Hazards and Prevention of Occupational Health and Safety in Hospital Settings

1. Kharkov National Medical UniversityDepartment of Hygiene and Ecology №1 Special problems of hospital hygiene

2. Main problems of lecture Occupational Health and Safety Hazards for Medical and Surgical Staff Hospital-acquired infection and their prophylaxis Peculiarities of internal design and hygienic regimen in specialized departments of hospitals

3. Structure of doctor’ morbidity • essential hypertension • myocardial ischemia • diseases of musculoskeletal system • gynecologicdiseases, complications of pregnancy and puerperal period • diseases ofliver, gallbladder andpancreas

4. Physical hazards • Ionizing radiation • Laser beams • Microwave or radiofrequency radiation • Unfavorable microclimate • Inadequate lighting • Noise

5. Accident hazards • Cuts from sharp instrument • Burns and scalds • Electrical shock • Cryogenic agents • Asphyxiation in confined spaces • Heat and cold stresses • Associated with slips, trips and falls

6. Chemical hazards disinfectants mercury latex a variety of cleaning agents scented products ethylene oxide anesthetic gases methyl methacrylate hydrogen peroxide vehicle exhaust from ambulances chemicals used in terrorist activities

7. Сontactant dermatitis

8. Biological hazards bloodborne pathogens airborne biological agents droplets containing infectious biological agents environmental biological contaminants

9. Ergonomic hazards • associated with patient handling • associated with computer use • associated with material handling of equipment, furniture and supplies including lifting, carrying, pushing, pulling, etc. • associated with positioning and holding limbs, equipment, etc.

10. Nervous-emotional strain

11. Occupational Hazards in the Operating Room

12. Hazards of surgeon work • Unfavorable microclimate • Contaminated air • High risk of trauma

13. Hazards of surgeon work • A break of work and rest regimen • Working upright posture • Hard physical work

14. Overstrain of a working hand

15. The increased strain of vision

16. Hospital acquired infections Hospital acquired infection is also called Nosocomial infection or Healthcare-associated infection nosocomial “nosus” = disease “komelion” = to take care of

17. Condition of HAI spreading

18. Prevalence of HAI • diseases of upper respiratory organs, children’s infections • staphylococcal and streptococcal infections of the skin, hypodermic cellular tissue, mucous membranes, post-operative suppurative inflammatory complications, septic diseases • intestinal infections

19. Sources of HAI

20. Сost of HAI treatment

21. Risk factors of HAI with multiresistant pathogens • Advanced age • Underlying disease • Severity of illness • Transplantation • Gastrointestinal surgery • Exposure to medical devices • Heavy exposure to antimicrobial therapy • Prolonged hospital stay • Interinstitutional transfer of patient

22. Prevention of HAI transmission • Nonspecific measures : architectural planning, sanitary and technical, sanitary and antiepidemic, disinfection and sterilization measures. • Specific measures : planned • and urgent specific prophylaxis

23. General Recommendations for Control and Prevention of HAI transmission • Regular hand washing after contact with patients or surfaces in a hospital • Regular disinfection of potentially contaminated surfaces and equipment • Surveillance cultures necessary for infection control purposes for specific organisms such as VRE • Alcohol-based hand washing liquids • Antibiotic formulary intervention or restriction

24. ADMISSION DEPARTMENT

25. SURGICAL DEPARTMENT

26. FUNCTIONAL AREAS OF OPERATIONAL UNIT Operating rooms Sterilization Preopera- tional Anaesthetic Equipment room Artificial blood circulation apparatus and other devices Washing room I zone II zone III zone IVzone Disassembly and cleaning of instruments Clean linen Portable equipment A mobile X-ray apparatus The protocol room Instrumental material Pantry of cleaning equipment Pantry of gypsum Gypsum room Photo- laboratory Sanitary- Inspection room for personnel Premises of personnel Rest room of personnel Premises of personnel Storage areas

27. Sterile zone operating room

28. Especially clean zone • Sterilization room • Preoperating room • Anaesthetic room • Equipment room • Artificial blood circulation apparatus and other devices • Washing room

29. Clean zone • Disassembly and cleaning • of instruments • Clean linen • Portable equipment • A mobile X-ray apparatus • The protocol room • Instrumental material • Pantry of cleaning equipment • Gypsum room • Pantry of gypsum • Photo-laboratory

30. Zone of general hospital regimen • Sanitary inspection roomfor personnel • Premises of personnel • Rest room of personnel • Storage

31. INFECTIOUS DEPARTMENT

32. Box for 2 beds • Entrance from street • Tambour • Ward • Bath • Wash basin • Entrance from сorridor • Sluice • Bed

33. Semibox • Ward • Sanitary room • Wardrobefor change white coat • Sluice • Entrance from сorridor

34. Thank for your attention!