Health and Safety in Healthcare Settings

Maintaining a Safe Environment

• Providing and maintaining a safe environment involves nursing practices to ensure safety.
• A safe environment is where the person is undertaking their activities with a sense of security.
• A healthy hospital environment does not harm patients or employees.

Factors Affecting Hospital Safety

• Health and safety in the hospital environment can be affected by chemical, physical, infectious, ergonomic, and psychosocial factors
• Chemical factors include antiseptics, disinfectants, and cytotoxic substances.
• Physical factors include heat, humidity, lighting, and noise.
• Infectious factors refers to microorganisms and infection control methods.
• Ergonomic factors include wet floors, steps, benches, and seats at an inappropriate height.
• Psychosocial factors are violence, anxiety, anger, stress, and job dissatisfaction.

Reducing Risks

• To reduce the risks, wear PPE like gowns, gloves, goggles, and masks.
• Ensure the environment is properly ventilated.
• If there is contact with chemicals, the affected skin should be washed.
• The drugs side effects need to be assessed.
• Measures should be taken to prevent malpractice.

Reducing Physical and Ergonomic Risks

• Noise should be suppressed, and there should not be loud talking.
• Machines causing noise need to be renewed/lubricated.

General Initiatives for Safety

• Inform individuals about the hospital environment upon admission.
• Evaluate and observe security risks of the individual.
• Minimize chemical, physical, infectious, ergonomic, and psychosocial risks.
• Create a secure environment which provides benefit rather than harm.

Preventing Falls

• The patient needs to be assessed to avoid falling.
• To avoid falling, there should be night lights installed and precautions need to be taken to prevent slipping.
• Places which may be slippery should have supports to grab like bathrooms and stairs.

Safe Hospital Rooms

• Windows have to be closed in a safe hospital room to prevent potential patients from attempting to escape or self-harm.
• There is a need to come in with permission and have appropriate cleaning and lighting
• Flowers are not allowed, and no outside food/beverages either.
• The order of the patient room affects their healing process and patient's health.
• A patient needs to feel safe.

Entering Patient Room

• It is important to provide a safe physical environment that includes appropriate environmental control and cleanliness.
• The basic rule of providing a safe environment for the patient = hospitals do not harm patients.
• Enter only with permission and after knocking on the door.

What Not to Have in Patient Rooms

• In patient's rooms, there should not be any real or fake flowers.
• Food and dirty goods should not be in the patient's room.

Units Commonly Found in Patient Rooms

• Bed that contains bed sheets, pillows, pillow faces, and an intermediate sheet
• Whatnot/Drawer
• Nursing call bell or light
• Central oxygen system
• Suction system
• Patient chair
• Overbed table

Hospital Bed Purpose

• Prevents hospital infection
• Provides a hygienic and comfortable environment
• Prevents transfer of microorganisms
• Prevents skin sores
• Ensures psychological health.
• Should protect bed against injury and insects

Reducing Contamination

• Hands should be washed before and after the technique.
• Do not mix clean and dirty clothes Fold contaminated surfaces inward.
• Keep dirty items away from uniforms.
• Dirty items should be thrown into the dirty trolley without touching the floor of the patient room.

Patient Safety

• It is important to protect patients from errors and undesirable siuations relating to the health service

Principles of Patient Safety

• There are seven Patient Safety Pinciples
• Identification and verification of patient identification information
• Ensuring communication security in health service delivery
• Ensuring drug safety
• Ensuring the safety of blood transfusions and blood products
• Ensuring surgical safety
• Ensuring radiation safety
• Preventing patient falls.

