SAFETY AND QUALITY ASSURANCE
HEALTH INSTITUTIONS
• CDC – Center for Disease Control and Prevention
• CLSI - Clinical Laboratory Standards
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• OSHA – Occupational Safety and Health Administration
• HICPAC – Healthcare Infection Control and Practices Advisory Committee
THE ROLE OF HEALTH INSTITUTIONS
• Considers the Biosafety and Biosecurity of the society, laboratory personnel, and general population.
BIOSAFETY
• The application of combinations of laboratory practices and procedures, laboratory facilities, and safety equipment to prevent accidental release of potentially infectious hazardous microorganisms within the laboratory or the community
• Unintentional
BIOSECURITY
• The application of combinations of laboratory practices and procedures, laboratory facilities, and safety equipment to prevent the potential access of people into these potentially infectious hazardous microorganisms
• Intentional
BIOLOGICAL HAZARDS
• CHAIN OF INFECTION – The process of how microorganisms are transmitted. Originally consisted of 3 factors:
SMS – Source, Mode of Transmission, Susceptible Host
• FURTHER CONSISTED OF 6 FACTORS:
1. Infectious agent
o Presence of microorganisms
o PRIONS – abnormally folded proteins; similar to the structure of viruses; extremely resistant to routine sterilization protocols; Highly pathogenic and highly associated with neurodegenerative diseases such as the “MADCOW DISEASE”
o FORMALDEHYDE – used to kill prions, since moist heat sterilization is not enough to eliminate them
2. Reservoir
o Can be an infected individual, sample, animal, or human
o Place where microorganism can multiply
3. Exit (Portal of)
o Pathogens can enter or exit the host through mucous membranes, eyes, ears, circulation, skin, nasal cavities
4. Mode of transmission
o How microorganism is able to penetrate in the portal of entry
5. Entry (Portal of)
6. Susceptible Host
o Has existing conditions that makes them extremely vulnerable to microorganisms
o PEDIATRIC PATIENTS – it may take them a longer time to develop their immunity
o GERIATRIC PATIENTS – their metabolic functions decreases as they grow old, as well as their state of health
o IMMUNOCOMPROMISED PATIENTS – patients diagnosed with immunodeficiency disorders
PRIMARY IMMUNODEFICIENCY – present at birth; pre-disposing factors at the genome level
SECONDARY IMMUNODEFICIENCY – pre-disposing factors acquired at adulthood (e.g., HIV infection)
o Simple means of breaking the chain of infection is by handwashing and proper hygiene
IN 1987
• CDC instituted “UNIVERSAL PRECAUTIONS”
• “All patients are considered to be possible carriers of blood borne pathogens”
UNIVERSAL PRECAUTIONS
• WEAR GLOVES – when collecting blood or handling blood contaminated other bodily fluids
• WEAR FACE SHIELDS – when dangers of blood splashing on mucous membranes are present or when disposing needles and sharp objects in puncture resistant containers
• Done to avoid spread of INFECTIOUS AEROSOLS that is the most common cause of infection among laboratorians
BODY SUBSTANCE ISOLATION (BSI)
• WEAR GLOVES AT ALL TIMES
• “They all consider all body fluids and moist body substances to be infectious”
• DISADVANTAGES OF BSI: Don’t promote handwashing after removing gloves unless visual contamination is present
STANDARD PRECAUTIONS
• 1996 - CDC and HICPAC (Healthcare Infection Control and Practices Advisory Committee)
• Combines the UP and BSI:
1. Handwashing and Alcohol based antiseptic cleansers
o Best means of practicing Hand Sanitation: Soap and Water for 15 seconds
o ALCOHOL – for 15 seconds as well; non-sporicidal
o IODINE – ALCOHOL TINCTURE
Potent Body Sanitizers
IODINE – capable of killing spore-forming organisms; (e.g., Bacillus & Clostridium spp.)
Used in cultures and cleansing site for surgeries
2. Gloves
3. Mouth, Nose and Eye Protection
4. Gown
5. Patient Care Equipment
6. Environmental Control
7. Linens
8. Occupational Health/ Blood Borne Pathogens
9. Patient Placement
10. Respiratory Hygiene and Cough Etiquette
SEQUENCE OF WEARING AND REMOVING PPE’S FROM CDC
CORRECT ORDER OF PUTTING PPEs
1. Gown
2. Mask or Respirator
3. Goggles or Face Shield
4. Gloves
CORRECT ORDER OF REMOVING PPEs
1. Gloves
2. Goggles or Face Shield
3. Gown
4. Mask or Respirator
• Wash hands or use an alcohol-based hand sanitizer immediately after removing all PPE
DISPOSAL OF BIOLOGICAL WASTES
• All biologic wastes, except urine must be placed in appropriate containers labeled with the biohazard symbol
• Urine can be discarded in the sink, flush with water and disinfect with 1:5 or 1:10 dilutions of Sodium Hypochlorite must be done daily
• LIGHT BLUE – might be transparent with blue inscription
• RADIOACTIVE WASTES – are more harmful than infectious wastes. We do not have any forms of medications to treat radioactive diseases (genetic mutations). In that case, we dispose the specimen of chemotherapy patients undergone radioactive therapy to the orange waste bin.
