chapter 3 safety and infection control practices health care science technology copyright © the...

Chapter 3Safety and Infection Control Practices

Health Care Science Technology

Copyright © The McGraw-Hill Companies, Inc.

Copyright © The McGraw-Hill Companies, Inc. Chapter 32

Accidents and Injuries

Safety means freedom from danger, risks, and injury.


Prevention

Injuries are prevented by preventing accidents.


Governing Agencies

The Occupational Safety and Health Administration (OSHA) is required to oversee safety in the workplace.

OSHA requires that material safety data sheets (MSDS) be kept on all chemicals handled at a facility.


Governing Agencies (cont.)

Manufacturers are required to provide a copy of the MSDS for all products they sell.


The MSDS should contain:– Manufacturer’s name and address.– Safety exposure limits.– Chemical name.– Health hazards.– Flammability level.– Reactivity level.– Personal protective equipment (PPE) required

when handling the chemical.– Hazard rating for the chemical.




Failure to maintain properly labeled hazardous materials can result in large fines.

A safety officer may be appointed to oversee continuing education regarding hazardous materials.



The Centers for Disease Control and Prevention (CDC) has developed standard safety precautions.

Other governing agencies include:– Individual states.– U.S. Department of Public Health.– Food and Drug Administration (FDA).– Environmental Protection Agency

(EPA).


Preventing Accidents

The best way to deal with workplace injuries is to prevent them.

Education is the key to an accident-free facility.

The two main categories of accidents are:– Accidents related to the physical

environment and equipment.– Accidents related to client care.


Guidelines for preventing accidents

– Know the environment, including the location of exits, stairs, fire alarms and extinguishers, call signals, paging systems, and emergency lights.


– Know the safety policies and procedures for your facility.

– Operate only the equipment you are trained to use.

– Report accidents, spills, and damaged or malfunctioning equipment immediately.

– Do not use frayed or damaged electrical cords or ungrounded equipment.


– Never use any product that does not have a readable label.

– Read all labels at least 3 times before using the product.

– Read the MSDS for any product you will be using.

– Wear personal protective equipment when handling hazardous or unknown chemicals.

– Never mix solutions or chemicals.


– Know how to report an accident or obtain emergency assistance.

– Use the right side of the hallway and stop at intersections.

– Allow others to exit before you enter stairways, doorways, or elevators.


Guidelines for client safety:

– Ensure that the client knows how to operate call signals, emergency call lights, handrails, safety rails, and how to locate the bathroom.

– Identify client and explain a procedure before beginning.

– Perform only those procedures for which you have been trained.


– Report safety hazards, such as spills, loose carpet, or extremely hot food or drinks.

– Be aware of any changes in the client and report them to your supervisor immediately.

– Ensure the privacy, safety, and comfort of your client.


Fire Safety

Fires need 3 things to start:

1. Oxygen (Air)

2. Fuel (any material

that will burn)

3. Heat (Sparks,

matches, flames)

Chapter 317


Major Causes of Fires

Carelessness with smoking and matches

Misuse of electricity (overloading a circuit or overuse of extension cords)

Improper rubbish disposal Improper storage of flammables

(such as gasoline) Arson


Types of Extinguishers

5 types are available, with ABC being the most common.

Table 3-1 Fire Extinguishers

Class

A (Water)

B (Carbon dioxide)

C (K bicarbonate)

D

ABC (Chemical)

Common combustibles

Flammable liquids

Electrical

Combustible metals (magnesium)

All ABC fires

Application


How to Use a Fire Extinguisher

Remember the key word PASS:– P = Pull the pin.– A = Aim at the base of the fire.– S = Squeeze handle.– S = Sweep nozzle from side to

side to displace oxygen away

from the fire.


When a Fire Emergency Occurs

STAY CALMRemember the key word RACE:

– R = Rescue.– A = Alarm. Assign someone to

pull the alarm.– C = Contain. Close the windows

and doors.– E = Evacuate.


Emergency Fire Rules

Be prepared! Know your responsibilities.

Know when and how to evacuate.

Know where the fire alarms are located and how to activate them.

Keep fire extinguishers in plain view and readily accessible.

