CBRF Standard Precautions Training

CBRF Standard Precautions Training FACILITATOR GUIDE Developed by: University of Wisconsin Oshkosh Center for Career Development (CCDET) Approved by: Wisconsin Department of Health Services Division of Quality Assurance Bureau of Assisted Living March 2010

Important Note Participants must successfully complete this two-hour training to meet the CBRF training requirements of Ch. DHS 83.20 (2)(a) Standard precautions. This standardized training material is the only curriculum approved by the WI Department of Health Services to meet the requirement listed above. In addition, the training must be delivered by an instructor approved by the UW Oshkosh Center for Career Development (CCDET). To view the registry of approved instructors, go to www.uwosh.edu/ccdet/cbrf Participants who successfully complete this training will be added to a registry located at www.uwosh.edu/ccdet/cbrf University of Wisconsin Oshkosh Page 2 of 33

Table of Contents Important Note... 2 CBRF Standard Precautions Training Overview... 4 A Note to Participants... 5 Learning Points... 5 Opening Activity: Influenza (Flu)...6 Standard Precautions... 8 CBRF Infection Control Program...8 Bloodborne Pathogens... 9 Communicable Diseases... 10 Prevention... 11 Hand Hygiene...11 Activity: Practice Hand Hygiene Techniques...12 Personal Protective Equipment...16 Activity: Removing Gloves...17 Vaccinations...18 Handling Infectious Materials... 19 Specimens...19 Regulated Waste...20 Sharps...20 Food Service... 22 Housekeeping... 24 Laundry... 26 Exposure Incident... 27 Post Exposure Plan... 28 Wrap-Up... 29 Facilitator Preparation... 30 Resources... 33 University of Wisconsin Oshkosh Page 3 of 33

CBRF Standard Precautions Training Overview In Wisconsin, Community Based Residential Facilities, or CBRFs, are regulated by the Department of Health Services (DHS) Division of Quality Assurance (DQA). The rules for CBRFs are outlined in State Statute and more specifically defined in the Wisconsin Administrative Code, often called Administrative Rules. Chapter DHS 83, Wisconsin Administrative Code, is the rule that defines the responsibilities and restrictions of CBRFs. DHS 83.20 requires all CBRF employees, who may be exposed to infectious materials in the course of their jobs, to complete this two-hour training. The training must be successfully completed prior to performing any task that may expose the employee to infectious material. The Occupational Safety and Health Administration (OSHA) is the federal agency that enforces rules for the health and safety of employees. OSHA requires employees in certain settings, including CBRFs, to receive training on bloodborne pathogens in order to protect themselves from diseases that spread through contact with blood or other body fluids. OSHA requires those employees to have access to the federal requirements, located at: http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=sta NDARDS&p_id=10051 University of Wisconsin Oshkosh Page 4 of 33

A Note to Participants As part of this two-hour training, you will receive a copy of this participant guide. Use the guide to make notes, write questions, and underline or highlight important material. The participant guide is yours to keep and can serve as an important resource when you return to your job. At the end of this training, you will complete a quiz. You will be allowed to use your participant guide to complete the quiz. Therefore, it s very important that you pay close attention to the materials, take notes as needed and ask questions if you don t understand. Learning Points These are the major topics contained in the training material: Learn about standard precautions and why they are important in your work Understand how bloodborne diseases and other communicable diseases spread from person to person Learn how to prevent the spread of communicable diseases Learn what to do during and after an exposure incident University of Wisconsin Oshkosh Page 5 of 33

Opening Activity: Influenza (Flu) [NOTE: This format is used for instructor guidance throughout this document. This text does not appear in participant guides. Ask participants whether they are familiar with these terms: standard precautions, bloodborne diseases and communicable diseases. Assure them that it s normal for them not to be completely familiar with the terms at the start of the training. Next, ask participants if they are familiar with the term: the flu. (It may be helpful to be more specific in identifying a certain strain of the flu, such as the normal flu or h1n1 to avoid confusion.) Explain to them that influenza (flu) is a common communicable disease and much of what they already know about the flu applies to what they will learn in this training.] Here are some important facts about influenza (flu) provided by the federal Centers for Disease Control (CDC). In an average year in the United States: Between 5% and 20% of the population gets the seasonal flu 200,000 people are hospitalized 36,000 people die Please take a few minutes to write down some of the things you know about the flu. What are some of the symptoms of the flu? How does the flu spread from one person to another? University of Wisconsin Oshkosh Page 6 of 33

