Infection Control, HIPPA, Electrical safety and more Flashcards
What is the standard line voltage in the US?
120v
What does GFCI stand for?
Ground Fault Current Interuptions
What type of shock passes through a patients torso?
Macro Shock
What type of ground is used for common mode rejection?
Patient ground
What type of metal are subdermal electrodes made out of?
Steel or platinum
What does the nasopharyngeal electrode record from?
Anterior Mesial surface of temporal lobe
Why type of allergic reaction is life threatening?
Latex hypersensitivity
What % of healthcare workers have a latex allergy?
5-10%
What is the advantage and disadvantage for collodian use?
Advantage: Secure
Disadvantage: Exposure to harmful agents
What is the advantage and disadvantage for paste use?
Advantage: No harmful agents
Disadvantage: May dislodge, causing artifact
Where does the Sphenoidal electrode record from?
Inferior lateral surface of temporal lobe
Where do electrocorticographic electrodes record from?
The Cortex during neurosurgery
What is the function of Subdural electrodes?
To stimulate cortex to map cortical function & localize epileptiform activity
HIPPA Breach Notification Rule
Notification of breach or unsecured PHI
HIPPA Privacy Rule
Protects the privacy of the PHI
How does HIPPA affect the healthcare provider (part 2):
BAs & CEs must comply with HIPPA Rules:
-Interaction/use of PHI (see, use or share)
-Patient interaction
How does HIPPA affect the healthcare provider?
HIPPA protects patient health information held by:
1. CEs: Covered entities (Doctors, pharmacies etc)
2. BAs: Business associations
What patient information MUST be protected?
All personal and health information that exists for every individual in any form
-Written
-Oral
-Electronic
This information is considered to be Protected Health Information (PHI)
Occupational Safety & Health Act (OSHA)
-US department of labor
-OSHA issues workplace health and safety regulations
What are other names for Material Safety Data Sheet (MSDS)
Also known as:
-Safety data sheet (SDS)
-Product data sheet (PDS)
HIPPA Security Rule
Sets standards for the security of electronic PHI
HIPPA Regulations
Privacy Rule
Security Rule
Breach Notification Rule
Isolated Inputs
-Isolated inputs are used for conductors that have a direct pathway to the heart
-The Underwriter’s Laboratories (UL) require the inputs to withstand 2500v for 1 minute w/o failing
-Each state and localities have specific standards for electrical codes for AC current
Leakage Current
Current finds a way from the electronics to the chassis of the system
Machines should have low leakage current and be well grounded
Leakage current Less than 1/1000A
How is leakage current measured
By interrupting the ground line and sending current through a testing meter
What are leakage current values
100uA
Earth Ground
Connection where the current’s return path returns to the physical earth (ground)
Patient Ground
Used for Common Mode Rejection
Ground Loop
-Loop of wire running around the room (inside the walls)
-Can be avoided by plugging all patient connected items into the same group of outlets
Grounding
Grounding on the receiving location solves some problems but creates others
A person must come into contact with two points to be shocked
-The physical ground counts as one of the 2 contact points,
increasing risk of being shocked
What are the 3 elements to a fire safety plan?
Prevention, Evacuation, Fire fighting
What is the acronym for fighting a fire?
PASS
Pull
Aim
Squeeze
Sweep
AC Power
Alternating current
Electricity
Electricity is sent through power lines at high voltages
-This causes letting loss of current through the cables
At the receiving site, the high voltage is decreased to the standard line voltage of 120v & 240v
The receiving site must be grounded to stop additional voltage changes
Technologist Responsibility to Safety
-Inspect power cords for damage
-Do not use ungrounded devices
-Use electrical outlets in the same area as other patient related
machines
-Do not use extension cords
Grounding and Chassis Leakage
Broken ground
Could result in increased current running through patient
Ground Integrity is tested using an ohmeter
Should be less than 0/15 Ohms
What issues cause patient’s to be more at risk for shock?
-The patient is grounded
-Patients are connected to multiple instruments with multiple chances
for leakage
-The skin is compromised by incorrectly placed electrodes
-The patient may not be able to react to a painful shock
-The patient’s heart might be weak and could react to lower levels of
current than normal
Electrical Injury (PIE)
-Current pathway
-Current intensity
10 ma is enough current to be deadly to a person
-Duration of exposure
Microshock
Extremely small electrical current applied directly (or very close) to the heart
Macroshock
Strong shock from current passing through a person’s head or torso
Outlets
The Standard outlet has:
*A Long slot connected to the NEUTRAL
*A Short slot HOT LINE
*A U-Shaped connected to the GROUND
Ground Fault Current Interrupters (GFCIs)
Cause the current to flow out of the instrument, but some leaks into the metal chassis and is carried to a neutral spot through the grounding line
What types of hazards do healthcare workers face?
