TLE

• Caregiving is the act of looking after individuals, helping them to do what they would do by themselves if they could, and helping them if they can no longer move or do things for themselves.
• The primary objective of caregiving is to help a patient become independent as his/her health permits.
• A patient can be anyone suffering from an injury or illness and requiring care.
• Infection is a condition caused by microorganisms entering the body.
• Bacteria, Viruses, Fungi and yeast, and protozoa are different types of microorganisms present in the environment that could invade the body.
• Microorganisms enter the body through broken or damaged skin, orifices such as the nose, mouth, anus, vagina and urethra, eyes and ears, hair follicles, and bloodstream.
• Caregiver's main responsibility


  Protect himself/herself and his/her patient from the risk of contamination by microorganisms that cause diseases
• Basic Infection Control


  • A basic infection control practice that every member of the family should establish is the habit of handwashing
  • Washing hands is responsibility of a caregiver but of everyone in general
• Hygiene


  The practice of precautionary measures to maintain physical health and prevent the spread of diseases
• Hand hygiene

  • The most effective way to prevent the risks of microorganisms transmission
  • Reduces morbidity, mortality and costs
• Infection control policies and procedures


  Definite rules or guides as well as methods of action that are observed and followed to ensure that individuals and the environment are free from infection
• Wounds


  • Can become infected
  • If an infection starts, it may cause damage to the body
  • Prevention is the best way to avoid this problem
• Types of Open Wounds

  • Abrasion
  • Incision
  • Laceration
  • Puncture
  • Avulsion
  • Amputation
• Abrasion


  A scrape or scratch on the skin resulting in partial loss of skin surface. It has less bleeding, and the common cause is rubbing or scraping.
• Incision


  A skin wound (cut) with smooth edges and can cause severe bleeding. The usual cause of the injury is a sharp object.
• Laceration


  A skin wound with uneven edges. The usual cause is a blunt object tearing the skin. It can have severe bleeding because veins and arteries can be affected, and there is danger of infection.
• Puncture


  A skin wound (cut) with smooth edges and can cause severe bleeding. The usual cause of the injury is a sharp object. If the object is embedded in the wound, the risk of infection is high.
• Avulsion


  Partial tearing of a patch of skin or other tissue and the torn-off tissue is left hanging. Most often, it involves ears, fingers, and hands.
• Amputation


  Involves the cutting or tearing off body parts such as fingers, toes, hands, feet, arms, or legs.
• What to Do When Dealing with Open Wounds

  1. Wear disposable latex gloves, but when not available, use several layers of gauze pads, plastic wrap, or bag. Bare hands should not be used and should be the last resort in worst-case scenarios.

  2. To see where the blood is coming from, remove or cut the clothes of the patient and expose the wound.

  3. To control bleeding, apply direct pressure with a finger or palm. Place a sterile gauze pad or clean cloth over the entire wound. Elevation may be used in combination with direct pressure, and it stops most bleeding.
• Procedure in Cleaning Open Wounds

  1. Wash your hands with soap and water. Wash them with a vigorous scrubbing action. Dry your hands and wear disposable plastic gloves.

  2. For a shallow wound, wash it with soap and water.

  3. For a wound with high risk for infection like larger wounds or extremely dirty wounds, seek medical care for wound cleaning.

  4. Use sterile tweezers to remove small objects not flushed out by irrigation. If not cleaned well, a wound will leave a scar on the patient's skin.

  5. Cover the wound with a sterile and nonstick dressing. For a shallow wound, an antibiotic ointment can be applied.

  6. Change the dressing daily and more often if it gets wet and dirty.
• Initial Procedure in Treating Close Wounds

  1. Apply an ice pack for 20 minutes. Place a wet cloth between the ice and the skin to protect the skin from frostbite.

  2. Apply elastic bandage with a pad if the arm or leg is involved.

  3. The patient must be examined for a possible fracture.

  4. To lessen the pain and swelling, the injured part should be kept at a level above the patient's heart level.

  5. Seek medical help if you suspect internal bleeding or a broken bone and if bruises show up for no apparent reason.
• Treat an infected wound by

  1. Keeping the area clean;

  2. Soaking in warm water or applying a warm pack;

  3. Elevating the infected part;

  4. Applying an antibiotic ointment;

  5. Changing the dressing daily; and

  6. Seeking medical help if the infection persists or become worse.
• Some Don'ts in Cleaning Wounds

  • Do not irrigate a wound with full strength iodine preparation such as 10 povidone-iodine or 70% isopropyl alcohol as it kills body cells and bacteria.
  • Do not use antibiotic ointment on wounds requiring stitches or on other wounds where drainage may be prevented.
  • Do not breathe or blow on the wound or dressing.
  • Do not close the wound with butterfly adhesive strips or skin closure adhesive tape because when bacteria are trapped in the wound, infection is more likely to happen.
  • Do not use hydrogen peroxide because it does not kill bacteria.
• Procedures in Controlling Wound Infection

  1. The area of the wound must be cleaned. Dirt must be washed away, and the wound must be covered with a dressing. The dressing should be good enough to prevent bacteria from entering the wound.

