. If this is not possible or the risk is still significant, you should not perform the task. You can use the hierarchy of control to help you to solve manual handling problems with your work team.

Look back at the case study on Liliana to see how this was done in Liliana’s workplace.

In Australia, a range of publications have provided design guidance for residential aged care facilities, including “Design Guidelines for Queensland Residential Aged Care Facilities”, “Guide to the Safe Design of Aged Care Facilities”, and “Residential Aged Care Built Environment Audit Tool”. The importance of the functional capacity of the older person and the associated manual handling needs when designing acute health and aged care facilities were considered in the development of the WorkSafe Victoria “Guide to designing workplaces for safer handling of people (3rd Ed)” . Of note, this pivotal manual handling guidance publication highlighted problems associated with compliance with the “Building Code of Australia”.

Activity: Watch and Answer

Watch this YouTube video by Vocam Business Training TV about health and safety for people working in aged care: ‘Aged Care – Health and Safety for Carers

Answer the following questions:

  1. Briefly describe three situations shown in the video where an aged care worker may be injured.
  2. Identify at least one strategy for preventing injury in each of these situations.

Home Care - Community Support Worker’s Role in Manual Handling

Caring young home care physiotherapist satisfied with recovery progress of elderly person with mobility walker supporting

As a home care community support worker you may be involved in many manual handling tasks when working with clients with disabilities or the elderly, manual handling tasks are an integral part of your day-to-day work.

Here's an overview of the process and procedures involved

Assess the Client's Needs - Before performing any manual handling tasks, assess the client's needs and capabilities. Understand their mobility limitations, any specific medical conditions, and their level of assistance required.

Plan the Tasks - Based on the assessment, plan the manual handling tasks required for the day. This may include tasks such as transferring the client from bed to wheelchair, assisting with toileting, bathing, dressing, or helping them move around their home.

Use Proper Body Mechanics - Practice proper body mechanics to prevent injury to yourself and the client. This includes maintaining a stable base, bending at the knees rather than the waist, and using your leg muscles to lift rather than your back.

Utilize Assistive Devices - Use assistive devices such as transfer belts, slide sheets, or hoists to aid in safe and comfortable transfers. Ensure these devices are properly positioned and secured before use. Communicate with the Client: Maintain open communication with the client throughout the manual handling tasks. Explain what you are doing and involve them as much as possible in the process. Respect their dignity and privacy at all times.

Involve Others When Necessary - If a manual handling task requires more than one person or specialized equipment, seek assistance from colleagues or healthcare professionals. Do not attempt tasks beyond your physical capabilities.

Monitor for Signs of Discomfort or Injury - Throughout the manual handling tasks, monitor the client for any signs of discomfort or injury. Be attentive to their verbal cues and body language, and adjust your approach accordingly.

Document Activities - Document the manual handling tasks performed, including any difficulties encountered, observations of the client's condition, and any assistance provided. This documentation is important for continuity of care and may be required for reporting purposes. Reflect and Review: At the end of each day, reflect on the manual handling tasks performed and any challenges encountered. Discuss any concerns with your supervisor and seek additional training or support if needed. By following these procedures, you can ensure safe and effective manual handling practices as a home care community support worker working with clients with disabilities or the elderly.

As a home care support worker, manual handling tasks in a client's home may involve a variety of activities, including lifting boxes.

Here's how such tasks could be undertaken

Assessment: Before lifting boxes or engaging in any manual handling tasks, assess the weight and size of the boxes to determine if you can safely lift them alone or if assistance is needed. Assess the environment for any obstacles or hazards that may impede safe lifting, such as cluttered pathways or uneven surfaces.

Preparation: Ensure you are wearing appropriate clothing and footwear for lifting tasks, such as comfortable and non-slip shoes. Warm up your muscles with gentle stretching exercises to prevent injury. Lifting Techniques: Utilize proper lifting techniques to minimize the risk of strain or injury. This includes: Keeping your back straight and bending at the knees, not the waist. Holding the box close to your body with a firm grip. Using the strength of your legs to lift, rather than relying solely on your back. Avoiding twisting your body while lifting or carrying the box.

Communication and Assistance: If the box is too heavy or awkward to lift safely alone, seek assistance from a colleague or the client themselves if they are able to help. Communicate with the client to ensure they are aware of any lifting tasks being performed in their home and to enlist their cooperation if necessary.

