Environmental Services Professional Training Course. Morning Schedule. (15 min.) Introductions (15 min.) Course Development and Objective, Pre-test, Overview of Occupational Hazards, Definitions
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(15 min.) Introductions
(15 min.) Course Development and Objective, Pre-test, Overview of Occupational Hazards, Definitions
(60 min.) Microorganisms & Infectious Agents (show 27 min. video before lecture/discussion)
(15 min.) Break
(75 min.) Infectious Waste (includes 22 min. video)
(40 min.) Cleaning for Health
(50 min.) Lunch
(40 min.) Hazardous Material Safety
(40 min.) Needlestick and Injury Prevention
(15 min.) Break
(30 min.) Spill Response
(60 min.) Regulated Medical Waste Transportation Requirements
(45 min.) Post Test and Course Evaluations
When they enter patient rooms, they may become exposed to infectious diseases.
They risk exposure to bloodborne pathogens from dirty needles that are occasionally thrown away in the biohazard and general waste streams.
They are a category of worker at risk of latex allergy from ongoing latex exposure.
They may become injured from slips, trips, and falls, or heavy lifting.
1. Bacterial agents - Tuberculosis (TB), Staphylococcus (staph), or Legionella
2. Fungal agents - Aspergillus (mold), Tinea (ringworm)
3. Viruses - Hepatitis B, Hepatitis C, HIV
4. Parasitic agents - Giardia and Trichomoniasis
5. Prions - Kuru and Creutzfeldt-Jakob Disease
6. Rickettsial agents - Rocky Mountain spotted fever and Lyme Disease
EXAMPLE 1 - Tuberculosis
EXAMPLE 2 - Hepatitis B
1) To get a Hepatitis B vaccination
2) To report all needlestick injuries to the infection control nurse and accept post-exposure treatment.
Biohazard Labeled Bag or Container
Only about 10% of the waste is actually infectious ...
And 2% of the waste is pathological, requiring incineration.
A number of actions can be taken to reduce the amount of solid waste within the hospital system that is sent in biohazard bags to medical waste incinerators for disposal.
1. There must be a comfortable home or reservoir in which to hang out which is just about anyplace, and
2. They need nourishment just like us in the form of food and water.
What kind of food do these organisms “eat?”
in the building ventilation system in areas where organic matter (dust) and water are present. Where would you expect to find this organism in a health care facility?Can this organism kill a patient?
How do you think patients become infected with this bacteria?
Patients may become infected with VRE by touching contaminated surfaces such as bedrails, sinks, faucets, and doorknobs, or coming into contact with health-care workers who do not wash their hands.
Nosocomial diseases are illnesses that patients acquire during their stay in the hospital.
Daily cleaning reduces the amount of microorganisms in the patient care environment.
Diligent housekeeping keeps microorganisms and other bio-pollutants under control and reduces the spread of nosocomial disease.
What is nosocomial disease?
Environmental services professionals routinely use chemical disinfectants to clean surfaces and kill infectious agents in patient rooms and other areas of the health care facility. If not handled properly, these chemicals can cause serious injuries such as eye damage, respiratory problems, chemical burns, or severe skin irritation. To prevent such injuries, the OSHA Hazard Communication Standard requires all health care employers to provide information and training to their employees about the hazards associated with the chemicals in their workplace.
In order to understand the hazard information provided by the MSDS, environmental services professionals must first learn something about the nature of chemicals. Chemicals are made up of single or multiple elements.
Water- two elements, two molecules of hydrogen and one molecule of oxygen (H20)
The most common chemicals in use are made up of three elements - carbon, hydrogen, and oxygen.
What are some chemicals used everyday in healthcare facilities?
H-3, also known as Tritium, is an example of a radioactive material which is made up of three hydrogen molecules. It is often used by scientists in biomedical research laboratories.
Gasoline is a common chemical that becomes an airborne vapor at and below room temperature. It is very flammable with a flash point of -45 degrees F.
Any chemical can be harmful to human health. How harmful a chemical is depends on how much of it gets into the body and how toxic it is.
It is very important to wear Personal Protective Equipment (PPE) when working with corrosive material.
Some hazardous materials have warning properties that alert the worker to a potential exposure in the event of a release. Examples of warning properties include odor, headache, burning or tearing eyes, or coughing.
Example: Ethylene oxide is a toxic gas that is used in many healthcare facilities to sterilize surgical instruments. It is considered a carcinogen and a reproductive hazard.
If a substitute material cannot be found to do the job, a toxic or other hazardous material can be used safely in the work place as long as precautions and procedures are in place to protect the worker from exposure.
To summarize, manufacturers must develop a Material Safety Data Sheet (MSDS) and provide it to people and organizations that purchase their products. Employers such as hospital organizations are then required to train their employees on the hazard information provided by the MSDS.
It is estimated that 600,000 to 800,000 needlestick and other percutaneous injuries occur annually among health care workers in the United States. About half of these injuries go unreported. Data suggests that at an average hospital, approximately 30 needlestick injuries occur per year for every 100 beds.
How many beds are in the hospital that you work at?
Environmental services professionals routinely respond to calls for assistance in cleaning up spilled materials on the patient wards and other areas of the hospital. The spilled materials often consist of human body fluids such as urine, blood, and feces that may or may not be infectious. Regardless of whether or not the material is actually infectious, any human body fluid must be considered potentially infectious.
It is up to management personnel to decide whether or not a spill is incidental.
There is a great deal of concern about the proper management of health care facility wastes. Environmental services professionals are responsible for picking up the waste at each point of generation and transporting it to the designated place of disposal or storage at the facility. If certain wastes are mishandled or improperly disposed of, health care facilities may be subject to fines. Some of the waste generated in the health care setting could be infectious and transmit disease if improperly handled or disposed of.
OSHA regulates infectious waste in the workplace by enforcing the requirements of the Bloodborne Pathogens Standard. When environmental services professionals pick up infectious waste at each point of generation in the healthcare facility and transport it to the designated place of treatment or storage at the facility they must do so “in accordance with OSHA regulations”. What does this mean?
DOT regulations require that all infectious substances, including regulated medical waste, be prepared for shipment off-site by trained personnel. Specifically, personnel must receive initial and recurrent training (every two years) that meets the DOT training requirements in three subject areas.
DOT Definition of Regulated Medical Waste - a waste, or reusable material, that contains an infectious substance and is generated in the diagnosis, treatment, or research of humans or animals
2. Function-specific training to familiarize the employee with the DOT shipping requirements related to the job that he/she performs;
DOT requires that personnel be tested after receiving the training on the three subject areas.
Each record must include the employee’s name, the most recent training date, a copy of the training materials, the name and address of the trainer, and a certification that the employee was trained and tested.
A shipping paper must also be prepared for every regulated medical waste shipment that leaves the health care facility.
It is important for environmental services professionals to understand that untreated regulated medical waste is considered an infectious substance and a DOT hazardous material. It must be transported from the health care facility in accordance with DOT shipping regulations.