Healthcare Safety and Standard Precautions Competencies 1-2

List regulatory agencies and the

requirements they set for safety standards for healthcare facilities, their employees, and clients.

• Identify selected safety terminology relevant to healthcare.

• Identify the CDC and list its safety requirement(s) as they pertain to the healthcare environment.

• Identify OSHA and the Department of Health and list safety regulations as they pertain to the healthcare environment.

• Identify the Joint Commission and describe its role in regulating safety with the healthcare environment.

• Identify the OSHA Bloodborne Pathogens Standard and list its requirements.

Competency 1

Review list

Terminology and Definitions

10. Miscellaneous Agricultural Workers

9. Driver/Sales Workers and Truck Drivers

8. Roofers

7. Electrical Power Line Installers/Repairs

6. Farmers and Ranchers

5. Refuse and Recyclable Material Collectors

4. Structural Iron and Steel Workers

3. Logging Workers

2. Aircraft Pilots and Flight Engineers

1. Fishers and Related Workers

American’s Top 10 Most Dangerous Jobs

CDC – Center for Disease Control & Prevention

OSHA – Occupational Safety & Health Administration

MDH - Minnesota Department of Health (Example MN)

TJC – The Joint Commission

Regulatory Agencies

CDC as the lookout for the health of the people of the U.S. and throughout the world, strives to protect people’s health and safety, provide reliable health information, and improve health through strong partnerships.

Established in 1946 to control Malaria outbreaks in post WW2 war areas.

CDC – Center for Disease Control

• Study the causes and distribution of diseases.

• Formulate safety guidelines to help prevent and control the spread of infectious diseases.

• Identifies Standard Precautions apply to every client in the healthcare environment

• Identifies Transmission-Based Precautions for Airborne, Droplet, Contact

CDC Operates to:

• Permissible Exposure Limits (PEL) is the maximum concentration of chemicals

• Hazard Communication is the “Right to Know” and requires employers to communicate information about hazardous chemicals in the workplace.

• Bloodborne Pathogens (BBP) is the standard to prevent exposure to healthcare workers.

• Personal Protective Equipment (PPE) are gloves, masks, eye protections, aprons, etc.

Regulatory Impact of Occupational Safety and Health Administration (OSHA)

• Hazard Communication Rule: Right to Know

• Informs workers when working with hazardous/ infectious materials and provides for the availability of infection control measures if necessary.

• MDH supervises the compliance of facilities to health regulations.

Minnesota Department of Health (MDH)

Mission Statement:

To continuously improve safety and quality of care provided to the public through the

provision of health care accreditation and related services that support performance

improvement in health care organizations.

Formed in 1951

The Joint Commission (TJC)

• General, psychiatric, children’s & rehabilitation hospitals

• Critical access hospitals

• Medical equipment services, hospice services

• Nursing homes & other long term care facilities

• Behavioral health care organizations

The Joint Commission Provides Evaluation and Accreditation for:

• Private, non-profit organization whose purpose is to encourage the attainment of high standards of institutional medical care.

• Establishes guidelines for operation

• Conducts inspections

The Joint Commission Role

• Improve accuracy of patient identification.• Improve effectiveness of communication.• Improve safety of using medications.• Reduce the risk of health care-associated infections.• Reduce the risk of patient harm from falls.• Prevent health care associated pressure ulcers• Reduce safety risks to patients• Pre-procedure verification process• Encourage patients’ active involvement in their own case as a patient

safety strategy.• Reduce harm associated with clinical alarm systems

The Joint Commission Patient Safety Goals - 2014

• occupational exposure• non-intact skin• exposure incident

OSHA Bloodborne Pathogens Standard

OSHA

Two main standards that effect healthcare workers

1. Blood-borne Pathogen Standard

2. Occupational Exposure to Hazardous Chemicals Standard

Preventing Accidents

• Engineering controls

• Work practice controls

• PPE (personal protective equipment)

• HBV vaccine

Exposure control plan (Control methods)

Explain the current requirements of standard

precautions and the procedures used at a variety of healthcare facilities to support those standards. • Explain the purpose of standard precautions and when they are applied.• List common pathogens.• Identify PPE (personal protective equipment) and usage.• List compliance measures for Blood borne Pathogens Standards.• Identify types of Isolation Precautions and describe why isolation is used in a

healthcare facility. • Identify concerns and needs of clients in isolation.

