Performing a Risk Assessment

A risk assessment is essential for determining:

Risk Presented by the Task

risk of exposure to:

blood and body fluids

mucous membranes

non-intact skin

contaminated equipment

splash/spray

cough or sneeze

ROUTINE PRACTICES

Risk Presented by the Patient/Client

patient/client has a known infection

patient/client has symptoms of an undiagnosed infection

ROUTINE PRACTICES + ADDITIONAL PRECAUTIONS

Other Considerations

Practice setting-specific factors (e.g., long-term care facility, home care)

Government and related agency (e.g., Ministry of Health and Long-Term Care, Public Health Ontario, Public Health Agency of Canada) health alerts, surveillance, screening and reporting of suspected illness such as:

Acute Respiratory Illness (ARI)

Influenza-Like Illness (ILI)

Novel Respiratory Illness (NRI)



RESOURCE

Routine Practices Risk Assessment Algorithm for All Client/Patient/Resident Interactions .
(Checklist for Office Infection Prevention and Control (publichealthontario.ca)

Professional Accountabilities:

Members are expected to consider their own health status and whether they are at risk to spread infection to others.

Administrative Controls

Policies and procedures to ensure that staff are able to deal effectively with transmission risks associated with infectious illnesses

Staff education to heighten awareness of infectious diseases, their mode of transmission and prevention of transmission

Healthy workplace policies that exclude staff from working when ill with a communicable disease that would put clients/patients/residents and colleagues at risk

Immunization programs for staff and for clients/patients/residents where applicable

Respiratory etiquette for both staff and clients/patients/residents

Monitoring of compliance with feedback is built into the program to measure compliance with Routine Practices, including hand hygiene

Sufficient staffing

References

Association for the Advancement of Medical Instrumentation (AAMI). (2015). FDA proposes new criteria for surgical gowns. Retrieved from Association for the Advancement of Medical Instrumentation website: www.aami.org/newsviews/newsdetail.aspx?ItemNumber=2650

Canadian Patient Safety Institute. (n.d.). Ventilator-associated pneumonia (VAP). Retrieved from Canadian Patient Safety Institute website: www.patientsafetyinstitute.ca/en/topic/pages/ventilator-associatedpneumonia-(vap).aspx

Centers for Disease Control and Prevention. (2011). Central line-associated bloodstream infections: Resources for patients and healthcare providers. Retrieved from Centers for Disease Control and Prevention website: www.cdc.gov/HAI/bsi/CLABSI-resources.html

Critical Care Secretariat. (2012). Ventilator associated pneumonia and central line infection prevention toolkit. Retrieved from Critical Care Services Ontario website: www.criticalcareontario.ca/EN/Toolbox/Performance%20Improvement%20Collaborative/VAP%20and%2 0CLI%20Toolkit%20(2012).pdf

Immunize Canada. (2016). ImmunizeCA app. Retrieved from Immunize Canada website: http://immunize.ca/en/app.aspx

Loeb, M., Dafoe, N., Mahony J., John, M., Sarabia, A., Glavin, V., Walter, S.S. (2009). Surgical mask vs N95 respirator for preventing influenza among health care workers: A randomized trial. JAMA, 302(17), 1865- 1871. doi:10.1001/jama.2009.1466. Retrieved from http://jama.jamanetwork.com/article.aspx?articleid=184819

PIDAC. (2012a). Best practices for infection prevention and control programs in Ontario (3rd ed.). Retrieved from Public Health Ontario website: www.publichealthontario.ca/en/eRepository/BP_IPAC_Ontario_HCSettings_2012.pdf

PIDAC. (2012b). Routine practices and additional precautions in all health care settings (3rd ed.). Retrieved from Public Health Ontario website: www.publichealthontario.ca/en/eRepository/RPAP_All_HealthCare_Settings_Eng2012.pdf

PIDAC. (2013). Annex B: Best practices for prevention of transmission of acute respiratory infection in all health care settings. Retrieved from Public Health Ontario website: www.publichealthontario.ca/en/eRepository/PIDAC-IPC_Annex_B_Prevention_Transmission_ARI_2013.pdf

PIDAC. (2014). Best practices for hand hygiene in all health care settings, (4th ed.). Retrieved from Public Health Ontario website: www.publichealthontario.ca/en/eRepository/2010-12%20BP%20Hand%20Hygiene.pdf

PIDAC. (2015a). Best practices for prevention, surveillance and infection control management of novel respiratory infections in all health care settings. Retrieved from Public Health Ontariowebsite: www.publichealthontario.ca/en/eRepository/Best_Practices_Novel_Respiratory_Infections.pdf

PIDAC. (2015b). Infection prevention and control for clinical office practice. Retrieved from Public Health Ontario website: www.publichealthontario.ca/en/eRepository/IPAC_Clinical_Office_Practice_2013.pdf

PIDAC. (2016). Tools for preparedness: Triage, screening and patient management for Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infections in acute care settings. Retrieved from Public Health Ontario website: www.publichealthontario.ca/en/eRepository/PIDAC-IPC_Preparedness_Tools_MERS_CoV_2013.pdf

Public Health Agency of Canada. (2013). Canadian immunization guide. Retrieved from Public Health Agency of Canada website: http://phac-aspc.gc.ca/publicat/cig-gci/p03-work-travail-eng.php#a1

Public Health Agency of Canada. (2014). Canadian Tuberculosis Standards (7th ed.). Retrieved from http://www.phac-aspc.gc.ca/tbpc-latb/pubs/tb-canada-7/assets/pdf/tb-standards-tb-normes-prefeng.pdf

Public Health Agency of Canada. (2016). Summary of assessment of public health risk to Canada associated with Middle East Respiratory Syndrome Coronavirus (MERS-CoV). Retrieved from Public Health Agency of Canada website: www.phac-aspc.gc.ca/eri-ire/coronavirus/risk_assessment-evaluation_risque-eng.php

Public Health Ontario. (n.d.a). Chain of transmission and risk assessment: Glossary of terms. Retrieved from Public Health Ontario website: www.publichealthontario.ca/en/LearningAndDevelopment/OnlineLearning/InfectiousDiseases/IPACCore/Documents/CORE_Trainers_COT_and_RA_Module_Glossary_April _2014.pdf

Public Health Ontario. (n.d.b). Risk Algorithm to Guide PPE Use. Retrieved from Public Health Ontario website: www.publichealthontario.ca/en/eRepository/IPAC_Clinical_Office_Practice_Risk_Algorithm_PPE_2013.pdf

World Health Organization. (2015). Middle East respiratory syndrome coronavirus (MERS-CoV). Retrieved from World Health Organization website: www.who.int/mediacentre/factsheets/mers-cov/en/