Infection prevention.pptx ghkfghhhytrstrstr

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1. BLUE NILE COLLEGE PROGRAM TITLE: Midwivies level – I II MODULE TITLE: Manage Infection Prevention And control procedures Has 5 LO LO1 : Apply Infection Prevention Techniques LO2: Establish and Maintain Participative Arrangements LO3: Assess And Control Risk And Hazards LO4: Establishment of an OHS induction and training program LO5:Establishment and maintenance of system for OHS records sept-21 1

2. LO1: Apply Infection Prevention Techniques sept-21 M.G 2

3. Infection Def: The invasion of bodily tissue by pathogenic microorganisms that proliferate, resulting in tissue injury that can progress to disease. The invasion and multiplication of microorganisms such as bacteria, viruses, and parasites those are not normally present within the body. An infection may cause no symptoms and be subclinical, or it may cause symptoms and be clinically apparent. An infection may remain localized, or it may spread through the blood or lymphatic vessels to become systemic (body wide). sept-21 M.G 3

4. Cont… Microorganisms that live naturally in the body are not considered infections. For example, bacteria that normally live within the mouth and intestine are not infections. Infection prevention: refers to policies and procedures used to minimize the risk of spreading infections, especially in hospitals and human or animal health care facilities. sept-21 M.G 4

5. Disease transmission Introduction to disease transmission The term  disease  refers to a disturbance in the normal functioning of the body and is used interchangeably with ‘illness’. Diseases may be classified as communicable or non-communicable Communicable   diseases  are caused by infectious agents that can be transmitted to other people from an infected person, animal or a source in the environment. Communicable diseases constitute the leading cause of health problems in Ethiopia. sept-21 M.G 5

6. Basic concepts in transmission of communicable disease Organisms that cause communicable diseases are called  infectious   agents , and their transmission to new uninfected people is what causes communicable diseases e.g. malaria and tuberculosis . Diseases such as heart disease, cancer and diabetes mellitus, which are not caused by infectious agents and are not transmitted between people, are called  non - communicable   diseases . JUN-22 6 M.G

7. Classification of disease JUN-22 M.G Based on the cause infectious - caused by living organisms based on clinical time course infectious agent mode of transmission non infectious -caused by other than living organism. 7

8. Based on clinical manifestation/system involved a. Diarrhea disease : -secretary/watery or invasive/dysentery. b. Febrile disease :- malaria ,relapsing fever. c. Respiratory disease :- Upper or Lower d. CNS infection : -meningitis ,encephalitis e. CV infection : -endocarditis, myocarditis, vasculitis f. UTI infection :-upper and lower UTI JUN-22 M.G 8

9. Diarrhea disease Diarrhoea : is usually a symptom of an infection in the intestinal tract, which can be caused by a variety of bacterial, viral and parasitic organisms. Infection is spread through contaminated food or drinking-water, or from person-to-person as a result of poor hygiene. Diarrhea is very common , happening in most people a few times each year. When you have diarrhea, your stool will be loose and watery. JUN-22 M.G 9

10. What stops diarrhea A diet known as BRAT may also quickly relieve diarrhea. BRAT stands for  bananas, rice, applesauce, and toast . This diet is effective due to the bland nature of these foods, and the fact that they're starchy, low-fiber foods. These foods have a binding effect in the digestive tract to make stools bulkier. JUN-22 M.G 10

11. Febrile disease A fever is a higher-than-normal body temperature. It's a sign of your body's natural fight against infection. For adults, a fever is when your temperature is  higher than 100.4°F. What is febrile illness symptoms? Acute fever or acute febrile illness (a rapid onset of fever and symptoms such as  headache, chills or muscle and joint pains ) is common in the tropics and sub-tropics and can be caused by very diverse pathogens JUN-22 M.G 11

12. Cont… Treatments vary depending on the cause of the fever. For example,  antibiotics   would be used for a  bacterial infection and ante malaria drugs for malaria. Respiratory disease: are  pathological  conditions affecting the organs and tissues that make  gas exchange  difficult in  air-breathing JUN-22 M.G 12

13. Cont… They include conditions of the  respiratory tract   including the  trachea , bronchi ,  bronchioles ,  alveoli ,  pleurae ,  pleural cavity , the nerves and  muscles of respiration . Respiratory diseases range from mild and self-limiting, such as the  common cold ,  influenza , and  pharyngitis  to life-threatening  diseases  such as  bacterial pneumonia ,  pulmonary embolism ,  tuberculosis ,  acute asthma ,  lung cancer , and  severe acute respiratory syndromes , such as  COVID-19 . JUN-22 M.G 13

