COMMON

COMPETENCIES
 COMMON COMPETENCY

IMPLEMENT AND MONITOR INFECTION CONTROL POLICIES AND

PROCEDURES
IMPLEMENTING AND MONITORING INFECTION CONTROL POLICIES AND
PROCEDURES

• This unit is concerned with infection control responsibilities of employees

with supervisory accountability to implement and monitor infection
control policy and procedures in a specific work unit or team within an
organization. This unit does not apply to a role with organization-wide
responsibilities for infection control policy and procedure development,
implementation or monitoring.
What are the hazards in a risk assessment?

• Here are some examples of the things that should be included in a risk
assessment:

• Hazards: electrical safety, fire safety, manual handling, hazardous

substances, risk factors for repetitive strain injury, stress, violence,
infectious diseases (COVID-19).
Infection control policy and procedures are implemented
by supervisor and members of the work group

• Infection is caused by pathogens ('bugs') such as bacteria, viruses, protozoa or

fungi getting into or onto the body.

• It can take some time before the microbes multiply enough to trigger symptoms
of illness, which means an infected person may unwittingly be spreading the
disease during this incubation period.
• Infection control in the workplace aims to prevent pathogens from coming
into contact with a person in the first place.

• Employers are obliged under the Occupational Health and Safety Act 2004 to
provide a safe workplace for their employees, including the provision of
adequate infection control procedures and the right equipment and training.
 Transmission of infection

Infectious agents can be spread in a variety of ways, including:

• Breathing in airborne germs – coughs or sneezes release airborne

pathogens, which are then inhaled by others.

• Touching contaminated objects or eating contaminated food – the

pathogens in a person's feces may be spread to food or other objects, if their
hands are dirty
• Skin-to-skin contact – the transfer of some pathogens can occur through
touch, or by sharing personal items, clothing or objects

• Contact with body fluids – pathogens in saliva, urine, faeces or blood

can be passed to another person's body via cuts or abrasions, or through
the mucus membranes of the mouth and eyes.
Assumption of risk

• The basis of good infection control in the workplace is to assume that

everyone is potentially infectious. Proper procedures have to be followed
at all times. Every workplace should have an appropriate first aid kit, with
at least one staff member trained in first aid. Equipment such as gloves,
gowns, eye goggles and face shields should be provided if necessary.
 Workplace infection control – personal
hygiene practices
Infection control procedures relating to good personal hygiene include:

• Hand washing – the spread of many pathogens can be prevented with regular hand
washing. Thoroughly wash your hands with water and soap for at least 15 seconds
after visiting the toilet, before preparing food, and after touching clients or equipment.
Dry your hands with disposable paper towels

• Unbroken skin – intact and healthy skin is a major barrier to pathogens. Cover any
cuts or abrasions with a waterproof dressing
• Gloves – wear gloves if you are handling body fluids or equipment containing
body fluids, if you are touching someone else's broken skin or mucus
membrane, or performing any other invasive procedure. Wash your hands
between each client and use fresh gloves for each client where necessary

• Personal items – don't share towels, clothing, razors, toothbrushes, shavers or

other personal items.
Food preparation and workplace infection control

When preparing food:

• Wash your hands before and after handling food.

• Avoid touching your hair, nose or mouth.
• Keep hot food hot and cold food cold.
• Use separate storage, utensils and preparation surfaces for cooked and uncooked foods.
• Wash all utensils and preparation surfaces thoroughly with hot water and detergent after
use.
Infection control and workplace cleanliness

Infection control procedures relating to cleanliness in the workplace include:

• regularly washing the floors, bathrooms and surfaces( such as tables and bench tops) with
hot water and detergent

• periodically washing the walls and ceilings

• thoroughly washing and drying mops, brushes and cloths after every use – drying mops and
cloths is particularly important, since many pathogens rely on moisture to thrive
• using disinfectants to clean up blood and other spills of bodily fluids.

• when using disinfectants – always wearing gloves, cleaning the surfaces

before using the disinfectant, and always following the manufacturer's
instructions exactly.

• spot cleaning when necessary.

 Dealing with spills of body fluids

• Examples of body fluids include blood, saliva, urine and faeces.

