Examination and Treatment Areas

1. 9 Examination and Treatment Areas

2. Learning 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.

3. 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.

4. Introduction • Care and maintenance of exam room • Equipment • Supplies • Infection control practices

5. The Exam Room • Number and size of rooms • Two per physician • Accommodate the physician, patient, and one assistant • Supplies and equipment must be in reach

6. Furnishings • Arrangement • Efficiency • Patient comfort • Physician convenience • Examining table • Step • Drawers • Adjustable positioning

7. Furnishings Items commonly found in exam rooms Wastebasket with lid Puncture-proof containers Wall brackets High-intensity lamp • One or more chairs • A rolling stool • Weight scale • Biohazard container

8. Special Features • The 1990 Americans with Disabilities Act (ADA) • Requires “reasonable accommodations” • Accessibility • Guidelines

9. Apply Your Knowledge When arranging an examination room, what three things should you consider? ANSWER:You need to consider efficiency, patient comfort, and physician convenience when arranging an examination room. Right!

10. Sanitization and Disinfection • Sanitization • For cleaning items that touch only healthy, intact skin • First step in disinfection and sterilization for other equipment

11. Collect items for sanitization PPE Separate sharps from other equipment Scrub items Small brush Neutral pH detergent Dry Sanitization (cont.)

12. Sanitization (cont.) • Rubber and plastic items • Ultrasonic cleaning • For delicate instruments and those with moving parts • Sound waves generated through a cleaning solution to loosen contaminants

13. Disinfection • Adequate for some instruments • For others, it is the second step prior to sterilization • Sterilization is necessary for visible contamination with blood

14. Disinfection (cont.) • Using disinfectants • Cleaning products for inanimate materials • Reduce or eliminate infectious organisms • Manufacturer’s guidelines • Effectiveness

15. Disinfection (cont.) • Choose the correct disinfectant • Handling disinfected supplies • Prevent contamination with other surfaces • Use sterile transfer forceps • Wear gloves • Store in clean, moisture-free environment

16. Apply Your Knowledge What 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. Nice Job!

17. Preparation of the Exam and Treatment Areas • Clean and well organized • Safeguards • Making hand hygiene a priority; • Keeping the examining table clean; and • Disinfecting all work surfaces.

18. Infection Control • Hand hygiene • Handwashing • Alcohol-based hand cleaners • Examining Table • Paper cover • Linens

19. Infection Control (cont.) • Disinfect surfaces • Visibly contaminated with tissue, blood or other body fluids • At end of shift • Per office schedule

20. Infection Control (cont.) • Storage • Store biohazardous specimens properly • Work practice controls • Store testing kits properly

21. Putting the Room in Order • Straighten and put items away • Contributes to physical safety • Housekeeping

22. Apply Your Knowledge Other 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.

23. Room Temperature, Lighting, and Ventilation • Maintain examination room temperature at about 72°F • Eliminate drafts Temperature

24. Lighting • Accurate diagnoses • Perform medical procedures • Read orders and instructions • Prevent accidents

25. Ventilation • Examination area should smell clean and fresh • Eliminate source of odors • If opening windows, monitor room temperature • Room deodorizer or spray

26. Apply Your Knowledge Why is it important to have good lighting in the examination room? ANSWER: Good lighting is needed for making accurate diagnoses, performing medical procedures, reading orders and instructions, and preventing accidents. Excellent!

27. Medical Instruments and Supplies • Maintain instruments and supplies • Order and stock all needed supplies • Sanitize, disinfect, and/or sterilize instruments as needed • Instruments and supplies should be placed within easy reach for the physician

28. Instruments Used in a General Physical Exam

29. Instruments for a General Physical Exam(cont.)

30. Instruments for a General Physical Exam (cont.)

31. Instruments for a General Physical Exam (cont.) • Inspecting and maintaining instruments • Arranging instruments • Mounted on wall • Out on countertop • Set on a clean towel or tray

32. Instruments for a General Physical Exam (cont.) • Preparing instruments • Cleaning instruments • Dispose of supplies in the appropriate containers • Use approved procedures for sanitizing, disinfecting, and sterilizing

33. Supplies for a General Physical Exam Needles and Syringes Curettes Cervical scraper Sterile and clean gloves Cotton balls Cotton-tipped applicators Gauze, dressings, and bandages Specimen containers Papertissues Glass slides Occult bloodtest slides Tonguedepressors

34. Supplies for a General Physical Exam (cont.) • Consumable supplies • Fixative • Isopropyl alcohol • Lubricant • Be sure patients do not have access to • Prescription blanks • Drugs • Needles

35. Store supplies Label drawers Put items back in correct place Routinely straighten and clean Restocking supplies Supplies for a General Physical Exam (cont.)

36. Apply Your Knowledge stethoscope penlight sphygmomanometer nasal speculum laryngeal mirror tuning fork reflex hammer ophthalmoscope anoscope otoscope tape measure A 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? ANSWER: *penlight *nasal speculum *laryngeal mirror *tuning fork *ophthalmoscope *otoscope Good Choices!

37. In Summary 9.1 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.

38. 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.

39. 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. In Summary (cont.)

40. End of Chapter 9 As a general thing, an individual who is neat in his person is neat in his morals ~Henry Wheeler Shaw