What are some of the things that you can do to keep from getting the flu or spreading it to other people? [Give participants a few moments to write notes and then ask for voluntary responses. Don t correct misconceptions or wrong answers at this time. The purpose of this exercise is to focus participants on the topic. It will also give you an opportunity to measure the general knowledge base of your participants.] University of Wisconsin Oshkosh Page 7 of 33

Standard Precautions Standard precautions are ways of doing your work to lower the chance of spreading disease. They consist of hand hygiene, protective equipment, care of the environment and safe injection practices. They are based on the principle that all blood, body fluids, secretions, excretions except sweat, non-intact skin and mucous membranes may be capable of transmitting infection. You must follow standard precautions whenever you care for a resident, even if the person doesn t seem to have an infection or a disease that can spread to another person. Standard precautions can prevent you from becoming infected. They can also protect residents by ensuring that you don t carry infectious agents on your hands, clothing or equipment. CBRF Infection Control Program Every CBRF is required to have a written infection control program for implementing standard precautions. The program must cover the responsibilities of the CBRF and the responsibilities of employees. The infection control program must be readily available to all employees. It will describe the details of how the state and federal rules are implemented to keep residents and staff safe from the spread of communicable diseases in that particular CBRF. While programs may vary among CBRFs, each must address the components of standard precautions, including these components: Procedures to prevent the spread of infectious diseases Procedures for collecting and disposing of specimens Procedures for disposing of regulated waste Procedures for the use and disposal of sharps Practices surrounding food service, housekeeping and laundry A plan to handle an exposure and post exposure incident University of Wisconsin Oshkosh Page 8 of 33

In this training, we will review each of the infection control program requirements and the rules you must follow. [Obtain a copy of a CBRF infection control program. If you are training participants from one CBRF, it is preferable to use the program for that CBRF. Distribute a copy of the program to each participant. They will be using it later in the training. See Facilitator Preparation for further details.] Bloodborne Pathogens Bloodborne pathogens are materials in blood that can spread diseases from person to person. If you are exposed to blood containing these materials, you are at risk for serious illness or even death. Bloodborne pathogens can spread from one person to another through direct or indirect contact with blood or other body fluids. Direct contact transmission happens when infected blood or body fluid from one person enters another person s body. Bloodborne pathogens can spread if the infected blood comes in contact with another person s eye, nose, mouth or an open sore on the skin. Needlesticks are a common example of direct contact transmission. Indirect contact transmission happens when a person touches an item that contains infected blood or body fluid. Touching a used bandage or dirty laundry when you have an open sore on your hand is one example. There are four bloodborne diseases covered under OSHA s rules. HIV stands for human immunodeficiency virus. This virus can cause AIDS. HIV is different from most other viruses because it attacks the immune system. The immune system gives our bodies the ability to fight infections. HIV finds and destroys a type of white blood cell (T cells or CD4 cells) that the immune system must have to fight disease. AIDS stands for acquired immunodeficiency syndrome. AIDS is the final stage of HIV infection. Having AIDS means that the virus has weakened the body to the point where it has a difficult time fighting infection. When University of Wisconsin Oshkosh Page 9 of 33

someone has certain types of infections, some kinds of cancer, or a very low number of T cells, he or she has AIDS. Hepatitis B is a liver disease caused by the Hepatitis B virus (HBV). It can cause infection, cirrhosis (scarring) of the liver, liver cancer, liver failure and death. Hepatitis C is a liver disease caused by the Hepatitis C virus (HCV). This form of hepatitis is less common in CBRFs than Hepatitis B. Communicable Diseases Communicable diseases are bloodborne and other diseases that can spread through contact between people. Can you think of some examples of other common communicable diseases? [Ask participants to name some examples. List them on a flip chart. Examples may include: colds, the flu, measles, athlete s foot, whooping cough, ringworm, etc.] All new CBRF employees must be screened for clinically apparent communicable diseases, including tuberculosis. The purpose of this is to prevent the spread of communicable disease to residents and other staff. Employees who exhibit signs and symptoms of a communicable disease may not be permitted to work and should seek the advice of a medical professional. New CBRF residents must have a health exam to check for health problems and screen for clinically apparent communicable diseases, including tuberculosis. This helps to make sure that residents get proper treatment so that illnesses are not passed on to other residents or staff. University of Wisconsin Oshkosh Page 10 of 33

