Health and Safety in Hospitals

• A safe environment is where individuals perform activities in a healthy way with a sense of security.
• Health professionals create healthy hospital environments.
• Hospitals should not harm patients or employees.

Factors Affecting Health and Safety in Hospitals

• Chemical factors include antiseptics, disinfectants, cytotoxic substances, mercury, and latex.
• Physical factors include heat, humidity, lighting, and noise.
• Infectious factors involve microorganisms and infection control methods.
• Ergonomic factors include wet floors, steps, inappropriate benches, and seats.
• Psychosocial factors encompass violence, anxiety, anger, stress, and job dissatisfaction.

Reducing Chemical Risks

• Protective personal equipment (PPE) like gowns, gloves, goggles, and masks reduces the risk of contact with hazardous materials.
• The environment should be ventilated.
• Skin should be washed with plenty of water if chemical substances come into contact with it.
• Chemical substances should be used and prepared as recommended.
• The side effects of drugs should be evaluated.
• Measures should be taken to prevent malpractice.

Reducing Physical and Ergonomic Risks

• Noise should be suppressed, and loud talk should be avoided.
• Periodical machine maintenance and lubrication should be done and parts causing noise should be renewed.

General Initiatives for Maintaining a Safe Environment

• Every individual admitted to the hospital should be informed about the environment.
• Security risks should be evaluated and observed.
• Chemical, physical, infectious, ergonomic and psychosocial risks should be minimized.
• Secure environments that benefit rather than harm should be created.
• The patients fall risk is determined
• Precautions should be taken to prevent slipping
• Bathrooms, toilets an stairs should holding places
• A night light can be used

Features of a Safe Hospital Room

• Windows should be closed.
• Permission should be required for entry.
• Appropriate cleaning and lighting should be ensured
• No flowers in the hospital room.
• No outside food or beverages allowed.
• The order of patients room should be influential to the healing process.
• Patients should feel safe in the room.

Patient Units

• Include a bed, whatnot/drawer, nursing call bell or light, central oxygen system, suction system, patient chair, and overbed table.

Hospital Bed

• Includes a bed (mattress), pillows, pillow faces, intermediate sheet, bed sheet, mattress protector, and blanket.

Purpose of Making a Bed

• Prevent nosocomial (hospital) infection.
• Provide a hygienic environment.
• Prevent the transfer of microorganisms and prevent skin sores.
• Ensure the patient's comfort and psychological health.

Reducing Contamination

• Follow proper hand washing before and after procedures.
• Fold contaminated surfaces inward.
• Keep clean and dirty items separate.
• Keep dirty items away from uniforms.
• Dispose of dirty items in the dirty trolley without touching the patient room floor.

Patient Safety

• Ensuring identification and verification of patient identification information
• Ensuring communication security in health service delivery,
• Ensuring drug safety,
• Ensuring the safety transfusion of blood and blood products,
• Ensuring surgical safety,
• Ensuring radiation safety,
• Preventing patient falls.

First Principle of Patient safety: Patient Identification

• It is done via identification markers, located on the patient's armband.
• Relevant patient information: patient name, surname, protocol number, T.R identification number, and date of birth.

Effective Communication in Health Service Delivery

• Timely, accurate, complete, clear, and understandable communication between healthcare professionals prevents errors and ensures patient safety.

Ensuring Drug Safety

• This process continues from drug production, to consumption phase, , long-term drug effect, and until complete removed.

Medication Errors Due to Application

• Giving the wrong medication or wrong dose of medicine, at the wrong way or wrong time
• Giving the drug at the wrong rate or giving the drug to the wrong patient.
• Never giving the medicine.
• Failing to record the administered medication
• Failure to observe the effect of the administered medication

Blood transfusions steps

• Performing blood/blood product transfusion procedures in accordance with scientific criteria and without complications.

Ensuring Surgical Safety

• Right Side or Correct patient surgery.

Ensuring Radiation Safety

• Radiation is the movement of energy in the medium in the form of particles or electromagnetic waves.
• Protective gear should be used, minimize area of exposure, close doors and pregnant individuals must be informed

Prevention of Patient risk to falls via precaution

• Awareness of patient risk of falls
• Taking necessary precautions.
• Falls can result in pain, permanent disability, and death.

