Health and Safety Flashcards
What types of animals can legislation in veterinary medicine apply to?
- Livestock (must stricter rules for the role and use of drugs, especially if the animal is entering the food chain)
- Companion animals, including dogs, cats and rabbits
What are the Veterinary Medicines Regulations (2005)?
The main legislation regarding veterinary medicine in the UK. It covers:
- the control of veterinary medicine
- marketing authorisations for veterinary medicines
- classification of veterinary medicines
- requirements for SQPs
What year were the Veterinary Medicine Regulations introduced?
2005
Define an SQP
A person who is permitted to prescribe and supply veterinary medicines that fall into the, POM-VPS, NFA-VPS and AVM-GSL categories
What can a SQP help to control/manage?
- Prescription requirements
- Registration of premises
- Storage requirements for drugs including temperature and light requirements
What is the prescribing cascade?
A set of rules that allows the prescription of medicines to animals that may be off license, human medicines, or imported, if there is no suitable alternative. Should always be used in order
What does an off license product require?
Signed disclaimer from the owner acknowledging that the drug is off license
Define OFF LICENSE
An medicine that has no license for use in a specific species, or for a specific condition. i.e. it has not been specifically tested in that species or for that condition
An example is the use of omeprazole in dogs
What is the first step of the prescribing cascade?
A medicine authorised for treatment of the condition in a target species i.e. there is a dedicated drug used to treat a specific condition in a particular species
What is the second step of the prescribing cascade?
Use of another veterinary medicine authorised in the UK. This may be for another species or a drug designed to treat a different condition
What is the third step of the prescribing cascade?
Use of UK human medicine or imported EU veterinary medicines (anything being imported requires a Special Import Certificate)
What is a Special Import Certificate?
A certificate that allows the importation of a veterinary medicine from another country when there is no suitable alternative in the UK. The certificate must be signed by the prescribing vet
What is the fourth step of the prescribing cascade?
Medicines that are prepared extemporaneously (specials). Must be formulated by a vet surgeon, authorised specials manufacturer, or pharmacy.
Not common, needs strong clinical justification
What is the fifth step of the prescribing cascade?
Medicines that are human or veterinary imported from outside the EU
What are the 4 distributions of licensed veterinary medicines?
POM-V
POM-VPS
NFA-VPS
AVM-GSL
Who can prescribe a POM-V medication?
A vet.
The animal must be under their care, must have been seen recently for a clinical examination, and the vet should be working with a diagnosis or possible diagnosis
What are the rules surrounding remote prescribing?
Generally in emergency situations only. Has to have strong clinical justification
What are some examples of POM-V drugs?
Anti-inflammatories (such as metacam/meloxaid), antibiotics, some flea and worm treatments
Who can prescribe a POM-VPS medicine?
A vet, a pharmacist, or an SQP.
This drug category does not require a clinical examination, or diagnosis. Mainly used for farm animals.
What are some examples of POM-VPS drugs?
Equimax wormer for horses
Other wormers and external parasite treatments for farm animals
Some local anaesthetics
Who can prescribe an NFA-VPS medication?
A vet, pharmacist or SQP
No clinical exam required, and no diagnosis needed
What are some examples of NFA-VPS drugs?
Over the counter wormers, such as droncit
Who can supply AVM-GSL drugs?
Anyone, it has no restrictions and can be given over the counter with no special advice
What are some examples of AVM-GSL drugs?
Supplements such as YuMove
Flea treatments such as Bob Martin for cats and dogs
Can AVM-GSL products be on display to the public?
Yes. Only AVM-GSL drugs may be displayed to the public, all other categories of drug must be kept separately (e.g. in a dispensary)
How many schedules of controlled drugs are there?
5
What are controlled drugs in veterinary medicine?
Medicines that can only be prescribed by a vet, and supplied by the vet/pharmacist in accordance with the prescription.
What legislation is relevant to controlled drugs?