• When dealing with spills of body fluids, infection control procedures need to
be followed carefully. Always:

• - Isolate the area.

• - Wear gloves, a plastic apron and eye protection, such as goggles.

• - Soak up the fluid with disposable paper towels, or cover the spill
with a granular chlorine-releasing agent for a minimum of 10 minutes.
Scoop up granules and waste using a piece of cardboard (or similar), place in
a plastic bag and dispose of appropriately.
•
- Mix one part bleach to 10 parts water and apply to the area for 10 minutes

- Wash the area with hot water and detergent.

- Dry the area.

- Dispose of paper towel and gloves appropriately.

- Wash your hands.

- Rinse any contaminated clothing in cold running water, soak in bleach solution for half
an hour, then wash separately from other clothing or linen with hot water and detergent.
 Infection control – disposing of infectious waste

To dispose of infectious waste that has been contaminated with blood or

other body fluids:

• Wear heavy duty gloves.

• Place waste in plastic bags marked 'infectious waste'.
• Dispose of waste in accordance with EPA guidance.
 Workplace infection control – handling
contaminated sharps
Infection control procedures when handling needles and other sharp
contaminated objects include:

• Never attempt to re-cap or bend used needles.

• Handle by the barrel.
• Place in an appropriate puncture-proof container– this will be yellow,
labelled 'Danger contaminated sharps' and marked with a black biohazard symbol.
 Infection control – occupational exposure
to body fluids

If you come in contact with blood or body fluids:

• Flush the area with running water.

• Wash the area with plenty of warm water and soap.
• Report the incident to the appropriate staff member.
• Record the incident via the Disease/Injury/Near Miss/Accident (DINMA)
reporting procedure.

• Seek medical advice.

Employers and occupational health and safety representatives should investigate all
incidents involving contact with blood or body fluids, and take action to prevent a
similar incident from happening again.
 COMMON COMPETENCY:

APPLYING BASIC FIRST AID

• This unit covers the knowledge, skills and attitudes required to provide an initial
response where First Aid is required. In this unit it is assumed that the First Aider
is working under supervision and/or according to established workplace First Aid
procedures and policies.
 Physical Hazards
• Physical hazard are based on the intrinsic properties of the chemical.
There are five main classes of physical hazard namely Explosive,
Flammable, Oxidizing, Gases under Pressure and Corrosive to metals.
These are then sub-divided into different categories depending on the
degree of danger and these are assigned specific hazard statements to
identity them.
• Explosive May explode if exposed to fire, heat, shock, friction.
• Avoid ignition sources (sparks, flames, heat)
• Keep your distance
• Wear protective clothing
• Flammable

• Flammable if exposed to ignition sources, sparks, heat. Some substances with this symbol may give
off flammable gases in contact with water.
- Avoid ignition sources (sparks, flames, heat)
- Keep your distance
- Wear protective clothing
• Oxidizing

Can burn even without air, or can intensify fire in combustible materials.
- Avoid ignition sources (sparks, flames, heat)
- Keep your distance
- Wear protective clothing
• Gas under Pressure

Contains gas under pressure. Gas released may be very cold. Gas container may
explode if heated.
- Do not heat containers
- Avoid contact with skin and eyes
• Corrosive

May corrode metals.

• Keep away from metals
 Apply Basic First aid Techniques
• First aid is the immediate care a sick or injured person gets. In some cases, it may be the
only care a person needs. In others, first aid is a way to prevent a person's condition from
worsening and keep them alive until paramedics arrive or they are taken to the hospital.

• The best way to prepare for these events is to get official first-aid training. In the
meantime, there are some basic life-saving steps you can learn.

• This article goes over the first aid steps to follow in 10 different situations and how to tell
if more care is needed.
 9 First Aid Tips Everyone Should
Know
ABCs of First Aid

• If someone is unconscious or unresponsive, the basic principle of first aid

that you need to know is ABC: airway, breathing, and circulation.

• Airway: If someone’s not breathing, the first thing you need to do is

clear their airway.
• Breathing: If you have cleared a person’s airway but they’re still not
breathing, provide rescue breathing.

