THE UNIVERSITY OF THE WEST INDIES
FACULTY OF MEDICAL SCIENCES
THE UWI SCHOOL OF NURSING, MONA
BACHELOR OF SCIENCE IN NURSING
ACADEMIC YEAR 2013/2014 YEAR 1 SEMESTER 1
COURSE OUTLINE
COURSE TITLE
COURSE CODE
DURATION
CREDITS
CO-REQUISITE
:
:
:
:
:
PATIENT AND HEALTH CARE WORKER SAFETY
NURS
75 Hours
3 (2 Theory, 1 Lab)
Microbiology
COURSE DESCRIPTION
This theory and clinical practice course provides the student with key concepts and principles of
infection prevention and control, injection safety, and blood safety, which are fundamental to
safe nursing practice.
LEARNING OUTCOMES
At the end of the course, the student will be able to:
1. Review the epidemiology of disease transmission;
2. Demonstrate knowledge of the spread of organisms in health care settings;
3. Apply concepts of microbiology to infection prevention and control;
4. Analyze factors that influence the outcome of an exposure;
5. Demonstrate knowledge of the main components of infection prevention and control;
6. Understand the policies and guidelines of infection prevention and control;
7. Explain the benefits to patients and health care workers of adhering to scientifically accepted
principles and practices of infection prevention and control;
8. Explain the nurse’s responsibility for monitoring compliance of infection prevention and
control practices of those for whom she/he is responsible;
9. Recognize strategies for preventing transmission of pathogenic organisms;
10. Describe circumstances requiring use of personal protective equipment and other barriers to
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Patient and Health Care Worker Safety
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prevent patient or health care worker contact with potentially infectious material;
11. Describe specific practices and settings that increase the opportunity for exposure to health
care workers and patients.
12. Understand occupational control measures and their hierarchy;
13. Demonstrate knowledge of the application of these controls measures and hierarchy in the
prevention and management of exposures;
14. Recognize occupational health strategies for preventing bloodborne diseases and other
communicable diseases in health care workers.
UNIT 1
Hours :
:
MAJOR COMPONENTS OF INFECTION PREVENTION
& CONTROL
5 Theory
5 Practical
Specific Objectives
At the end of the unit, the student will be able to:
1. Review the modes and mechanisms of transmission of pathogenic organisms in the health care
setting;
2. Define major concepts of infection prevention and control;
3. List the main components of infection prevention and control;
4. Discuss each component listed above;
5. Identify specific barriers or personal protective equipment for patient and healthcare worker
protection from exposure of potentially infectious material;
6. Discuss the importance of the correct application of reprocessing methods for assuring the
safety and integrity of patient care equipment;
7. Discuss the creation and maintenance of a safe environment for patient care through
application of infection prevention and control policies and guidelines.
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Content
1. Review of modes & mechanisms of transmission of pathogenic organisms in the health care
settings
2. Definition of terms

Asepsis

Medical asepsis

Surgical asepsis

Aseptic technique

Isolation

Reverse isolation

Barrier

Barrier nursing

Nosocomial infection

Bloodborne pathogens/disease

Universal precautions

Standard Precautions

Basic precautions

Transmission-based precautions

Air-borne precautions

Droplet precautions

Contact precautions

Personal protective equipment (PPE)
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3. Main components of infection prevention & control

Isolation

Standard Precautions

Transmission-based Precautions

Disinfection & Sterilization

Housekeeping

Health Care Waste Management

Risk Management
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UNIT 2
Hours
:
:
MANAGEMENT OF INFECTION PREVENTION & CONTROL
10 Theory
20 Practical
Specific Objectives
At the end of the unit, the student will be able to:
1. Discuss levels of responsibility for infection prevention and control;
2. Identify the individual’s professional responsibility for maintaining a safe patient care
environment;
3. Discuss the quality assurance framework for infection prevention and control;
4. Outline the use of occupational controls to reduce the opportunity for patient and health care
worker contact with potentially infectious material for bloodborne pathogens.
Content
1. Levels of responsibility

