Current Employee Test #4: Sanitation

Maintaining sanitary practices in your duties while caring for Homewell Senior Care and Five Star Home Health Care clients is expected of you and will determine if you will receive assignments from Homewell Senior Care and Five Star Home Health Care. This in-service will review practices you should be using in your care of clients. The spread of germs can cause illness in your clients. Poor food handling can lead to food poisoning causing hospitalization and even death in severe cases. Your client’s are at a great risk for contracting infections and it is your job to prevent the client from contracting disease from unsanitary practices and poor home conditions

Food Handling
do not buy foods that are near or past their expiration date
do not buy dented or swollen cans
place meat in plastic bags and pack separately from fresh foods
do not buy meat or fish that has a funny color or odor
do not buy perishable foods in outdoor markets unless they have been refrigerated properly
do not leave meat, dairy or other perishable foods in the car, take it right home and put it away promptly
do not re-freeze food that has defrosted

Food handling tips-
thaw frozen meat in the refrigerator not on the counter
use the defrost setting on the microwave if you need to defrost quickly
be sure the refrigerator temperature is 40 degrees or lower
put meat on a plate to defrost so that it does not drip onto other foods
do use cutting boards, utensils or knives on fresh produce or other foods after it has been in contact with raw meat
wash cutting boards thoroughly with soap and water after cutting raw meats or fish
wash your hands before handling foods
wash your hands after handling raw meat, fish or eggs
cook meats to a safe temperature (beef 160 degrees and chicken 165 degrees)
do not leave foods out more than 2 hours, 1 hour on a hot day- if foods are out longer than this discard them
clean kitchen counters and food preparation areas after use
a bleach soln of ½ cup bleach to 1 gallon of water is a good germ fighter
do not touch the inside of drinking glasses or the tops of plates that you will be serving the client
do not touch the eating surfaces of forks and spoons that the client will use to eat
wash dishes in the dishwasher or with warm soapy water
only use dishwasher detergent made for the dishwasher in dishwashers never use regular dish soap
check foods like flour for bugs before using
report insects etc in the kitchen area
check the refrigerator for expired foods and throw them out
always check products your are about to serve for expiration dates
wrap foods tightly before placing in the refrigerator especially leftovers
throw out leftovers after 72 hours
do not serve leftovers that have a funny odor or appearance
dry foods such as cookies, crackers and cereals should be sealed between use
check breads for mold before serving throw out moldy breads- mold may be white or green and is easily noted on the bread products

Microwave safety
When microwaving foods all plastics are not equal. Microwave dinners that come in containers with instructions to microwave are generally safe to use in the microwave. Many others are not safe and can breakdown in the microwave and cause toxins to leach into foods. Plastics must be free of PVC’s to be safe

What’s safe to use in the microwave
heat proof glass like Pyrex
glass ceramics like Corning Ware
oven cooking bags
straw and wood bread baskets lined with paper towels
UNPRINTED paper plates, towels and napkins (ink from prints will leach into food)
wax paper or parchment paper
heavy plastic wrap as long as it does not touch the food
glass, porcelain and china dishes without metallic trim

What’s not safe for the microwave
margarine, yogurt, or whipped topping containers
recycled paper products
anything metal
take out containers with metal handles
metal twist ties
aluminum foils
any container that warps during heating
Styrofoam containers or plates

Burn prevention
vent plastic covers in the microwave to prevent steam burns
use caution when heating water it can become superheated and explode from the container
use caution when heating foods with high sugar or fat contents as they heat very quickly
never warm baby’s bottles in the microwave they heat unevenly and can make pockets of scalding liquid that can burn the baby’s mouth and throat
use caution when opening microwave packets allow the steam to dissipate before opening

Kitchen cleanliness-
use an antibacterial cleaner or dilute bleach soln to clean up the kitchen
wash your hands frequently while working in the kitchen
after meal prep the counter and stove or inside of the microwave should be cleaned
always clean cutting boards after use and if you are not sure before use, never use the same cutting board after using it to prepare meats until it is cleaned and sanitized
dish cloths should be changed and washed daily never use a kitchen dish cloth to clean ANYTHING else it remains in the kitchen
dishtowels should be changed and washed daily
sponges should be washed in the dishwasher and changed frequently, do not use if they look dirty or smell funny
wipe down refrigerator shelves frequently
throw out expired foods and leftover that are 72 hours old
dishes should be washed in warm soapy water and rinsed unless there is a dishwasher then rinse dishes and use dishwasher
use a dishcloth or sponge to clean dishes do not put your hand inside glasses
be sure ice trays are clean and refilled often
the kitchen should be swept daily
kitchen floors need to be damp mopped weekly
dirty water from cleaning and mopping should be discarded in the toilet not down sinks or tubs.
Do not allow dirty dishes to pile up in the sink

Cleaning the bedroom-
dust furniture (use a clean cloth not used in the kitchen)
vacuum (empty and change vacuum bags that are ¾ full)
pick up dirty laundry and launder
hang up clean clothing
be sure there is no clutter that the client can trip over especially at night
change linens as needed (at least weekly) (more frequently for incontinent clients or those who request it)
do not shake linens wrap them up and wash in the laundry
be sure the appropriate linens are on the bed for the season and temperature clients may need an extra blanket in cold weather

