{"ref":"PA-HC-IC-01","title":"Infection Control and Standard Precautions","category":"Infection control","own":false,"summary":"Sets the infection control practices every direct care worker follows in consumers’ homes: hand hygiene, standard precautions and gloves, respiratory hygiene, cleaning, laundry and food safety, work restrictions for sick workers, and what to do when a consumer has an infection or there is an outbreak in the community.","inShort":["Clean your hands when you arrive, before and after care, after gloves, before food, and before you leave.","Wear gloves for any contact with body fluids, broken skin, or soiled linen, and change them between tasks.","Do not work if you have a fever, vomiting, or diarrhea. Call the scheduler as early as you can.","Clean and disinfect bathing and toilet equipment after use, and handle soiled laundry as little as possible.","Tell your supervisor the same day if a consumer shows signs of infection.","Ask the office for supplies before you run out. They are free."],"primaryCitation":"28 Pa. Code §611.55(b)(5)","citations":["28 Pa. Code §611.55(b)(5)","28 Pa. Code §611.55(b)(6)","28 Pa. Code §611.4(c)","28 Pa. Code §611.56","35 P.S. §448.806(d.1)(5)"],"federalCitations":["29 CFR §1910.1030"],"surveyorAsks":["Ask a direct care worker: when do you wash your hands or use hand sanitizer during a visit?","What supplies does the Agency give workers, and how do they get more?","What does a worker do if they wake up with a fever or vomiting before a shift?","Show me the infection control training for this worker."],"version":"1.0","effectiveDate":"2026-10-01","reviewDate":"2027-10-01","approvedBy":"Pat Sample, Administrator","forms":[{"ref":"PA-HC-IC-01-A","title":"Infection Control Competency and Supply Checklist"}],"sections":[{"heading":"Terms of Reference","body":["This section sets out the standing under which this policy is issued, who owns it, who is bound by it, and how it is kept current. It is not itself a procedure. The obligations begin at Section 1."],"table":{"caption":null,"headers":[["Item"],["Detail"]],"rows":[[["Issued by"],["The governing body of ",{"k":"field","name":"agency.name","text":"Sample Agency, LLC"}]],[["Document owner"],[{"k":"field","name":"people.administrator.name","text":"Pat Sample"},", ",{"k":"field","name":"people.administrator.title","text":"Administrator"}]],[["Authority"],["Adopted under 28 Pa. Code §611.55(b)(5) and (6) (competency subjects \"Basic infection control\" and \"Universal precautions\"), §611.4(c) (compliance with health and sanitation standards), §611.56 and section 806(d.1)(5) of the Health Care Facilities Act (freedom from communicable disease), and the OSHA Bloodborne Pathogens Standard (29 CFR §1910.1030)."]],[["Applies to"],["Every direct care worker, supervisor, and office staff member with consumer contact, and the Administrator."]],[["Status"],["Mandatory. Adherence is a condition of employment and of any contract for services. No provision may be waived, shortened, or varied by any employee."]],[["Not covered here"],["The OSHA Exposure Control Plan, hepatitis B vaccination, and exposure incidents, which are Policy PA-HC-IC-02. Tuberculosis screening of staff, which is Policy PA-HC-HR-05. Emergencies such as a pandemic that disrupt services, which are Policy PA-HC-EP-01."]],[["Review"],["Reviewed by the document owner at least every ",{"k":"field","name":"settings.reviewFrequencyMonths","text":"12"}," months and, as the Agency’s own standard, within 30 days of any amendment to a rule cited at Section 16. Each review is recorded at Section 19 whether or not the text changes."]],[["Amendment"],["Any change requires the approval of the governing body and the issue of a new version number. Superseded versions are retained for six years from the date they were last in effect (45 CFR §164.530(j))."]],[["Distribution"],["Master copy held in the policy manual at the Agency’s licensed office at ",{"k":"field","name":"agency.address","text":"100 Example Street, Suite 100, Harrisburg, Pennsylvania 17101"},". Each person named under \"Applies to\" receives it at orientation and whenever it changes."]],[["Questions"],["Direct to the document owner on ",{"k":"field","name":"agency.phone","text":"(717) 555-0100"}," or ",{"k":"field","name":"agency.email","text":"office@example.com"},"."]]]},"edited":false},{"heading":"1. Purpose","body":["This policy protects consumers and staff of ",{"k":"field","name":"agency.name","text":"Sample Agency, LLC"}," (the \"Agency\") from infections that can spread during home care, using practical precautions based on current Centers for Disease Control and Prevention (CDC) guidance."],"edited":false},{"heading":"2. Scope","body":["This policy covers every visit to a consumer’s home or community activity, the office, and travel between homes. It applies to all infections, including colds and influenza, COVID-19, stomach viruses, skin infections, and drug-resistant organisms."],"edited":false},{"heading":"3. Definitions","body":["For the purposes of this policy, the following terms have the meanings below. 