ENVIRONMENTAL AND

PATIENT/THERAPIST SAFETY

Preparation for Patient Care

• Preparing clear patient care environment/ room

• Preparation of the treatment area for the next patient at the end of each patient treatment

• Risk Management• Maintenance of the treatment area• Prior to patient treatment

Aseptic Techniques

• CDC guidelines (Center for Disease Control and Prevention)

• Microorganism transmission barriers/isolation • Transmission-based precautions• Modes of transmission

• Contact transmission• Droplet transmission• Airborne transmission• Common vehicle transmission• Vectorborne transmission.

Precautions

• Isolation precaution• administrative controls

• Education• Adherence to precautions

• Standard Precautions (prevents clinician to become a vectorborne)• Universal precaution + body substance isolation + all

body fluids may contain transmissible infectious agents.• Includes: hand hygiene, gloves, gown, mask, eye

protection/face shield and safe injection practices.

New elements of standard precautions

• Respiratory hygiene/cough etiquette• Cover mouth and nose with tissue when

sneezing/coughing• Safe injection practices

• Proper disposal of needles in the sharp containers and disinfected needle sites

• Use of masks for insertion of catheters or injection of material into spinal or epidural spaces via lumbar puncture procedures

Standard Precautions • Hand Hygiene

• Hand wash• rubbed vigorously during 20 seconds with

special attention paid to the backs of the hands, wrists, between the fingers, and under fingernails.

• Rinse the hands well while leaving the water running as well as drying with a single-use towel

• Turn off the water with a paper towel and prevent re-contamination

Personal Protective equipment (PPE)

• Where to wear and where to discard it• Gloves

• sterile techniques • nonsterile techniques

• Gowns (prevent splash and soil clothing)

When in direct contact with patients• Mask/goggles/face shields

Personal Protective equipment (PPE) – cont.

• Patient-care equipment and instruments/devices• Handling and transporting to follow the facilities’ P&P.• Wear PPE to clean an used or contaminated equipment.

• Care of the environment• To follow facilities’ P&P• Clean and disinfect surfaces that are likely to be

contaminated. In case of doubt, consider it contaminated.

• Textiles and laundry• Avoid agitation to prevent airborne contamination

Precautions Protocols

• For safety, we consider all patients are contaminated until proof the opposite. Therefore use standard precautions

• Contact – gowns and gloves done prior to enter the patient’s room and doff before exiting patient’s room.

• Patient transport – acute hospitals, LTAC, ECF

• Sterile Techniques.

Draping

• Covering a patient appropriately • Edge of sheets and towels must be secured • Hospital gowns, towels and bed sheets or

appropriate attire• Safety measures • Follow the specific policies of each facility• Transportation equipment

Case study 2

• This is Tom who was diagnosed with lymphedema to his LLE.

• Take his Vital Sign• Setup his intermittent

compression pump

• Preparation for Patient Care1

• Positioning/Draping2

Today’s Overview

Summary

• Take full advantage of your open labs and your instructor’s time

• Set realistic expectation• All competency exams are timed and

cues will be given for those who ask.• Practice, Practice, Practice

QUESTIONS?