1. A SMILE Program Presentation
Laboratory Safety
A SMILE Program Presentation
Patient Safety Monitoring in International Laboratories (SMILE) Program

2. Responsibility
Who is responsible for safety in laboratories clinics and hospitals participating in clinical trials
Patient Safety Monitoring in International Laboratories (SMILE) Program

3. Responsibility Employer Establishes necessary policies
Standard Operating procedures and Safety Plan
Engineering and work practice controls
Personal protective equipment (PPE)
Safety equipment such as fire extinguishers and eye wash stations
Training
Patient Safety Monitoring in International Laboratories (SMILE) Program

4. Responsibility Employee
Knows and understands safety policies and procedures
Follows safety policies and procedures
Reports unsafe conditions to the Safety Officer or Laboratory Director
Patient Safety Monitoring in International Laboratories (SMILE) Program

5. Safety is Everyone’s Responsibility!
Patient Safety Monitoring in International Laboratories (SMILE) Program

6. Components of a Safety Program
Fire safety
Chemical Safety
Bloodborne Pathogens
Patient Safety Monitoring in International Laboratories (SMILE) Program

7. Fire Safety
Patient Safety Monitoring in International Laboratories (SMILE) Program

8. Fire Safety The Fire Triangle Reaction Heat Oxygen Fuel Chemical
Patient Safety Monitoring in International Laboratories (SMILE) Program

9. What should you do in case of a fire ?
Fire Safety
What should you do in case of a fire ?
Remember the acronym – RACE
Rescue – any people in danger
Alarm – activate the fire alarm
Contain – the fire by closing doors and windows
Extinguish – the fire if it is small enough
Patient Safety Monitoring in International Laboratories (SMILE) Program

10. Fire Safety Types of Fire Extinguishers
A – Combustibles (paper, trash, cloth)
B – Flammable liquids
C – Electrical Equipment
D – Combustible metals
(not Common)
Patient Safety Monitoring in International Laboratories (SMILE) Program

11. How do you operate a fire extinguisher?
Fire Safety
How do you operate a fire extinguisher?
Remember PASS
Pull the pin
Aim – at the base of the Fire
Squeeze - the handle
Sweep to cover the fire
Patient Safety Monitoring in International Laboratories (SMILE) Program

12. Maintenance of Fire Extinguishers
Fire Safety
Maintenance of Fire Extinguishers
Fire extinguishers should be visually inspected on a monthly basis. The inspection should assure that Fire extinguishers are:
In their assigned place
Not blocked or hidden
Pressure gauges show adequate pressure
Pins and seals are in place
No signs of damage
The nozzles are free of blockages
Patient Safety Monitoring in International Laboratories (SMILE) Program

13. Chemical Safety
Patient Safety Monitoring in International Laboratories (SMILE) Program

14. How Do Chemicals enter the body?
Chemical Safety
How Do Chemicals enter the body?
Inhalation – breathing in (e.g. powders, fumes)
Absorption – on skin or mucus membranes
Ingestion – entry through the mouth
Injection - through skin by foreign body
Patient Safety Monitoring in International Laboratories (SMILE) Program

15. Examples of Chemical Hazards
Chemical Safety
Examples of Chemical Hazards
Carcinogens – cancer
Corrosives –burns
Hepatotoxins –liver damage
Mutagens-damage genetic materials in cells
Nephrotoxins – Kidney damage
Neurotoxins – damage to the nervous system
Tertatogens – birth defects
Patient Safety Monitoring in International Laboratories (SMILE) Program

16. How can you obtain information about the Chemicals you use?
Chemical Safety
How can you obtain information about the Chemicals you use?
Patient Safety Monitoring in International Laboratories (SMILE) Program

17. Chemical Safety Material Safety Data Sheet (MSDS) Name of Chemical
The following Data Can be found on MSDS sheets……….
Name of Chemical
Physical Characteristics and hazards
Health information
First Aid required if there is a spill or exposure
Date of most recent update
Patient Safety Monitoring in International Laboratories (SMILE) Program

