Download Unit 4A: Purpose of Standard Precautions and when they are applied

Healthcare Safety and Standard Precautions
Competencies 3-4
Competency 3
Describe the methods healthcare facilities use to achieve
physical, chemical, and biological safety.
2
Competency 3
3. Describe the methods healthcare facilities use to achieve physical,
chemical, and biological safety.
A. Explain physical hazards and list safe practice guidelines.
B. Explain chemical hazards and labeling requirements.
C. Explain biological hazards and safety guidelines
Unit 3A: Physical Hazards
Recommended Content
 At this point in the curriculum, physical hazards and safety
guidelines are discussed.
 Those physical hazards are:
 Electrical
 Fire
 These hazards will be discussed on the following slides.
Unit 3A: Physical Hazards-Electrical
 Electrical equipment needs to be in good working order and grounded. The
third (longer) prong in an electrical plug is the ground.
 Theoretically the ground prong carries any stray electrical current back to
the ground whereas, the other two prongs carry the power to the piece of
electrical equipment.
 Improperly grounded & malfunctioning, or faulty electrical equipment
(frayed cords) increases the risk of electrical injury & fire. (Potter & Perry, p. 842)
 It is the healthcare worker’s responsibility to remove faulty equipment from
service & make a report to the appropriate person at the healthcare facility.
(Ramont & Niedringhaus, pp. 728-729)
Unit 3A: Physical Hazards-Electrical
Major causes of electrical fires are:
1. Improper use of smoking materials
2. Defects in the heating systems
3. Improper trash disposal
4. Misuse of electrical equipment
5. Spontaneous combustion
Unit 3A: Physical Hazards-Fire
Recommended Content
 In healthcare agencies, fire is particularly hazardous when people are
incapacitated and unable to leave the building without assistance.
 Healthcare workers must be aware of the fire safety regulations and
fire prevention practices of the agency in which they work.
 Healthcare workers should know the location of exits, fire alarms, and
extinguishers.
(Ramont & Niedringhaus, pp. 126)
Unit 3A: Physical Hazards-Fire
When a fire occurs, the healthcare worker follows four sequential
priorities. Use the acronym RACE to help remember the procedure.
R = Rescue or Remove clients immediately in danger.
A = Activate the Alarm Pull the alarm or call to report.
C = Confine or Contain the fire by closing all doors, making sure the
medical gas valves are turned off and that circuit breaker panels are
turned off.
E = Extinguish the fire or E = Evacuate.
Unit 3A: Physical Hazards-Fire
PASS
When using an
extinguisher,
remember PASS.
P = Pull pin
A = Aim
S = Squeeze
S = Sweep
(Juliar, p. 167)
Unit 3A: Physical Hazards-Fire
PASS
Pull the pin
Aim
Squeeze
Sweep
Competency 3
Safety within Healthcare Facilities
Recommended Learning Activities
Assignment
Resources
Notes
HCS Competency 3 - 7: Fire
Safety
Extinguish or Evacuate
YouTube video
Can be completed in pairs
or individually and
presented to the class
HCS Competency 3 – 5:
Scenarios Environmental
Safety
PowerPoint on
Environmental Safety
Students review two
scenarios with questions on
the application of
environmental safety for
discussion
Unit 3B: Chemical Hazards and Labeling
Recommended Content
 Healthcare settings have hundreds of chemicals, such as cleaning
solutions, anesthesia, and chemotherapeutic drugs.
 Chemicals can cause harm & injury if swallowed, inhaled, or absorbed
through the skin or mucous membranes. Some chemicals create fire
hazards.
 OSHA requires all health care facilities to have an exposure control plan.
 In addition, Safety Data Sheets (SDS) must be available to all employees.
Unit 3B: Chemical Hazards and Labeling
What are Safety Data Sheets (SDS)?
 There is a SDS for each chemical & the SDS contains the precautions to
take when handling the chemical, safety instructions for use, requirements
for clean-up, and first aid measures to take if exposure occurs.
 Each person is responsible for knowing the chemical used and any potential
risks to themselves and their clients. One should read the label of the
chemical before using or review the SDS. Know where the SDS is located &
how to access them.
 Containers must be labeled with the chemical name & function. Labels must
also tell any danger or hazard that may exist with that chemical or
ingredients, the name, address, & phone number of the manufacturer.