Competency 2

Purpose is to decrease transmission risk of disease producing microorganisms

• Used on all clients/patients• Used at exposure to body fluids• Used at contact with mucous membranes• HIV or HBV risk• Caregiver/client has non-intact skin

Standard Precautions

CDC recommends use of Transmission-Based Precautions with patients who are documented or suspected to be infected with pathogens.

Used for ALL clients

Transmission – Based Precautions

• Used if client or caregiver has non-intact or broken skin.

• Used when there is exposure or potential exposure to body fluids such as blood,

urine, stool, saliva, vaginal secretions.

• Contact with mucous membranes that are HIV and HBV risk.

• Remember: perspiration is not a body fluid.

When to use Standard Precautions

• To prevent the spread of infectious disease

• Infectious disease is any disease caused by the growth of pathogens.

• Pathogens are disease-causing microorganisms (germs) in the body.

• Microorganisms are very small, usually one-celled living plants or animals.

Infection Control

Bacteria which are one-celled plants.• Staph, whooping cough, strep, TB

Fungus which is the largest group of simple plants.• Athlete’s foot, candida

Viruses which are the smallest of microbes.• Common cold, herpes simplex, HIV, Hepatitis A, B, C

Types of Microbes

• MRSA =Methicillin Resistant Staph Aureus

• CMV =Cytomegalovirus

• VRE =Vancomycin Resistant Enterococcus

Drug Resistant Organisms

• Food Borne Illnesses

• Sexually Transmitted Diseases (STDs)

• Measles, Mumps, Rubella (MMR)

Types of Transmitted Illnesses

• Handwashing• Personal Protective Equipment (PPE)• Patient Care Equipment• Environment Control• Linen• Occupational Health & Blood-borne Pathogens

Standard Precautions Required by Healthcare Workers

Conditions for Growth

• Temperature 40 – 110 F• Moisture• Air (if needed)• Darkness• Food source• Body secretions

Chain of Infection

• To protect the client

• To protect the public and healthcare worker

Uses for Isolation Precautions

Airborne

• Travels short distance through air• Deposited on host’s conjunctiva, nasal mucosa, or mouth• Talking, sneezing, coughing

Examples: Chicken Pox, Rubeola

3 Types of Transmission-Based Precautions

Droplet

• Droplet or dust particles containing infectious agent• Can be widely dispersed• Talking, sneezing, whispering, coughing

Examples: Mumps, Influenza

3 Types of Transmission-Based Precautions

Contact

• Most frequent mode of nosocomial infections• Direct-contact• Indirect-contact

Examples: Herpes, Scabies, Wounds

3 Types of Transmission-Based Precautions

Uses:

Protect client/patient, protect healthcare worker & public

Procedures:

Restriction to a room, procedures for disposal of trash/linens, special equipment

Clients needs/feelings:

Evidence of acceptance, additional checks, lonely, unclean, why

Isolation

• Patient needs private room

• Special equipment

• Frequent visits by nurses

• Forced solitude/isolation

Disadvantages of Transmission Precautions

• Biological waste disposal

• Use of gloves

• Antiseptics

• Disinfectants, Methods of supplies and equipment

• Sterilization Methods

Biological Waste Disposal

• Well balanced diet, rest, exercise, good mental health

• Do not go to work if ill and teach visitors to stay away from facility if ill

Maintain Workers Own Good Health

Author: Dede Carr, BS, LDA

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