302 - impact of health and safety legislation. Flashcards
Purpose of health & safety?
Set of rules and guidelines for employers to follow to protect employees and patients.
Purpose of legislation?
Protect public from workplace.
Health and Safety at work act
- Enforced by HSE.
- Protects staff and patients by informing of potential hazards.
- Practice is visited by inspectors.
What should a practice with more than 5 employees have?
A health and safety policy
What is the policy made up of?
A statement of intent - practices commitment to managing health and safety.
Health and Safety (sharps instruments in healthcare) regulations.
Responsibility of ensuring risks of sharps is assessed and measures in place to prevent sharps injury.
What happens when there is a sharps injury?
Record in accident book.
Investigate so doesn’t happen again.
What measures should individual with sharps injury take?
- Hold wound under running water
- Dry wound with waterproof plaster/dressing.
- If necessary go to occupational health.
what does COSHH stand for?
Control of substances hazardous to health.
What do COSHH do?
Require employers to control substances that are hazardous to health.
How do employers control substances?
Find out the health hazards and prevent harm to health.
What substances used in dentistry are seen as hazardous?
- Acid etchant, burns when in contact with skin - hold aspirator close.
- Amalgam - wear correct PPE, dispose in amaglam tub.
Purpose of current ionising radiations regulations.
Ensure radiation is used safely to protect patients from risk of harm during exposure.
Current ionising radiation (medical exposure) regulations.
- Prevent exposure to radiation - step out of room.
what is the minimum safety distance.
2 meters.
Dental practice radiation responsibilities
- minimise exposure for only necessary.
- justify use of exposure, benefit outweighs risks.
- optimise diagnostic doses, keep as low as possible.
What must local rules contain?
- Designated area for x-ray
- Instructions how to safely work with x-ray.
- Dose investigation level stated.
- Radiation protection supervisor stated.
Current Regulations in Reporting of Injuries, Diseases, Dangerous Occurrences Regulations (RIDDOR).
Involves reporting injuries, disease and dangerous occurrences in workplace.
When should you report to HSE.
If it causes more than 7 days absence fro work.
What is ergonomics?
Study of working conditions and how we adapt them to support workers.
Examples of ergonomics?
- Stair lift
- Adjustable seating
- Chair with backrest to follow spine curvature.
what are the steps of a risk assessment?
- identify the hazard
-identify who may be harmed
-evaluate the risk
-control the risk
-record the risk assessment findings
-review the assessment process
what is the aim of a risk assessment?
to minimise risks identified so there is little chance they harm anyone
what does a COSHH written report include?
every potential chemical hazard found :
- hazardous ingredient
-nature of risk
-possible health effects of hazardous ingredient
what hazardous substances are found in a dental practice?
mercury exposure
acid etchant
sodium hypochlorite
nitrous oxide exposure
where should chemicals be stored?
in cupboards away from public access
where should mercury be stored?
in a cool cupboard in properly sealed containers
where should oxygen and nitrous oxide cylinders be stored?
ideally outdoors, if not then a well-ventilated fire resistant store
how is ventilation achieved?
open windows
extractor fans
why is adequate ventilation essential?
to prevent accumulation of hazardous vapours and gases
what is the ideal room temperature in a dental practice?
20c
what is mercury?
a liquid metal mixed with various metal powders to form dental amalgam
how can mercury enter the body?
inhalation: toxic vapours
absorption: through skin, nail beds and eye
ingestion: particles contaminate food and drink
since 2018 who has amalgam been banned to use on?
deciduous teeth
permanent teeth of under 15
pregnant and nursing mothers unless necessary
how to handle a mercury spillage?
use of capsulated amalgam products
should all mercury spillages be reported even if they are small?
yes - a written report should be done
why is it important mercury spillages are reported?
in the event of long term health effects, report provides evidence of correct procedures being followed
what to do if a small spillage occurs?
wear PPE
suck up small globules into aspirator
put particles into waste amalgam container
what to do if a large spillage occurs?