Unit 3B: Chemical labels are coded according to the
National Fire Protection Association
Unit 3B: Chemical Label Sample
(www.mountnittany.org, n.d.)
Unit 3B: Chemical Hazards and
Labeling
Recommended Learning Activities
Assignment
Resources
Notes
HCS Competency 3 – 5:
Safety Data Sheets Activity
Assignment found on
website
Students choose 3
chemicals, select SDS
for each and answer
questions.
Unit 3C: Biological Hazards & Safety
Recommended Content
 Healthcare environments contain many potential hazards. It is
essential to follow safety practices that consider the well-being of
others.
 Follow the Standard Precautions and Bloodborne Pathogens
Standards are discussed in Competency #1, Unit #2.
Unit 3C: Biological Hazards & Safety
The following are what might be common sense to many, others need
to be instructed on safety with biological hazards.
 Do not wear uniforms in non-work places.
 Keep floors clear by immediately picking up dropped objects. Use
OSHA standards when cleaning up glass, spilled specimens, and
liquids.
 Broken glass is best picked up with a brush or broom and dustpan &
placed in a puncture-resistant wrap or container prior to placing in a
plastic bag. This will prevent cuts for whoever handles the bag.
 When spills involve bodily secretions or blood, follow the Standard
Precautions by wearing gloves and disposing of waste in special
bags designated for biohazardous waste.
(Juliar, p. 163)
Unit 3C: Biological Hazards & Safety
 Infectious waste is any item or product that has the potential to
transmit disease. Infectious waste must be handled using standard
and transmission-based precautions, placed in containers or bags
labeled as to type of waste (i.e., linen, sharps, trash), decontaminated
onsite, or removed by licensed removal facility for decontamination.
 It is the healthcare worker’s responsibility to follow the facility’s
policies and procedures in proper handling, containment, clean-up of
spills, and disposal of infectious waste.
 Any direct contact with waste that puts the worker at risk for infections
should be reported per facility policy.
(Juliar, p. 171)
Competency #4
Describe the principles and standards of
infection control.
Competency 4
Units included in this competency are:
A. Explain the purpose of standard precautions and when they are to
be applied.
B. List guidelines that reduce the spread of infection.
Unit 4A: Purpose of Standard Precautions and when they are
applied
Recommended Content
 The curriculum defines infection control as “the practices that prevent the
growth and spread of disease producing microorganisms called pathogens
or germs.”
 Infection control consists of policies and procedures of a hospital or other
healthcare facility to minimize the risk of nosocomial or community-acquired
infections spreading to patients and other staff members.
 Infection control is routine in whatever actions healthcare workers
perform.
 The healthcare worker’s knowledge of infection, the application of infection
control principles, & use of common sense help protect patients from
infections.
(Kockrow, p. 271)
Unit 4A: Purpose of Standard Precautions and when they are
applied
The presence of a pathogen does not mean that an infection will occur. Infection
occurs in a cycle that depends on the presence of all of the following elements:






An infectious agent or pathogen
A reservoir or source for pathogen growth
A portal of exit from the reservoir
A mode of transmission
A portal of entry to a host
A susceptible host
The following slides will briefly address the chain of infection.
Unit 4A: Purpose of Standard Precautions and when they are
applied
Infectious Agent
 Microorganisms (bacteria, viruses, fungi, & protozoa)
Reservoir
 Reservoir is a place where a pathogen can survive, may or may not multiply.
 For example, hepatitis A virus survives in shellfish, but does not multiply.
Carriers
 Persons who show no symptoms of illness but who have pathogens on or in their
bodies that can be transferred to others.
 To thrive, organisms require a proper environment including appropriate food,
oxygen, water, temperature, pH, and light.
Unit 4A: Purpose of Standard Precautions and when they are
applied
Portal of Exit
 After microorganisms find a site to grow and multiply, they must find a
portal of exit if they are to enter another host and cause illness.
