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Commonwealth Nurses Federation South Asia 4 Safety Workshop 2009 ____________________________________ Theme 2 A Safe Workplace Jill ILIFFE Executive Secretary Commonwealth Nurses Federation Commonwealth Nurses Federation South Asia 4 Safety Workshop 2009

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slide1

Commonwealth Nurses Federation

South Asia 4 Safety Workshop 2009

____________________________________

Theme 2

A Safe Workplace

Jill ILIFFE

Executive Secretary

Commonwealth Nurses Federation

slide2

Commonwealth Nurses Federation

South Asia 4 Safety Workshop 2009

____________________________________

(a) WORKPLACE HEALTH AND SAFETY

The focus is on the prevention of injuries and the fair and equitable treatment of nurses who are injured at work or develop a work- related illness. Nurses have the right to work in an environment that does not threaten their health, safety or welfare.

slide3

Commonwealth Nurses Federation

South Asia 4 Safety Workshop 2009

____________________________________

WORKPLACE HEALTH AND SAFETY

A safe nurse, a safe patient, a safe workplace, a safe profession

are all embodied in the concept of workplace health and safety.

Workplace health and safety is a PRIORITY requirement for work.

slide4

Commonwealth Nurses Federation

South Asia 4 Safety Workshop 2009

____________________________________

  • WORKPLACE HEALTH AND SAFETY
  • Safe work environments
  • Healthy work environments
  • Safe workplace design
  • Safe work processes and systems
  • Safe work procedures and practice
  • Safe patient care
slide5

Commonwealth Nurses Federation

South Asia 4 Safety Workshop 2009

____________________________________

  • 1. Safe Work Environments
  • means the existence of:
  • Safe equipment
  • Hygienic conditions
  • Safe walking and working surfaces
  • Freedom from violence
  • Non-hazardous and toxic materials,
  • and if they are present, provision for
  • safe handling, storage and disposal of
  • them
slide6

Commonwealth Nurses Federation

South Asia 4 Safety Workshop 2009

____________________________________

2. Healthy work environments

Safety measures are in place in relation to blood borne and body fluid pathogens to prevent contamination of nurses and patients

slide7

Commonwealth Nurses Federation

South Asia 4 Safety Workshop 2009

____________________________________

  • 3. Safe workplace design
  • Good ergonomics in relation to:
  • Seating
  • Equipment use
  • Adequate lighting
  • Safe exits/egresses (clearly marked, open and well-lit)
slide8

Commonwealth Nurses Federation

South Asia 4 Safety Workshop 2009

____________________________________

4. Safe work processes and systems

  • Written and up-to date standards,
  • protocols, policies, procedures
  • Adherence and compliance with
  • these
  • Adequate staffing
  • Safe delegation of duties
slide9

Commonwealth Nurses Federation

South Asia 4 Safety Workshop 2009

____________________________________

5. Safe Work Procedures and Practices

  • Lifting techniques
  • Prevention of needle stick and other injuries
  • Adequate break times for nurses to prevent tiredness and increase the risk of medication and other errors
slide10

Commonwealth Nurses Federation

South Asia 4 Safety Workshop 2009

____________________________________

6. Safe patient care

  • Safe administration of medication and

other skills

  • Competent staff (skilled and

knowledgeable)

  • Adherence to proper work standards
  • and ethics
slide11

Commonwealth Nurses Federation

South Asia 4 Safety Workshop 2009

____________________________________

The patients’ rights are the nurses’ responsibilities (professional, ethical, legal)

The nurses’ rights are the employers’ responsibilities (liability laws, ILO conventions, labour laws, occupational health and safety legislation)

www.commonwealthnurses.org

slide12

Commonwealth Nurses Federation

South Asia 4 Safety Workshop 2009

____________________________________

  • A nurses’ right to safety is the employers’ responsibility
  • The law mandates of the employer:
  • Safe systems of work
  • Safe equipment
  • Competent colleagues

www.commonwealthnurses.org

slide13

Commonwealth Nurses Federation

South Asia 4 Safety Workshop 2009

____________________________________

  • Safe systems of work
  • Written practice standards
  • Written policies, protocols and procedures
  • Appropriate documentation systems
  • Systems of accountability for care given, or
  • not given and actions taken
  • Adequate staffing systems

www.commonwealthnurses.org

slide14

Commonwealth Nurses Federation

South Asia 4 Safety Workshop 2009

____________________________________

  • Safe equipment
  • Available
  • In good working order
  • Well maintained
  • With staff knowledgeable in its use

www.commonwealthnurses.org

slide15

Commonwealth Nurses Federation

South Asia 4 Safety Workshop 2009

____________________________________

  • Competent colleagues
  • Continuing education
  • Fair system of appraisal
  • Supervisors and managers with the
  • necessary skills to manage
  • Requires: recruitment, training,
  • deployment, promotion and retention
  • strategies

www.commonwealthnurses.org

slide16

Commonwealth Nurses Federation

South Asia 4 Safety Workshop 2009

____________________________________

ILO Convention No: 155 Concerning Occupational Safety and Health and the Working Environment.