Patient Identification Information Verification

• Identifiers such as name, social security number, date of birth verifies patient’s identity. Markers are located on the arm band
• Identification prevents errors

Healthcare Communication Security

• It is important to have Timely, accurate, complete, clear and understandable communication

Drug Safety

• Ensure drug safety from production - consumption - long term removal

Medication Errors

• Most medication errors are:
• Giving the wrong medication
• Giving the wrong dose of medicine
• Giving the medicine in the wrong rate
• Giving the medicine to the wrong patient.
• Giving the medicine at the wrong time
• Never giving the medicine or failure to record the administered medication.
• Failure to observe the effect of the administered medication
• Incorrect route of administration
• Inaccurate dosage
• Negligence
• Misunderstanding
• Illegible handwriting
• Lack of training
• Lack of experience

Ensuring The Safety of the Blood

• Follow scientific guidelines and complications

Ensuring Surgical Safety

• Correct patient/right side of the body/correct surgery sites
• It is physician’s responsibility and nurse’s can warn them

Ensuring Radiation Safety

• Radiation is the movement of energy in the medium in the form of electromagnet waves
• Have the patient wear a protective equipment
• Only have part where the machine should shot be irradiated
• The doors need to be closed and pregnant women/suspect of pregnancy need the information

Preventing Patient Falls

• Every Institution should be aware if their patients will be falling

Reasons to be Falling

• Patient and Hospital
• Falls can result in pain, permanent disability and can cause death.

Fall Risk Assessment

• Fall risk should be assessed within 12 hours of admission
• If there is any change, there needs to be another risk assessment
• The Hendrich II Scale or the Itaki fall risk scale may be used

Fall Risk Follow Up

• If there is a fall, it should be determined if safe to move or get assistance
• Fall risk is determined. Then appropriate precautions are taken

Recommended Practices

• Make sure to monitor falls within a hospital, and assess them
• Display an image of the patient if they are falling
• Make sure that dangerous areas are kept from the patient
• Keep the patient bed on the lowest level, make sure borders at night are lifted

Individual Assessment for Patient’s Needs

• Providing a non slip shoe if needed/frequent the observation with patience
• Patient rooms at a certain size

Thoughts on Restrictive

• Should restrict based on Dr’s order, with consideration of the needs the patient

Infection and Control Prevention

• Pathogens are microorganisms that cause disease.
• Normal flora are microorganisms settled in various parts of the body and part of body’s response
• Women are more vulnerable for Infections because they are shorter than men

Infections

Infection is the disease process that is brought by microorganisms.

• There are microorganisms in body normally, if it changes its place, it’s more
• Brought to infection if pathogens reach

Chain of Infection

• Includes causative agent, reservoir, portal of exit, mode of transmission, portal of entry and susceptible host

Infection: The Process

• When a pathogen goes into the body and takes effect.
• Incubation period: pathogens begin
• The period when the first signs and symptoms appear
• The period when the disease is evident.
• Recovery period.

Nosocomial Infections

• A nosocomial infection, also known as a healthcare-associated infection (HAI), is an infection that a patient contracts while receiving medical care in a healthcare setting, such as a hospital, clinic, or nursing home.
• It can show up 48-72 hours after admission + 10 days discharge
• Also if there is an implant, 3 month after has an infection, then it is now nosocomial infection

Source and The Most Infections

• The most known of infections are the urinary tract infections
• Prevent all, take action of the antimicrobial

Sources of Nosocomial Infections

• Contaminated medical equipment: Catheters, ventilators, and other medical devices can harbor bacteria and spread them to patients.
• Surgical procedures: Infections can occur during surgery if proper sterile techniques are not followed.
• Healthcare workers: Healthcare workers can spread infections if they do not wash their hands properly or if they are ill.
• Environmental factors: Factors in the hospital environment, such as contaminated surfaces or air, can also contribute to infections.

The Importances

• It is important to reduce, otherwise you could cause these:
• Cost + Delay heal + Antibiotic resistance + Extended hospital day

Infection Control and Asepsis

• There is a need to prepare guidelines for healthcare professionals.
• Keep complying to the medical guidelines to prevent hospital infection, especially hospital contamination need control

Guidelines and Safety

• In basic principles you should provide to prevent/take action for it

Sanitation

• Reduces the amount of bacteria.

