Transcript ANSWER

CHAPTER
6
Basic Safety and
Infection Control
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6-2
Learning Outcomes
6.1
Describe the components of a medical office
safety plan.
6.2
Identify OSHA’s role in protecting healthcare
workers.
6.3
Describe basic safety precautions you
should take to reduce electrical hazards.
6.4
Illustrate the necessary steps in a
comprehensive fire safety plan.
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6-3
Learning Outcomes (cont.)
6.5
Summarize proper methods for handling and
storing chemicals used in a medical office.
6.6
Explain the principles of good ergonomic
practice and physical safety in the medical
office.
6.7
Illustrate the cycle of infection and how to
break it.
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6-4
Learning Outcomes
6.8
Summarize the Bloodborne Pathogens
Standard and Universal Precautions as
described in the rules and regulations of the
Occupational Safety and Health
Administration (OSHA).
6.9
Describe methods of infection control
including those preventing healthcareassociated infections.
6.10 Describe Centers for Disease Control and
Prevention (CDC) requirements for reporting
cases of infectious disease.
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6-5
Introduction
• Accidents can occur in healthcare settings
• Remove or correct hazards
– Physical
– Chemical
– Biohazardous
• Removal or correction of hazards is
integral to risk management
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6-6
Medical Office Safety Plan
• Minimize risk
• Establish a safety plan
• Education about potential dangers
facilitates the removal or correction of
these hazards
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6-7
Medical Office Safety Plan (cont.)
• Comprehensive written safety plan
• Easily accessible
• Updated annually
• Know and follow the plan’s policies and
procedures
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6-8
Apply Your Knowledge
Why is it important to have a safety plan in a
medical office and what should the plan cover?
ANSWER: It is important to have a safety plan to help
minimize risk and make everyone aware of potential
hazards. A safety plan should contain:
• OSHA Hazard Communication
• Electrical and fire safety
• Emergency action plan
• Chemical safety
• Blood borne pathogen exposure
• Personal protective equipment
• Needlestick prevention
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6-9
Occupational Safety and Health
Administration
• Employee safety
• Specific standard vs. General Duty
Clause
• Enforces guidelines established by the
Centers for Disease Control and
Prevention (CDC)
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6-10
OSHA Hazard Communication
• Biohazard labels
• Warning signs
• Material Safety Data
Sheets (MSDSs)
• Hazard labels
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6-11
OSHA
• Final rule
– Standardize
• Labeling
– Changes
• Hazard
• Safety information
– Right to understand
classification
• Labels
• MSDSs
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6-12
Apply Your Knowledge
Why is it important for hazardous materials be
correctly labeled?
ANSWER: So employees can take measures to
protect themselves against harm.
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6-13
Electrical Safety
• Know location of power shutoffs
• Avoid using extension cords
• Observe for frayed electrical wires
• Dry hands before working with electrical devices
• Do not position electrical devices near sources
of water
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6-14
Apply Your Knowledge
List three electrical safeguards to practice in the
healthcare setting?
ANSWER:
• Avoid using extension cords. Tape extension cords to
the floor to avoid tripping.
• Repair or replace equipment that has a broken or frayed
cord.
• Dry your hands before working with electrical devices.
• Do not position electrical devices near sinks, faucets, or
other sources of water.
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6-15
Fire Safety
• Many potential
hazards in a medical
office
• Fire Prevention
– Hazards in the exam
room
– Office laboratory ~
open flame
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6-16
In Case of Fire (cont.)
• Using safety equipment
– Fire extinguisher – “PASS”
system
– Fire blanket
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6-17
Emergency Action Plans and Drills
• Responsibility
– Reporting fire
– Overseeing
evacuation
• Building evacuation
routes
– Current location
– Nearest exit
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6-18
Emergency Action Plans and Drills (cont.)
• Evacuation Procedure
– Ensure patients and staff are evacuated
– Check that everyone has left
– Take MSDS book
– Assembly area
– Emergency action plan drills
– Local emergency contacts
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6-19
Apply Your Knowledge
Once at the assembly area after an evacuation
how would you account for employees and
patients?
ANSWER: Conduct a roll call of all employees. You
can use the check-in roster to account for patients.
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6-20
Chemical Safety
• Proper handling and storage
• MSDS
• General precautions
• Eye wash station
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6-21
Chemical Safety (cont.)
• Do not hold under
nose
• Use fume hood or
personal ventilation
device
• No mouth pipetting
• Add acid to other
substances
• Clean up spills
properly
• Only combine
chemicals as required
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6-22
Apply Your Knowledge
What are the precautions you should take
when working with hazardous substances?
