Section F Flashcards
Three class of control measures to reduce exposure to hazards
engineering controls - most effective. The most effective way to control a hazard is to eliminate it
adminstrative controls
personal controls
Major elements of WHMIS 2015 are
safety data sheets
labels
training
Universal Precaution applies to
semen vaginal secretions synovial fluid , amniotic fluid cerebrospinal fluid pleural fluid peritoneal fluid pericardial fluid
Body Substance isolations includes
Included urine, joint fluid, semen, saliva, etc.
Focused on the use of barrier protection
STANDARD PRECAUTION or ROUTINE PRACTICE
It is a Combination of Universal and Body Substance Isolation precautions.
minimum infection prevention practices that apply to all patient care, regardless of suspected or confirmed infection status of the patient, in any setting where healthcare is delivered.
2000’s –New Addition to Routine Practice:
Applies to any patient with sign of coughing, congestion, rhinorrhea, or increased production of respiratory secretion
Education of health care workers, patient and visitors
Posted signs and instructions in language appropriate to the population served
Covering sneezes with tissue paper or mask
Cough or sneeze into your upper sleeve , not hand
Hand Hygiene
Five Components of Routine Practice
Component 1: Risk Assessment
Before any task is performed, evaluate the risk of disease transmission.
The risk assessment should take into account the following:
the time it takes to complete the task
the type of body fluids that the worker may come into contact with
the presence of microorganisms in the bodily fluids
the route of potential exposure to these microorganisms
the susceptibility of the worker to these microorganisms
the environment in which the task is carried out
Five Components of Routine Practice
Component 2: Hand Hygiene: Wash hands with soap and water frequently.
Before and after direct contact with a patient, blood , body fluid or medial equipment
After removing gloves.
Any type of plain soap may be used.
Bar soap should be kept in a self draining holder that is cleaned thoroughly before new bars are put out. However should not be used in Health care facilities
Liquid soap containers.
What are alcohol rubs/gels/rinses?
Alcohol rubs/gels/rinses are excellent hand antiseptics, provided they contain more than 60% alcohol.
They are widely used in the health care settings, or in situations where running water is not available.
How do I use alcohol based hand rubs?
Alcohol-based hand rubs should only be used if no visible dirt is present on the hand
Five Components of Routine Practice
Component 3: PPE-Protective Barriers
PPE refers to a variety of barriers and respirators used alone or in combination to protect mucous membranes, airways, skin, and clothing from contact with infectious agents.
Should be worn at all times when working with blood or blood products or body fluids or waste that may contain blood.
Gloves should be worn by laboratory personnel when handling biomedical specimens and infectious materials.
Most health care facility have a NON-Latex policy
All gloves are permeable to some extent and the longer they are worn, the more likely they are to develop small holes or tears.
To prevent loss of protection, gloves should be changed after 30 minutes of work or sooner if they are soiled.
Hands should be thoroughly washed after glove use and between glove changes to remove any microorganisms that may have penetrated through the gloves.
KNOW THE ORDER OF DONNING AND DOFFING
Five Components of Routine Practice
Component 4: Environmental Controls
Environmental control refers to controlling and minimizing the level of microorganisms in the environment.
Environmental control measures include:
Equipment and work area cleaning
Proper disposal of waste such as sharps, biomedical, and pathological waste
Appropriate ventilation and other engineering controls
Installation of easily accessible and clearly identified waste containers, hand hygiene product dispensers, and dedicated hand wash sinks
Effective placement and segregation of sources of contamination - using single patient room or using a “blood work only” biological cabinet for laboratory work associated with blood samples
Five Components of Routine Practice
Component 5: Administrative Controls
Administrative controls are critical to ensure that the principles of routine practices are effectively and properly executed in the workplace
how to cough, immunizations
Routine Practice - Engineer control :
t is the responsibility of the employer to ensure safe practices in the workplace and hence to remove or isolate a hazard in the workplace.
Examples:
Provide Sharp disposal containers
Use Needles with built in safety mechanism
NOSOCOMIAL infections
The term nosocomial refer only to infections acquired in hospitals.
Transient microorganisms found on the hands of health care personnel are more frequently implicated as the source of nosocomial infections. The most common transient flora includes Staphylococcus aureus
PORTS OF ENTRY
Skin or eye
Inhalation
Ingestion
Injection
Labeling Biomedical Waste
Biohazardous waste should be identified as:
Human Infectious or Non-infectious Anatomical or Non-anatomical (blood/blood products, clinical equipment or sharps) Must have biological hazard symbol Facility name and address Date
Packaging of Biomedical Waste
Hazardous waste must be separated at the point of generation from regular waste.
Human and infectious non-anatomical waste: Biohazard Autoclave Bags- gowns, masks and gloves, culture plates, plastic pipettes and media, blood –May be dispose regular garbage
Biohazard Sharps Containers- needles in non- penetrable (rigid) container .This waste is transported off site by a licensed bio-medical waste transportation and disposal company.
Disinfectant (hypo chlorite solution)-liquids
Off and On–Site Movement of Waste
Packaged, labelled and transported according to TDGR and WHMIS
Colour coded –Orange
Biohazard label
Risk Group 1
Low individual risk and low community risk
Risk Group 2
moderate individual risk and low community risk
Risk Group 3
high individual risk and low community risk
Risk Group 4
high individual risk and high community risk
Containment Level 1 (CL1)
basic laboratory
Any biological agent unlikely to cause disease in healthy health care workers.