28 Pa. Code Chapter 611 calls the person served a \"consumer\"; 55 Pa. Code Chapter 52 calls a consumer who receives Medical Assistance waiver services a \"participant\". In this policy the two words mean the same person."],"table":{"caption":null,"headers":[["Term"],["Meaning"]],"rows":[[["Standard precautions"],["The CDC’s basic set of practices used with every person, every time, whether or not they are known to have an infection: hand hygiene, gloves and other protective equipment based on the task, respiratory hygiene, safe handling of soiled items, and cleaning. Standard precautions include the \"Universal precautions\" required by 28 Pa. Code §611.55(b)(6) and 29 CFR §1910.1030(d)(1)."]],[["Hand hygiene"],["Washing hands with soap and water, or rubbing them with an alcohol-based hand sanitizer."]],[["Personal protective equipment (PPE)"],["Gloves, gowns or aprons, masks, and eye protection supplied by the Agency at no cost to the worker."]],[["Communicable disease"],["An illness that can spread from one person to another."]],[["Outbreak"],["More cases of an infection than expected among consumers or staff, or any case the Department of Health or local health department tells the Agency to treat as an outbreak."]]]},"edited":false},{"heading":"4. Policy Statement (28 Pa. Code §611.55(b)(5))","body":["Every direct care worker is trained and checked on \"Basic infection control.\" and \"Universal precautions.\" (28 Pa. Code §611.55(b)(5) and (6)) before any assignment (Policy PA-HC-CMP-01). The Agency complies \"with applicable environmental, health, sanitation and professional licensure standards which are required by Federal, State and local authorities\" (28 Pa. Code §611.4(c)), including the OSHA Bloodborne Pathogens Standard (Policy PA-HC-IC-02).\n\nNo direct care worker or other staff member with direct consumer contact works with consumers without documentation that they are free from active tuberculosis and communicable disease (28 Pa. Code §611.56; 35 P.S. §448.806(d.1)(5); Policy PA-HC-HR-05).\n\nChapter 611 does not prescribe specific infection control practices. The practices in Sections 5 to 12 are the Agency’s own standards, based on CDC guidance for standard precautions. Staff use standard precautions with every consumer at every visit."],"edited":false},{"heading":"5. Hand Hygiene","body":["Hand hygiene is the most important way to prevent infection. Workers clean their hands:"],"list":[["on arrival at the home and before leaving;"],["before and after touching the consumer, and before putting on and after taking off gloves;"],["before preparing food or helping the consumer eat, and before helping with medications;"],["after toileting, incontinence care, or contact with any body fluid, soiled linen, or trash;"],["after using the bathroom, blowing your nose, coughing, or sneezing; and"],["whenever hands look dirty."]],"ordered":false,"note":["Use soap and water for at least 20 seconds when hands are visibly dirty, after contact with diarrhea, and before handling food. Otherwise, an alcohol-based hand sanitizer with at least 60 percent alcohol may be used, rubbing until dry. Keep nails short and do not wear artificial nails during care. Use the consumer’s sink with the Agency’s liquid soap and paper towels if the consumer does not have them."],"edited":false},{"heading":"6. Gloves and Other Protective Equipment","body":[],"list":[["Wear disposable gloves for any contact with blood, body fluids (urine, stool, vomit, saliva, wound drainage), mucous membranes, or broken skin; for incontinence and perineal care; for handling soiled linen or clothing; for cleaning bathrooms; and for emptying commodes or drainage bags."],["Change gloves between tasks (for example, after toileting and before helping with dressing) and when they tear. Never wash or reuse disposable gloves. Clean hands after removing them."],["Wear a gown or apron when clothing could be soiled, and a mask and eye protection when splashing is likely (for example, cleaning up vomit)."],["Wear a well-fitting mask when the consumer or the worker has respiratory symptoms, when the consumer’s physician or the health department recommends it, and as the Agency directs during community outbreaks."],["Remove PPE before leaving the home, place it in a bag, and put it in the consumer’s trash, then clean hands."]],"ordered":false,"edited":false},{"heading":"7. Respiratory Hygiene and Vaccination","body":[],"list":[["Cover coughs and sneezes with a tissue or your elbow, throw the tissue away, and clean your hands."],["Help consumers who are coughing to do the same, and offer them