examination and treatment areas

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CHAPTER

9Examination and Treatment Areas

9-2


Learning Outcomes (cont.)

9.1 Describe the layout and features of a typical examination room.

9.2 Differentiate between sanitization and disinfection.

9.3 List steps to prevent the spread of infection in the exam and treatment rooms.

9-3


Learning Outcomes (cont.)

9.4 Describe the importance of temperature, lighting, and ventilation in the exam room.

9.5 Identify instruments and supplies used in a general physical exam and tell how to arrange and prepare them.

9-4


Introduction• Care and maintenance of exam room

– Equipment

– Supplies

– Infection control practices

9-5


The Exam Room• Number and size of rooms

– Two per physician

– Accommodate the physician, patient, and one assistant

– Supplies and equipment must be in reach

9-6


Furnishings• Arrangement

– Efficiency– Patient comfort– Physician

convenience

• Examining table– Step– Drawers– Adjustable

positioning

9-7


Furnishings• Items commonly found in exam rooms

One or more chairs

A rolling stool

Weight scale

Biohazard container

Wastebasket with lid

Puncture-proof containers

Wall brackets

High-intensity lamp

9-8


Special Features• The 1990 Americans with Disabilities Act

(ADA)

– Requires “reasonable accommodations”

– Accessibility

– Guidelines

9-9


Apply Your Knowledge

ANSWER: You need to consider efficiency, patient comfort, and physician convenience when arranging an examination room.

When arranging an examination room, what three things should you consider?

Right!

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Sanitization and Disinfection• Sanitization

– For cleaning items that touch only healthy, intact skin

– First step in disinfection and sterilization for other equipment

9-11


Sanitization (cont.)

• Collect items for sanitization– PPE

– Separate sharps from other equipment

• Scrub items– Small brush

– Neutral pH detergent

– Dry

9-12


Sanitization (cont.)

• Rubber and plastic items

• Ultrasonic cleaning – For delicate instruments and those with

moving parts

– Sound waves generated through a cleaning solution to loosen contaminants

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Disinfection

• Adequate for some instruments

• For others, it is the second step prior to sterilization

• Sterilization is necessary for visible contamination with blood

9-14


Disinfection (cont.)

• Using disinfectants

– Cleaning products for inanimate materials

– Reduce or eliminate infectious organisms

– Manufacturer’s guidelines

– Effectiveness

9-15


Disinfection (cont.)

• Choose the correct disinfectant

• Handling disinfected supplies– Prevent contamination with other surfaces

– Use sterile transfer forceps

– Wear gloves

– Store in clean, moisture-free environment

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What is sanitation and for what items is sanitation adequate for cleaning?

ANSWER: Sanitation is scrubbing with a brush and detergent to remove blood, mucus, and other contaminants or media where pathogens can grow. It is adequate for cleaning items that touch only healthy, intact skin.

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Preparation of the Exam and Treatment Areas

• Clean and well organized

• Safeguards

– Making hand hygiene a priority;

– Keeping the examining table clean; and

– Disinfecting all work surfaces.

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Infection Control

• Hand hygiene– Handwashing– Alcohol-based hand

cleaners

• Examining Table– Paper cover– Linens

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Infection Control (cont.)

• Disinfect surfaces– Visibly contaminated with tissue, blood or

other body fluids

– At end of shift

– Per office schedule

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Infection Control (cont.)

• Storage– Store biohazardous specimens properly

– Work practice controls

– Store testing kits properly

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Putting the Room in Order

• Straighten and put items away

• Contributes to physical safety

• Housekeeping

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Other than at the end of your shift, when should you disinfect the surfaces in the examination rooms?

ANSWER: Whenever there is visible contamination with blood, body fluid, or body tissue.

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Room Temperature, Lighting, and Ventilation

• Maintain examination room temperature at about 72°F

• Eliminate drafts

9-24


Lighting• Accurate

diagnoses

• Perform medical procedures

• Read orders and instructions

• Prevent accidents

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Ventilation• Examination area should smell clean

and fresh

• Eliminate source of odors

• If opening windows, monitor room temperature

• Room deodorizer or spray

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ANSWER: Good lighting is needed for making accurate diagnoses, performing medical procedures, reading orders and instructions, and preventing accidents.

