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CHAPTER

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6 Basic Safety and

Infection Control

6-2


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

6-3


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)

6-4


OSHA General Duty Clause Each employer “shall furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees”

6-5


OSHA Hazard Communication

• Biohazard labels

• Warning signs

• Material Safety Data

Sheets (MSDSs)

• Hazard labels

6-6


6-7


OSHA

• Final rule

– Standardize

• Labeling

• Safety information

– Right to understand

The next slide shows the

“final rule”

– Changes

• Hazard

classification

• Labels

• MSDSs

6-8


In this final rule, OSHA is modifying its Hazard Communication Standard (HCS) to conform to the United Nations’ Globally Harmonized System of Classification and Labelling of Chemicals (GHS). OSHA has determined that the modifications will significantly reduce costs and burdens while also improving the quality and consistency of information provided to employers and employees regarding chemical hazards and associated protective measures

6-9



ANSWER: So employees can take measures to

protect themselves against harm.

Why is it important for hazardous materials be

correctly labeled?

6-10


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

6-11



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.

List three electrical safeguards to practice in the

healthcare setting?

6-12


Fire Safety

• Many potential

hazards in a medical

office

• Fire Prevention

– Hazards in the exam

room

– Office laboratory ~

open flame

6-13


Pull, Aim, Squeeze, and Sweep It's easy to remember how to use a fire extinguisher if you can remember the acronym PASS, which stands for Pull, Aim, Squeeze, and Sweep. This will allow you to discharge the extinguisher. How To Use a Fire Extinguisher

http://ehs.okstate.edu/modules/exting/howto.htm

http://ehs.okstate.edu/modules/exting/howto.htm

6-14


In Case of Fire (cont.)

• Using safety equipment

– Fire extinguisher – “PASS”

system

– Fire blanket

A fire extinguisher

Should be located

Every 70 feet

“RACE” is described next

6-15


An easy acronym to help staff retain the information is R.A.C.E., which stands for Rescue, Alert/Alarm, Confine/Contain, and Extinguish/Evacuate. Each of these steps should be accomplished while responding to a fire emergency at any location throughout the building.

6-16


Emergency Action Plans and Drills

• Responsibility

– Reporting fire

– Overseeing

evacuation

• Building evacuation

routes

– Current location

– Nearest exit

6-17


Emergency Action Plans and Drills (cont.)

• Evacuation Procedure

– Ensure patients and staff are evacuated

– Check that everyone has cleared the building

– Take MSDS book

– Assembly area

– Emergency action plan drills

– Local emergency contacts

6-18



Once at the assembly area after an

evacuation how would you account for

employees and patients?

Have a roll call for all employees

and patients

6-19


• Proper handling and storage

• MSDS

• General precautions

• Eye wash station

Chemical Safety

6-20


Chemical Safety (cont.)

• Do not hold under

nose

• Use fume hood or

personal ventilation

device

• Only combine

chemicals as required

• No mouth pipetting

• Add acid to other

substances

• Clean up spills

properly

6-21



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

6-22


Ergonomics and Physical Safety

• Ergonomics

• Maintain a healthy

and safe posture

• Do not over reach

• Lift properly

6-23


Ergonomics

• Transferring a patient

– Lift with knees

– Ask for assistance

– Use transfer device

• Adjust seat

• Take frequent breaks

from the computer

6-24


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

6-25


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

6-26



• Safeguards for the

laboratory environment

– Wear protective gear

– Follow manufacturer’s

guidelines

6-27



• Special safety precautions

– Children ex: glass, sharp corners

– Patients with physical disabilities

• Safe flooring

• Handrails

6-28



ANSWER: The employer

Whose responsibility is it to ensure a safe work

environment?

Whose responsibility is it to follow safe work

practices? ANSWER: The employee

6-29


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

6-30


Cycle of Infection

Back

6-31


Cycle of Infection (cont.)

• Reservoir Host –

body capable of

sustaining pathogen

growth

– Carrier

– Endogenous infection

– Exogenous infection

• Means of Exit - how

the pathogen leaves

the host

Click for Cycle of

Infections

6-32


endogenous infection n. An infection caused by an infectious agent that is already present in the body, but has previously been inapparent or dormant

exogenous infection Etymology: Gk, exo, outside, genein, to produce; L, inficere, to infect an infection that develops from bacteria normally outside the body that have gained access to the body.

6-33



• Means of transmission – how the

pathogen spreads to a host

– Airborne

– Bloodborne

– During pregnancy or birth

Click for Cycle

of Infection

6-34



• 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

6-35



• 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

6-36



• Environmental factors

– Dense populations

– Animals and insects

– Economic and political

factors

– Availability of transportation

– Urbanization and population

growth rates

– Sexual behavior

6-37


Breaking the Cycle

• Asepsis

– Maintain strict housekeeping standards

– Adhere to government guidelines

– Educate patients

• Hygiene

• Health promotion

• Disease prevention

The following is an example something that can happen if you don’t do this!!!

6-38


Germ that causes terrible Diarrhea Follow Contact Precautions Hand Hygiene with Soap and Water ONLY!!! Clean equipment - wheelchair, carts with Bleach product (Dispatch

C. Difficile

6-39



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..

6-40


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

6-41


6-42


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… you must be

offered this within 10 days of hire

6-43


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

The following four slides show standard precautions,

then the lecture returns to Universal Precautions.

6-44


6-45


6-46


6-47


6-48


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

6-49


Written Exposure Plan

• Determination of exposure

• Implementation of control methods

• Post-exposure evaluation and follow-up

• Communication and training

• Recordkeeping

• Evaluation of exposure incidents

6-50


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

6-51


Other OSHA Requirements

• HBV vaccine

• Needlestick Safety and Prevention Act

– Engineered safety devices

– Employer recommendations

• Engineering controls

• Needlestick safety programs

6-52


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

6-53



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

OSHA divides medical tasks by level of risk.

What are these risk categories?

6-54


Infection Control Methods

• Knowledge of

– Medical asepsis

• Based on cleanliness

• As few microorganisms as possible

– Surgical asepsis

• Sterile environment

• No microorganisms

6-55


Infection Control Methods (cont.)

• Keep office clean

• Prevent cross-

contamination

– Follow guidelines

– Use protective gear

6-56


Hand Hygiene

• Handwashing

• Alcohol-based hand disinfectants

(AHD)

• Fingernail length---1/4 inch or less

• Nail polish and artificial nails—clear or

natural, no chips, no artificial nails

6-57


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

6-58


Personal Protective Equipment

• Gloves

• Masks and protective eyewear or face shields

• Protective clothing

• Use of multiple types of PPE

6-59


Transmission from Healthcare Workers

• Healthcare-associated infections (HAI)

• Adhere to OSHA Standards

• High risk procedures

• HIV, HBV status of healthcare workers

6-60



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.

6-61


Reporting Guidelines for Infectious Diseases

• State or county health department

• Information is forwarded to the CDC

• National Notifiable Disease Surveillance

System

• What are some notifiable diseases?

6-62


Reporting Guidelines (cont.)

• Reporting – correct form

– Disease identification

– Patient identification

– Infection history

– Reporting institution name

6-63



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.

6-64


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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