Chapter 18: Safety and Infection Control

1. Chapter 18: 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) • 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

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

29. 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

30. Infectious Disease (cont’d) • Airborne Diseases • Tuberculosis • Chickenpox • Common cold • Diphtheria • Influenza • Measles • Meningitis • Pneumonia • Whooping cough

31. Infectious Disease (cont’d) • Health care-associated infections

32. Infectious Disease (cont’d) • Blood-Borne Diseases • Human immunodeficiency virus (HIV) • Hepatitis B • Hepatitis C

33. 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

34. 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

35. 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

36. 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

37. 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

38. 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

39. Preventing the Spread of Disease (cont’d) • Personal Protective Equipment • Gloves • Masks • Gowns • Eye protection

40. Preventing the Spread of Disease (cont’d) • Regular Waste • Paper • Plastic • Disposable tray wrappers • Packaging materials

41. Preventing the Spread of Disease (cont’d) • Sharps Waste • Needles • Microscope slides • Used ampules • Razors

42. 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

43. 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