Hospital Safety, Body Mechanics & Patient Transportation RTEC 106/123 Ch 13 & 14. 1

Safety in the Imaging Department Occupational Safety and Health Administration –Federal agency governing safety in the workplace. OSHA – Provides guidelines to ensure a high level of safety for hospital workers. It is important for you to be familiar with safety procedures at your work setting. 2

Fire Be Prepared…. Hospitals have a clearly defined plan for staff action in the event of a fire. You must become familiar with your departments plan. 3

Mobile Equipment No parking in the red zone…. Imaging often use mobile stretchers, wheelchairs, carts and x-ray machines, care must be taken to avoid obstructing passage and doorways. All equipment must be parked on the same side of the hallway. Not lining both walls. 4

Equipment safety Make sure room is available to pass easily. “Would this piece of equipment be a problem in this location if quick evacuation is necessary ?” 5

In Case of Fire…… If you discover a fire, your primary responsibility is to evacuate everyone in the immediate area to a safe location. Beyond at least two fire doors. Second, report the fire and location using the prescribed code procedure. 6

Fire in another part of the hospital… Close all doors Shut off all electrical equipment Shut off main oxygen valves. O2 is very flammable. Prepare patients for further evacuation while awaiting instruction 7

Questions…… 8

Body Mechanics Low Back Pain - Can be reduced with proper techniques 9

Muscle strains are common among hospital workers. The most common injury reported by radiographers. 10

3 Major Concepts Base of support: The portion of the body in contact with the floor or other horizontal surface. A broad base of support provides stability for body position and movement. 11

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Center of gravity Center of body weight. The point around which body weight is balanced. Usually located in the midportion of the pelvis or lower abdomen, depending on body build. Any object your hold adds to the weight on the base of support… affecting the location of your center of gravity 13

Body is most stable when the center of gravity is nearest the center of the base of support 14

Center of gravity for most people is S 2 15

Line of gravity Imaginary vertical line passing thought the center of gravity. The body is most stable when the line of gravity bisects the base of support 16

Not so good Good 17

Rules of Body Mechanics Provide a broad base of support Work at a comfortable height When lifting, bend your knees and keep your back straight Keep your load well balanced and close to your body Roll or push a heavy object. Avoid pulling or lifting. 18

Patient Comfort and Safety Put bed to lowest position Lock breaks Put rails up Return TV, tray Call light, etc Within patient’s reach Technologists should be aware of orthostatic hypotension 19

Padding & Support Lordotic = (concave) Kyphotic = (convex) For lengthy exams can improve patient’s cooperation Lessen motion 20

Radiation Protection Considerations Good patient care…… Padding placed under body prominences, such as the sacrum, heels, or mid thoracic curvature. Immobilization to reduce motion 1.Patient are better able to maintain the position needed. - Decubitus ulcers 21

Rule of thumb.. If a patient will be in one position on the x-ray table for longer than 10 minutes a full-size radiolucent pad should be used. 22

Immobilization While the text recommends this – it is not usually available in the clinical setting as a means of support for upright chest 23

Patient Positions Semi-Flower’s 24

Trendelenburg Lithotomy 25

Patient Transportation 26

Preparing for Safe Patient Transfer Check with nursing service, and obtain chart Check patient identification Make a plan, prepare the room Get transport equipment, and make sure it works! 27

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Preparing for Safe Patient Transfer Enlist the patient’s help and cooperation. Tell the patient what you are doing as you proceed Obtain additional help when necessary. Check to make certain your assistants understand their role in the transfer 29

Wheelchair Transfer To get started lower the patients bed as far as it will go and raise the head. Support the patients head and knees. Lift and rotate the patient to a sitting position with their legs hanging over the edge of the bed. Help the patient with slippers and robe. 30

Wheelchair Transfer This will allow patient time to regain a sense of balance. –Orthorstatic hypotension At this point some patient will be able to stand and get to the wheelchair on their own. 31

Transfer from bed or chair 32

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Two person transfer 34

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Infection Control per JCAHO 38

Who wears the mask when transporting a TB patient? The Patient Both patient and transporter wear appropriate mask when traveling in an enclosed vehicle What kind? Surgical mask 39

Patient Treatment Equipment 40

Be Careful with…. 41

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Urinary bag… 45

Central Line 46

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Before you act, think safety…. 48

JCAHO Joint Committee on Accreditation of Healthcare Organizations 49

JCAHO’s Process/Tracer Methodology Trace a patient from admission to discharge Assess relationships between disciplines and coordination of care Evaluate performance of processes Visit each department that provides care for the patient Ask staff questions how they cared for the patient 50

Tips for Talking with Surveyors RELAX …….. Listen to the question Think about the answer 51

Mission, Vision & Values Different for every Hospital Become familiar with your permanent facilities. 52

Questions…… 53

Health Care Risk Management Risk management refers to strategies that reduce the possibility of a specific loss. Risk management programs consist of both proactive and reactive components. Diagnosis—Identification of risk or potential risk. Assessment—Calculation of the probability of adverse effect from the risk situation. Prognosis—Estimation of the impact of the adverse effect. Management—Control of the risk.

The overall goal in healthcare risk management in both situations is to minimize the risk of: harm to our patients. liability exposure of our health care providers. financial loss to the Agency.

First introduced decades ago by the U.S. Air Force, checklists have enabled pilots to fly aircraft of mind-boggling sophistication. Now innovative checklists are being adopted in hospitals around the world, helping doctors and nurses & others prevent mistakes Even in the immensely complex world of surgery, a simple ninety-second variant has cut the rate of fatalities by more than a third.

The author begins by making a distinction between errors of ignorance (mistakes we make because we don’t know enough), and errors of ineptitude (mistakes we made because we don’t make proper use of what we know). Failure in the modern world is really about the second of these errors, a series of examples from medicine showing how the routine tasks of surgeons have now become so incredibly complicated that mistakes of one kind or another are virtually inevitable: it’s just too easy for an otherwise competent doctor to miss a step, or forget to ask a key question or, in the stress and pressure of the moment, Experts need checklists–literally–written guides that walk them through the key steps in any complex procedure.

Gawande describes where an emergency checklist saved a drowning victim who had spent half an hour underwater A cleanliness checklist in intensive care units virtually eliminated a type of deadly hospital infection. He explains how checklists actually work to prompt striking and immediate improvements.

How can you use a check list in learning radiography and good patient care?