2016 Safety at Work (Mandatory All) 1
CONTRACT STAFF – Please click to open in Slide Show view.
It’s mandatory AND It’s important for your safety and the safety of patients and visitors
Reminder … Passing score =100
July 7 – September 30, 2016
Table of Contents 2
Infection Prevention ¡ ¡ ¡ ¡ ¡ ¡
Hand Hygiene Bloodborne Pathogens Blood Spills and Exposures Personal Protective Equipment(PPE) Sharps Safety Standard Precautions
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Safe Handling of Compressed Gas Cylinders
•
Theft Prevention
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Safe Medical Devices Act (SMDA)
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Frequent Safety Rounds Issues
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Cleaning Patient Care Equipment
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Reporting Adverse Events
TB Symptoms & Precautions
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Emergency Codes Medical Gas Shutdown
Hand Hygiene Refer to the Hand Hygiene policy for complete details of all CDC Hand Hygiene indications
Hand Hygiene Expectations for Cone Health Employees: • In & out of a patient room or patient care space, even if vacant • Before & after glove use • After contact with the environment • Staff with supplies can put the supplies down and then perform Hand Hygiene • Staff going from one room directly to the room next door or across the hall without touching anything only perform Hand Hygiene when exiting the first room 3
Bloodborne Pathogens The BBP Exposure Control Plan provides information on:
§ § §
Hepatitis B Vaccinations, Jobs and tasks that are risky, How to choose Personal Protective Equipment (PPE)
If you have questions about BBP:
§ §
Contact Infection Prevention or Health at Work
§
Refer to the Bloodborne Pathogen Management Plan
After hours, hospital staff contact the Administrative Coordinator
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Blood Spills & Exposures To clean a blood spill: 1. 2. 3. 4. 5.
Put on gloves and other PPE appropriate to the size of the spill Contain the spill Clean up the blood and dispose of appropriately Spray the surface with an approved disinfectant Wipe clean
If you are exposed to blood or other body fluids: 1. IMMEDIATELY wash the exposed skin with soap and water or hand sanitizer (if soap & water not immediately available). Flush mucous membranes with water or saline 2. Report to your Health at Work nurse or the Administrative Coordinator after hours 3. Complete Report of Injury Illness (ROII) through Safety Zone Portal 5
Blood Spills & PPE When handling blood or “Other Potentially Infectious Materials” (OPIM) and anytime there is a risk of a splash you MUST use the following PPE:
§ §
Gloves – when handling blood or OPIM Gowns – when there is a risk of splash of blood or OPIM to clothing
§
Masks and Goggles (both) or Face Shields – when blood or OPIM could splash your face
Make sure you know where to find these items and how to use PPE! 6
Sharps Safety Sharps Safety Devices are for your protection and, by law, you MUST use them! Examples of Sharps Safety Devices:
§ § § § §
IM/SQ needles and syringes Needle-less IV tubing sets Safety lancets Phlebotomy devices IV safety catheter
ALWAYS discard sharps, and ONLY sharps, in a sharps disposal container! Safety Devices must be activated before disposal! 7
Standard Precautions In addition to hand hygiene, PPE, and safe injection practices, other elements of standard precautions include:
§ § § §
Care and cleanliness of Cone Health Cough etiquette and respiratory hygiene Safe handling of laundry Patients on precautions and safe transportation § Handling of dirty patient-care equipment, instruments and devices For more details, see Infection Prevention Standard and Transmission Based Precautions Policy 8
Tuberculosis (TB) Symptoms • Persistent cough • Bloody sputum • Weight loss • Night sweats TB smear positive for AFB (Acid fast bacilli)
MASK the patient until you can move him/her to a negative pressure room For more details, refer to Tuberculosis (TB) Management Plan 9
TB Precautions To prevent the spread of TB: Patient
§
Place on “Airborne Precautions” in a negative pressure room
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Patient must wear a surgical mask when outside the negative pressure room or when a negative pressure room is not available
Employee
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Before entering room, put on N95 mask or PAPR
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Educate patient/visitors to follow precautions
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Notify Infection Prevention and Facilities Management 10
Emergency Alerts Three types of emergency alerts will be used by Cone Health: 1.
Facility alerts (i.e. hazardous material spills and fires),
2.
Security alerts (i.e. active shooters and missing persons)
3.
Medical events (i.e. cardiac arrest)
Some of these emergency alerts are not overhead announced but get sent directly to specialized response teams via pager • To report a MEDICAL EMERGENCY, call the emergency number for your facility and state the specific request, location, and patient age (adult vs pediatric). • Example: Code Blue, 1st floor Radiology MRI room, Adult
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Emergency Alerts - FACILITY Event
Facility Alerts Recommend Plain Language
Notes
Sample Scripting
Evacuation
Facility Alert + Evacuation + Descriptor + Location
Overhead: Your attention please, Facility Alert, Immediate Evacuation, Unit 5Central.
Fire / Smoke Alarm
Facility Alert + Fire/Smoke Alarm + Descriptor + Location
Overhead: Your attention please, Facility Alert, Fire Alarm activation Unit 5North.
