Chapter 13: Safety and Infection Control. Copyright 2012 Wolters Kluwer Health Lippincott Williams & Wilkins

Transcription

1 Chapter 13: Safety and Infection Control

2 Role of Regulatory Agencies Occupational Safety and Health Administration (OSHA) Federal agency Ensures safety of workers Enforces safety & health legislation Requires health care facilities to establish practices Requires facilities keep practices in policy & procedure manual

3 Role of Regulatory Agencies (cont d) Center for Disease Control and Prevention (CDC) Federal agency Dedicated to prevention of disease, injury, & disability Part of Department of Health and Human Services Developed guidelines to prevent spread of infection Requires that all bodily substances be treated as if infectious

4 Principles of Safety Developmental Considerations Unborn children: exposure to drugs, alcohol, or smoke Children: increase in hazards as motor skills develop Adolescents: danger from drugs, alcohol, risky sexual activity Older adults: risk of abuse & injury from falls

5 Principles of Safety (cont d) Factors Affecting Safety: Physiological Musculoskeletal system Injury to or aging of bones, joints, or muscles Affects mobility & increases risk of injury Neurological system Impairment to brain, spinal cord, or nerves Interferes with judgment & motor control Fatigue Leads to poor perception of danger, faulty judgment, poor problem solving

6 Principles of Safety (cont d) Factors Affecting Safety: Environmental Home Poor ventilation Gas leaks Faulty electrical systems & appliances Lack of smoke detectors Unlabeled toxic substances

7 Principles of Safety (cont d) Factors Affecting Safety: Environmental (cont d) Workplace Dust Chemicals Noise Heights Dangerous machines Heavy lifting Repetitive motions

8 Principles of Safety (cont d) Factors Affecting Safety: Environmental (cont d) Community Air pollution Crime Hazardous waste sites Dilapidated housing Poor sanitation

9 Safety Precautions and Actions Patient Safety Orientation to facility layout, safety features, & equipment Adjustable bed & side rails Call system Use of safety straps & side rails during patient transport Identification bracelets Elimination of fall hazards, such as debris or objects on ground Proper use & maintenance of equipment

10 Safety Precautions and Actions (cont d) Health Care Worker Safety Proper posture Proper body mechanics Proper ergonomics Prevention of exposure to: Pathogens Chemicals Radiation

11 Safety Precautions and Actions (cont d) Fire: Prevention Measures Regular maintenance of electrical equipment Strict smoking policies Fire safety plan Emergency exits Fire extinguishers Instructions for reporting a fire

12 Safety Precautions and Actions (cont d) Fire Response Procedures: RACE Rescue anyone in immediate danger Activate the fire code system & notify the appropriate person Confine the fire by closing doors & windows Evacuate patients & other people to a safe area or extinguish fire, if safe to do so

13 Safety Precautions and Actions (cont d) Classes of Fires A Ordinary combustibles: wood, cloth, paper, plastic B Flammable liquids C Live electrical

14 Safety Precautions and Actions (cont d) Classes of Fire Extinguishers A For A fires only; do NOT use on B or C fires Cool & smother fire with ordinary water BC For B or C fires only; do NOT use on A fires Use dry chemical or carbon dioxide ABC For any type of fire Uses baking soda-like material

15 Safety Precautions and Actions (cont d) Directions for Operating a Fire Extinguisher: PASS Pull the locking pin Aim the nozzle at the base of the fire Squeeze the handle Sweep from side to side

16 Safety Precautions and Actions (cont d) Electrical Hazards Do not handle electrical devices & cords: With wet hands When wearing wet shoes Mop up spilled fluids Make sure all plugs are grounded Report any equipment damage Service equipment regularly

17 Safety Precautions and Actions (cont d) Oxygen Equipment Avoid open flames near oxygen equipment Place No Smoking signs nearby Make sure all electrical equipment is: Grounded In good working order Avoid synthetic fabrics that build up static electricity Avoid use of oils in area

18 Safety Precautions and Actions (cont d) Chemical Hazards Alcohol Used as a disinfectant Eye irritant, combustible, flammable Ethylene oxide Used for sterilizing Eye irritant, explosive, flammable Cleaning & disinfecting agents: eye, skin, & respiratory tract irritant Gases used for anesthetics or gas-powered equipment

19 Safety Precautions and Actions (cont d) Radiation Wear radiation detection badge Minimize time of exposure to source Maximize distance from source Use appropriate shielding (lead shields or aprons, gloves)

20 Safety Precautions and Actions (cont d) International radiation symbol

21 Safety Precautions and Actions (cont d) Workplace Violence: Factors Prevalence of handguns & other weapons Criminal holds & care of disturbed, violent people Release of mentally ill patients without follow-up care Presence of drugs & money Unrestricted movement of public in clinics & hospitals Long waits in emergency or clinic areas Presence of gang members, drug/alcohol abusers, trauma patients, distraught family members Isolated work with clients during examinations or treatment