18. Chemical Safety Need to check for updates annually
MSDS Sheets Continued……….
Need to check for updates annually
Highlight the name of the chemical and the first aid section for easy access in an emergency
Organize in alphabetical order
Must be available to everyone all of the time
The internet is also a good way to access MSDS sheets
Instrument manufacturers usually have MSDS sheets available on their websites.
Patient Safety Monitoring in International Laboratories (SMILE) Program

19. Chemical Safety What should you do if there is a chemical spill? RAFT
Rescue
Avoid the Chemical
Find the MSDS
Telephone
Patient Safety Monitoring in International Laboratories (SMILE) Program

20. Chemical Safety Chemical Exposures First AID
Flush with plenty of water
For at least 15 minutes
Remove contaminated clothing
Seek medical Attention
Document incident
Patient Safety Monitoring in International Laboratories (SMILE) Program

21. Characteristics of Liquid Nitrogen
Chemical Safety
Liquid Nitrogen
Characteristics of Liquid Nitrogen
78% of atmosphere
Colorless, Odorless, Tasteless, Nontoxic
Boils at -196 Degrees C
Non Flammable
Patient Safety Monitoring in International Laboratories (SMILE) Program

22. When returning to the gaseous state:
Chemical Safety
Liquid Nitrogen
When returning to the gaseous state:
Can displace oxygen from the air
Can lead to asphyxiation
Will not support Life
Patient Safety Monitoring in International Laboratories (SMILE) Program

23. Liquid Nitrogen – Precautions
Chemical Safety
Liquid Nitrogen – Precautions
Always wear safety equipment
Avoid use in a small enclosed area
Avoid prolonged breathing of vapors
Avoid rough handling of containers
Install O2 Monitors in LN work areas
Patient Safety Monitoring in International Laboratories (SMILE) Program

24. Chemical Safety Liquid Nitrogen PPE
Full face shield with safety glasses
Cryogenic gloves
Arm protection
Lab coat
Cuff-less pants
Close toed shoes
Patient Safety Monitoring in International Laboratories (SMILE) Program

25. Liquid Nitrogen Emergencies
Chemical Safety
Liquid Nitrogen Emergencies
Inhalation – Move person into the fresh air
Eyes – Flush with water for 15 minutes
Skin - soak affected area in tepid water
Seek medical attention
Document incident
Patient Safety Monitoring in International Laboratories (SMILE) Program

26. What’s Wrong with this picture?
Chemical Safety
What’s Wrong with this picture?
Answer to the Question on slide 33
Patient Safety Monitoring in International Laboratories (SMILE) Program

27. Carbon Dioxide – Dry Ice
Chemical Safety
Carbon Dioxide – Dry Ice
Characteristics of Carbon Dioxide
Colorless, odorless, tasteless nontoxic
Non flammable
Can only be solid when the temperature is < -78oC
Patient Safety Monitoring in International Laboratories (SMILE) Program

28. Chemical Safety Solid Carbon Dioxide Can displace oxygen from air
Can lead to asphyxiation
Will not support life
High concentrations cause rapid circulatory insufficiency
Nausea
Headache
Vomiting
Unconsciousness
Patient Safety Monitoring in International Laboratories (SMILE) Program

29. Solid Carbon Dioxide – Dry Ice
Chemical Safety
Solid Carbon Dioxide – Dry Ice
Always wear safety equipment
Avoid use in a small enclosed area
Avoid prolonged breathing of vapors
Vent Closed CO2 containers away from you when opening
Patient Safety Monitoring in International Laboratories (SMILE) Program

30. Solid Carbon Dioxide – PPE
Chemical Safety
Solid Carbon Dioxide – PPE
Full face shield with safety glasses
Cryogenic gloves
Lab coat
Close toed shoes
Patient Safety Monitoring in International Laboratories (SMILE) Program

31. Solid Carbon Dioxide – Emergencies
Chemical Safety
Solid Carbon Dioxide – Emergencies
Inhalation – Move person into the fresh air
Eyes – Flush with water for 15 minutes
Skin - soak affected area in tepid water
Seek medical attention
Document incident
Patient Safety Monitoring in International Laboratories (SMILE) Program

32. Managing Chemicals in the Laboratory
Chemical Safety
Managing Chemicals in the Laboratory
Storage
Hazard Communication
MSDS Updates
Acids and Bases in separate approved cabinets
Spill kits available
Patient Safety Monitoring in International Laboratories (SMILE) Program

