Safety in Healthcare

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1. Ethylene Oxide possesses several physical and health hazards that merit
(EtO) Steriliza- special attention. It is both flammable and highly reactive.
tion Acute exposures to EtO gas may result in respiratory irrita-
tion and lung injury, headache, nausea, vomiting, diarrhea,
shortness of breath, and cyanosis.

Its use has decreased in recent years because of the

health risk to Processing Staff. They are still in use in
some facilities. Proper ventilation, air monitoring, proper
signage, and training are all required to operate these
devices.

2. Medical Lasers Risks to the operator and service personnel include but
are not limited to direct and indirect exposure to the sur-
gical laser by the eye. The eye is the most at-risk part
of the anatomy as the laser could cause serious injury.
Burns to the skin are also a concern but secondary to Eye
protection.

3. Medical Grade an important supply in the hospital. Oxygen, medical air,

Gasses and vacuums are used in most areas of the hospital.
Additional gasses are used in the Operating rooms and
the Labor & Delivery rooms. These include Nitrous Ox-
ide along with oxygen, medical air and vacuum. The gas
supplies will have shut off valves to close when there is
a dangerous situation or if work needs to be done on the
supply. Only specific personnel are allowed to shut it off
or turn it back on. Follow hospital policy regarding medical
gasses safety.

4. Anesthetic also present in the OR and L&D and special waste gas
gasses sources will be present to evacuate exhaled gasses.

5. OR attire scrubs, caps, masks, cover shoes

6. central supply at- specific gowns and scrubs

tire

7.

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diagnostic imag- follow ALARA procedure; diagnostic imaging includes
ing precautions x-ray, mammography, CAT scans, nuclear medicine and
magnetic resonance imaging (MRI).

8. ALARA as low as reasonably possible; this is a radiation safety

concept for minimizing radiation dose

9. 3 major princi- -Time: Minimizing the time of exposure directly reduces

ples to maintain radiation dose.
radiation doses -Distance: Doubling the distance between your body and
ALARA the radiation source will divide the radiation exposure by
a factor of four.
-Shielding: Using absorbent materials such as lead for
x-rays is an effective way to reduce radiation exposure.

10. energy-deliver- these devices almost always pose some danger to the
ing devices technician but devices that deliver energy are particular-
ly dangerous; include defibrillators, electrosurgical units,
lasers, and therapeutic ultrasounds

11. microtomes a tool used in labs to slice specimens, with very sharp
blades and very strong motors. Use extra caution when
opening these devices.

12. Magnetic reso- generate extremely powerful magnetic fields and can pose
nance imaging a serious danger to patients and staff if MRI safety guide-
(MRI) systems lines are not strictly adhered to. Safety recommendations
involve first restricting access to areas within the magnetic
field and second, taking steps to ensure that no ferrous
metals enter the MRI suite itself.

13. Occupational the governing body that sets guidelines for the health and
Safety and safety of workers.
Health
Administration
(OSHA)

14. Health Communi- Some of OSHA's most important standards; requires em-
cation Standards ployers to establish hazard communication programs to
(HCS) transmit information on the hazards of chemicals to their
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employees by means of labels on containers, safety data
sheets, and training programs.

15. safety data provide detailed information on each hazardous chemical,

sheets (SDS) including its potential hazardous effects, its physical and
chemical characteristics, and recommendations for appro-
priate protective measures.

16. National Fire Pro- a national public health institute concerned with fire and
tection Associa- electrical safety
tion (NFPA)

17. NFPA 70: Nation- applies to the design and installation of electrical distribu-
al Electrical Code tion systems and equipment in general

18. NFPA 99: Health based largely on NFPA 70, but covers more than electrical
Care Facilities systems and equipment in healthcare. It also has require-
Code ments for healthcare facility and equipment management.

19. Patient Safe- agencies that specifically inspect and research the field
ty Organizations of patient safety; include the joint commission, ECRI insti-
(PSO) tute, AAMI, Institute for Healthcare Improvement.

20. Blood pathogens infectious microorganisms in human blood that can cause
disease including hepatitis B (HBV), hepatitis C (HCV),
and human immunodeficiency virus (HIV).

21. Universal pre- methods of infection control to treat all human blood and
cautions certain human body fluids as if they were known to be
infectious. These include Personal Protective Equipment
(PPE)-all hospital staff, patients, and visitors should use
PPE when there will be contact with blood or other bodily
fluids.

22. Personal Protec- include barrier gowns, gloves, eyewear (goggles or glass-
tive Equipment es), face masks, and face shields; Gloves protect the
(PPE). hands, gowns or aprons protect the skin and/or clothing,
masks and respirators protect the mouth and nose, gog-
gles protect the eyes, and face shields protect the entire
face.
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23. Hospital Associ- infections that a patient acquired during their stay in the
ated Infections hospital. These conditions are reported to the safety com-
(HAI) mittee and are tracked to find solutions to limit these
infections. Include iatrogenic diseases, and nosocomial
infections

24. Iatrogenic Dis- type of HAI caused by doctors. These are induced by a
eases drug prescribed by a doctor, after a medical or surgical
procedure, or failing medical equipment.

25. Nosocomial In- type of HAI caused from the facility. These infections are
fections caused by toxins or other germs in the building or area.

26. Hospital-Ac- an undesirable situation or condition that affects a patient

quired Condition and that arose during a stay in a hospital or medical facility.
These conditions are reported to the safety committee and
are tracked to find solutions to limit these infections.