Why is it important to have good lighting in the examination room?

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Medical Instruments and Supplies

• Maintain instruments and supplies– Order and stock all needed supplies

– Sanitize, disinfect, and/or sterilize instruments as needed

– Instruments and supplies should be placed within easy reach for the physician

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Instrument PurposeAnoscope Used to open the anus for

examinationExam light Provides additional lightingLaryngeal mirror Reflects inside of mouth and

throatNasal speculum Used to enlarge the opening of

the noseOphthalmoscope Used to examine the inner eye

surfaces

Instruments Used in a General Physical Exam

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Instrument PurposeOtoscope Used to examine the inner

earPenlight Small flashlight used to view

a small areaReflex hammer Used to check patient’s

reflexesSphygmomanometer Used to measure blood

pressure

Instruments for a General Physical Exam (cont.)

9-30


Instrument PurposeStethoscope Used to listen to body sounds

Tape measure Used to measure size or development of an area

Thermometer Used to measure body temperature

Tuning fork Used to test hearingVaginal speculum

Used to enlarge the vagina for specimens from cervix and vagina


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• Inspecting and maintaining instruments

• Arranging instruments– Mounted on wall

– Out on countertop

– Set on a clean towel or tray

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• Preparing instruments

• Cleaning instruments– Dispose of supplies in the appropriate

containers

– Use approved procedures for sanitizing, disinfecting, and sterilizing

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Cervical scraper

Cotton balls Cotton-tipped applicators

Curettes

Needles and Syringes

Gauze, dressings, and bandages

Glass slides

Sterile and clean gloves

Paper tissues

Occult blood test slides

Specimen containers

Tongue depressors

Supplies for a General Physical Exam

9-34


Supplies for a General Physical Exam (cont.)

• Consumable supplies– Fixative– Isopropyl alcohol– Lubricant

• Be sure patients do not have access to– Prescription blanks– Drugs– Needles

9-35


Supplies for a General Physical Exam (cont.)

• Store supplies – Label drawers

– Put items back in correct place

– Routinely straighten and clean

• Restocking supplies

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stethoscope

nasal speculum

reflex hammer

otoscope

penlight

laryngeal mirror

ophthalmoscope

tape measure

sphygmomanometer

tuning fork

anoscope


A medical assistant is preparing the treatment room for a local ENT specialist. Which of the following instruments might be used in this office to assess patient ear, nose, and throat functioning?

*nasal speculum

*otoscope

*penlight

*laryngeal mirror

*ophthalmoscope

*tuning fork

ANSWER:

Good Choices!

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In Summary9.1 A typical examination room is about 8 by 12 feet, large enough to accommodate the physician, the patient, and

one assistant. Instruments and equipment in the room should be easily accessible.

9.2 Sanitization is the scrubbing of instruments and equipment with special brushes and detergent to remove blood, mucus, and other contaminants or media where pathogens can grow. Disinfection uses special cleaning products applied to instruments and equipment to reduce or eliminate infectious organisms.

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In Summary (cont.)

9.3 Steps involved in preventing the spread of infection in the examination room include covering the examination table with a paper cover and changing the cover between each patient. It is also important to disinfect all surfaces that come in contact with blood or body fluids after each patient, and at the beginning and end of the day.

9.4 It is important that patients feel comfortable in the examination room. A comfortably warm, well lit, and properly ventilated room will help the patient feel comfortable during his examination.

9-39


In Summary (cont.)

9.5 A variety of instruments and supplies are used in a general physical examination. To ensure the examination room always has the necessary instruments and supplies, the medical assistant should order and stock all supplies needed for examinations and treatment procedures; keep the instruments sanitized, disinfected, or sterilized and in working order;

and place all instruments and supplies where the physician can easily reach them.

9-40


End of Chapter 9

examination and treatment areas

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