A SMILE Program Presentation Laboratory Safety A SMILE Program Presentation Patient Safety Monitoring in International Laboratories (SMILE) Program

Responsibility Who is responsible for safety in laboratories clinics and hospitals participating in clinical trials Patient Safety Monitoring in International Laboratories (SMILE) Program

Responsibility Employer Establishes necessary policies Standard Operating procedures and Safety Plan Engineering and work practice controls Personal protective equipment (PPE) Safety equipment such as fire extinguishers and eye wash stations Training Patient Safety Monitoring in International Laboratories (SMILE) Program

Responsibility Employee Knows and understands safety policies and procedures Follows safety policies and procedures Reports unsafe conditions to the Safety Officer or Laboratory Director Patient Safety Monitoring in International Laboratories (SMILE) Program

Safety is Everyone’s Responsibility! Patient Safety Monitoring in International Laboratories (SMILE) Program

Components of a Safety Program Fire safety Chemical Safety Bloodborne Pathogens Patient Safety Monitoring in International Laboratories (SMILE) Program

Fire Safety Patient Safety Monitoring in International Laboratories (SMILE) Program

Fire Safety The Fire Triangle Reaction Heat Oxygen Fuel Chemical Patient Safety Monitoring in International Laboratories (SMILE) Program

What should you do in case of a fire ? Fire Safety What should you do in case of a fire ? Remember the acronym – RACE Rescue – any people in danger Alarm – activate the fire alarm Contain – the fire by closing doors and windows Extinguish – the fire if it is small enough Patient Safety Monitoring in International Laboratories (SMILE) Program

Fire Safety Types of Fire Extinguishers A – Combustibles (paper, trash, cloth) B – Flammable liquids C – Electrical Equipment D – Combustible metals (not Common) Patient Safety Monitoring in International Laboratories (SMILE) Program

How do you operate a fire extinguisher? Fire Safety How do you operate a fire extinguisher? Remember PASS Pull - the pin Aim – at the base of the Fire Squeeze - the handle Sweep - to cover the fire Patient Safety Monitoring in International Laboratories (SMILE) Program

Maintenance of Fire Extinguishers Fire Safety Maintenance of Fire Extinguishers Fire extinguishers should be visually inspected on a monthly basis. The inspection should assure that Fire extinguishers are: In their assigned place Not blocked or hidden Pressure gauges show adequate pressure Pins and seals are in place No signs of damage The nozzles are free of blockages Patient Safety Monitoring in International Laboratories (SMILE) Program

Chemical Safety Patient Safety Monitoring in International Laboratories (SMILE) Program

How Do Chemicals enter the body? Chemical Safety How Do Chemicals enter the body? Inhalation – breathing in (e.g. powders, fumes) Absorption – on skin or mucus membranes Ingestion – entry through the mouth Injection - through skin by foreign body Patient Safety Monitoring in International Laboratories (SMILE) Program

Examples of Chemical Hazards Chemical Safety Examples of Chemical Hazards Carcinogens – cancer Corrosives –burns Hepatotoxins –liver damage Mutagens-damage genetic materials in cells Nephrotoxins – Kidney damage Neurotoxins – damage to the nervous system Tertatogens – birth defects Patient Safety Monitoring in International Laboratories (SMILE) Program

How can you obtain information about the Chemicals you use? Chemical Safety How can you obtain information about the Chemicals you use? Patient Safety Monitoring in International Laboratories (SMILE) Program

Chemical Safety Material Safety Data Sheet (MSDS) Name of Chemical The following Data Can be found on MSDS sheets………. Name of Chemical Physical Characteristics and hazards Health information First Aid required if there is a spill or exposure Date of most recent update Patient Safety Monitoring in International Laboratories (SMILE) Program

Chemical Safety Need to check for updates annually MSDS Sheets Continued………. Need to check for updates annually Highlight the name of the chemical and the first aid section for easy access in an emergency Organize in alphabetical order Must be available to everyone all of the time The internet is also a good way to access MSDS sheets Instrument manufacturers usually have MSDS sheets available on their websites. Patient Safety Monitoring in International Laboratories (SMILE) Program

