Y khoa - Dược - Chapter 6: Basic safety and infection control

6Basic Safety and Infection ControlLearning Outcomes6.1 Describe the components of a medical office safety plan. 6.2 Identify OSHA’s role in protecting healthcare workers.6.3 Describe basic safety precautions you should take to reduce electrical hazards.6.4 Illustrate the necessary steps in a comprehensive fire safety plan.Learning Outcomes (cont.)6.5 Summarize proper methods for handling and storing chemicals used in a medical office.6.6 Explain the principles of good ergonomic practice and physical safety in the medical office. 6.7 Illustrate the cycle of infection and how to break it.6.8 Summarize the Bloodborne Pathogens Standard and Universal Precautions as described in the rules and regulations of the Occupational Safety and Health Administration (OSHA). 6.9 Describe methods of infection control including those preventing healthcare- associated infections. 6.10 Describe Centers for Disease Control and Prevention (CDC) requirements for reporting cases of infectious disease.Learning OutcomesIntroduction Accidents can occur in healthcare settingsRemove or correct hazardsPhysicalChemicalBiohazardousRemoval or correction of hazards is integral to risk managementMedical Office Safety PlanMinimize riskEstablish a safety planEducation about potential dangers facilitates the removal or correction of these hazardsMedical Office Safety Plan (cont.)Comprehensive written safety plan Easily accessible Updated annuallyKnow and follow the plan’s policies and proceduresApply Your KnowledgeWhy is it important to have a safety plan in a medical office and what should the plan cover?ANSWER: It is important to have a safety plan to help minimize risk and make everyone aware of potential hazards. A safety plan should contain:OSHA Hazard CommunicationElectrical and fire safetyEmergency action planChemical safetyBlood borne pathogen exposurePersonal protective equipmentNeedlestick prevention Right!Occupational Safety and Health AdministrationEmployee safetySpecific standard vs. General Duty ClauseEnforces guidelines established by the Centers for Disease Control and Prevention (CDC)OSHA Hazard CommunicationBiohazard labelsWarning signsMaterial Safety Data Sheets (MSDSs)Hazard labelsOSHAFinal rule Standardize LabelingSafety informationRight to understandChangesHazard classificationLabels MSDSsApply Your KnowledgeANSWER: So employees can take measures to protect themselves against harm.Why is it important for hazardous materials be correctly labeled?Electrical SafetyKnow location of power shutoffsAvoid using extension cordsObserve for frayed electrical wiresDry hands before working with electrical devicesDo not position electrical devices near sources of waterApply Your KnowledgeANSWER: Avoid using extension cords. Tape extension cords to the floor to avoid tripping. Repair or replace equipment that has a broken or frayed cord. Dry your hands before working with electrical devices. Do not position electrical devices near sinks, faucets, or other sources of water. List three electrical safeguards to practice in the healthcare setting?Fire SafetyMany potential hazards in a medical officeFire Prevention Hazards in the exam roomOffice laboratory ~ open flameIn Case of Fire (cont.)Using safety equipmentFire extinguisher – “PASS” systemFire blanketEmergency Action Plans and DrillsResponsibilityReporting fireOverseeing evacuationBuilding evacuation routesCurrent locationNearest exitEmergency Action Plans and Drills (cont.)Evacuation ProcedureEnsure patients and staff are evacuatedCheck that everyone has leftTake MSDS bookAssembly areaEmergency action plan drillsLocal emergency contactsApply Your KnowledgeOnce at the assembly area after an evacuation how would you account for employees and patients?ANSWER: Conduct a roll call of all employees. You can use the check-in roster to account for patients. Proper handling and storageMSDSGeneral precautionsEye wash stationChemical SafetyChemical Safety (cont.)Do not hold under noseUse fume hood or personal ventilation deviceOnly combine chemicals as requiredNo mouth pipettingAdd acid to other substancesClean up spills properlyApply Your KnowledgeWhat are the precautions you should take when working with hazardous substances?ANSWER: Store below eye levelWear protective gearCarry with both handsProperly ventilatedGreat!Ergonomics and Physical SafetyErgonomicsMaintain a healthy and safe posture Do not over reachLift properly ErgonomicsTransferring a patientLift with kneesAsk for assistanceUse transfer