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Chapter 3Safety and Infection Control Practices
Health Care Science Technology
Copyright © The McGraw-Hill Companies, Inc.
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Accidents and Injuries
Safety means freedom from danger, risks, and injury.
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Prevention
Injuries are prevented by preventing accidents.
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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.
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Governing Agencies (cont.)
Manufacturers are required to provide a copy of the MSDS for all products they sell.
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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.
Governing Agencies (cont.)
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Governing Agencies (cont.)
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.
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Governing Agencies (cont.)
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).
Copyright © The McGraw-Hill Companies, Inc. Chapter 39
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.
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Guidelines for preventing accidents
– Know the environment, including the location of exits, stairs, fire alarms and extinguishers, call signals, paging systems, and emergency lights.
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– 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.
Copyright © The McGraw-Hill Companies, Inc. Chapter 312
– 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.
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– 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.
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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.
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– 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.
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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
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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
Copyright © The McGraw-Hill Companies, Inc. Chapter 319
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
Copyright © The McGraw-Hill Companies, Inc. Chapter 320
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.
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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.
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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
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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.
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Definition of Body Mechanics
Positions and movements used to maintain proper posture and avoid muscle and bone injuries
Chapter 324
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Principles of Body Mechanics
Body alignment depends on the correct positioning of the head, back, and limbs.
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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!
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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.
Copyright © The McGraw-Hill Companies, Inc. Chapter 328
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.
Copyright © The McGraw-Hill Companies, Inc. Chapter 329
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.
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Microorganisms
We usually do not notice or think about microorganisms until they cause some form of physical illness.
Remember many are beneficial
Chapter 330
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Nature of Microorganisms
Pathogens are microorganisms that cause disease.
Non-pathogens are microorganisms that do not cause disease.
Copyright © The McGraw-Hill Companies, Inc. Chapter 332
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.
Copyright © The McGraw-Hill Companies, Inc. Chapter 333
Factors That Influence Microbial Growth (cont.)
Aerobic microbes – live only in the presence of oxygen.
Anaerobic microbes – grow best in the absence of oxygen.
Copyright © The McGraw-Hill Companies, Inc. Chapter 334
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.
Copyright © The McGraw-Hill Companies, Inc. Chapter 335
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.
Copyright © The McGraw-Hill Companies, Inc. Chapter 337
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.
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Types of Microorganisms (cont.)
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.
Copyright © The McGraw-Hill Companies, Inc. Chapter 339
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).
Types of Microorganisms (cont.)
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Principles of Infection 3-5
AsepsisHistory of AsepsisChain of InfectionSigns and Symptoms of InfectionNosocomial Infections
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Definition of Asepsis
1. Freedom from infection.
2. The prevention of contact with microorganisms
Chapter 341
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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
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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
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Middle Ages 800 – 1400 AD
– Arabian physicians used mercuric chloride was used to prevent sepsis in wounds
Chapter 344
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16th & 17th Century
Anton van Leeuwekhoek (1676)– Dutch Scientist– The Father of
Microbiology
– invented microscope
– observed microorganisms
Chapter 345
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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
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19th and 20th Century
Joseph Lister– Developed antiseptics
by soaking surgical tools before surgery
– Prior to this 80% of patients contracted gangrene
Chapter 347
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20th century
Ernst von Bergmann– German Scientist– Introduced steam
sterilization under pressure for treating instruments and other medical equipment used for surgery
Chapter 348
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20th century
William Stewart– Famous surgeon
from John Hopkins– Introduced sterile
rubber gloves to the field of medicine
Chapter 349
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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
Copyright © The McGraw-Hill Companies, Inc. Chapter 351
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.
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Elements in Chain of Infection
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.
Copyright © The McGraw-Hill Companies, Inc. Chapter 353
Elements in Chain of Infection
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.
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Signs and Symptoms of Infection
Redness Swelling Tenderness Warmth Drainage
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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
Copyright © The McGraw-Hill Companies, Inc. Chapter 356
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.
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Methods That Destroy Microorganisms
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
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Methods That Destroy Microorganisms
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
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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
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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
Copyright © The McGraw-Hill Companies, Inc. Chapter 361
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
Copyright © The McGraw-Hill Companies, Inc. Chapter 362
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.
Copyright © The McGraw-Hill Companies, Inc. Chapter 363
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.
Copyright © The McGraw-Hill Companies, Inc. Chapter 364
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.
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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
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Gowns or aprons should be worn during any procedure that is likely to cause splashing of blood and body fluids
Chapter 366
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Masks and protective eyewear or face shields should be worn during procedures that may produce droplets of blood or body fluids
Chapter 367
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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
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Spills and splashes of blood and body fluids should be wiped up immediately. The area should be cleaned with a disinfectant.
Chapter 369
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Infectious wastes should be placed in special infectious waste bags or biohazardous material bags. These are usually autoclaved prior to disposal
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Report any cut, injury, needle stick or splashing of blood or body fluids immediately
Chapter 371
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Pre-procedure– Assemble need
supplies– Remove your rings,
bracelets, and watch or push your watch up on your arm
– Wash your hands
Chapter 372
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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
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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
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Put on gloves– Pull the
glove cuffs up over the sleeves of your gown
Chapter 375
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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
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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
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Remove the Mask & Goggles
Chapter 378
Touch only the strings. Do not touch the outside of a contaminated mask
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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
Copyright © The McGraw-Hill Companies, Inc. Chapter 380
STOP
WASH HANDS!Before Entering &
Leaving
Use Standard Precautions