Hazardous / Materials Spill Facility Alert + Chemical Spill + Descriptor + Location
Overhead: Your attention please, Facility Alert, Chemical Spill, 1st Floor Laboratory.
Mass Casualty
Facility Alert + Mass Casualty + Descriptor (may have levels) + Location
Overhead: Your Attention Please, Facility Alert, External Mass Casualty Incident, Emergency Department.
Medical Decontamination
Facility Alert + Medical Decontamination + Descriptor (biological, chemical, radiological, or unknown) + Location
Overhead: Your Attention Please, Facility Alert, Medical Decontamination event, Emergency Department. Decontamination Team please report to the Emergency Department.
Surge Capacity/Mass Casualty
Facility Alert + Surge Capacity/Mass Casualty + Descriptor (may have levels) + Location
Overhead: Your Attention Please, Facility Alert, Mass Casualty Incident, Emergency Department.
Utility / Technology Interruption
Facility Alert + Type of Service Interruption + Descriptor + Location
May not overhead page but may be sent as an Email message
Weather
Facility Alert + (Instruction) + Weather + Descriptor (National Weather Service Statement)+ Location
Also sent via email Overhead: Attention, Facility Alert Tornado Warning. and text messages Move away from windows to interior portions of the building. The National Weather Service has issued a Tornado Warning for the local area in effect until (time).
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Overhead: Your Attention please, Facility Alert IT Network Downtime, Implement downtime procedures for (patient charting, VoIP phones, and paging systems)
Emergency Alerts - SECURITY Event Missing Infant / Child 18 yrs.
Security Alert + Missing Person + Descriptor (Age, gender) + Last Seen Location
Armed Intruder / Shooter/ Hostage Situation / Threat of Violence
Security Alert + (Instruction) + Descriptor + (Type of Threat) + Location
Bomb Threat / Suspicious Package
Security Alert + (Type of Threat) + Descriptor + Location
Emergency lockdown
Security Alert + Controlled Access + Descriptor +Location
Notes
Sample Scripting Overhead Page: Security Alert Infant Abduction, male infant, last seen in room 322.
Overhead: Security Alert Missing Person 65 year old female wearing a hospital gown last seen 4th Floor West Wing.
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Not Overhead Paged. Use Emergency Lockdown Announcement Not Overhead Paged. Sent via email and phone notification to identified areas.
Radio Communications to Officers:
Phone or text notification to Officers:
Overhead: Attention, Security Alert, Emergency Lockdown Emergency Department. (Radio Communications to Officers with details)
Emergency Alerts – MEDICAL EMERGENCY Medical Alerts Event Medical Emergency or Incident
!!!
Recommend Plain Language Medical Alert + (Type of EmergencyIncident if available) + Descriptor + Location
Notes
Sample Scripting
Not Overhead paged. Send via Emergency response Team, Pagers and phones
!!!
To report a MEDICAL EMERGENCY
Call the emergency number for your facility and state the specific request , location, and patient age (adult vs pediatric). Example: Code Blue, 1st floor radiology MRI room, adult 14
Fire Safety 15
4 steps to respond to a fire:
1. R
escue anyone in immediate danger!
2. A
ctivate the alarm & call the emergency number
3. C
lose doors & windows
4. E
xtinguish if possible - Evacuate if necessary
4 steps for using an extinguisher: P.A.S.S.
1
2
3
4
Need a Safety Data Sheet? 16
1. Go to Cone Connects and type msds in the Search bar
2. Click the MSDS (Material Safety Data Sheets) link
3. Select MSDS Search and search for the product
Safety Data Sheet Search
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International Safety Data Sheets Phasing in the new symbols …
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Medical Gas Shutdown § The department’s charge nurse (or designee) shall contact Facilities, describe the circumstances and determine if shutdown is necessary. § Clinical personnel receive authorization from nurse in charge to initiate shutdown. § Remove the cover on the valve box. § Grasp the handle on the affected gas line and pull forward, rotating the handle outward until it is fully closed and protruding from the valve box. § Close all other affected medical gases in like manner. 19
Open the policy for more details
Safe Handling of Compressed Gas Cylinders O2 tanks and other compressed gas cylinders can explode! They must be handled with extreme care! § Secure with a chain or in a rack when stored § Use only an approved carrier during transport – an approved carrier is designed for this purpose § Store in limited quantities - No more than 12 tanks are allowed in one smoke compartment unless stored in an approved cabinet
§ Full, empty, and ready to use tanks must be stored separately and clearly labeled for easy identification 20
Theft Prevention 21
Reduce your risk of becoming the victim of a theft. Your best defense is to limit the opportunity. Here are some basic security reminders: Parking Lots Keep valuables out of sight Place money, purses/wallets, GPS devices, packages & shopping bags in your car’s trunk Always lock your vehicle Park in well-lit areas When it’s dark outside, walk to your car with friends & co-workers. You may also request an escort by calling Security Services, if available. Secure motorcycles & mopeds Secure bicycles with a lock in the bicycle rack
Security awareness is everyone’s business
Theft Prevention 22