wear suitable PPE
open windows to ventilate
inform senior staff
use mercury spillage kit
mix powders and use on spillage
once dry, wipe contaminated paste and spillage with damp towel
when should the HSE be informed of a mercury spillage?
when the spillage is the size of a full bottle of mercury
what is acid etchant?
chemically roughen the enamel surface and ensure bonding of filling
what material is etch?
phosphoric acid
what can happen is etch contacts the skin?
burn soft tissues
what is sodium hypochlorite (bleach)?
a disinfectant which plays a major role in decontamination
how much solution is used to disinfect non-metallic/non-fabric surfaces
10,000ppm (1%) solution
how much solution is used to disinfect impression?
10,000ppm (1%)
what does HTM 07-01 relate to?
safe management of healthcare waste
why must healthcare waste be segregated appropriately?
-items may cause injury when handled
-items may be infectious and cause cross-infection
-chemicals may damage environment
what is non-hazardous waste?
-offensive waste (non-contaminated PPE) - yellow bag with black stripe
-non-cytotoxic/cytostatic medicines (out of date) - yellow/blue tub with blue lid
-domestic waste (staffroom/kitchen) - black bag
-office waste - recycling
what is hazardous waste?
-bagged clinical waste: orange sack
-sharps waste: yellow lidded container
-sharps waste uncontaminated with medicines
-sharps waste contaminated with medicines
what must every practice ensure in relation to waste management?
-have a written healthcare waste policy
-segregate waste and store safely
-use correct storage containers
-securely fasten orange waste bags
what does the Health and Safety (display screen equipment) Regulations cover?
protect Health and Safety of workers who use display screen equipment.
what should be considered in a workstation risk assessment for DSE users?
-Adequate workstation training for staff
-Workstation issues
-Display screen issues
-Regular breaks from workstation
-Eyesight test for staff who experience headaches/eyestrain after DSE use
what does Health and Safety (First-Aid) Regulations cover?
Requires employers to provide adequate and appropriate equipment, facilities and personnel to ensure employees receive immediate attention if injured/ill.
where must the first aid kit be located?
in an easy access sign posted location
first aid principle for severe bleeding?
restrict the blood flow to wound and encourage clotting to reduce blood loss
what does arterial bleeding do and what colour is it?
-it spurts rhythmically and is cherry red
what does venous bleeding do and what colour is it?
-it gushes quickly and is dark red/purple
what does capially bleeding do and what colour is it?
- it oozes and is dark red
what is required treatment for severe bleeding?
- raise the injured part above heart and apply direct pressure to wound for up to 15 minutes
what is a burn?
injury caused by dry heat, corrosive chemicals or irridation
what is a scald?
a wet burn caused by steam or hot liquids
what is the first aid principle for burns and scalds?
prevent infection of underlying tissues and prevent clinical shock developing due to loss of blood serum
what is the required treatment for burns and scalds?
to remove patient from source of danger and reassure if they are conscious
what to do with injured part of body from a burn/scald?
place under cold water for minimum of 10 minutes to reduce blistering
what is the first aid principle for poisoning?
to limit the exposure of the casualty to poison and maintain life if necessary
what is the required treatment for poisoning?
to remove the casualty from the source of poison without endangering other lives.
what do you provide when vapours are the cause of poisoning?
good ventilation
what is electrocution?
an electrical current passing through the body
what is the first aid principle for electrocutions?
to remove the casualty from the electrical source and maintain life
what is required treatment after electrocution?
to isolate the electrical supply if safe to do so
until electrical supply is isolated can you touch the casualty?
no
what is a fracture?
break of a bone, either contained within surrounding soft tissues or puncturing through them
what is the first aid principle for fractures?
to prevent further tissue damage by restricting movement of casualty
what is the required treatment for fractures?
not move any injured part of body and to cover open skin wounds
what is manual handling?
actions which involve hands-on moving or lifting of items without support of lifting equipment
what must be considered when deciding if manual handling task is hazardous or not?
- weight/size of object being moved
-likelihood of staff having to reach,bend or twist
-frequency of manual handling task
what to consider with a heavier load?