Ministry of Health

Parish

District

Health care facility

Community

Individual

Health professionals educational institutions

Regulatory Bodies

Professional Associations
2. Quality assurance framework

Infection prevention & control policies

Roles & responsibilities of
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3. Occupational control measures & hierarchies

Elimination of hazards

Work practice controls

Administrative controls

Engineering controls

Personal protective equipment.
UNIT 3
Hours
:
:
INJECTION SAFETY
5 Theory
15 Practical
Specific Objectives
At the end of the unit, the student will be able to:
1. Define the term injection safety;
2. Explain the World Health Organization/Safe Injection Global Network (WHO/SIGN)
strategies for injection safety;
3. Identify the nine ‘rights’ of injection safety;
4. Discuss ‘best’ practices for injection safety;
5. Discuss adverse events associated with injections;
6. Discuss the role of the provider, administrator, and receiver of injections;
7. Discuss the role of the community in injection safety;
8. Discuss the management process for health care workers with needlestick and other sharps
injuries.
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Content
1. Definition of term injection safety
2. WHO/Safe Injection Global Network (SIGN) safe injection strategies

Behaviour change of patient & health care workers

Availability of essential supplies & equipment

Appropriate & safe waste disposal
3. Nine ‘rights’ of injection safety

Right patient

Right drug

Right formulation

Right injection equipment

Right dosage

Right time

Right route

Right storage

Right method of disposal
4. ‘Best’ practice

Definition

Associated activities
5. Adverse events

Definition

Types

Management
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6. Roles & responsibilities of

Prescriber of injections

Provider/administrator of injections

Receiver of injections

Community
7. Needlestick& other sharps injuries

Definition

Post-exposure prophylaxis (PEP) management.
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UNIT 4
Hours
:
:
BLOOD SAFETY
10 Theory
5 Practical
Specific Objectives
At the end of the unit, the student will be able to:
1. Define blood transfusion related terms;
2. Describe the various blood products, uses & storage;
3. Explain the ‘rights’ of blood transfusion;
4. Explain the hospital standard operation procedures for the blood transfusion process;
5. Discuss the respective roles and responsibilities of clinical and blood bank staff in ensuring the
safety and availability of blood products for transfusion;
6. Discuss the hospital procedure for ordering, collection, storage, transportation and
administration of blood products, and for monitoring the transfused patient;
7. Identify the reactions and infections resulting from blood transfusion;
8. Discuss the management of blood transfusion reactions.
Content
1. Definition

Blood products

Rhesus factor

ABO groups

ABO blood groups antigens & antibodies

Compatibility

Incompatibility

Blood cold chain
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2. Blood & blood products uses & storage conditions

Types

Uses

Storage
3. ‘Rights’ of blood transfusion

‘Right’ blood

‘Right’ patient

‘Right’ time

‘Right’ environment
4. Hospital standard procedures (SOP) for blood transfusion process

Ordering blood & blood products for elective surgery

Ordering blood & blood products in an emergency

Completing blood request form

Taking pre-transfusion sample

Collecting blood & blood products from blood bank

Storing & transporting blood &blood products including storage in clinical area

Identity checks
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
Administering blood &blood products including final patient identity check

Recording transfusion in patient records

Monitoring process for transfused patient
ing transfusion

Monitoring information

At each stage, record the following
tal signs: TPR, B/P

Record
e effects
5. Roles & responsibilities of clinical & blood bank staff in blood safety & availability
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6. Hospital procedure for ordering, collection, storage, transportation & administration of blood
products,& for monitoring the transfused patient
7. Reactions of blood transfusion
a. Acute complications
Category 1: Mild reactions
Moderate–severe hypersensitivity (severe urticarial reactions)
Category 2: Moderately severe reactions

Febrile non-haemolytic reactions:

Possible bacterial contamination (early signs)

