Environmental and patient/therapist safety

1. Environmental and patient/therapist safety

2. Preparation for Patient Care • Preparing clear patient care environment/ room • Preparation of the treatment area for the next patient at the end of each patient treatment • Risk Management • Maintenance of the treatment area • Prior to patient treatment

3. Aseptic Techniques • CDC guidelines (Center for Disease Control and Prevention) • Microorganism transmission barriers/isolation • Transmission-based precautions • Modes of transmission • Contact transmission • Droplet transmission • Airborne transmission • Common vehicle transmission • Vectorborne transmission.

4. Precautions • Isolation precaution • administrative controls • Education • Adherence to precautions • Standard Precautions (prevents clinician to become a vectorborne) • Universal precaution + body substance isolation + all body fluids may contain transmissible infectious agents. • Includes: hand hygiene, gloves, gown, mask, eye protection/face shield and safe injection practices.

5. New elements of standard precautions • Respiratory hygiene/cough etiquette • Cover mouth and nose with tissue when sneezing/coughing • Safe injection practices • Proper disposal of needles in the sharp containers and disinfected needle sites • Use of masks for insertion of catheters or injection of material into spinal or epidural spaces via lumbar puncture procedures

6. Standard Precautions • Hand Hygiene • Hand wash • rubbed vigorously during 20 seconds with special attention paid to the backs of the hands, wrists, between the fingers, and under fingernails. • Rinse the hands well while leaving the water running as well as drying with a single-use towel • Turn off the water with a paper towel and prevent re-contamination

7. Personal Protective equipment (PPE) • Where to wear and where to discard it • Gloves • sterile techniques • nonsterile techniques • Gowns (prevent splash and soil clothing) When in direct contact with patients • Mask/goggles/face shields

8. Personal Protective equipment (PPE) – cont. • Patient-care equipment and instruments/devices • Handling and transporting to follow the facilities’ P&P. • Wear PPE to clean an used or contaminated equipment. • Care of the environment • To follow facilities’ P&P • Clean and disinfect surfaces that are likely to be contaminated. In case of doubt, consider it contaminated. • Textiles and laundry • Avoid agitation to prevent airborne contamination

9. Precautions Protocols • For safety, we consider all patients are contaminated until proof the opposite. Therefore use standard precautions • Contact – gowns and gloves done prior to enter the patient’s room and doff before exiting patient’s room. • Patient transport – acute hospitals, LTAC, ECF • Sterile Techniques.

10. Draping • Covering a patient appropriately • Edge of sheets and towels must be secured • Hospital gowns, towels and bed sheets or appropriate attire • Safety measures • Follow the specific policies of each facility • Transportation equipment

11. Case study 2 • This is Tom who was diagnosed with lymphedema to his LLE. • Take his Vital Sign • Setup his intermittent compression pump

12. Today’s Overview

13. Summary • Take full advantage of your open labs and your instructor’s time • Set realistic expectation • All competency exams are timed and cues will be given for those who ask. • Practice, Practice, Practice

14. Questions?