-split load to make it lighter
-ask other staff to help lift and move it
what is likely to cause injury when manual handling?
twisting and bending while lifting and moving a load
what training should staff have for manual handling?
correct handling technique in moving and lifting objects
what types of equipment does the Pressure Systems Safety Regulations relevant to?
Autoclaves and air receivers (compressors)
what do autoclaves do?
sterilise hand instruments and items used on patients so they are safe to reuse
what to air receivers do?
compress atmospheric air used to drive dental handpieces and suction units
what hazards are associated with working autoclaves?
-high temperatures produce steam = scalds
-high pressures may blow open unsecured door causing injury to someone near
how must autoclaves and large air receivers comply with regulations?
- before initial use, ‘competent person’ must draw up written scheme of examiantion
-written records of examination kept
how often must autoclaves be inspected?
every 14 months
how often must large air receivers be inspected?
every 2-4 years
what must periodic examination and inspection of pressure vessels include?
- servicing
-performance testing
-maintenance
-safety examination
What does the Regulatory Reform (fire safety) Order 2005 relate to?
The employer/owner of premises is responsible person - reduce risk from fire
what does a fire risk assessment consider?
-identify fire hazards on premises
-identify who may be harmed
-evaluate the risk of a fire occurring
-control the risk by taking precautions
-record risk assessment findings
-review risk assessment periodically
what does a fire safety inspection advise?
-number and positioning of smoke detectors
-number and positioning of fire extinguishers
-written records of staff training in use of fire extinguishers
-types of fire extinguishers to be provided (minimum 2)
what is a manual system for fire warning?
small open plan workplace
unlikely for fire to break out
basic smoke alarm
whistle/klaxon horn raise alarm
what is an electrical system for fire warning?
larger workplaces - several storeys
whistle/horn unlikely to be heard
activated manually by breaking glass
what is an automatic system for fire warning?
for larger premises (clinic/hospital)
require expert design and installation
how many employees does a workplace need for an emergency fire plan?
5 or more
what should every emergency fire plan include?
actions staff taken in event of fire
warning system used e.g. klaxon/whistle
contacting fire service: dial 999 ask ‘fire’
evacuation procedures
started assembly point and attendance check
key escape route
location of fire equipment
responsibilities of nominated staff
record of regular staff training
what is a class A fire caused by?
ignition of carbon-containing items: paper/wood/textiles
what is a class B fire caused by?
flammable liquids: oils/solvents/petrol
what is a class C fire caused by?
flammable gases: domestic gases/butane/liquefied petroleum gas
what is a class D fire caused by?
reactive metals that oxidise in air: sodium/magnesium
what is a class F fire caused by?
liquid fats: used in kitchens/restaurants
what is a red (water) extinguisher used for?
all except electrical fires
what is a black (carbon dioxide) extinguisher used for?
all fires
what is a blue (dry powder) extinguisher used for?
all fires
how often must extinguishers be inspected and certificated?
annually by competent person
where should extinguishers be located?
in easy reach, along escape route ideally
in conspicuous position - not hidden
on wall mounting signposted
in similar position on each level of premises
what must escape routes be free from?
obstructions to allow immediate evacuation
where must fire exits lead to?
directly to place of safety
how must fire exits be marked?
clearly with green sign with pictogram of running man
how is emergency lighting activated?
automatically when fire alarm starts
what direction do emergency doors open?
direction of escape, shouldn’t operate electrically
what doors shouldn’t be used as fire exits?
sliding or revolving doors
where should ‘no smoking’ signs be located?
at each entrance
what does RIDDOR stand for?
Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013
what does RIDDOR require employers to notify HSE?
major accidents and dangerous occurrences that happened on premises
how long must an accident that causes absence last to report to HSE?
more than 7 days absence from work
what are the 2 categories that accidents fall under in workplace?
minor accident and major accident
what is a minor accident?
result in no serious injury to person or premises
dealt with in house
should a written record be made when a minor accident occurs?