ANSWER:
• Store below eye level
• Wear protective gear
• Carry with both hands
• Properly ventilated
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6-23
Ergonomics and Physical Safety
• Ergonomics
• Maintain a healthy
and safe posture
• Do not over reach
• Lift properly
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6-24
Ergonomics
• Transferring a patient
– Lift with knees
– Ask for assistance
– Use transfer device
• Adjust seat
• Take frequent breaks
from the computer
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6-25
Physical Safety
• Walk, do not run, in the office.
• Wipe up spills immediately
• Clear the floor of dropped objects
• Be sure there are no snags or tears in the carpet
• Destroy and dispose of medications that are
dropped on the floor
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6-26
Physical Safety (cont.)
• Be careful when carrying objects
• Close cabinets, doors, and drawers
• Inspect furniture for rough edges
• Tape down cords and equipment cables
• Never use damaged equipment or supplies
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6-27
Physical Safety (cont.)
• Safeguards for the
laboratory environment
– Wear protective gear
– Follow manufacturer’s
guidelines
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6-28
Physical Safety (cont.)
• Special safety precautions
– Children
– Patients with physical disabilities
• Safe flooring
• Handrails
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6-29
Apply Your Knowledge
Whose responsibility is it to ensure a safe work
environment?
ANSWER: The employer
Whose responsibility is it to follow safe work
practices?
ANSWER: The employee
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6-30
Infection Control
• Medical assistant
– Help to create and maintain a safe and
healthy environment
– Understand how infections
• Occur
• Are transmitted in the population
– Practice infection control precautions
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6-31
Cycle of Infection
Back
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6-32
Cycle of Infection (cont.)
• Reservoir Host –
body capable of
sustaining pathogen
growth
• Means of Exit - how
the pathogen leaves
the host
– Carrier
– Endogenous infection
– Exogenous infection
Click for Cycle of
Infections
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6-33
Cycle of Infection (cont.)
• Means of transmission – how the
pathogen spreads to a host
– Airborne
– Bloodborne
– During pregnancy or birth
Click for Cycle
of Infection
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6-34
Cycle of Infection (cont.)
• How the pathogen spreads to a host
– Foodborne
– Vector-borne
– Touching
• Direct – contact with an infected persons mucous
membranes
• Indirect – fomites
Click for Cycle
of Infection
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6-35
Cycle of Infection (cont.)
• Means of Entrance
– Any cavity lined with
mucous membrane
–
Breaks in the skin
• Susceptible Host
– An individual with little
or no immunity
– Factors influencing
susceptibility
Click for Cycle
of Infection
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6-36
Cycle of Infection (cont.)
• Environmental factors
– Dense populations
– Animals and insects
– Economic and political
factors
– Availability of transportation
– Urbanization and population
growth rates
– Sexual behavior
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6-37
Breaking the Cycle
• Asepsis
– Maintain strict housekeeping standards
– Adhere to government guidelines
– Educate patients
• Hygiene
• Health promotion
• Disease prevention
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6-38
Apply Your Knowledge
What is your role as a medical assistant in
breaking the cycle of infection in the medical
office?
ANSWER: To apply these measures:
• Maintain strict housekeeping standards to reduce the
number of pathogens present
• Adhere to government guidelines to protect against
diseases caused by pathogens
• Educate patients in hygiene, health promotion, and
disease prevention..
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6-39
OSHA Bloodborne Pathogens Standard and
Universal Precautions
• Disposal of infectious or potentially infectious
waste
• Laws protect healthcare workers and
patients
– Training personnel
– Record keeping
– Housekeeping
– Wearing protective gear
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6-40
OSHA Bloodborne Pathogens Standard
• Employers must
– Develop an OSHA Exposure Control Plan
– Provide training to all employees
• Documentation
• PPE, Universal Precautions, engineering controls
• What to do if exposure occurs
– Provide the hepatitis B vaccine
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6-41
Universal Precautions (cont.)
• Universal Precautions apply to all blood
and body fluids
• Standard Precautions
– Used in healthcare facilities for the care of all
patients
– Prevents the transmission of disease
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6-42
Universal Precautions (cont.)
• Risk categories
I. Tasks that require specific protective
measures
II. Tasks that require precautions in certain
situations
III. Tasks requiring no special protection
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6-43
Written Exposure Plan
• Determination of exposure
• Implementation of control methods
• Post-exposure evaluation and follow-up
• Communication and training
• Recordkeeping
• Evaluation of exposure incidents
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6-44
Exposure Incidents
• Notify the physician or employer
immediately
• Refer the employee to a licensed
healthcare provider
– Counsel the employee
– Draw blood and prescribe treatment
– Written report
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6-45
Other OSHA Requirements
• HBV vaccine
• Needlestick Safety and Prevention Act
– Engineered safety devices
– Employer recommendations
• Engineering controls
• Needlestick safety programs
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6-46
Other OSHA Requirements (cont.)
• Employee recommendations
– Avoid using needles
– Help choose devices
– Use devices provided
– Do not recap needles
– Dispose of sharps correctly
– Report injuries and hazards
– Participate in training
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6-47
Apply Your Knowledge
OSHA divides medical tasks by level of risk.