27. Airborne Infec- apply to patients known or suspected to be infected with

tion Control microorganisms transmitted by airborne droplet nuclei.
Preventing airborne transmission requires personal respi-
ratory protection and special ventilation and air handling.
Include positive and negative pressure rooms.

28. Positive pres- maintain a higher pressure inside the treated area than
sure rooms that of the surrounding environment. This means air can
leave the room without circulating back in. In this way, any
airborne particle that originates in the room will be filtered
out. Germs, particles, and other potential contaminants
in the surrounding environment will not enter the room.
In medical settings, a positive pressure room (protective
environment) allows staff to keep vulnerable patients safe
from infections and disease. Examples would be Operat-
ing Rooms, ICUs, Delivery rooms, Pharmacy, and NICU.

29. negative pres- uses lower air pressure to allow outside air into the segre-
sure room gated environment. This traps and keeps potentially harm-
ful particles within the negative pressure room by prevent-
ing internal air from leaving the space. Negative pressure
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rooms in medical facilities isolate patients with infectious
conditions. Examples of Negative pressure areas are ER
Waiting Rooms, Isolation Rooms and decontamination
rooms.

30. N95 Masks BMETs are expected to be fitted for a special mask to re-
duce the dangers of airborne infections. There are specific
areas where this mask will be required.

31. poor hand hy- the biggest single contributor to HAIs

giene

32. Medical Gas Tank green color

(Oxygen)

33. Medical Gas Tank gray color

(CO2)

34. Medical Gas Tank blue color

(Nitrous Oxide)

35. Medical Gas Tank brown color

(Helium)

36. Medical Gas Tank black color

(Nitrogen)

37. Medical Gas Tank yellow color

(Air)

38. Diameter Index standard used for Oxygen, Nitrous Oxide, Air, Nitrogen
and Safety Sys- and Suction. Each type has its own pitch (thread type and
tem (DISS) size) and is not interchangeable.

39. Pin Index Safety a means of connecting high-pressure cylinders containing

System (PISS) medical gases to a regulator or other utilization equipment.
It uses geometric features on the valve and yoke to prevent
mistaken use of the wrong gas

40.
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Medical Gasses A connection used to allow the quick connection of
Quick Connect or all medical gases. Quick connects are male, couplers
Coupler are female. Ohio or Omeda, Chemtron, Puritan Bennett,
Schrader and Oxeyquip are the different styles.

41. radiation sign The international symbol of radiation, usually accompa-

nied by more specific text. The symbol can be magenta or
black, on a yellow background. The sign must be posted
where radioactive materials are handled or where radia-
tion-producing equipment is used.

42. laser classifica- There are four main classes for visible-beam lasers: Class
tion 2, Class 3R, Class 3B and Class 4 (low power to high
power).

43. Class 2, Class 3R lasers that are relatively safe for eye exposure
lasers

44. Class 3B and lasers that are hazardous

Class 4 lasers.

45. Laser hazard must be conspicuously posted to warn onlookers of the

signs potential hazard. The appropriate warning or danger sign
shall be posted at the entryway(s) and, if deemed neces-
sary by the Laser Safety Officer, should also be posted
within the laser-controlled area.

For Class 3B and Class 4 signs, ensure the signs include:

type of laser(s)
wavelength(s) used

46. chemical hazard a pictogram applied to containers of dangerous chemical

symbol compounds to indicate the specific hazard, and thus the
required precautions.

47. Biohazard Sign used in the labeling of biological materials that carry a
significant health risk, including viral samples, and used
hypodermic needles.

48.
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Isolation Room are placed at the doorway to the patient's isolation room,
Sign along with a stop sign. This means that everyone entering
the room must take precautions. Ensure you are wearing
the required PPE the sign instructs you to put on prior to
entering the patient room.

49. color signage Colors are an important way of communicating hazards to

workers. The American National Standards Institute has
established rules governing what specific colors mean.
Standardized rules can help people easily recognize and
understand the message being conveyed

50. red color signage used for:

-fire protection equipment
-danger, high risk of injury or death
-emergency stops and alarms

51. orange color sig- used for:

nage -moderate risk of injury
-guarding devices

52. yellow color sig- used for:

nage -Caution statements
-Minor risk of injury
-Materials handling equipment

53. green color sig- used for:

nage -Safety equipment or information
-First aid equipment or location

54. blue color sig- used for:

nage -no immediate hazard

55. placards Trucks, rail cars, and other containers must have placards
attached indicating the hazard level of the container's con-
tents. The meanings of various colors on these placards
also are standardized:

56. red placards used for combustible materials

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57. yellow placards used for oxidizers

58. white placards used for poisonous or toxic materials

59. orange placards used for explosives

60. green placards used for non-flammable gas

61. red and white used for non-flammable solids

striped placards

62. LockOut TagOut refers to specific practices and procedures to safeguard

(LOTO) employees from the unexpected energization or startup
of machinery and equipment, or the release of hazardous
energy during service or maintenance activities.

Employees can be seriously or fatally injured if machinery

they service or maintain unexpectedly energizes, starts
up, or releases stored energy. This practice and procedure
is necessary to disable machinery and prevent the release
of potentially hazardous energy while maintenance or ser-
vicing activities are performed.

63. LOTO Procedure 1. Consult the detailed procedure for how to shut down the
equipment
2.Notify affected employees
3.Shut down equipment properly
4.Disconnect all primary energy sources
5.Address all secondary sources
6.Verify the lockout
7.Keep it in force during shift change
8.Bring the equipment back on line

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