How Does Bloodborne Exposure Occur? Needlesticks are the most common (OSHA estimates that between 600,000 and 800,000 needlesticks occur in the U.S. each year.) Cuts from other contaminated sharps such as scalpels or broken glass Contact with mucous membranes (the eye, nose or mouth) or broken (cut or scraped) skin with contaminated blood Prevention Benjamin Franklin once said, An ounce of prevention is worth a pound of cure. In other words, it s better to avoid problems in the first place than try to fix them later. For just this reason, today s training focuses on preventing the spread of disease. The CBRF is responsible for providing the equipment and supplies you need to prevent the spread of disease. You are responsible for following the rules for using proper equipment, supplies and techniques at all times. Hand Hygiene Hand hygiene is the easiest and most effective way to prevent the spread of infection. Keeping your body clean, including your hands, helps keep diseases from spreading from person to person. Hand hygiene includes both washing with soap and water or using alcohol gel. Always use soap and water if your hands are visibly dirty, before preparing food and after using the restroom. These are the recommendations of the CDC: University of Wisconsin Oshkosh Page 11 of 33

You Must Perform Hand Hygiene Before: Having contact with residents Putting on gloves Caring for any invasive device, such as a catheter Handling food Administering medication Right after: Having contact with a resident s skin Having contact with body fluids (even when gloves are worn) Having contact with resident items such as dressings, dirty laundry, dishes or trash Taking off gloves Moving from parts of the resident s body that could be contaminated to clean parts of the resident s body Using the restroom Coughing or sneezing Smoking Activity: Practice Hand Hygiene Techniques What is the correct way to cleanse your hands to protect yourself and others from contagious diseases? Hand rub (foam or gel) Apply to palm of one hand Rub hands together until dry, covering all parts of the hand, especially fingertips and fingernails Use enough rub to take at least 15 seconds to dry University of Wisconsin Oshkosh Page 12 of 33

Hand washing (soap and water) Wet hands with water Apply soap Rub hands together for at least 15 seconds, covering all parts of the hand, especially fingertips and fingernails Rinse hands under running water and dry with a disposable towel Use the towel to turn off the faucet In this activity, the facilitator will demonstrate proper hand hygiene techniques using both soap and water and gel or foam. Next, each participant will have a chance to practice both techniques. The training cannot proceed until each participant has correctly demonstrated both techniques to the facilitator. [A hand hygiene activity is a mandatory part of this training. Use of the Center for Disease Control s (CDC) web-based video, located at http://www.cdc.gov/handhygiene/training/interactiveeducation/ is highly recommended. A link to this site is embedded in the Power Point presentation that accompanies this training. Important Note: You may not move forward in the session until all participants have satisfactorily demonstrated both hand hygiene techniques. Ask participants to locate hand hygiene policies in the CBRF infection control program. Ask for comments on whether the policies are present, understandable and whether they are familiar with them. Encourage participants to give feedback on the plan to their employer.] University of Wisconsin Oshkosh Page 13 of 33

Soap vs. Hand Rubs According to the CDC, alcohol-based hand rubs are more effective in killing bacteria than soap and water. This is how they rate effectiveness: Alcohol-based hand rubs are less drying to hands than using soap and water. Hand rubs can be placed in locations where sinks aren t available so they are more convenient to use. Use of Hand Lotions Caregivers may experience dryness from frequent hand cleansing. Lotions are important to prevent dryness and irritation. You should only use hand lotions approved by your CBRF. Other lotions can: make hand hygiene less effective cause a breakdown of disposable gloves become contaminated with bacteria if dispensers are refilled Fingernails Your CBRF may have a policy regarding fingernails. If not, it s best to keep your fingernails natural and cut to about ¼ inch. Artificial or long nails harbor bacteria, take longer to clean and can puncture disposable gloves. University of Wisconsin Oshkosh Page 14 of 33

