Chapter 3
Safety and Infection
Control Practices
Health Care
Science
Technology
Copyright © The McGraw-Hill Companies, Inc.
Accidents and Injuries

2
Safety means freedom from danger,
risks, and injury.
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Chapter 3
Prevention

3
Injuries are
prevented by
preventing
accidents.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Governing Agencies


4
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.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Governing Agencies (cont.)

5
Manufacturers are required to
provide a copy of the MSDS for all
products they sell.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Governing Agencies (cont.)

The MSDS should contain:
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6
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.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
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.
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7
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Governing Agencies (cont.)
The Centers for Disease Control and
Prevention (CDC) has developed
standard safety precautions.
 Other governing agencies include:
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Individual states.
U.S. Department of Public Health.
Food and Drug Administration (FDA).
Environmental Protection Agency
(EPA).
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Preventing Accidents
The best way to deal with workplace
injuries is to prevent them.
 Education is the key to an accidentfree facility.
 The two main categories of accidents
are:
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9
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Accidents related to the physical
environment and equipment.
Accidents related to client care.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Guidelines for preventing
accidents
–
10
Know the environment,
including the location of
exits, stairs, fire alarms
and extinguishers, call
signals, paging systems,
and emergency lights.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
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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.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
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12
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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.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
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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.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Guidelines for client safety:
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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.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
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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.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Copyright © The McGraw-Hill Companies, Inc.
Fire Safety
Fires need 3 things
to start:
1. Oxygen (Air)
2. Fuel (any material
that will burn)
3. Heat (Sparks,
matches, flames)

17
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
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
Copyright © The McGraw-Hill Companies, Inc.
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)
19
Application
Common combustibles
Flammable liquids
Electrical
Combustible metals (magnesium)
All ABC fires
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
How to Use a Fire Extinguisher

Remember the key word PASS:
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20
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.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
When a Fire Emergency Occurs
STAY CALM
 Remember the key word RACE:

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21
–
R = Rescue.
A = Alarm. Assign someone to
pull the alarm.
C = Contain. Close the windows
and doors.
E = Evacuate.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Emergency Fire Rules



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22
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.
Copyright © The McGraw-Hill Companies, Inc.
3rd Floor Plan
Chapter 3
Emergency Fire Rules (cont.)



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23
Keep areas uncluttered.
Evacuate ambulatory clients first, then
the wheel-chair bound, then the bedbound.
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.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Definition of Body Mechanics

24
Positions and movements used to maintain
proper posture and avoid muscle and bone
injuries
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Chapter 3
Principles of Body Mechanics

25
Body alignment
depends on the
correct positioning
of the head, back,
and limbs.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
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.

26
Copyright © The McGraw-Hill Companies, Inc.
WEAR A BACK
SUPPORT!
Chapter 3
Key Components of Body
Mechanics


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27
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.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Key Components of Body
Mechanics (cont.)
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
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28
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.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Key Components of Body
Mechanics (cont.)




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29
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.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Microorganisms


30
We usually do not
notice or think about
microorganisms until
they cause some
form of physical
illness.
Remember many are
beneficial
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Nature of Microorganisms
Pathogens are microorganisms that
cause disease.
 Non-pathogens are microorganisms
that do not cause disease.
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31
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Factors That Influence Microbial
Growth

Following factors influence microbial
growth:
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Temperature.
pH, or the values used in chemistry to express
the degrees of acidity of a substance.
Food.
Moisture.
Oxygen.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Factors That Influence Microbial
Growth (cont.)
33

Aerobic microbes – live only in
the presence of oxygen.

Anaerobic microbes – grow
best in the absence of oxygen.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
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.

34
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Types of Microorganisms

Bacteria
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–
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35
A.
One-celled microorganisms
that are classified according
to their shape and
C.
arrangement.
Cause diseases such as
strep throat, pneumonia, and
tuberculosis. (Table 3-4)
Some bacteria produce
spores, which help them
reproduce.
B.
D.
E.
F.
H.
G.
I.
Name the microorganisms A to I. Click HERE to see answers.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Types of Microorganisms (cont.)

Fungi
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
Protozoa
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37
A plantlike organism that lives on
dead matter.
Cause conditions such as ringworm,
athlete’s foot, yeast infections, and
thrush.
Tiny animals found in contaminated
water.
Cause diseases such as malaria,
trichomoniasis, and amebic
dysentery.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Types of Microorganisms (cont.)

Rickettsiae
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38
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.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Types of Microorganisms (cont.)