3rd Floor Plan


Emergency Fire Rules (cont.)

Keep areas uncluttered. Evacuate ambulatory clients first, then

the wheel-chair bound, then the bed-bound.

If possible, never leave a client alone in a fire emergency.

Never use an elevator in a fire situation. Never open windows. Never open a door that feels hot.


Definition of Body Mechanics

Positions and movements used to maintain proper posture and avoid muscle and bone injuries

Chapter 324


Principles of Body Mechanics

Body alignment depends on the correct positioning of the head, back, and limbs.


Body Mechanics Failure

Causes back problems including acute strains, sprains, disc strain and bulge, disc herniation, and fatigue.

Prevention is the best cure for back pain. WEAR A BACK

SUPPORT!


Key Components of Body Mechanics

Keep feet a shoulder-width apart. Always use 2 hands to move someone or

something. Face the direction in which you intend to move.

Never twist. Avoid unnecessary reaching. Keep your chin up and look straight ahead. Keep your shoulders back.


Key Components of Body Mechanics (cont.)

Bend at the hips and knees. Keep your back straight. Keep the object you are lifting

close to your body. Exhale when you are lifting or

exerting force. Tighten your abdominal

muscles. Lift with your legs, not your

back.


Key Components of Body Mechanics (cont.)

Push, pull, or slide instead of lifting. Pushing is the best technique for moving

something large. Use the weight of your body to help you

push or pull. Always ask for help whenever needed. Tell the client what you are going to do

and ask for the client’s help.


Microorganisms

We usually do not notice or think about microorganisms until they cause some form of physical illness.

Remember many are beneficial

Chapter 330


Nature of Microorganisms

Pathogens are microorganisms that cause disease.

Non-pathogens are microorganisms that do not cause disease.


Factors That Influence Microbial Growth

Following factors influence microbial growth:– Temperature.– pH, or the values used in chemistry to express

the degrees of acidity of a substance.– Food.– Moisture.– Oxygen.


Factors That Influence Microbial Growth (cont.)

Aerobic microbes – live only in the presence of oxygen.

Anaerobic microbes – grow best in the absence of oxygen.


Methods That Destroy Microorganisms

Antiseptics – solutions applied directly to the skin that prevent or inhibit the growth of pathogens.

Disinfection – using strong chemicals, such as bleach to destroy pathogens, usually on objects, not skin.

Sterilization – the most effective way to destroy all microorganisms.


Types of Microorganisms

Bacteria– One-celled microorganisms

that are classified according to their shape and arrangement.

– Cause diseases such as strep throat, pneumonia, and tuberculosis. (Table 3-4)

– Some bacteria produce spores, which help them reproduce.

A. B.

C. D.

E.

F. G.

H. I.

Name the microorganisms A to I. Click HERE to see answers.


Types of Microorganisms (cont.)

Fungi– A plantlike organism that lives on

dead matter.– Cause conditions such as ringworm,

athlete’s foot, yeast infections, and thrush.

Protozoa– Tiny animals found in contaminated

water.– Cause diseases such as malaria,

trichomoniasis, and amebic dysentery.



Rickettsiae– Parasites that live inside the cells of

other living organisms.– Transmitted to humans by fleas, lice,

and ticks.– Cause diseases such as Rocky

Mountain spotted fever.


Viruses– Smallest of all microorganisms.– Live inside cells.– Spread by contact with blood and other

body fluids.– Difficult to destroy.– Associated with diseases such as the

common cold, chicken pox, herpes, hepatitis B, and acquired immune deficiency syndrome (AIDS).



