Personal Support Worker Program Notes (PSW) (C112) PDF

George brown college Winter Semester 2025 Email: [email protected] Personal Support Worker Program (PSW) (C112)​ ___ Notes Introduction: Role of the PSW in Client Care A personal support worker plays a crucial role in patient care. They provide direct care to the elderly and frail, the disab...

George brown college Winter Semester 2025 Email: [email protected] Personal Support Worker Program (PSW) (C112)​ ___ Notes Introduction: Role of the PSW in Client Care A personal support worker plays a crucial role in patient care. They provide direct care to the elderly and frail, the disabled, and the chronically ill, as well as those who need help with their daily activities. ​ Tasks ○​ Personal needs; bathing, eating, dressing, and also mobility. ○​ They also offer emotional support and monitor health conditions ○​ Communicate with other healthcare professionals to ensure their clients' well-being. Personal Support Workers (PSWs) need a variety of communication skills to provide care and support to patients and their families ​ Being able to provide conversation helps decrease this feeling of isolation and can improve their overall mental health. ○​ Having and maintaining a friendly demeanor ○​ Making eye contact, participating in the discussion, actively listening, and demonstrating your presence to listen are all ways to support general mental health and wellness. ○​ Active listening is a key interpersonal skill during your PSW career. It shows your clients that you are engaged and acknowledge them. ○​ Every client is unique and has various requirements, and as a PSW, you should recognize this so that you can actively listen to those needs and know how to respond appropriately.  The PSW Role ( week 1) Objectives: ​ Describe the goal of support work. ​ Identify the role of support workers within the health care team. ​ Outline the main responsibilities of support workers. ​ Differentiate between activities of daily living (ADLs) and instrumental activities of daily living (IADLs). ​ Distinguish between regulated and unregulated healthcare providers. ​ Explain the importance of understanding the roles and responsibilities of support work. ​ Highlight the significance of maintaining a professional approach to support work. ​ List the principles of client-centered care. ​ Identify key considerations for critical thinking and problem-solving. WHAT: -​ To assist and support clients ( and their families) HOW: -​ Personal care -​ Home management -​ Social and recreational activities WHEN: -​ 24/7 (shift work) WHERE: -​ Variety of settings (facility vs community) WHY: -​ Less nurses and more care needed in the home and more cost-effective What qualities should a PSW have? Week One: Infection Prevention Objectives; Be able to define: -​ Microbes, Bacteria, pathogens, and non-pathogens -​ MRO: Multiple resistant organisms -​ PPE: Personal protective equipment -​ Modes of transmission Describe: -​ The infection cycle ( risk factors, signs and symptoms, prevention of infection) -​ Hand washing guidelines -​ The chain of infection Describe: -​ The difference between standard practices and transmission-based precautions -​ How and When to use PPE -​ Cleaning, disinfection, and sterilization methods. Microorganisms -​ A form of life (organism) that is so small (micro) it can be seen only with a microscope Microbes -​ What is a microbe? How do we define microbes? This is when multiple microorganisms cannot be seen by the naked eye but underneath a microscope. Some of them are beneficial ( ex; food prep) and some are not (disease-causing) Bacteria Virus fungus Parasite Lives naturally on Infects and disrupts Lives on organic matter Gets their nourishment everything living cells Ex; humans, animals, by living off of another and plants living thing. Pathogenic ( causes They take over the Yeast and mold are Can be transmitted illness) non-pathogenic living cell and then use forms of fungi Human to Human (doesn't cause illness) it to grow and multiply. Animal to Human Multiply quickly It Can stay dormant and They are usually in Can be spread through then activate again places like: the groin, contaminated water and years later feet, and skin food. Surrounded by a hard Not treated with Athletes foot, vaginal Can sometimes be seen shell antibiotics but treated yeast infections without the use of a with antiviral microscope. Treated with antibiotics Prevented by Treated by antifungals Lice, mites and vaccination pinworms Bacteria- Single-celled microbes that naturally occur on living, dead, or inanimate objects. Pathogens- disease-causing microbes Nonpathogens- non-disease-causing microbes personal protective equipment (PPE)- Special clothing and equipment that act as a barrier between microbes and a person’s hands, eyes, nose, mouth, and clothes; includes