- The Misuse of Drugs Regulations (2001)
- The Misuse of Drugs Act (1971)
What is a schedule 1 drug?
These are drugs that are not used in practice, and only used in research settings as they are dangerous
What is a schedule 2 drug?
Drugs that must be locked away, ‘in safe custody’. Their usage and disposal must be recorded. These drugs have narrow safety margins and although they have therapeutic use, they have the potential to be abused
What is a schedule 3 drug?
Not classed as abusable, but have narrow safety margins. They are not required to be in safe custody, but usually are kept in a locked cupboard anyway
What is a schedule 4 drug?
Do not need to be locked away, but sometimes are for ease.
What is a schedule 5 drug?
Drugs that do not need to be locked away - they are much weaker preparations of schedule 2 drugs
Give some examples of schedule 1 drugs
Ecstasy, MDMA, LSD
Give some examples of schedule 2 drugs
Mainly opioids, due to their addictiveness.
Examples include methadone, ketamine, and fentanyl
What are the specifications for a DD cabinet?
- it must exist as part of the fabric of the building (mounted to an external wall)
- it should not advertise itself as a DD cupboard
- should have one person responsible for locking and securing it
How long is a prescription for a schedule 2-4 drug valid for?
Up to 28 days
Give some examples of schedule 3 drugs
Gabapentin, midazolam, phenobarbitone, and buprenorphine
Give some examples of schedule 4 drugs
Anabolic steroids, and diazepam
How long can a prescription for a schedule 5 drug be valid for?
Up to 6 months
What is specific about the disposal of schedule 2 drugs?
The drugs must be denatured (neutralised) before disposal, usually using a denaturing kit. The disposal itself must be witnessed by an appropriate person
Who can witness the disposal of schedule 2 drugs?
A vet who is not affiliated with the practice
A VMD inspector
A controlled drugs officer from the police
What is a written requisition?
A written request for the drug that is signed by the prescribing vet and sent to the wholesaler.
Give some examples of schedule 5 drugs
Pardale (contains codeine) or codeine itself
What are the prescription requirements for CD?
Prescription must contain:
- the quantity of the drug (in words and numbers)
- the strength of the drug (in words and numbers)
- instructions for dosing
- the original prescription must be presented prior to prescribing
These are requirements for CD, and desirable for POM-V
What is the Veterinary Medicines Directorate?
An executive agency, within DEFRA. It aims to promote and protect animal health and welfare, and it also assures the quality, safety and efficacy of veterinary medicines
What does the VMD do?
- controls all national marketing authorisations for veterinary medicines
- controls the manufacture and distribution of veterinary medicines
- monitors adverse reactions to veterinary medicines
- enforces UK legislation for veterinary medicines
- monitors residues in animals and animal products
Define PRESCRIPTION
An instruction written by a medicinal practitioner that authorises a patient to be issued with a medicine or treatment
What are the legal requirements for a prescription?
- name and address of those prescribing, including credentials (MRCVS, SQP etc)
- name and address of the owner/keeper
- identification of the animal (s) that the prescription is for
- date of prescription
- signature of person prescribing
- name and amount of product prescribed
- dosage and administration instructions
- any necessary warnings
- any applicable withdrawal period
- must be written in indelible ink
What is the method of disposal for whole pharmaceuticals?
A blue DOOP (disposal of old pharmaceuticals) bin
Solids and liquids should be separated, and all medicines should remain in their original packaging. All contents should be recorded.
What is the method of disposal for controlled drugs?
Denatured, then put in normal DOOP bin.
Schedule 2 should be with supervision
What is the method of disposal for cytotoxic drugs?
In their own purple topped disposal bin. Must be kept separate from other waste/drugs and they are hazardous.
What is the method of disposal for needles contaminated with drugs?
Yellow sharps bin. They are hazardous
What is the method of disposal for sharps with no pharmaceutical (blood is permitted)?
Orange sharps bin.
Still hazardous, but do not require incineration
What are some possible consequences of poor health and safety to humans?