Chemical Safety What should you do if there is a chemical spill? RAFT Rescue Avoid the Chemical Find the MSDS Telephone Patient Safety Monitoring in International Laboratories (SMILE) Program

Chemical Safety Chemical Exposures First AID Flush with plenty of water For at least 15 minutes Remove contaminated clothing Seek medical Attention Document incident Patient Safety Monitoring in International Laboratories (SMILE) Program

Characteristics of Liquid Nitrogen Chemical Safety Liquid Nitrogen Characteristics of Liquid Nitrogen 78% of atmosphere Colorless, Odorless, Tasteless, Nontoxic Boils at -196 Degrees C Non Flammable Patient Safety Monitoring in International Laboratories (SMILE) Program

When returning to the gaseous state: Chemical Safety Liquid Nitrogen When returning to the gaseous state: Can displace oxygen from the air Can lead to asphyxiation Will not support Life Patient Safety Monitoring in International Laboratories (SMILE) Program

Liquid Nitrogen – Precautions Chemical Safety Liquid Nitrogen – Precautions Always wear safety equipment Avoid use in a small enclosed area Avoid prolonged breathing of vapors Avoid rough handling of containers Install O2 Monitors in LN work areas Patient Safety Monitoring in International Laboratories (SMILE) Program

Chemical Safety Liquid Nitrogen PPE Full face shield with safety glasses Cryogenic gloves Arm protection Lab coat Cuff-less pants Close toed shoes Patient Safety Monitoring in International Laboratories (SMILE) Program

Liquid Nitrogen Emergencies Chemical Safety Liquid Nitrogen Emergencies Inhalation – Move person into the fresh air Eyes – Flush with water for 15 minutes Skin - soak affected area in tepid water Seek medical attention Document incident Patient Safety Monitoring in International Laboratories (SMILE) Program

What’s Wrong with this picture? Chemical Safety What’s Wrong with this picture? Answer to the Question on slide 33 Patient Safety Monitoring in International Laboratories (SMILE) Program

Carbon Dioxide – Dry Ice Chemical Safety Carbon Dioxide – Dry Ice Characteristics of Carbon Dioxide Colorless, odorless, tasteless nontoxic Non flammable Can only be solid when the temperature is < -78oC Patient Safety Monitoring in International Laboratories (SMILE) Program

Chemical Safety Solid Carbon Dioxide Can displace oxygen from air Can lead to asphyxiation Will not support life High concentrations cause rapid circulatory insufficiency Nausea Headache Vomiting Unconsciousness Patient Safety Monitoring in International Laboratories (SMILE) Program

Solid Carbon Dioxide – Dry Ice Chemical Safety Solid Carbon Dioxide – Dry Ice Always wear safety equipment Avoid use in a small enclosed area Avoid prolonged breathing of vapors Vent Closed CO2 containers away from you when opening Patient Safety Monitoring in International Laboratories (SMILE) Program

Solid Carbon Dioxide – PPE Chemical Safety Solid Carbon Dioxide – PPE Full face shield with safety glasses Cryogenic gloves Lab coat Close toed shoes Patient Safety Monitoring in International Laboratories (SMILE) Program

Solid Carbon Dioxide – Emergencies Chemical Safety Solid Carbon Dioxide – Emergencies Inhalation – Move person into the fresh air Eyes – Flush with water for 15 minutes Skin - soak affected area in tepid water Seek medical attention Document incident Patient Safety Monitoring in International Laboratories (SMILE) Program

Managing Chemicals in the Laboratory Chemical Safety Managing Chemicals in the Laboratory Storage Hazard Communication MSDS Updates Acids and Bases in separate approved cabinets Spill kits available Patient Safety Monitoring in International Laboratories (SMILE) Program

