PROMOTION OF SAFETY - Principles of Health Sciences 1 – 2 - ثاني ثانوي

Link to digital lesson CHAPTER www.ien.edu.sa 1 PROMOTION OF SAFETY Case Study Investigation Noura is a nurse at her local hospital. She is giving an insulin injection to her patient, Maryam, who has diabetes mellitus. She carefully draws up the correct dose and has it cross-checked by another nurse. When she walks into the room, Maryam asks Noura to help her to the bathroom before she gives her the insulin because she cannot maneuver around the power cord for the bed. After Noura assists Maryam to the bathroom, she removes her gloves and washes her hands before administering Maryam's medication. She makes sure that she disposes of the needle in the sharps container, the power cord is tucked safely under the bed, and the call light is clipped to the bed's siderail before she leaves the room. What does Noura do that addresses patient safety? How does she make sure that Maryam's environment is safe, and equipment is correctly maintained? At the end of this chapter, you will be asked about the basic safety techniques Noura needs to be aware of to keep both herself and her patient safe. LEARNING OBJECTIVES After completing this chapter, you should be able to: Define body mechanics. • Use correct body mechanics while carrying objects. • Identify the general principles for preventing accidents and injuries. •Follow safety regulations around hazardous chemicals, pathogens, equipment, and solutions. • Identify the causes of fires, and follow safety regulations around fires, including a fire emergency plan, and the use of fire extinguishers. ⚫ Simulate the operation of a fire extinguisher by following the directions on the extinguisher and specific measures for observing fire safety. KEY TERMS base of support body mechanics ergonomics fire extinguishers good posture radiation exposure NOTE: To further emphasize the key terms, they appear in color within the chapter. 12 CHAPTER 1 وزارة التعليم - Ministry of Education 2022-1444 DES-MIOWA CC 32 HITH SA to 18012023 14:28

وزارة التعليم 1:1 USING BODY MECHANICS To prevent injury to yourself and others, it is important that you observe good body mechanics and maintain correct posture. Body mechanics refers to the way in which the body moves and maintains balance while preventing strain and helping to maintain muscle strength. There are four main reasons for using good body mechanics: ⚫ Muscles work best when used correctly. (A) ⚫ The correct use of muscles makes lifting, pulling, and pushing easier. (B) ⚫ Correct body mechanics prevent unnecessary fatigue and strain, and save energy. . Correct body mechanics prevent injury to self and others. Eight basic rules of good body mechanics include: • Maintain a broad base of support by keeping the feet 20-25 cm (8-10 inches) apart, placing one foot slightly forward, balancing weight on both feet, and pointing the toes in the direction of movement. .Bend from the hips and knees to get close to an object, and keep your back straight (Figure 1-1A). Do not bend at the waist. . Use the strongest muscles to do the job. The larger and stronger mus- cles are located in the shoulders, upper arms, hips, and thighs. Back muscles are weak. . Use the weight of your body to help push, pull, or slide an object rather than lifting it. Carry heavy objects close to the body (Figure 1-1B). Stand close to any object or person being moved. Avoid twisting your body as you work. Turn with your feet and entire body when you change the direction of movement. ⚫ Avoid bending for long periods. If something is too heavy for you to lift alone, always get help. Good posture is also an essential part of correct body mechanics. Aligning the body correctly puts less stress on muscles and prevents fatigue (Figure 1-2): Stand straight with your feet aligned with your shoulders, and your weight supported equally on each foot. Pull in your stomach muscles. Relax your shoulders, and pull them back. Hold your chin and chest up. FIGURE 1-1 (A) Bend from the hips and knees to get close to an object. (B) Carry heavy objects close to the body. FIGURE 1-2 Good posture puts less stress on muscles and prevents fatigue. Minor Ecomon 2022 1444 GE44.PATHWAYS.002.S2.HLTH.58.indb 13 PROMOTION OF SAFETY 13 | 18/01/2023 14:28