Biological safety cabinets (BSCs) are not required.
Work may be done on an open bench top
Containment is achieved through the use of practices normally employed in a basic microbiology laboratory.
Containment Level 2 (CL2)
Any pathogen that can cause human disease under normal circumstances
The primary exposure hazards associated with organisms requiring CL2 are through the ingestion, inoculation and mucous membrane route.
BSCs and centrifuges with sealed rotors or safety cups
PPE - appropriate personal protective equipment (i.e., gloves, laboratory coats, protective eyewear).
Environmental contamination must be minimized by the use of handwashing sinks and decontamination facilities (autoclaves).
Containment Level 3 (CL3)
Any pathogen that can cause serious human disease
HEPA filtration of exhausted laboratory air and strictly controlled laboratory access.
Containment Level 4 (CL4)
Any pathogen that usually produce very serious human disease, often untreatable
CLASS 1 BIOSAFETY CABINETS (1a and 1b)
Provides partial personal protection, no product protection and are suitable for handling low –moderate biohazard aerosol. Connected to the building exhaust system HEPA filter in the duct outside No flammables or toxic chemical Air is drawn through the front
CLASS 2 TYPE A1- BIOSAFETY CABINETS (A1, A2, B1 &B2 )
Provide product and partial personal protection, and are suitable for handling
low –moderate biohazard aerosol.
Class A’s –recirculation back into the lab.
Class B’s no air recirculation within the cabinet
100% HEPA filter exhaust
May be used with toxic, volatile or radio- active material
CLASS 3 BIOSAFETY CABINETS-or GLOVE - BOX
Totally closed front and gas tight
Protect worker and product
Impermeable rubber gloves attached to the cabinet front opening
Two HEPA filter that moves contaminated air into an exhaust system
Negative pressure compared to the lab
Provide the highest personal protection and clean work environment
Use with highly bio-hazard agents
Level 4 pathogens
HEPA FILTER- High Efficiency Particulate Air
They are designed to remove microbes, chemical and radiation airborne particles of 0.3 um (micro meter).
They do not remove chemical vapours from the air
Filtration occur by: interception, inertial impaction and diffusion
Start-up procedures when preparing for work in the BSC
- Turn off UV lights if in use and ensure that the sash is in the appropriate position.
- Turn on fluorescent light and cabinet blower, if off.
- Check the air intake and exhaust grilles for obstructions.
- If the cabinet is equipped with an alarm, test the alarm and switch it to the “on” position.
- Confirm inward airflow by holding a tissue at the middle of the edge of the viewing panel and ensuring that it is drawn in.
- Disinfect the interior surfaces with a suitable, noncorrosive disinfectant.
- Assemble all materials required for the procedure and load them into the cabinet; do not obstruct the air grilles; the working surface may be lined with absorbent paper with plastic backing; segregate “clean” items from “contaminated” items.
- Wait 5 minutes to purge airborne contaminants from
Do not work with open flames inside the BSCs. the work area.
Work 10-15 cm from the opening of the cabinet.
Procedures upon completion of the work
- Allow the cabinet to run for 5 minutes with no activity.
- Close or cover open containers before removing them from the cabinet.
- Surface disinfect objects in contact with contaminated material before removal from the cabinet.
- Remove contaminated gloves and dispose of them as appropriate; wash hands.
- Don clean gloves, and ensure that all materials are placed into biohazard bags within the cabinet.
- Using a suitable non-corrosive disinfectant (e.g., 70% ethanol), disinfect interior surfaces of cabinet; periodically remove the work surface and disinfect the area beneath it (including the catch pan) and wipe the surface of the UV light with disinfectant.
- Turn off the fluorescent light and cabinet blower when appropriate (some cabinets must be left on at all times; if you are unsure, check with your cabinet certifier, safety officer or building maintenance personnel).
- Turn on the UV light if appropriate (do not turn on when people are working close by); UV must be tested to ensure that it is emitting a germicidal wavelength (ask your cabinet certifier to perform this test).
Thermal burns
burns due to external heat sources which raise the temperature of the skin and tissues and cause tissue cell death or charring.
Example:Hot metals, scalding liquids, steam, and flames, when coming in contact with the skin, can cause thermal burns.
Radiation burns
urns due to prolonged exposure to ultraviolet rays of the sun, or to other sources of radiation such as x-ray, gamma rays
Chemical burns
burns due to strong acids, bases, detergents, or solvents coming into contact with the skin and/or eyes.
Electrical burns
burns from electrical current, either alternating current (AC) or direct current (DC)
Spills and splashes on the skin
Prevention and First Aid
Wear lab coat and gloves
Remove contaminated clothing
Run with cold water for 15 min or till it stops hurting
Strong acid
Prevention and First Aid
Wear rubberized apron and gloves
Remove contaminated clothing
Run with cold water for 15 min or till it stops hurting
Splashes in the eyes
Prevention and First Aid
Use safety glasses or face shield Proceed to nearest eye wash station Rinse open eye for 15 min Remove contact lens and wash for 15 min Seek medical treatment