What are these risk categories?
ANSWER: There are three categories of risk:
Category 1: Expose a worker to blood, body fluids, or
tissues and require specific protective measures
Category 2: Usually do not involve risk of exposure,
but precautions are required in certain situations
Category 3: No risk of exposure, so no special
protection is required
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6-48
Infection Control Methods
• Knowledge of
– Medical asepsis
• Based on cleanliness
• As few microorganisms as possible
– Surgical asepsis
• Sterile environment
• No microorganisms
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6-49
Infection Control Methods (cont.)
• Keep office clean
• Prevent crosscontamination
– Follow guidelines
– Use protective gear
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6-50
Hand Hygiene
• Handwashing
• Alcohol-based hand disinfectants
(AHD)
• Fingernail length
• Nail polish and artificial nails
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6-51
Other Aseptic Precautions
• Avoid leaning against sinks, etc.
• Avoid touching your face and
mouth
• Use tissues for coughing or
sneezing; wash hands
afterward
• Avoid working with patients if
you have a cold; wear gloves
and mask
• Stay home if you have a fever
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6-52
Personal Protective Equipment
•
•
•
•
Gloves
Masks and protective eyewear or face shields
Protective clothing
Use of multiple types of PPE
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6-53
Transmission from Healthcare Workers
• Healthcare-associated infections (HAI)
• Adhere to OSHA Standards
• High risk procedures
• HIV, HBV status of healthcare workers
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6-54
Apply Your Knowledge
Describe the difference between medical and
surgical asepsis.
ANSWER: Medical asepsis is based on cleanliness and
reducing the number of microorganisms as much as
possible. Surgical asepsis is maintaining a sterile
environment by eliminating all microorganisms.
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6-55
Reporting Guidelines for Infectious
Diseases
• State or county health department
• Information is forwarded to the CDC
• National Notifiable Disease Surveillance
System
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6-56
Reporting Guidelines (cont.)
• Reporting – correct form
– Disease identification
– Patient identification
– Infection history
– Reporting institution name
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6-57
Apply Your Knowledge
How is the information on reportable diseases
used by the CDC?
ANSWER: The CDC uses the information reported to
them to help control the spread of infection.
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6-58
In Summary
6.1 The medical office safety plan should include OSHA’s
Hazard Communication; electrical, fire, and chemical
safety; emergency action plans; bloodborne pathogen
exposure plans; PPE; and needlestick prevention plans.
6.2 The U.S. Department of Labor created OSHA to protect
the employees’ safety in the workplace.
Through the creation and enforcement of standards such
as the Bloodborne Pathogens Standard, Hazard
Communication, and the Needlestick Safety and
Prevention Act, OSHA serves to protect healthcare
workers from hazards.
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6-59
In Summary (cont.)
6.3 To reduce electrical hazards in the medical office, you
should avoid using extension cords, repair or replace
damaged cords, avoid overloading circuits, ensure that
all plugs are grounded, dry your hands before using
electrical devices, and keep electrical devices away
from sinks or other sources of water.
6.4 A comprehensive fire safety plan must include fire
prevention strategies, actions to take in the event of a
fire, building evacuation routes and plans, fire drills,
and local emergency contacts.
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6-60
In Summary (cont.)
6.5 When using chemicals in the medical office, you
should always wear protective gear, carry the
container with both hands, work in a well-ventilated
area, never combine chemicals unless it is specifically
required in the test procedures, and properly clean up
spills immediately.
6.6 In order to protect yourself from work-related
musculoskeletal disorders at work, you must follow the
principles of good body mechanics.
Your physical safety at work depends on
understanding and applying appropriate workplace
safeguards.
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6-61
In Summary (cont.)
6.7 In order for an infection to occur, these five elements
must be in place: a reservoir host, a means of exit, a
means of transmission, a means of entrance, and a
susceptible host.
The most effective means of breaking the cycle of
Infection is by using aseptic techniques.
6.8 Laws set forth in the OSHA Bloodborne Pathogens
Standard of 1991 dictate how you must handle
infectious or potentially infectious waste generated
during medical or surgical procedures.
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6-62
In Summary (cont.)
6.9 The two basic methods of infection control are medical
asepsis and surgical asepsis.
OSHA recommends that healthcare workers who work
with high-risk patients know their HIV and HBV status,
participate in a HBV vaccination program, and avoid
direct patient contact if they have a skin condition
characterized by sores that secrete fluid.
6.10 The CDC requires reporting of certain diseases to the
state or county department of health, who then reports
the information to the National Notifiable Disease
Surveillance System of the CDC.
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6-63
End of Chapter 6
Soap and education are not as sudden
as a massacre, but they are more
deadly in the long run.
~ Mark Twain
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in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.