When it comes to infection control in the non-medical home care world, many agencies don't quite take it as seriously as they should. While we can't actually "Control" anything, much less when our clients and staff get sick, we CAN help mitigate their exposure within the realm of their interactions with the agency.
If you're licensed by the state, when you sign up a client, you have a limited responsibility for their wellbeing. While we don't full have "control", we do still need to be monitoring our clients and their wellbeing, and paying attention to any infections they acquire. This has always been important but now even more so since the onset of COVID.
Infection control is something that every agency needs to address. Your staff need to be trained, per OSHA requirements, on bloodborne pathogens as well as universal precautions and clean procedures after any sort of bodily fluids. In non-medical home care, the risks of exposure are less than that of medical home health and hospice, but still relevant.
At a minimum, Infection Control Policies should address the following 5 areas:
1. Training - minimum initial and annual staff training, per OSHA, on blood borne pathogens to include Hepatitis B, HIV, and universal precautions is a must. The OSHA General Duty Clause covers all infection control, training, and measures, as well as emergency preparedness standards and procedures. It's up to the agency how these are handled. You or the agency will be held accountable if an incident occurs and is investigated by OSHA. I do always recommend checking the CDC & OSHA websites at least once a year.
2. Protocols - policies also need to address protocols for staff to prevent them from getting sick themselves and also prevent them from contaminating or reinfecting a client. Primarily you're going to be using PPE and universal precautions to cover this. If you're still having your staff self-screen prior to client contact, your protocols need to address the agency's response if/when the answers to those screening questions are flagged.
OSHA's General Duty Clause requires that you have a Respiratory Protection Program when N95 respirators are in use. Slusher Consulting has edited a Mini-Respiratory Protection Program written by the Texas Department of Insurance, to fit the needs of a Non-Medical Home Care agency. You can download this document and add it to your own Infection Control program for FREE HERE.
3. Source Control - This is where the germs came from. Hospital waiting rooms, doctors' offices, the grocery store, etc. How could we reduce or prevent that infection from happening to begin with? Do you have enough PPE to protect your staff and clients if another wave hits or if a new disease arises? PPE is vital to source control. That is why it is so important for every agency to have a good supply of gloves, masks, gowns, hand sanitizer, all those kinds of precautionary items.
4. Monitoring - per the CDC, you need to monitor community transmission levels on a regular weekly or bi-weekly basis, at least. Especially if you're in the more urban areas where the populations are greater, you monitor the community transmission levels through your local health department to determine what the risk might be for COVID or any other communicable disease that is of current concern. (Think flu season.)
5. Reporting - What are we going to report or log? Any client infection, not just communicable disease. This includes, but is not limited to: urinary tract infection, respiratory infection, sinus, ear/nose/throat infections, strep throat, any systemic infection, or a skin infection. All of those need to be monitored because they're going to help you track the general wellbeing, and sometimes decline, of your clients. This goes a long way in helping your staff and clients' families maintain clients safely at home. Also, this is information that you'll use during your quality assurance or QAPI meetings that are done at least two times a year.
Check your CDC and OSHA websites, and your local health department. Save all those links, and use them. There is so much more going around now than there used to be. Germs are adapting, so we must do the same. It used to just be if you're sick, don't go to work. Right? It's just not that simple anymore. There's more to it now with lots of risks and lots to manage but it IS manageable.
Download Your Free Mini-Respiratory Protection Program - Take some time to look around while you're there!
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