1. E NVIRONMENTAL AND PATIENT / THERAPIST SAFETY

2. Preparation for Patient Care Preparing clear patient care environment/ room Preparation of the treatment area for the next patient at the end of each patient treatment Risk Management Maintenance of the treatment area Prior to patient treatment

3. Aseptic Techniques CDC guidelines (Center for Disease Control and Prevention) Microorganism transmission barriers/isolation Transmission-based precautions Modes of transmission Contact transmission Droplet transmission Airborne transmission Common vehicle transmission Vectorborne transmission.

4. Precautions Isolation precaution administrative controls Education Adherence to precautions Standard Precautions (prevents clinician to become a vectorborne) Universal precaution + body substance isolation + all body fluids may contain transmissible infectious agents. Includes: hand hygiene, gloves, gown, mask, eye protection/face shield and safe injection practices.

5. New elements of standard precautions Respiratory hygiene/cough etiquette Cover mouth and nose with tissue when sneezing/coughing Safe injection practices Proper disposal of needles in the sharp containers and disinfected needle sites Use of masks for insertion of catheters or injection of material into spinal or epidural spaces via lumbar puncture procedures

6. Standard Precautions Hand Hygiene Hand wash rubbed vigorously during 20 seconds with special attention paid to the backs of the hands, wrists, between the fingers, and under fingernails. Rinse the hands well while leaving the water running as well as drying with a single-use towel Turn off the water with a paper towel and prevent re-contamination

7. Personal Protective equipment (PPE) Where to wear and where to discard it Gloves sterile techniques nonsterile techniques Gowns (prevent splash and soil clothing) When in direct contact with patients Mask/goggles/face shields

8. Personal Protective equipment (PPE) – cont. Patient-care equipment and instruments/devices Handling and transporting to follow the facilities’ P&P. Wear PPE to clean an used or contaminated equipment. Care of the environment To follow facilities’ P&P Clean and disinfect surfaces that are likely to be contaminated. In case of doubt, consider it contaminated. Textiles and laundry Avoid agitation to prevent airborne contamination

9. Precautions Protocols For safety, we consider all patients are contaminated until proof the opposite. Therefore use standard precautions Contact – gowns and gloves done prior to enter the patient’s room and doff before exiting patient’s room. Patient transport – acute hospitals, LTAC, ECF Sterile Techniques.

10. Draping Covering a patient appropriately Edge of sheets and towels must be secured Hospital gowns, towels and bed sheets or appropriate attire Safety measures Follow the specific policies of each facility Transportation equipment

11. Case study 2 This is Tom who was diagnosed with lymphedema to his LLE. Take his Vital Sign Setup his intermittent compression pump

12. Preparation for Patient CarePreparation for Patient Care 1 Positioning/DrapingPositioning/Draping 2 Today’s Overview

13. Summary Take full advantage of your open labs and your instructor’s time Set realistic expectation All competency exams are timed and cues will be given for those who ask. Practice, Practice, Practice

14. Q UESTIONS ?