checkpoint 1. Define body mechanics. 2. Why is good posture important? 1:2 PREVENTING ACCIDENTS AND INJURIES Safety is the responsibility of every health care provider. It is essential that established safety standards be observed by everyone. This protects the provider, the employer, and the patient. The Ministry of Human Resources and Social Development is respon- sible for occupational safety and health matters in the Kingdom of Saudi Arabia. The Saudi Standards, Metrology, and Quality Organization is responsible for setting standards in the Kingdom. SASO provides envi- ronmental and health protection, and general safety by ensuring that products comply with the standards approved by SASO. The Saudi Food and Drug Authority (SFDA) ensures the safety of food, drugs, biological, and chemical substances as well as medical devices that are related to human health. The Saudi Arabia Public Health Authority aims to protect and promote public health, prevent disease, and raise awareness of public health emergencies. It works to monitor, measure, evaluate, control, and prevent any risk factors related to public health in the Kingdom of Saudi Arabia, including communicable and noncommunicable diseases, inju- ries, and other health challenges. The following sections show how to prevent accidents and injuries with regard to chemical hazards, environmental safety, patient/resident safety, and personal safety. CHEMICAL HAZARDS All employers should inform employees of all chemicals and hazards in the workplace. They should also train their employees to follow the proper procedures or policies for: . Identifying the types and locations of all chemicals or hazards. ⚫ Locating and using safety manuals. • Reading and interpreting chemical labels and hazard signs. 14 CHAPTER 1 ⚫ Using personal protective equipment such as masks, gowns, goggles, and gloves. • Locating cleaning equipment and following the correct methods for managing spills and disposal of chemicals. ⚫ Reporting accidents or exposures and documenting any incidents. وزارة التعليم Maisinjor Education 2022-1444 GE44 PATHWAYS.G02.82.HLTH.S8.indb 14 18/01/2023 14:28

وزارة التعليم OCCUPATIONAL EXPOSURE TO BLOOD AND BODY FLUIDS Health care providers should follow standard precautions to protect them- selves and their patients from diseases caused by exposure to body fluids. Examples of body fluids include blood and blood components, urine, feces, cerebrospinal fluid, saliva, mucus, and other similar fluids. Three diseases that can be contracted by exposure to body fluids include hepati- tis B, caused by the hepatitis B virus; hepatitis C, caused by the hepatitis C virus; and acquired immune deficiency syndrome (AIDS), caused by the human immunodeficiency virus (HIV). Further discussion of standard precautions is presented in detail in Chapter 2, Section 2:3. ENVIRONMENTAL SAFETY Ergonomics is an applied science used to promote the safety and well-be- ing of a person by adapting to the environment and using techniques to prevent injuries. The health care provider must be conscious of personal and patient/resident safety at all times. In addition, every health care provider must be alert to unsafe situations and report them immediately. Examples include burned-out lightbulbs, frayed electrical cords, scalding water in a sink or bath area, missing floor tiles or torn carpet, and other similar hazards. Environmental hazards in health care facilities can also endanger patients, health care personnel, other individuals, and the environment. Radiation exposure is a major concern in radiology departments and dental offices. . In dental offices, the person taking x-rays usually stands outside the room to avoid exposure to the rays. .In radiology departments, machines that emit radiation waves must be checked frequently to make sure they are operating correctly and not leaking radiation. Radiographers should stand behind a protective shield when activating the machines and wear dosimeter badges that measure exposure to radiation. Radioactive iodine is used to treat thyroid diseases. After it has been given to a patient, small amounts of radiation are present in the neck area for several days. This is a beneficial treatment for the patient, but precautions must be taken to protect the patient's family and friends. . Drugs used to treat different cancers can be hazardous to health care personnel and pregnant individuals, and must be handled with care. Contaminated waste containing body fluids such as blood or tissues can spread disease if it is not destroyed properly. Ministry of Eduction 2022-1444 GE44.PATHWAYS.002.82.HLTH.58.indb 15 PROMOTION OF SAFETY 15 | 18/01/2023 14:28