deviceAdjust seatTake frequent breaks from the computerPhysical SafetyWalk, do not run, in the office. Wipe up spills immediately Clear the floor of dropped objectsBe sure there are no snags or tears in the carpetDestroy and dispose of medications that are dropped on the floorPhysical Safety (cont.)Be careful when carrying objects Close cabinets, doors, and drawers Inspect furniture for rough edgesTape down cords and equipment cablesNever use damaged equipment or suppliesPhysical Safety (cont.)Safeguards for the laboratory environmentWear protective gear Follow manufacturer’s guidelines Physical Safety (cont.)Special safety precautionsChildren Patients with physical disabilitiesSafe flooring HandrailsApply Your KnowledgeANSWER: The employerWhose responsibility is it to ensure a safe work environment? SUPER!Whose responsibility is it to follow safe work practices?ANSWER: The employeeInfection ControlMedical assistant Help to create and maintain a safe and healthy environment Understand how infectionsOccurAre transmitted in the populationPractice infection control precautionsCycle of InfectionBackCycle of Infection (cont.)Reservoir Host – body capable of sustaining pathogen growthCarrierEndogenous infection Exogenous infection Means of Exit - how the pathogen leaves the hostClick for Cycle of InfectionsCycle of Infection (cont.)Means of transmission – how the pathogen spreads to a hostAirborneBloodborne During pregnancy or birthClick for Cycle of InfectionCycle of Infection (cont.)How the pathogen spreads to a hostFoodborneVector-borneTouchingDirect – contact with an infected persons mucous membranesIndirect – fomites Click for Cycle of InfectionCycle of Infection (cont.)Means of EntranceAny cavity lined with mucous membraneBreaks in the skinSusceptible Host An individual with little or no immunityFactors influencing susceptibility Click for Cycle of InfectionCycle of Infection (cont.)Environmental factorsDense populationsAnimals and insectsEconomic and political factorsAvailability of transportationUrbanization and population growth ratesSexual behaviorBreaking the CycleAsepsis Maintain strict housekeeping standardsAdhere to government guidelines Educate patients Hygiene Health promotionDisease prevention Apply Your KnowledgeWhat is your role as a medical assistant in breaking the cycle of infection in the medical office?ANSWER: To apply these measures: Maintain strict housekeeping standards to reduce the number of pathogens presentAdhere to government guidelines to protect against diseases caused by pathogensEducate patients in hygiene, health promotion, and disease prevention..OSHA Bloodborne Pathogens Standard and Universal PrecautionsDisposal of infectious or potentially infectious waste Laws protect healthcare workers and patientsTraining personnelRecord keepingHousekeeping Wearing protective gearOSHA Bloodborne Pathogens StandardEmployers mustDevelop an OSHA Exposure Control PlanProvide training to all employeesDocumentationPPE, Universal Precautions, engineering controlsWhat to do if exposure occursProvide the hepatitis B vaccineUniversal Precautions (cont.)Universal Precautions apply to all blood and body fluids Standard PrecautionsUsed in healthcare facilities for the care of all patients Prevents the transmission of diseaseUniversal Precautions (cont.)Risk categoriesTasks that require specific protective measuresTasks that require precautions in certain situationsTasks requiring no special protectionWritten Exposure PlanDetermination of exposureImplementation of control methodsPost-exposure evaluation and follow-upCommunication and trainingRecordkeepingEvaluation of exposure incidentsExposure IncidentsNotify the physician or employer immediatelyRefer the employee to a licensed healthcare provider Counsel the employee Draw blood and prescribe treatmentWritten reportOther OSHA RequirementsHBV vaccineNeedlestick Safety and Prevention ActEngineered safety devicesEmployer recommendationsEngineering controlsNeedlestick safety programsOther OSHA Requirements (cont.)Employee recommendations Avoid using needlesHelp choose devicesUse devices providedDo not recap needlesDispose of sharps correctlyReport injuries and hazardsParticipate in trainingApply Your KnowledgeANSWER: There are three categories of risk:Category 1: Expose a worker to blood, body fluids, or tissues and require specific protective measuresCategory 2: Usually do not involve risk of exposure, but precautions are required in certain situationsCategory 3: No risk of exposure, so no special protection is requiredOSHA