Personal Characteristics



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Standard Precaution Scenarios




What should be used to protect health care workers? You should act the following scenarios in small groups.

1. Michael is attending phlebotomy school at night. He has been informed that gloves are a must when performing venipuncture.
Michael is mentoring with Mrs. Hill, a MLT for 24 years. Upon entering the room of a gravely ill patient with a very productive cough, Mrs. Hill gets out a syringe, blood tubes, tourniquet, alcohol swabs, gauze and a Bandaid. As Mrs. Hill applies the tourniquet, Michael asks “What about your gloves?” Mrs. Hill states, “I’ve been doing it like this for 24 years without any problems, and I can feel the vein better this way.”

2. Louisa is cleaning the room of a recently examined tuberculosis patient. As she cleans the counter, she notices soiled wet tissues in the drawer, dried blood on the tray, and a suction liner still in the canister on the wall. When she moves the trashcan, she also finds a syringe with a needle intact lying on the floor.

3. Larry has decided to register for MSII next year. Before he begins his mentorship, several requirements must be met. He is not very happy because it means getting “shots,” and Larry has always been terrified of needles.

4. Stan needs to collect a sputum specimen from the patient who is HIV positive. After collecting the specimen, he takes the cup and places it on the counter by the phone to complete the lab slip before taking the specimen to the lab.

5. Samantha and Carlita are Medical Science II students. They are helping a patient onto the exam table. The patient is recovering from a mild left-sided CVA. The patient states “I feel like I’m going to pass out,” suddenly stops breathing, and falls to the floor. Samantha starts CPR, while Carlita screams for help.

Disinfection


  • Chemicals frequently used for aseptic control

  • They do not kill spores & viruses so it’s not sterilization

  • Used to disinfect instruments that don’t penetrate body tissue:

      • dental instruments

      • percussion hammers

      • thermometers

        • Examples:

  • 90% isopropyl alcohol

  • formaldehyde-alcohol

  • 10% bleach solution

  • Lysol

  • Zephiran

  • Boiling water disinfects but does not sterilize

  • Usually 15-30 minutes

  • Ultrasonic unit – used in dental & medical offices to disinfect

  • Uses sound waves to produce millions of microscopic bubbles

  • Cavitation – bubbles hit instrument and explode, driving cleaning solution into article


Sterilizing with an Autoclave


  • Uses steam under pressure or gas

  • Destroys ALL microbes, pathogenic and nonpathogenic – including spores & viruses

  • Before wrapping, instruments must be clean

  • Wraps must allow for penetration of steam

  • Muslin

  • Autoclave paper

  • Special plastic or paper bags

  • Autoclave containers

  • Indicators are used to ensure articles have been sterilized

  • Autoclave must be loaded correctly

  • Amount of time depends on the article to be sterilized – usually 15–30 minutes

  • If wrap becomes torn or wet, it is contaminated

  • Expires in 30 days


Sterile Technique - Principles


  • Surgical Asepsis – procedures that keep an object or area free from living organisms

  • Sterile – free from all organisms, including spores and viruses

  • Contaminated – organisms/pathogens are present

  • A clean, uncluttered work area necessary when working with sterile supplies

  • Sterile field – sterile area – never reach across a sterile field – reach in from the side

  • Never turn your back on a sterile field

  • 2-inch border of sterile field is considered contaminated

  • Common techniques:

  • Drop technique

  • Mitten technique

  • Transfer forceps

  • Keep sterile field dry (pathogens travel through wet) and be careful when pouring fluids

  • Be sure sterile field is open and ready before putting on sterile gloves

  • Sterile gloves are contaminated on the inside – once on, keep hands away from body and above waist

  • When in doubt, consider it contaminated



Opening Sterile Packages


  • Check to be sure the sterile package has not expired




  • Open the distal end and pull it away from you, reaching around the package, not across







  • Pull the bottom down toward you

  • Drop technique

  • Mitten technique

  • Transfer forceps


Isolation: Fact or Fiction?
Fill in the blank with "Fact" if the statement is true about isolation practices, or "Fiction" if the statement is NOT true and why.
1.Isolation precautions always require the use of a gown, gloves, and a mask.

2. Isolation techniques are used for all hospitalized patients.

3. Before gloving, remove rings and put them in your pocket or pin them to your uniform.

4. Two people are required to take equipment out of an isolation unit.

5. Many agencies use special isolation linen bags that dissolve in the washing machine.

6. Protective isolation is the same thing as reverse isolation.

7. A special two-room unit is necessary for isolation.

8. Isolation is a method of caring for patients with a communicable disease.

9. A patient with tuberculosis would be placed on Contact Precautions.

10. Gloves should be removed after leaving an isolation room.

11. A severely burned patient would be placed on Contact Precautions.

12. It is best to leave patient care equipment (stethoscope, sphygmomanometer, etc.) in the room of an isolation patient.

13. If you are wearing a mask in an isolation room and you sneeze, the first thing you should do is wash your hands.

14. Gloves should be tucked under the sleeve of the isolation gown.

15. The inside of a contaminated gown is considered clean.

16. Metal utensils used for meals should be washed and remain in the isolation room for the next meal.

17. After you've been in an isolation unit, the neck and waist ties of the gown are considered contaminated.

18. Special filters are used in all isolation rooms to filter the air.

19. A young, female health care worker who is susceptible to measles should NOT enter the isolation room of a patient with measles.

