Archive for: Notes from the field
Notes from the field: The sound of no hands washing
Last week as I was doing a mock OSHA inspection I saw several employees standing by the restroom door listening to the activities going on in the restroom.
As I tried to control my response to this comical picture, I whispered the question “why are you standing outside this door?”
The response: they were listening to see if this very prominent physician washed his hands before coming out of the restroom.
Notes From the field: No thank you, I am not that thirsty
Recently I was in an office going over some safety issues. One of the staff members said she had a pot of coffee in their break room and asked if I would like a cup.
“Sure,” I said.
The nurse and I walked back to the break room. Sure enough the coffee was just about ready as it brewed in the coffee pot that was sitting next to the autoclave. There was also a towel laying on the sink with “cleaned” vaginal speculum awaiting a cycle in the autoclave.
Notes From the field: High-level disinfecting AND autoclaving?
Recently, I have noticed this issue during several of my mock OSHA inspections. Glutaraldehyde should only be used to disinfect heat-sensitive instruments. When the soaking time is long enough, most high-level disinfectants can achieve complete sterilization.
If an instrument has been manufactured to withstand heat, it should be autoclaved (sterilized)
Some physician offices are using the glutaraldehyde as a soaking solution, AND autoclaving the instrument.
This is over-kill.
Notes from the field: “Why are you standing on the ledge under the sink cabinet?”
As I was walking past an exam room last week during an inspection, I couldn’t believe what I seeing.
One of the medical assistants (MA) was too short to reach the wall mounted sharps container, so she opened the under the sink cabinet door, stood on the ledge, reached up over her head, and put the used safety device in the sharps container.
Notes from the field: “Your fire extinguisher is where!”
During my OSHA inspections, I always ask to see the fire extinguisher(s) so that I can verify the last inspection date.
Usually this is a simple process. I walk down the hallway and take a look at the fire extinguisher that is either hanging on the wall or in a recessed glass enclosure. Imagine my disbelief when the physician said he would “get it for me.”
Notes From the field: What’s that smell; why are my eyes burning?
The culprit was an open container of the high level disinfectant glutaraldehyde. The minute I stepped into the lab of a physician’s practice, I could smell the glutaraldehyde solution. There was a large basin sitting in the sink piled high with metal instruments.
This mixture should ALWAYS be kept in a tightly closed bin/container.
Notes From the field: Why can’t I re-use the vacutainer tube holder?
During my OSHA inspections last week, I witnessed several phlebotomists removing contaminated needles from vacutainer tube holders. The OSHA Bloodborne Pathogens Standard [29 CFR 1910.1030(d)(2)(vii)(A)] addresses the “prohibition against the removal of contaminated needles from blood tube holders following a blood drawing procedure.”
Notes from the field: What’s the difference, mask vs. N95 respirator?
This week several medical practices asked what is better for protection against the current influenza A (H1N1), swine flu, face masks or N95 respirators?
A mask is a paper device that will slow or stop large droplets (sneezing, splashes, and sprays) that may infect you.
Notes from the field: Are you prepared for pandemic flu?
The CDC has been warning us for the past three years to be prepared for “when” not “if,” and the “when” is closing in on us very quickly this week.
The World Health Organization (WHO) has declared a public health emergency for swine influenza A (H1N1) viruses. The WHO has moved to a worldwide phase 4 pandemic alert. At a Phase 6 we would be at a full blown pandemic characterized by outbreaks in at least 2 regions of the world.
