Safety and Infection Control

1. Safety and Infection Control Sarah Woolard, Jessica Bozych, Lisa Anderson, Jessica Linn, Barb Lowell

2. Overview To educate patients and staff on work place safety and infection control. “The understanding that employee safety is just as important as patient safety must be constantly re-enforced so that nurses realize it is not ok to go home with a backache every day. It is a culture change and it is an important one.” -Karen Witzman

3. Hazard Control • Fire Prevention • Fuel, Oxygen, and Heat • Spontaneous combustion • Paint • Oily rags • Oily waste (2010). Saftey and Infection Control

4. Hazard Control • Fire Safety • RACE • Rescue • Alarm • Contain • Evacuate/ Extinguish (2010). Saftey and Infection Control

5. Hazard control • Fire Safety • Pass • Pull the Pin • Aim the nozzle • Squeeze the handle • Sweep (2010). Saftey and Infection Control

6. Hazard control • Fire Safety • Class A • Paper or wood • Class B • Flammable liquids or gases • Class C • Electric equipment or wiring (2010). Saftey and Infection Control

7. Hazard Control • Electric Shock • Ground Plugs • Equipment that is used near any type of water • Overload circuits • Connecting to many circuits to a single outlet • Extension Cords • Never use extension cords us an approved power strip • Proper Approval • All equipment and circuits must be approved for safety before being used after set up. (2010). Saftey and Infection Control

8. Hazard Control • Falls and Collisions • Equipment put to close to a corner • Storage areas • Heavy items places on the floor or near the floor • Electric cords should not be strung across doorways or traffic areas • If cord must be placed in areas tape down to the floor to reduce tripping. (2010). Saftey and Infection Control

9. Work Place Safety • Ergonomics • Good body mechanics is using the body in efficient and careful ways and includes good posture, balance, and using the largest muscles to do the heaviest work. • Most common injuries in the office is to the eyes and the back Walsh, M. C. (2004, July 24).

10. Work place safety • Eye Strain • Problems with the eyes in the office: • Double vision • Burning and dry eyes • Eye fatigue • Light sensitivity • After images • Prevention • Have good lighting • No glare • Use high quality monitor • Take breaks from the computer • Make sure you are blinking when at a computer for long amounts of time Walsh, M. C. (2004, July 24).

11. Work place Safety • BACK, NECK, SHOULDER • Prevention • Change positions every 20-30 minutes • Warm up or stretch before activities • Avoid twisting and bending • Avoid over extending yourself • Bend from your hips not you waits when lifting Walsh, M. C. (2004, July 24).

12. Work place safety • BODY MECHANICS • You need to learn how the body works and moves so you can prevent injury • Make sure you always have good posture • An exercise that may help is to squeeze your shoulders blades together and pull your elbows behind your back. Do this and count to five. • Do not sit slumpy. Make sure you stand or sit with your shoulders and head erect and balanced all day. This will lessen future back pain. Kalnitsky, A., MA. (1999, November 22).

13. Work place safety • CHEMICAL SPILL MANAGEMENT • Wear PPE • Gloves, gowns, boots, shields/goggles, respiratory equipment • Bund – a wall of brick, stone, concrete, or other impervious material, which may form part of or the entire perimeter of a compound and provides a barrier to retain liquid. • Hazardous Substance – substance that contains ingredients that may be harmful to health • Dangerous Goods - a hazardous substance that contains ingredients defined by the Dangerous Substance Act of 1979. Chemical Spill Management.

14. Work place safety • CHEMICAL SPILL MANAGEMENT CONTINUED • Your office should have MSDS and everybody should know where they are • Immediately report and spill • Follow written procedure • Appropriately store all equipment • Risk assessment includes nature of spill, quantity of spill, location of spill • Make sure you evaluate the situation before you start cleaning Chemical Spill Management.

15. Work place safety • CHEMICAL SPILL MANAGEMENT CONTINUED • If there is a spill kit available....USE IT • What to do: • Clear affected area • Check people involved • Isolate spill • Contact emergency personnel if necessary • Gather all information regarding spill • Clean appropriately Chemical Spill Management.

16. Assisting Patients • TRANSFERRING PATIENTS • Stand in front of patient • Make sure transfer belt is on securely • Lift with your knees • Make sure you legs are shoulder width apart • Help the person lean forward and put both hands on the sides of the patient grabbing the belt • Instead of lifting them rock their weight to their hips and this happens help them stand • Turn them to the new chair and assist them down slowly • Equipment available: • Wheelchairs • Belts • Canes • Crutches Two-Person Transfer. (2008).