- employee injury
- employee absence
- employee ill health
- injury to clients
All of these can result in loss of income for the business
What are some possible consequences of poor health and safety to a business?
- increased cost to cover staff injury
- possible criminal proceedings (and related costs)
- loss of business and a possible poor reputation
What is the Health and Safety at Work Act (1974)?
The main piece of legislation that governs health and safety while at work. Employers must keep the workplace safe, provide appropriate PPE (specifically for zoonotic diseases), provide first aid facilities, keep records of accidents and injuries etc.
When was the Health and Safety at Work Act introduced?
1974
What are some employer responsibilities in regards to health and safety at work?
- to have Employer’s Liability Insurance (and make sure it is up to date)
- to have a safe and healthy work environment for workers including toilets, washing facilities, drinking water and suitable lighting/temperature
- to report certain work related illnesses, diseases and incidents to RIDDOR
What are some employee responsibilities in regards to health and safety at work?
- taking reasonable care for their own health and safety, and that of others
- cooperating with employer on health and safety
- correctly use work items provided by the employer, including PPE
What is the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (2013)?
Also known as RIDDOR
Legislation that requires employers to report and keep records of work related accidents and incidents.
What is Employer’s Liability Insurance?
Insurance that covers an employer if an employee gets injured at work and decides to make a claim.
It is a legal requirement for all businesses.
What are two specific instances that would be reported to RIDDOR?
Occupational dermatitis
Carpal tunnel syndrome
What is the correct work:break ratio?
For every 6 hours work, an employee is entitled to a 20 minute break
When should a risk assessment be performed?
For any potentially hazardous procedure. The risk assessment is used to help determine what in practice could cause harm to people, so decisions can be made as to whether there are enough precautions in place to reduce risk
Define HAZARD
Something that may cause harm
What are the 5 key stages of a risk assessment?
- Identify the hazard
- Decide who may be harmed and how
- Evaluate risks and decide on precautions
- Record and implement findings
- Review and update risk assessment
What are some common hazards in a veterinary practice?
- Handling/restraint of animals (bites/scratches)
- Ionising radiation
- Chemicals
- Veterinary medicines
- Manual handling
Name some particularly vulnerable groups who may be more affected by hazards
- Disabled people, may be clients or employees
- Young people e.g. those in for work experience
- New mothers or pregnant women
- Asthmatic people
- Client, or those with no clinical training
What are some appropriate control measures for reducing risk?
- switching to less hazardous products with the same effectiveness
- organising work to reduce exposure e.g. chemical restraint for x rays rather than manual restraint
- correct use of PPE
- removal of the risk altogether
How many employees does a business have to have for it to record the findings of a risk assessment?
5, but it is recommended for all businesses
How often should risk assessments be reviewed?
At least annually, but more regularly if circumstances change, e.g. a new piece of equipment
What are task assessments?
Risk assessment for specific tasks that staff are expected to perform. They are classed and low, medium or high risk
Define an SOP
Standard operating procedure.
Written protocols for each job within the practice
They are influenced by the findings of the risk and task assessments
Give some examples of SOPs
- dispensing drugs
- spillages
- use of the autoclave
- manual handling
- use of lab equipment
- radiation protection
What areas of practice may have specific SOPs?
- Reception/waiting area
- Consult rooms
- Prep area
- Operating theatre
- Patient accommodation
What is COSHH?
The Control of Substances Hazardous to Health
A set of regulations put in place to protect employees from ill health when working with specific substances or materials.
There should be datasheets for each potentially hazardous substance
What are the Ionising Radiation Regulations (1999)?
A set of regulations that requires practices to assess risks, identify hazards, evaluate risks and identify measure to help reduce staff exposure to radiation
When were COSHH regulations introduced?
2002
What are the anaesthetic gas limits?
Halothane - 10ppm
Isoflurane - 50ppm
Sevoflurane - 60ppm
Nitrous oxide - 100ppm
These are over an 8 hour weighted average
What is a Radiation Protection Advisor?
