Transcript Fire hazard

Healthcare Safety & Standard
Precautions
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2
3. Describe the methods healthcare facilities use
to achieve physical, chemical, and biological
safety.
a. Explain physical hazards and list safe practice
guidelines.
b. Explain chemical hazards and their labeling
requirements.
c. Explain biological hazards & their safety
guidelines
ENVIRONMENTAL SAFETY
Environmental safety means identifying and
correcting potential hazards that can result in
accidents.
 Examples: Faulty wiring, slippery floors, &
infectious wastes in open containers.
 Healthcare workers must understand & follow
workplace safety policies and procedures to reduce
hazards, prevent accidents, and know how to
handle incidents correctly if they do occur.
 OSHA, as you learned in lesson #1 has many
regulatory measures that apply to workplace
issues.
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(Juliar, p. 162)
GENERAL SAFETY GUIDELINES
PREVENTION is the best approach to safety.
 There are many ways healthcare workers can
contribute to the prevention of common
accidents and injuries in the healthcare
environment.
 Personal safety practices are one way
 Environmental hazards that may pose a risk in
the healthcare environment
ELECTRICAL HAZARDS
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Electrical equipment needs to be in good working
order and grounded. The third (longer) prong in
an electrical plug is the ground.
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Theoretically the ground prong carries any stray
electrical current back to the ground whereas, the
other two prongs carry the power to the piece of
electrical equipment.
Improperly grounded & malfunctioning, or faulty
electrical equipment (frayed cords) increases the
risk of electrical injury & fire. (Potter & Perry, p. 842)
ELECTRICAL HAZARDS
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It is the healthcare worker’s responsibility to remove faulty
equipment from service & make a report to the appropriate
person at the healthcare facility.
Using machines in good repair, wearing shoes with rubber
soles, standing on a non-conductive floor, and using nonconductive gloves are all ways to prevent shock.
However, even with such precautions, the rescuer must never
touch the victim until the electricity is turned off or the victim
has been removed from contact with the electrical current;
otherwise the rescuer may also receive electrical injury.
If a client receives an electrical shock in the healthcare setting,
immediately determine whether the client has a pulse. If no
pulse, initiate cardiopulmonary resuscitation (CPR) & notify
emergency personnel. (Ramont & Niedringhaus, pp. 728-729)
RADIATION HAZARD
Radiation injury can occur from overexposure to radioactive
materials used in diagnostic and therapeutic procedures (x-ray
or radiation therapy).
Excessive radiation exposure can put the employee at risk for
developing tissue damage, contracting cancer, or becoming
sterile (unable to bear children), or may lead to infants being
born with birth defects.
Exposure to radiation can be minimized by a) limiting the time
near the source, b) providing as much distance from the
source, c) using shielding devices, such as lead aprons when
near the source.
Employees at risk for radiation exposure must wear safety
monitoring film badges that record the amount of exposure.
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Safety guidelines have been developed that determine the maximum
level of radiation exposure allowed per employee.
(Juliar, p. 171; Ramont & Niedringhaus, p. 130)
RADIATION HAZARDS
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are also strict guidelines for proper
disposal of radiological wastes.
 Radioactive
waste must be placed in a special
container labeled a “radioactive.” It should never
be placed in the trash, incinerated, or placed in a
bag with other waste products or put down a
drain.
 Only a licensed removal facility can remove these
waste from the healthcare facility.
(Juliar, p. 171)
EXCESSIVE NOISE
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Excessive noise is a health hazard that can cause hearing loss,
depending on the overall level of noise, the frequency range of
the noise, the duration of the exposure and individual
susceptibility.
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Sound levels above120 decibels (units of loudness) are painful and
may cause hearing damage even if a person is exposed only a short
period. Exposure to 85 to 95 decibels for several hours a day can lead
to progressive or permanent hearing loss.
Tolerance of noise is largely individual. When ill or injured,
people are frequently sensitive to noises that normally would
not disturb them.