FIGURE 1-3 Read the relevant standards before using hazardous chemical solutions. • Mercury is used in dental offices, older sphygmomanometers (an instrument for measuring blood pressure), and glass thermometers, and can present a danger to people and the environment if it is not disposed of correctly. All health care providers are responsible for identifying hazards and for following the approved method of disposal. Health care providers must always follow approved policies and procedures to create a safe environment. EQUIPMENT AND SOLUTIONS SAFETY Basic rules when working with equipment and solutions include: Do not operate or use any equipment until you have been instructed on how to use it. Read and follow equipment operating instructions. If you do not understand the instructions, ask for assistance. ⚫ Report damaged or malfunctioning equipment immediately, and do not use it. ⚫ Do not use frayed or damaged electrical cords. ⚫ Never handle electrical equipment with wet hands or around water. ⚫ Store all equipment in its proper place. Observe all safety precautions when handling equipment. . Read the relevant standards before using hazardous chemical solutions. • Never use solutions from bottles that are not labeled. . Read the labels of solution bottles at least three times during use to be sure you have the correct solution (Figure 1-3): before taking the bottle off the shelf, before pouring from the bottle, and after you have poured from the bottle. . Do not mix any solutions together unless instructed to do so, or you can verify that they are compatible. ⚫ Some solutions can be harmful or poisonous. Avoid contact with your eyes and skin. Avoid inhaling any fumes emitted by a solution. ⚫ Store chemical solutions in a locked cabinet or closet following the manufacturer's recommendations. For example, some solutions must be kept at room temperature, while others must be stored in a cool area. .Dispose of chemical solutions according to the instructions provided for the solution. 16 CHAPTER 1 وزارة التعليم Ministry of EmcoDon 2022-1444 GE44 PATHWAYS.G02.82.HLTH.S8.indb 16 18/01/2023 14:28

وزارة التعليم If any equipment is broken or any solutions spilled, immediately report the incident to an instructor/immediate supervisor. They will advise on how to dispose of the equip- ment or how to remove the spilled solution (Figure 1-4). PATIENT/RESIDENT SAFETY Basic rules that must be followed to protect a patient or resident include: . Do not perform any procedure on patients unless you have the proper authorization, and follow instructions carefully. Ask ques- tions if you do not understand. . Use correct and approved methods while performing any procedure. Provide privacy for all patients. Knock on the door before entering a room. Speak to the patient and identify yourself (Figure 1-5A). Ask for permission to enter before going behind closed privacy curtains. Close the door or draw the curtains for privacy before beginning a procedure on a patient (Figure 1-5B). ⚫Always identify patients correctly by check- ing the identification wristband and asking the patient to state their name. Check the name on the patient's bed and record. . Always explain the procedure so the patient knows what you are going to do. Make sure you have the patient's consent before per- forming any procedure (Figure 1-5C). Never perform a procedure if a patient refuses to allow you to do so. Observe the patient closely during any procedure and report any changes in the patient's condition immediately. Frequently check the patient area and waiting room for safety hazards. Report all unsafe situations immediately. (A) (B) (D) FIGURE 1-4 To clean a spill: (A) Pour coagulating powder on the spill. (B) When the material has been absorbed, pick up the residue and (C) place it in a biohazard container. (D) Clean the area thoroughly with a disinfecting solution. Myding of Eschbor 2022-1444 GE44.PATHWAYS.002.82.HLTH.58.indb 17 PROMOTION OF SAFETY 17 | 18/01/2023 14:28

(A) (B) FIGURE 1-5 (A) Always knock on the door or speak before entering a patient's room. (B) Close the door or draw the curtains for privacy before beginning a procedure. (C) Explain the procedure and make sure you have the patient's consent. (A) Before leaving a patient in a bed, observe all safety checkpoints and make sure the patient is comfortable (Figure 1-6A). . Wash your hands thoroughly with soap and water (Figure 1-6B). If your hands are not visibly dirty or contaminated with blood or body fluids, they can be cleaned with a hand gel (Figure 1-6C). PERSONAL SAFETY Basic rules that must be followed to protect yourself and others include the following .It is your responsibility to protect yourself and others from injury. ⚫ Use correct body mechanics while performing any procedure. ⚫ Wear appropriate personal protective equipment. • Walk-do not run-in the laboratory area or clinical area, in hall- ways, and especially on stairs. • Promptly report any personal injury or accident. If you see an unsafe situation, report it to your instructor/immediate supervisor promptly. (B) (C) FIGURE 1-6 (A) Lower the bed and place the call signal and other supplies within easy reach of the patient before leaving a patient. (B) Wash your hands before and after any procedure, and any time they become con- taminated during a procedure. (C) If your hands are not visibly dirty or contaminated with blood or body fluids, they can be cleaned with a hand gel. 18 CHAPTER 1 وزارة التعليم Missingor Econ 2022 1444 GE44 PATHWAYS.G02.82.HLTH.S8.indb 18 18/01/2023 14:29