Someone external to the practice who advises on best practice for the imaging machines and radiation use.
May be a suitably trained vet or a human radiographer
What is a Radiation Protection Supervisor?
Someone within the practice whose role it is to supervise any x rays taken and ensure that local rule are followed
What are examples of PPE used for radiation protection?
Lead aprons, lead gloves, lead thyroid protectors. Should be at least 0.35mm thick
Give some examples of potentially hazardous substances in a veterinary practice
- chemicals
- veterinary medicines
- clinical waste
- animal tissue
- cleaning agents
- imaging radiation
What are some examples of low/medium risk substances in a veterinary practice?
- antibiotics
- injectable anaesthetics
- steroids
- disinfectants
What are some examples of high risk substances in a veterinary practice?
- cytotoxic drugs
- hormones
- oil based vaccines
What is the NOAH compendium?
A comprehensive list of all data sheets for veterinary medicines
NOAH - National Office of Animal Health
What legislation governs the use of cleaners and disinfectants in practice?
Chemicals (Hazardous Information and Packaging for Supply) Regulations (2009)
Which piece of legislation controls the use of asbestos?
The Control of Asbestos Regulations (2006)
Who regulates the disposal of waste?
The Environment Agency
What is a waste transfer note?
One should accompany each movement of waste. It should be signed by both parties, and be kept for 2 years
How much hazardous waste per year does a practice need to produce before it needs to register with the Environment Agency as a hazardous waste producer?
500kg
This is under the Hazardous Waste (England and Wales) Amendment Regulations (2009)
What are yellow or orange waste bags used for?
Infectious waste
Yellow bags are incinerated, orange bags are not
What is classed as offensive waste and how is it disposed of?
Non clinical waste that is non infectious (no pharmaceuticals or chemicals).
Examples include animal faeces, disposable gloves, masks, swabs etc
Black/yellow ‘tiger bags’
What legislation governs fire safety?
The Regulatory Reform Fire Safety Order (2005)
What is required under the The Regulatory Reform Fire Safety Order (2005)?
Requires employers, building owners and occupiers to complete fire risk assessments, covering all staff and clients, and take reasonable steps to reduce the risk from fire, ensuring that people can safely escape from one.
Give some examples of fire risks in a veterinary practice
- oxygen cylinders
- volatile liquids
- dryers
- cooking equipment
What legislation helps to govern use of practice equipment?
The Electricity at Work Regulations (1989)
What is required under The Electricity at Work Regulations (1989)?
Regular servicing of all electrical equipment and PAT testing of portable electrical equipment (should be at least every 2 years)
What are the Health and Safety (Display Screen Equipment) Regulations (1992)?
Legislation that requires employers to examine the design of work stations, the task being carried out and the specific needs of the individual staff in order to assess risks linked to screen use
What are some typical consequences of frequent use of screens at work?
- eye strain
- headaches
- back/neck/muscle pain
- poor posture
- aching limbs
What is the correct ratio for screen use and breaks?
A 5-10 minute break for every 60 minutes of continuous screen use
What are some hazards on a home visit?
- Difficult to handle animals
- Security
- Lone working (should have two members of staff where possible)
What are the Manual Handling Operations Regulations (1992)?
The main piece of legislation that governs manual handling and its safe use in the workplace
What are some possible risks of manual handling?
Injury, including repetitive injuries
What factors should be considered when assessing manual handling tasks?
- the task itself
- the load
- the working environment
- the individual’s capability
- trip/slip hazards
What methods are used to mitigate the risk of manual handling?
- use of mechanical assistance, such as trolleys or lifts
- storing heavy items on low shelves
- avoiding manual handling altogether
What are some guidelines for manual handling?
- assess the load before starting
- ask for assistance where available
- ensure the area is clear from hazards
- lift with thighs, not with the back
What should be done for an incident if it is not significant enough to be reported to RIDDOR?
