2.1.1 Adheres to health and safety policies in the practice including the ability to implement appropriate measures for infection control.

Question 1

What happens if a px goes unconscious

Answer 1

If the person is breathing and it is unlikely that they have a spinal injury, roll them into a recovery position on their side. Adjust their legs so their hips and knees form right angles. Tilt their head gently back to help keep their airway open.

Question 2

The Room…

Answer 2

• Essentially, every solution must be in date with caps on, the room cannot look like a mess. It should smell nice too and you must sanitise trial frame, slit lamp, patient chair, handheld occluder etc & use hand sanitiser along with having appropriate PPE (Type 2 or type 2R surgical masks, Aprons, Gloves)
• Put open date on solutions - must be used within 3 months after opening

Question 3

Health and Safety at Work etc Act 1974

Answer 3

• Controls risks to persons at work and other persons in connection with the activities of persons at work i.e. patients etc
• https://www.college-optometrists.org/clinical-guidance/guidance/safety-and-quality/health-and-safety-on-the-premises#Principlesofhealthandsafety
• Identifying hazards, Risk assessment, First aid
• Must provide adequate first aid facilities. First aid Box:
  
  • a leaflet giving general guidance on first aid (for example, HSE’s leaflet Basic advice on first aid at work);
    individually wrapped sterile plasters (assorted sizes), appropriate to the type of work (hypoallergenic plasters can be provided if necessary);
    sterile eye pads;
    individually wrapped triangular bandages, preferably sterile;
    safety pins; - to secure the wrap of a wound dressing
    large sterile individually wrapped unmedicated wound dressings;
    medium-sized sterile individually wrapped unmedicated wound dressings;
    disposable gloves (for advice on latex gloves please see Selecting latex gloves)
• Must report to employer/supervisor/manager if you think inadequate precautions are being put in place causing risk to yourself &/or the px

Question 4

Fire estinguisher use

Answer 4

• CO2 fire extinguisher used for electrical fires & class B fires (flammable liquids, gases, oils)
• Dry powder exstinguishers is for class A,B,C & electrical fires up to 1000V

Question 5

Risk Assessment

Answer 5

• If you do something incorrectly, you have a duty of candour to the px.
• Be candid when things have gone wrong
  Offer an apology
  Offer appropriate remedy
  Explain potential effects
  Say what you will do to prevent it happening again
• not admitting liability or wrong doing (not admitting that you have to pay for damages)
• an apology or other step taken in accordance with this guidance does not of itself amount to an admission of negligence or a breach of statutory duty
  1. Something must have actually gone wrong, not a near-miss. AND 2. the patient must have suffered psychologically or physically. This is different to a complaint. This can turn into a complaint though if the px makes a claim against you.

Question 6

Make sure environment & equipment is hygienic, minimise infection

Answer 6

PPE regulations 1992 - ensure that suitable personal protective equipment (PPE) is provided free of charge “wherever there are risks to health and safety that cannot be adequately controlled in other ways.” The PPE must be ‘suitable’ for the risk in question, and include protective face masks and goggles, safety helmets, gloves, air filters, ear defenders, overalls and protective footwear

Question 7

Manual handling

Answer 7

Must avoid as much as possible to get involved in helping a physically disabled person get out & into wheelchair. Of course, ask if they need help but you should avoud manual handling where possible to prevent preventable injury

Question 8

Ensure equipment is appropriately maintained

Answer 8

ensure the safety and suitability of work equipment for the purpose for which it is provided;
properly maintain the equipment, irrespective of how old it is; protect employees & patients from dangerous parts of machinery

Question 9

other health and saftey

Answer 9

• Follow regulations on drops & substance use
• Dispose of things correctly (see below)

Question 10

Hygiene

Answer 10

• COVID - https://www.college-optometrists.org/clinical-guidance/covid-19-clinical-guidance
  
  • Might want to learn the importance of the optical wipes in Specsavers & why they disinfect so well
• Hand sanitiser must be 60% alcohol or more, fragrance free & suitable for sensitive skin
• Masks must be type 2 or 2R disposable masks
• Infection Control - https://www.college-optometrists.org/clinical-guidance/guidance/safety-and-quality/infection-control

Question 11

Disposal of Waste

(you must know where each of these bins are in your practice!)

Answer 11

1. General Domestic Waste
   This can be disposed of in the normal way
2. Non-hazardous waste
   This includes disposable tonometer heads, used iCare probes, used Tonopen sheaths and large quantities of contact lenses. These items are classed as ‘offensive’ waste but do not present a risk of infection, and should be disposed of in a yellow and black striped ‘tiger’ bag for incineration
3. Non-hazardous pharmaceutical waste
   This includes used or out of date minims and fluorets. These must be discarded in a medicine disposal box, which is normally coloured yellow, for incineration. Disposal transfer notes for this type of waste should be kept for at least two years
4. Hazardous waste
   This type of waste requires specialist disposal and a hazardous waste note from the waste contractor, and notably includes chloramphenicol. Computer monitors, fridges, some batteries, some cleaning products. Disposal boxes are normally coloured purple (cytotoxic). Consignment notes for this type of waste should be kept for at least three years.
   
   1. Has hazordous waste symbol on the bin itself!
5. Sharps
   Some optometrists may use sharps for procedures such as removing corneal foreign bodies or performing blood tests. These should be disposed of in a sharps box, colour coded to indicate whether the waste is infectious. It is disposed of using autoclaving, whereby it is sterilized using steam to decontaminate & then dispose of in a regular fashion as regular waste
6. PPE - keep in separate bin to other waste and in a black bag. It should then be disposed of after every 72 hours to allow decontamination

Question 12

Disinfection of Tonometer Heads