Principles of Infection 3-5

AsepsisHistory of AsepsisChain of InfectionSigns and Symptoms of InfectionNosocomial Infections


Definition of Asepsis

1. Freedom from infection.

2. The prevention of contact with microorganisms

Chapter 341


History of Aseptic Technique

Greek Medicine1200 BC –200 BC– First to study causes

of diseases, this helped eliminate superstitions

– Sanitary practices were associated with the prevention of disease

Chapter 342


History of Aseptic Technique

Roman Medicine753 BC – 410 AD

Learned from the Greeks and developed a sanitation system– Aqueducts and sewers– Public baths used filtering systems to prevent

disease

Chapter 343


Middle Ages 800 – 1400 AD

– Arabian physicians used mercuric chloride was used to prevent sepsis in wounds

Chapter 344


16th & 17th Century

Anton van Leeuwekhoek (1676)– Dutch Scientist– The Father of

Microbiology

– invented microscope

– observed microorganisms

Chapter 345


19th and 20th Century

Inez Semmelweiss– identified the cause of puerperal fever

which led to the importance of hand washing

Louis Pasteur (1860 –1895)– discovered that microorganisms cause

disease (germ theory of communicable disease)

Chapter 346


19th and 20th Century

Joseph Lister– Developed antiseptics

by soaking surgical tools before surgery

– Prior to this 80% of patients contracted gangrene

Chapter 347


20th century

Ernst von Bergmann– German Scientist– Introduced steam

sterilization under pressure for treating instruments and other medical equipment used for surgery

Chapter 348


20th century

William Stewart– Famous surgeon

from John Hopkins– Introduced sterile

rubber gloves to the field of medicine

Chapter 349


Chain of Infection

Chain of infection contains 6 elements. If broken, infection will not occur.

Infectious Agent

Portal of Exit

Reservoir

Mode of Transmission

Portal of Entry

Susceptible Host


Elements in Chain of Infection

Infectious Agent. Microorganisms that normally reside on the skin.

Reservoir. Residence of microorganisms.

– Fomites are nonliving materials that house microorganisms.



Portal of Exit.– Respiratory tract.– Skin.– Blood.– Gastrointestinal tract.– Mucous membrane.

Mode of Transmission.– How a pathogen is transmitted.– Can be through direct contact or airborne droplet.– Hand washing is one of the most effective means

of preventing the spread of pathogens.



Portal of Entry.– Respiratory tract, mucous membranes, and

gastrointestinal tract are common.– Damaged skin.

Susceptible Host. – One that is capable of being infected.– Microorganisms must be present in large

enough quantity to be virulent.– The host must be susceptible.– Individuals with an immunity to certain

pathogens will not be susceptible.


Signs and Symptoms of Infection

Redness Swelling Tenderness Warmth Drainage


Nosocomial Infections

Infections acquired at the health care facility.

90,000 of the 98,000 patients who die each year in hospitals are due to nosocomial infections. These infections are preventable with closer attention to Hand hygiene and Infection Control guidelines by ALL health care worker


Asepsis

Medical asepsis– Called “clean technique.”– Includes hand washing, standard

precautions and transmission-based precautions

Surgical asepsis– Called “sterile technique.”– Only sterile objects can come in contact

with sterile objects. Otherwise, they must be considered contaminated.



Antiseptics – solutions applied directly to the skin that prevent or inhibit the growth of pathogens.

Examples: hydrogen peroxide, alcohol, betadine

Antiseptics are not useful against all microorganisms.

Chapter 357



Disinfection – using strong chemicals, such as bleach to destroy pathogens, usually on objects, not skin.– Example: Bleach

Sterilization – the most effective way to destroy all microorganisms. Sterilization uses steam under pressure.– Examples: autoclave, radiation, gas

Chapter 358


Why is cleaning your hands between patients important?

Many studies have shown that the bacteria that cause hospital-acquired infections are most frequently spread from one patient to another on the hands of healthcare workers

Chapter 359


HAND HYGIENEHAND HYGIENE

No Fungus among usNo Fungus among us

- NO ARTIFICIAL NAILS

- CLEAN HANDS - THE MOST

IMPORTANT MEANS OF PREVENTING THE SPREAD OF

INFECTION Germs don’t have a

chance with the proper

use of these weaponsSoap / Water Alcohol-based

handhygiene products


According to OSHA standards regarding bloodborne pathogens, handwashing should be performed, at a minimum:

• Before and after every patient contact • After removing gloves and other protective wear • After handling blood or other body fluids • When visibly contaminated with blood or tissues • Before leaving the patient area • Before and after eating, applying makeup, using

the bathroom, handling contact lenses, handling equipment


Proper hand washing techniques include:

• Soap aids in the removal of pathogens.