a mask if they are willing."],["The Agency encourages all staff to keep up to date with vaccinations recommended by the CDC for health care personnel, including the annual influenza vaccine, and gives staff information on where to obtain them. Hepatitis B vaccination is offered under Policy PA-HC-IC-02."]],"ordered":false,"edited":false},{"heading":"8. Cleaning, Laundry, and Waste in the Home","body":[],"list":[["Clean and disinfect items used in personal care (shower chairs, commodes, bedpans, basins, grab bars) after each use, using a household disinfectant the consumer provides or the Agency supplies, following the label directions."],["Clean from cleaner areas to dirtier areas, and clean the bathroom and kitchen surfaces the consumer uses."],["Handle soiled linen and clothing as little as possible, hold it away from your body, and do not shake it. Put it straight into the washer or a bag. Wash in the warmest water the fabric allows and dry completely."],["Clean up spills of blood or body fluids promptly with gloves and disposable towels, then disinfect, as Policy PA-HC-IC-02 directs."],["Put used gloves, incontinence products, and dressings the consumer has removed in a plastic bag, tie it, and place it in the household trash. Needles and other sharps belonging to the consumer are handled only as Policy PA-HC-IC-02 directs."],["Do not use a consumer’s personal items (towels, razors, toothbrushes) for anyone else, and do not bring personal items from one home to another."]],"ordered":false,"edited":false},{"heading":"9. Food Safety","body":[],"list":[["Clean hands, surfaces, and utensils before and after preparing food."],["Keep raw meat, poultry, and eggs away from ready-to-eat foods, and use separate cutting boards where possible."],["Cook foods to safe temperatures, and refrigerate leftovers promptly."],["Check dates and throw away spoiled food only with the consumer’s agreement; tell the supervisor if the consumer often keeps spoiled food, as this can be a change in condition (Policy PA-HC-SAF-02)."],["Follow any special diet in the service plan."]],"ordered":false,"edited":false},{"heading":"10. When a Worker Is Sick","body":["A worker who is ill must not go to a consumer’s home. The worker calls the scheduler as early as possible so the visit can be covered (Policy PA-HC-SVC-01). As the Agency’s own standards:"],"table":{"caption":null,"headers":[["If the worker has"],["Stay away from consumers until"]],"rows":[[["Fever (100.0°F or higher)"],["At least 24 hours with no fever without fever-reducing medicine, and other symptoms are improving."]],[["Vomiting or diarrhea"],["At least 48 hours after symptoms stop."]],[["Respiratory illness (cough, sore throat, runny nose) without fever"],["Symptoms are improving. The worker may return sooner only if the supervisor approves and the worker wears a mask for the rest of the illness."]],[["A positive test for COVID-19 or influenza"],["The supervisor confirms return under the CDC guidance current at the time."]],[["Pink eye, an open or draining skin wound or rash, shingles that cannot be covered, scabies, or lice"],["A health care professional says the worker may return, or the condition is treated and no longer spreadable."]],[["Symptoms of tuberculosis or a tuberculosis exposure"],["Policy PA-HC-HR-05 is followed."]],[["Any other communicable disease, or uncertainty"],["The supervisor decides, and may require a note from a health care professional."]]]},"note":["Workers are not penalized for staying home when sick under this policy."],"edited":false},{"heading":"11. When a Consumer Has an Infection, and Outbreaks","body":[],"list":[["A worker who notices signs of infection in a consumer (fever, new cough, burning on urination, new confusion, redness or drainage from the skin, diarrhea) tells the supervisor the same day as a change in condition (Policy PA-HC-SAF-02). The supervisor contacts the representative and encourages the consumer to contact their physician."],["If a consumer has an infection that spreads easily (for example, influenza, COVID-19, a stomach virus, scabies, or a drug-resistant organism the consumer’s physician has identified), the supervisor tells the assigned workers, without sharing more health information than they need, and makes sure they have the right PPE. Where possible, the same worker is assigned for the rest of the illness."],["The Agency follows any instructions from the Pennsylvania Department of Health or the local health department during an outbreak or public health emergency. If the Administrator learns that a consumer or staff member has a disease the health department is tracking, the Administrator contacts the local health department or the Department of Health for instructions and keeps a record of the advice."],["A significant disruption of services caused by an outbreak is handled under Policy