وزارة التعليم ⚫ Keep all areas clean and neat, with all equipment and supplies in their proper locations at all times. . Wash your hands before and after any procedure, and any time they become contaminated during a procedure. ⚫ Keep your hands away from your face, eyes, mouth, and hair. ⚫ Dry your hands thoroughly before handling any electrical equipment. ⚫ Wear safety glasses when instructed to do so and in any situations that might result in possible eye injury. If any solutions come into contact with your skin or eyes, immediately flush the area with cool water. Inform your instructor/supervisor. If a particle gets in your eye, do not try to remove the particle or rub your eye. checkpoint 1. What is radioactive iodine used for? 2. How many times should you read the label of a solution bottle to be sure that you have the correct solution? 1:3 OBSERVING FIRE SAFETY Health care providers must know three basic facts about fires: how they start, how to prevent them, and how to respond when they occur. Fires need three things to start (Figure 1-7): 1. Oxygen-present in the air. 2. Fuel-any material that will burn. 3. Heat-sparks, matches, or flames. The major cause of fires is unattended cooking fires. Other causes include misuse of electricity (over- loaded circuits, frayed electrical wires, improperly grounded plugs), defects in heating systems and portable heaters, use of inhalers and matches, candles, spontaneous ignition, improper waste dis- posal, children playing with matches and lighters, and arson. Heat Fire Fuel Oxygen FIGURE 1-7 The fire triangle shows the three things needed to start a fire. Ministry or Emicinon 2022-1444 GE44.PATHWAYS.002.82.HLTH.58.indb 19 PROMOTION OF SAFETY 19 | 18/01/2023 14:29

FIRE EXTINGUISHERS Fire extinguishers are metal cylinders filled with water or chemicals used to put out fires. They are portable and easy to operate, and are mainly used to put out small fires before flames spread. Fire extinguishers are classified and labeled according to the kind of fire they extinguish. The main classes are: ⚫ Class A: used on fires involving combustibles such as paper, cloth, plastic, and wood. ⚫ Class B: used on fires involving flammable liquids such as gasoline, oil, paint, grease, and cooking fat. ⚫ Class C: used on electrical fires such as fuse boxes, appliances, wiring, and electrical outlets that are nonconductive. Water is a good conduc- tor of electricity, so the electricity should be turned off before using an extinguisher on an electrical fire, if possible. • ⚫ Class D: used on burning metals; often specific for the type of metal being used, and not used on any other types of fires. ⚫ Class K: used on burning cooking materials (fats, grease, and oils) and appliances in commercial cooking sites such as restaurants. Many different types of fire extinguishers are available. The main types are: • • Water: contain pressurized water-only for use on class A fires. Carbon dioxide: contain carbon dioxide gas that smothers the fire by forming a cloud of cool ice that displaces the air and oxygen. They leave a powdery residue that irritates the skin and eyes, and can be dangerous if inhaled-most effective on class B or C fires. CLASSES OF FIRE EXTINGUISHERS B D K FIGURE 1-8 Fire extinguishers contain diagrams and/or letters to show the type of fire on which they should be used. 20 CHAPTER 1 وزارة التعليم Minising or Emucjan 2022-1444 GE44 PATHWAYS.G02.82.HLTH.58.indb 20 18/01/2023 14:29

⚫ Dry chemical: contain a chemical that acts to smother a fire: ⚫Type BC extinguishers leave a mildly corrosive residue that must be cleaned up as soon as possible. ⚫ Type ABC extinguishers leave a sticky residue that can damage electrical appliances such as computers. ⚫ Type K extinguishers leave a soapy foam that can damage appliances. All the residues from extinguishers used on class A, B, C, or K fires can irritate the skin and eyes. ⚫Halon: contain a gas that interferes with the chemical reaction that occurs when fuels burn-used on electrical equipment because they do not leave a residue and will not damage appliances such as comput- ers; most effective on class C fires. Most fire extinguishers are labeled with a diagram and/or a letter showing the type of fire for which they are effective (Figure 1-8). The main rules to be followed in case of fire are: • Keep calm. If your personal safety is endangered, evacuate the area according to the stated method and sound the alarm. .If the fire is small, confined to one area, and your safety is not endan- gered, determine what type of fire it is and use the proper extinguisher. FIRE EMERGENCY PLAN Most institutions have a fire emergency plan, which should be followed in all cases of fire outbreak. ⚫The fire alarm should be activated as quickly as possible (Figure 1-9). . All doors and windows should be closed, if possible, to prevent drafts, which cause fire to spread more rapidly. ⚫ Electrical equipment and oxygen should be shut off. FIRE BREAK GLAS ESS HERE وزارة التعليم Missioyo EC000 2022 1444 FIGURE 1-9 When a fire occurs, the fire alarm should be activated as quickly as possible. GE44.PATHWAYS.002.82.HLTH.58.indb 21 PROMOTION OF SAFETY 21 | 18/01/2023 14:29