Pyrogens
Category 3: Life threatening reactions

Acute intravascular haemolysis

Bacterial contamination & septic shock

Fluid overload

Anaphylactic reactions

Transfusion-associated lung injury
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b. Delayed complications
Categories
i. Transfusion-transmitted infections

HIV-1 &HIV-2

HTLV-I & II

Viral hepatitis B & C

Syphilis

Chagas disease

Malaria

Cytomegalovirus

Other rare infections: e.g. human parvovirus B19 & hepatitis A
ii. Other delayed complications of transfusion

Delayed haemolytic reaction

Post-transfusion purpura

Graft vs. host disease

Iron overload (in patients who receive repeated transfusions)
8. Infections resulting from blood transfusion

Screening

Infections
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-Jakob disease (CJD)
9. Management & investigations of blood transfusion reactions according to category

Signs & symptoms

Investigation

Prevention

Management

Recording

Reporting.
Teaching/Learning Methodologies
 Lecture/Discussion
 PowerPoint presentation
 Demonstration
 Case study
 Video presentations
 Role plays
Areas used for Learning
 Classroom
 Library
 Clinical Learning Centre (Nursing Skills Laboratory)
 Clinical areas
Learning Experiences

Visits to clinical areas to observe injection safety

Visits to Blood Bank to observe blood collection and storage process
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Required Skills
1. Hand hygiene
2. Standard Precautions
COURSE ASSESSMENT
IN COURSE ASSESSMENT 40%
A. GROUP PROJECT AND INDIVIDUAL REFLECTIVE PAPER 20%
This is a written assignment that is due for submission by week 7.
B. MID SEMESTER EXAMINATION 20%
This consist of a thirty items multiple choice examination to be administered under strict
examination conditions during week 8.
FINAL EXAMINATION 60%
This will be a one hundred items multiple choice examination.
Required Reading
International Labour Organization (ILO). (2005). Joint ILO/WHO guidelines on health services
and HIV/AIDS. Geneva: Author.
Reid, Una V. (2008). Manual of infection prevention and control policies and guidelines. Port of
Spain, Trinidad & Tobago: Author. Available on the Internet.
WHO/AFRO/JSI/ Reid, Una V.: (2005). DO NO HARM: Injection safety in the context of
infection prevention and control. Facilitators’ guide. Washington, DC: Author.
WHO/Una V. Reid (2008). WHO best practices for injections and related procedures toolkit.
Geneva: Author.
Recommended Reading
Berman, A., Synder, S., Kozier, B. &Erb, G. (2008). Fundamentals of nursing: Concepts,
process and practice. (8the.d.). New Jersey: Pearson Prentice Hall.
WHO.(2011). Patient safety curriculum guide.Multi-professional edition. Retrieved from
http://whqlibdoc.who.int/publications/2011/9789241501958_eng.pdf
WHO websites on Blood Safety, Injection Safety, Infection Prevention & Control
CDC websites: topic related.
UWISON BScN/2013: Year 1: Semester 1 (VHF)
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THE UNIVERSITY OF THE WEST INDIES
FACULTY OF MEDICAL SCIENCES
THE UWI SCHOOL OF NURSING, MONA
BACHELOR OF SCIENCE IN NURSING
ACADEMIC YEAR 2013/2014 YEAR 1 SEMESTER 1
COURSE TITLE:
COURSE CODE:
CREDITS:
PATIENT AND HEALTH CARE WORKER SAFETY
NURS
3
CO-REQUISITE:
Microbiology
COURSE ASSESSMENT
IN COURSE ASSESSMENT 40%
A. GROUP PROJECT 20%
DATE GIVEN: WEEK2
DATE DUE: WEEK 8 OCT. 25, 2013 AT 2-3PM
This will require that the students visit selected wards at the hospital/health centre.
Purpose
This assignment will allow students to use the recommended WHO and SIGN policies and guidelines for
blood and injection safety to analyze the infection prevention and control practices in effect at selected
health care institutions.
General instructions
1. The paper should be typed using Times Roman, size 12 font, and be double- spaced.
2. Use the American Psychological Association (APA), 6th edition, style of referencing.
o The following Uniform Resource Locator (URL) may be useful to the student in
meeting this requirement – http://owl.english.purdue.edu/owl/resource/560/01/
3. The page limit should be 8 pages, excluding title and reference pages.
4. The anti-plagiarism policies of the university apply. You are required to submit a signed declaration
along with the completed project.
Guidelines for project: In groups of 5-6 persons, students are required to:



Describe the recommended WHO and SIGN infection prevention and control policies and
guidelines that will reduce the risk of patients and health care workers becoming exposed to
blood borne illnesses and needle stick injuries
Describe the institutions policies and practices related to the “blood cold chain”
Explain the institution’s policies and practices related to ordering, collecting, storing,
transporting and administering blood/blood products, as well as for monitoring the patient
being transfused
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

Explain the institution’s policies for the management of blood transfusion reactions and needle
stick injuries
Critically analyze the policies and practices of the institution as they relate to compliance with
recommendations by WHO and SIGN for blood and injection safety
ALLOCATION OF MARKS FOR GROUP ASSIGNMENT
Content inclusive of critical analysis/discussion 12 %
Use of Evidence (in text citation)
3%
References (at least six)
3%
Format
2%
Total
20 %
B. MID SEMESTER EXAMINATION 20%
This will be a thirty items multiple choice examination that will be administered on Friday
October 18, 2013 from 9am – 10:00amunder strict examination conditions. This
examination will include content covered in units one and two of the course, inclusive of the
clinical skills.
FINAL EXAMINATION 60%
This will be a 100 items multiple choice examination covering all the units taught in the course.
The examination will be for 2 hours.
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THE UNIVERSITY OF THE WEST INDIES
FACULTY OF MEDICAL SCIENCES
THE UWI SCHOOL OF NURSING, MONA
BACHELOR OF SCIENCE IN NURSING
ACADEMIC YEAR 2013/2014 YEAR 1 SEMESTER 1
PATIENT AND HEALTH CARE WORKER SAFETY
RUBRIC TO ASSESS THE CONTENT FOR GROUP ASSIGNMENT
Score
Awarded
ASSESSMENT CRITERIA
Possible Score
1.
6marks
At least 2 policy
statements/guidelines for
each area
6 marks
At least 2 safe practice
standard for each area
RECOMMENDED STANDARDS
1.1 WHO & OR SIGNinfection prevention and control
policies and guidelines related to
REMARKS
a) Blood borne illnesses---------------------------------b) Needle stick injury-------------------------------------c) Nosocomial infections (YEAR 1 STDS)
1.2 SAFE PRACTICES TO PREVENT
a) Blood borne illnesses
b) Needle stick injuries
c) Nosocomial infections (YEAR 1 STDS)
2.
3.
INSTITUTIONS POLICIES& PRACTICESRE: BLOOD
PRODUCTS (YEARS 1 & 3 STUDENTS)
a) Ordering --------------------------------------------------b) Collecting ------------------------------------------------c) Transporting ---------------------------------------------d) Storing ----------------------------------------------------e) Transfusing------------------------------------------------
10 marks
One policy statement and
one
observation/feedback
from staff related to
practices for each aspect
6 marks
Two observations related
to each area
6 marks
Any three
policy/guidelines with
explanation/rationale for
policy or guidelines
INSTITUTIONS PRACTICES RELATED TO THE PREVENTION
OF: (YEARS 1 & 3 STUDENTS)
a) Blood borne illnesses
b) Needle stick injuries
c) Nosocomial infections
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12 marks
4.
INSTITUTIONS POLICIES/GUIDELINESRE: MANAGEMENT OF
BLOOD TRANSFUSION REACTIONS (YEARS 1 & 3
STUDENTS)
5. CRITICAL ANALYSIS OF POLICIES AND PRACTICES OF THE
INSTITUTION RELATED TO THE PREVENTION OF BLOOD BORNE