Use of Equipment: If available, use appropriate lifting aids or equipment such as trolleys, dollies, or lifting straps to assist with moving heavy or bulky boxes. Ensure you are trained in the proper use of any equipment and follow manufacturer guidelines.

Teamwork and Coordination: If working with a colleague or team, coordinate your movements and communicate effectively to ensure safe and efficient handling of boxes. Use verbal cues and signals to synchronize lifting and moving actions.

Rest and Recovery: Take regular breaks between lifting tasks to rest and allow your muscles to recover. If you experience any discomfort or signs of fatigue, stop immediately and seek assistance if needed.

Documentation: Document any manual handling tasks performed, including details such as the weight and size of the boxes, any assistance or equipment used, and any incidents or near misses. By following these guidelines and procedures, home care support workers can safely undertake manual handling tasks such as lifting boxes in a client's home while minimizing the risk of injury to themselves and others.

woman putting first aid kit with vitamins, drugs, antibiotics and cure at kitchen cupboard

You will need to be familiar with your own organisation’s emergency policy and procedures and to understand what your role and responsibilities are in the event of an emergency. Emergencies can include:

  • Internal emergencies, such as gas leaks, partial building collapse, fire or flood
  • Natural disasters, such as bushfires, earthquakes, floods or major storms
  • Aggression and violent threats, such as from an intruder or known offender
  • Bomb threats over the phone.

Check with your own organisation and your own particular work site to access this information. Ask your supervisor if you are not sure how to find this information.

If you are caring for someone in their home you will need to follow and be aware of the following procedures for managing various types of emergencies.

Medical Emergency

In Australia, home care support workers may encounter various medical emergencies while providing assistance to clients at home. Some of the common emergencies include cuts resulting in bleeding, slips or falls, and other medical emergencies such as chest pain, breathing difficulties, or sudden illness. A support worker needs to refer to the individual support plan (ISP). The ISP contains crucial information about the client's health, any pre-existing medical conditions, allergies, medications, and specific protocols or procedures to follow in case of emergencies or injuries.

Common organisation policies and procedures for managing medical emergency involves:

Here Are Policies and Procedures for Handling These Situations

Cuts and Bleeding

Policy: The policy for managing cuts and bleeding should prioritize the safety and well-being of the client while minimizing the risk of infection and further injury.

Procedure:

  1. Assess the severity of the cut and the extent of bleeding.
  2. Apply direct pressure to the wound using a clean cloth or sterile dressing to control bleeding.
  3. Elevate the affected limb if possible to reduce blood flow to the wound.
  4. If bleeding is severe or cannot be controlled with direct pressure, call emergency services (000 in Australia) immediately.
  5. Once bleeding is controlled, clean the wound with mild soap and water, apply an antiseptic, and cover with a sterile dressing.
  6. Monitor the client for signs of infection or complications and seek medical attention if necessary.
Slips or Falls

Policy: The policy for slips or falls should focus on ensuring the safety of the client, preventing further injury, and assessing for any underlying medical issues contributing to the fall.

Procedure:

  1. Assess the client's condition and any injuries sustained from the fall. If the client is injured or complains of pain, avoid moving them and call emergency services (000) immediately.
  2. If the client is not injured but requires assistance getting up, assess the environment for hazards and ensure a safe lifting technique is used.
  3. Help the client into a comfortable position and monitor for signs of shock or other complications.
  4. Document the incident, including details of the fall, any injuries sustained, and actions taken.
Other Medical Emergencies

Policy: The policy for other medical emergencies should emphasize prompt assessment, appropriate first aid intervention, and timely activation of emergency services if required.

Procedure:

  1. Assess the client's condition and vital signs, including consciousness, breathing, and circulation.
  2. Provide any necessary first aid interventions based on the client's symptoms, such as administering oxygen, assisting with medications, or performing CPR if necessary and if qualified to do so.
  3. If the client's condition deteriorates or if they exhibit signs of a life-threatening emergency (e.g., chest pain, difficulty breathing), call emergency services (000) immediately. Stay with the client, provide reassurance and comfort, and continue to monitor their condition until help arrives.
  4. Document the incident, including the client's symptoms, interventions performed, and any changes in their condition.

It's important for home care support workers to receive appropriate training in first aid, emergency response procedures, and infection control to effectively manage medical emergencies in the home setting while adhering to organizational policies and protocols.

Organisations' Responsibility in Managing Emergencies

It is the legal responsibility of your service to ensure that workers and others have easy access to emergency equipment, such as fire extinguishers and fire blankets, and know how to use them. All organisations are required to hold practices or drills for emergency procedures such as fire and evacuation drills. Emergency procedures and emergency telephone numbers are displayed in a place where they can be easily seen. A copy of the emergency and evacuation floor plan and instructions must be displayed in a prominent position near each exit at the service. Casual staff should also be inducted into emergency plans and exits as part of their introduction to the service.

Staff Members Responsibility in Managing Emergencies

Emergencies can take several different forms, and you and other workers must be trained to manage them using emergency procedures while remaining calm and keeping in mind the welfare of clients and others around you. Familiarise yourself with emergency response procedures and evacuation assembly points for your work area. Know where equipment such as duress alarms and evacuation kits are kept, and be familiar with how they work.

During and after any emergency, your main priorities should be as follows:

  • If you feel a situation is at all threatening or out of your control, never hesitate to call or ask another person to call 000. If the situation improves soon after, you can cancel the service.
  • Stay calm. If you talk and think calmly, you are more likely to be in control of a positive outcome.
  • Do not take risks with your own life or safety to protect others. You must only help others in an emergency situation if it is safe to do so. If you are in a personal risk situation, get yourself to safety before calling for help.
  • Continue to provide care and support to clients or residents after an evacuation.
Watch

Watch the following YouTube video by Andrew Mclean about evacuating in response to a fire in an Australian Aged care facility: ‘Evacuation Procedures Aged Care’

Fire Safety in Clients’ Homes Sources of home fires can include:
  • Faulty electrical equipment or wiring
  • Stovetop fires
  • Candles and other open flames
  • Combustible materials near heaters and open flame fire places

Some clients can put themselves and you at higher risk of a fire. When a person has dementia, for example, they might forget how to use the stovetop or might put a plastic electric kettle on a stove. They might have trouble remembering not to go too close to an open flame heater while wearing a highly flammable dressing gown or might use candles near a curtain. Dementia and other cognitive disabilities can also cause the person to forget how to respond to fire safety. They might panic and cause the fire to spread further. Small children and people with disabilities, including reduced mobility, hearing and sight impairments, are also more at risk in the event of a fire.

Responding to a Home Fire

If it is safe to do so, you can attempt to put out a small fire using a fire blanket, domestic fire extinguisher or by covering a pot with a lid. If you cannot do this without the risk of you or someone else being harmed, follow this procedure:

  1. Remove anyone in immediate danger, such as the client, if it is safe to do so Alert others in the house to the presence of the fire, and tell them to call 000
  2. Contain the fire by closing doors on the room with the fire
  3. Evacuate the house immediately and call 000 Fire Blankets
Fire blankets

are primarily for use on hot oil fires such as frying pans or small deep fat fryers. They can also be used on someone whose clothing has caught fire. They work by smothering the fire, stopping access to the oxygen fuelling it and extinguishing it.

Watch

Watch this YouTube video by FIRE & EVAC SOLUTIONS to see how to safely use a fire blanket in a person’s home: ‘How to use a Fire Blanket Australia.’

Smoke Alarms

By law, all homes must have working smoke alarms. They are placed in all bedrooms, bedrooms, living areas and hallways, and should be checked and maintained regularly. If the person cannot do this themselves, you can refer them to your supervisor, to their landlord or to services who specialise in installing and checking smoke alarms. For people who have a hearing impairment, special types of smoke alarms that vibrate the person’s bed or chair, have flashing lights and are connected directly to emergency services can be funded and installed through government programs. You can find out more about smoke alarms for people with hearing impairments and the funding scheme on the Deaf Services Australia website: ‘Smoke Alarm Subsidy Scheme.’

Threats to Personal Safety

Your safety can be put at risk when a client or other person becomes aggressive or when you are walking alone between your car and the client’s home. This is especially true when it is dark. In-home and community environments, where you do not have other workers around you to call for help, it can be more difficult to leave these situations.