gloves, gowns, masks, and eye protection. How do microbes grow? -​ In wet, warm and dark places -​ Can grow on the skin at body temperature, especially wet skin -​ Can live long on surfaces Multidrug-resistant organism (MRO)- A strain of bacteria that is very difficult to treat with common Antibiotics. Caused by overuse of antibiotics or not finishing treatment. MROS learns how to change your DNA and protect itself from antibiotics. Spreads easily in hospitals. Types of MROS -​ VRE Is a bacteria found in the digestive tract, but is not harmful to healthy people with strong immune systems. As the balance of healthy flora in their digestive tract keeps the bacteria from getting out of control. However, the strain of bacteria VRE has become resistant to all antibiotics including vancomycin. It is commonly spread through the hands of healthcare workers who handle patients who were colonized or infected with VRE and also deal with contaminated equipment/material. VRE is dangerous because it cannot be controlled with antibiotics, and can cause life-threatening infections in people who have compromised immune systems. Such as very young clients, very old and very ill clients. It can easily pass on the resistant gene to other more dangerous bacteria such as; Staphylococcus and Streptococcus. Other ways VRE can be spread is through contaminated surfaces; bed rails, call bells, blood pressure cuffs, and other equipment. VRE can also spread in the environment the patient is in. An example of this is when a patient has diarrhea. Prevention and protection techniques; -​ Handwashing with soap and water is one of the best defenses against VRE , frequently -​ Proper PPE (gloves)  -​ C-Diff This causes mild to severe diarrhea and can cause intestinal conditions ( which causes swelling in the colon) C-Diff is caused by a prolonged use of antibiotics, which destroy the natural flora in the stomach which gives C-Diff bacteria a place to grow. When this occurs, the C. difficile bacteria produce toxins, which can damage the bowel and cause diarrhea. However, some people can have C. difficile bacteria in their bowel and not show symptoms. Prevention and protection techniques; -​ Handwashing with soap and water is one of the best defenses against C-diff bacteria. If soap and water are not available, frequent use of alcohol-based sanitizer is encouraged. Hand sanitizer is not as effective as washing with soap and water; it does not kill the C-diff bacteria. -​ MRSA A type of bacterium that is not killed by most antibiotics. The symptoms of MRSA depend on which body system it infects. MRSA can cause; Sepsis, TSS (toxic shock syndrome), pneumonia, and necrotizing fasciitis (flesh-eating disease). Most people with MRSA do not show signs or symptoms of the infection, but carry it through the skin, Inside the nose, or in the gastrointestinal tract. A carrier with this bacteria may not carry these bacteria forever; as they can be treated with very strong antibiotics or go away on their own. Hospitals with patients who have; tubes, wounds, or incisions, are prone to MRSA because it makes it possible for these germs to spread in their bodies. This can spread by healthcare professionals in hospitals or long-term health care, due to skin to skin contact and discharging a patient that is already infected. improper hand hygiene and not wearing proper gloves after dealing with patients can cause the spread of this infection. Prevention and protection techniques; -​ Hand washing with soap and water frequently when dealing with patients with this infection -​ Wearing the proper gloves and PPE. -​ A test can be done to confirm the presence of MRSA. If the test is positive, Multiple powerful antibiotics are administered through IV. With an antibacterial soap; and gloves when needed, healthcare workers should always change them between clients. Also, healthcare workers should limit the amount of people visiting, to one. When it comes to a very ill person. Visitors also should be reminded to wash/sanitize their hands before and after visiting. Residents of long-care facilities transferred to larger hospitals are usually tested for MROS before being transferred back to their facilities. if one is found, they are isolated from the other residents. When caring for clients with a multi-drug resistant organism (MRO) in their homes, it is crucial to take specific precautions to prevent infection. While staying home does minimize the risk of infecting others, caregivers are still at risk for infection, if proper safety measures are not followed. 1.​ Familiarize yourself with the client’s care plan and required personal protective equipment (PPE). 2.​ Upon entering the home, change into appropriate footwear and store outerwear according to agency guidelines. 3.​ Use alcohol-based hand sanitizer and let it dry. 4.