Guest blog: Hand in Mouth

By: December 16th, 2014 Email This Post Print This Post

The following is a guest blog by Dan Scungio, MT (ASCP), SLS, a Laboratory Safety Officer for Sentara Healthcare, a multi-hospital system in the Tidewater region of Virginia.

The safety culture varies greatly from laboratory to laboratory. Most lab employees these days know that eating food or drinking in the lab is against most (if not all) lab regulatory agency rules and guidelines. However, it is surprising that many do not seem to understand that gum chewing or using hard candy or throat lozenges is also not permitted in a laboratory setting.

OSHA’s Bloodborne Pathogen Standard specifically states that “Eating, drinking, smoking, applying cosmetics or lip balm, and handling contact lenses are prohibited in work areas where there is a reasonable likelihood of occupational exposure.” Obviously the goal of this regulation is to prevent employees from obtaining infection via ingestion. A secondary goal is to limit hand to mouth contact while working in the laboratory. That goal is also to there to prevent ingestion infection.

So far there has been no mention of gum or cough drops in the standards, and you’re going to tell me your staff is going to argue against this.

In the National Research Council’s Prudent Practices in the Laboratory (1995), it states that “Eating, drinking, smoking, gum chewing, applying cosmetics, and taking medicine in laboratories where hazardous chemicals are used should be strictly prohibited.” In CLSI’s document Clinical Laboratory Safety (GP-17 A3, 2012), it states that “Food, drink, and substances that provide potential hand-to-mouth contact (including chewing gum and lip balm) are pro­hibited in technical work areas.”

Most inspectors of the laboratory will cite the lab for gum chewing or the like. An employee may respond that the gum was placed into their mouth outside the lab, but proving that would be difficult at best. It’s an inappropriate and unsafe practice, and it should not be allowed.

Again, limit hand to mouth or hand to face contact in the laboratory. What about telephone use? There are speaker options for phones which can help, but some labs are too noisy for that type of use. Disinfect phones often if that is the case.

As with any other safety regulation, if you explain it to staff, and if you make it easy to comply, your safety culture will improve. Educate your staff about these guidelines and standards and why they exist. Unfortunately, many laboratorians fell victim to harmful infectious diseases before these regulations were developed. Don’t let your staff become another part of those unfortunate lab safety statistics.

Expert tips on training for Ebola

By: December 9th, 2014 Email This Post Print This Post

Hear that? That’s the relative quiet we’ve been enjoying since the media furor over the U.S. cases of Ebola died down. It doesn’t mean the virus is gone, and it’s safe to say we haven’t seen the last of it in U.S. healthcare facilities.

But healthcare took a hard blow, and as healthcare workers spoke up about the lack of confidence they had in their training facilities had to get real about making sure they were prepared. Meanwhile, the government stepped up, understanding they needed to take more of proactive approach to helping them prepare.

I had the pleasure this week of talking with some notable experts in the field of infection control, including Peter Provonost, MD, critical care physician and medical director of the Quality and Safety Research Group at Johns Hopkins Hospital in Baltimore, who teamed up with the CDC to develop and record a series of easy-to-follow training videos designed to help healthcare workers in clinics and hospitals understand the complicated steps involved in donning and doffing the PPE required to treat patients with Ebola.

Access the training videos at the following link: http://www.cdc.gov/vhf/ebola/hcp/ppe-training/

Meanwhile, here’s some tips experts suggest for safety officials to consider when training their own staff:

Know what you don’t know. Ebola is uncharted territory for many of you out there. The CDC and many other safety agencies have changed their recommendations about protocols as recently as within the last six months, and unless you are constantly keeping up on things, you’ll soon be out of compliance. Keep up on all the latest journals, bookmark government agencies for all the latest information on the Ebola outbreak, and talk to your employees. What do they want to know? Find out the answers and have a training session.

Be open to new things. Instead of using lectures or simply printing out guidelines released by the CDC or OSHA for your staff to review, try video training or printing posters or other visual aids that can be hung around the clinic for them to review. Even better, hire a consultant to come in and do some hands-on training. Some companies (and hospitals) will actually bring gowns, coveralls, and masks to your facility and let your staff practice donning and doffing PPE. In addition, it’s a good idea to let them get into pairs and practice using a buddy system when doing procedures.

Get to know your neighbors. In the event that even one Ebola patient walks through your door, it’s going to immediately take over all resources you have. You’re going to need some help. If your facility is connected to a hospital, maybe you have a deal worked out to have physicians, nurses, and other staff to come help out with the extra patient load. You will need to have vendors who can resupply your facility quickly if a high patient surge drains your backup stashes quickly, and if your facility is a lab, or if you have a lab on site, make sure you’ve checked with your couriers to ensure who will transport blood samples.

Practice for the real thing. Perhaps it’s time to hold a drill just like the safety folks at hospitals do every year to maintain accreditation with agencies such as the Joint Commission. You can make it as real as possible: perhaps using volunteer “victims” to walk in and engage your staff, acting as if they may have traveled to African nations and now they are exhibiting Ebola-like symptoms. The idea is to challenge your staff and to test their responses. They will make mistakes; your goal is to help them learn from them and improve.

Review sharps safety with your staff!

By: November 19th, 2014 Email This Post Print This Post

The following is a guest blog by Dan Scungio, MT (ASCP), SLS, a Laboratory Safety Officer for Sentara Healthcare, a multi-hospital system in the Tidewater region of Virginia.

Rita did not place the top on the sharps container when she replaced it in the morning. Later, she threw a gram stain slide into the container from a distance, and the slide shattered. Pieces of glass and what she felt was wet material flew into Rita’s eye.