• Circulation: As you are doing rescue breathing, perform chest

compressions to keep the person’s blood circulating. If the person is
breathing but is not responsive, check their pulse. If their heart has stopped,
provide chest compressions
• Whenever possible, wash your hands thoroughly with soap and water before
providing first aid. Use hand sanitizer only if soap and water are not available.
This will help keep you from passing bacteria on to the person you are assisting.
A simpler version of the ABCs is:

• Awake: If the person is not awake, try to wake them. If they don’t wake up, make sure someone
is calling 911 and move on to the next step.

• Breathing: If a person is not awake and not breathing, start rescue breathing and chest
compressions. Then, move to the next step.

• Continue care: When you call for help, follow instructions from 911 or continue treatment until
an ambulance arrives.
Some first aid courses also include D and E:

• D can stand for: Disability assessment, deadly bleeding, or automated

external defibrillator (AED). An AED is a device that shocks the heart to make it
start beating again.1

• E can stand for: Examination (checking the person for signs of injury,
bleeding, allergies, or other problems once you know they’re breathing and their
heart is beating).
Where to Get First Aid Training

• Taking a formal CPR class will help you become familiar with doing chest
compressions, rescue breathing, and using an AED. You can find courses
from the American Red Cross, your local community first responders, and
online.
First Aid for a Stopped Heart

• Elva Etienne / Getty Images

• Cardiopulmonary resuscitation (CPR) is one of the most important emergency

medical procedures that a person can know.

• If a person’s heart is not beating, they could die. When a person is in cardiac
arrest, doing CPR and/or using an AED could save their life.2

• AEDs are available in many public areas and businesses. These first aid devices
are made to be easy to use even if you have no training.
 Life-Saving First Aid Skills
What to Do
• If you think someone is in cardiac arrest, there are four steps you can take to help them.

1. Find a person nearby. Make eye contact, point to them, and say: “Call 911.”

2. Start doing chest compressions on the person who needs help. Using both your hands, push down
hard and fast in the center of the person’s chest. Let their chest come back up naturally between
compressions. You may hear pops or snaps; this is normal.

3. Keep going until someone with more training arrives.

 4. If you’re trained in CPR, you can use chest compressions and rescue
breathing.

5. If it’s available, use an AED. However, do not put off doing chest
compressions to go look for an AED. If possible, instruct someone else to go
find the device and bring it to you.
First Aid for Bleeding

• If someone is injured and bleeding, there are a few basics about how
blood works that will be helpful for you to know.
• The color of the blood and how it’s leaving the body can give you a sense of the extent of the injury:

• Capillaries: Bleeding from the smallest blood vessels (capillaries) looks like a trickle. This
kind of bleeding usually stops on its own.

• Veins: A consistent blood flow and blood that’s a dark red color is most likely coming from
the veins. This type of bleeding can range from mild to severe.

• Arteries: Arteries are the largest blood vessels and carry a lot of oxygen. If they are injured,
bright red blood will spurt out. Blood can be lost very fast with this kind of bleeding
The color of the blood and how it’s leaving the body can give you a sense of the
extent of the injury:

• Capillaries: Bleeding from the smallest blood vessels (capillaries) looks

like a trickle. This kind of bleeding usually stops on its own.

• Veins: A consistent blood flow and blood that’s a dark red color is most
likely coming from the veins. This type of bleeding can range from mild to
severe.

• Arteries: Arteries are the largest blood vessels and carry a lot of oxygen.
If they are injured, bright red blood will spurt out. Blood can be lost very fast
with this kind of bleeding.
• Almost all bleeding can be controlled with first aid. If severe bleeding
keeps going, a person can go into shock and may die
First Aid for Puncture Wounds

• What to Do?

- While it is important to stop bleeding, begin with the ABCs of first aid
• The next steps are to:

1. Wash your hands or put on disposable gloves if you have them. This will protect you from
infectious diseases like viral hepatitis and HIV/AIDS that can be spread in a person’s
blood.

2. Rinse the wound with water.

3. Cover the wound with a gauze or cloth (e.g., towel, blanket, clothing).
4. Apply direct pressure to stop the flow of blood and encourage clotting (when
blood naturally thickens to stop blood loss).

