1. Chapter 3 Safety and Infection Control Practices
Health Care Science Technology
Copyright © The McGraw-Hill Companies, Inc.

2. Accidents and Injuries
Safety means freedom from danger, risks, and injury.
Chapter 3

3. Prevention
Injuries are prevented by preventing accidents.
Chapter 3

4. Governing Agencies
The Occupational Safety and Health Administration (OSHA) is required to oversee safety in the workplace.
OSHA requires that material safety data sheets (MSDS) be kept on all chemicals handled at a facility.
Chapter 3

5. Governing Agencies (cont.)
Manufacturers are required to provide a copy of the MSDS for all products they sell.
Chapter 3

6. Governing Agencies (cont.)
The MSDS should contain:
Manufacturer’s name and address.
Safety exposure limits.
Chemical name.
Health hazards.
Flammability level.
Reactivity level.
Personal protective equipment (PPE) required when handling the chemical.
Hazard rating for the chemical.
Chapter 3

7. Governing Agencies (cont.)
Failure to maintain properly labeled hazardous materials can result in large fines.
A safety officer may be appointed to oversee continuing education regarding hazardous materials.
Chapter 3

8. Governing Agencies (cont.)
The Centers for Disease Control and Prevention (CDC) has developed standard safety precautions.
Other governing agencies include:
Individual states.
U.S. Department of Public Health.
Food and Drug Administration (FDA).
Environmental Protection Agency (EPA).
Chapter 3

9. Preventing Accidents
The best way to deal with workplace injuries is to prevent them.
Education is the key to an accident-free facility.
The two main categories of accidents are:
Accidents related to the physical environment and equipment.
Accidents related to client care.
Chapter 3

10. Guidelines for preventing accidents
Know the environment, including the location of exits, stairs, fire alarms and extinguishers, call signals, paging systems, and emergency lights.
Chapter 3

11. Know the safety policies and procedures for your facility.
Operate only the equipment you are trained to use.
Report accidents, spills, and damaged or malfunctioning equipment immediately.
Do not use frayed or damaged electrical cords or ungrounded equipment.
Chapter 3

12. Never use any product that does not have a readable label.
Read all labels at least 3 times before using the product.
Read the MSDS for any product you will be using.
Wear personal protective equipment when handling hazardous or unknown chemicals.
Never mix solutions or chemicals.
Chapter 3

13. Know how to report an accident or obtain emergency assistance.
Use the right side of the hallway and stop at intersections.
Allow others to exit before you enter stairways, doorways, or elevators.
Chapter 3

14. Guidelines for client safety:
Ensure that the client knows how to operate call signals, emergency call lights, handrails, safety rails, and how to locate the bathroom.
Identify client and explain a procedure before beginning.
Perform only those procedures for which you have been trained.
Chapter 3

15. Ensure the privacy, safety, and comfort of your client.
Report safety hazards, such as spills, loose carpet, or extremely hot food or drinks.
Be aware of any changes in the client and report them to your supervisor immediately.
Ensure the privacy, safety, and comfort of your client.
Chapter 3

16. BASIC
FIRE SAFETY

17. Fire Safety Fires need 3 things to start: 1. Oxygen (Air)
2. Fuel (any material
that will burn)
3. Heat (Sparks,
matches, flames)
Chapter 3

18. Major Causes of Fires Carelessness with smoking and matches
Misuse of electricity (overloading a circuit or overuse of extension cords)
Improper rubbish disposal
Improper storage of flammables (such as gasoline)
Arson

19. Types of Extinguishers
5 types are available, with ABC being the most common.
Table 3-1 Fire Extinguishers
Class
A (Water)
B (Carbon dioxide)
C (K bicarbonate) D
ABC (Chemical)
Common combustibles
Flammable liquids
Electrical
Combustible metals (magnesium)
All ABC fires
Application
Chapter 3

20. How to Use a Fire Extinguisher
Remember the key word PASS:
P = Pull the pin.
A = Aim at the base of the fire.
S = Squeeze handle.
S = Sweep nozzle from side to
side to displace oxygen away
from the fire.
Chapter 3

21. When a Fire Emergency Occurs
STAY CALM
Remember the key word RACE:
R = Rescue.
A = Alarm. Assign someone to
pull the alarm.
C = Contain. Close the windows
and doors.
E = Evacuate.
Chapter 3

22. Emergency Fire Rules Be prepared! Know your responsibilities.
Know when and how to evacuate.
Know where the fire alarms are located and how to activate them.
Keep fire extinguishers in plain view and readily accessible.
3rd Floor Plan
Chapter 3

