Safety

Patient/Resident Safety

Basic rules that must be followed to protect a patient or resident include: ♦ Do not perform any procedure on patients unless you have been instructed to do so. ♦️Make sure you have the proper authorization. ♦️ Follow instructions carefully. ♦️ Ask questions if you do not understand. Use correct or approved methods while performing any pro- cedure. ♦️ Avoid shortcuts or incorrect tech- niques.

Personal safety

Basic rules that must be followed to protect your- self and others include: ♦ Remember, it is your responsibility to protect yourself and others from injury. ♦ Use correct body mechanics while performing any procedure. ♦ Wear the required uniform. ♦ Walk—do not run—in the laboratory area or clinical area, in hallways, and especially on stairs. Keep to the right and watch carefully at intersections to avoid collisions. Use handrails on stairways. ♦ Promptly report any personal injury or acci- dent, no matter how minor, to your instruc- tor/immediate supervisor. ♦ If you see an unsafe situation or a violation of a safety practice, report it to your instructor/ immediate supervisor promptly. ♦ Keep all areas clean and neat with all equip- ment and supplies in their proper locations at all times.

Body mechanics

Body mechanics refers to the way in which the body moves and maintains balance while making the most efficient use of all its parts. Basic rules for body mechanics are provided as guide- lines to prevent strain and help maintain muscle strength.

Base of support

By keeping feet 8-10 inches apart placing one foot slightly forward, balancing weight on both feet, and pointing the toes in the direction of movement

Base of support

Compare using a narrow base of sup- port to using a broad base of support. Stand on your toes, with your feet close together ♦️ Next, stand on your toes with your feet farther apart. ♦️ Then, stand with your feet flat on the floor but close together. ♦️ Finally, stand with your feet flat on the floor but approximately 8-10 inches apart and with one foot slightly forward. ♦️ Balance your weight on both feet. ♦️ You should feel the best support in the final position because the broad base supports your body weight.

Equipment and Solutions Safety

Do not mix any solutions together unless instructed to do so by your instructor/idiate supervisor or you can verify that they are compatible. ♦ Some solutions can be injurious or poisonous. Avoid contact with your eyes and skin. Avoid inhaling any fumes displaced by a solution. Use only as directed. ♦ Store all chemical solutions in a locked cabi- net or closet following the manufacturer's rec- ommendations. For example, some solutions must be kept at room temperature, while oth- ers must be stored in a cool area. ♦ Dispose of chemical solutions according to the instructions provided on the MSDS for the solution. ♦ If you break any equipment or spill any solu- tions, immediately report the incident to your instructor/immediate supervisor. You will be told how to dispose of the equipment or how to remove the spilled solution

Fire extinguisher

Do not spray into the center or top of the fire, because this will cause the fire to spread in an outward direction.

Equipment and Solutions Safety

Do not use frayed or damaged electrical cords. Do not use a plug if the third prong for ground- ing has been broken off. Never use excessive force to insert a plug into an outlet. ♦ Never handle any electrical equipment with wet hands or around water. ♦ Store all equipment in its proper place. Unused equipment should not be left in a patient's room, a hallway, or a doorway. ♦ When handling any equipment, observe all safety precautions that have been taught. ♦ Read MSDSs before using any hazardous chemical solutions. ♦ Never use solutions from bottles that are not labeled. ♦ Read the labels of solution bottles at least three times during use to be sure you have the correct solution

Hazards

Exam- ples include burned-out lightbulbs, frayed elec- trical cords, scalding water in a sink or bath area, missing floor tiles or torn carpet, and other simi- lar hazards.

Blood borne pathogen standard

Examples of body fluids include blood and blood components, urine, stool, semen, vaginal secre- tions, cerebrospinal fluid, saliva, mucus, and other similar fluids.

Three things in order to start a fire

Fuel , heat,Oxygen

Three diseases that can be contracted by exposure to body fluids include

Hepatitis B Hepatitis C AIDS

Disaster plans

In addition to fires, other types of disasters may occur. ♦️ Examples include tornadoes, hurricanes, earthquakes, floods, and bomb threats. ♦️ In any type of disaster, stay calm, follow the policy of the health care facility, and provide for the safety of yourself and the patient. ♦️ it is important to note that health care workers are legally responsible for familiarizing themselves with disaster policies so appropriate action can be taken when a disaster strikes.

Halon

Most effective on Class C fires

Most fire extinguishers

Most fire extinguishers are labeled with a dia- gram and/or a letter showing the type of fire for which they are effective

PASS

P-Pull the pin. A- Aim the extinguisher at the near edge and bottom of the fire. S - Squeeze the handle to discharge the extinguisher. S-Sweep the extinguisher from side to side at the base of the fire.