What’s Wrong with this picture? Chemical Safety What’s Wrong with this picture? Glass chemical bottles stored on the floor even more hazardous if the bottles are full. Patient Safety Monitoring in International Laboratories (SMILE) Program

SAFETY – Waste Disposal Tips for safe disposal of laboratory waste: Place all sharps in approved sharps containers Use goggles or full face shields to protect mucus membranes from splashes when disposing of liquid waste or specimen tubes. Refer to MSDS sheets for information on the safe disposal of chemicals Patient Safety Monitoring in International Laboratories (SMILE) Program

Bloodborne Pathogens Bloodborne Pathogens Patient Safety Monitoring in International Laboratories (SMILE) Program

What are bloodborne pathogens? Viruses, bacteria or other micro-organisms that are carried in the bloodstream and are capable of causing disease. Other body fluids that can spread bloodborne pathogens include: Blood products (plasma, platelets) Abdominal fluids Amniotic fluids Cerebrospinal fluids Vaginal secretions Semen Patient Safety Monitoring in International Laboratories (SMILE) Program

Most Common Bloodborne Pathogens Hepatitis B Hepatitis C HIV Discussion Suggestions - which of these three organisms is most infectious? What are the chances of healthcare workers being infected in the event of a needle stick from an infected person? Patient Safety Monitoring in International Laboratories (SMILE) Program

Standard Precautions Bloodborne Pathogens Standard Precautions replaces Universal Precautions – using Standard Precautions all blood and body fluids are treated as infectious all of the time. Patient Safety Monitoring in International Laboratories (SMILE) Program

Bloodborne Pathogens Personal Protective Equipment (PPE) Gloves Safety glasses/Goggles Lab coats (should be fluid resistant) Face shields Notes – Fluid resistant lab coats are recommended. They are available in materials that allow for adequate ventilation in hot climates. See the www.safetylady.com website for details. Patient Safety Monitoring in International Laboratories (SMILE) Program

Bloodborne Pathogens PPE Continued……. How much PPE should you use? Wear as much or as little as you anticipate you will need to prevent blood and other infectious materials from contact with your skin, mucus membranes and clothing. Patient Safety Monitoring in International Laboratories (SMILE) Program

Blood borne Pathogens General Safety Rules Handle sharps with care: Do not recap needles or other sharps Do not bend or break off needles Dispose of sharps in puncture resistant containers DO Not: Eat, drink, smoke, apply cosmetics, take medication in areas where you are working with blood and other body fluids Patient Safety Monitoring in International Laboratories (SMILE) Program

What should you do if there is a blood or body fluid exposure ? Bloodborne Pathogens What should you do if there is a blood or body fluid exposure ? Follow the post exposure prophylaxis (PEP) plan Wash puncture wounds with soap and water Flush affected mucus membranes with water Inform Safety Officer or administrative staff member Seek medical attention Complete an incident report form At this point it would be a good idea to review the specific instructions for your institution. Make sure that employees know where to find the procedure for PEP – it is a good idea to have it posted. Patient Safety Monitoring in International Laboratories (SMILE) Program

A basic but very important method of reducing your risk of infection. Bloodborne Pathogens Hand Washing A basic but very important method of reducing your risk of infection. Patient Safety Monitoring in International Laboratories (SMILE) Program

Hand Washing Bloodborne Pathogens What song should you sing while you are washing your hands so that you know that you have washed for enough time? Answer on the notes section of the next page. Patient Safety Monitoring in International Laboratories (SMILE) Program

Questions and Comments Laboratory Safety Questions and Comments Answer to the Question on slide 43 is - Happy Birthday. It takes about 15 seconds to sing happy birthday which is the minimum length of time that is recommended for Hand Washing Patient Safety Monitoring in International Laboratories (SMILE) Program

Laboratory Safety References: 1.PPD (May, 2005) – PowerPoint Presentation, Presented at the Washington DC GCLP Meeting. 2. WWW.safetylady.com Patient Safety Monitoring in International Laboratories (SMILE) Program