Communicable Disease Exposure Control Plan - Control Measures

Control measures are all the necessary steps to protect workers. Managers/Supervisors are responsible to identify and implement controls based on the hierarchy of controls. You can learn more about the hierarchy of controls on the Hierarchy of Controls webpage.

There are numerous controls used to eliminate or minimize your risk of exposure. Below you can learn more about each control, including how it protects you and the limitations of that protection.

Team members must be aware of, trained in and use all controls to eliminate or minimize the risk of exposure to an infectious material or organism.

Elimination

Adjust procedures that do not require the use of needles/sharps/in-person visits, if possible.

Substitution

Needleless Systems

Needleless systems are devices that do not use needles, eliminating the risk of a percutaneous injury.

Engineering Controls

Physical Barriers

Physical barriers function by:

  • Intercepting respiratory droplets that may transmit viruses; and
  • Re-enforcing physical distancing requirements.

It is essential that physical barriers are designed, installed, and maintained to exceed the breathing zone of partition users by a wide margin. The breathing zone circle with a radius of 30 cm (12 inches) extending from mid-point between the person's ears. Therefore, the height of the physical barrier must take into account the tallest user and the way physical barrier will be approached ad the width must account for user's behaviour.

Any required opening for interactions should be kept as small as possible and should be placed off-centre, rather than directly in front of the user. It may be useful to install a slider or flap if a larger opening is required (e.g. to receive packages). Speaking ports or grates should not be installed.

Additionally, partitions should be designed to minimize airflow around the edges.

Safety Engineered Sharps Device (SESD)

An SESD is a device that has a built-in sharps injury protection mechanism such as an attached sheath covering the needle or scalpel or needles that retract after use. An SESD protects the user from exposure to bloodborne pathogens or chemical hazards.

To be most effective, SESDs should:

  • Be integrated into the device;
  • Be easy to identify whether or not the sharps injury prevention feature is activated;
  • Not have the ability to be deactivated once engaged and remain engaged throughout disposal;
  • Allow active devices to be activated with a single-hand technique, allowing the user's hand to remain behind the sharp;
  • Completely enclose the needle in the needle sheath;
  • Allow for the sharp to be fully retracted within the housing if a retractable sharp; and
  • Have a housing that extends beyond the sharp, if a fixed recessed needle.

Limitations of SESDs:

  • SESDs do not provide protection while the device is in use; therefore, they only minimize the risk of exposure;
  • May require the user to activate the safety mechanism, presenting the potential for user error; and
  • It may not be obvious how the safety features work and training is required.

Ventilation Resources

Facility Ventilation
Air Purifiers
Negative Air Systems
Local Exhaust Hoods

Administrative Controls

Routine Practices

Routine Practices are used for all individuals, in all health care settings, all of the time to prevent and control the spread of infection.

At times, individuals are placed on additional precautions due to the organism present and risk of transmission.

Team members are expected to follow all additional precautions as identified by signage.

Point of Care Risk Assessment

Point of Care Risk Assessment (PCRA) involves assessing the risk of spreading infection before every interaction with an individual and their environment.

Refer to the Point of Care Risk Assessment Guidelines  for additional information.

Hand Hygiene

Hand hygiene is the single most important step in preventing infections.

All team members shall comply with the SHA Hand Hygiene Policy and perform effective hygiene.

Sharps Safety and Disposal

Sharps are devices, such as needles, scalpels, and lancets, which are used to cut or pierce skin, blood vessels, or tissue.

Elimination of sharps and substitution for safer sharp devices should be considered wherever possible. 

In general, users should not recap needles.

Improper sharps disposal presents risk to team members, individuals, and the community.

  • Users shall place used sharps directly into a puncture-resistant container specifically designed for disposal;
  • Do not recap, bend, manipulate, or break used needles;
  • Sharps disposal containers should be conveniently located close to site of use; and
  • Do not overfill sharps containers.

Proper sharps disposal is heavily dependent on user practice and always presents some risk of exposure if adequate training is not provided and implemented.

Related Document

Sharps Container Examples
(PDF 240.9 KB)
Published February 18, 2025

Vaccines

Workers are at risk of a workplace communicable disease exposure due to their contact with patients/clients/residents or an infectious agent (microorganism). The Staff Safety – OH/EH Nursing Team will advise workers of the recommended vaccinations that they are eligible to receive. Vaccination appointments should be scheduled during the worker’s normal working hours. If unable to arrange an appointment during their normal working hours, the worker should not experience a loss of pay or benefits. Vaccinations are provided at no cost to the worker.

Workers with vaccination related questions can contact their local Occupational Health Nurse/Employee Health Nurse.

Waste Management

All waste will be segregated, sorted, and managed at the point of us in a safe manner and in compliance with SHA Standards of Work.

Clinical Standards

SHA standardized clinical safe work practices are available through the SHA's Policy & Clinical Standards Document Finder. If no SHA standardized practice is available, team members are to reference their former health region's safe work practice/procedure.

Personal Protective Equipment Controls

PPE is equipment or clothing worn to minimize exposure to infectious agents (microorganisms) or chemical hazards in the workplace.

PPE does not remove or reduce workplace hazards and does not replace effective engineering or administrative control measures such as substitution or ventilation. PPE is the last line of defense when the hazard cannot be removed or controlled adequately. Proper selection, use, and care of the equipment are vital to provide the proper level of protection.

Refer to SHA IPAC Routine Practices for further guidance.

Gloves

Gloves are used to provide a protective barrier, reducing the risk of hand contamination. Gloves also reduce the risk of germ dissemination to the environment and transmission from team members to individuals and vice versa.

Gloves are effective when:

  • Used appropriately;
  • Timely hand hygiene is performed; and
  • Properly donned and doffed.

If glove integrity is compromised (e.g. punctured), it should be changed and hand hygiene should be performed as soon as possible.

Team members should ensure to select the correct type of glove for the task (e.g. vinyl gloves do not always provide protection when working with chemicals).

Gown

Wear a gown to protect exposed skin and clothing during activities likely to cause splashes or sprays of blood or body fluid, secretions, or excretions, or if likely to come into contact with mucous membranes, undiagnosed rashes, non-intact skin, or contaminated items.

Eye Protection

Eye protection (goggles) provides a barrier to prevent infectious materials or organisms from entering the eye. To adequately protect, goggles should be tight fitting, indirectly vented or non-vented.

Eye protection does not protect the user's face, and based on point of care risk assessment, face protection may be required.

Personal glasses are not a substitute for goggles.

Face Protection

Face shields protect the face, mouth, nose, and eyes; should cover the forehead and wrap around the side of the face. Face shields should be sealed at the forehead.

Respiratory Protection

Surgical Masks

Surgical masks protect the nose and mouth and should fully cover your nose and mouth to prevent fluid penetration.

Masks protect the user from droplets, splashes, sprays, or splatter. Masks do not filter small particles. 

Masks should be changed if they become soiled or damaged. They are single use and are not intended to be re-used. 

Respirators

Wear a properly fitted, seal-checked N95 respirator when there is a risk of exposure to an airborne communicable disease.

Refer to SHA Respirator Fit Test Orientation Summary for further guidance.

Note: Workers are to be fit tested at least every two years unless there is a change in your physical condition (i.e. significant weight loss or gain, changes to facial structure), change in respirator make/model/size, and discomfort during use or difficulty completing a successful user seal check. 

Donning and Doffing PPE

Appropriately putting on (donning) and taking off (doffing) PPE is vital in minimizing worker exposure to potentially infectious organisms. Please refer to the Infection Prevention and Control Routine Practices, posters and videos for resources to support proper donning and doffing.

References: