Download Hospital Environment and Health

HOSPITAL
ENVIRONMENT AND
SAFETY
INTRODUCTION :
• The hospital environment presents
particular and, in some cases, unique
safety problems when compared with
other industrial settings. These problems
affect the patient, staff, and visitor.
• The causes of such hazards fall into two
broad categories:
• a) Failure of a device to correctly perform
the desired function. • b) Failure of hospital personnel to correctly
use medical equipment.
• every hospital needs a safety program and
a safety committee to oversee these
aspects of the hospital's daily function.
THE SAFETY PROGRAM:
• A safety program has three major
components. These are:
• A) The identification of hazards and risk.
• b) The prevention of hazards and risk.
• c) Documentation
The identification
• component requires constant vigilance
with respect to in- hospital activities and
information from outside sources on the
hazards and risks associated with
procedures or equipment. It is particularly
important that the identification phase be
an ongoing one that can respond to new
information. One particularly important part
of identification is incident analysis.
protection to personnel and
patients
• Elimination or direct control of the hazard
and
• Supervision and education of the worker.
• Inspection and preventive maintenance,
The replacement or change in types of
equipment, changes in procedures, the
addition of safety and protective devices,
and improved worker qualifications.
Documentation
• serves as a record of the program
• provide visual and concrete documentation to
accrediting or licensing bodies such as the Joint
Commission for Accreditation of Hospital
Organization (JCAHO), which requires a
documented program
• review the prevention efforts and the "causes of
incidents and also serve as a permanent record
of what was done and why
HOSPITAL EMPLOYEE HEALTH
AND SAFETY
• Hospital environmental exposures are
categorized in the same way as in other
workplaces; there are chemical, physical,
biological, and psychological conditions.
The hospital has many of the same
exposures in these categories, as do other
workplaces; electrical equipment
deficiencies, toxic gases, weights to lift or
move, job motivation and responsibility,
and poor housekeeping.
NIOSH
• The National Institute for Occupational Safety
and Health
• completed a survey of 3687 hospitals to identify
the types and frequencies of injuries and
illnesses among hospital employees. This study
found that among all the exposures typified, the
most common types of injury were strains and
sprains. These injuries are usually caused by
improperly lifting objects, including patients, and
slipping and falling on slippery floors, stairs, or
ladders.
Hospital Occupational Health and
Safety
• 1. Pre-placement medical examinations
should be given to all new employees.
These examinations should include a
medical history, a thorough physical
examination, laboratory tests (blood, urine,
chest X-ray, etc.), and special
consultations as indicated by the history ,
physical findings, or special job
requirements.
• 2. Periodic health maintenance
procedures should be instituted that
include a general examination, as in item 1
above, an assessment of continued job
compatibility, and special appraisals
necessitated by extensive illness or job
changes
• 3. Health and safety education programs
should be developed to include job
orientation safe working habits, relevant
health information and the use of the
hospital occupational health unit for
reporting injury or illness.
• 4. Employee immunizations should be given that include
smallpox, diphtheria, tetanus, polio, and other diseases
as indicated by epidemics or unusual laboratory
conditions. Updating should also be a part of this
program.
• 5. Provisions for care of illness and injury at work should
include arrangements for medical, surgical,
psychological, and rehabilitative services; specific
location availability of competent medical personnel, and
a formalized procedure should be maintained. Treatment
and reports of occupational injuries and illnesses should
conform to state compensation laws and OSHA
requirements.
• 7. Environmental control and surveillance services
should be provided to detect, avoid, or limit harmful
occupational exposures. Special attention should be
given to hazardous occupational exposures for women
of childbearing age, to employees exposed to ionizing or
non-ionizing radiation, and to operating room personnel
exposed to anaesthetic gases.
• 8. Employee health and safety records should be
maintained in the health unit. These must include
examinations, injury or illness reports, radiation records,
and other environmental exposure reports or records.
• 9. Coordinated planning is recommended
between the health unit and other hospital
departments and services including the
safety committee, infection control
committee, labour union, and similar
groups.
Hospital Acquired Infection
• Nosocomial infection
Infection occurring during hospitalization is
considered the major problem.
• ‘cross infection’
• Agents: staph aureus, hemolytic strep,
ecoli, klebsiella, pseudomones and
viruses.
• Sources: patients: staff working in the
hospital and environment
Routes of spread:
• Direct contact: from hands of a doctor or
nurse
• Droplet
• Air borne
Recipients
• All patient are potential recipients of
infection from sources within hospital
some patients are more susceptible or
more liable for cross infection than others
especially the severely ill and the and
those in whom the ability to resist infection
is reduced
Prevention and control
• Isolation
• Disinfection: is an agents which destroy all
micro-organism but not usually the spore
forming…
• E,g: phenol lysol
• Sterilization:
sterilization
•
Is the only process that reliably kills all forms of
microbial life (bacteria, spores, fungi, and
viruses). Several types of sterilization have been
used in hospitals (e.g.; dry heat, chemical bath,
or irradiation) but two methods are most
commonly used: steam and gas sterilization.
Steam sterilization is the oldest method (dating
from the 1800s) and the least expensive.
However, some items cannot be steam sterilized
because of heat sensitivity.
• Ethylene oxide (ETO) sterilization is an
important method owing to the quantity of
medical devices that cannot be steam
sterilized. In this method, ETO gas is
introduced into the sterilizer chamber and
the sterilization cycle lasts from I to 4 hrs
Types of disinfection
• Concurrent disinfection
• terminal disinfection
• Prophylactic disinfection
SAMPLING METHODS
• Air sampling:
• Water Sampling:
• Surface sampling