divides medical tasks by level of risk. What are these risk categories?Infection Control MethodsKnowledge of Medical asepsis Based on cleanlinessAs few microorganisms as possibleSurgical asepsisSterile environmentNo microorganismsInfection Control Methods (cont.)Keep office cleanPrevent cross-contaminationFollow guidelinesUse protective gearHand HygieneHandwashingAlcohol-based hand disinfectants (AHD)Fingernail lengthNail polish and artificial nailsOther Aseptic PrecautionsAvoid leaning against sinks, etc.Avoid touching your face and mouthUse tissues for coughing or sneezing; wash hands afterwardAvoid working with patients if you have a cold; wear gloves and mask Stay home if you have a feverPersonal Protective EquipmentGlovesMasks and protective eyewear or face shieldsProtective clothingUse of multiple types of PPETransmission from Healthcare WorkersHealthcare-associated infections (HAI)Adhere to OSHA StandardsHigh risk procedures HIV, HBV status of healthcare workersApply Your KnowledgeDescribe the difference between medical and surgical asepsis.ANSWER: Medical asepsis is based on cleanliness and reducing the number of microorganisms as much as possible. Surgical asepsis is maintaining a sterile environment by eliminating all microorganisms.Good Answer!Reporting Guidelines for Infectious DiseasesState or county health departmentInformation is forwarded to the CDC National Notifiable Disease Surveillance SystemReporting Guidelines (cont.)Reporting – correct formDisease identificationPatient identificationInfection historyReporting institution nameApply Your KnowledgeHow is the information on reportable diseases used by the CDC?ANSWER: The CDC uses the information reported to them to help control the spread of infection. Good Answer!In Summary6.1 The medical office safety plan should include OSHA’s Hazard Communication; electrical, fire, and chemical  safety; emergency action plans; bloodborne pathogen exposure plans; PPE; and needlestick prevention plans.6.2 The U.S. Department of Labor created OSHA to protect  the employees’ safety in the workplace. Through the creation and enforcement of standards such  as the Bloodborne Pathogens Standard, Hazard  Communication, and the Needlestick Safety and  Prevention Act, OSHA serves to protect healthcare  workers from hazards.In Summary (cont.)6.3 To reduce electrical hazards in the medical office, you  should avoid using extension cords, repair or replace  damaged cords, avoid overloading circuits, ensure that  all plugs are grounded, dry your hands before using  electrical devices, and keep electrical devices away  from sinks or other sources of water.6.4 A comprehensive fire safety plan must include fire  prevention strategies, actions to take in the event of a  fire, building evacuation routes and plans, fire drills, and local emergency contacts.In Summary (cont.)6.5 When using chemicals in the medical office, you  should always wear protective gear, carry the  container with both hands, work in a well-ventilated  area, never combine chemicals unless it is specifically  required in the test procedures, and properly clean up  spills immediately.6.6 In order to protect yourself from work-related  musculoskeletal disorders at work, you must follow the  principles of good body mechanics. Your physical safety at work depends on  understanding and applying appropriate workplace  safeguards.In Summary (cont.)6.7 In order for an infection to occur, these five elements  must be in place: a reservoir host, a means of exit, a  means of transmission, a means of entrance, and a  susceptible host. The most effective means of breaking the cycle of  Infection is by using aseptic techniques. 6.8 Laws set forth in the OSHA Bloodborne Pathogens  Standard of 1991 dictate how you must handle  infectious or potentially infectious waste generated  during medical or surgical procedures. In Summary (cont.)6.9 The two basic methods of infection control are medical asepsis and surgical asepsis. OSHA recommends that healthcare workers who work  with high-risk patients know their HIV and HBV status,  participate in a HBV vaccination program, and avoid  direct patient contact if they have a skin condition  characterized by sores that secrete fluid. 6.10 The CDC requires reporting of certain diseases to the  state or county department of health, who then reports  the information to the National Notifiable Disease  Surveillance System of the CDC.End of Chapter 6Soap and education are not as sudden as a massacre, but they are more deadly in the long run.~ Mark Twain