23. Emergency Fire Rules (cont.)
Keep areas uncluttered.
Evacuate ambulatory clients first, then the wheel-chair bound, then the bed-bound.
If possible, never leave a client alone in a fire emergency.
Never use an elevator in a fire situation.
Never open windows.
Never open a door that feels hot.
Chapter 3

24. Definition of Body Mechanics
Positions and movements used to maintain proper posture and avoid muscle and bone injuries
Chapter 3

25. Principles of Body Mechanics
Body alignment depends on the correct positioning of the head, back, and limbs.
Chapter 3

26. Body Mechanics Failure
Causes back problems including acute strains, sprains, disc strain and bulge, disc herniation, and fatigue.
Prevention is the best cure for back pain.
WEAR A BACK SUPPORT!
Chapter 3

27. Key Components of Body Mechanics
Keep feet a shoulder-width apart.
Always use 2 hands to move someone or something.
Face the direction in which you intend to move. Never twist.
Avoid unnecessary reaching.
Keep your chin up and look straight ahead.
Keep your shoulders back.
Chapter 3

28. Key Components of Body Mechanics (cont.)
Bend at the hips and knees.
Keep your back straight.
Keep the object you are lifting close to your body.
Exhale when you are lifting or exerting force.
Tighten your abdominal muscles.
Lift with your legs, not your back.
Chapter 3

29. Key Components of Body Mechanics (cont.)
Push, pull, or slide instead of lifting.
Pushing is the best technique for moving something large.
Use the weight of your body to help you push or pull.
Always ask for help whenever needed.
Tell the client what you are going to do and ask for the client’s help.
Chapter 3

30. Microorganisms
We usually do not notice or think about microorganisms until they cause some form of physical illness.
Remember many are beneficial
Chapter 3

31. Nature of Microorganisms
Pathogens are microorganisms that cause disease.
Non-pathogens are microorganisms that do not cause disease.
Chapter 3

32. Factors That Influence Microbial Growth
Following factors influence microbial growth:
Temperature.
pH, or the values used in chemistry to express the degrees of acidity of a substance.
Food.
Moisture.
Oxygen.
Chapter 3

33. Factors That Influence Microbial Growth (cont.)
Aerobic microbes – live only in the presence of oxygen.
Anaerobic microbes – grow best in the absence of oxygen.
Chapter 3

34. Methods That Destroy Microorganisms
Antiseptics – solutions applied directly to the skin that prevent or inhibit the growth of pathogens.
Disinfection – using strong chemicals, such as bleach to destroy pathogens, usually on objects, not skin.
Sterilization – the most effective way to destroy all microorganisms.
Chapter 3

35. Types of MicroorganismsB. C. D. E. F. G. H. I.
Bacteria
One-celled microorganisms that are classified according to their shape and arrangement.
Cause diseases such as strep throat, pneumonia, and tuberculosis. (Table 3-4)
Some bacteria produce spores, which help them reproduce.
Name the microorganisms A to I. Click HERE to see answers.
Chapter 3

36. Types of Microorganisms (Answers)
A. Streptococci
B. Staphylococci
C. Diplococci
D. Micrococci
E. Flagellated forms
F. Bacilli
G. Vibrios
H. Spirilla
I. Spirochetes
BACK
Chapter 3

37. Types of Microorganisms (cont.)
Fungi
A plantlike organism that lives on dead matter.
Cause conditions such as ringworm, athlete’s foot, yeast infections, and thrush.
Protozoa
Tiny animals found in contaminated water.
Cause diseases such as malaria, trichomoniasis, and amebic dysentery.
Chapter 3

38. Types of Microorganisms (cont.)
Rickettsiae
Parasites that live inside the cells of other living organisms.
Transmitted to humans by fleas, lice, and ticks.
Cause diseases such as Rocky Mountain spotted fever.
Chapter 3

39. Types of Microorganisms (cont.)
Viruses
Smallest of all microorganisms.
Live inside cells.
Spread by contact with blood and other body fluids.
Difficult to destroy.
Associated with diseases such as the common cold, chicken pox, herpes, hepatitis B, and acquired immune deficiency syndrome (AIDS).
Chapter 3

40. Principles of Infection 3-5
Asepsis
History of Asepsis
Chain of Infection
Signs and Symptoms of Infection
Nosocomial Infections
Chapter 3

41. Definition of Asepsis Freedom from infection.
2. The prevention of contact with microorganisms
Chapter 3

42. History of Aseptic Technique
Greek Medicine 1200 BC –200 BC
First to study causes of diseases, this helped eliminate superstitions
Sanitary practices were associated with the prevention of disease
Chapter 3