Cleaning the bathroom-
use a cloth or sponge that is only used for the bath room
disposable cloths or paper towels are preferred for the bathroom
hang up towels and washcloths
clean the mirrors first then the sink and tub and finally the toilet
do use sponges or cloths on sinks or tubs after cleaning the toilet
throw out empty shampoo bottles etc
be sure the clients toothbrush is clean and in good shape or change it
keep the toothbrush in a toothbrush holder or a covered container do not leave it out lying on the sink
be sure denture cups are cleaned and sanitized between uses
use gloves when handling toothbrushes and dentures as well as denture cups
clean the toilet last wiping down the outside of the toilet and under the seat
be sure the seat is secure and not loose or broken
sweep and damp mop the floor
flush dirty cleaning water down the toilet
wash the commode bucket in the bathroom all commode contents and cleaning water are flushed down the toilet NEVER in the sink or tub
bedpans contents and cleaning water are also flushed down the toilet NEVER the sink
commode buckets are NEVER used for any purpose except in the commode
urinals are emptied and washed flushing urine and water down the toilet NEVER the sink
containers used to empty foley catheters are always emptied down the toilet, rinse with water and soap if needed and empty down the toilet NEVER the sink- these containers are NEVER used for any other purpose

Cleaning the living area-
dust furniture surfaces and vacuum the floor frequently
pick up items and return them to their proper place
be sure throw rugs are not a fall hazard for clients
keep walking paths free of items that could trip the client
use water proof pads on furniture if the client is incontinent
report urine stains on upholstered furniture

Hygiene tips for providing client personal care
toothbrushes and denture cups should be kept in a clean dry area
wash your hands before and after oral care and wear gloves
oral care should be provided at a minimum of 2 times a day
toothbrushes should be changed frequently and always after a cold or flu type illness
if the client can not go to the sink a separate basin should be used for rinsing the mouth, wash the basin with soap and water after use
assist clients in the bathroom as needed
be sure the help the client wash their hands after using the bathroom
wash your hands and wear gloves when helping a client in the bathroom
wash your hands and wear gloves while bathing clients
when bathing the client uses clean washcloths and start at the face washing the eye area first start with the eye farthest from you
wash limbs from closest to the body to the farthest away
change water when dirty or if it is cold
always change water and wash cloths after washing the perineal area
always wash the cloths after providing perineal care do not re use
wash female perineal areas from front to back to avoid contamination of the urethra or vagina from fecal matter
when bathing uncircumcised males, retract the foreskin and wash in a circular motion away from the urethral opening
clean the bathroom and basin after bathing
dirty water from wash basins should be flushed down the toilet

Handling equipment-
Clients may have several different types of equipment that will require cleaning. If you are unsure of how to clean any equipment call the office for assistance. Remember to wash your hands before and after cleaning and wear gloves when cleaning equipment

Wheelchairs, walkers, canes, hoyer lifts and crutches, – wipe down with soap and water be sure to dry the items before the client uses them and be sure you do not create a puddle under the items that could cause a fall hazard for the client

Hospital beds – keep the frame free of dust, wipe the side rails down with damp cloth and soap if needed- wash mattresses with soap and water during linen changes if the client is incontinent- keep linens clean and dry change as needed, use caution when using water near the electric controls and always unplug the bed if you are washing down the controls

Oxygen tanks – wipe down with a damp cloth

Oxygen concentrators- UNPLUG the machine before wiping it down with a damp cloth to remove dust or dirt. Clean filters on the side or back of the machine daily with soap and water, wring out and return to the machine (some newer machines have internal filters that you will not need to clean) BE SURE TO KEEP THESE FILTERS CLEAN DIRTY FILTERS CAN CAUSE THE MACHONE TO OVERHEAT AND CREATE A FIRE HAZARD AND DIRTY FILTERS WILL LIMIT THE AMOUNT OF OXYGEN THAT THE CLIENT RECIEVES AND CAN CAUSE REPIRATORY DISTRESS

Humidifier bottles mostly found on concentrators but can be on tanks and other respiratory equipment. Rinse out bottles when refilling, look for build up of minerals in bottle or a slimy film in the bottle. Bottles can be soaked in a 2/3 water and 1/3 white vinegar solution to sanitize and clean- keep the water level between the two lines on the bottle, do not under fill or overfill which will interrupt the normal flow of oxygen. There should be spare bottles available to change out if needed. Bottles should be changed after a respiratory illness such as a cold or the flu

Nebulizer’s- the nebulizer should be unplugged and wiped down with a damp cloth. The nebulizer cup should be disassembled after use and washed with soapy water, rinsed and set out on paper towels to dry thoroughly between uses. The cup should be soaked in a 1/3 white vinegar and 2/3 water solution for 20 minutes once a day. There should be spare cup in the home and they should be changed out at least monthly and after a respiratory illness

Bedside commodes – rinse commode bucket between uses and flush contents down the toilet. The bucket is never used for any other reason than toileting the client or emptying foley catheters. Wash the bucket with soap and water daily and as needed and flush contents down the toilet. Never rinse water from bucket into the tub or a sink

Shower chairs – shower chairs should be rinsed after use and washed thoroughly with soap and water weekly and if soiled

Glucometer’s- when handling glucometer’s wash your hands before and after touching the machine and wear gloves. The machines may have traces of blood on them. Do not handle needles used for blood testing, the client must dispose of needles into puncture proof containers. You should wipe down the machine and case daily with a damp cloth. Do not get water or dampness near the opening for the test strip

Floor care-Floors should be vacuumed or swept daily and tile or vinyl floors damp mopped weekly or more frequently if soiled. Dirty water from floor care is discarded in the toilet not in the sink or tub. Always be sure floor surfaces are clean and not slippery or soiled. Mop up spills right away to prevent falls.

Handling trash-
do not handle trash if you see needles in the trash
do not put hands or feet into trash cans to mash down the trash
do not look through the trash with your hands
carry trash away from you body
wear gloves and wash your hands when handling trash