14. Cont… The most common  upper respiratory tract infection  is the  common cold . The most common lower respiratory tract infection is  pneumonia . CNS infection infections involving the brain (cerebrum and cerebellum), spinal cord, optic nerves, and their covering membranes—are  medical emergencies  that are associated with substantial morbidity, mortality, or long-term sequelae . Antibiotics given through a vein, as well as medications for fever and headache, are used in the treatment of brain infections. JUN-22 M.G 14

15. CV infections Endocarditis is a  life-threatening inflammation of the inner lining of your heart's chambers and valves  ( endocardium ). Endocarditis is usually caused by an infection. Most cases of endocarditis can be treated with  a course of antibiotics. JUN-22 M.G 15

16. UTI infection A urinary tract infection (UTI) is  an infection of the urinary system . This type of infection can involve your urethra (a condition called urethritis ), kidneys (a condition called pyelonephritis ) or bladder, (a condition called cystitis). The following factors can increase the likelihood of developing a UTI: sexual intercourse, especially if more frequent, intense, and with multiple or new partners. poor personal hygiene, problems emptying the bladder completely. having a urinary catheter, bowel incontinence. blocked flow of urine, kidney stones Rx is caurse of antibiotics. JUN-22 M.G 16

17. 2 . Based on the time Acute :- indicate abrupt onset or short duration(<2wk) rapidly progressive ,and need of urgent care. b. Chronic :-indicate a duration usually >2wk JUN-22 M.G 17

18. 3 . Based on infectious agent Metazoan :- melticellular organisms e.g. helminthiasis b. Protozoan :-unicellular organisms e.g. malaria, amebiasis. c. Bacterial: - tuberculosis , meningitis d. Fungal :- candidiacies e. Viral : - measles ,polio JUN-22 M.G 18

19. 4. Based on mode of transmission Direct transmission - no 3 rd agents are involved An infectious agent is transferred from a reservoir to a susceptible host by direct contact or droplet spread . Direct contact occurs through skin-to-skin contact, kissing, and sexual intercourse. b. Indirect transmission - 3 rd agents are involved Indirect transmission refers to  the transfer of an infectious agent from a reservoir to a host by suspended air particles , inanimate objects (vehicles), or animate intermediaries (vectors). JUN-22 M.G 19

20. The burden of communicable diseases in Ethiopia Communicable diseases are the main cause of health problems in Ethiopia. According to the Ethiopian Federal Ministry of Health, communicable diseases accounted for most of the top ten causes of illness and death  JUN-22 20 M.G

21. Over view of health situation of Ethiopia 60-80% of the nation’s health problems are due to nutritional problems & communicable disease. In general , communicable disease in Ethiopia situation: Are commonest cause of morbidity& mortality Are relatively easy to prevent and control Are epidemic prone (cause wide spread out breaks of disease ). Put most of the population at risk JUN-22 M.G 21

22. Disease transmission cycle Transmission is a process in which several events happen one after the other in the form of a chain . It is known as a  chain of transmission Six major factors can be identified : the infectious agent, the reservoir, the route of exit, the mode of transmission, the route of entry and the susceptible host.  22 M.

23. Components of Chain of disease transmission M. 23

24. 1. Infectious agent The infectious agent is virus , bacteria, parasite or other microbes The agent to causes infection and disease 2. Reservoir: is the habitat in which an infectious agent lives, grows, transforms and/or multiplies itself 3. Portal of Exit The portal of exit is the route by which the infectious agent leaves the infectious hosts or reservoirs M. 24

25. 4. Modes of Transmission Mode of transmission is the mechanism by which the infectious agent escapes from a reservoir and enters into a susceptible human host There are two major mechanisms of transmission: Direct transmission Indirect Transmission M. 25

26. 5. Portal of Entry Portal of entry is the route through which a microorganism enters into the susceptible human host 6 . Susceptible Human Host The susceptible human host is the final link in the infectious disease transmission process Host factors influence individual's exposure, susceptibility or response to infectious agent Host susceptibility can be seen at the individual level and at the community level 26 M.

27. Infection Prevention Techniques … Hand Hygiene Hand hygiene is the single most important infection prevention and control (IPC) precaution and one of the most effective means to prevent transmission of pathogens within health care services. Hand hygiene is a general term that includes handwashing , antiseptic hand rub, and surgical hand antisepsis. N.B Hand hygiene is the single most important infection prevention procedure. 27 M.

28. cont… Hand washing - for the purpose of physically or mechanically removing dirt, organic material, and/or microorganisms. Alcohol hand rub – applying an antiseptic handrub to reduce or inhibit the growth of microorganisms without the need for a water source. Surgical hand antisepsis - antiseptic handwash or antiseptic hand rub performed preoperatively by the surgical team to eliminate transient flora and reduce resident skin flora. 28 M.

29. Appropriate hand hygiene must be carried out: Before examining (coming in direct contact with) a client/patient Before putting on sterile or high-level disinfected surgical gloves, or examination gloves After any situation in which hands may be contaminated, such as: Handling contaminated objects, including used instruments Touching mucous membranes, blood, body fluids, secretions or excretions (except sweat) After removing gloves 29 M.