22 Safety Precautions and Actions (cont d) Emergency Action Plan Method for reporting fires & other emergencies Evacuation policy Emergency escape procedures Names & contact info of key people Procedures for shutting down critical operations Procedures for operating fire extinguishers Designated rescue & medical duties Site of alternative communications center Secure onsite or offsite location for storing records

23 Infectious Disease Infectious Microorganisms Pathogen: disease-causing microorganism Found in almost all environments Bacteria: aerobic vs. anaerobic Viruses: smallest Fungi: plantlike organisms (molds & yeasts)

24 Infectious Disease (cont d) Disease-Producing Factors Number of organisms in exposure Virulence of organism Relative strength of person s immune system Length & intimacy of contact between person & microorganism

25 Infectious Disease (cont d) The Chain of Infection: Five Links Reservoir: person infected (carrier) Exit from reservoir: nose, mouth, rectum, open wound Vehicle of transmission Portal of entry: nose, mouth, GI system, wound Susceptible host: person who becomes infected

26 Infectious Disease (cont d) Chain of infection

27 Infectious Disease (cont d) Chain of infection

28 Infectious Disease (cont d) Chain of infection

29 Infectious Disease (cont d) Modes of Transmission: Direct Touching contaminated blood or body fluids Shaking hands with contaminated person Inhaling infected air droplets Intimate contact (kissing, sexual intercourse) with infected person

30 Infectious Disease (cont d) Modes of Transmission: Indirect Contaminated food or water Disease-carrying insects Soil Drinking glasses Improperly disinfected medical instruments

31 Infectious Disease (cont d) Sources of Transmission Human hosts with infectious disease Carriers of disease who are not ill with it Those incubating a disease but not yet showing symptoms Infected animals: dogs, cats, birds, cattle, rodents, flies, roaches, ticks, mosquitoes

32 Infectious Disease (cont d) Airborne Diseases Tuberculosis Chickenpox Common cold Diphtheria Influenza Measles Meningitis Pneumonia Whooping cough

33 Infectious Disease (cont d) Health care-associated infections

34 Infectious Disease (cont d) Blood-Borne Diseases Human immunodeficiency virus (HIV) Hepatitis B Hepatitis C

35 Infectious Disease (cont d) Training Points for Prevention of Blood-Borne Diseases Descriptions of diseases Methods of transmission Related symptoms Protective equipment & its location in facility Risks of contracting hepatitis B HBV vaccine Exposure control plan Post-exposure procedures & follow-up care

36 Preventing the Spread of Disease Standard Precautions: Overview Procedures to reduce transmission of microorganisms Must be used when touching: Blood Body fluids Damaged skin Mucous membranes

37 Preventing the Spread of Disease (cont d) Standard Precautions: Requirements Hand washing Alcohol rubs Gloves, masks, gowns, & eyewear Disposal of single-use items & sharps in proper containers Avoiding sharps injuries Not recapping, bending, or breaking needles Not eating, drinking, or putting anything in your mouth while working

38 Preventing the Spread of Disease (cont d) Medical Asepsis: Hand Washing Before & after every patient contact After contact with blood, body fluids, or contaminated material After handling specimens After coughing, sneezing, or blowing your nose After using the restroom Before & after lunch, taking breaks, & leaving for the day

39 Preventing the Spread of Disease (cont d) Cleaning Use of soap or detergent & water Reduces # of microorganisms to safe level Disinfection Use of agent to destroy many, but not all, pathogens Antiseptics

40 Preventing the Spread of Disease (cont d) Sterilization Total destruction of all microorganisms on objects & surfaces Bactericidal or germicidal means 4 methods Steam under pressure in an autoclave Specific gases, such as ethylene oxide Dry heat ovens Immersion in a chemical agent

41 Preventing the Spread of Disease (cont d) Personal Protective Equipment Gloves Masks Gowns Eye protection

42 Preventing the Spread of Disease (cont d) Regular Waste Paper Plastic Disposable tray wrappers Packaging materials

43 Preventing the Spread of Disease (cont d) Sharps Waste Needles Microscope slides Used ampules Razors

44 Preventing the Spread of Disease (cont d) Biohazard Waste Soiled dressings & bandages Soiled examination gloves Soiled examination table paper Cotton balls & applications used on body

45 Preventing the Spread of Disease (cont d) Reporting an Exposure: Criteria for Submitting Report Work-related exposure requiring medical treatment Loss of consciousness or medical removal Loss of days at work or transfer to other job Injury involving sharp contaminated with blood Exposure to tuberculosis Positive blood test for contagious disease