33. What’s Wrong with this picture?
Chemical Safety
What’s Wrong with this picture?
Glass chemical bottles stored on the floor even more hazardous if the bottles are full.
Patient Safety Monitoring in International Laboratories (SMILE) Program

34. SAFETY – Waste Disposal
Tips for safe disposal of laboratory waste:
Place all sharps in approved sharps containers
Use goggles or full face shields to protect mucus membranes from splashes when disposing of liquid waste or specimen tubes.
Refer to MSDS sheets for information on the safe disposal of chemicals
Patient Safety Monitoring in International Laboratories (SMILE) Program

35. Bloodborne Pathogens Bloodborne Pathogens
Patient Safety Monitoring in International Laboratories (SMILE) Program

36. What are bloodborne pathogens?
Viruses, bacteria or other micro-organisms that are carried in the bloodstream and are capable of causing disease.
Other body fluids that can spread bloodborne pathogens include:
Blood products (plasma, platelets)
Abdominal fluids
Amniotic fluids
Cerebrospinal fluids
Vaginal secretions
Semen
Patient Safety Monitoring in International Laboratories (SMILE) Program

37. Most Common Bloodborne Pathogens
Hepatitis B
Hepatitis C
HIV
Discussion Suggestions - which of these three organisms is most infectious? What are the chances of healthcare workers being infected in the event of a needle stick from an infected person?
Patient Safety Monitoring in International Laboratories (SMILE) Program

38. Standard Precautions Bloodborne Pathogens
Standard Precautions replaces Universal Precautions – using Standard Precautions all blood and body fluids are treated as infectious all of the time.
Patient Safety Monitoring in International Laboratories (SMILE) Program

39. Bloodborne Pathogens Personal Protective Equipment (PPE) Gloves
Safety glasses/Goggles
Lab coats (should be fluid resistant)
Face shields
Notes – Fluid resistant lab coats are recommended. They are available in materials that allow for adequate ventilation in hot climates. See the website for details.
Patient Safety Monitoring in International Laboratories (SMILE) Program

40. Bloodborne Pathogens PPE Continued……. How much PPE should you use?
Wear as much or as little as you anticipate you will need to prevent blood and other infectious materials from contact with your skin, mucus membranes and clothing.
Patient Safety Monitoring in International Laboratories (SMILE) Program

41. Blood borne Pathogens General Safety Rules Handle sharps with care:
Do not recap needles or other sharps
Do not bend or break off needles
Dispose of sharps in puncture resistant containers
DO Not:
Eat, drink, smoke, apply cosmetics, take medication in areas where you are working with blood and other body fluids
Patient Safety Monitoring in International Laboratories (SMILE) Program

42. What should you do if there is a blood or body fluid exposure ?
Bloodborne Pathogens
What should you do if there is a blood or body fluid exposure ?
Follow the post exposure prophylaxis (PEP) plan
Wash puncture wounds with soap and water
Flush affected mucus membranes with water
Inform Safety Officer or administrative staff member
Seek medical attention
Complete an incident report form
At this point it would be a good idea to review the specific instructions for your institution. Make sure that employees know where to find the procedure for PEP – it is a good idea to have it posted.
Patient Safety Monitoring in International Laboratories (SMILE) Program

43. A basic but very important method of reducing your risk of infection.
Bloodborne Pathogens
Hand Washing
A basic but very important method of reducing your risk of infection.
Patient Safety Monitoring in International Laboratories (SMILE) Program

44. Hand Washing Bloodborne Pathogens
What song should you sing while you are washing your hands so that you know that you have washed for enough time?
Answer on the notes section of the next page.
Patient Safety Monitoring in International Laboratories (SMILE) Program

45. Questions and Comments
Laboratory Safety
Questions and Comments
Answer to the Question on slide 43 is - Happy Birthday. It takes about 15 seconds to sing happy birthday which is the minimum length of time that is recommended for Hand Washing
Patient Safety Monitoring in International Laboratories (SMILE) Program

46. Laboratory Safety References:
1.PPD (May, 2005) – PowerPoint Presentation, Presented at the Washington DC GCLP Meeting. 2.
Patient Safety Monitoring in International Laboratories (SMILE) Program