5. Elevate the bleeding body part above the person’s head if you can.

6. Do not remove the cloth if it becomes soaked. Removing the first layer will
interfere with the clotting process and result in more blood loss. Instead, add more
layers if needed.

7. Once bleeding has stopped, put a clean bandage on the wound.

Get medical help if:

• The wound is deep.

• The wound has widely separated sides.

• The injury oozes blood after pressure has been applied.

• The injury is from an animal or human bite.
• The injury is a puncture, burn, or electrical injury.
• You think there is arterial bleeding.
• Blood is soaking through the bandages.
• The bleeding is not stopping.5
• If you are taking the person to the hospital, make sure that you have
someone else who can keep administering first aid while you drive.
First Aid for Choking

• Choking happens when a person’s windpipe (trachea) gets blocked by

food or an object. It is a serious event that can lead to unconsciousness or
even death.7
Signs of choking include:

• Gagging, gasping, or wheezing

• Inability to talk or make noise
• Turning blue in the face
• Grabbing at the throat
• Waving arms
• Looking panicked
Using the Heimlich Maneuver

• The Heimlich maneuver is a series of abdominal thrusts that can help

dislodge the thing a person is choking on. This first aid technique should
only be done if someone is truly choking.

• Before doing anything, ask the person if they are choking. Remember: If
someone is coughing or talking, they are not choking.
What to Do?

• If someone is choking, you should know how to use the Heimlich

maneuver.8
• Here are the steps:

1. Stand behind the person and lean them slightly forward.

2. Put your arms around their waist.
3. Clench your fist and place it between their belly button (navel) and
rib cage.
4. Grab your fist with your other hand.
5. Pull your clenched fist sharply backward and upward under the
person’s rib cage in five quick thrusts.
6. Repeat until the object is coughed up.
 First Aid for Burns

• The first step to treating a burn is to stop the burning process.10

• This might mean:

• Cleaning up chemicals
• Turning off electricity
• Cooling heat with running water
• Covering up or taking a person inside out of the sun
The severity of a burn is based on how deep in the skin it is and how big it is:

• First-degree burn: This kind of burn only affects only the outer layer of skin
and causes redness and swelling. It is considered a minor burn.

• Second-degree burn: This kind of burn affects two layers of skin and causes
blistering, redness, and swelling. It is considered a major burn if it’s more than 3
inches wide or is on the face, hands, feet, genitals, buttocks, or over a major joint.
 • Third-degree burn: This kind of burn affects deeper layers of skin and
causes white or blackened skin that can be numb. It is always considered a
major burn.11
First Aid for Burns

What to Do?

• Major burns need emergency medical attention.11 Once you’ve stopped

the burning process, call 911 or get someone else to.
For burns that are not an emergency, you can take these first aid steps:

1. Flush the burned area with cool running water for several minutes. Do not use
ice.
2. Apply a light gauze bandage. If the burn is minor, you can put on an ointment,
like aloe vera, before you cover it.
3. Take Motrin (ibuprofen) or Tylenol (acetaminophen) for pain relief if you need it.
4. Do not break any blisters that form.
First Aid for Blisters

• Blisters protect damaged skin while it heals.

• Some blisters need to be treated and others don’t. Whether you need to
treat a blister depends on how bad it is and your overall health.
What Is a Blood Blister?

What to Do?

• If the blister is small, not open, and doesn’t hurt, it’s best to leave it alone. You
can cover it to prevent rubbing, which could cause it to swell and burst.

• Do not pop a small blister. This could let bacteria get inside it and cause an
infection.

• If the blister is big or painful, you need to take different steps to treat it.
Here are the first-aid steps to take for a more serious blister:

1. Wash your hands.

2. Sterilize a needle with alcohol.
3. Make small holes at the edge of the blister.
4. Gently push out the fluid.
5. Apply antibiotic ointment.
6. Put on a bandage.
7. If possible, take steps to protect the area from further rubbing or pressure.
What to Do If You Spill Bleach on Your Skin?

• If you have a compromised immune system, you are more likely to get an
infection and should not drain a blister on your own.15 However, your
healthcare provider may want to drain it to help prevent infection.
If a blister breaks open on its own:

1. Gently wash the area with clean water only.

2. Smooth the flap of broken skin over the newly exposed skin, unless it’s dirty,
torn, or there is pus under it.
3. Put petroleum jelly on it.
4. Cover it with a bandage.