22 CHAPTER 1 وزارة التعليم Ministry or EmicuDon 2022-1444 GE44 PATHWAYS.G02.82.HLTH.58.indb 22 Rescue anyone in immediate danger. In a health care facility, move patients to a safe area. If a patient can walk, escort them to a safe area. It may be necessary to move a patient in a bed or carry the patient to a safe area. ⚫ Elevators should never be used during a fire. ⚫ Activate the fire alarm. Sound the alarm and give the location and type of fire. By following the fire emergency plan, knowing the location of fire extin- guishers and exit doors, and remaining calm, you can help to prevent loss of life or serious injury during a fire. Safety Preventing fires is everyone's job. Constantly be alert to potential causes of fires, and correct all situations that can lead to fires. Some rules for preventing fires are: Obey all "No Smoking" signs. ⚫ Extinguish matches, inhalers, and any other flammable items completely. .Dispose of all waste materials into proper containers. . Before using electrical equipment, check for damaged cords or improper grounding. Avoid overloading electrical outlets. ⚫ Store flammable materials in proper containers and in a safe area. If you spill a flammable liquid, wipe it up immediately. ⚫ Do not allow clutter to accumulate in rooms, closets, doorways, or traffic areas. Make sure no equipment or supplies block any fire exits. ⚫ When oxygen is in use, observe special precautions. Post a "No Smoking-Oxygen in Use" sign. Avoid the use of electrically operated equipment whenever possible. Do not use flammable liquids such as alcohol, nail polish, and oils. Avoid static electricity by using cotton blankets, sheets, and gowns. HOW TO USE A FIRE EXTINGUISHER 1. Check the extinguisher type to be sure it is the proper one to use on the fire (Figure 1-10A). 2. Locate the lock or pin at the top handle. Release the lock following the manufacturer's instructions (Figure 1-10B). 18/01/2023 14:29

وزارة التعليم 3. Grasp the handle to hold the extinguisher firmly in an upright position. 4. Stand approximately 2-3 meters (6-10 feet) from the near edge of the fire. 5. Aim the nozzle at the fire (Figure 1-10C). 6. Discharge the extinguisher. Use a side-to-side motion. Spray toward the near edge of the fire at the bottom of the fire. 7. Take care: do not spray into the center or top of the fire because this will cause the fire to spread in an outward direction. 8. Continue with the same side-to-side motion until the fire is extinguished. 9. Take care: avoid contact with residues from chemical extinguishers as they can irritate the skin and eyes. (A) DISASTER PLANS In addition to fires, other types of disasters may occur, such as earthquakes and floods. In any type of disaster, stay calm, follow the most current policy of the health care facility, and provide for the safety of yourself and the patient. Health care providers have a duty to famil- iarize themselves with disaster policies so that appropri- ate action can be taken when a disaster strikes. checkpoint 1. What three things do fires need to start? 2. Where should you store flammable materials? (B) (C) FIGURE 1-10 (A) Check the extin- guisher type to make sure it is the correct one to use. (B) Release the pin on the fire extinguisher. (C) Aim the nozzle at the near edge of the fire, and push the handle to discharge the extinguisher. Case Study Investigation Conclusion Noura needs to think of patient safety, equipment safety, environmental safety, and her own personal safety. What two techniques did Noura use to keep Maryam safe? What personal protective equipment did she use to keep herself safe? Did you list moving the bed's power cord as one way she addressed environmental safety? The way Noura disposed of the used insulin needle showed her concern for equipment safety. Did your answer include all of these areas? Mesinjo Educon 2022-1444 GE44.PATHWAYS.002.82.HLTH.58.indb 23 PROMOTION OF SAFETY 23 | 18/01/2023 14:29