Coughing and Sneezing Protocol A simple and effective way to stop the spread of germs that cause colds, flu, whooping cough and severe acute respiratory syndrome (SARS) is to use good hygiene practices when coughing or sneezing. These illnesses can make all of us sick, but they may be especially dangerous to the residents of the CBRF. Cover your mouth and nose with a tissue when you cough or sneeze Put your used tissue in the waste basket If you don t have a tissue, cough or sneeze into your upper sleeve or elbow, not your hands Wash your hands every time you cough or sneeze You may be asked to put on a mask to protect others Biohazard Warning Labels OSHA has set strict rules for storing and disposing of materials that could contain blood or other body fluids. The rules are designed to keep contagious diseases from spreading within the CBRF and to individuals outside of the CBRF who collect and dispose of the materials. The OSHA rules must always be followed by the CBRF and by all employees. Warning labels are required on: Containers of regulated waste Refrigerators and freezers containing blood and other potentially infectious materials Other containers used to store, transport, or ship blood or other potentially infectious materials Red bags or containers may be substituted for labels. University of Wisconsin Oshkosh Page 15 of 33

Personal Protective Equipment Personal protective equipment is specialized clothing or equipment. Wear it to protect your skin and to prevent soiling or contamination of your clothing from contact with bloodborne pathogens. You must wear gloves whenever there is a chance that your hands could have contact with blood or other body fluids You must wear a gown whenever there is a chance that other parts of your body may be exposed to blood or other body fluids You must wear a mask or eye protection whenever there is a chance that your eyes, nose or mouth could come in contact with blood or other body fluids Your CBRF must provide personal protective equipment at no cost to you. It must be available to you whenever you need it. If you believe you need personal protective equipment to complete a task safely and the equipment is not available, do not proceed with the task. Report the lack of equipment to your supervisor. When you remove personal protective equipment, put it in an appropriately designated area or container for storage, washing or disposal. Gloves Gloves are a very important part of keeping both you and residents safe from communicable diseases. Gloves can only do their job if you put them on before you are exposed to blood or body fluids. Most facilities use disposable gloves. Hypoallergenic (not likely to cause allergic reaction) gloves must be available. Latex gloves are an example of gloves that may cause allergic reactions in some people. University of Wisconsin Oshkosh Page 16 of 33

Rules for Wearing Gloves Wear clean gloves when: Touching blood or any other body fluid Caring for any invasive device, such as a catheter Having contact with items that could contain body fluids such as dressings, dirty laundry, dishes or trash Moving from parts of the resident s body that could be contaminated to clean parts of the resident s body Your CBRF s policy requires the use of gloves Always follow these rules: Carefully remove used gloves so that the outer surface never touches your skin Wear gloves that fit gloves that are too small or too big can tear Wash your hands after glove removal Never wear the same gloves for the care of more than one resident! Never reuse gloves! Activity: Removing Gloves What is the correct way to remove gloves? The CDC offers these instructions and drawings: Grasp outside edge near wrist Peel away from hand, turning glove inside-out Hold in opposite gloved hand Slide ungloved finger under the wrist of the remaining glove Peel off from inside, creating a bag for both gloves Discard University of Wisconsin Oshkosh Page 17 of 33

In this activity, the facilitator will demonstrate the proper way to remove gloves. Next, each participant will have a chance to practice. The training cannot proceed until the facilitator observes each participant correctly remove a pair of gloves. [A glove removal activity is a mandatory part of this training. Provide a variety of hypoallergenic gloves in appropriate sizes so that each participant can choose gloves that fit. [Important Note: You may not move forward in the session until all participants have satisfactorily demonstrated the correct glove removal technique. [Ask participants to locate glove and other personal protective equipment policies in the CBRF infection control program. Ask for comments on whether the policies are present, understandable and whether they are familiar with them.] Vaccinations OSHA requires all CBRFs to offer new employees the Hepatitis B Vaccine within 10 days of hire. You are not required to accept the vaccine. If you decline the vaccine but change your mind, your CBRF must provide it at that time. The CBRF may not require you to pay for the vaccine, no matter when you decide to take it. University of Wisconsin Oshkosh Page 18 of 33

