Infection Control

This policy deals with the prevention of transmission of all infections at Dawn Farm. Written guidelines will be posted in appropriate areas.

HAND WASHING

Simple hand washing is essential to prevent the spread of many diseases.  Wearing  gloves does not preclude the need for hand washing. Residents and staff should thoroughly wash their hands with soap and hot water in the following situations:

• after using the bathroom

• after coughing or sneezing

• before and after any contact with food (esp. meat)

• after any contact with bodily fluids (blood, semen, feces, urine, vaginal secretions) 

HOUSE CLEANING

Staff and residents should follow these procedures when cleaning:

• wear gloves when emptying trash, cleaning bathroom, changing linens and doing laundry

• clean all toilets, sinks, bathroom and kitchen floors with disinfectant every day

• spray shower stalls with bleach mixture before and after each shower

SPECIFIC DISEASES 

If there is an outbreak of any infectious disease, Dawn Farm will immediately contact their Medical Director. If  unavailable and/or necessary, Dawn Farm will call the Washtenaw County Health Department for consultation and institute appropriate education and prevention strategies. All infectious diseases are now specifically marked within our electronic incident reports. The Health and Safety Coordinator follows up and ensures necessary precautions are taken. See Communicable Disease procedure. All information is considered confidential and will be shared with the WCHD only if they deem it necessary.

• Chicken pox- This is a virus, spread by direct contact, airborne respiratory tract secretions or contact with secretions of the pox.  Symptoms include a slight fever and red bumps that form water blisters and eventually scab over. 

• Shingles- This is a re-activation of the chicken pox virus in an adult. Symptoms are lesions appearing ion nerve pathways, often across forehead and on midsection. Anyone with shingles must have no contact with infants or anyone with immuno-suppression.

• Influenza- This is a viral, respiratory disease spread through contact with airborne respiratory secretions, either by breathing them or coming into contact with the germs on surfaces. Symptoms include fever, chills, dry cough and fatigue. When symptoms are severe, medical attention should be sought. Frequent hand washing and careful disposal of tissues is imperative.   

• Conjunctivitis- This is a bacterial infection of the eye with symptoms of redness, itching and irritation of the eye. Medical attention should be sought. It is spread by any contact with eye secretion or respiratory droplets. Frequent hand washing and careful disposal of tissues will help prevent the spread.  

• CMV- This is a viral infection related to herpes. It is of danger only to pregnant women due to potential harm to the fetus. It is spread through contact with bodily fluids to proper adherence to the Blood Borne Pathogen Policy will prevent its spread.

• Diarrhea- This is loose stools, cramping and vomiting caused by bacteria, virus, or parasitic infections. This is spread by fecal material on the hands of an infected person. Frequent hand washing is essential to prevent its spread.

• Herpes Simplex I (cold sores) - This is a viral infection characterized by a localized skin lesion and spread by contact with the saliva of a carrier or contact with secretions from the lesion. Frequent hand washing is the best prevention.

• Herpes Simplex II (genital herpes)- This is a virus which causes painful blisters and is spread through sexual contact.

• Impetigo- This is a staph or strep bacterial infection of the skin that causes a crusty yellow lesion. It is spread through contact with open lesions and frequent washing of the lesions and hand washing are suggested. Antibiotic cream is also helpful.

• Mononucleosis- This is an viral disease with fever, sore throat, swollen glands and fatigue as the major symptoms. It is spread only through close contact with oral or nasal secretion and frequent hand washing and proper disposal of tissues are the best preventive measures.

• Lice- These are parasites that infest parts of the body with dense hair. Symptoms are itching and it is spread through direct contact with an infected person or their personal belongings. Hairbrushes, hats, towels and pillows should never be shared and anyone with lice must receive immediate medical treatment.

• Meningitis- This is either a viral or bacterial infection resulting in an inflammation of the membranes that cover the brain. Symptoms include sudden onset of fever, headache, vomiting and a stiff neck. It is spread through direct contact with respiratory droplets and frequent hand washing is the best prevention. Medical care will be sought immediately and in the event of a case of bacterial meningitis the WCHD will be consulted.

• Rubella- This is a mild viral disease of danger primarily to pregnant women due to potential harm to the fetus. Symptoms include a fine rash and fever and it is spread through direct or indirect contact with secretions from an infected person’s nose or throat. Since it is communicable for a week prior to symptoms, the best prevention is vaccination. Any case must be reported to WCHD.

• Strep throat- This is a bacterial infection of the throat with symptoms of sore throat and fever. A person can carry the virus without any symptoms. The virus can be transmitted by contact with an infected person or a carrier. Medical attention is necessary, since left untreated, the disease can develop into rheumatic fever. A person is contagious for 24 hours after beginning medication. Frequent hand washing and proper use of antibiotics are essential to prevention.

• TB- This is a bacterial disease that most often strikes the lungs. It can remain dormant for any length of time but nay become active if a person’s immune system is suppressed for any reason. It is only contagious when active. Symptoms include chronic cough, night sweats, unexplained weight loss and fatigue. It is spread through airborne direct contact. Covering the mouth and nose with a tissue when coughing or sneezing and then immediately disposing of the tissue can help prevent its spread. All new staff and residents will receive a TB skin test. Clients with a positive test will be referred back to their PCP or main clinic Dawn Farm is working with at the time for further diagnosis and treatment. If a client is both positive and active staff must do their best to find an appropriate alternative facility for the client to stay in until treated. If a new client has symptoms of TB, their admission may be delayed until an X-ray rules out active TB.

*Staff refer to TB Testing at Dawn Farm Procedures under the Health & Safety section on the Intranet for information around staff testing.

CARF Standard: 1.H.11