PA-HC-EP-01."]],"ordered":false,"edited":false},{"heading":"12. Supplies","body":["The Agency supplies, at no cost to workers, disposable gloves in each worker’s size, alcohol-based hand sanitizer, masks, gowns or aprons, eye protection, liquid soap and paper towels where needed, disinfectant wipes, and plastic bags. Workers check their supplies on Form PA-HC-IC-01-A and ask the office for more before they run out. Supervisors check supplies during supervisory visits (Policy PA-HC-CMP-02)."],"edited":false},{"heading":"13. Responsibilities","body":["Accountability under this policy is allocated as follows."],"table":{"caption":null,"headers":[["Role"],["Responsibility under this policy"]],"rows":[[[{"k":"field","name":"people.administrator.name","text":"Pat Sample"},", ",{"k":"field","name":"people.administrator.title","text":"Administrator"}],["Owns this policy; keeps it in line with current CDC guidance; decides on return to work when needed; contacts the health department during outbreaks."]],[["Supervisors"],["Check infection control practice during supervisory visits; act on reports of consumer infections; brief workers."]],[["Office staff"],["Keep PPE and supplies in stock and issue them promptly; arrange cover when a worker is sick."]],[["Direct care workers"],["Follow this policy at every visit; report illness before a shift; report signs of infection in consumers."]]]},"edited":false},{"heading":"14. Records and Compliance Monitoring","body":["Infection control competency is documented in each worker’s file (Policy PA-HC-CMP-01). Supply checks (Form PA-HC-IC-01-A), supervisory visit findings (Form PA-HC-CMP-02-A), and the Administrator’s records of health department advice are kept for six years, as the Agency’s own standard. Each quarter the Administrator reviews worker illness absences, consumer infections reported, and supervisory findings for trends and reports them under the quality management plan (Policy PA-HC-QM-01)."],"edited":false},{"heading":"15. Staff Training","body":["Basic infection control and universal precautions are part of competency training (28 Pa. Code §611.55(b)(5) and (6); Policy PA-HC-CMP-01) and of the annual training plan (Policy PA-HC-TRN-01), with a hand hygiene and glove removal skills check each year as the Agency’s own standard."],"edited":false},{"heading":"16. References","body":["This policy implements the following authorities."],"list":[["28 Pa. Code §611.55(b)(5) and (6), Competency requirements"],["28 Pa. Code §611.4(c), Requirements for home care agencies and home care registries"],["28 Pa. Code §611.56, Health screening"],["Health Care Facilities Act §806(d.1)(5) (35 P.S. §448.806(d.1)(5))"],["29 CFR §1910.1030, Bloodborne pathogens"],["Centers for Disease Control and Prevention, standard precautions and hand hygiene guidance for health care settings (current edition)"]],"ordered":false,"edited":false},{"heading":"17. Related Policies and Forms","body":["The following documents are read together with this policy."],"table":{"caption":null,"headers":[["Reference"],["Title"]],"rows":[[["Policy PA-HC-IC-02"],["Bloodborne Pathogens Exposure Control Plan"]],[["Policy PA-HC-HR-05"],["Health Screening and Tuberculosis"]],[["Policy PA-HC-CMP-01"],["Direct Care Worker Competency Requirements and Training Program"]],[["Policy PA-HC-CMP-02"],["Supervision and Annual Competency Review of Direct Care Workers"]],[["Policy PA-HC-TRN-01"],["Annual Staff Training"]],[["Policy PA-HC-SAF-02"],["Medical Emergencies, Advance Directives, and Changes in Condition"]],[["Policy PA-HC-SVC-01"],["Scheduling, Missed Visits, and Backup Coverage"]],[["Policy PA-HC-EP-01"],["Emergency Preparedness and Continuity of Services"]],[["Policy PA-HC-QM-01"],["Quality Management Plan"]],[["Form PA-HC-IC-01-A"],["Infection Control Competency and Supply Checklist"]]]},"edited":false},{"heading":"18. Approval","body":["This policy is adopted by the governing body of ",{"k":"field","name":"agency.name","text":"Sample Agency, LLC"},". The effective date, the person who approved it, and the date of approval are shown in the header block and recorded in the signature lines below."],"edited":false},{"heading":"19. Revision History","body":["Every version of this policy, the date it took effect, a summary of what changed, and who approved it is recorded below. Where a rule cited in Section 16 is amended, the amendment is recorded in this table and a new version of this policy is issued."],"edited":false}],"missing":[],"editedCount":0,"pack":"pa-hca","state":"Pennsylvania","service":"Home care","guides":[{"path":"/guides/infection-control-policy/","h1":"What should a home care infection control policy include?"},{"path":"/guides/home-care-agency-policies/","h1":"What policies does a home care agency need?"}],"sample":true,"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}