Handling Infectious Materials Certain materials have the potential to cause infection if not handled properly. Let s discuss some of the most common materials and ways of proper collection and disposal to minimize risk. Specimens A specimen is a sample of blood, urine, stool, sputum or other body fluids. Specimens may contain blood or other infectious materials. Handle specimens carefully to avoid contact with them. You must use personal protective equipment if you are collecting or handling specimens. The CBRF must provide containers that meet OSHA standards for collecting and storing specimens. Food and drink may never share storage space such as refrigerators, cabinets, countertops, etc. with specimens. [Ask participants where specimen containers are located in their CBRF. If they are not sure where to find them or the CBRF s policy on their use, stress the importance of contacting their supervisor as soon as they return to their jobs.] University of Wisconsin Oshkosh Page 19 of 33

Regulated Waste Regulated waste is anything that could contain infectious materials. Some examples are: Items, such as bandages or tissues, that could have blood or other body fluids on them, either wet or dried Contaminated sharps Lab wastes containing blood or other body fluids Because regulated waste may contain blood or other infectious materials, handle it in ways that prevent contact with your body or clothing. Use personal protective equipment when you are exposed to regulated waste. Your CBRF must provide containers for regulated waste that meet the OSHA standards. The Biohazard symbol, warning labels or brightly colored bags are ways of marking regulated waste containers. If the container leaks, always put the first container inside a second container. [Ask participants where regulated waste containers are located in their CBRF and how they are disposed of. If they are not sure where to find them or the CBRF s policy on their use, stress the importance of contacting their supervisor as soon as they return to their jobs.] Sharps Sharps are any object that can penetrate your skin. Some examples are: Needles Lancets Scalpels Broken glass Broken capillary tubes Never bend, recap or handle sharps in any way other than to throw them away immediately. University of Wisconsin Oshkosh Page 20 of 33

Your CBRF must make sure that containers for contaminated sharps are located close to the area where the sharps are used. Containers must meet the OSHA standards. The containers must have the Biohazard symbol on them. If the container leaks, always put it inside a second container. Always replace containers before they become completely full. [Ask participants to locate specimens, regulated waste and sharps policies in the CBRF infection control program. Ask for comments on whether the policies are present, understandable and whether they are familiar with them. Ask participants where sharps containers are located in their CBRF and how they are disposed of. If they are not sure where to find them or the CBRF s policy on their use, stress the importance of contacting their supervisor as soon as they return to their jobs.] University of Wisconsin Oshkosh Page 21 of 33

Food Service Most employees of the CBRF will play some part in food service. Food service involves bringing food into the building, preparing food, serving meals to residents, cleaning up after meals, washing dishes and disposing of waste. Always Use clean and safe work habits Use hand washing sinks in the kitchen Keep work areas and equipment clean and neat Keep cleaning products such as soaps, polishes, insecticides and poisonous products labeled and away from food Keep food and drink away from dust, insects, vermin, rodents, or anything else that can contaminate it Keep refrigerated food at 40 degrees Fahrenheit or below Keep frozen food at 0 degrees Fahrenheit or below Keep food protected from contamination while it is being prepared and served Prepare food as close to serving time as possible Carefully wash raw fruits, vegetables and poultry Keep food preparation areas clean and sanitary at all times Throw away food returned from residents plates Keep cooking utensils clean and covered Keep garbage that isn t put in a garbage disposal in closed containers, and remove it from the CBRF every day Carefully clean all garbage, rubbish and recyclables containers often Never Touch food or food service equipment if you have: An open or infected wound A disease that could spread to others through handling food Diarrhea or jaundice University of Wisconsin Oshkosh Page 22 of 33

Return to food service until your wound is healed or you are no longer ill Reuse disposable eating utensils such as paper plates, plastic cups, forks, spoons, etc. Place, wash or rinse soiled linen where food is prepared, served or stored Use a towel or drinking cup that is also used by someone else Put food or drink on the floor Cut cooked food on the same surfaces as raw food unless the surfaces are carefully washed in between [Ask participants to locate food service policies in the CBRF infection control program. Ask for comments on whether the policies are present, understandable and whether they are familiar with them.] University of Wisconsin Oshkosh Page 23 of 33

