1. Copyright 2003 by Mosby, Inc. All rights reserved. CHAPTER 3 SAFETY PRACTICES

2. Copyright 2003 by Mosby, Inc. All rights reserved. Disease Transmission Microorganism- can not be seen with the human eye Pathogen is a microorganism that causes disease; bacteria, fungi, virus etc. *Infection requires three elements – Source of microorganisms that is a pathogen – A susceptible host – A means of transmission to the host *Nosocomial Infection-____________________ ____________________________________

3. Copyright 2003 by Mosby, Inc. All rights reserved. Methods of Transmission Contact –Direct or indirect through an inanimate object Droplet Airborne Common vehicle –Water, food, contaminated equipment Through vectors –Mosquitoes, flies, rats, and other such vermin **Equipment /work surfaces must be cleaned when they are visibly contaminated or at the end of the day

4. Copyright 2003 by Mosby, Inc. All rights reserved. Infection Symptomatic Asymptomatic- No symptoms Local infection is limited to a small area of the body Systemic infection is located throughout the body Signs and symptoms of a general infection include fever, chills, pain, an ache or tenderness, general feeling of tiredness, and night sweats Signs and symptoms of a local infection may include redness, heat, swelling, pain, or fluid

5. Copyright 2003 by Mosby, Inc. All rights reserved. Isolation Precautions 2 levels of precautions established by the Hospital Infection Control Standard Isolation Precautions (Universal Precautions) are applied to ALL patients; designed to reduce the transmission of microorganisms both diagnosed and undiagnosed Transmission-Based Precautions are applied to patients with known or suspected infections PERSONAL PROTECTIVE EQUIPMENT (PPE)- gloves, gowns, eyewear, footwear, masks, headwear -An mask and eye protection must be worn if fluids can splash or spray

6. Copyright 2003 by Mosby, Inc. All rights reserved. Table 3-1 Isolation Precautions

7. Copyright 2003 by Mosby, Inc. All rights reserved. Box 3-2 Requirements of Standard Precautions

8. Copyright 2003 by Mosby, Inc. All rights reserved. Box 3-3 Bioterrorism Agents Bacteria Classification: 1.Shape 2.Aerobic 3.Anaerobic *Staphylococci are round and cause impetigo and boils *Bacilli are rod-shaped *Diplococci- paired *Streptococci- chains

9. Copyright 2003 by Mosby, Inc. All rights reserved. Types of Microorganisms Bacteria Fungi Protozoa Rickettsiae (parasites) Viruses

10. Copyright 2003 by Mosby, Inc. All rights reserved. Handwashing Technique Hands are washed thoroughly at the beginning of the work period – Between each client contact – Before and after eating – Before and after using the restroom – Before leaving the work environment Gloves are worn when contact is made with body fluids, mucous membranes, or wet secretions

11. Copyright 2003 by Mosby, Inc. All rights reserved. Principles of Asepsis Medical asepsis can be evaluated on three levels – Antiseptics, which inhibit the growth of bacteria; they can be used on the skin – Disinfectants are agents that destroy most bacteria and viruses. They can be caustic or harmful to the skin. Disinfection can be accomplished by boiling as well as by using chemical agents. – Sterile, also referred to as surgical asepsis, is a state of sterility or the use of sterile technique -removes all microorganisms -use of an autoclave -isolation of a patient

12. Copyright 2003 by Mosby, Inc. All rights reserved. Ominbus Budget Reconciliation Act (OBRA) Regulations OBRA requires training for nursing assistants. This includes: – Completion of a written examination – Demonstration of ability to perform skills correctly – Continuing education – Periodic evaluation of performance – Retraining if the nursing assistant does not work in the field for 2 years or more at one time

13. Copyright 2003 by Mosby, Inc. All rights reserved. Occupational Safety and Health Administration (OSHA) Regulations Established in 1970 To establish standards of safety for the workplace and to enforce the standards To research and provide documentation to OSHA regarding the safe level of exposure to hazards in the workplace Employee exposure protocol= 2 hours to report Ex of OSHA for patients: requires all tattoo parlors to have a health dept permit; must have consent before performing a tattoo or piercing; tetanus is possible contamination with tattoos

14. Copyright 2003 by Mosby, Inc. All rights reserved. Box 3-4 Material Safety Data Sheet OSHA- “Right to Know” for employees

15. Copyright 2003 by Mosby, Inc. All rights reserved. Safe Movement Body mechanics – Refers to the way the body is moved to prevent injury to oneself and to others – Accomplished by using knowledge of proper body alignment, balance, and movement – Posture is the position of body parts in relation to each other – Balance is the ability to maintain a steady position that does not tip

16. Copyright 2003 by Mosby, Inc. All rights reserved. Symbols of Access Wheelchair ramps Doors are wide enough to accommodate a wheelchair Elevators have Braille indicators Telephones and drinking fountains are placed at a lower height

17. Copyright 2003 by Mosby, Inc. All rights reserved. Identifying and Reporting Hazards A fire may be controlled or extinguished Oxygen and electrical equipment may be turned off Four classes of chemical fire extinguishers –Class A: for use on paper, wood, trash, cloth, upholstery, rubber, and similar materials –Class B: for use on fuel oil, gas, paint, solvents, and other flammable liquids –Class C: for use on electrical equipment, fuse boxes, wiring and appliances –Class D: for use on metals

18. Copyright 2003 by Mosby, Inc. All rights reserved. Hazardous Waste Waste is divided into two categories – Biomedical Hazardous and infectious waste is placed in sealed bags before removing it from the area of use; the bag is labeled and sealed to alert workers; sharps containers are used for needles, razors and glass – General

19. Copyright 2003 by Mosby, Inc. All rights reserved. Emergency Disaster Procedures Caused by nature or man – Tornados – Explosions – Plane crashes – Earthquakes