43. History of Aseptic Technique
Roman Medicine 753 BC – 410 AD
Learned from the Greeks and developed a sanitation system
Aqueducts and sewers
Public baths used filtering systems to prevent disease
Chapter 3

44. Middle Ages – 1400 AD
Arabian physicians used mercuric chloride was used to prevent sepsis in wounds
Chapter 3

45. 16th & 17th Century Anton van Leeuwekhoek (1676) invented microscope
Dutch Scientist
The Father of Microbiology
invented microscope
observed microorganisms
Chapter 3

46. 19th and 20th Century Inez Semmelweiss Louis Pasteur (1860 –1895)
identified the cause of puerperal fever which led to the importance of hand washing
Louis Pasteur (1860 –1895)
discovered that microorganisms cause disease (germ theory of communicable disease)
Chapter 3

47. 19th and 20th Century Joseph Lister
Developed antiseptics by soaking surgical tools before surgery
Prior to this 80% of patients contracted gangrene
Chapter 3

48. 20th century Ernst von Bergmann German Scientist
Introduced steam sterilization under pressure for treating instruments and other medical equipment used for surgery
Chapter 3

49. 20th century William Stewart Famous surgeon from John Hopkins
Introduced sterile rubber gloves to the field of medicine
Chapter 3

50. Chain of Infection
Chain of infection contains 6 elements. If broken, infection will not occur.
Infectious Agent
Portal of Exit
Reservoir
Mode of Transmission
Portal of Entry
Susceptible Host
Chapter 3

51. Elements in Chain of Infection
Infectious Agent. Microorganisms that normally reside on the skin.
Reservoir. Residence of microorganisms.
Fomites are nonliving materials that house microorganisms.
Chapter 3

52. Elements in Chain of Infection
Portal of Exit.
Respiratory tract.
Skin.
Blood.
Gastrointestinal tract.
Mucous membrane.
Mode of Transmission.
How a pathogen is transmitted.
Can be through direct contact or airborne droplet.
Hand washing is one of the most effective means of preventing the spread of pathogens.
Chapter 3

53. Elements in Chain of Infection
Portal of Entry.
Respiratory tract, mucous membranes, and gastrointestinal tract are common.
Damaged skin.
Susceptible Host.
One that is capable of being infected.
Microorganisms must be present in large enough quantity to be virulent.
The host must be susceptible.
Individuals with an immunity to certain pathogens will not be susceptible.
Chapter 3

54. Signs and Symptoms of Infection
Redness
Swelling
Tenderness
Warmth
Drainage
Chapter 3

55. Nosocomial Infections
Infections acquired at the health care facility.
90,000 of the 98,000 patients who die each year in hospitals are due to nosocomial infections. These infections are preventable with closer attention to Hand hygiene and Infection Control guidelines by ALL health care worker
Chapter 3

56. Asepsis Medical asepsis Surgical asepsis Called “clean technique.”
Includes hand washing, standard precautions and transmission-based precautions
Surgical asepsis
Called “sterile technique.”
Only sterile objects can come in contact with sterile objects. Otherwise, they must be considered contaminated.
Chapter 3

57. Methods That Destroy Microorganisms
Antiseptics – solutions applied directly to the skin that prevent or inhibit the growth of pathogens.
Examples: hydrogen peroxide, alcohol, betadine
Antiseptics are not useful against all microorganisms.
Chapter 3

58. Methods That Destroy Microorganisms
Disinfection – using strong chemicals, such as bleach to destroy pathogens, usually on objects, not skin.
Example: Bleach
Sterilization – the most effective way to destroy all microorganisms. Sterilization uses steam under pressure.
Examples: autoclave, radiation, gas
Chapter 3

59. Why is cleaning your hands between patients important?
Many studies have shown that the bacteria that cause hospital-acquired infections are most frequently spread from one patient to another on the hands of healthcare workers
Chapter 3

60. - CLEAN HANDS - THE MOST IMPORTANT MEANS OF PREVENTING
No Fungus among us
HAND HYGIENE
- NO ARTIFICIAL NAILS
- CLEAN HANDS - THE MOST IMPORTANT MEANS OF PREVENTING
THE SPREAD OF INFECTION
Germs don’t have a
chance with the proper
use of these weapons
Soap / Water
Alcohol-based hand
hygiene products
Chapter 3

