Module 3

• Universal precaution


  Observe to prevent contact with blood and other potentially infectious materials. All patients shall be assumed infected with HIV/AIDS and other blood-borne pathogens.
• Engineering and Work Practice Control

  1. Employees shall wash their hands as soon as possible after the removal of gloves or other PPE and after hand contact with blood or other potentially infectious material

  2. All PPE shall be removed immediately upon leaving the work area or as soon as possible if the work is overtly contaminated. Place the PPE in an appropriately designated area, or container for storage, washing, decontamination or disposal

  3. Used needles and other sharps shall not be sheared/cut off, bent, broken, recapped, or re-sheathed/to cover by hand. Used needles should not be removed from disposable syringes

  4. Eating, drinking, smoking, applying cosmetics or lip balm, or handling contact lenses are prohibited in work areas where there is potential occupational exposure

  5. Food and drinks shall not be stored in refrigerators, freezers, or cabinets where blood or other potentially infectious materials are stored or in other areas of possible contamination

  6. All procedures involving blood or other potentially infectious materials shall be performed in such a manner as to minimize splashing, spraying, and aerosolization

  7. Mouth pipetting/ suctioning is prohibited
• Suggested control measures for primary care clinics in the community setting

  • Use of barrier apparel
  • Persons hygiene
  • Environmental cleaning
  • Universal precaution
• Barrier apparel


  • Mask for all staff
  • Mask for patients with respiratory problems
• Handwashing


  1. Practice proper handwashing with the use of soap and water

  2. Wash hands before and after patient contact and after removing the gloves
• Gloving


  1. Wear gloves for all direct contact with patients

  2. Change gloves and wash hands every after each patient
• Gowning


  Wear gown during procedures which are likely to generate splashes or sprays of blood and body fluids, secretions, or excretions
• Eye protection


  Wear goggles for aerosol/splashes generating procedures
• Environmental disinfection

  Clean surfaces daily with disinfectant (diluted household bleach, 70% alcohol)
• Health Promotion


  Activities that help clients maintain or enhance their present levels of health. Includes routine exercise and good nutrition.
• Wellness


  Education that teaches people how to care for themselves in a healthy way. Includes topics like physical awareness, stress management and self-responsibility.
• Illness Prevention


  Activities that motivate people to avoid a decline in health or functional levels. Includes immunization to protect people from actual or potential health threats.
• Levels of Preventive Care

  • Primary prevention - precedes a disease or dysfunction, aims at health promotion
  • Secondary prevention - focuses on individuals experiencing health problems or illness, reduces severity and enables return to normal health
  • Tertiary prevention - minimizes effects of long-term disease or disability, prevents complications and deterioration
• Health education for patients with communicable disease

  Educate the family and the client on: Availability and importance of prophylactic/immunization; Manner in which infectious illness is spread and methods of avoiding the spread; Importance of seeking medical advice for any signs of health problem; Importance of environmental cleanliness and personal hygiene; Means of preventing contamination of food and water supply
• Immunization


  Introduction of specific protective antibodies in a susceptible person or animal. Immunity is a condition of being secure against a particular disease.
• Sub-clinical immunity


  Immunity acquired through constant exposure to a particular disease or organism.
• Antigen


  Any substance that causes the immune system to produce antibodies against it. Can be a foreign substance from the environment or formed inside the body.
• Types of Antigen

  • Inactivated - made from microorganisms that have been killed, cannot cause disease
  • Attenuated - vaccine created by reducing the virulence of a pathogen, but keeping it "live"
• All vaccines lose their potency after a certain time. Expiry date should be noted on the label or printed on the vaccine
• Heat and sunlight damage vaccines, especially the live vaccines. Freezing damages the killed vaccines and toxoids. Use water only in cleaning the refrigerator/freezer. Antiseptics, disinfectants, and detergents or alcohol may lessen the potency of vaccines.
• The safest thing to do is to keep all vaccines at the correct cold temperature 2-8 C
• Levels of Water Supply Sanitation


  • Level I - Protected well or developed spring with an outlet but without a distribution system
  • Level II - Communal Faucet System or Stand Points
  • Level III - Waterworks system or individual house connections
• Levels of Excreta and Sewage Disposal

  • Level I - Non water carriage toilet facility (pit latrines, reed odorless earth closet)
  • Level II - Water-sealed and flush type with septic vault/tank disposal facilities
  • Level III - Water carriage toilet connected to septic tanks or to sewerage system to treatment plant
• Policies on Food Sanitation

  • Inspection/approval of all food sources
  • Compliance to sanitary permit requirements for all food establishments
  • Provision of updated health certificates for food handlers, cook, and cook helpers
  • Destruction/banning of food unfit for human consumption
  • Training food handlers and operators on foods sanitation
• Ambulant food vendors shall also comply with the requirements as to the issuance of health certificate
• Household food sanitation is to be promoted and monitored and food hygiene sanitation needs to be intensified
• Policies on Hospital Waste Management

  • All newly constructed/renovated government and private hospitals shall prepare and implement a Hospital Waste Management (HWM) Program as requirement for registration/renewal of licenses
  • The use of appropriate technology and indigenous materials for HWM shall be adopted
  • Training of hospital personnel involved in waste management shall be an essential part of the hospital training program
  • Local ordinances regarding the collection and disposal techniques, especially incinerators, shall be institutionalized
• Nursing Responsibilities and Activities

  1. Development and dissemination of IEC materials and messages, their utilization and distribution

  2. Providing individual and group counseling, and holding of community assemblies and bench conferences

  3. Working with other nursing staff and personnel in other government and private agencies who can also be responsible for imparting the need for an effective and efficient environmental sanitation in their place of work

  4. Active participation in training/workshops related to environmental health

  5. Acting as advocate or as facilitator to families in the community in matters pertaining to programs/projects or activities on environmental health

  6. Effective and efficient participation in environmental sanitation campaigns and projects in the community

  7. Being role model for others in the community in terms of cleanliness in the home and surrounding

  8. Helping in the integration and implementation of PD 856
• Control System for Communicable Diseases

  • Isolation and quarantine
  • Disinfection (Concurrent and terminal)
  • Disinfection or killing of undesirable small animals by physical or chemical means
  • Fumigation/disinfection fogging - application of gaseous agent to kill or drive organisms and insects
• Curative Aspect for Communicable Diseases

  • Medical management
  • Nursing management
• Rehabilitative Aspect for Communicable Diseases

  • Activity
  • Nutrition
• Means of Controlling the Spread of Communicable Disease

  • Elimination of the source of infection
  • Interruption of transmission
  • Protection of susceptible host
• Isolation


  Separation of patients with communicable diseases from others to prevent or reduce transmission of infectious agent directly or indirectly
• Categories of Isolation

  • Strict Isolation - to prevent highly contagious or virulent infections
  • Contact Isolation - to prevent the spread of infection primarily by close or direct contact
  • Respiratory Isolation - to prevent transmission of infectious diseases over short distances through the air
  • TB Isolation - for TB patients with positive smear or with CX-ray strongly suggesting active TB
  • Enteric Isolation - for infections with direct contact with feces
  • Drainage/Secretion Precaution - to prevent infections transmitted by direct or indirect contact with purulent materials or drainage from an infected body site
  • Universal Precaution - applied when handling blood and body fluids, to prevent parenteral, mucous membrane, and non-intact skin exposure of healthcare workers to blood-borne pathogens