Woman-Centered Abortion Care

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Woman-Centered Abortion Care
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Purpose

• This module discusses the knowledge and
  attitudes health-care workers must have in order
  to successfully prevent infection to themselves,
  clients, coworkers and communities when providing
  abortion-care services.

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Objectives

• By the end of this module, learners should be
  able to
• Explain infection-transmission routes in the
  abortion-care setting.
• Identify essential elements of infection
  prevention, including standard precautions.
• Explain procedures for managing occupational
  exposure to blood and body fluids.

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Why Protect Against Blood-Borne Pathogens?

• They can cause incurable infections such as HIV,
  HBV and Ebola.
• Health facilities are ideal settings for
  transmission.

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How Do Blood-Borne Diseases Spread?

• Infectious agents transmitted by
• Cuts or openings in skin
• Contact with mucous membranes

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Most Common Blood-Borne Transmission

• Injuries from sharp instruments, such as needle
  sticks
• Splashes of blood on non-intact skin or mucous
  membranes

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Which Women Have Blood-Borne Diseases?

• It is not always possible to tell who is
  infected.
• Precautions should be taken with every person.

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Essential Elements of Infection Prevention

• Handwashing
• Personal protective barriers
• Proper handling of sharp items
• Proper instrument processing
• Environmental cleanliness
• Proper infectious-waste disposal
• Aseptic technique

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When Should We Wash Our Hands?

• Before and after each client contact
• After contact with contaminated items, even if
  wearing gloves
• Many times a day

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How Should We Wash Our Hands?

• Use soap and clean water for each person.
• Use flowing water, not standing pools of water.
• Use a clean or individual towel.

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Handwashing
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When to Wear Personal Protective Barriers

• Barriers must be worn whenever a particular part
  of the body is likely to be exposed to blood or
  body fluids.

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Personal Protective Barriers for Performing MVA
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When Should We Wear Gloves?

• Wear gloves when contact with body fluids is
  likely.
• Change gloves between clients.
• Remove gloves before touching other items.

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How Can We Prevent Injuries From Sharp Items?

• Assign a particular place for keeping sharps.
• Announce the presence of sharps to avoid
  accidentally sticking others.
• Use the scoop and pull technique.
• Be very careful when handling any sharp item.

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Scoop and Pull Technique

• If syringes must be recapped during a procedure
  
• Scoop cap onto needle without touching cap or
  needle.
• Pull cap onto needle by holding cap near base.
• Never put fingers on tip of cap while pushing cap
  onto needle.

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Scoop and Pull Technique
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Safe Needle Disposal

• Immediately drop needles into sharps container.
• Do not recap, remove, cut or bend needles.
• Place sharps containers everywhere that needles
  are used.

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If Exposed

• If exposure caused bleeding, allow to bleed
  briefly.
• Immediately flush with clean water.
• Wash wound and skin thoroughly flush mucous
  membranes.
• Determine exposure risk.
• Give post-exposure prophylaxis if available.

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If Exposed (cont.)

• Consult an infectious-disease specialist.
• Record exposure and action taken.
• Offer voluntary, confidential counseling and
  testing.
• Medically evaluate acute illnesses that develop.

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Environmental Cleanliness

• Everything in the clinic should be clean and dry.
  
• Use 0.5 chlorine solution or soapy water for
  cleaning.

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When Should the Clinic Be Cleaned?

• At the beginning of each session
• Between clients as needed
• At the end of each day

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Infectious Waste

• All disposable material that has come in contact
  with body fluids.
• Proper waste disposal protects the community.

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Safe Infectious-Waste Disposal

• Secured not in an open pile
• Ideally, incinerated
• Buried and protected by a fence, away from water
  source
• Liquid waste buried or poured down a drain

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Aseptic Technique for Abortion Care Includes

• Antiseptic cervical preparation
• No-touch technique
• Proper processing and handling of instruments

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Cervical Preparation
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Illustrations by Stephen C. Edgerton.