  1. The most important thing to remember is that you must leave immediately.
  2. Do not stay and argue or help the person, even if they or others are in danger.
  3. Leave the area in any way you can, and call the police as soon as it is safe.
  4. Be aware at all times of your personal safety. Carry a mobile phone, and park as close as possible to the person’s home.
  5. Know the exits to a house or other space, and never allow yourself to be cornered by an aggressive person away from an escape route.
  6. Passive self-defence is a strategy that aims to allow you to leave an aggressive situation safely.

When you are trapped in a room or space where an aggressive person is making threats or making you feel frightened. You should:

  • Agree with the person rather than arguing — Being in agreement, even with untrue statements, can help to deescalate the person’s aggression long enough for you to get away. If you need to, divert blame directed at you to another source, such as to your manager or the government.
  • Use passive body language — Keep your body movements to a minimum and use a low, calm voice. Make yourself appear smaller and unthreatening by lowering your shoulders and avoiding prolonged or insistent eye contact.
  • Keep a distance between you and the person — Move away from them and towards a safer area such as a door if possible. Do not try to approach the person or touch them to calm them.
  • Use objects to protect yourself — Make use of items such as chairs, tables or other items you are able to pick up. Protect yourself from harm with the item in your grasp while you attempt to leave so that you can call for help.
Watch

View the following video to see the steps on how to use a Fire Extinguisher.

Read the case study below highlighting what you can do when you face a threat to personal safety.

Case Study

Toby is a support worker. He is visiting Marie to deliver her weekly medication in a Webster pack. Marie lives with her boyfriend James in a high-rise block of flats. Marie is in her early twenties and has a developmental disability. James drinks heavily; on several previous visits, he has been drunk and verbally abusive towards Toby. He also has convictions for drug use and assault. When Marie lets Toby into the flat, James sits on the lounge room sofa, drinking bourbon and coke from a can. He asks Toby if he has any cigarettes, and when he replies that he does not smoke, he swears at him and snatches his satchel, which he empties out onto the floor looking for cigarettes. Toby leaves immediately. He runs downstairs to his car and drives to the next street, where he calls the police.

Let's do a quick knowledge check by completing the quiz below, before you proceed further

Concentrated young female employee worker wearing medical facial mask and protective gloves, using laptop in office

Infection Control can be defined in medical terms as ‘the invasion and multiplication of microorganisms such as bacteria, viruses, and parasites that are not normally present within the body’. Infections can cause symptoms or not cause symptoms and can stay localised or spread throughout the body. Complying with infection control policies and procedures is an essential part of your job, and it is part of your duty of care towards your clients, colleagues and the community. You must have a good basic understanding of what infections are, how they are transmitted and what you can do to prevent and control their transmission.

For an infection to occur, certain conditions must be in place. This is described as the chain of infection, and at any point in the chain, infection can be stopped by a link being broken. The chain of infection comprises these six links:

  1. Infectious agent – the disease-causing pathogen
  2. Reservoir – where the pathogen lives (e.g. in animals, medical equipment, water or people)
  3. Portal of exit – the means by which the infectious agent leaves the reservoir (e.g. through sneezing, open wounds or aerosols)
  4. Mode of transmission – how the infectious agent can be passed on (e.g. through inhalation or direct contact)
  5. Portal of entry – the means by which the infectious agent can enter a new host (e.g. through the respiratory tract or broken skin) 
  6. Susceptible host – a person who may be at risk of infection (in many cases, this can be any individual)
Watch

The following video provide further information about how the chain of infection works.

Personal Protective Equipment

Personal protective equipment (PPE) is anything a worker uses or wears to keep them healthy and safe.

The World Health Organisation (WHO) advises that PPE is equipment used to prevent or minimise exposure to hazards such as:

  • Biological hazards
  • Chemical hazards
  • Radiological hazards
  • Electrical hazards
  • Mechanical hazards
  • Etc.

Without PPE, exposure could lead to injuries and illnesses. A range of industries use PPE to protect their workforce from occupational hazard. The construction, mining, chemical and pharmaceutical industries are among those using PPE on regular basis. Healthcare workers also use PPE to ensure safety during working hours.