61. Before and after every patient contact
According to OSHA standards regarding bloodborne pathogens, handwashing should be performed, at a minimum:
Before and after every patient contact
After removing gloves and other protective wear
After handling blood or other body fluids
When visibly contaminated with blood or tissues
Before leaving the patient area
Before and after eating, applying makeup, using the bathroom, handling contact lenses, handling equipment
Chapter 3

62. Proper hand washing techniques include:
Soap aids in the removal of pathogens.
Warm water
Friction
All surfaces of the hands must be cleaned - palms, backs, between the fingers.
Nails must be cleaned.
Fingertips pointed downward - prevents water from getting on forearms and then running back down onto the hands and recontamination
Dry paper towels are used to turn faucet on and off - prevents contamination of hands from organisms on the faucet.
Chapter 3

63. Standard Precautions Personal protective equipment is necessary (PPE).
All blood and body fluids are considered contaminated.
Guidelines established by OSHA.
Hand washing is vital.
Personal protective equipment is necessary (PPE).
Equipment and procedures depend upon the disease and how it is spread.
Chapter 3

64. Transmission-Based Precautions
Prevent spread of highly infectious diseases.
Three types of precautions:
Airborne. Used for diseases such as tuberculosis, which is spread by airborne droplets.
Droplet. Used for diseases such as whooping cough, which is spread by a cough or sneeze.
Contact. Used for skin and wound infections, which are transmitted by direct or indirect contact.
Chapter 3

65. Gloves Gloves should be worn:
whenever contact with blood and body fluids, mucous membranes, or non intact skin is possible
When handling items possibly soiled with blood or body fluids
When performing any invasive procedure
Gloves should be changed after contact with each patient
Chapter 3

66. Gowns
Gowns or aprons should be worn during any procedure that is likely to cause splashing of blood and body fluids
Chapter 3

67. Masks
Masks and protective eyewear or face shields should be worn during procedures that may produce droplets of blood or body fluids
Chapter 3

68. Sharps
Extreme caution should be taken while handling sharp objects. They should be left uncapped and attached to the syringe and placed in a puncture resistant sharps container
Chapter 3

69. Spills and Splashes
Spills and splashes of blood and body fluids should be wiped up immediately. The area should be cleaned with a disinfectant.
Chapter 3

70. Infectious wastes should be placed in special infectious waste bags or biohazardous material bags. These are usually autoclaved prior to disposal
Chapter 3

71. Report
Report any cut, injury, needle stick or splashing of blood or body fluids immediately
Chapter 3

72. Donning and Removing PPE
Pre-procedure
Assemble need supplies
Remove your rings, bracelets, and watch or push your watch up on your arm
Wash your hands
Chapter 3

73. Put on face mask and goggles
Position the mask so that your mouth and nose are covered. Usually a small bendable strip is on the mask. Place it over your nose
Tie the upper strings at the back of your head. If the mask has an elastic band, pull it on around the back of your head
Tie the strings at the base of your head
Pinch the bendable metal strip over your nose to secure the mask
Chapter 3

74. Gown
Put on the gown
Unfold the gown and pull the sleeves up on your arms, with the opening in the back.
Tie the gown at the neck
Overlap the gown at the back to close it.
Tie the gown at the waist
Chapter 3

75. Pull the glove cuffs up over the sleeves of your gown
Put on gloves
Pull the glove cuffs up over the sleeves of your gown
Chapter 3

76. Removing PPE Remove your gloves
Remove the first glove by grasping it just below the cuff
Pull the glove down over your hand so that it is inside out
Hold the removed glove with your other gloved hand. Do not touch the outside of a contaminated glove with your bare hand
Reach inside the other glove with the first two fingers of your ungloved hand.
Pull the glove down over the other glove
Chapter 3

77. Removing your Gown Remove the gown Untie the gown at waist and neck
Do not touch the outside of the gown; it is contaminated. Using your dominant hand reach inside the gown to the opposite shoulder and remove the gown gently
Reach the other arm inside the sleeve and pull it down
Hold the gown away from you as you fold it inside out
Chapter 3

78. Remove the Mask & Goggles
Touch only the strings. Do not touch the outside of a contaminated mask
Wash your Hands !!!
Chapter 3

79. What Type of PPE Would You Wear?
Giving a bed bath?
Suctioning oral secretions?
Transporting a patient in a wheel chair?
Responding to an emergency where blood is spurting
Drawing blood from a vein?
Cleaning an incontinent patient with diarrhea?
Irrigating a wound?
Taking vital signs
Chapter 3

80. Before Entering & Leaving
STOP
WASH HANDS!
Before Entering & Leaving
 Use Standard Precautions
Chapter 3