17. immobilization • The process of holding a joint or bone in place by using: • Splint • Cast • Brace • To prevent an injured area from moving while it heals • Restricts motion • Reduce pain, swelling and muscle spasm • In some cases to repair bones, tendons or ligaments • Also allows for proper alignment • Immobilization usually extends from the joint above the injury to the joint below the injury. Immobilization. (2010).

18. immobilization • Casts and Splints • Generally used with a broken bone • Should not get wet • Custom made • Made from plaster or fiberglass • Fiberglass weighs less than plaster, is more durable, and allows more airflow • Splints are used for dislocated joint • Finger injuries- fractures or Baseball finger • Arm or leg immediately after injury before moving the person • Made from acrylic, polyethylene foam, plaster of paris, or aluminum Immobilization. (2010).

19. immobilization • Slings • Used to support the arm after fracture or other injury • Generally used with a cast or splint • Triangular bandage under arm and tied around neck • Braces • Used to support, align, or hold a body part in the correct position • Can easily be removed for exercise • Used with physical therapy • Custom made or ready made Immobilization. (2010).

20. immobilization • Collars • Generally used for neck injuries • Cervical collars are used by emergency personnel at the scene • Traction • Method for applying tension to correct the alignment of two structures and hold them correct position • Strongest form involves inserting a stainless steel pin though a bony prominence attached by a horse-shoe shaped bow and rope to a pulley and weights suspended over the end of the pt’s bed • Must be balanced by countertraction • Tilt bed • Pt.’s body acts as counterweight • Or use weights pulling in the opposite direction • Requires careful observation and adjustment Immobilization. (2010).

21. immobilization • Aftercare • After cast or splint is on: • Elevate for 24 to 72 hours • Raised above level of heart • Rest • Fingers and toes can be exercised after casting • Decreases swelling and stiffness • Ice injured area • After cast, splint, brace is removed: • Careful exercise to regain muscle strength and motion • Possible hydrotherapy • Heat treatments • Physical therapy Immobilization. (2010).

22. immobilization • Risks • Traction: • Bedrest can lead to bedsores (decubitus ulcers) and skin infection • Can lead to build up of fluid or infection in lungs (pneumonia) • UTI • Casts, splints, and braces: • Decreased muscle tone • Muscle shrinkage (atrophy) • If immobilization doesn’t fit properly (too tight) can lead to loss of circulation • Excessive pressure over a nerve can cause irritation or possible damage • If fits too loose, or breaks or malfunctions it can lead to deformity Immobilization. (2010).

23. Accident and incident reports • Also referred to as Unusual Occurrence Reports • All incidents must be reported no matter if the victim is a patient, visitor, or staff member. • Even minor accidents should be reported. • Things that should be on the report: • WHO? The name of victim and person reporting • WHAT? What happened? • WHERE? Location of the incident and injury on the victim • WHEN? The date and time of the accident or unusual occurrence • Corrective actions or treatment administered **It is very important to be as specific as possible when reporting and incident (McGill University. (2009, January).

24. Disease Transmission • Direct Contact- an infected person touching a non-infected person • Fomites/Indirect Contact- non-infected person touching an object that has been infected • Airborne Contamination- spread by dust containing droplet nuclei • Droplet Contamination- involves contact with the mucous membranes when a person coughs, sneezes, or speaks • Vehicle Transmission- spread of infectious agents through food, water, blood, and drugs • Vector Transmission- occurs when an insect whose body is infected with the disease infects a new host (Dionne, 2002)

25. Infectious Diseases • HIV • AIDS • Hepatitis A, B, C, D, and E • Tuberculosis • MRSA • Smallpox • HPV • STD’s Dionne, S. I. (2002)

26. Preventing Disease TransmissionStandard Precautions • Wash hands • Wear gloves • Wear a protective gown • Wear a mask • Place needles and sharps in designated disposal container Dionne, S. I. (2002)

27. Preventing Disease TransmissionMedical Asepsis • Microbial Dilution- reducing total number of organisms • Disinfection- destruction of pathogens by chemical agents • Sterilization- treating items with heat, gas, or chemicals to make them germ free • Good hand hygiene • Good Housekeeping Dionne, S. I. (2002)