20. A patient with severe viral influenza would not be placed on isolation.

Using Body Mechanics



Why use body mechanics?
Body Mechanics The way in which the body moves and maintains balance while making the most efficient use of all its parts
Four main reasons for using proper body mechanics:


Muscles work best when used correctly.

Correct use makes lifting, pulling and pushing easier.


Correct use prevents unnecessary fatigue and strain, and saves energy.

Correct body mechanics prevent injury to self.



Good Body Mechanics Rules
1. Use a broad base of support.
2. Don’t twist and lift.
3. Don’t bend for long periods of time.
4. Get help if the load is too heavy.
5. Bend from the hips and knees, not the waist.
6. Use the strongest muscles to do the job.
7. Push or pull using the weight of your body.
8. Carry objects close to the body.

Good or bad?

Preventing Accidents and Injuries

Whose responsibility is it to assure that safety standards are followed in a health care facility?



For each safety rule, provide a brief explanation of WHY you think the rule is important.



Rule

Why?




  • Do not operate or use any equipment until you have been instructed on how to use it.










  • Read and following operating instructions. If you don’t understand, ask for help.










  • Do NOT operate equipment if your instructor is not in the room.










  • Report any damaged or malfunctioning equipment immediately. Do not use it.










  • Do not use frayed or damaged electrical cords. Do not use a plug if the third (grounding) prong is broken off.










  • Observe all safety precautions when handling equipment.










  • Never use solutions from bottles that are not labeled.










  • Read labels of solution bottles three times.










  • Do NOT mix solutions unless instructed to do so.







Preventing Accidents and Injuries Page 2


Rule

Why?




  • Avoid contact of solutions with your eyes and skin.










  • If you break equipment or spill solutions, immediately report the incident to your instructor/immediate supervisor.










  • Do NOT perform any procedures on patients unless you have been instructed to do so. When you perform procedures, do so responsibly.










  • Provide privacy for all patients. Knock on the door before entering a room. Speak before going behind privacy curtain.










  • Always identify your patient. Be absolutely positive you have the right patient.










  • Always explain the procedure so the patient knows what you are going to do. Never perform a procedure if a patient refuses to allow you to do it.










  • Observe the patient closely during any procedure. Report any change immediately.










  • Frequently check the patient area for safety hazards. Report unsafe situations immediately.










  • Before leaving a patient area, observe all safety checkpoints.










  • Use correct body mechanics.










  • Wear the required uniform.






Preventing Accidents and Injuries Page 3




Rule

Why?




  • Walk – do NOT run – in the lab, clinical area, hallways, and on stairs. Walk to the right. Use handrails.










  • Report any injury or accident to your instructor.










  • If you see any unsafe situation, report it to your instructor immediately.










  • Keep all work areas clean and neat.










  • Wash your hands frequently.










  • Dry your hands before handling electrical equipment.










  • Wear safety glasses when instructed to do so.










  • When working with a partner, observe all safety precautions, and avoid horseplay and practical jokes.










  • If a solution comes in contact with your eyes, flush the area with water. Inform your instructor.










  • If a particle gets in your eye, inform your instructor. Do NOT try to rub your eye or remove the particle.








Observing Fire Safety

Oxygen

Fuel Heat

THREE THINGS

NEEDED TO START

A FIRE

MAJOR CAUSES OF FIRES




  • Carelessness with smoking and matches

  • Misuse of electricity

  • Defects in heating systems

  • Spontaneous ignition

  • Improper rubbish disposal

  • Arson


Fire Extinguishers

1. Class A- (pressurized water)

Use on combustibles

For ordinary materials such as paper, cloth, wood, and cardboard


2. Class B- (carbon dioxide CO2 )

Use flammable or combustible liquids

For gasoline, oil, paint, liquid, cooking fats, etc.


    • Leaves a powdery, snow-like residue that irritates the skin and eyes

    • If water is used on these types of fires, it will spread

3. Class C- (dry chemical-contains potassium bicarbonate or potassium chloride)

Use on electrical fires

For energized electrical equipment such as power tools, appliances, and switches



    • Water is particularly dangerous because of the risk of electrical shock.

4. Class ABC– (graphite-type chemical)



Use on all fires Multipurpose extinguisher

In case of fire:
Remain calm

If your safety is in danger, evacuate the area and sound the alarm.




If the fire is small (and you are not in danger) determine what type of fire it is and use the proper extinguisher.

Know your health facility’s fire safety plan


  • Remove patients from harm

  • Sound the alarm

  • Close all doors and windows

  • Shut off electrical equipment and oxygen

  • Do NOT use the elevators

Rules for Preventing Fires



    • Obey NO SMOKING signs

    • Extinguish matches, cigarettes, and other flammable items completely

    • Dispose of all waste materials in proper containers

    • Before using electrical equipment, check for damaged cords or improper grounding

    • Avoid overloading electrical outlets

    • Store flammable materials in proper containers and in safe areas. If you spill a flammable liquid, wipe it up immediately.

    • Do not allow clutter to accumulate in rooms, closets, doorways or traffic areas Make sure nothing is blocking fire exits

    • When oxygen is in use, post a No-Smoking – Oxygen in Use sign. Remove all smoking materials from the room.



RACE/ PASS WORK SHEET


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