Viruses
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39
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).
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Principles of Infection 3-5
Asepsis
 History of Asepsis
 Chain of Infection
 Signs and Symptoms of Infection
 Nosocomial Infections

40
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Definition of Asepsis
1.
Freedom from infection.
2. The prevention of contact with
microorganisms
41
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
History of Aseptic Technique

Greek Medicine
1200 BC –200 BC
–
–
42
First to study causes
of diseases, this
helped eliminate
superstitions
Sanitary practices
were associated with
the prevention of
disease
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Chapter 3
History of Aseptic Technique
43

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
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Chapter 3
Middle Ages 800 – 1400 AD
–
44
Arabian physicians
used mercuric
chloride was used to
prevent sepsis in
wounds
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Chapter 3
16th & 17th Century

Anton van
Leeuwekhoek (1676)
–
–
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45

Dutch Scientist
The Father of
Microbiology
invented
microscope
observed
microorganisms
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
19th and 20th Century
 Inez
–
Semmelweiss
identified the cause of puerperal fever
which led to the importance of hand
washing
 Louis
–
46
Pasteur (1860 –1895)
discovered that microorganisms cause
disease (germ theory of communicable
disease)
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
19th and 20th Century

Joseph Lister
–
–
47
Developed antiseptics
by soaking surgical
tools before surgery
Prior to this 80% of
patients contracted
gangrene
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
20th century

Ernst von Bergmann
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–
48
German Scientist
Introduced steam
sterilization under
pressure for treating
instruments and other
medical equipment
used for surgery
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
20th century

49
William Stewart
– Famous surgeon
from John Hopkins
– Introduced sterile
rubber gloves to
the field of
medicine
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Chain of Infection

Chain of infection
contains 6
elements. If broken,
infection will not
occur.
Infectious
Agent
Susceptible
Host
Reservoir
Portal of Exit
Portal of Entry
Mode of
Transmission
50
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Elements in Chain of Infection
Infectious Agent. Microorganisms that
normally reside on the skin.
 Reservoir. Residence of
microorganisms.

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51
Fomites are nonliving materials that
house microorganisms.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Elements in Chain of Infection

Portal of Exit.
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Mode of Transmission.
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52
Respiratory tract.
Skin.
Blood.
Gastrointestinal tract.
Mucous membrane.
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.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Elements in Chain of Infection

Portal of Entry.
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–

Susceptible Host.
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53
Respiratory tract, mucous membranes, and
gastrointestinal tract are common.
Damaged skin.
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.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Signs and Symptoms of Infection




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54
Redness
Swelling
Tenderness
Warmth
Drainage
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Nosocomial Infections


55
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
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Asepsis

Medical asepsis
–
–

Surgical asepsis
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56
Called “clean technique.”
Includes hand washing, standard
precautions and transmission-based
precautions
Called “sterile technique.”
Only sterile objects can come in contact
with sterile objects. Otherwise, they
must be considered contaminated.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Methods That Destroy
Microorganisms


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57
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.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Methods That Destroy
Microorganisms

Disinfection – using strong chemicals, such
as bleach to destroy pathogens, usually on
objects, not skin.
–

Sterilization – the most effective way to
destroy all microorganisms. Sterilization
uses steam under pressure.
–
58
Example: Bleach
Examples: autoclave, radiation, gas
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Why is cleaning your hands
between patients important?

59
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
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
No Fungus among us
HAND HYGIENE
- NO ARTIFICIAL NAILS
- CLEAN HANDS - THE MOST
IMPORTANT MEANS OF
PREVENTING
THE SPREAD OF INFECTION
Soap / Water
60
Germs don’t have a
chance with the proper
use of these weapons
Copyright © The McGraw-Hill Companies, Inc.
Alcohol-based hand
hygiene products
Chapter 3
According to OSHA standards regarding
bloodborne pathogens, handwashing should be
performed, at a minimum:
•
•
•
•
•
•
61
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
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
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.
62
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Standard Precautions



63
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.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Transmission-Based Precautions


Prevent spread of highly infectious
diseases.
Three types of precautions:
–
–
–
64
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.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3

65
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
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3

66
Gowns or aprons
should be worn
during any
procedure that is
likely to cause
splashing of blood
and body fluids
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3

67
Masks and protective
eyewear or face
shields should be
worn during
procedures that may
produce droplets of
blood or body fluids
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3

68
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
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3

69
Spills and splashes
of blood and body
fluids should be
wiped up
immediately. The
area should be
cleaned with a
disinfectant.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Infectious wastes should be placed in
special infectious waste bags or
biohazardous material bags. These are
usually autoclaved prior to disposal
70
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3

71
Report any cut, injury, needle stick or splashing
of blood or body fluids immediately
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3

Pre-procedure
–
–
–
72
Assemble need
supplies
Remove your rings,
bracelets, and watch
or push your watch
up on your arm
Wash your hands
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3

Put on face mask and goggles
–
–
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–
73
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
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Gown

Put on the gown
–
–
–
–
74
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
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
 Put
on gloves
– Pull the
glove cuffs
up over the
sleeves of
your gown
75
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3

Remove your gloves
–
–
–
–
–
76
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
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3

Remove the gown
–
–
–
–
77
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
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
Remove the Mask & Goggles
Touch only the strings. Do not touch
the outside of a contaminated mask
78
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
What Type of PPE Would You
Wear?

•
•
•
79
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
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3
STOP
WASH HANDS!
Before Entering &
Leaving
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80
Use Standard Precautions
Copyright © The McGraw-Hill Companies, Inc.
Chapter 3