30. 1. Alcohol hand rub Alcohol hand rub is the first choice for hand hygiene if hands not visibly soiled as it is: • More effective in killing microorganisms than antimicrobial hand-washing agents or plain soap and water • Faster to perform than hand washing • Can to be placed directly at point of care • Can to be used without sink, water, or towelling • Kinder to hands than other methods 30 M.

31. 2. Routine Hand washing The purpose of handwashing is to mechanically remove soil and debris from skin and reduce the number of transient microorganisms. Hand washing with soap and clean water is as effective in cleaning hands and removing transient microorganisms as washing with antimicrobial soaps and causes less skin irritation. 31 M.

32. For appropriate handwashing : Thoroughly wet hands. Apply a hand washing agent (plain soap or detergent). Vigorously rub all areas of hands and fingers for 10–15 seconds. Rinse hands thoroughly with clean running water Dry hands 32 M.

33. 3. Surgical Hand scrub The purpose of surgical hand scrub is to remove soil, debris, transient organisms and to reduce resident flora prior to performing any surgical procedure The goal is to prevent wound contamination by microorganisms from the hands and arms of the surgeon and assistants 33 M.

34. Appropriate surgical hand scrub involve following steps : 1. Remove rings, watches and bracelets. 2. Thoroughly wash hands with soap and water 3. Clean nails with a nail cleaner 4. Rinse thoroughly with clean, running water. 5. Apply an antiseptic agent (e.g., 2–4% chlorohexidine ). 6. Vigorously rub all surfaces of hands, fingers and forearms for at least 2 minutes. 7. Rinse hands and arms thoroughly, holding hands higher than the elbow 8. Keep hands up and away from the body. 9. Do not touch any surface or article and dry hands and forearms with a clean, dry towel or air dry. 10. Put sterile or high-level disinfected surgical gloves on both hands. 34 M.

35. Technique of hand washing 35 M.

36. Personal Protective Equipment PPE: Protective barriers and clothing, now commonly referred to as personal protective equipment (PPE), have been used for many years to protect clients from microorganisms present on medical staff and others working in the healthcare setting. More recently, with the emergence of HIV/AIDS and HBV/HCV and resurgence of tuberculosis in many countries including Ethiopia, PPE now become important for protecting the healthcare providers as well. 36 M.

37. Cont… Caps are used to keep the hair and scalp covered so that flakes of skin and hair are not shed into the wound during surgery. Caps should be large enough to cover all hair. Eyewear protects staff in the event of an accidental splash of blood or other body fluid by covering the eyes. Footwear is worn to protect feet from injury by sharp or heavy items or fluids that may accidentally fall or drip on them 37 M.

38. Cont… Gloves protect hands from infectious materials and protect patients from microorganism on staff members’ hands. They must be worn anytime there is a possibility of contact with potentially infectious materials or when handling contaminated waste or cleaning or disinfecting instruments. Gloves should be changed between each client contact to avoid cross contamination. 38 M.

39. Cont… Mackintosh or plastic apron is used to protect clothing or surfaces from contamination. Aprons made of rubber or plastic provide a waterproof barrier along the front of the healthcare worker’s body and should also be worn during procedures where there is a likelihood of splashes or spillage of blood, body fluids, secretions or excretions (e.g., when conducting deliveries). 39 M.

40. Cont… Masks should be large enough to cover nose, lower face, jaw and all facial hair. They are worn in an attempt to contain moisture droplets expelled as health workers or surgical staff speak, cough or sneeze, as well as to prevent accidental splashes of blood or other contaminated body fluids from entering the health workers’ nose or mouth. Should be used as part of a comprehensive strategy of measure to suppress transmission and save live from COVID-19. It alone is not sufficient to provide protection against COVID-19 40 M.

41. Cont… Cover gowns are worn over, or instead of, routine clothes. A V-neck shirt must not be cut so low as to slide off the wearers’ shoulders or expose men’s chest hair. Surgical gowns were first used to protect patients from microorganisms present on the abdomen and arms of the healthcare staff during surgery. 41 M.

42. Proper handling of sharp items Keep a puncture resistant container nearby. Use each needle and syringe only once. Do not recap, bend or break needles after giving an injection. Drop all used (disposable) needles, plastic syringes and blades directly into this container 42 M.

43. Cont…. Safe sharps containers are essential for the correct and immediate disposal of sharps devices to ensure patient, HCW and community safety. The safe disposal of sharps is a major challenge, particularly in developing countries. 43 M.

44. Sharps containers must: • Be sufficient in number be puncture-resistant, leak-proof • Be stable when on horizontal surfaces • Have suitable for the safe deposition of sharps used in that area • Possess a handle for carrying • Be easily visible, accessible, and un obstructed in all areas of any protruding sharps 44 M.