28. Infection Control • Cycle of Infection: In order for a disease to be transmitted there must be: • An infectious organism • A reservoir of infection • A susceptible host • And means of transportation from reservoir to susceptible individual Environmental Health… (2002)

29. Infection Control • Infectious Agents: • Viruses: • Cannot multiply independently • Invade a cell and stimulate formation of additional virus particles • Examples include: Influenza virus, HIV, herpesvirus, rhinovirus (common cold) • Hard to fight because of risk of harm to needed host cell • Bacteria: • Single-celled organism • Adapt to new conditions readily, have ability to mutate • Can survive in the presence of antimicrobial drugs • Cause tuberculosis, strep throat, infectious diarrhea Environmental Health… (2002).

30. Infection Control • Infectious Agents: • Protozoa: • Complex, single-cell animals • Rarely invade the human body, some have the ability to • Can cause malaria • Fungi: • Occur as single-celled yeasts • Cause skin infections (athlete’s foot, ringworm), respiratory infections, and affect people with compromised immune systems Environmental Health… (2002).

31. Infection Control • Reservoir for Infection: • Moist, nutrient-rich, warm environment necessary • Carriers who are not aware of hosting infectious organisms • Humans are most common, but microorganisms can grow in any suitable environment not cleaned regularly • Susceptible Host: • Fatigue, stress, malnutrition, illness, and injury cause increased susceptibility Beck, D. (2009).

32. Infection Control • Modes of Transmission: • Direct contact • Fomites: object that has come in contact with pathogenic organisms • Vectors: Insects carrying an infectious organism that cause Lyme disease, West Nile, or Yellow Fever • Vehicles: Anything that transports organisms, including food, water, and blood. • Airborne Contamination: Contaminated dust, inhaled • Droplet Contamination: Infected droplet contact with mucous membranes Beck, D. (2009).

33. Infection Control • Surgical Asepsis: • Objects are sterile only when free of all microorganisms • Sterilization Process: • Chemical sterilization • Gas sterilization • Gas plasma technology • Autoclave • Sterile Fields: • Sterile Packages • Sterile Opening • Sterile Gloving • Sterile Dressing Application and Removal Beck, D. (2009).

34. Bibliography • Beck, D. (2009). Maintaining Asepsis Within a Sterile Field in Surgery. Retrieved from Infection ControlToday,website:  http://www.infectioncontroltoday.com/articles/maintaining-asepsis- sterile-field.html#. • Chemical Spill Management. (n.d.). Human Resource Unit. Retrieved March 4, 2010, from http://www.unisa.edu.au/ohsw/procedures/chemicalspills.asp. • Environmental Health and Safety. (2002). Infection Control. Retrieved from Washington University in St. Louis website address: http://ehs.wustl.edu/new/infection.htm. • Immobilization. (2010). The free dictionary.com [Medical dictionary]. Retrieved March 9, 2010, from http://medical-dictionary.thefreedictionary.com/immobilization • Kalnitsky, A., MA. (1999, November 22). Body Mechanics 101. In SpineUniverse. Retrieved March 4,2010, from SpineUniverse database. • McGill University. (2009, January). Accident, incident & occupational disease report form. In Environmental health and safety. Retrieved from http://www.mcgill.ca/ehs . • Santa Clara County Emergency Medical Services Agency. (n.d.). Unusual occurrence report. In Emergency medical services agency. Retrieved March 9, 2010, from http://www.sccemsagency.org • Two-Person Transfer. (2008). ICE Learning Center. Retrieved March 4, 2010, from SpineUniverse database. • Walsh, M. C. (2004, July 24). Ergonomic Standards. In spineuniverse.com, Retrieved March 4, 2010, from SpineUniverse.com website: http://www.spineuniverse.com/print/wellness/ergonomics/ergonomic-standards • WF, B.J. (1965, 10 28). Electric Shock Hazards in Radiology Departments. Retrieved March 1, 2010, from www.ajronline.org/cgi/reprint/95/4/976.pdf. • (2010). Saftey and Infection Control. In B. W. Long, E. D. Frank, & R. A. Ehrlich, Radiography Esssentials for Limited Practice (pp. 459-461). St.Louis: Saunders Elsevier. • Dionne, S. I. (2002). Healthline Connect to Better Health. Retrieved March 12, 2010, from Healthline Connect to Better Health: http://www.healthline.com/galecontent/disease-transmission