ILLNESS, NEEDLE STICK INJURY AND NOSOCOMIAL INFECTION
(COMPARE AND CONTRAST POLICIES AND PRACTICES WITH
LEVEL OF COMPLIANCE WITH WHO & SIGN
RECOMMENDATIONS) ----------------------(YEARS 1 & 3
STUDENTS)
4 marks
Logical discussion of
relevant ideas
Any two
recommendation from
any two areas
6. RECOMMENDATIONS TO IMPROVE PRACTICE based on
observations related to the prevention of blood borne illnesses, needle
stick injuries, and nosocomial infections (at least 4)-----TOTAL
50 marks =
12% of total
marks for project
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THE UNIVERSITY OF THE WEST INDIES
FACULTY OF MEDICAL SCIENCES
THE UWI SCHOOL OF NURSING, MONA
BACHELOR OF SCIENCE IN NURSING
ACADEMIC YEAR 2013/2014 YEAR 1 SEMESTER 1
COURSE TITLE
COURSE CODE
DURATION
CREDITS
CO-REQUISITE
:
:
:
:
:
PATIENT AND HEALTH CARE WORKER SAFETY
NURS
75 Hours
3 (2 Theory, 1 Lab)
Microbiology
TEACHING SCHEDULE AND RELATED CLINICAL LEARNING ACTIVITIES
WEEKS
1
2
3
4
UNITS & RELATED CONTENT
Overview
Unit 1: Components of infection
prevention and control
Modes of transmission of
pathogenic organisms
Definition of concepts related to
infection prevention and control
Unit 1 (Cont’d)
Main components of infection
prevention and control
Unit 2: Management of infection
prevention and control
Levels of responsibility for
infection prevention and control
Unit 2 (Cont’d)
Quality Assurance framework for
infection prevention and control
RELATED CLINICAL
ACTIVITY
Hand hygiene
TEACHING
STRATEGIES/APPROACHES
1. Constructivist
2. Cooperative learning
and
3. Principles related to
Multiple Intelligences
Hand hygiene
Hand hygiene
Injection safety
lecture/ Video/demo
5
Unit 2 (Cont’d)
Occupational control measures
and hierarchies
Injection safety
lecture/video/demo
6
Unit 3: Injection safety
Definition; safe injection
strategies; nine “rights” of
injection safety; ” best” practices
for injection safety;
Unit 3 (Cont’d)
Visit to blood bank
7
FACILITATOR/GUEST
PRESENTER
Visit to blood bank
UWISON BScN/2013: Year 1: Semester 1 (VHF)
Patient and Health Care Worker Safety
Observational visit
to hspl/health
centre review of
relevant
institutional policies
Observational visit
to hspl/health
centre review of
relevant
institutional policies
Observational visit
to hspl/health
centre review of
relevant
institutional policies
Observational visit
Page 20
Adverse events associated with
injection; roles and
responsibilities; needle stick and
other sharp injuries
8
Unit 4: Blood safety
Definitions; blood and blood
products uses and storage
In-course test
No Class Monday
Holiday
Project due Friday 2pm
9
10
11
12
13
14
15
Unit 4: (Cont’d)
Hospital standard procedures for
blood transfusion process
Unit 4(Cont’d)
Roles and responsibilities of clinical
and blood bank staff
Hospital procedures for ordering,
collection, storage, transportation,
and administration of blood products
& for monitoring transfused patients.
Unit 4 (Cont’d)
Reactions to blood transfusion
Unit 4 (Cont’d)
Infections resulting from blood
transfusion
Management and investigations of
blood transfusion reactions according
to category
Revision
Examination period
Examination period
to hspl/health
centre review of
relevant
institutional policies
Observational visit
to hspl/health
centre review of
relevant
institutional policies
CSSD
CSSD
PPE
PPE
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