Good communication is one of the most important factors in the prevention and management of infection hazards and risks.
It is important to discuss infection control regularly in all community services settings. Speaking with others about concerns, problems, opportunities or ideas can help to increase awareness, reduce anxiety and ensure that the most effective controls are in place and working well.
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Your responsibilities and obligations to infection control includes taking all reasonable steps to prevent the spread of infection and following instructions and procedures.
Your employer will have outlined and provided you with instructions and procedures in their infection control policies and procedures. These will have been written to reflect the established national standards and guidelines for the prevention and control of infection in aged care and health care settings.
Risks need to be controlled according to the level of harm they could cause, and the likelihood that they could happen. A risk assessment matrix can help you and your managers decide how high the risk is, and how urgently it needs to be controlled.
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Read Managing risks from Safe Work Australia to learn more about hazards and risks in healthcare and social assistance industries.
The hierarchy of control
When you and your colleagues are approaching an infection risk, it is good practice to use the hierarchy of control to decide the safest possible way to manage the risk.
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The hierarchy of control asks you to consider the most effective controls possible, working your way through the lower levels of control until you find one or more measures that effectively control the risk.
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Select each bar to expand and reveal further information about each of the controls.
Case study
This case study demonstrates how the hierarchy of control is used in an aged care home.
Ivan and his team have admitted Mr Anand, a new resident to the aged care home. Mr Anand has hepatitis C, an infectious bloodborne condition. Mr Anand has dementia and is diabetic, which means he needs regular injections of insulin by the nurses. Support workers are concerned that they might come into contact with used needles or contract the condition in other ways, such as via Mr Anand’s saliva or blood.
The staff talk to the nurses and doctors about how the condition is spread and how it can be controlled. They use this knowledge and the hierarchy of control to put in place steps to reduce the risk of harm to staff and other residents.
They consider whether it is possible to eliminate the risk altogether by outsourcing any of the high-risk tasks such as the insulin injections. While it is not practical to outsource the injection of insulin to outside of the facility, they decide that they can use a flash glucose monitoring system, which uses sensor technology to test glucose levels without needing to prick a finger.
They consider whether they could use substitution to reduce the risk. The manager agrees to purchase retractable needles to replace the needles that are currently being used.
The staff consider whether isolation would be an option to reduce risk. Since hepatitis is a bloodborne disease, isolating Mr. Anand from other residents or staff is not necessary and would not be useful in this case. This layer of control is not relevant to this situation.
The staff discuss whether engineering controls might help. They consider placing a small sharps bin in Mr Anand’s bathroom, so that needles can be placed directly there. However, they decided that this would increase the risk since Mr Anand has dementia; a sharps bin that he could access might lead to him removing needles and placing them where they could cause harm. This level of control is not considered relevant to this situation.
Administrative controls, the next level on the hierarchy, is considered. The managers agree to provide additional training to support staff, to help them to understand how hepatitis is and is not spread and the everyday measures that staff might need to take. They also agree to support all staff to make it easier for them to obtain their required series of hepatitis vaccinations.
PPE is discussed next. Some staff are concerned that they should wear gloves and a mask whenever they are caring for Mr Anand. The staff are assured that this level of protection is not necessary for this condition. However, they require that all staff wear gloves when they are concerned that they might come into contact with Mr Anand’s blood, such as when administering insulin and supporting him to clean his teeth and shower.
Record and report hazards and risks
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Speak up early when you have worries or concerns, and document what you have seen or heard, so that it can be acted on correctly. |
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Recording and reporting on risks or concerns can also help the work team to act early on new hazards and risks. Documenting may mean that you write notes in a person’s care or support plan or communication book so other workers can read about the risk and actions that were or are in the process of occurring. You will need to speak to a supervisor or team leader about what you have observed. This may need to happen immediately, depending on the likelihood of the risk causing harm, or can be discussed during a team meeting or in a workplace health and safety meeting.
You have a duty of care to identify and act on infection control risks before they cause harm, within the scope of your responsibilities and job role. This means understanding the policies and procedures required as part of your job role and when to report information to a more senior or experienced colleague or seek their advice on actions that need to be taken. The Australian guidelines and standards listed in the previous section detail procedures for infection prevention and control and when incidents and outbreaks must be reported.
This might include:
- when you become aware of a new infection or signs of infection in yourself or in clients or residents, such as when a resident has an episode of diarrhoea
- when you have an idea for improving something in the workplace, such as moving waste bins to a place where they are more accessible
- when you have questions about an infectious condition that has developed in the service, such as when a resident has scabies, and you want to know how you can reduce the risk of infecting yourself and others
- when you have concerns that something is not being done well or according to regulations, or is ethically wrong, such as when a staff member is heard encouraging a resident not to get vaccinated because of something they read on Facebook.
If there has been an incident or accident, you may be required to complete an incident report and provide a copy to the organisation. These documents will be discussed in a following topic.
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