Housekeeping Housekeeping covers all duties that keep the CBRF clean and orderly. Cleaning surfaces in the residents rooms, disinfecting items used to care for residents, taking away trash or other soiled items and cleaning common areas are all examples of housekeeping. Always Pick up items that were used to care for residents in a way that avoids contact with your body or clothes Write down when and how you cleaned on the CBRF housekeeping chart Follow the rules of your CBRF for cleaning and disinfecting surfaces and equipment Completely clean reusable equipment before it is used for another resident Disinfect surfaces after you take care of residents Put contaminated waste in OSHA approved containers Double bag contaminated waste Never Throw away contaminated waste with regular garbage University of Wisconsin Oshkosh Page 24 of 33

Disinfectants Your CBRF will use several types of disinfectants. Each disinfectant has a special purpose. Chlorine bleach is the best way to disinfect most items. Alcohol solution is used for cleaning objects that may be put into a person s mouth. Your CBRF may also use ethyl or isopropyl alcohol, phenolic germicidal detergent, hydrogen peroxide, quaternary ammonia germicidal detergent, ionosphere germicidal detergent and other disinfectants. With all kinds of disinfectants, always follow your CBRF s policies on when and how to use them. [Ask participants to locate housekeeping policies in the CBRF infection control program. Ask for comments on whether the policies are present, understandable and whether they are familiar with them.] University of Wisconsin Oshkosh Page 25 of 33

Laundry Laundry services include moving soiled items from the resident s room to the laundry room as well as washing, drying and replacing bedding, towels, clothing, etc. Always Wear gloves Carry linens away from your body so that your clothes aren t contaminated Wear any other personal protective equipment that is necessary to keep you safe Immediately clean and change your clothes if they become contaminated Roll soiled linens up Put laundry in a laundry bag or container with the Biohazard symbol Keep the laundry bag as close as possible to the contaminated linen Handle contaminated laundry as little as possible Use separate containers for clean linen and dirty linen Change residents linens at least weekly Change linens as often as needed to keep residents clean Never Sort or rinse laundry before putting it in the bag Shake or rub laundry that could be contaminated [Ask participants to locate laundry policies in the CBRF infection control program. Ask for comments on whether the policies are present, understandable and whether they are familiar with them.] University of Wisconsin Oshkosh Page 26 of 33

Exposure Incident Exposure incident means a specific eye, mouth, other mucous membrane, non-intact skin, or parenteral (injection) contact with blood or other potentially infectious materials. Contact results from the performance of an employee's duties. Exposure incidents include both direct contact transmission and indirect contact transmission. What to do if an exposure occurs: Wash exposed area with soap and water Flush splashes to nose, mouth or skin with water Irrigate eyes with water or saline Report the exposure See a healthcare professional [Ask participants to locate exposure incident policies in the CBRF infection control program. Ask volunteers to describe an exposure incident that occurred in their CBRF. (If most of the participants are new to their jobs, you may have to provide some examples.) Record the incidents on a flip chart. Have participants explain what happened immediately following the exposure. After referring back to the CBRF s exposure incident plan, ask whether proper procedures were followed. If not, or if the CBRF s policy isn t clear, ask the group for input on how this type of incident should be handled in the future.] University of Wisconsin Oshkosh Page 27 of 33

Post Exposure Plan Managing the situation post (after) an exposure incident is an essential part of preventing infection. Both direct caregivers and supervisors share responsibility in carrying out the plan. Post exposure requirements: Notify a supervisor or another person in charge of any possible exposure incident or accident Document the exposure incident using the CBRF s Incident/Accident Report Form In the report, explain the situation before the exposure and how the exposure happened Record injuries from contaminated sharps in a sharps injury log Obtain consent from the person who was the source of the blood or other body fluid and the exposed employee, and test their blood as soon as possible after the exposure incident Provide risk counseling and offer post-exposure treatment for disease, if needed The CBRF also has the responsibility to examine what happened with the incident and plan for protection against the same kind of incident happening in the future [Ask participants to locate the post exposure section of the infection control program. Go back to the list of exposure incident examples on the flipchart. Ask participants how the incident was handled post exposure. They may not be familiar with some of the steps. For example, they may have reported the incident to a supervisor and the supervisor then completed the incident/ accident report form. If this is the case, have them describe how the plan should have been carried out.] University of Wisconsin Oshkosh Page 28 of 33