​ Put on the required PPE, which should be located near the front door. 5.​ If PPE is unavailable, notify your supervisor immediately and do not enter the home without it. These steps ensure both the safety of the caregiver and the proper care of the client. The spread of pathogens. Infections are caused by pathogens that invade the body, either through inanimate objects (soiled sheets) or from other individuals with communicable diseases such as; the common cold, influenza, chicken pox, hepatitis, pneumonia, and tuberculosis is caused by pathogens that spread easily. Infections can be local, affecting one body part (e.g., an infected cut), or systemic, affecting the entire body with generalized symptoms. Exposure to pathogens doesn’t always result in an infection, as the body can defend itself. There are three possible outcomes when exposed to a pathogen: 1.​ The immune system destroys the pathogen, preventing infection. 2.​ The immune system does not destroy the pathogen, but an infection does not develop. 3.​ Infection occurs if the immune system fails to eliminate the pathogen. In some cases, previous exposure to a pathogen may lead to "immunological memory," enabling the body to fight off the infection without noticeable symptoms. Older person's (signs and symptoms of infection/illness) -​ Older adults are vulnerable to infections due to age-related changes to their bodies and weakened immune systems. -​ Infections like pneumonia, influenza, and COVID-19 are more dangerous for them, as their immune response is often less robust than that of younger individuals. -​ Older persons may not exhibit common signs of infection, such as fever, pain, or swelling, because of lower body temperatures and decreased pain sensitivity. Instead, changes in behavior can be the primary indicator of infection. Signs to watch for include: -​ New or increased confusion/delirium -​ Increased nasal discharge or cough -​ New or increased incontinence -​ Loss of appetite -​ Decreased ability to perform daily activities (ADLs) -​ Increased falls -​ Changes in mood, such as becoming unusually quiet or uncooperative Signs of infection include: - Fever and chills - Increased pulse and breathing rate - Aches, pain, or tenderness - Fatigue and loss of energy - Loss of appetite - Nausea, vomiting, or diarrhea - Rash or sores on mucous membranes - Redness, swelling, or discharge with a foul odor - New or worsening cough, sore throat, or nasal symptoms - Burning or frequent urination - Behavioral changes, especially in older adults Hospital Acquired Infections (HAI) -​ is an infection patients get (acquire) after being admitted to a health care facility, or acquired from any type of health care provider. -​ Healthcare-associated infections (HAIs) are infections acquired in healthcare settings or from healthcare providers, including home care and community settings. -​ Infections like MRSA and VRE bloodstream infections have increased in recent years. Healthcare workers may develop immunity to infections through "memory cells," but these can also increase the risk of spreading pathogens to vulnerable clients. -​ Infections can spread through contaminated equipment, and workers must take precautions to minimize risk. Common HAIs include respiratory, urinary, gastrointestinal, and skin infections. Frail and older clients are particularly susceptible, so preventing the spread of infection is crucial for the healthcare team. Infections in Health Care Settings: Your Patients Are at Greater Risk **Factors That Increase Infection Risk:** - Extreme ages (very young or old) - Poor nutrition - Stress and lack of sleep - Weakened immunity due to disease (e.g., AIDS, cancer, organ transplants, kidney failure) or treatments (e.g., chemotherapy) - Certain medications - Invasive procedures (e.g., surgeries, intubation) and devices (e.g., IV lines, catheters) - Open wounds - Close contact with communicable diseases - Interaction with multiple caregivers Mode of transmission -​ mode of transmission is the way a pathogen travels to the new host. eg: direct or indirect contact, droplet, etc… Modes of Transmission and Examples of Infectious Diseases: 1.​ Contact Transmission: Microbes are spread through physical touch, either directly (skin-to-skin, personal care activities) or indirectly (touching contaminated objects like linens or equipment).​ ○​ Examples: Multidrug-resistant organisms (MROs), gastrointestinal (GI) infections, skin and wound infections. 2.​ Droplet Transmission: Microbes are spread through droplets propelled over short distances (less than 1 meter) by coughing, sneezing, or talking. Droplets can settle on others or surfaces.​ ○​ Examples: Meningitis, pneumonia, influenza (including H1N1), mumps, COVID-19. 3.​ Airborne Transmission: Microbes are spread over long distances (greater than 1 meter) via air currents in dust particles or evaporated droplets. They can travel far and be inhaled or deposited on the skin.