Occupational health and safety guidelines

Occupational health and safety guidelines

The manual uses symbols to denote procedures with

# Risk of exposure

# Risk of splash

# Manual handling risk

# Low level risk is denoted by one symbol

# Medium level risk is denoted by two symbols

# High level risk is denoted by three symbols

Risk of exposure to body fluids

Gloves and protective eyewear must be worn throughout the procedure. If exposure occurs, wash the area thoroughly and contact the occupational health and safety department immediately (accident and emergency department after hours). All reusable equipment must be sent to the HSDU department for autoclaving. All other single use equipment can be discarded in the general waste bin for disposal. Ensure your hepatitis immunisation is kept up to date

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Risk of exposure to radiation

During routine X-ray procedures the nurse must stand at least six feet away from and not in direct line with the X-ray beam. Generally the golden rule is if you stand next to or behind the X-ray technician you are a safe distance away. Protective lead aprons and thyroid shields must be worn by those nurses who need to attend to the patient during the procedure (CVIU, pacemaker insertion). Children and women of childbearing age must have the lower abdomen covered with a lead apron during routine X-ray procedures.

Risk of slash injury

Gloves and protective eyewear must be worn throughout the procedure. If exposure occurs, wash the area thoroughly and contact the occupational health and safety department immediately (accident and emergency department after hours). All reusable equipment must be sent to the HSDU department for autoclaving. All other single use equipment can be discarded in the general waste bin for disposal. Ensure your hepatitis immunisation is kept up to date.

Risk of manual handling injury

The cardiothoracic intensive care unit has a no lift policy. The Jordan frame lifter (available from Tempo orderlies) must be used to transfer patients onto the Thermacair mattress. Patients are turned with three nurses for routine turns and four nurses for dermalux washes. All patients must have a slippery-sam insitu on top of the mattress and directly under the bottom sheet.

For procedures requiring continuous bending the bed must be at a height so as to minimise the degree of bending required. The beds are to be positioned away from the wall as to facilitate easy access to the head of the bed. All cords and cables must be placed neatly out of harms way so as not to cause tripping.

For transferring patients out of bed and into a chair three nurses are required. The patient’s weight bearing ability is assessed by sitting the patient on the edge of the bed in the first instance so as to ascertain whether they are able to support themselves in an upright position. The black belt is used for all stand and pivot turns. If a patient cannot weight bear the electric lifter must be used.

For all bed transfers in and out of the unit the services of an orderly are required. For transfers of ventilated patients two orderlies are required to manoeuvre the bed.

Infection control

Infection control is a major issue in hospitals and particularly in busy intensive care units where critical illness, CPB and therapeutic interventions impair the body defence mechanisms. Reducing available routes of infection, preventing transfer of organisms, improving the body defence mechanisms and preventing the development of resistant strains are all an important infection control strategy. The infection control guidelines outlined at the end of this chapter must be adhered to at all times.