• Warm water

• Friction

• All surfaces of the hands must be cleaned - palms, backs, between the fingers.

• Nails must be cleaned. • Fingertips pointed downward - prevents water from getting on forearms and

then running back down onto the hands and recontamination

• Dry paper towels are used to turn faucet on and off - prevents contamination of hands from organisms on the faucet.


Standard Precautions

All blood and body fluids are considered contaminated.

Guidelines established by OSHA.– Hand washing is vital.

– Personal protective equipment is necessary (PPE).

Equipment and procedures depend upon the disease and how it is spread.


Transmission-Based Precautions

Prevent spread of highly infectious diseases. Three types of precautions:

– Airborne. Used for diseases such as tuberculosis, which is spread by airborne droplets.

– Droplet. Used for diseases such as whooping cough, which is spread by a cough or sneeze.

– Contact. Used for skin and wound infections, which are transmitted by direct or indirect contact.


Gloves should be worn:– whenever contact with blood and body fluids,

mucous membranes, or non intact skin is possible– When handling items possibly soiled with blood or

body fluids– When performing any invasive procedure– Gloves should be changed after contact with each

patient

Chapter 365


Gowns or aprons should be worn during any procedure that is likely to cause splashing of blood and body fluids

Chapter 366


Masks and protective eyewear or face shields should be worn during procedures that may produce droplets of blood or body fluids

Chapter 367


Extreme caution should be taken while handling sharp objects. They should be left uncapped and attached to the syringe and placed in a puncture resistant sharps container

Chapter 368


Spills and splashes of blood and body fluids should be wiped up immediately. The area should be cleaned with a disinfectant.

Chapter 369


Infectious wastes should be placed in special infectious waste bags or biohazardous material bags. These are usually autoclaved prior to disposal


Report any cut, injury, needle stick or splashing of blood or body fluids immediately

Chapter 371


Pre-procedure– Assemble need

supplies– Remove your rings,

bracelets, and watch or push your watch up on your arm

– Wash your hands

Chapter 372


Put on face mask and goggles– Position the mask so that your mouth and nose are

covered. Usually a small bendable strip is on the mask. Place it over your nose

– Tie the upper strings at the back of your head. If the mask has an elastic band, pull it on around the back of your head

– Tie the strings at the base of your head– Pinch the bendable metal strip over your nose to

secure the mask

Chapter 373


Gown Put on the gown

– Unfold the gown and pull the sleeves up on your arms, with the opening in the back.

– Tie the gown at the neck– Overlap the gown at the back to

close it.– Tie the gown at the waist

Chapter 374


Put on gloves– Pull the

glove cuffs up over the sleeves of your gown

Chapter 375


Remove your gloves– Remove the first glove by grasping it just below the cuff– Pull the glove down over your hand so that it is inside

out– Hold the removed glove with your other gloved hand.

Do not touch the outside of a contaminated glove with your bare hand

– Reach inside the other glove with the first two fingers of your ungloved hand.

– Pull the glove down over the other glove

Chapter 376


Remove the gown– Untie the gown at waist and neck– Do not touch the outside of the gown; it is contaminated.

Using your dominant hand reach inside the gown to the opposite shoulder and remove the gown gently

– Reach the other arm inside the sleeve and pull it down– Hold the gown away from you as you fold it inside out

Chapter 377


Remove the Mask & Goggles

Chapter 378

Touch only the strings. Do not touch the outside of a contaminated mask


What Type of PPE Would You Wear?

Giving a bed bath?• Suctioning oral

secretions?• Transporting a patient

in a wheel chair?• Responding to an

emergency where blood is spurting

• Drawing blood from a vein?

• Cleaning an incontinent patient with diarrhea?

• Irrigating a wound?• Taking vital signs

Chapter 379


STOP

WASH HANDS!Before Entering &

Leaving

Use Standard Precautions

chapter 3 safety and infection control practices health care science technology copyright © the...

Documents

mcgrawhill companies

injuries safety

governing agencies

occupational safety

safety policies

safety officer

report accidents

standard safety precautions