​ ○​ Examples: Measles, chickenpox, tuberculosis (TB), SARS, febrile respiratory illness (FRI), COVID-19. 4.​ Vehicle Transmission: Microbes are transmitted through contaminated sources like food, water, medications, medical equipment, or body fluids. A single source can infect many people.​ ○​ Examples: Hepatitis A, B, and C; HIV/AIDS. Chain of infection; The Chain of Infection describes the process through which infections develop and spread. It includes six interconnected steps: 1.​ Pathogen: A microbe capable of causing disease. 2.​ Reservoir: The environment where the pathogen lives before infecting a person, such as on or in humans, animals, food, water, soil, or objects. 3.​ Portal of Exit: The route by which the pathogen leaves the reservoir, including body openings (e.g., mouth, nose) and breaks in the skin or mucous membranes. Pathogens are carried through blood, body fluids, or secretions. 4.​ Mode of Transmission: How the pathogen travels to the next host. This includes direct or indirect contact, airborne droplets, infected vehicles (e.g., mosquitoes), or contaminated objects (fomites). 5.​ Portal of Entry: The entry point into the new host, which mirrors the portals of exit. 6.​ Susceptible Host: A person at risk of infection due to a weakened immune system or lack of prior exposure to the pathogen. Breaking any link in this chain can help prevent the spread of infection. How can healthcare workers break the chain of infection? How Health Care Workers Break the Chain of Infection: ​ Understand how infections spread: Recognize the modes of transmission and points of vulnerability in the chain of infection. ​ Practice proper hand hygiene: ○​ Wash hands thoroughly using the correct technique (scrub all areas for at least 20 seconds). ○​ Use hand sanitizer when soap and water are not available, ensuring it contains at least 60% alcohol. ​ Wear personal protective equipment (PPE): Use gloves, masks, gowns, and eye protection as needed to prevent exposure. ​ Follow isolation precautions: Adhere to guidelines for contact, droplet, or airborne precautions to prevent cross-contamination. ​ Clean and disinfect equipment: Regularly sanitize tools, devices, and surfaces to remove pathogens. ​ Dispose of waste properly: Handle and discard contaminated items (e.g., needles, linens, and dressings) in designated containers to prevent spread. What do these words mean/ what are the differences Contaminated Anything that has been exposed to pathogens, does not matter if it is seen or not. (Remember microbes are so small they cannot be seen and must be put under the microscope, these can be on surfaces.) Dirty/visible soiled Anything that has visible contaminates Clean Anything with no visible contaminants Asepsis The practice of reducing or eliminating pathogens. 2 types (medical and surgical) Medical asepsis Reducing the amount of pathogen and preventing spread. ( Person to person, or place to place). This needs to be practiced by all healthcare professionals. Surgical asepsis Eliminating all microbes and their spores. ​ Standard Practices VERSUS Isolation Precautions Standard Precautions is sometimes called Routine Practices are guidelines to prevent the spread of infection from the following: -​ Blood -​ Exposure to all body fluids , secretion and excretions. Weather it is visible or not. -​ non -intact skin. (wounds, cuts, scrapes, open sores, breaks) -​ Mucous membrane (nose, mouth, vaginal, rectum) Standard Precautions now includes surgical mask and goggles/shield due to Covid-19. AGMP; Aerosol generating medical procedures. -​ Medical procedures involving the respiratory tract, and generate aerosols smaller than 5 mirons can contain the virus. -​ Particles smaller than 5 mirons require an N95 mask. -​ Patients on oxygen , ventilators. and have diffuvlty breathing and breathing tube (intubated). Standard Practices Definition: These are basic infection prevention measures applied to all individuals, regardless of their infection status. They assume that everyone could potentially carry infectious agents, even if they do not show symptoms. Transmission-Based Precautions Definition: These are additional measures used in addition to standard practices for patients or situations where a specific infection or pathogen is suspected or confirmed. These precautions are tailored to the mode of transmission of the infectious agent. Isolation precautions -​ Clients that are infected with certain pathogens are placed under isolation precautions -​ They are guidelines to contain pathogens to clients rooom/area. -​ Isolation procautions are extra precautions in addition to standard procedures. -​ It is required to wear PPE in the patients room/area -​ You will be told when this is needed for a client, check care plan and look for sign at the door. Contact precaution ​ Gloves and gowns Droplet contact ​ Gloves, gown, fluid resistant mask and eye protection. Airborne precautions ​ N95 mask required ​ Door closed Hand hygiene ( best defense against pathogens) -​ Hand hygine is a forn of medical asepsis -​ Perfroming hand hygiene correctly is the important way for healthcare workers to prevent the spread of infection 2 types of hand hygiene -​ Washing with soap and water ( should only take 15-20 secs) -​ Hand sanitation with the use of rubbing alcohol Hand Hygiene and Donning / Doffing PPE ( STEPS) -​ Hand hygiene should always be practiced after contact with bodily fluids. 