HHC Health & Home Care Clinical Policy And

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HHC HEALTH & HOME CARE Section: 12-1 Nutrition __RN ORGANIZATIONS: General Nutrition Information American Dietetic Association 120 S.Riverside Plaza, Suite 2000 Chicago, IL 60606-6995 (800) 877-1600 http://www.eatright.org Diabetes American Association of Diabetes Educators 100 W. Monroe St., Suite 400 Chicago, IL 60603 (800) 338-3633 http://www.diabeteseducator.org American Diabetes Association National Center 1701 N. Beauregard St., Alexandria, VA 22311 (800) 342-2383 http://www.diabetes.org Heart Disease American Heart Association National Center 7272 Greenville Avenue Dallas, TX 75231-4596 (800) 242-8721 http://www.americanheart.org National Heart, Lung and Blood Institute Information Center Attention: Web Site P.O. Box 30105 Bethesda, MD 20824-0105 (301) 592-8573 http://www.nhlbi.nih.gov Renal Disease National Kidney Foundation, Inc. 30 East 33rd Street, Suite 1100 New York, NY 10016 (800) 622-9010 http://www.Kidney.org Pulmonary Disease Cancer American Lung Association 61 Broadway, 6 th Floor New York, NY 10006 (212) 315-8700 http://www.lungusa.org National Cancer Institute Public Inquiries Office 6116 Executive Blvd. MSC8322 Bethesda, MD 20892-8322 1-800-4-CANCER http://www.cancer.gov American Institute for Cancer Research 1759 R Street NW Washington, DC 20009 (800) 843-8114 http://www.aicr.org Nutrition Support American Society for Parenteral & Enteral Nutrition 8630 Fenton Street, Suite 412 Silver Spring, MD 20910 (301) 587-6315 http://www.nutritioncare.org To order a free copy of "The Food Guide Pyramid" booklet, send request to: Center for Nutrition Policy and Promotion 3101 Park Center Drive Room 1034 Alexandria, VA 22303-1594 276
HHC HEALTH & HOME CARE Section: 13-1 Infection Control: Universal Precautions __RN PURPOSE: To reduce the risk of exposure and prevent the transmission of infection to patients and personnel. CONSIDERATIONS: 1. While all body fluids are not known to transport bloodborne pathogens, they do transmit other infectious agents. Thus, Universal Precautions should be applied to all body fluids, except sweat. 2. Assume that blood and body fluids from all patients are potentially infectious and, thus, utilize Universal Precautions in the care of all patients. 3. Personal protective equipment (PPE) includes gloves, gowns/aprons, masks, eye protection, and resuscitation devices that prevent blood or body fluids from contact with the clinical staffs' clothes, skin, eyes, mouth, or other mucous membrane under normal conditions of use and for the duration of time that the protective equipment will be used. PPE must be used appropriately and according to manufacturer's instructions, removed when soiled or penetrated with blood or body fluids, and replaced and disposed of according to Disposal/Handling of Infectious Medical Waste, No. 14.11. 4. Hand Hygiene - Indications for hand washing and/or hand antisepsis include but not limited to the following: a. When hands are visible dirty or contaminated; b. Before and after direct contact with each patient; c. Contact with blood or body fluids; d. Immediately after removing gloves to avoid transfer of microorganisms to the environment; e. Before eating and after toileting; f. Before donning and after removing gloves; g. It may be necessary to wash hands between tasks and procedures on the same patient to prevent cross-contamination of different body sites. (See Hand Hygiene, No. 14.03.) 5. Gloves must be worn when it can be reasonably anticipated to have direct contact with blood, body fluids, mucous membranes, or non-intact skin; when handling items soiled with blood or body fluids; or when touching equipment or surfaces contaminated with blood or body fluids. This includes, but is not limited to the following: a. Suctioning procedures. b. Catheter care and removal of catheters. c. Dressing changes. d. Handling of contaminated linens. e. The collection and emptying of all suction and drainage devices, e.g., Foley catheter bags, hemovacs, etc. f. Starting and discontinuing intravenous infusion, caring for central and peripheral lines. g. Providing personal care involving contact with mucous membranes, including oral hygiene. h. Bowel procedures, including enema administration. I. Cleaning patient rooms, bathrooms, emptying trash, or changing linens on patient's bed. j. Venipuncture or other vascular access procedures. k. Handling of contaminated sharps. l. Cleaning reusable equipment. m. Cleaning up after spill of blood or body fluids or incontinence. n. While performing care when the clinical staff has open cuts, sores, or other breaks in the skin on their hands or wrists. (See Gloves, Donning Sterile, No. 14.05.) 6. Gowns or aprons must be impervious and worn when there is a potential for blood or body fluid spatters or sprays. Examples may include venipunctures, arterial punctures, catheter or nasogastric tube insertions, intubation, care of an incontinent patient. 7. Eye protection, goggles, protective shields, or glasses must be worn when there is a potential for a splash, spray, spatter, or droplets of blood or body fluids. Examples include dental cleaning, suctioning, arterial punctures, and intubation. 8. Masks should be worn when there is a potential for a splash, spray, or splatter of blood or body fluids, whenever eye protection is used and when the patient is on respiratory precautions. 9. Resuscitation Devices: a one-way mouthpiece, resuscitation mask or other ventilation device should be used during all resuscitations. 277
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