• Change the bandage any time it gets wet. Take it off when you go to bed to give
the area a chance to air out.
First Aid for a Broken Bone or Fracture

• Any injury to your limbs, hands, and feet needs to be treated as a broken bone
until an X-ray can be done.

• While broken bones or fractures do need medical treatment, they do not all
require an emergency trip to the hospital. First aid steps can help stabilize the
bone until you can see a healthcare provider.

What to Do?
• In some cases, you will need emergency medical care to deal with a broken
bone.16
Call 911 if:

• The person is bleeding a lot, is unresponsive, is not breathing, or has more

than one injury.

• You think a person has a fracture or other serious injury in their spinal
column, head, hip, pelvis, or thigh. In this case, do not move the person.

• A broken bone is poking through the skin (open or compound fracture).

 • The area below an injured joint feels cold and clammy or looks bluish.
• You cannot keep the injury from moving well enough to transport the
person.

• Otherwise, you can use first aid, then go to urgent care or contact your
healthcare provider for guidance.
First Aid for Sprains

• A sprain is an injury to the connective tissues that hold bones, cartilage, and joints
together (ligaments).

• Sprains are most often caused when the twisting of a joint overstretches or tears
these tissues. They tend to happen in the ankles, knees, and wrists.

• The symptoms of a sprain are similar to those of a broken bone. A person will
need to have an X-ray to figure out which injury they have.
 Sprains vs. Strains
What to Do?

• The first thing to do is make sure that the injured person stops any
unnecessary activity, as moving can make the injury worse.
• Sprains often don’t require emergency treatment.However, you should get immediate medical
care if the injured person:

• Has severe pain when they move or are touched

• Cannot put any weight on the injured joint
• Has increased bruising
• Has numbness or pins-and-needles near the sprain
• Shows signs of infection
• Has little or no improvement during the first week after the injury happens
If emergency care is not needed, follow these first aid steps:

1. Keep the limb as still as possible.

2. Apply a cold pack.
3. Elevate the injured part if you can do so safely.
4. Use NSAIDs for pain.
5. Ask your provider about any other treatment for a sprain you might need.
First Aid for Nosebleeds

• Nosebleeds can have various causes. In children, the most common cause
of a nosebleed is digital trauma—better known as picking your nose.20
Other causes of a bloody nose include:

• Dry or hot air

• High altitudes
• Chemical fumes that irritate the nasal passages
• Colds and allergies
• Blowing your nose hard or often
• Trauma to the nose
• Deviated septum (crooked nasal cartilage)
• Nasal polyps (non-cancerous or cancerous growths in the nasal passage and
sinuses) or nasal tumors
• Bleeding disorders (e.g., hemophilia and leukemia)
• High blood pressure
• Pregnancy
• Frequent use of nasal sprays, decongestants, and antihistamines NSAIDs
• Blood thinners (e.g. warfarin)
• Cocaine and other drugs that are inhaled or snorted
First aid for a nosebleed has a few simple steps.

• If your nose is bleeding:

1. Lean slightly forward, not back.

2. Pinch your nose just below the bridge. It needs to be high enough that the
nostrils are not pinched closed.
3. After five minutes, check to see if the bleeding has stopped. If not, continue
pinching and check after another 10 minutes.
4. Apply a cold pack to the bridge of your nose while you’re pinching.
How to Remove a Bee Stinger?

What to Do

• Call 911 immediately or get the person to the hospital if they have signs of an
allergic reaction to a bee sting.

• If the person who was stung has a known allergy to bee stings, use an EpiPen to
prevent anaphylaxis.
In someone without a known bee allergy, watch for signs of an allergy
while you’re performing first aid:

• Get the stinger out immediately. This will prevent additional venom from
getting into the person. To remove a stinger, it is best to use a straight-
edged object such as a credit card to scrape the stinger out of the skin.
Avoid squeezing the venom sac with tweezers or your fingers, as this can
inject venom into the skin.
• Wash the area with soap and water.
• Use a cold pack to help with the swelling at the site; however, do not
apply ice directly to the skin.
• Use an allergy medication or antihistamine (like Benadryl) to reduce
swelling and itching.

