First impressions count, and the way your office appears to patients, potential new employees or OSHA inspectors, should send the right message. Using a safety checklist can help. Does your practice look well-organized, efficient, and safety centered? The next time you enter your office, walk in the front door and visualize the space as a patient, potential new employee or even an OSHA inspector. Ask the following questions:
Is the waiting area clean and organized?
Are there silk plants dusty?
Is the carpet in good repair?
How old are the magazines?
Are the clinical areas filled with items not in use?
Are the counters free of clutter so surface disinfection can easily occur?
Are sharps containers overfilled?
Is the sterilization area clean and well organized?
Perhaps you can see where this is going, but actually there are some compliance basics that go along with appearance and the overall well being of your physical location. We will look at safety from two different perspectives: employee safety and patient safety.
Employee safety standards are often referred to as OSHA standards. Listed below are safeguards which must be in place to ensure employees are provided a safe work environment. Take a few moments to review the checklist and document what you have in place and which areas you can to improve.
Training: Employees must be trained in order to understand current safety measures. Annual training is not only a best practice; bloodborne pathogen training is required by law every 365 days.
Policies and Procedures: Written plans on exposure control and hazardous communication must be available at all times. Each employee should know where to locate the written plan as well as where to locate Safety Data Sheets (SDS) for all chemicals they work with.
Vaccinations: Appropriate documentation of hepatitis B vaccination or vaccination declination must be included in each worker’s file who is at risk of exposure to blood or other potentially infectious material (OPIM).
Personal protective equipment (PPE): Provided by the employer at no cost, PPE provides a layer of protection against splash or spatter of blood or OPIM. Employers must also provide laundering of reusable PPE, and not allow employees to take contaminated PPE home for cleaning.
Engineering Controls: The availability and use of engineering controls was mandated by the Needlestick Safety and Prevention Act of 2001. Examples of engineering controls include sharps containers, safety scalpels, safety needles, and safety IV access devices.
Check for the following items when walking through the practice:
GFIC outlets in restrooms and outlets: They should be where there is potential for splash or splatter of water.
Clearance around breaker boxes: There should be three feet of clearance and appropriate labeling.
Fire extinguishers: Are they being checked monthly? Do you have annual maintenance checks by outside sources scheduled to ensure proper functioning if needed?
Sharps containers: Are they located in direct areas of use?
Transport of contaminated reusable, sharps by placing the sharps in a container that is leak proof on sides and bottom, closable and labeled.
Patient safety is provided in part by following established standards for infection control. The CDC has issued multiple guidelines to address specific processes such as handwashing, disinfection and sterilization. By following the established guidelines, overall risk from acquiring infection through the delivery of patient care can be reduced. Each practice should have an infection control plan which is thoroughly implemented.
Key items to review in your practice include:
Instrument Cleaning Process: Processes must be focused on reducing in actual handling of soiled instrumentation, i.e. use of ultrasonic cleaner instead of scrubbing by hand.
All employees are expected to use heavy duty utility gloves during this process.
Sterilization process and cycle:
The process should be properly monitored with internal and external indicators on every package.
Spore testing on a weekly basis for each sterilizer in use.
Appropriate loading of sterilization unit, and removal of instrument packages only once they are completely dry and cool.
Single use devices:
Must be discarded, not disinfected or sterilized after use as directed by the manufacturer. Single dose medications must be discarded after patient use even if there is solution is remaining.
Hand washing must be a top priority for all personnel.
Research has proven this is a challenge in all health care environments, yet it is the one thing which will consistently reduce the likelihood of spread of infection.
One person in the practice must be identified as the point person for oversight of the infection control program.
If there are opportunities for improvement, start now to ensure your practice reflects a strong culture of both patient and worker safety. Start 2017 off right focusing on the safety of all!