Bloodborne Pathogens, Infection Control & Personal Protective Equipment

Why Infection Control Matters in Elder Care

Older adults are among the most vulnerable people to infectious disease. Aging changes the immune system, skin integrity, and lung function, all of which lower the body's natural defenses. As an elder care aide, you are often in close, hands-on contact with clients throughout the day. That contact creates real pathways for germs—including bloodborne pathogens—to travel between people. Infection control is not optional; it is a core professional and legal responsibility.

What Are Bloodborne Pathogens?

Bloodborne pathogens are microorganisms present in human blood (and certain other body fluids) that can cause disease in humans. The most commonly cited examples in healthcare training are Hepatitis B (HBV), Hepatitis C (HCV), and HIV. Transmission requires a route of entry: a needlestick or sharps injury, contact with mucous membranes (eyes, nose, or mouth), or contact with broken skin. Intact, healthy skin is an effective barrier, but you should never assume your skin has no small cuts or abrasions.

OSHA's Bloodborne Pathogens Standard requires that workplaces with occupational exposure maintain an Exposure Control Plan, provide personal protective equipment at no cost, offer hepatitis B vaccination, and train workers annually. You should know this standard exists and follow your employer's written plan.

Standard Precautions

Standard precautions, defined by the CDC, treat the blood and certain body fluids of every person as potentially infectious—regardless of their diagnosis or how healthy they appear. This approach protects both you and your client. Standard precautions apply to:

• Blood
• All body fluids (except sweat, unless visibly bloody)
• Non-intact skin
• Mucous membranes

The key elements of standard precautions are hand hygiene, appropriate personal protective equipment (PPE), safe sharps handling, and proper disposal of contaminated materials.

Hand Hygiene: The Single Most Important Skill

Handwashing with soap and water or using alcohol-based hand rub (ABHR) is the most effective way to prevent the spread of infection. The CDC recommends the following full sequence:

1. Wet hands with clean, running water.

2. Apply enough soap to cover all hand surfaces.

3. Lather and scrub all surfaces for at least 20 seconds—including palms, backs of hands, between fingers, backs of fingers, thumbs, and fingernails.

4. Rinse thoroughly under running water.

5. Dry with a clean paper towel; use the towel to turn off the faucet.

Alcohol-based hand rub is acceptable when hands are not visibly soiled, but soap and water must be used after known or suspected contact with Clostridioides difficile (C. diff) spores and whenever hands are visibly dirty or contaminated with blood or body fluids.

When to perform hand hygiene: before and after direct client contact, before putting on PPE, immediately after removing PPE, after touching potentially contaminated surfaces, before preparing or handling food, and after using the restroom.

Personal Protective Equipment (PPE)

PPE creates a physical barrier between you and infectious material. Selecting the right PPE depends on the task and the expected level of exposure.

| PPE Item | When to Use |

|---|---|

| Gloves | Any time you may contact blood, body fluids, mucous membranes, or non-intact skin |

| Surgical mask | Procedures that may generate splashes or sprays to the mouth/nose |

| Eye protection (goggles or face shield) | Risk of splashing to the eyes |

| Gown | Risk of soiling clothing with blood or body fluids |

Donning (Putting On) Order

1. Gown first

2. Mask or respirator

3. Eye protection

4. Gloves last

Doffing (Removing) Order — the critical safety step

Doffing is when contamination most often occurs. The outside surfaces of your PPE are considered contaminated.

1. Gloves first (the gloves are the most contaminated item)

2. Eye protection (handle by the clean ear pieces or head band, not the front)

3. Gown (roll it away from your body, inside out, touching only the inside)

4. Mask last (handle by the ear loops or ties only)

5. Perform hand hygiene immediately after each glove removal and again after the final item is removed.

Never touch your face during doffing. Dispose of all single-use PPE in the appropriate waste container.

Safe Sharps Handling and Disposal

Sharps include needles, lancets, and any item that can puncture skin. Injuries from contaminated sharps are one of the leading causes of occupational bloodborne pathogen exposure.

Never recap a used needle using both hands. If recapping is necessary, use the one-handed scoop technique or a mechanical device. Immediately after use, place sharps in an approved, puncture-resistant, leak-proof sharps container labeled with the biohazard symbol. Do not overfill the container beyond the marked fill line. Do not reach into a sharps container.

If a needlestick or exposure to blood or body fluids occurs, wash the site immediately with soap and water, report the incident to your supervisor, and follow your employer's post-exposure protocol without delay. Time matters.

Applying This in Elder Care Settings

In home care or a residential facility, you may assist with wound care, incontinence care, oral hygiene, or blood glucose monitoring—all tasks with infection risk. Before each task, mentally ask: What body fluids might I contact? Is the client's skin intact? Could there be splashing? Your answers guide PPE selection. When in doubt, add a layer of protection. Proper infection control is one area where over-caution is never wrong.