Sterilization

• Destroy every bacteria that can harm

The Groupings

According to the infection risk Three are the following groupings: critical, semi-critical, and non-critical Each can harm depending on how they enter

Critical

• Items penetrating body tissues allowing contact with the bloodstream or another sterile area
• Items such as surgical and dental instruments.
• Potential contact with open injuries

Semicritical

• Items coming into contact with non intact skin or mucous membranes but do not penetrate body surfaces
• E.g. Nozzles, trans rectal probes, nasal specula

Not Critical

• Items not touching the client or only touching the skin
• Things such as surface

Sterilization Basics and Usage

• Sterilization should never be misused, it can cause more harm.
• Sterilization should be stored for better management
• Sterilization should be washed for the affect the surface

The Word Sterile

• Sterilization implies the destruction of viable organisms, it the word to use and if there are
• Some contamination it can cause harm

Disinfection

• The process preventing or destroying microorganisms to non living/harmful objects.

Chemicals and Disinfectant

• Use of chemicals to ensure safety
• Antiseptic to not harmful items but alive.

In order for the disinfection to be successful:

The object should be fully immersed. Material needs to be washed and rinsed with water

Methods For Sterilization

• Heat
• Liquid
• Gasses such as gamma

How Important is Heat

One of the main known methods. Needs to be dry or moist

Heat Categories

• Includes:
• Sterilization with steam
• Most commonly used is autoclave
• Pastor oven
• Burining/Flaming

High Pressure in the Sterilization

• Make sure the objects can be sterilize with autoclave

More Notes on Sterilization

• The best method can be found throughout testing and use, it is also the most popular/used

What to Sterilize

• Items such as surgical instruments and tools

Packaging For Safety

• It is important to have for the autoclave, the indicator tells the user about the sterilization

Gas Chemical Sterilization

• Used for Complex precise instruments and tools, commonly made by ethylen oxide Used to destory TB Generally made up of Glutarahdehyde

UV Rays

• Its low for rays to destory, can prepare the instruments without damage, places such as TB

How to Control Sterilization Methods/Measurements

• The best and safest methods can be read of the temperature for its best use

Waste Disposing Of

• Follow guidelines of the country

Safety and Disinfectors

• The best ways are following sterilization, otherwise it is not effective and can do worse

Other Things To Note

• There should be standards used
• There need to be a set place/room for the materials that need to be checked off

In the End

• Keep in touch with the new methods with a new use for sterilization, there could easily be better items.

Asepsis

• Asepsis is the absence of disease-producing organisms.

Asepsis control purposes

• Prevent cross infection on the hospital environment
• Control infection.
• Support patient's comfort, safety and psychological well-being.

Medical vs Surgical

• Medical (contaminated), surgical (surgical)

Medical asepsis "Clean Technique”

• All practices that reduce the growth, transfer and spread of pathogenic microorganisms

Medical Asepsis Steps

• Dirty instruments are always to be washed off
• Avoid shaking instruments and tools after use
• Avoid using tools that can help transmit viruses and bacterias are washed, sterilized after each procedure

The Most Asepsis and Hand Washing

• That there is a way to handwash and do better, by removing all things for a safe infection in a easy way, is the best way
• The handwashing techniques is very important.

Surgical Asepsis Techniques

Practices that keep an area or objects free from all microorganisms non pathogenic and pathogenic including spores and viruses

• Clean all instruments

Boundaries in Medical Procedure?

• Surgical aspesis
• Clean up + don’t touch after start
• Don’t come close or touch the area with gloves

Medical Precautions

• Follow the medical to have protection with the body and wear the correct items needed

The Key

• Is that they must be in order so they work to protect

Gloves

• Is is important to have and know when the tools can be at the best use for the protection of the people Hand hygeine needs to be preformed

Infections and Precautions

• For the precautions needed use to help, it starts with hand hygeine that will do the deed of being clean to protect the user during and after

Stand Precautions in Full

• Precautions need to be taken with many steps to make sure to reach the goal of helping and keeping a health environment during times that may be difficult Bigger means more need for protection for those involved.

This lesson covers key aspects of health and safety in hospitals. It emphasizes the roles of health professionals in maintaining a healthy environment. Topics include chemical risk minimization, ergonomic risks, PPE use, and patient safety.