• Use Tylenol (acetaminophen) or Advil (ibuprofen) for pain.

What are common first aid procedures?

CPR, the Heimlich maneuver, and assessing and treating minor injuries like
wounds, burns, sprains, and broken bones are common first aid procedures
covered in a basic first aid course.
Should I use a tourniquet to stop bleeding?

• This is best left to healthcare professionals, as there are big risks to using
a tourniquet—even when it’s done the right way. However, if direct
pressure is not stopping the bleeding and a person’s life is in danger,
anyone can make a tourniquet using a belt or torn piece of fabric
 COMMON COMPETENCY
MAINTAINING HIGH STANDARDS OF PATIENT SERVICES

• This unit covers the knowledge, skills and attitudes required in the maintenance
of high standards of patient services
Effective communication strategies and techniques are identified and used to
achieve best patient service outcome

• Effective communication is foundational to healthy working and personal

relationships. People communicate in various ways, and understanding how and
when to use each type of communication can benefit your ability to communicate
effectively.

• In addition to strengthening your communication skills, you can also find better
connections in your personal and professional life by learning strategies to
address common communication barriers that may involve cultural or linguistic
differences.
• In this article, you'll learn strategies for more effective communication
and explore different communication styles.
Importance of effective strategies in communication

• Good communication helps prevent conflicts that may arise in the ambiguity of
miscommunication. Effective communication skills are foundational to any good
personal or professional relationship. Learning successful strategies in
communication can impact your ability to motivate others, have more engaging
conversations, share information, and practice more efficient problem-solving.

• Effective organizational communication strategies can help employees and

coworkers understand what is expected of them, meet goals, and boost
motivation. Communication skills are essential if you're in a leadership position
or manage a team where you must delegate responsibilities while maintaining a
respectful relationship.
7 effective strategies in communication

• Building your communication skills takes practice, but it is entirely

possible and worth it. Find your weaknesses and consider focusing on one
or two strategies at a time. To improve communication skills, notice your
current communication style. With time and effort, you’ll convey better
ideas, thoughts, actions, and opinions in your personal and professional
life. Use the following strategies to get started.
1. Convey important points clearly and concisely.

• It may be tempting to insert additional information, include popular

phrases to relate to the listener, or fall back on filler words that lack true
meaning. However, this could be perceived as clutter when you want
others to understand your message fully. Many people read or listen to
tons of communications all day, so it's important to choose your words
wisely and organize your thoughts in a way that's easy to follow.
2. Use multiple modes of communication.
• We often communicate to others using a wide range of different communication
styles without even noticing it. In an email to a coworker, you may include a
screenshot of a document—a visual and written method of communication. When
you speak to someone face-to-face, meanwhile, you likely use nonverbal
communication with your body language and verbal communication as you’re
speaking.

• Intentionally using multiple modes of communication can add clarity to what

you’re trying to convey. Match the modes of communication you choose to the
type of communication and listener. Consider the best way to communicate based
on the end goal and needs of the listener, and prepare to use multiple modes of
communication if sharing with a group.
3. Be mindful of your tone.

• The way in which you say something – and the medium through which you do it
– affects how your communication is received by others. As a result, the tone of
your voice or your written communication should appropriately match what
you’re trying to convey.

• Think about how the interaction would be received if you were on the receiving
end. If you’re communicating a policy change to a group of employees, think
about their pain points, any questions they may have, and their needs. In your
communication, build in that information with a tone of understanding and
openness so that employees who may be anxious about such changes are calmed.
• When emotions get involved, it may be hard to maintain the tone you
intend. Take time to think through what you’ll say and how you’ll say it to
maintain better control of your emotions.
4. Maintain awareness of your body language and nonverbal cues.

• Similar to tone, it’s vital that you are aware of what your body language
and gestures convey to listeners. It may be challenging to control certain
nonverbal cues, especially if you struggle with emotions tied to the
conversation. Practice being aware of your body and facial expressions in
your daily communication to start understanding where you can improve.
Ask for feedback if appropriate.
5. Know your audience.

• To know your audience is to understand their thoughts and feelings—it involves

perspective and will take time and thoughtfulness. Modulate your tone, gestures,
and body language to help your audience perceive your motives and intentions.
Before you send an email, approach a coworker, or walk into a meeting, take the
time to understand the audience and consider how they may feel or react to what
you’re about to communicate to them.
6. Focus on what others say and acknowledge it.

• When you can focus on what you are saying and what others say in response, you
can tailor your communication style and content appropriately. Referred to as
active listening, this technique shows you are listening through nonverbal
communication.

• You may be more effective in your communication when you can acknowledge
the perception of others and respond appropriately to their feedback, questions, or
suggestions. Be open and listen, avoiding defensiveness and interrupting. If you
don’t know how to respond, simply tell the other person that you'll get back to
them once you've given it greater consideration. There is no harm in asking for
time to provide a thoughtful response.
7. Request and provide feedback.

• Asking for feedback can be helpful if you’re struggling with effective

communication. It can also help you build useful communication strategies in a
leadership role.

• Ask a boss or coworker to provide constructive feedback, or record yourself and

watch for any nonverbal communication that could negatively affect your ability
to transmit your message successfully. Manage your emotions and pride to accept
and implement constructive criticism. When you ask for feedback, invite the
listener to point out things you might be struggling with, thank them, and be
mindful of their time.
 COMMON COMPETENCY

RESPONDING EFFECTIVELY TO DIFFICULT/CHALLENGING BEHAVIOR

• This unit covers the knowledge, skills and attitudes to effectively respond to
difficult or challenging behavior of patient.
 10 Common Behavioral Problems
• Common behavioral problems for people living with dementia include:

1. Catastrophic reaction
• Over-reaction to trivial matters; this may result in weeping, screaming or
unreasonable accusations.

2. Repetitive behaviour
• Compulsion to follow relatives or staff asking the same questions over and over.
3. Hoarding
Hoarding all sort of items for safe keeping. Often accusing others of stealing their precious
possessions.

4. Inappropriate sexual behaviour

Loss of inhibitions and the consequent lack of awareness of the rules of appropriate behavior.

5. Aggressiveness
Physical (pushing, hitting) or verbal (abusive language)
6. Paranoia/Suspicion
• Often suspicious of staff and neighbors; they imagine that people are plotting
against them.

7. Wandering
• Aimless or purposeful wandering that can result in getting lost, leaving a safe
environment or intruding in inappropriate places.

8. Restlessness
• Pacing and fidgeting; this could be due to thirst, pain, medication side effects or
even boredom, stress, noise, lack of exercises.
9. Screaming and shouting
• Calling out continuously or weeping and whimpering for extended periods
of time. (Sometimes this behavior is a result of brain damage or
hallucinations and medical assistance is needed)

10. Sundowning
• An end-of-day confusion and restlessness that manifests as dusk
approaches.
 10 Ways to Respond to Challenging
Behavior
• Approach in a calm, respectful manner.

• It is best not to touch the person by leading or holding their arms; it may
aggravate the situation. Instead talk in a consoling and empathetic manner
and offer your arm: "Here, take my arm, let’s go to the dining
room/bedroom/veranda.“
• Try not to over-react even if the behavior is embarrassing; remember that
it is the illness causing the behavior.

• Avoid arguing; remember the person is not deliberately trying to upset

you. Their logic and reasoning are impaired by the illness and it is up to
you to comfort and reassure them.
• Be flexible; if the behavior is about a shower they don’t want to have, leave this
task for later when the person has calmed down.

• Observe the person and what their body language is conveying. Give them time to
calm down while offering solace.

• Validate their feelings. If a 95 year old man is very agitated ands asks you
whether you have seen his mother it is no use to point out to him that she is dead.
Go along with him, say something like: "No, I haven't seen her. Was she a great
cook? What did she cook that you loved?"
• Be mindful and 'in the moment'. If you are talking to the person and your
thoughts are elsewhere there is a good chance you won’t get the best result. Often
your body language and demeanor will speak louder than your words. Use a soft
tone of voice and some physical touch to add emphasis to the communication.

• Offer a distraction such as a walk or a board game.

• When you identify a strategy that works, write it down so other staff can use it
too.
• Understanding what may be causing the challenging behavior and learning
how to respond to it will enable carers to take control of situations when
they arise and diminish the occurrence the behavior.
Responding with Positive Communication

• Use calm statements, give space, reassure, refocus, and redirect whenever
possible. Clients rely on caregivers to be their anchors, which is why
simply remaining calm can help de-escalate challenging behaviors.
How do you respond effectively to difficult or challenging behaviour?

• Stay calm. treat the situation with humor, rather than getting angry. distract their
attention, rather than getting confrontational. if other people are present, explain to
them that the behaviour is because of an illness and is not personal

• Dealing with difficult behaviour can be challenging for both the recipient and the
person displaying the behaviour.

• When at work, we may come across challenging behaviour from a number of sources –
our colleagues, our manager, our customers or suppliers. Consequently, how you
manage the difficult behaviour, may be slightly different dependent upon the context of
the situation. For example, if you are dealing with a customer’s difficult behaviour, you
may find our tips on handling complaints helpful.
1. Appreciate and adjust

• Ask yourself why this person may be behaving this way and is this typical
or out of character. If you do wish to respond to the behaviour, adjust your
frame of mind to one that is positive and focused on helping them and you
move forward.
2. Build rapport and empathy

• Show some empathy and understanding appropriate to their behaviour and

‘state’ of mind. For example, if someone is angry, you can calm him or her
down by simply lowering your voice. However, responding back in anger
is only going to inflame the situation!
3. Change the environment

• Try physically moving away from the current environment, moving

chairs, or giving the person space and time. As a result, the situation will
tend to calm down and the negative, or difficult behaviour, you are
experiencing will subside.
4. Defuse the emotion first

• It is advisable to defuse the emotion before addressing the root cause of

the behaviour. For example, if the person is angry or upset, they are
unlikely to respond as rationally and calmly as you need them to, to get to
the root of the reason for their behaviour.
5. Explore the root cause of behavior

• Ask them open questions such as:

- “What has led you to feeling this way?”
- “What are your real concerns about this situation?”

• Then actively listen, summarized and reflect back their comments to check out
your understanding of what they are telling you. As well as calming the situation,
this will also help them recognized that you are listening to them and taking them
seriously.
6. Focus on the future outcome wanted

• Focusing on a positive outcome will address their root concerns and

ultimately change their challenging behaviour to be more amenable and
positive. In addition, check along the way that you have a clear
understanding of the outcome they are seeking.
• If you are not clear, ask them:
- “What would help us move forward”, Or, alternatively…
- “What would make the situation better”

• Adopting this strategy will help them consider and convey what they want
or need. As well as this, it will help the person move on from focusing
purely on the past or the negative aspects of a situation.
7. Develop an agreed solution

• The agreed solution will be one that both you and the person view as a
win/win outcome. Alternatively, you may reach a compromised solution
that satisfies the main elements or issues in a constructive way.
8. Highlight agreement and next steps

• Reaffirm your commitment to addressing the person’s concerns or needs.

In addition, provide assurance that you have effectively addressed the
issue in full. Thank the person for bringing the matter to your attention.
9. Inform others where appropriate

• Inform others of the situation or issue to ensure no future misunderstanding

occurs, or problems re-surface. Obviously, where difficult behaviour has
occurred due to personal issues, it may not be appropriate to inform or share
information with others. If you commit to retaining confidentiality, your
credibility in dealing with the difficult behaviour and relationships in
general will be at risk, as well as the original trust in the relationship.
10. Judge your success and learning

• Ask yourself what you have learnt from this situation, what you did well and what
you might do differently next time. Every experience in dealing with difficult
behaviour will be slightly different, so your ability to adapt to the person and the
context of the situation will be vital. There is always something new to learn.

• Finally, before implementing any of the above strategies for dealing with difficult
behaviour at work, we first need to ‘take a step back’ and think for a moment. In
particular, review your own perception and thought processes around the
behaviour. Ask yourself “why do we find this behaviour difficult?”
• Being clear of your purpose or reason for changing the behaviour is
important, as it keeps you focused at all times.
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