PPE can include:

  • hearing protective devices, such as ear muffs and ear plugs
  • respiratory protective equipment
  • eye and face protection, such as safety glasses and face shields
  • safety helmets
  • fall arrest harnesses for working at heights
  • skin protection, such as gloves, gauntlets and sunscreen
  • clothing, such as high visibility vests, life jackets and coveralls
  • footwear, such as safety boots and rubber boots.
Watch

The following video shows how to don/doff (put on and remove) PPE equipment in a healthcare setting:

Infection Risks, Prevention and Control Transmission of Infection

In all health and community services settings, using measures to prevent and control the spread of infection is essential. This is especially important in residential settings and remote communities. In residential settings, vulnerable clients are living together, and support workers are circulating among them, perhaps working across different sites, and in remote community settings, residents live in close contact with each other. Settings like these have the potential to become hot spots for infections unless prevention and control procedures are followed stringently. What is prevention and control of infection?

It is important to understand the difference between the prevention and the control of infection:

  • ‘Prevention’ means stopping an infection from being transmitted and stopping a disease from harming people.
  • ‘Control’ means limiting or minimising the spread of infection and limiting the harm it does to people. Infection prevention and infection control aim to minimise and prevent the spread of infection. Preventing, controlling and minimising infection are crucial actions in health and community services work, particularly in residential settings where a large number of people live and work together and are in close day-to-day contact with each other.

Since the COVID-19 pandemic, society as a whole has become more aware of the need to have and follow effective infection control procedures. The need to protect yourself and others became a community responsibility from March 2020 in Australia because coronavirus affected everyone’s wellbeing. Measures like social distancing, separating vulnerable people from other groups, isolating infected or potentially infected people and adopting strict hygiene measures, such as frequent handwashing, were established as everyday occurrences.

The Australian guidelines for the prevention and control of infection in healthcare is a nationally accepted approach to infection prevention and control. The guidelines focus on core principles of infection control and outline priority areas for health services. The routine work practises outlined in the Guidelines for Infection Control are designed to reduce the number of infectious agents in the work environment; prevent or reduce the likelihood of transmission of these infectious agents from one person or item/location to another; and guidelines to make areas as free as possible from infectious agents.

here is the link to the Australian Guidelines for infection control and prevention https://www.nhmrc.gov.au/sites/default/files/documents/infection-control-guidelines-feb2020.pdf

Common Types of Infectious Risk in the Work Environment, and Ways to Prevent and Reduce Harm

Risk of sustaining injury through sharps
  1. If exposed to sharp injury ensure to disinfect and wash your hands
  2. use personal protective equipment where appropriate use gloves, protective clothing, and other protective equipment when necessary
  3. remove or isolate the hazard by using sharps disposal containers
  4. handle needles and sharp objects safely
  5. attend education and training on the correct use of medical devices incorporating sharps protection mechanisms including demonstrated competent use of the device
Risk of coming in contact with people who have an increased prevalence of having an infectious disease
  1. Thoroughly wash hands with water and soap for at least 15 seconds after visiting the toilet, before preparing food, and after touching clients or equipment. Dry hands with disposable paper towels
  2. Cover any cuts or abrasions with a waterproof dressing to stop the spread of infection.
  3. Wear gloves when handling body fluids or equipment containing body fluids, when touching someone else's broken skin or mucus membrane, or performing any other invasive procedure.
  4. Wash hands between each client and use fresh gloves for each client where necessary
  5. Don't share towels, clothing, razors, toothbrushes, shavers or other personal items.
working in an area in which a potentially infectious organism is endemic or where there is an outbreak of infection
  1. Maintaining good hand hygiene and using hand disinfectant (hand sanitizer)
  2. Not touching face with your hands if there are higher chances of being exposed to the infection
  3. Having good cleaning routines in the workplace
  4. Equipping and organising the workplace to prevent infection
  5. Using safety gloves if the risk assessment shows it is necessary.
contact with animals that have an increased prevalence of having an infectious disease
  1. Use appropriate insect repellent.
  2. Practise good hand hygiene. Thorough hand washing after handling any potential source of infection is also necessary.
  3. Use personal protective equipment (PPE) when needed.
  4. Wear protective clothing and wearing gloves when handling animals or their tissues, taking care not to rub the face with contaminated hands or gloves.
  5. Get vaccinated against tick-borne encephalitis virus (TBE).

Standard and Transmission Based Precautions

Beautiful mother and daughter are talking and smiling while sitting on couch at home.

Infection prevention and control uses a risk management approach to minimise or prevent the transmission of infection. The two-tiered approach of standard and transmission-based precautions provides a high level of protection to patients, healthcare workers and other people in healthcare settings. Standard Precautions Standard precautions are those that must be used routinely to prevent and control the transmission of any infection. Standard precautions are the minimum that must be expected at all times. Standard precautions include:

  • Hand hygiene
  • The use of PPE
  • Environmental control

Transmission-Based Precautions

Additional precautions to standard measures are used when there is a specific threat, such as when there is the presence of a highly infectious or contagious condition that cannot be contained by standard precautions alone, for example, outbreaks of diseases like measles, chicken pox or the flu; and pandemics like COVID-19. Transmission-based precautions are used for patients who are known to be, or who may be, infected with highly transmissible infection-causing pathogens. The type of precautions put in place depend on the route of transmission. Transmission-based precautions include wearing:

  • Gloves
  • A P2 respirator
  • A surgical-style mask Additional precautions do not replace standard precautions. Standard precautions must continue to be used alongside transmission-based precautions

Lets look at the standards and additional precautions in detail now.

In healthcare, infection control measures are essential for preventing the transmission of infectious agents. There are two main types of infection control precautions: standard precautions and additional (or transmission-based) precautions.

Standard Precautions

Standard precautions are a set of infection control practices that healthcare professionals follow to prevent the transmission of pathogens in healthcare settings. These practices apply to all patients, regardless of their diagnosis or presumed infection status.

They include:

  • Hand hygiene: Washing hands before and after patient care and using hand sanitizers when necessary.
  • Use of personal protective equipment (PPE): Such as gloves, gowns, masks, and eye protection, depending on the situation and potential exposure to infectious materials.
  • Respiratory hygiene and cough etiquette: Covering mouth and nose during coughing and sneezing, disposing of tissues properly, and wearing masks as needed.
  • Safe injection practices: Using sterile needles and syringes, and properly disposing of them. • Safe handling and disposal of sharps and contaminated materials: Including needles, scalpels, and other potentially contaminated items.
  • Proper handling of potentially contaminated equipment and surfaces: Cleaning and disinfecting equipment and surfaces that may have come into contact with infectious materials.
  • Safe waste disposal: Ensuring that all potentially infectious waste is properly contained and disposed of.

Additional (Transmission-Based) Precautions

Additional precautions, also known as transmission-based precautions, are used in addition to standard precautions when caring for patients with known or suspected infectious diseases that are spread in specific ways. These precautions are tailored to the particular pathogen involved and the route of transmission.

They include:

  • Contact precautions: Used for pathogens spread by direct or indirect contact. This involves using gloves and gowns when in contact with the patient or their environment.
  • Droplet precautions: Used for pathogens spread through large respiratory droplets (e.g., when the patient coughs, sneezes, or talks). This involves wearing a mask when within close proximity (e.g., 1 meter) of the patient.
  • Airborne precautions: Used for pathogens spread through small airborne particles that can remain suspended in the air for extended periods (e.g., tuberculosis, measles). This involves using specialized PPE, such as an N95 respirator, and placing the patient in an airborne infection isolation room (AIIR) if available.

Additional precautions are specific to the mode of transmission of the pathogen and are intended to further minimize the risk of transmission in healthcare settings.

In summary, while standard precautions are universally applied for all patients to minimize the risk of infection transmission, additional precautions are implemented based on the specific infectious agent and its mode of transmission.

COVID-19 Precautions

COVID-19 precautions are an example of additional transmission-based precautions, meaning they are precautions that must be used in addition to standard precautions. There are variances in how different states and territories across Australia have implemented COVID-19 precautions, and you will need to seek specific guidelines and information on transmission-based precautions for your location. You can check the guidelines for preventing and controlling the spread of infection:

  • From your state/territory’s health authority
  • From the Australian Government Department of Health
  • For your community care sector
Watch

Watch the video below on additional precautions

Module Linking
Main Topic Image
medical instructor with compressive tourniquet standing at flip chart and looking at student asking question during first aid seminar, emergency preparedness
Is Study Guide?
Off
Is Assessment Consultation?
Off