DEALING WITH CHEMICAL SPILLS
• Best first aid is to flush the area with large amounts of water for at least 15 minutes then seek medical attention
• Do not neutralize chemicals that come in contact with the skin
• Do not neutralize acid with a base
DEALING WITH CHEMICAL REAGENTS
• Always add acid to water to avoid splashing.
• An Explosion can occur if water is added to acid
FIRE HAZARDS
NATIONAL FIRE PROTECTION ASSOCIATION (HAZARDOUS MATERIAL CLASSIFICATION)
YELLOW WHITE BLUE RED
Reactive/ Stability Specific Hazard Health Hazard Flammability
0 – Stable
1 – Unstable when Heated
2 – Violent Chemical change
3 – Shock and Heat. May deteriorate
4 – May Deteriorate OXY – Oxidizer
ACID – Acid
ALK – Alkali
COR – corrosive
W – Use no water
☢ – Radiation 0 – Normal Material
1 – Slight Hazardous
2 – Hazardous
3 – Extreme Danger
4 – Deadly 0 – will not burn
1 – above 200F
2 – below 200F
3 – below 100 F
4 – below 73F
BIOHAZARD SYMBOL
• ALL TYPES OF MEDICAL WASTES SHOULD BE LABELLED WITH BIOHAZARD SYMBOL
• 3 HALF RINGS – SMS
• CIRCLE – methodologies of breaking of cycle of chain of infection
DEGREES OF HAZARD
0 1 2 3 4
No/Minimal Hazard Slight Hazard Moderate Serious Extreme
DEALING WITH FIRE HAZARDS
FIRE TYPE TYPE OF HAZARD EXTINGUISHER
TYPE A Ordinary combustibles, paper, clothes, rubbish, plastics and wood; Non-infectious dry wastes Water, Dry Chemical, Loaded Steam
TYPE B Flammable Liquids, Grease, Gasoline, Paints Oil; Wet Dry Chemical, Carbon Dioxide, Halon Foam
TYPE C Electrical Equipment and motor switches Dry Chemical, Carbon Dioxide, Halon
TYPE D Flammable Metals, Mercury, Magnesium, Sodium, Lithium Metal X, Fought by fire fighters only
TYPE E Detonation (Arsenal Fire); Explosives Allowed to burn out and nearby materials are protected
TYPE K Cooking material, grease, oil and fat Liquid designed to prevent splashing and cool the fire
WHAT TO DO IN FIRE ACCIDENTS?
DEALING WITH FIRE HAZARDS
• Flammable chemicals are stored in safety cabinets and explosion proof refrigerators.
• Persons with burning clothes should be wrapped in a blanket to smother the flames
ELECTRICAL HAZARDS
DEALING WITH ELECTRICAL HAZARDS
• Do not operate machinery with wet hands
• All electrical equipment must be grounded with 3 pronged plugs
• Never touch an electrically shocked person or the equipment
• Makes use of various insulating devices
• Turn off the circuit breaker
• Unplug the equipment
• Move the equipment using a nonconductive glass or wood object
• Three prong plugs prevent electrical shock by providing ground
DISPOSAL OF SHARPS
• Sharp objects like needles, lancets, broken glassware must be disposed in PUNCTURE-RESISTANT CONTAINERS
• The lesser manipulation of equipment provides increasing risk prevention (dispose whole syringe in the container)
RADIOACTIVE HAZARDS
• Commonly encountered in Nuclear Medicine
• When procedures using radioisotopes are performed
• Exposure to radiation during pregnancy presents a danger to a fetus
• PPE that blocks of gamma radiation (Strongest of all radiations; longest decay time); LEAD METALS blocks gamma radiation carried by radioisotopes
PHYSICAL HAZARDS – general laboratory etiquettes
1. No running inside the laboratory premises
2. Watch for wet floors
3. Bend knees when lifting heavy objects
4. Keep long hair pulled
5. Don’t wear excessive jewelry
6. Maintain clean and well-organized area
7. Wear Closed-toe shoes
8. No eating and drinking in the laboratory
• FALLING/ FALLS – common cause of injuries of the elderly (poor lighting of facilities, not structurally ergonomic facility) [Show Less]