Loud voices, the clatter of dishes, and even a nearby TV can
disturb clients, some of whom may react angrily.
Physiological effects of noise include: increased heart and
respiratory rates, increased muscular activity, nausea, and
hearing loss, if the noise is sufficiently loud. (Berman et al., p. 728)
FIRE HAZARD
In healthcare agencies, fire is particularly
hazardous when people are incapacitated and
unable to leave the building without
assistance.
 Healthcare workers must be aware of the fire
safety regulations and fire prevention practices
of the agency in which they work.
 Healthcare workers should know the location
of exits, fire alarms, and extinguishers.
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(Ramont & Niedringhaus, pp. 126-127)
FIRE HAZARDS
A fire needs three components in order to start:
fuel (trash, linen, chemicals), oxygen/air, & heat
(sparks, flames, matches).
Most frequent causes of fires:
 Improper use of smoking materials
 Defects in a heating system
 Improper trash disposal
 Misuse of electrical equipment
 Spontaneous combustion
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FIRE HAZARD
When a fire occurs, the healthcare worker follows
four sequential priorities. Use the acronym RACE
to help remember the procedure.
R = Rescue or Remove clients immediately in
danger.
A = Activate the Alarm Pull the alarm or call to
report.
C = Confine or Contain the fire by closing all doors,
making sure the medical gas valves are turned off
and that circuit breaker panels are turned off.
E = Extinguish the fire or E = Evacuate.
EXTINGUISHING A FIRE
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Extinguishing the fire requires
knowledge of three categories of
fire, classified according to the
type of material burning.
Class A: paper, wood, upholstery,
rags, ordinary rubbish
Class B: Flammable liquids & gases
(gasoline, grease, oils, paint
thinner)
Class C: Electrical
EXTINGUISHING A FIRE
The right type of extinguisher
must be used to fight the fire.
1. Air-pressurized water –
used on Class A fire only.
2. Carbon dioxide – used on
Class B & C fires only.
3. Dry chemical – used on
Class B & C fires only.
 Each extinguisher has picture
symbols showing the type of
fire for which it is to be used.
(Ramont & Niedringhaus, p. 127)
EXTINGUISHING A FIRE
PASS
When using an
extinguisher,
remember PASS.
P = Pull pin
A = Aim
S = Squeeze
S = Sweep
(Juliar, p. 167)
EXTINGUISHING A FIRE
PASS
When using an
extinguisher,
remember PASS.
P = Pull pin
A = Aim
S = Squeeze
S = Sweep
(www.emory.edu, n.d.)
Pass
 Pull
the pin
 Aim
 Squeeze
 Sweep
EXTINGUISH OR EVACUATE?
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Watch this 4:45 minutes YouTube video to
learn when to use a fire extinguisher and when
to evaluate.
Extinguish or Evacuate
See the Word Document entitled, “Fire Safety”
located under “Content” tab Lesson #4.
FIRE HAZARDS
The most common cause of death related to a
fire is smoke inhalation.
 Remain low to the floor, cover your mouth and
nose with a moist cloth, and avoid inhaling too
much smoke.
Remember that most residents/clients can not
not get as low to the ground as we can.
Give them a moist cloth to cover their
mouth and nose as well. (Juliar, p. 169)
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FIRE SAFETY
Prevention is the Key to Fire Safety
 Inspect electrical cords for exposed wires
 Do not use space heaters
 Do not allow residents to smoke in their rooms
 Keep the client’s room free of clutter
 Do not overload electrical outlets
PREVENTION OF ELECTRICAL HAZARDS
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Be thoroughly familiar with any equipment before
attempting to use independently for the first time. Know
& follow all safety precautions.
Review & follow the manufacturer’s operating
instructions. Healthcare workers should not take short
cuts or experiment with unfamiliar equipment.
If any damage to the equipment is noted, do not attempt
to use it, but report it to the proper person for repair.
