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The Home Care and Community Health Support Pocketbook was created to bring awareness to several health and safety issues faced in home and community care.
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In long-term care it is increasingly apparent that who is on shift is just as important as how many staff are on shift. Quality care is difficult to achieve when we do not routinely engage with one another in a positive, or civil, manner.
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WorkSafeBC’s healthcare and social services planned inspection initiative focuses on high-risk activities in the workplace that lead to serious injuries and time-loss claims.
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WorkSafeBC is releasing a discussion paper with proposed amendments to the Current Rehabilitation Services and Claims Manual that guide wage rate decisions related to short-term and long-term disability compensation. Recommended amendments include: These changes may affect your claims costs. Click here to view the proposed changes and offer feedback to WorkSafeBC – The deadline is 4:30 p.m. on Friday, […]
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Hierarchy of Control

Infection Prevention - Home and Community Care

Reducing exposure to communicable disease involves an approach that considers the hierarchy of controls for infection prevention to eliminate or minimize exposure in the workplace.

The first step to reducing exposure is to identify and assess tasks that may result in exposure to communicable disease. Be sure to involve staff and your JOHS Committee or OHS representative in this process.  Then, using the hierarchy of controls, implement control strategies starting from the most effective control measures. Applying multiple control strategies is the most effective.

Below, we outline general steps for reducing exposure in a home or community care setting. These steps align with the hierarchy of controls for infection prevention that will safeguard the well-being of both staff and clients.

Elimination
Physically remove the hazard.
Substitution
Replace the hazard.
Engineering Controls
Isolate people from the hazard.
Administrative Controls
Change the way people work.
PPE
Protect people with personal protective equipment.

Elimination

Remove the risk of exposure to communicable disease.  The best way to eliminate communicable disease is to prevent exposure in the first place.
Examples:
  • Contact clients or family members ahead of the scheduled visit to see if anyone is experiencing respiratory symptoms/illness. If someone is not well and the visit can be delayed, reschedule the visit.
  • Provide virtual check-ins for clients or family members where possible.
  • Encourage health care workers to self-monitor for signs and symptoms of illness prior to work.

Substitution

Replace the hazard in the workplace with a safer alternative.
Examples:
  • Substitute less effective cleaning agents with cleaning and disinfecting agents that are suitable for the task.
  • Ensure disinfectants have a Health Canada drug identification number (DIN), or a Natural Product Number (NPN).
  • Substitute re-usable care items or medical supplies with single use items where possible.
  • Substitute in-person staff meetings with virtual meetings.
  • Implement electronic charts/health records instead of paper binders.

Engineering Controls

Isolate workers from exposure to communicable disease. These controls involve modifying the environment to reduce the risk of infection transmission.
Examples:
  • Ensure physical barriers or social distancing are in place between sick family members and the client in care, and that sick family members are isolated from the client receiving care.
  • Ensure indoor spaces are adequately ventilated with outside air.
  • Ensure an adequate personal supply of alcohol-based hand sanitizer for staff visiting clients. Encourage regular hand hygiene for the client receiving care.

Administrative Controls

Change the workflow at your organization. Administrative controls involve policies, procedures, and guidelines to manage risk of infection.
Examples:
  • Actively screen staff and clients, as well as their household members, for signs of illness.
  • Develop and communicate infection control policies and procedures, such as exposure control plans.
  • Encourage respiratory hygiene/cough etiquette, and provide tissues and individual receptacles.
  • Provide staff training in hand hygiene, respiratory hygiene, and cough etiquette.
  • Provide training in the use of PPE (donning and doffing).
  • Assign staff schedules to avoid rotating staff among clients.
  • Handle and dispose of sharps according to safe work procedures. Follow sharps handling procedures such as discarding any disposable, contaminated sharps in sharps disposal containers as soon as possible after use.

PPE

Give the worker something to wear to reduce exposure to communicable disease. PPE should be used when other control measures are not sufficient to reduce the risk.
Examples:
  • Require staff to conduct a point-of-care risk assessment before any client interactions to determine personal protective equipment required.
  • Ensure that workers who are required to wear a N95 respirator as indicated by a point of care assessment have been fit tested within the last year.
  • Ensure staff perform proper donning and doffing of PPE, and proper hand hygiene (link a huddle here).
  • Ensure face masks are replaced if soiled, damaged, or hard to breathe through.
The above are examples of control measures that could be considered for each step in the hierarchy of controls, and act only as a guidance for possible controls measures that may be suitable for your organization. You are still required to minimize workplace hazards through an organization-specific risk assessment. The information in this document does not override the current provincial measures or guidance from your local health authority.
Infection Prevention - Home and Community Care

Additional Resources

Prevent the spread of infectious diseases such as COVID-19 and influenza by taking proper infection control measures in your workplace.
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More Hierarchy of Controls

Reducing exposure to communicable disease involves an approach that considers the hierarchy of controls for infection prevention to eliminate or minimize exposure in the workplace. The first step to reducing exposure is to identify and assess tasks that may result in exposure to communicable disease. Be sure to involve staff and your JOHS Committee or […]
View Hierarchy of Control
Reducing exposure to communicable disease involves considering the hierarchy of controls for infection prevention to eliminate or minimize exposure in the workplace. The first step to reducing exposure in your care home is to identify and assess tasks that may result in exposure to communicable disease. Be sure to involve staff and your JOHS Committee […]
View Hierarchy of Control
Safe resident handling involves an approach that considers the hierarchy of controls to eliminate or minimize the risk of injury in the workplace. The first step is to identify and assess tasks that may result in injury from resident handling. Be sure to involve staff and your JOHS Committee in this process. Then, using the […]
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Safe client handling involves an approach that considers the hierarchy of controls to eliminate or minimize the risk of injury in the workplace. The first step is to identify and assess tasks that may result in injury from client handling. Be sure to involve staff and your JOHS Committee in this process.  Then, using the […]
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