1.​ Before washing your hands, you must remove all jewlery ( including rings and watches) 2.​ Long sleeves should be rolled up 3.​ Stand away from sink so uniform does not touch it 4.​ Turn water on, until its warm. Make sure the flow of water minimizes splash. 5.​ Wet both hands and wrist thoroughly ( DO NOT TOUCH SINK) 6.​ Pump liquid soap and rub into palms. Keeping elbows up and wrists down. 7.​ Rub liquid soap palm to palm, right hand over left then interlaced 8.​ the left hand over right then interlace 9.​ Rub tips of fingers to of left hand, into opposing palm, and same with right hand. 10.​ Clean under finger nails with one of your fingernails, for both hands 11.​ Rub left thumb in rotation and do the same for the right tumb. 12.​ Rub left wrist up to forearm and right wrist up to forearm 13.​ Rinse thoroughly and keep elbow down and wrist up, rinse until soap is gone 14.​ Pat dry in one direction and same with other hand and change sheets each dry. (do not ball up sheets) 15.​ Get a paper towel and turn off sink Hand washing is done; 1.​ Prior to patient contact 2.​ Prior to aseptic or clean procedures 3.​ Following body fluid exposure risk 4.​ After patient contact 5.​ Witin a procedure 6.​ Before and after removing gloves 7.​ When handling soiled linen and clothes PPE- Personal protective equipment PPE includes; -​ Gloves -​ Gowns: Gowns protect your clothes and body from blood, body fluids, secretions, and excretions. They also protect you from getting wet while you are bathing a client. -​ Masks: To protect you from contact with or inhalation of infectious agents from the client. To protect the client from infectious agents carried in your nose or mouth during sterile procedures 2 types: -​ Surgical mask: protects from droplet particles and illnesses spread by droplet -​ N95: are a particular kind of mask that filters air particles. It is worn when caring for clients with airborne illnesses (TB, measles, chicken pox). -​ N95 masks come in various shapes to fit different shaped faces. You need to be tested to ensure you are wearing the right one for your face; this is vital to ensuring that microscopic particles do not leak into your mask for you to breathe in. It is your responsibility to get N95 fitted and you wear it correctly -​ Eye protection (goggles)/ shields  Donning 1.​ Always check the clients care plan; look for special instructions and clients abilities and limitations. Incase of an isolate patient, know what protective you will need on hand. 2.​ Before you start procedure, gather all your equipment needed. Ex: (isolation gown, mask, goggles. Surgical mask, gloves and hand sanitizer.) 3.​ Before procedure, wash hands or use hand sanitizer. 4.​ To don equipment, use new gown and make it unfold naturally in front of you (NO shaking) 5.​ Put arm into sleeves and tie the neck strings at the back of the neck and waist strings facing the back. Covering you completely 6.​ Apply surgical mask with colour side on the outside and pleats facing down. 7.​ Secure elestic band by placing it over ears 8.​ Pinch nose with one hand and pull mask down. 9.​ Place goggles over face and eyes and adjust to fit 10.​Put on clean disposable gloves, extend gloves to cover wrist of gown Acornym for donning H- hands G - gown M -mask G- goggles G- gloves Doffing 1.​ If gown was tied to the front, untie strings first then remove gloves 2.​ If gown was tied to the back remove gloves then untie 3.​ Grasp outside of one glove with opposing hand, and when thats done roll nside out 4.​ Take other hand, place two fingers under and peel off the glove and cover it with the first glove, making sure youre are careul! 5.​ Discard gloves into garabge  6.​ Untie strings from neck and back, making it fall over on its own and only touching the insides of the gown. 7.​ Turn gown inside out as you did with the gloves and throw out. 8.​ Preform hand hygiene 9.​ Remove goggle and dispose in appropriate area 10.​Remove mask, making sure not to touch outside (contaminated) 11.​Remove all PPE before leaving clients room. 12.​Hand hygiene precautions and sanitization after leaving room Acornym for doffing T- Ties G - gloves G- gown H - hand sanatizer G-goggles M- mask H- hand sanitizer