*BBP (Bloodborne Pathogens)
*Biological Hazards
*Chemical/Drug exposures
-Formaldehyde
-Paracetic acide (used for sterilization)
*Waste/anesthetic gas exposure
*Workplace violence
*Lab hazards
*Radio active material
*Xray hazards
*Ergonomic
OSHA’s Mission
Assure safe and healthful working conditions for working men and women by setting and enforcing standards and by providing training, outreach, education and assistance
Employer Reponsibilities (OSHA)
*Inform employees about hazards through training, labels, alarms,
color-coded systems, chemical information sheets
*Keep accurate records of work-related injuries and illnesses
*Perform tests in workplace such as air sampling
*Find and correct safety and health problems
*Eliminate and reduce hazards first by making changes in working
conditions rather than just relying on masks, gloves, ear plugs or other
types of PPE
*Switching to safer chemicals, enclosing processes to trap harmful
fumes, or using ventilation systems to clean the air
*Provide hearing exams and other medical tests
*Post OSHA citations, injury and illness data, and an OSHA poster in the
workplace where workers will see them
*Notify OSHA within 8 hours of a workplace incident in which there is a
death or when 3 or more workers go to the hospital
*Not discriminate or retaliate against a worker for using their rights
under the law
What to do if there is a dangerous situation at work?
Bring the conditions to the attention of the employer
You may file a complaint with OSHA
Why OSHA?
Provides workers & emergency personnel with procedures for handling or working with hazardous substances in a safe manner
Must be posted in the workplace & explained during the new employee orientation
Components of OSHA
Product and company identification
Ingredients & hazards identification
First aid measures
Fire fighting measures
Accidental release measures
Handling and storage
OSHA enforcement
*Whistleblowers
*Compliance, safety & health offices go to work sites, inspect, assess
fines
*Site Visits
-Responds to workplace incidents
-Workers complaints
-Referrals by other individuals
What is HIPPA (Health Insurance Portability and Accountability Act)
Established a national platform of consumer privacy protection and marketplace reform. Some key provisions include insurance reforms, privacy and security, administrative simplification and cost savings
Goals of HIPPA
*Protect the privacy of patient’s personal and health information
*Provide security of personal and health information
*Standardize coding to simplify billing and other transactions
What’s so important about protecting a patient’s privacy and security?
Its the ethical thing to do
Its the legal thing to do
HIPPA law requires it
Violations lead to penalties
HIPPA violations
- Violations that the entity did not know about and would not have
known about by exercising reasonable diligence
2.Violations due to “reasonable cause”
3.Violations due to “willful neglect” that are corrected within 30 days
MSDS EEG Products
*Collodion and Collodion remover
*Acetone
*Skin preparation gel
-Nu-prep
-Lemon prep
*Electrode paste
-10-20, Elefix, EC2 cream
*Bleach
*Disinfectants
Which process destroys bacterial spores?
Sterilization
EEG disc electrodes fall under what type of patient care item?
Semi-critical item
What is the proper contact time for semi critical items?
10-30 minutes
What is another name for bleach?
Sodium hypochlorite
Can 2 prep gels be combined?
NO
What does HAI stand for?
Healthcare associated infections
What is another name for HAI?
Nosocomial infections
What are the 3 main reasons for an HAI?
*Inadequate hand hygiene
*Aseptic or sterile technique
*Ineffective cleaning or disinfection of patient care environment or medical equipment
Creutzfeldt-Jakob Disease (CJD)
*Transmissible spongiform encehalopathy
*Prion-based disease
*CJD is passed by contact with tissue from certain organs or CSF, not
through contact with blood
*Standard precautions, as mandated by OSHA are required for all
patients including those with known or suspected CJD
*Disposable, single use EEG electrodes
*Non-invasive reusable electrodes must undergo high-level disinfection
What is direct contact transmission?
Direct: Micro-organisms transferred from one person to another
What is indirect contact transmission?
Indirect: When the infecting agent is transferred through contamination environment
What is the most common mode of transmission?
Contact transmission
What is the minimum contact time when washing your hands?
20 seconds
Are antiseptic rubs a great substitute for washing hands?
NO
When should gloves be worn?
During all patient contact
Which process does not remove micro-organisms
Cleaning
What are the 5 types of infection transmission?
*Contact transmission
*Droplet transmission
*Airborne transmission
*Common vehicle transmission
*Vectoborne transmission