Y khoa - Dược - Chapter 9: Examination and treatment areas

9Examination and Treatment AreasLearning Outcomes (cont.)9.1 Describe the layout and features of a typical  examination room. 9.2 Differentiate between sanitization and  disinfection. 9.3 List steps to prevent the spread of infection in  the exam and treatment rooms. Learning Outcomes (cont.)9.4 Describe the importance of temperature,  lighting, and ventilation in the exam room. 9.5 Identify instruments and supplies used in a  general physical exam and tell how to arrange  and prepare them. IntroductionCare and maintenance of exam roomEquipment Supplies Infection control practicesThe Exam RoomNumber and size of roomsTwo per physicianAccommodate the physician, patient, and one assistantSupplies and equipment must be in reachFurnishingsArrangementEfficiencyPatient comfortPhysician convenienceExamining tableStepDrawersAdjustable positioning FurnishingsItems commonly found in exam roomsOne or more chairs A rolling stool Weight scale Biohazard containerWastebasket with lid Puncture-proof containersWall bracketsHigh-intensity lampSpecial FeaturesThe 1990 Americans with Disabilities Act (ADA)Requires “reasonable accommodations”Accessibility GuidelinesApply Your KnowledgeANSWER: You need to consider efficiency, patient comfort, and physician convenience when arranging an examination room.When arranging an examination room, what three things should you consider?Right!Sanitization and DisinfectionSanitizationFor cleaning items that touch only healthy, intact skinFirst step in disinfection and sterilization for other equipmentSanitization (cont.)Collect items for sanitizationPPESeparate sharps from other equipmentScrub itemsSmall brushNeutral pH detergentDry Sanitization (cont.)Rubber and plastic items Ultrasonic cleaning For delicate instruments and those with moving partsSound waves generated through a cleaning solution to loosen contaminantsDisinfectionAdequate for some instruments For others, it is the second step prior to sterilizationSterilization is necessary for visible contamination with bloodDisinfection (cont.)Using disinfectantsCleaning products for inanimate materials Reduce or eliminate infectious organisms Manufacturer’s guidelinesEffectivenessDisinfection (cont.)Choose the correct disinfectantHandling disinfected suppliesPrevent contamination with other surfacesUse sterile transfer forcepsWear glovesStore in clean, moisture-free environmentApply Your KnowledgeWhat is sanitation and for what items is sanitation adequate for cleaning?ANSWER: Sanitation is scrubbing with a brush and detergent to remove blood, mucus, and other contaminants or media where pathogens can grow. It is adequate for cleaning items that touch only healthy, intact skin.Preparation of the Exam and Treatment AreasClean and well organizedSafeguards Making hand hygiene a priority;Keeping the examining table clean; andDisinfecting all work surfaces.Infection Control Hand hygieneHandwashingAlcohol-based hand cleanersExamining TablePaper coverLinens Infection Control (cont.)Disinfect surfacesVisibly contaminated with tissue, blood or other body fluids At end of shiftPer office scheduleInfection Control (cont.)StorageStore biohazardous specimens properlyWork practice controlsStore testing kits properlyPutting the Room in OrderStraighten and put items awayContributes to physical safetyHousekeeping Apply Your KnowledgeOther than at the end of your shift, when should you disinfect the surfaces in the examination rooms?ANSWER: Whenever there is visible contamination with blood, body fluid, or body tissue.Room Temperature, Lighting, and VentilationMaintain examination room temperature at about 72°FEliminate drafts TemperatureLightingAccurate diagnosesPerform medical proceduresRead orders and instructionsPrevent accidents VentilationExamination area should smell clean and freshEliminate source of odorsIf opening windows, monitor room temperatureRoom deodorizer or sprayApply Your KnowledgeANSWER: Good lighting is needed for making accurate diagnoses, performing medical procedures, reading orders and instructions, and preventing accidents.Why is it important to have good lighting in the examination room?Medical Instruments and SuppliesMaintain instruments and suppliesOrder and stock all needed suppliesSanitize, disinfect, and/or sterilize instruments as neededInstruments and supplies should be placed within easy reach for the physicianInstrumentPurposeAnoscopeUsed to open the anus for examinationExam lightProvides additional lightingLaryngeal mirrorReflects inside of mouth and throatNasal speculumUsed to enlarge the opening of the noseOphthalmoscopeUsed to examine the inner eye surfacesInstruments Used in a General Physical ExamInstrumentPurposeOtoscopeUsed to examine the inner earPenlightSmall flashlight used to view a small areaReflex hammerUsed to check patient’s reflexesSphygmomanometerUsed to measure blood pressure Instruments for a General Physical Exam (cont.)InstrumentPurposeStethoscopeUsed to listen to body soundsTape measureUsed to measure size or development of an areaThermometerUsed to measure body temperatureTuning forkUsed to test hearingVaginal speculumUsed to enlarge the vagina for specimens from cervix and vaginaInstruments for a General Physical Exam (cont.)Instruments for a General Physical Exam (cont.)Inspecting and maintaining instruments Arranging instrumentsMounted on wallOut on countertopSet on a clean towel or trayInstruments for a General Physical Exam (cont.)Preparing instrumentsCleaning instrumentsDispose of supplies in the appropriate containersUse approved procedures for sanitizing, disinfecting, and sterilizingCervical scraperCotton ballsCotton-tipped applicatorsCurettesNeedles and SyringesGauze, dressings, and bandagesGlass slidesSterile and clean glovesPaper tissuesOccult blood test slidesSpecimen containersTongue depressorsSupplies for a General Physical Exam Supplies for a General Physical Exam (cont.) Consumable suppliesFixativeIsopropyl alcoholLubricant Be sure patients do not have access toPrescription blanksDrugsNeedles Supplies for a General Physical Exam (cont.) Store supplies Label drawersPut items back in correct placeRoutinely straighten and clean Restocking suppliesstethoscopenasal speculumreflex hammerotoscopepenlightlaryngeal mirrorophthalmoscopetape measuresphygmomanometertuning forkanoscopeApply Your KnowledgeA medical assistant is preparing the treatment room for a local ENT specialist. Which of the following instruments might be used in this office to assess patient ear, nose, and throat functioning?*nasal speculum*otoscope*penlight*laryngeal mirror*ophthalmoscope*tuning forkANSWER:Good Choices!In Summary9.1 A typical examination room is about 8 by 12 feet, large enough to accommodate the physician, the patient, and  one assistant. Instruments and equipment in the room  should be easily accessible. 9.2 Sanitization is the scrubbing of instruments and  equipment with special brushes and detergent to  remove blood, mucus, and other contaminants or  media where pathogens can grow. Disinfection uses  special cleaning products applied to instruments and  equipment to reduce or eliminate infectious organisms.In Summary (cont.)9.3 Steps involved in preventing the spread of infection in  the examination room include covering the examination  table with a paper cover and changing the cover  between each patient. It is also important to disinfect all  surfaces that come in contact with blood or body fluids  after each patient, and at the beginning and end of the  day.9.4 It is important that patients feel comfortable in the examination room. A comfortably warm, well lit, and  properly ventilated room will help the patient feel  comfortable during his examination.In Summary (cont.)9.5 A variety of instruments and supplies are used in a  general physical examination. To ensure the  examination room always has the necessary  instruments and supplies, the medical assistant should  order and stock all supplies needed for examinations  and treatment procedures; keep the instruments  sanitized, disinfected, or sterilized and in working order;  and place all instruments and supplies where the  physician can easily reach them.End of Chapter 9