Never use electrical cords that are not completely intact,
plugs that have been altered (third prong removed), and
do not use excessive force to insert a plug into the outlet.
(Juliar, p. 170)
PREVENTION OF ELECTRICAL HAZARDS
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Never handle any electrical equipment around water
because electrocution can occur (water conducts
electrical currents).
Holding electrical equipment with wet hands, standing
in water, or removing equipment that has accidently
dropped in water can be life threatening. Always dry
hands, clean up spilled water, and remove the power
source.
If someone is shocked (electrically), do not touch the
person or pull the plug from the outlet, because this
places you at risk. Instead, turn off the main source of
power immediately and be prepared to administer
emergency care and call for help. (Juliar, p. 170)
OXYGEN PRECAUTIONS
Special precautions when oxygen is used are:
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Sparks may come from some electrical appliances, equipment, or
toys. Before using any of these, always check with the supervisor.
Examples include hair dryers, heating pads, space heaters, fans,
radios, electric shavers, & hand-held computer games.
Never use flammable liquids, such as alcohol, oils, adhesive tape
remover, nail polish, or nail polish remover.
An oxygen tank should be secured to prevent if from falling over. Do
not place it in the sunlight or near heat.
Use cotton blankets, gowns, & clothing. Wools and synthetics are
more apt to create static electricity.
Smoking is not allowed when oxygen is in use & smoking materials
should be removed from the room.
No lit matches or open flames should be permitted in the area.
(Juliar, 172)
CHEMICAL HAZARDS
Healthcare settings have hundreds of chemicals,
such as cleaning solutions, anesthesia, and
chemotherapeutic drugs.
 Chemicals can cause harm & injury if swallowed,
inhaled, or absorbed through the skin or mucous
membranes. Some chemicals create fire hazards.
 Take good care when working with these agents.
 OSHA requires all health care facilities to have an
exposure control plan.
 In addition, The Globally Harmonized System of
Classification and Labeling of Chemicals (GHS)
must be available to all employees.
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GUIDELINES IN HANDLING CHEMICALS
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If a container is not properly labeled or if it can’t be read clearly, do
not use it.
Recheck labels at least three times. Read the label carefully when you
first locate it, and then reread it after removing the solution, and
again before returning it to the proper location.
Never mix any two chemicals together without first verifying
compatibility.
Avoid contact with the eyes & skin & do not inhale.
Take precautions not to slash or spill solutions.
Wear personal protective equipment (PPE) as indicated.
Make sure chemicals are used only for their intended purpose.
Store chemicals as labeled.
Do not pour toxic (poisonous), flammable, foul-smelling, or irritating
chemicals down the drain. Place in specified container per policy.
If you spill any solutions, clean up immediately according to
established procedures and dispose of debris properly. (Juliar, p. 171)
WHAT IS GHS?
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The GHS is an acronym for The Globally Harmonized
System of Classification and Labeling of Chemicals.
The GHS is a system for standardizing and harmonizing
the classification and labeling of chemicals.
It is a logical and comprehensive approach to:
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Defining health, physical and environmental hazards of chemicals;
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Creating classification processes that use available data on chemicals for
comparison with the defined hazard criteria; and
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Communicating hazard information, as well as protective measures, on labels
and Safety Data Sheets (SDS).
WHAT IS THE GHS?
G
H
S
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Globally
Harmonized
System of Classification and Labeling of Chemicals
A common and coherent approach to defining and classifying
hazards, and communicating information on labels and safety
data sheets.
Target audiences include workers, consumers, transport
workers, and emergency responders.
Provides the underlying infrastructure for establishment of
national, comprehensive chemical safety programs.
