Clinic and Laboratory Safety

Clinic and Laboratory Safety

Laboratory Safety A SMILE Program Presentation Patient Safety Monitoring in International Laboratories (SMILE) Program 1 Responsibility Who is responsible for safety in laboratories clinics and hospitals participating in clinical trials Patient Safety Monitoring in International

Laboratories (SMILE) Program 2 Responsibility Employer Establishes necessary policies Standard Operating procedures and Safety Plan Engineering and work practice controls

Personal protective equipment (PPE) Safety equipment such as fire extinguishers and eye wash stations Training Patient Safety Monitoring in International Laboratories (SMILE) Program 3 Responsibility Employee Knows and understands safety policies and

procedures Follows safety policies and procedures Reports unsafe conditions to the Safety Officer or Laboratory Director Patient Safety Monitoring in International Laboratories (SMILE) Program 4 Responsibility Safety is Everyones Responsibility! Patient Safety Monitoring in International

Laboratories (SMILE) Program 5 Components of a Safety Program Fire safety Chemical Safety Bloodborne Pathogens Patient Safety Monitoring in International Laboratories (SMILE) Program 6

Fire Safety Patient Safety Monitoring in International Laboratories (SMILE) Program 7 Fire Safety The Fire Triangle Oxygen Chemical Reaction Heat

Fuel Patient Safety Monitoring in International Laboratories (SMILE) Program 8 Fire Safety What should you do in case of a fire ? Remember the acronym RACE Rescue Alarm Contain Extinguish any people in danger

activate the fire alarm the fire by closing doors and windows the fire if it is small enough Patient Safety Monitoring in International Laboratories (SMILE) Program 9 Fire Safety Types of Fire Extinguishers A Combustibles (paper, trash, cloth) B Flammable liquids C Electrical Equipment D Combustible metals

(not Common) Patient Safety Monitoring in International Laboratories (SMILE) Program 10 Fire Safety How do you operate a fire extinguisher? Remember PASS Pull Aim Squeeze Sweep

- the pin at the base of the Fire the handle to cover the fire Patient Safety Monitoring in International Laboratories (SMILE) Program 11 Fire Safety

Maintenance of Fire Extinguishers Fire extinguishers should be visually inspected on a monthly basis. The inspection should assure that Fire extinguishers are: In their assigned place Not blocked or hidden Pressure gauges show adequate pressure

Pins and seals are in place No signs of damage The nozzles are free of blockages Patient Safety Monitoring in International Laboratories (SMILE) Program 12 Chemical Safety Patient Safety Monitoring in International Laboratories (SMILE) Program 13

Chemical Safety How Do Chemicals enter the body? Inhalation breathing in (e.g. powders, fumes) Absorption on skin or mucus membranes Ingestion entry through the mouth Injection - through skin by foreign body Patient Safety Monitoring in International Laboratories (SMILE) Program 14 Chemical Safety Examples of Chemical Hazards

Carcinogens cancer Corrosives burns Hepatotoxins liver damage Mutagens-damage genetic materials in cells Nephrotoxins Kidney damage Neurotoxins damage to the nervous system Tertatogens birth defects

Patient Safety Monitoring in International Laboratories (SMILE) Program 15 Chemical Safety How can you obtain information about the Chemicals you use? Patient Safety Monitoring in International Laboratories (SMILE) Program 16 Chemical Safety

Material Safety Data Sheet (MSDS) The following Data Can be found on MSDS sheets. Name of Chemical Physical Characteristics and hazards Health information First Aid required if there is a spill or exposure Date of most recent update Patient Safety Monitoring in International Laboratories (SMILE) Program 17

Chemical Safety MSDS Sheets Continued. Need to check for updates annually Highlight the name of the chemical and the first aid section for easy access in an emergency Organize in alphabetical order Must be available to everyone all of the time The internet is also a good way to access MSDS sheets

Instrument manufacturers usually have MSDS sheets available on their websites. Patient Safety Monitoring in International Laboratories (SMILE) Program 18 Chemical Safety What should you do if there is a chemical spill? RAFT Rescue Avoid the Chemical Find the MSDS Telephone

Patient Safety Monitoring in International Laboratories (SMILE) Program 19 Chemical Safety Chemical Exposures First AID Flush with plenty of water For at least 15 minutes Remove contaminated clothing Seek medical Attention Document incident

Patient Safety Monitoring in International Laboratories (SMILE) Program 20 Chemical Safety Liquid Nitrogen Characteristics of Liquid Nitrogen 78% of atmosphere Colorless, Odorless, Tasteless, Nontoxic Boils at -196 Degrees C Non Flammable Patient Safety Monitoring in International

Laboratories (SMILE) Program 21 Chemical Safety Liquid Nitrogen When returning to the gaseous state: Can displace oxygen from the air Can lead to asphyxiation Will not support Life Patient Safety Monitoring in International Laboratories (SMILE) Program 22

Chemical Safety Liquid Nitrogen Precautions Always wear safety equipment Avoid use in a small enclosed area Avoid prolonged breathing of vapors Avoid rough handling of containers Install O2 Monitors in LN work areas Patient Safety Monitoring in International Laboratories (SMILE) Program 23

Chemical Safety Liquid Nitrogen PPE Full face shield with safety glasses Cryogenic gloves Arm protection Lab coat Cuff-less pants Close toed shoes