Yes in the accident book
what is an example of a minor accident?
trip or fall - no serious injury
clean needlestick injury
minor mercury spillage
what is a major accident?
results in serious injury or death to a person or severe damage to premises
what are major accidents classed as?
significant events
who should major accidents be reported to?
the HSE
what injuries MUST be reported?
death of any person
fracture of skull, spine or pelvis
fracture of long bone of arm or leg
amputation of hand or foot
serious burns of more than 10% of body
injury requiring 24 hour hospital trt admission
what occupational disease must be reported when it is likely to have been caused or worsened by persons usual work?
carpal tunnel syndrome
severe cramp of hand or forearm
occupational dermatitis
hand-arm vibration syndrome
occupational asthma
inflammation of tendons or sheath
any occupational cancer
disease caused by occupational exposure to biological agent
what diseases must be reported to RIDDOR that cause acute ill-health by infection with dangerous pathogen?
legionella
hepatitis B or C infection
HIV
what is a dangerous occurrence?
significant event that could result in serious injury or death to anyone on premises
what dangerous occurrences must be reported?
explosion, collapse or burst of pressure vessel
electrical short circuit or overload causing more than 24 hour stoppage
explosion of fire due to gases/inflammable products causing more than 24 hour stoppage
uncontrolled release or escape of mercury vapour due to spillage
how often should PAT testing be done?
every 1-3 years
what does the Water Supply (water fittings) Regulations 1999 relate to?
mains water supply provided to dental workplace must be protected by back-siphonage, where contaminated water is drawn back
how is backflow of water prevented?
presence of air gap between point where main water exits tap/connecter and point where it enters dental water unit line
what dental equipment is affected by these regulations?
dental spittoon
delivery system: bracket table with handpieces
wet-line suction equipment
washer-disinfector machines
automatic radiograph processors
how do workplaces abide by HSE to prevent legionella infection?
assess risks of legionella contamination in workplace
prepare written course of action for preventing/controlling the risk
use competent services to help in applying health & safety requirements
between what water temperatures may legionella increase?
if water lies above 20 degrees to below 45 degrees
how do you know if a solution is effective?
if the colour range is 80ppm or above
how often should DUWLs be flushed through before the first patient?
2 minutes
how often should DUWLs be flushed through between each patient?
20-30 seconds
why should DUWLs be flushed often?
help reduce build-up of biofilm in lines
what are occupational hazards?
those that a staff member may encounter during normal working day due to nature of their work while in workplace
examples of occupational hazards in the dental workplace?
exposure to ionising radiation
cross-infection and inoculation injuries
exposure to hazardous chemicals:
-mercury
-acid etchant
-sodium hypochlorite
-nitrous oxide
exposure to hazardous waste
exposure to lasers/curing lamps and teeth whitening
use of display screen equipment (DSE)
how can lasers cause harm in the dental workplace?
generate intense narrow beam of light or other electromagnetic radiation use to cut hard or soft tissue
what danger do lasers pose?
damage to the eyes if viewed directly
burn other tissues if beam is too intense
how can curing lamps and teeth whitening lamps cause harm in the dental workplace?
use blue halogen bulbs as their electromagnetic radiation light source
what danger can curing lamps pose?
damage to the retina if viewed without orange-tinted shield/safety glasses
what are general safety measures?
relate to any workplace where staff are employed to provide service to public
what are the general safety measures to prevent injury?
safe entry which is adequately lit with no obstructions
non-slip floor coverings
no dust traps in decor of surgical areas
no sharp edges on furniture or fittings
guards around fires and heaters to prevent burns
no trialing electrical cables
what are general security measures?
locking the premises during times where we are low in staff to not be left vulnerable and open to attack
how is security maintained during the day in the dental workplace?
ensuring premises is only accessed by those who have right of entry
what methods can be used to achieve security during the day?
locked entry point with speaker phone
fire exits which can only be opened from inside
entry way that has to pass through reception
panic button
how is security maintained out of hours?
adequate alarm system in place
only senior staff given alarm code
key holders kept to minimum
loss of key must be reported immediately to employer
ensure all monies are banked daily
all windows have locks on them