At Work Lock valuables and personal items in a desk drawer, locker, or enclosed office Always wear your Cone Health ID badge If an unfamiliar person is in an employee area without an ID badge, do not assume they are supposed to be there. Ask how you can assist and call Security Services immediately if they act suspicious If you misplace or lose your keys, notify Security Services as soon as possible Be aware of your responsibility to protect patient’s property from theft
Security awareness is everyone’s business
Theft Prevention 23
Cone Health Security Services Moses Cone Hospital Wesley Long/BHH/LeBauer Women’s Hospital Annie Penn Hospital Alamance Regional High Point MedCenter Kernersville MedCenter Physician Offices
2-7849 2-1850 2-4900 (336) 951-4478 (336) 586-4297 (336) 884-3648 (336) 992-5100 Call 911
Security awareness is everyone’s business
Safe Medical Devices Act Federal law requires a REPORT of all incidents where there is a reasonable suspicion that a medical device caused or contributed to a patient’s: Serious injury
Serious illness
Death
Medical devices include anything, other than drugs, used in a patient care or diagnostic setting. Here are some examples:
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Beds
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Defibrillators
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Bandages
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Wheelchairs
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Monitors
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Infusion Pumps
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Rehab Equipment
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Implants
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Catheters
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Lift Equipment
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Lab Devices
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IV Sets
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Safe Medical Devices Act Incidents are reportable if they:
§ Require surgery or medical intervention, § Result in permanent impairment of a body function, or § Permanently damage a body structure If a patient is injured by a medical device: 1. Take care of patient’s immediate needs, 2. Remove device (save all settings and disposables), 3. Label device – “Do not use”, date, time, 4. Alert your supervisor, 5. Go to Cone Connects 6. Complete Safety Zone Portal (SZP) 25
Frequent Safety Rounds Issues Do Not Block the Following Items
• • • • •
Eyewash Stations
Medical gas panels Electrical panels Fire extinguishers Fire doors Fire alarm pull stations
Battery Recycling & Disposal Recycle: Lithium, Nickel Cadmium, Silver Oxide, Nickel Metal Hydride, Lead Acid, Mercury Oxide (button cell) Each recycle battery must be placed in an individual clear plastic bag and placed in your department’s battery recycling container. Never use a plastic bag that has a biohazard symbol on it. Do not recycle any type of alkaline battery. Place in regular trash.
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•
Flush weekly and enter into log
•
Must activate with one motion
Cleaning of Patient Care Equipment 27
Purple Top - Wet/contact time “2 minutes”
Clean BP cuffs, stethoscopes, bedrails, IV pumps, glucometers
Use for items/surfaces contaminated with blood/body fluids
Bleach wipe - Wet/contact time “4 minutes” Equipment from room where patient is on Enteric Contact Precautions
Always wear gloves when using either of these products
Pharmaceutical Waste Collection Some regulatory agencies mandate pharmaceutical waste collection: • EPA (Environemntal Protection Agency) • NC-‐DENR (North Carolina Department of Environment & Natural Resources) • DOT (Department of Transportation) Hazardous Drug W aste Place empty packaging in a plain, clear, plastic bag, seal, and dispose of in the black bin -‐ Coumadin (warfarin) -‐ Nicotine gum and patches
Infectious Medication Waste Discard in r egulatd medical waste sharps container -‐ Human Albumin -‐ Thrombin Fluids with No A dded Medications Discard down the sink drain -‐ Normal saline -‐ D5W -‐ Lactated ringers Solid W aste Discard in the trash -‐ Empty vials -‐ Empty IV bags Discard in sharps container -‐ Empty syringes, including needleless devices
Inhalers and A erosol Sprays Return to pharmacy for disposal
Corrosive A cids Return to Pharmacy for further segregation -‐ Any partial medications in this category Pharmaceutical Waste Segregation Chart
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Reporting Adverse Events (Incidents) ü What is an Adverse Event/Incident? • “Any happening not consistent with the routine operation of Cone Health or the routine care of a particular patient. Such incidents may or may not result in actual injury”. • Examples: Skin tear, pressure ulcer, fall, medication error, needle on a meal tray, skin marker that is not visible, unsuccessful catheter insertion, lab specimen mislabeled ü Why report adverse events? • When you report incidents and near misses you help make Cone Health a safer place for patients, staff and visitors ü How do you report? • Report adverse events/incidents via SafetyZone™ Portal (SZP) • Go to Cone Connects > SafetyZone Portal
• For detailed instructions, complete the on-‐line module “SZP_Safety Zone Portal_ Mandatory All Cone Health New Hires” found in the HealthStream (HLC) Catalog 29
Resources For questions concerning the content of this course or other Safety related questions or concerns, contact: Cone Health Safety Office 832-4357
[email protected] or visit Safety Department Website on Cone Connects
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Take Test 31
Now let’s see what you’ve learned -Continue to the Test
Remember … the passing score is
100