Patient Safety Monitoring in International Laboratories (SMILE) Program 24 Chemical Safety Liquid Nitrogen Emergencies Inhalation Move person into the fresh air Eyes Flush with water for 15 minutes Skin - soak affected area in tepid water Seek

medical attention Document incident Patient Safety Monitoring in International Laboratories (SMILE) Program 25 Chemical Safety Whats Wrong with this picture? Patient Safety Monitoring in International Laboratories (SMILE) Program

26 Chemical Safety Carbon Dioxide Dry Ice Characteristics of Carbon Dioxide Colorless, odorless, tasteless nontoxic Non flammable Can only be solid when the temperature is < -78oC Patient Safety Monitoring in International

Laboratories (SMILE) Program 27 Chemical Safety Solid Carbon Dioxide Can displace oxygen from air Can lead to asphyxiation Will not support life High concentrations cause rapid circulatory insufficiency Nausea Headache Vomiting Unconsciousness

Patient Safety Monitoring in International Laboratories (SMILE) Program 28 Chemical Safety Solid Carbon Dioxide Dry Ice Always wear safety equipment Avoid use in a small enclosed area Avoid prolonged breathing of vapors Vent Closed CO containers away from you 2 when opening

Patient Safety Monitoring in International Laboratories (SMILE) Program 29 Chemical Safety Solid Carbon Dioxide PPE Full face shield with safety glasses Cryogenic gloves Lab coat Close toed shoes Patient Safety Monitoring in International Laboratories (SMILE) Program

30 Chemical Safety Solid Carbon Dioxide Emergencies Inhalation Move person into the fresh air Eyes Flush with water for 15 minutes Skin - soak affected area in tepid water Seek medical attention Document

incident Patient Safety Monitoring in International Laboratories (SMILE) Program 31 Chemical Safety Managing Chemicals in the Laboratory Storage Hazard Communication MSDS Updates

Acids and Bases in separate approved cabinets Spill kits available Patient Safety Monitoring in International Laboratories (SMILE) Program 32 Chemical Safety Whats Wrong with this picture? Patient Safety Monitoring in International Laboratories (SMILE) Program

33 SAFETY Waste Disposal Tips for safe disposal of laboratory waste: Place all sharps in approved sharps containers Use goggles or full face shields to protect mucus membranes from splashes when disposing of liquid waste or specimen tubes. Refer to MSDS sheets for information on the safe disposal of chemicals Patient Safety Monitoring in International Laboratories (SMILE) Program

34 Bloodborne Pathogens Bloodborne Pathogens Patient Safety Monitoring in International Laboratories (SMILE) Program 35 Bloodborne Pathogens What are bloodborne pathogens? Viruses, bacteria or other micro-organisms that are carried in the bloodstream and are capable of causing disease.

Other body fluids that can spread bloodborne pathogens include: Blood products (plasma, platelets) Abdominal fluids Amniotic fluids Cerebrospinal fluids Vaginal secretions Semen

Patient Safety Monitoring in International Laboratories (SMILE) Program 36 Bloodborne Pathogens Most Common Bloodborne Pathogens Hepatitis B Hepatitis C HIV Patient Safety Monitoring in International Laboratories (SMILE) Program

37 Bloodborne Pathogens Standard Precautions Standard Precautions replaces Universal Precautions using Standard Precautions all blood and body fluids are treated as infectious all of the time. Patient Safety Monitoring in International Laboratories (SMILE) Program 38

Bloodborne Pathogens Personal Protective Equipment (PPE) Gloves Safety glasses/Goggles Lab coats (should be fluid resistant) Face shields Patient Safety Monitoring in International Laboratories (SMILE) Program 39 Bloodborne Pathogens PPE Continued.

How much PPE should you use? Wear as much or as little as you anticipate you will need to prevent blood and other infectious materials from contact with your skin, mucus membranes and clothing. Patient Safety Monitoring in International Laboratories (SMILE) Program 40 Blood borne Pathogens General Safety Rules Handle sharps with care: Do not recap needles or other sharps

Do not bend or break off needles Dispose of sharps in puncture resistant containers DO Not: Eat, drink, smoke, apply cosmetics, take medication in areas where you are working with blood and other body fluids Patient Safety Monitoring in International Laboratories (SMILE) Program 41 Bloodborne Pathogens What should you do if there is a blood or body

fluid exposure ? Follow the post exposure prophylaxis (PEP) plan Wash puncture wounds with soap and water Flush affected mucus membranes with water Inform Safety Officer or administrative staff member Seek medical attention Complete an incident report form Patient Safety Monitoring in International Laboratories (SMILE) Program 42 Bloodborne Pathogens Hand Washing

A basic but very important method of reducing your risk of infection. Patient Safety Monitoring in International Laboratories (SMILE) Program 43 Bloodborne Pathogens Hand Washing What song should you sing while you are washing your hands so that you know that you have washed for enough time?

Patient Safety Monitoring in International Laboratories (SMILE) Program 44 Laboratory Safety Questions and Comments Patient Safety Monitoring in International Laboratories (SMILE) Program 45 Laboratory Safety

References: 1.PPD (May, 2005) PowerPoint Presentation, Presented at the Washington DC GCLP Meeting. 2. WWW.safetylady.com Patient Safety Monitoring in International Laboratories (SMILE) Program 46

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