Download Practise high standards of personal hygiene (Audiometry)

Practise high standards of personal
hygiene (Audiometry)
Contents
Introduction
2
Maintain personal hygiene with understanding of
contamination and infection risks
2
Safely dispose of infectious and/or hazardous waste material
7
Report or initiate action within own area of responsibility to
redress any potential workplace hazards
7
Summary
8
Feedback to activity
8
Key to resources
The following resource is located in Your resources.
Resource 1: Microbiology (.html 33kB)
Resource 2: Handwashing video
Window Media (10,772 kB)
MPEG movie (25,437 kB)
Video text version (.doc 99kB)
Practise high standards of personal hygiene (Audiometry)
© NSW DET 2007
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Introduction
Personal hygiene is one of the keys to protecting ourselves and others from
illness—with hand washing is the single most important procedure for
preventing transmission of infection.
Maintain personal hygiene with
understanding of contamination and
infection risks
Role of microbiology in disease
The ear canals can contain large numbers of potentially disease-producing
(pathogenic) organisms which, while usually causing no harm to the host,
may cause disease if spread to another person. These can exist on the skin of
the external ear or the ear canal. Exudate from the middle ear, cerumen and
blood can frequently be found in the external ear and ear canal. The
presence of blood or exudate in the ear greatly increases the risk if the
person is a known or unknown carrier of a disease such as Hepatitis B, C or
HIV.
Whether the spread of micro-organisms causes clinical infection depends on
the power a particular micro-organism to infect.
Go to Resource 1 (Microbiology)
This resource is in Your resources.
Code of conduct
Being a health professional, it is important that the Audiometrist looks the
part. You need to always remain conscious of projecting an efficient and
professional image in everything you do.
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
Professional appearance means the following:

Personal cleanliness is maintained.

Nails are kept short and clean.
Practise high standards of personal hygiene (Audiometry)
© NSW DET 2007

Hands are washed regularly.

Hair is neat. If it is long, it is tied back.

Clothing is always clean. A professional person also wears clothing
that is appropriate in the particular context.

Jewellery is kept to a minimum.

Shoes are comfortable and clean.
Hand washing
Hand washing is the single most important procedure for preventing
transmission of infection.
A number of infectious diseases, eg gastrointestinal infections and hepatitis
A, can be spread from by contaminated hands. By washing our hands
properly, we can help prevent the spread of the organisms that cause these
diseases.
Remember, in audiometry many of our clients are young children and
elderly people—and some forms of gastroenteritis can cause serious
complications.
Watch the video on correct hand washing procedures:
Window Media (10,772 kB)
MPEG movie (25,437 kB)
Remember:

Hands are to be washed after touching blood, body substances such
as cerumen and contaminated items such as speculums, impression
syringes, and ear moulds—even if you had been wearing gloves.

Wash hands immediately after gloves are removed and between
patient contacts to avoid transfer of micro-organisms to other
patients or environments. It may be necessary to wash hands
between tasks and procedures on the same patient to prevent crosscontamination between one ear and the other.

You may be saying to yourself: 'I know how to wash my hands and I
know how important it is'. However, sometimes it is easy to
overlook these important practices:

Use warm water and a liquid soap that is Chlorhexidine or Hibitanebased. These agents help to inhibit the growth of micro-organisms
Practise high standards of personal hygiene (Audiometry)
© NSW DET 2007
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on the skin and break down debris and oils in which microorganisms are harboured.

Wet your hands and then add the cleaning agent.

After washing, rinse hands thoroughly from fingertips to wrist.
Remember not to contaminate your clean hands when you are
turning off the tap.

Dry hands thoroughly with paper towelling.
Here are more important points:

The use of an oil-free moisturiser is important to replenish the skins'
moisture that is removed by regular hand washing.

All cuts, sores and abrasions must be covered with, preferably, a
waterproof dressing. The dressing will need to be changed frequently
each day.

Hands must be washed before putting on gloves and after removing
them. The wearing of gloves is ineffective without thorough
handwashing.
Now have a look at an example of how cross-infection can take place in a
hearing aid audiometry setting:

An ear impression is made on a client with an undiagnosed fungal
infection of the ear canal. The impression is taken to the reception
area.

The receptionist handles the ear impression while despatching it to
the earmould laboratory.

The receptionist answers the phone

Another staff member uses the same telephone

Another client brings her hearing aid to the counter and hands it to
the receptionist for checking before returning it to her ear

The client goes home and puts a new battery in her husband's
hearing aid.
The possibilities are endless. Reflect on how cross-contamination can occur
in your workplace.
From your notes you have gained an understanding of the significance of
handwashing. It is the single-most important procedure for preventing the
transmission of disease.
The correct technique was demonstrated to you on the video and we hope
you take the opportunity to practise this technique. Understanding the
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Practise high standards of personal hygiene (Audiometry)
© NSW DET 2007
importance of handwashing is probably one of the easiest concepts to grasp,
although sometimes we tend to underestimate its significance and that is
what makes it so important.
Activity 1
When should hands be washed in the workplace?
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Feedback is provided at the end of this topic.
Hand care
Looking after our hands means putting the following into practice:
Cover cuts and abrasions on exposed skin with a water-resistant occlusive
dressing.
Protect hands from chafing by regularly using non-oil based moisturising
creams or lotions. Compatibility between lotion and antiseptic products and
the integrity of gloves should be considered.
It is important to know that long finger nails and artificial nails increase the
risk of micro-organisms growing under nails or in cracked nail polish.
Therefore:

keep finger nails short and clean

do not wear nail polish, artificial nails, rings, watches and bracelets.
Staff immunisation
As health care workers, we do not want any risk of cross-infection to occur
(whether it is from patient-to-patient, or patient-to-staff).
Immunity is about a person’s ability to fight a particular disease or microorganism. When we say someone is immune to a certain disease – for
example measles – we essentially mean that the person cannot catch the
disease because they have a resistance to the organism through their body’s
ability to make antibodies to fight the disease-causing organisms.
Practise high standards of personal hygiene (Audiometry)
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Immunity is specific to each disease type, so while someone may be
immune to Hepatitis A, for example, they are not automatically immune to
Hepatitis B. Immunity can be achieved in one of two ways: inherent or
acquired.
Inherent immunity basically means that you have inherited antibodies from
your mother to help you fight particular diseases.
Acquired immunity means that at some stage in your life you have either
been exposed to the disease or have been immunised, and have subsequently
developed the antibodies to protect you against becoming infected.
As you are dealing with people in close proximity and with body fluids,
adequate vaccination is required against such diseases as tetanus, mumps,
measles and hepatitis B. It is highly advisable to be immunised against
influenza also. Other types of vaccinations may be considered if there is a
risk of potential exposure, such as tuberculosis.
Prior to vaccination it is highly advised to have a blood test to determine the
need for vaccination. After some vaccinations blood tests may be needed to
determine if the level of antibodies is sufficient.
Employers must offer Hepatitis B vaccine to all health care workers whose
work places them at a risk. This must be made available within 10 working
days of commencement of employment. Staff members should maintain a
record of their immune status (NSW Health Circular 96/40). This consists
of a series of three injections over six months. Immune status should be
checked to ensure that the immunization has been effective.
Employers in the Health Care Industry are obliged to provide the following
safety support services to their staff:
 Procedures to facilitate access to treatment as required
 Education on immediate care of injuries
 Contact person for advice on needle stick injuries
 Expert advice available to all health care workers 24 hours a day.
Australia’s immunisation policy has prevented many people from
contracting serious diseases, such as measles. Most people born in Australia
started their immunisation program when they were infants and ended
approximately at the end of primary school.
However, some vaccinations like tetanus or the flu vaccination are given
throughout our lives, as the need arises. Health care workers are at risk of
exposure to several diseases that are preventable by vaccines, just like those
mentioned. It is because of the availability of vaccines that there is strong
recommendation for health care personnel to be immunised. It is
appreciated that the freedom of choice is an important consideration when
choosing not to be immunised, however, it is an ethical responsibility to
maintain a current immunisation status and can prevent legal implications.
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Practise high standards of personal hygiene (Audiometry)
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Further information can be found NSW Health website:
www.health.nsw.gov.au/ohs_vaccination/
Is your immunisation status current?
Safely dispose of infectious and/or
hazardous waste material
What types of clinical waste do you need to deal with in your workplace?
Does your workplace have waste management policy and procedures?
Clinical waste
Clinical waste includes the following: visibly blood-stained body fluids and
visibly blood-stained disposal material and equipment.
Clinical waste should be segregated (that is, placed in appropriate leak-proof
bags or containers) and contained at the source of generation.
Report or initiate action within own area
of responsibility to redress any
potential workplace hazards
Here is a checklist for the beginning of each day for setting up your
workplace. As you work through the list, consider potential risks. Watch for
stray leads and other tripping hazards.

Turn on all switches which might include lights, audiometer and
other test equipment, air-conditioner, computer, and water boilers
(for that much-needed cup of tea!).
Practise high standards of personal hygiene (Audiometry)
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Turn off answering machines and take down all messages. Attend to
these messages as soon as possible. They could be urgent messages,
eg your first patient ringing to cancel their appointment!
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Check your cabinet drawers for stock control and replenish where
necessary.
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Check all your equipment. For example, is the audiometer ready for
use? Is the tympanometry equipment ready? Is the otoscope ready,
including a supply of batteries and clean speculums of various sizes?
If you have a battery-operated audiometer, check the batteries. If it is
mains powered, check that it is plugged to the wall socket! Wipe
over the equipment, using a damp disposable cloth to remove any
dust that may have collected on the equipment overnight. Make sure
speculums are clean.

Check and action emails.
When this is finished sit and look at the area, as this gives you a patient's
view. Is everything looking neat and clean? Has anything been missed?
Report any hazards that you cannot easily fix.
Summary
In this topic we looked at how we need to maintain hygiene with an
understanding of contamination and infection risks. We looked at safely
disposing of infectious and hazardous waste material and taking
responsibility for redressing potential workplace hazards.
We saw that something as simple as handwashing can prevent a number of
infectious diseases from spreading from one person to another. Remember
that drying your hands properly is as important as washing them.
Feedback to activity
Activity 1 feedback
When to wash your hands:
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
On entering the workplace.
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Before and after patient contact.

Before and after the use of gloves.
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After performing any cleaning duties.
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Before going on breaks or finishing work.
Practise high standards of personal hygiene (Audiometry)
© NSW DET 2007
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After coughing, sneezing or any other action that may cause heavy
contamination of the hands.
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After any contact with blood and body substances.
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Before and after any contact with clients hearing aids or earmoulds.
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Before and after handling earphones, speculums, earlights, syringes,
impedance probe tips, hearing aids, earmoulds or REM insert tubes
that have been used on clients.
Practise high standards of personal hygiene (Audiometry)
© NSW DET 2007
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