1 Medical Assisting Chapter 22 PowerPoint ® to accompany Second Edition Ramutkowski  Booth  Pugh  Thompson  Whicker Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

2 Preparing the Examination and Treatment Area Objectives 22-1 Explain the medical assistant’s role in preparing the examination room Describe the layout and features of a typical examination room Describe steps to prevent the spread of infection in the examination room Explain how and when to disinfect examination room surfaces.

3 Objectives (cont.) 22-5 Describe the importance of such factors as temperature, lighting, and ventilation in the examination room Identify instruments and supplies used in a general physical examination, and tell how to arrange and prepare them Explain how to eliminate hazards to physical safety in the examination room. Preparing the Examination and Treatment Area

4 The Medical Assistant’s Role in Preparing the Examination Room  Maintain neatness and cleanliness of the room.  Ensure that all supplies and equipment needed are present for the physician’s use.  Make certain that potential safety hazards are eliminated.

5 The Examination Room The area where the physician: Observes the patient Listens to patient symptoms Performs a general physical examination Number and Size of Rooms Depends on the number of physicians in the medical practice Average size room is 8 X 12 ft. Rooms should be large enough for patient, physician and medical assistant yet small enough to have supplies within reach. The Medical Assistant’s Role in Preparing the Examination Room (cont.)

6 Furnishings  Should be arranged for: Efficiency Patient Comfort Physician Convenience Common Items Found In Examination Rooms One or more chairs A rolling stool Weight scale Biohazard container Puncture proof containers Wall brackets High intensity lamp

7 Special Features  The 1990 Americans with Disabilities Act (ADA) requires that ‘reasonable accommodations” be made for the disabled. Doorway must be at least 36 inches wide. Space in rooms and hallways must be at least 60 inches wide. Slip-resistant floor. Must have door opening hardware that can be grasped. Door closers adjusted to allow entry and exit time. Grab bars must be present in lavatories. ADA Accessibility Guidelines

8 Cleanliness in the Examination Room Infection Control Remember to: Keep examining table clean Make hand washing a priority Disinfect all work surfaces Wash Hands: At the beginning of the day Before and after contact each patient Before and after using gloves Before and after eating After coughing or blowing your nose Before handling clean or sterile equipment Before leaving for the day

9  Examining Table Always change the disposable paper that covers the examination table after each use. Dispose of paper coverings soiled by body fluids in a biohazardous waste container. Also place soiled linens and pillowcases in biohazard-labeled bags. Cleanliness in the Examination Room (cont.)

10  Surfaces Disinfect work surfaces such as the:  Sink & Countertops  Wastebaskets  Examination Table  Toilets  Storage Store biohazardous specimens properly. Store “testing kits” according to protocol. Many test kits require refrigeration. Cleanliness in the Examination Room (cont.)

11  Putting the Room in Order A neatly arranged room boosts patient confidence of medical personnel efficiency and abilities.  Housekeeping Many medical facilities usually contract with janitorial services for after-hours cleaning. The medical assistant may perform chores such as dusting surfaces since dust harbors bacteria and allergens. Cleanliness in the Examination Room (cont.)

12 A medical assistant at a busy Pediatrician Office notices a foul odor in two of the patient examination rooms. After careful inspection, the medical assistant finds soiled diapers in the biohazardous containers of both rooms. How would you handle this situation? Apply Your Knowledge

13 A medical assistant at a busy pediatrician office notices a foul odor in two of the patient examination rooms. After careful inspection, the medical assistant finds soiled diapers in the biohazardous containers of both rooms. How would you handle this situation? The first priority is to remove the source of odor, then to decontaminate the area. It may also help to designate a separate location in the office for soiled diapers so that parents will know how to dispose of them. Many pediatrician offices have a system in place to prevent such odors in treatment room areas. Answer Apply Your Knowledge - Answer

14 Room Temperature, Lighting, and Ventilation Be sure the examination room is warm enough (72°F). Lighting is needed to prevent accidents and to make accurate diagnoses. Ensure that the room smells clean and fresh.

15 Medical Instruments and Supplies  To maintain instruments and supplies the medical assistant must: Order and stock all needed supplies. Sanitize, disinfect, and/or sterilize instruments as needed. See that all instruments and supplies are placed within easy reach for the physician.