Class A:

Paper, cloth, plastic and wood

Patient/Resident Safety

Provide privacy for all patients. ♦️ Knock on the door before entering any room ♦️ Speak to the patient and identify yourself. ♦️ Ask for permission to enter before going behind closed privacy curtains. ♦️ Close the door and/or draw curtains for privacy before beginning a procedure on the patient

Class C

Used for electrical fires such as fuse boxes, wiring, electrical outlets, and appliances; if possible, turn off the electricity before using an extinguisher on this type of fire

Class B

Used for fires of flammable liquids and gases such as paint, gasoline, oil, grease, and cooking fats

Class A

Used for fires of ordinary combustibles such as wood, paper, cloth, and plastics

Halon

Used on Class C fire

Class D

Used on burning or combustible metals such as magnesium, titanium, and sodium; specific for the type of metal; not used on other types of fires

Personal safety

Wash your hands frequently. Hands should always be washed before and after any proce- dure, and any time they become contaminated during a procedure ♦ Keep your hands away from your face, eyes, mouth, and hair. ♦ Dry your hands thoroughly before handling any electrical equipment. ♦ Wear safety glasses when instructed to do so and in situations that might result in possible eye injury. ♦ While working with your partner in patient simulations, observe all safety precautions taught in caring for a patient. Review the role each of you will have before you begin practicing a procedure so each person knows his or her responsibilities. ♦️Avoid horseplay and practical jokes; they cause accidents. ♦ If any solutions come in contact with your skin or eyes, immediately flush the area with cool water. Inform your instructor/immediate supervisor. ♦ If a particle gets in your eye, inform your instructor/immediate supervisor. ♦️ Do not try to remove the particle or rub your eye.

The Occupational Safety and Health Admin- istration (OSHA)

a division of the Department of Labor, establishes and enforces safety stan- dards for the workplace.

Fire extinguisher

are classified and labeled according to the kind of fire they extinguish

Blood Borne pathogen standard

has mandates to protect health care providers from diseases caused by exposure to body fluids

Ergonomics

is an applied science used to pro- mote the safety and well-being of a person by adapting the environment and using techniques to prevent injuries.

Body mechanics

refers to the way in which the body moves and maintains balance while making the most efficient use of all its parts

Monoammonium phosphate

type ABC extinguishers contain monoammo- nium phosphate, a yellow powder that leaves a sticky residue that can damage electrical appliances such as computers

Class D:

used on burning or combustible met- als; often specific for the type of metal being used and are not used on any other types of fires

Class C:

used on electrical fires such as fuse boxes, appliances, wiring, and electrical out- lets; the C stands for nonconductive

Class B:

used on flammable or combustible liquids such as gasoline, oil, paint, grease, and cooking fat fires

Material Safety Data Sheets (MSDSs)

with any hazardous products they sell

The Occupational Exposure to Hazardous Chemicals Standard proper proce- dures or policies to follow with regard to:

♦ Identifying the types and locations of all chemicals or hazards ♦ Locating and using the MSDS manual con- taining all of the safety data sheets ♦ Reading and interpreting chemical labels and hazard signs ♦ Using personal protective equipment (PPE) such as masks, gowns, gloves, and goggles ♦ Locating cleaning equipment and following correct methods for managing spills and/or disposal of chemicals ♦ Reporting accidents or exposures and docu- menting any incidents that occur

Race

♦ R Rescue anyone in immediate danger. Move patients to a safe area. If the patient can walk, escort him or her to a safe area. At times it may be necessary to move a patient in a bed or use the bed sheets as lift sheets to carry a patient to a safe area. ♦ A Activate the alarm. Sound the alarm and give the location and type of fire. ♦ C Contain the fire. Close windows and doors to prevent drafts. Shut off electrical equip- ment and oxygen if your safety is not endan- gered. ♦ E Extinguish the fire or evacuate the area. If the fire is small and contained, and you are not in danger, locate the correct fire extin- guisher to extinguish the fire. If the fire is large or spreading rapidly, or you or a patient/resi- dent is in danger, evacuate the area.

Fire safety procedure

♦️ Aim the nozzle at the fire Discharge the extinguisher. ♦️ Use a side- to-side motion. Spray toward the near edge of the fire at the bottom of the fire

Potassium bicarbonate or sodium bicarbonate

contains a chemical that acts to smother a fire; type BC extinguishers contain potassium bicarbonate or sodium bicarbon- ate, which leaves a mildly corrosive residue that must be cleaned up as soon as possible;

Halon:

contains a gas that interferes with the chemical reaction that occurs when fuels burn; used on electrical equipment because it does not leave a residue and will not damage appliances such as computers; most effective on Class C fires

Carbon dioxide

contains carbon dioxide gas that provides a smothering action on the fire by forming a cloud of cool ice or snow that displaces the air and oxygen; does leave a powdery, snowlike residue that irritates the skin and eyes and can be dangerous if inhaled; most effective on Class B or C fires