Identifying Patient Risk of Falling

• Fall Risk Scale is used for determining risk of patient’s falling
• The Hendrich II Scale or the Itaki fall risk scale
• Evaluation should be made within 12 hours of admission, change of departments or medical conditions, or any instance’s one has fallen

Preventing Patient Falls

• Assess fall risk, monitor falls, and hang appropriate signage where needed
• Identify risky areas and improve, identify risk groups, lift borders at night, and keep the patient bed at the lowest level
• Handles for patient's usage, appropriate lighting
• Utilize restrictors to physician's standards
• Patient rooms should be large enough
• Educate patients
• Place confused patients close to nurse's station

Considerations for Using Restrictions

• Should not restrict the patient more than necessary or obstruct blood circulation.
• Patients bone structure for support, but also for proper body position.
• Should be disguised
• Loosen straps every fours hours and in case of numbness, pain and color change

Infection Control

• Infections can be transferred to a body via microorganisms
• Pathogens are microorganisms that cases disease.
• Infections in hospital settings has to be controlled and prevented.
• Nonpathogenic microorganisms doesn’t cause disease in normal conditions

Infection Processes

• Incubation period: the time when it contracts the "thing"
• Appear period of symptoms
• Period of effects
• Recovery

Nosocomial Infections

• Infections that patients contract while in hospitals
• Is every infection a hospital infection?
• Only those that occur at least 48-72 hours after patient admission
• There has to be at least 10 days after patient’s discharge

Common Nosocomial Infections

• Urinary tract’s infections, respiratory tract infection, catheter related infections, and Bacteremia (blood infections).

Why are Nosocomial Infections Importan

• They delay healing, causes antibiotics, intensive care, and delays patient recovery length.

Infection Control

• Involves following and complying with sterilization,rules, physical condition, and care
• Follow guidelines for all infection with committees.

Prevention Methodology For Infections

• Sanitations, sterilization and Disinfection

Disinfection

• Removal of microorganisms except spores with inanimate object
• Is done with chemicals and antisepsis

Sterilization in medical tools

• Should be washed, packaged and have sufficient duration.
• Sterility has to be in check and cannot spoil

Sterile Control

• A process instruments are sterilized.
• The time, date and type of sterilization should be in the sterilized objects.

Radiation Precautions

• Must have protective equipment. Low energy that can cause health problems, cancer in the future.

Asepsis

• Absence of disease, with comfort of hospital equipment
• Can cause types of infections

Infection Control Measure

Includes medical and surgical procedures.

• Hand Washing Techniques
• Reduces number of pathogens . Reffered to as “Clean Technique”
• Administrated the following Medications, Enemas, Tube feedings, Daily Hygiene .
• There are 3 types: Clean, surgical, or sterile.
• Handhygiene comes first.

Medical Aspesis

• Must wash hands and clean from dirty areas
• Must be cleaned from top down.

Safe field protocol

• Not allowed to cough or sneeze
• Area must be sterile.

Techniques for operations

The process will have to be clean.

Surgical techniques

Hands must be washed pre surgery, to the elbows

Sterile technique

• Jewelry has to be removed.

Removing Sterile Gloves tips

• Check the packaging to see it’s proper.
• Don’t touch the glove at all.
• Keep the package as clean as possible and keep it flat; don’t touch the inside and take one part at a time. After use make sure the trash stays clean

Surgical Setting Tips

• You must keep all material sterile
• It is imperative to check any contamination or exposure to wet environment
• Place every object safely.

Guidelines for surgical procedure

• Ensure medical history is reviewed to prevent the spread.

Isolation

• Prevention of infection

Standard Protection

• Includes what should be with the anticipate and contact of blood.
• Wearing gowns and gloves
• Standard protection

Extended Protecton

• Should wear a gown with gloves and mask,
• Respiratory isolation and protective equipment.

Isoloation Patient

• Needs ventilation, limited materials, equipment and disposables.
• Contamination needs to be labeled and kept for a while.