22 June 1981

www.commonwealthnurses.org

slide17

Commonwealth Nurses Federation

South Asia 4 Safety Workshop 2009

____________________________________

Workplace or occupational health and safety legislation can provide a framework, but what is required is the development of a culture of safety in health care.

slide18

Exposure to hazardous drugs and blood

borne pathogens

  • Air quality compromised by toxic

environmental cleaning substances

  • Heavy lifting and moving of patients and

medical equipment,

  • Workplace violence and abuse (intruders,

patients, relatives, other staff)

  • Needle stick injuries
  • Excessively long working hours and heavy workloads
slide19

Commonwealth Nurses Federation

South Asia 4 Safety Workshop 2009

____________________________________

Nurses, at all levels, need to

embrace safety and consider it

an integral part to the way work

is planned, resourced, performed,

monitored and evaluated

slide20

Commonwealth Nurses Federation

South Asia 4 Safety Workshop 2009

____________________________________

(b) INFECTION CONTROL

Every patient encounter

should be viewed as

potentially infectious

standard precautions
Standard Precautions
  • 1. Hand hygiene
  • Gloves
  • Facial protection
  • Gown
  • Prevention of needle stick injuries
  • Respiratory hygiene and cough etiquette
  • Environmental cleaning
  • Linens
  • Waste disposal
  • Patient care equipment
slide22

CHAIN OF INFECTION

Causative agent

(Pathogen)

Susceptible host

Reservoir

Portal of entry

Portal of exit

Mode of

transmission

All must be present to transmit an infectious agent

slide23
Infection control is all about interfering with the chain of infection at as many points as possibleUse ‘standard’ precautions
hand hygiene
Hand hygiene

* When hands are visibly dirty,

contaminated, or soiled, wash

with non-antimicrobial or

antimicrobial soap and water.

* If hands are not visibly soiled,

use an alcohol-based hand-rub

for routinely decontaminating

hands.

slide26

Ability of hand hygiene agents to reduce bacteria on hands

Time After Disinfection

%

log

0

60

180

minutes

99.9

3.0

99.0

2.0

Alcohol-based handrub

(70% Isopropanol)

Bacterial Reduction

90.0

1.0

Antimicrobial soap

(4% Chlorhexidine)

0.0

0.0

Plain soap

Baseline

Adapted from: Hosp Epidemiol Infect Control, 2nd Edition, 1999.

world health organisation
World Health Organisation

“One of the most powerful approaches to fighting health care related infections is also the simplest; health care providers need to clean their hands every time they see a patient”

slide28
Immunization of all health care

workers

Recommended vaccinations

*Hepatitis B

* Measles/Mumps/Rubella

* Varicella (chicken pox)

* Diphtheria/Tetanus

* Polio

* Influenza

* Others depending on disease prevalence in

the area

slide29

Prevention of injury:

* Use instruments to retract

* Use safety needles and re-cappers

* Pass instruments correctly and

safely

* Use sharps containers and replace

before full

needle stick injuries
Needle Stick Injuries

Persons providing routine nursing care (38%) and cleaning (15%)are the most common situations where needle stick injuries occur.

Invasive procedures such as injections and venipuncture are the most commonly reported causes of injury.

risk of infection after needle stick injury
Source

HBV

HCV

HIV

Risk of infection after needle stick injury

Risk

6.0-30.0%

1.8%

0.3%

1:3

1:300

slide33

Environmental safety:

* Appropriate medical waste disposal

- sharps

- blood

- contaminated disposable products

who has the responsibility
Who has the responsibility?

GOVERNMENT

- recognise the need

- set the policy in public and environmental health

- provide resources and facilities

- education and training

who has the responsibility35
Who has the responsibility?

HEATH ADMINISTRATORS

  • establish a safety culture
  • encourage and support reports of unsafe practices or situations
  • view errors and adverse events as opportunities to make systems safer
  • put systems in place to avoid predictable adverse events
who has the responsibility36
Who has the responsibility?

HEALTH CARE WORKERS

- recognise the need for action

- undertake training

- universal use of universal precautions

- conduct yourselves appropriately

- persuade others to do the same

who has the responsibility37
Who has the responsibility?

PROFESSIONAL ASSOCIATIONS

  • monitor quality in professional training
  • regulate and monitor safe health practices
  • protect the public from unsafe practitioners
  • establish and promote codes of ethics and conduct
who has the responsibility38
Who has the responsibility?

The public – YOU and ME

- recognise the need for action

- don’t tolerate inappropriate behaviour

- conduct ourselves appropriately

- persuade others to do the same

slide39

Commonwealth Nurses Federation

South Asia 4 Safety Workshop 2009

____________________________________

(c) SAFE STAFFING LEVELS

The environment in which health care is provided influences not only the quality of care delivered but also the safety and well being of the care provider.

nurses need their sleep and they need their breaks at work
Nurses need their sleep and they need their breaks at work

The effects of fatigue on the brain from sleep deficiency are similar to those of alcohol

Fatigue appears more rapidly with irregular work schedules

Risk of accidents is 7 times higher between midnight and 8 am

slide45

Measures that promote a safe work

environment

  • Ongoing employee education
  • Adequate staff so there are reasonable

shift lengths and workloads

  • Supervision and support for inexperienced staff
  • Measures to prevent stress, isolation and

burnout

  • Adherence to universal precautions
  • Provision of personal protective equipment
slide46

The challenge for nurses is to

further improve work practices

to ensure they do not risk their life

making a living.