Wrap-Up Be a role model. Show co-workers, supervisors and residents that you are serious about everyone s health and safety by practicing standard precautions at all times. A good slogan to remember is: Practice Standard Precautions It s Contagious! Learning Points Review Let s review the learning points from today s training: Learn about standard precautions and why they are important in your work Understand how bloodborne diseases and other communicable diseases spread from person to person Learn how to prevent the spread of communicable diseases Learn what to do during and after an exposure incident University of Wisconsin Oshkosh Page 29 of 33

Facilitator Preparation For this training, facilitators will need: Hand washing sink, soap, hand rub (foam or gel), paper towels Hypoallergenic, disposable gloves in sizes to fit all participants Copies of a CBRF infection control programs for each participant MS PowerPoint (PPT Viewer 2007 can be downloaded for free at Microsoft.com) LCD Projector (recommended) Screen for viewing the PPT (recommended) Internet access (recommended) Flip chart/whiteboard and markers Printed Participant Guides (one for each student) Pens or pencils UW Oshkosh CCDET class rosters Printed tests Evaluation information for participants Note: It is strongly recommended that the PPT be viewed using an LCD projector. If that option is not available, the PPT may be downloaded and printed as a handout. Infection Control Programs: All CBRFs are required to have a written infection control program. The program must provide detail on the responsibilities of the employees. The CBRF must make employees aware of the rules and practices that apply to their work. In preparation for this training, obtain an infection control program and become familiar with it. Whenever possible, use the program(s) from the facilities where participants are employed. If this is not possible, obtain a University of Wisconsin Oshkosh Page 30 of 33

sample program. Make copies for each participant. For each section of the training, you will ask participants to refer to the CBRF infection control program to determine whether the employee requirements are clearly covered. If you have a small group, have all the participants work together. For larger groups, divide participants into teams. Have participants work with employees from the same CBRF. Opening Activity: Influenza (Flu) Centers for Disease Control http://www.cdc.gov/flu/about/disease/index.htm This site provides annual flu statistics in the U.S. It is also a resource for flu symptoms and prevention. Activity: Hand Hygiene Centers for Disease Control http://www.cdc.gov/ncidod/dhqp/gl_handhygiene.html The CDC provides guidelines for hand hygiene in medical settings. An interactive training session is available. Note: The CDC resources may be used in the training session as auxiliary material, but a live hand washing demonstration must always be provided by the facilitator. Coughing and Sneezing Protocol Centers for Disease Control http://www.cdc.gov/flu/protect/covercough.htm The CDC provides guidelines for stopping the spread of germs through coughing and sneezing. The website also includes downloadable posters in many languages. University of Wisconsin Oshkosh Page 31 of 33

Activity: Removing Gloves Centers for Disease Control http://www.cdc.gov/ncidod/dhqp/ppe.html Glove removal practices may vary slightly as long as the basic rules are followed. This site provides an appropriate model with more information. Note: This resource may be used in the training session as auxiliary material, but a live glove removal demonstration must always be provided by the facilitator. University of Wisconsin Oshkosh Page 32 of 33

Resources The following are resources used for this curriculum. These resources may also provide valuable information about current standards and practices. Instructors and students are encouraged to explore the resources to increase program knowledge. Occupational Safety and Health Administration (OSHA) http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=sta NDARDS&p_id=10051 OSHA Regulations on Bloodborne Pathogens Centers for Disease Control http://www.cdc.gov/ncidod/dhqp/bp_universal_precautions.html Universal Precautions for Prevention of Transmission of HIV and Other Bloodborne Infections http://www.cdc.gov/ncidod/dhqp/ppe.html Glove removal and other Personal Protective Equipment guidelines Wisconsin Administrative Rule http://www.legis.state.wi.us/rsb/code/dhs/dhs083.pdf Chapter DHS 83 Community-Based Residential Facilities University of Wisconsin Oshkosh Page 33 of 33