WHY IS THE GHS NEEDED
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To have a common worldwide approach to classifying
chemical hazards and communicating hazard information
Harmonized definitions of hazards
 Specific criteria for labels
 Harmonized format for safety data sheets
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With world-wide use of chemicals a common approach was
needed to avoid sector-specific regulations
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Transportation
Production
Workplace,
Consumer products
WHY IS THE GHS NEEDED? (CONT)
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Example, a product may be considered flammable or toxic in
one country, but not in the country to which it is being shipped
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No country has the ability to identify and specifically regulate
every hazardous chemical
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In the area of trade, the need to comply with multiple
regulations regarding hazard classification and labeling is
costly and time-consuming
PURPOSE OF GHS
The GHS is intended to replace multiple systems of labeling and
classification with a single unified approach.
This is done by:
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Creating classification processes that use available data on
chemicals for comparison with world wide accepted defined
hazard criteria
More effectively and consistently communicating hazard
information and protective measures on labels and Safety Data
Sheets (SDS).
THE SCOPE OF GHS
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Covers all hazardous chemical substances, dilute solutions,
and mixtures
Covers all pharmaceuticals, food additives, cosmetics and
pesticide residues in food:
 Will not be covered at the point of intentional intake (use)
 But will be covered where workers may be exposed and
 In transport
IMPLEMENTATION OF GHS
Different federal agencies are tasked with implementing GHS:
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Workplace - OSHA
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Transport of Dangerous Goods – DOT
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Pesticides – EPA
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Consumer Products – CPSC
SAFETY DATA SHEETS (SDS)
What are safety data sheets (SDS)?
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There is a SDS for each chemical & the SDS contains the
precautions to take when handling the chemical, safety
instructions for use, requirements for clean-up, and first aid
measures to take if exposure occurs.
Each person is responsible for knowing the chemical used
and any potential risks to themselves and their clients. One
should read the label of the chemical before using or review
the SDS. Know where the SDS is located & how to access
them.
Containers must be labeled with the chemical name &
function. Labels must also tell any danger or hazard that
may exist with that chemical or ingredients, the name,
address, & phone number of the manufacturer.
(Ramont & Niedringhaus, p. 131)
SAFETY DATA SHEETS (SDS)
Safety Data Sheets (SDSs)
 Prepared by the chemical manufacturer or supplier,
SDSs provide detailed safety and health information not
found on container labels.
 With this information, supervisors/employees can
determine necessary controls such as ventilation, work
conditions, and procedures for using chemicals safely;
as-well-as protective equipment needed to prevent
worker contact with hazardous chemicals.
 SDSs can also be used to compare products available for
a particular job to determine which product is the
safest to use.
SAFETY DATA SHEETS
Healthcare workers have a right to learn about chemicals
they will work with & how to protect themselves before
working with them.
** Review “Employee Right-to-Know” Law
Healthcare workers should know:
 The requirements of the standard
 The location of the hazard communication program and SDSs
 How to read chemical container labels and SDSs
 The identity and location of work process involving chemicals
 The physical and health hazards, including the symptoms of
overexposure to the chemical
 How to safely use the chemical & appropriate protective equipment
 How to detect the presence or release of the chemical
 What to do in an emergency, such as an injury or an accidental
chemical spill.
(Ramont & Niedringhaus, p. 131)
REQUIRED INFORMATION ON SDS
A SDS can be in any format, but it
must contain some specific
information:
 The name of the chemical
 Name, address & phone number
for hazard & emergency
information
 Chemical & common names of
hazardous ingredients
 Physical & chemical
characteristics, such as the color
and form (solid, liquid, etc.)
 Physical hazards that the chemical
can pose under working
conditions (flammability,
explosiveness, reactions to other
chemicals)
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How the chemical can enter
your body
How much of a chemical you
can be exposed to safely
(exposure limits)
How the chemical can harm
you
How to tell if you have been
overexposed (dizziness, skin
irritation, shortness of
breath)
How to protect yourself from
being exposed, such as
personal protective clothing
& equipment
Chemical handling & safe use
Emergency and first aid
procedures.
CHEMICAL LABELS
Chemical labels are coded according to the
National Fire Protection Association
(www.safetysign.us, n.d.)
CHEMICAL LABEL SAMPLE
(www.mountnittany.org, n.d.)