Jason accidentally threw out the tube of blood before pouring off all of the send-out tubes of serum he needed. He thought it was safe to reach into the sharps container since he had gloves on. He pulled his hand out quickly when he felt a sudden pain, and he noticed an open bleeding cut through his glove.

Jane was busy and did not have time to replace the wall sharps container next to the phlebotomy chair when she noticed it was full. After the next patient, she activated the needle safety device and tried to shove it into the sharps container even though its safety lid was blocking her efforts. Jane pushed hard to dispose of the needle, and she felt a stinging sensation in her finger when she “succeeded.”

Sharps safety is no small matter. In the above scenarios, the incidents are particularly unsettling because each of those exposures is from unknown sources. There is no way to tell which patient is the exposure source, so it must be assumed the source is infectious. No exposure incident is good, even if the source is known and tested to be negative for HIV and Hepatitis. An unknown source exposure, however, may mean treatment with prophylactic drugs which can have unpleasant physical side effects. There is also follow-up testing and emotional impact for the employee while waiting (up to a year or more) to see if any infectious diseases were contracted.

Be sure to train lab staff properly about sharps safety. Proper activation of safety needle devices should be a part of that training. The correct placement and use of sharps containers is vital as well. Be sure floor or counter-mounted containers are prevented from tipping. Make sure lids are correctly in place in order to prevent splash-back or to keep hand and fingers out. Teach staff never to dig through a sharps container, and to always empty them before they are full.

Sharps safety should be an important piece of your lab’s Bloodborne Pathogens program, and staff education on the topic should be regular. Make sure lab staff gets the point…of sharps safety!

Keep up on the latest Ebola information

By: November 3rd, 2014 Email This Post Print This Post

By now, I’m sure you all have had just about your fill of news coverage about Ebola. And there’s a good chance your facility has upgraded or even changed its intake, security, and infection control protocols to comply with the newest CDC protocol recommendations.

Make no mistake, however. The threat of an outbreak is still out there, as the disease has not been controlled in Africa, and even though the patient count here in the United States has stabilized and the media frenzy has died down a bit, now is not the time to be complacent.

All it takes is one positive case to walk through your doors to change the game, and now is the time to take the lessons learned in Texas and other healthcare facilities to strengthen your own preparations for an Ebola case.

Are your sure that your staff are properly trained to quickly put the proper PPE on, and work in a stressful environment if an Ebola patient walks in to your facility? How will you disinfect your patient rooms properly so that there is no chance of spreading the infection?

From a public relation standpoint, how will you deal with a confused public, or patients who may need to be quarantined? As we saw in Maine recently with the case of a nurse who challenged the government’s attempts at a forced quarantine, there are many unanswered questions that remain about Ebola and the proper response and preparation of healthcare facilities.

We here at HCPro are committed to making sure you get the most up-to-date information, and I invite you to participate in a very special 60-minute webinar that will cover all the latest information, and answer any questions you my still have aboutpreapring for an Ebola outbreak.

The show, Ebola: How to Prepare Your Facility, will take place on Monday, November 17 from 1-2 p.m. Our featured speakers will include Marge McFarlane, an infection control expert for more than 30 years, and healthcare security expert Tom Smith, who was in charge of maintaining hospital security for facilities in North Carolina during the SARS outbreak in 2002.

By the end of the show, you’ll learn how to maintain ongoing communication regarding the situation both inside and outside the doors of your facility, povide your staff and security team with the tools they will need to maintain order and properly intake and triage patients in the event of a major outbreak of Ebola or similar disease, have an understanding of the PPE and isolation needs necessary to protect others from contracting Ebola, and identify how to properly manage, dispose of, and transport hazardous medical waste that will be generated during an Ebola outbreak.

More importantly, the show is being designed around YOU. We will be sure to allow plenty of time for questions you may have as the situation changes from day to day. For more information or to register, click here to visit the HCPro Marketplace.

 

Upcoming HCPro webcast helps prepare your facility for Ebola

By: October 28th, 2014 Email This Post Print This Post


Join us for Ebola: How to Prepare Your Facility, to learn all you need to know about protecting your healthcare facility while providing the highest level of care for your patients. The show will take place on Monday, November 17 from 1-2 p.m.

This program will help hospitals clear up misconceptions surrounding the latest Ebola outbreak and help facilities develop a response plan in the event they receive a patient with Ebola or similar disease.

During this 60-minute webcast, infection control expert Marge McFarlane and healthcare security expert Tom Smith will:

  • Assess the current status of the Ebola outbreak and the preparedness level of healthcare facilities
  • Separate fact from fiction about transmission and patient care
  • Provide tips on infection prevention as well as intake, isolation, and disinfection procedures unique to Ebola
  • Discuss emergency management and facility security control issues that occur during an outbreak
  • Discuss access control and compliance lessons learned from the SARS experience from 2003
  • Provide suggestions to improve staff training, communication, and support for frontline staff (police and security, valet parking, guest services, environmental services, engineering staff, admitting staff, etc.) when dealing with suspected cases

At the end of this webcast, you will be able to:

Confidently and quickly activate a facility response plan to an Ebola patient, knowing your staff has been adequately trained and briefed with the latest information from the CDC and other agencies

  • Maintain ongoing communication regarding the situation both inside and outside the doors of your facility
  • Provide your staff and security team with the tools they will need to maintain order and properly intake and triage patients in the event of a major outbreak of Ebola or similar disease
  • Have an understanding of the PPE and isolation needs necessary to protect others from contracting Ebola
  • Identify how to properly manage, dispose of, and transport hazardous medical waste that will be generated during an Ebola outbreak

For more information or to register, click here to visit the HCPro Marketplace.

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