Patient/Resident Safety

♦️ Always identify your patient. ♦️ Be absolutely positive that you have the correct patient. ♦️ Check the identification wristband, if present. ♦️ Ask the patient to state his or her name. Repeat the patient's name at least twice. ♦️ Check the name on the patient's bed and on the patient's record. ♦ Always explain the procedure so the patient knows what you are going to do ♦️ Answer any questions and make sure you have the patient's consent before performing any procedure. ♦️ Never perform a procedure if a patient refuses to allow you to do so. ♦ Observe the patient closely during any proce- dure. If you notice any change, immediately report this. Be alert to the patient's condition at all times. ♦ Frequently check the patient area, waiting room, office rooms, bed areas, or home envi- ronment for safety hazards. ♦️ Report all unsafe situations immediately to the proper person or correct the safety hazard. ♦ Before leaving a patient/resident in a bed, observe all safety checkpoints. ♦️ Make sure the patient is in a comfortable position. ♦️ Check the bed to be sure that the side rails are elevated, ♦️ if indicated; the bed is at the lowest level to the floor; and the wheels on the bed are locked to prevent movement of the bed.

Fire safety procedure

♦️ Check the extinguisher type to be sure it is the proper one to use for the mock fire ♦️Locate the lock or pin at the top han-dle. Release the lock following the manufacturer's instructions ♦️Grasp the handle to hold the extin- guisher firmly in an upright position. ♦️Stand approximately 6-10 feet from the near edge of the fire.

Rules to prevent fires

♦️ Do not allow clutter to accumulate in rooms, closets, doorways, or traffic areas. ♦️ Make sure no equipment or supplies block any fire exits. ♦ When oxygen is in use, observe special pre- cautions . ♦️ Post a "No Smoking—Oxygen in Use" sign. ♦️Remove all smoking materials, candles, lighters, and matches from the room. ♦️ Avoid the use of electrically operated equipment whenever possible. ♦️ Do not use flammable liq- uids such as alcohol, nail polish, and oils. ♦️ Avoid static electricity by using cotton blan- kets, sheets, and gowns.

Rules to prevent fires

♦️ Obey all "No Smoking" signs. Most health care facilities are now "smoke-free" environments and do not permit smoking anywhere on the premises. ♦️ Extinguish matches, cigarettes, and any other flammable items completely. ♦️ Do not empty ashtrays into trash cans or plastic bags that can burn. ♦️ Always empty ashtrays into sepa- rate metal cans or containers partially filled with sand or water. ♦ Dispose of all waste materials in proper con- tainers. ♦ Before using electrical equipment, check for damaged cords or improper grounding. ♦️ Avoid overloading electrical outlets. ♦ Store flammable materials such as kerosene or gasoline in proper containers and in a safe area. ♦️ If you spill a flammable liquid, wipe it up immediately.

Two main standards affect health care workers:

♦️ The Occupational Exposure to Hazardous Chemicals Standard ♦ The Bloodborne Pathogen Standard

Ergonomics

♦️Ergonomics includes the correct placement of furniture and equipment, ♦️training in required muscle movements, efforts to avoid repetitive motions, and an awareness of the environment to prevent injuries. ♦️The prevention of accidents and injury centers around people and the immediate environment.

Eight basic rules of good body mechanics include:

♦️Maintain a broad base of support by keep- ing the feet 8-10 inches apart, placing one foot slightly forward, balancing weight on both feet, and pointing the toes in the direction of movement ♦️Bend from the hips and knees to get close to an object, and keep your back straight (figure 13-2). Do not bend at the waist. ♦️Use the strongest muscles to do the job. The larger and stronger muscles are located in the shoulders, upper arms, hips, and thighs. Back muscles are weak. Use the weight of your body to help push or pull an object. Whenever possible, push, slide, or pull rather than lift. ♦️Carry heavy objects close to the body. Also, stand close to any object or person being moved. ♦️Avoid twisting your body as you work. Turn with your feet and entire body when you change direction of movement. ♦️Avoid bending for long periods. ♦️If a patient or object is too heavy for you to lift alone, always get help. Mechanical lifts, trans- fer (gait) belts, wheelchairs, and other similar types of equipment are also available to help lift and move patients.

The MSDSs must provide the following information

♦️Product identification information about the chemical ♦️Protection or precautions that should be used while handling the chemical (for example, wearing protective equipment or using only in a well-ventilated area) ♦️Instructions for the safe use of the chemical ♦️Procedures for handling spills, cleanup, and disposal of the product ♦️Emergency first-aid procedures to use if injury occurs

Back supports

♦️Some health care facilities now require health care workers to wear back supports while lifting or moving patients ♦️The supports are supposed to help prevent back injuries, but their use is controversial. Back supports may provide a false sense of security as an individual tries to lift heavier loads. ♦️It is important to remember that a back brace does not increase strength. Back supportsmay also cause sweating, skin irritation, and increased abdominal pressure. ♦️ remind the wearer to use good body mechanics. ♦️ At other times, it should be loosened to decrease abdominal pressure.

four main reasons for using good body mechanics:

🔴Muscles work best when used correctly. 🔴Correct use of muscles makes lifting, pulling, and pushing easier. 🔴Correct application of body mechanics pre- vents unnecessary fatigue and strain, and saves energy. 🔴Correct application of body mechanics pre- vents injury to self and others.