CHEMICAL LABEL SAMPLE
Here is a sample based on the NFPA’s coding.
(www.safetysign.us, n.d.)
BIOLOGICAL HAZARDS &
SAFETY GUIDELINES
Healthcare environments contain many
potential hazards. It is essential to
follow safety practices that consider the
well-being of others.
 Do not open more than one file cabinet
drawer at a time to prevent tipping.
 Do not place food in a refrigerator that
contains lab specimens & medications.
(Juliar, p. 163)
BIOLOGICAL HAZARDS &
SAFETY GUIDELINES
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Do not wear uniforms in non-work places.
Keep floors clear by immediately picking up dropped
objects. Use OSHA standards when cleaning up glass,
spilled specimens, and liquids.
Broken glass is best picked up with a brush or broom
and dustpan & placed in a puncture-resistant wrap or
container prior to placing in a plastic bag. This will
prevent cuts for whoever handles the bag.
When spills involve bodily secretions or blood, follow
the Standard Precautions by wearing gloves and
disposing of waste in special bags designated for
biohazardous waste. (Juliar, p. 163)
INFECTIOUS WASTES
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Infectious waste is any item or product that has the
potential to transmit disease. Infectious waste must be
handled using standard and transmission-based
precautions, placed in containers or bags labeled as to
type of waste (i.e., linen, sharps, trash), decontaminated
onsite, or removed by licensed removal facility for
decontamination.
It is the healthcare worker’s responsibility to follow the
facility’s policies and procedures in proper handling,
containment, clean-up of spills, and disposal of
infectious waste.
Any direct contact with waste that puts the worker at
risk for infections should be reported per facility policy.
(Juliar, p. 171)
REPORT FOR SAFETY
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Properly reporting unsafe conditions & accidents provides a
means of making corrections and preventing future
problems.
Report any unsafe conditions immediately, such as burned
out exit sign lights, equipment or flooring in need of repair.
And side rails or call lights that don’t work.
Report any accidents or injuries immediately and complete
an incident report. An incident report is a written document
completed when an unexpected situation occurs that can
cause harm to a patient, employee, or any other person.
An incident report contains only factual information, and
most facilities have policies that specify not to include the
report in the patient’s medical chart or to refer to it in the
documentation.
(Juliar, p. 165)
REFERENCES
Berman, A., Snyder, S.J., Kozier, B., & Erb, G. (2008).Asepsis. In A. Berman, S.J. Snyder, B.
Kozier, & G. Erb (Eds.). Kozier & Erb’s Fundamentals of nursing: Concepts, process,
and practice (8th ed.) (pp. 668-709). Upper Saddle River, NJ: Prentice Hall
Centers for Disease Control & Prevention. (2007). Guidance for the Selection and Use of
Personal Protective Equipment (PPE) in Healthcare Settings. [Power Point]
Retrieved from http://www.cdc.gov/
Juliar, K. (2003). Minnesota health care core curriculum, 2e. Clifton Park, NY: Delmar
Publishing, Thompson Custom Publishing
Kockrow, E.O.(2006). Medical/Surgical asepsis and infection control. In B.L.
Christensen & E. O. Kockrow (Eds.). Foundations and adult health nursing (5th ed.)
(pp. 270-314). St. Louis, MO: Elsevier, Mosby
Occupational Safety & Health Administration. (2011, January). OSHA Fact Sheet:
Bloodborne Pathogens Standard. Retrieved from www.osha.gov
Potter, P.A. & Perry, A.G. (2009). Infection prevention and control. In P.A. Potter & A.G.
Perry (Eds.). Fundamentals of nursing (7th ed.) (pp. 641-685). St. Louis, MO: Elsevier,
Mosby
Ramon, P.R. & Niedringhaus, D. M. (2008). Infection control and asepsis. Fundamental
nursing care (2nd ed.) (pp. 149-176). Upper Saddle River, NJ: Person Prentice Hall