16 InstrumentPurpose Anoscope Used to open the anus for examination Examination Light Provides additional lighting Laryngeal Mirror Reflects inside of mouth and throat Nasal Speculum Used to enlarge the opening of the nose Ophthalmoscope Used to examine the inner eye surfaces Medical Instruments and Supplies (cont.)

17 InstrumentPurpose Otoscope Used to examine the inner ear Penlight Small flashlight used to view a small area Reflex Hammer Used to check patient’s reflexes Sphygmomanometer Used to measure blood pressure Stethoscope Used to listen to body sounds Medical Instruments and Supplies (cont.)

18 InstrumentPurpose Tape Measure Used to measure size or development of an area Thermometer Used to measure body temperature Tuning Fork Tests patients’ hearing Vaginal Speculum Used to enlarge the vagina for specimens from cervix and vagina Medical Instruments and Supplies (cont.)

19  Inspecting and Maintaining Instruments Be sure instruments are in good working order  Arranging Instruments Keep instruments in same location, either:  Mounted on wall  Out on countertop  Set on a clean towel or tray  Preparing Instruments Some instruments require warming  Cleaning Instruments Place used instruments in a container and always handle carefully Medical Instruments and Supplies (cont.)

20 Cervical ScraperCotton balls Cotton-tipped applicators Curettes Disposable NeedlesDisposable syringes Gauze, dressings, and bandages Glass slides Sterile and clean glovesPaper tissues Occult blood test slides Specimen containers Tongue depressors Medical Instruments and Supplies (cont.)

21 Consumable Supplies Supplies that can be used up Storing Supplies Be sure to keep needles, medications, and prescription pads locked up and out of patient reach A good rule is to reorder when the first half of a box, tube, or bottle has been used. Restocking Supplies Medical Instruments and Supplies (cont.)

22 A medical assistant is preparing the treatment room for a local ENT Specialist. Which of the following instruments might be used in this office to assess patient ear, nose, and throat functioning? Apply Your Knowledge stethoscope nasal speculum reflex hammer otoscope penlight laryngeal mirror ophthalmoscope tape measure sphygmomanometer tuning fork anoscope

23 stethoscope nasal speculum reflex hammer otoscope penlight laryngeal mirror ophthalmoscope tape measure sphygmomanometer tuning fork anoscope Answer Apply Your Knowledge - Answer A medical assistant is preparing the treatment room for a local ENT Specialist. Which of the following instruments might be used in this office to assess patient ear, nose, and throat functioning? *nasal speculum *otoscope *penlight *laryngeal mirror *ophthalmoscope *tuning fork

24 Physical Safety in the Examination Room  Keeping the examination room free of hazards is a vital part of a risk management plan. Keep the following areas of the examination room free from potential hazards:  Floor  Cabinets and Drawers  Furniture  Cords and Cables

25 Special Safety Precautions Children Patients with Physical Disabilities Keep medication and dangerous items out of reach Toys should be washable and safe Be sure toys do not have any sharp surfaces Safe flooring and handrails help prevent falls in the reception area, bathroom, hallways, and the examination room.

26 Fire Safety Have a safe evacuation route. Locate area fire extinguishers Be sure to store and dispose hazardous substances. Post “No Smoking” signs in office areas. Fire Prevention In Case of Fire

27 The medical assistant has received the recently ordered office cleaning supplies. When unpacking the cleaning solutions for storage, it is apparent that two new disinfectant solutions are present that the medical assistant is unfamiliar with. How should the medical assistant handle this? A.Store the solutions with the other cleaning solutions in usual cabinet. B.Lock the new solution up in a separate cabinet. C.Read the label carefully, and check the MSDS information before storing the liquids. Apply Your Knowledge

28 A.Store the solutions with the other cleaning solutions in usual cabinet. B.Lock the new solution up in a separate cabinet. C.Read the label carefully, and check the MSDS information before storing the liquids. The medical assistant has received the recently ordered office cleaning supplies. When unpacking the cleaning solutions for storage, it is apparent that two new disinfectant solutions are present that the medical assistant is unfamiliar with. How should the medical assistant handle this? Answer Apply Your Knowledge - Answer

29 End of Chapter