 Portals of exit include sites such as blood, skin, and mucous
membranes (any break in the integrity of skin/mucous membranes),
respiratory tract (coughing/sneezing), genitourinary tract
(urination, catheters, & diversions/drains), gastrointestinal tract
(saliva, kissing, bowel elimination, emesis, drainage of bile from
surgical wounds, or draining tubes), reproductive tract (male’s
urethra or woman’s vagina during sexual contact, semen), blood-toblood contact and transplacental (mother to fetus). (Potter & Perry, p. 644)
Unit 4A: Purpose of Standard Precautions and when they are
applied
Modes of Transmission
 Each disease has a specific mode of transmission (manner in which
microorganisms get to the host).
 Once microorganisms have exited, there are many vehicles (means
by which organisms are carried about) on or by which they can travel
to the next host.
 It is critical that students have a clear understanding of the different
type of modes of transmission. They are:
 Direct Contact
 Indirect Contact
Unit 4A: Purpose of Standard Precautions and when they are
applied
Indirect Contact
 Personal contact of susceptible host with contaminated inanimate
object (e.g., needles or sharp objects,
dressings, environment).
Spread from person to person.
 Indirect contact also includes food, water,
counter tops, bedpans, mosquitoes, etc.
Unit 4A: Purpose of Standard Precautions and when
they are applied
Direct Contact
 Involves immediate &
direct transfer of
microorganisms from
person to person
through touching,
biting, kissing, or
sexual intercourse.
(Berman et al., p.
672)
 Person to person
 Spread by direct contact
with infected skin, mucus
membranes, or body fluids
 Physical contact between
source & susceptible host
(e.g., touching client’s feces
& then touching your inner
mouth or consuming
contaminated food)
 Ex. Hepatitis A
(Berman et al., p. 672)
Unit 4A: Purpose of Standard Precautions and when
they are applied
Portal of Entry
 Body openings such as eyes, ears, nose, mouth
 Microorganisms can enter through tubes in the body:
 Indwelling urinary catheters
 Gastrointestinal feeding tubes
 Tracheostomy tubes
 Intravenous catheters (IVs)
 Pins-Hardware in Bones
(Berman et al.)
)
Unit 4A: Purpose of Standard Precautions and when
they are applied
Portal of Entry
Inhalation
Skin Break
Respiratory System
Ingestion
Gastrointestinal System
Sexual Contact
Genitourinary System
Unit 4A: Purpose of Standard Precautions and when
they are applied
Susceptible Host
 Susceptible host is an individual who has impaired immune system
response & is at risk for developing an infection.
 The support of pathogen life & its reproduction depend on the degree of the
host’s resistance.
 A compromised host is someone who has a higher risk for getting an
infection for one or more reasons.
 Impairments of the body’s natural defenses & a number of other factors can
affect susceptibility to infections.
(Berman et al., p. 673)
Unit 4A: Purpose of Standard Precautions and when
they are applied
 Having completed discussing the Chain of Infection, it is quite common that
students do not grasp all of the concepts of the chain.
 However, what students can grasp and must understand are the ways in which to
break the Chain of Infection.
 The following slides will address guidelines to reduce the spread of infection.
(see next slide)
Unit 4B: Guidelines to reduce the spread of infection
What is the best defense?
 To decrease the sources of microorganisms
 Prevent transmission
 Maximize the resistance of the host
How can the healthcare worker decrease the source of microorganisms?
 Perform proper hand washing
 Decontaminate surfaces & equipment (antiseptics, disinfectant, sterilization)
 Avoid contact with patients & others when harboring infectious
microorganisms.
(Juliar, p. 145)
Unit 4B: Guidelines to reduce the spread of infection
How can the healthcare worker prevent the transmission of
microorganisms?
 Wear personal protective equipment (PPE) when indicated
 Follow isolation procedures when indicated
 Provide good skin hygiene, oral hygiene, bathing & shampooing
 Ensure proper nutrition and fluid intake
 Encourage adequate sleep
 Decrease stressors that weaken the immune response
(Juliar, p. 145)
Competency 4: Infection Control
Assignment
HCS Competency 4:
Epidemic Simulation
Resources
Notes
Small clear plastic cups (two
Students complete an
per student)
experiment which simulates
Weak sodium hydroxide
how quickly infectious agents
solution*
can spread.
Phenolphthalein solution
Water
HCS Competency 4 – 7: Students research the web
Team Research and
Team Research on
presentation on chain of
Infectious Agents and/or
infection, pandemics,
Bio/Chemical Warfare
chemical warfare or
biological warfare.
Author: Dede Carr, BS, LDA
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