  2. Sterilizing Equipment- Bacteria can be destroyed by boiling, fire, radiation or chemical disinfection, and steam under pressure. After such procedures, the equipment can now be used safely.

  3. Aseptic Technique- It is used when applying dressings to avoid building up of infections in a wound. A caregiver should observe some precautions when dressing a wound to avoid contamination.
• Factors that Contribute the Wound Infection

  • Dirty and foreign materials left on the wound
  • Ragged or crushed tissues
  • Injury to the underlying bone, joint, or tendon
  • Bite wounds from human or animals
  • Puncture wounds or other wounds that cannot drain
• Dressings


  A dressing covers and touches an open wound. Whenever possible, a dressing should be: sterile (If a sterile dressing is not available, use a clean cloth, handkerchief, washcloth, towel etc.); thick, soft, and compressible so that pressure is evenly distributed over the wound; and lint-free.
• Purpose of Dressing


  • To control bleeding
  • To prevent infection and contamination
  • To absorb blood and wound drainage
  • To protect from further injury
• Some Don'ts When Using Dressings

  • Do not use fluffy cotton or cotton balls as a dressing. Cotton fibers can get into the wound and would be difficult to remove.
  • Do not remove a blood-soaked dressing until the bleeding has stopped, cover it with a new dressing.
  • Do not pull off a dressing stuck to a wound. If it needs to be removed, soak it in warm water.
• Types of Dressings


  • Gauze Pads- These are use for small wounds.
  • Adhesive Strips- These are used for small cuts and abrasions and are a combination of both a sterile dressing and a bandage.
  • Trauma Dressings- These are made of large, thick, absorbent, and sterile materials.
  • Improvised Dressings- When commercial sterile dressings are not available, an improvised one should be as clean, absorbent, soft and lint- free as possible (handkerchief, towel).
• Bandages


  A bandage should be clean but need not be sterile. It can be used to hold a dressing in place over an open wound; apply direct pressure over the dressing to control bleeding; prevent or reduce swelling; and provide support and stability for an extremity or joint.
• Types of Bandages


  • Roller Bandage- comes in various widths, lengths, and types of materials.
  • Self-adhering, Conforming Bandage- rolls of slightly elastic, gauze-like material. They come in various widths. The self-adherent quality makes it easy to use.
  • Gauze Roller bandage- cotton, rigid, and non-elastic. They come in various width (1,2, and 3 inches) and are usually 10 yards long.
  • Elastic Bandage- used for compression bandages for sprains, strains and contusion.
  • Improvised Bandage- When commercial roller bandages are not available, you may use a belt or necktie, tear strips of cloth from a sheet, or other similar material as a substitute for commercial roller bandages.
  • Triangular Bandage- commercially available or can be made from a 30 to 40 inch square of preshrunk cotton muslin material that is cut diagonally from corner directly across from the base is the point, and the other two corners are called ends.
• Difficult and challenging behaviors

  Actions that detract the well-being of individuals due to physical or psychological distress. The patients affected can be either the initiator of the acts or those in the immediate surroundings.
• Identifying Difficult or Challenging Behavior

  • Due to illness, injury, or disability, a patient's behavior becomes difficult to handle
  • Because of the emotional and physical changes the patient is experiencing, his/her personality and behavior may change
  • There are persons who usually have difficult personalities and may become even more difficult to please
• Applying Response to Difficult or Challenging Situation

  1. The caregiver must be very understanding and tolerant of the patient's behavior

  2. He/she should adapt and adjust to the patient's behavior

  3. The caregiver should accept and understand the fact that the patient has the same needs as those who are feeling well and healthy
• Practices for the caregiver in dealing with any type of difficult behavior from the patient

  • Always remain calm and balanced
  • Be patient
  • Focus on difficult behavior, not on the patient
  • Ask the patient for request and politeness in a nice way
  • Practice gentle assertiveness and stand up for oneself to avoid resentment, hurt, and angry feelings
• Planning Safety and Preparing the Self Others When Responding to Difficult or Challenging Behavior

  • The home caregiver should be conscious of his/her own self
  • He/she must consider his/her safety and health condition
  • He/she should be conscious of his/her own posture and body movements that minimize the strain on joints and muscles and help to prevent fatigue
• First Aid

  The initial care to an illness or injury, mostly rendered by a non-expert to a sick or injured person until definitive medical treatment can be performed by a medical team or until the chance for recovery without medical care is ensured
• Physical Hazards to Self and Casualty's Health and Safety

  • Check the area for immediate danger to yourself or to the victim
  • Use protective equipment when giving first aid to a person with Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) to prevent contact with blood
  • Cover open wounds with dressings to prevent contact with blood
  • Use disposable latex gloves to minimize contact with blood
  • Use a device/equipment that will serve as a barrier to prevent fluid transfer between you and the victim while allowing air to pass through during CPR
• Precautionary measure after caregiver or person exposed to blood or body fluids of a victim with HBV and HIV

  1. Wash the exposed area immediately with soap and running water

  2. Report the incident promptly

  3. Get medical help, treatment, and counseling

  4. Ask about HBV globulin if you have not been given HBV vaccine