It should be recorded in the practice accident book. These records should be kept for 3 years
What are some consequences of staff burnout?
- increased illness
- increased staff turnover
- higher human error
- disinterest and resulting lack of patient care
What are the Health and Safety (First Aid) Regulations (1981)?
Legislation that requires qualified first aiders to be on site. Requires all accidents to be recorded, and these records kept for 3 years.
What are some examples of incidents that must be reported to RIDDOR?
- death
- electric shock
- poisoning
- amputations
- certain work related diseases (e.g. occupational dermatitis)
+ any injury or illness that requires the employee to be off for more than 7 days. Must be reported through the HSE website within 15 days
An incident that requires the employee to have 3-7 days off should be recorded, but not needed to go to RIDDOR.
After how long should significant incidents that have been reported to RIDDOR be reported to the Incident Control Centre?
Within 10 days
Name the legislation relevant to health and safety in veterinary practice
- The Health and Safety At work Act (1974)
- The Control of Substances Hazardous to Health (2002)
- The Electricity at Work Regulations (1989)
- The Hazardous Waste Regulations (2005)
- The Environment Protection Act (1990)
- Ionising Radiation Regulations (1999)
- The Reporting of Injuries, Diseases and Dangerous Occurences Regulations (RIDDOR) (2013)
- The Waste Electrical and Electronic Equipment Regulations (2013)
- Health and Safety (Display Screen Equipment) Regulations (1992)
- The Regulation Reform Fire Safety Order (2005)
- Veterinary Medicines Regulations (2005)
- Misuse of Drugs Act (1971)
- Misuse of Drugs Regulations (2001)
What are the The Hazardous Waste Regulations (2005)?
Legislation that governs the disposal of waste, both hazardous and non-hazardous.
What colour bag is anatomical waste disposed of in?
A red bag
What is the Environment Protection Act (1990)?
Legislation that governs the correct disposal of controlled waste, and punishes those who dispose of it in an unauthorised way.
Linked to the Hazardous Waste Regulations (2005).
What are local rules in the context of x rays?
A brief overview of the greatest risks and guidelines of using ionising radiation e.g. no under 16s. Should be pinned up near x ray and signed by all who use the equipment
At what level should radiation exposure be kept to?
ALARP - as low as reasonably possible
How far away from the tube head should you stand when taking an x ray?
2m
What is a dosimeter?
A device that measures the exposure to radiation. It should be worn every time a person is involved in taking x rays.
What is a notifiable disease?
A disease you are legally obliged to report to the APHA/DEFRA if identified e.g. rabies, brucellosis, avian influenza
What are The Waste Electrical and Electronic Equipment Regulations (2013)
Legislation that requires businesses to reduce their amount of electrical waste through recycling, reusing, responsible disposal etc
What are the requirements for an Employer Liability Insurance policy?
- must be renewed annually
- document should be kept indefinitely
- a minimum cover amount of £5 million
- must be kept visible to employees
Employers must also display an up to date Health and Safety poster
What does COSHH cover?
- chemicals
- medications
- fumes
- diseases, specifically zoonotic
What does COSHH not cover?
- lead poisoning
- asbestos
- x ray radiation
Give some examples of PPE in veterinary
- disposable gloves
- disposable masks
- disposable aprons
- shoe protectors
- goggles
Define FOMITE
Any inanimate object that can harbour bacteria
What are WELs?
Workplace Exposure Limits - the maximum amount of a substance an employee can be exposed to over a period of time, e.g. anaesthetic gases.
Readings should be taken every 6 months
How many zoonotic diseases are there in the UK?
Around 40
Give some examples of zoonotic diseases that are not notifiable
Giardia, leptospirosis, ringworm
What is the purpose of a clinical audit?
Helps to check and reflect on performance, and identify where improvements need to be made. Linked to EBVN
What is professional indemnity insurance?
Covers RVNs/MRCVS if a claim is made against them by a client. Usually provided through practice, but locum workers should have their own.
Can be got through the VDS