45. Proper processing of instruments and materials Create an infection-free environment, it is important that the rationale for each of the recommended infection prevention processes, and their limitations, be clearly understood by clinic staff at all levels—from healthcare providers to cleaning and maintenance. 45 M.

46. Cont… DECONTAMINATION Soak in 0.5% chlorine solution for 10 minutes CLEANING Wearing gloves and appropriate personal protective equipment, thoroughly wash and rinse to remove all blood and tissue from instruments STERILIZATION Chemical Gluteraldehyde 2% 10 hrs Formaldehyde 8% 24 hrs Autoclave 106k Pa (15lb/in2) pressure, 121o C (250o F) Unwrapped 20 min/Wrapped 30 min Dry Heat 170o C for 60 min 46 M.

47. Cont…. HIGH-LEVEL DISINFECTION Boil or Steam Completely covered (immersed), at rolling boil, with a lid on, for 20 min. Chemical Gluteraldehyde 2% 20 min Formaldehyde 8% 20 min Chlorine 0.1% (prepared using boiled water) 20 min . Cool and Use Immediately OR Store Properly 47 M.

48. Decontamination …. Decontamination is the first step in handling used instruments and gloves. Immediately after use, all instruments should be placed in an approved disinfectant such as 0.5% chlorine solution for 10 minutes to inactivate most organisms For achieving satisfactory decontamination: Make fresh solution every morning, or more often if the solution becomes cloudy. Use plastic, non-corrosive container for decontamination. This prevents, sharp instruments from getting dull due to contact with metal containers. It also prevents instruments from getting rusted due to chemical reaction (electrolysis) that can occur between two different metals when placed in water. 48 M.

49. Cont… Do not soak metal instruments in water for more than one hour, even if they are electroplated, to prevent rusting. Do not mix chlorine solutions with either formaldehyde or with ammonia-based solutions as toxic gas may be produced. Steps for Making a 0.5% Chlorine Solution for Decontamination A 0.5% chlorine solution ( Barkina ) can be made from readily available liquid or powder chlorine . Liquid chlorine is available under different brand names in different concentration for example " Ghion " available in Ethiopia contains 5% chlorine. Manufacturers of, widely used brand contains 5% chlorine 49 M.

50. Cont… Check concentration (% concentrate) of the chlorine product you are using. Determine total parts water needed using the following formula: Total Parts (TP) water = % Dilute -1 %Concentrate Mix 1 part concentrated bleach with the total parts water required. Example : Make a dilute solution (0.5%) from 5% concentrated solution STEP 1: Calculate TP water : 5. 0% -1 = 10 – 1 = 9 0.5% STEP 2: Take 1 part concentrated solution and add to 9 parts water. 50 M.

51. CLEANING After decontamination of soiled instruments or gloves in 0.5% chlorine solution for 10 minutes, they must be cleaned to remove organic materials or chemical residue. Using liquid soap, if available , is preferable. Liquid soap removes grease, oil, and other foreign matters in solution so that they can be removed easily by the cleaning process. Abrasive cleaners used for household cleaning , including steel wool, should be avoided as they can result in scratches on the instruments which can be a potential site for harboring microorganisms. 51 M.

52. STERILIZATION Sterilization should be used for instruments, surgical gloves and other items that come in direct contact with the blood stream or normally sterile tissues. Sterilization can be achieved by physical agents such as high-pressure steam (autoclaving ), dry heat, or chemical sterilants such as gluteraldehyde or formaldehyde 52 M.

53. Cont… Sterilization by Dry Heat When available, dry heat is a practical way to sterilize needles and other sharp instruments. Dry-heat sterilization can be achieved with a simple oven as long as a thermometer is used to verify the temperature inside the oven . HIGH-LEVEL DISINFECTION Although sterilization is the safest and most effective method for the final processing of instruments , often sterilization equipment is either not available or not suitable. In these cases, HLD is the only acceptable alternative . 53 M.

54. STORAGE All sterile items should be stored appropriately to protect them from dust, dirt, and moisture. The storage area should be located next to or connected to where sterilization occurs, in a separate enclosed area with limited access that is used just to store sterile and clean patient care supplies. In smaller clinics, this area may be just a room close to the Central supplies department or in the operating room. 54 M.

55. Environmental cleanliness Clean and disinfect patient areas daily, with particular attention to frequently touched surfaces – counter tops, door handles, medical equipment. Use bleaching powder (7g/1L water ie 70% available chlorine) for disinfection o toilets/bathrooms Clean and dry cleaning/disinfection equipment after each use. Clean and disinfect mop heads daily and dry thoroughly before re-use Put used linen in linen bag inside the room; place in another bag outside the room when taking to laundry area for washing – treat as soiled/contaminated M. 55

56. Proper infectious-waste disposal Waste must be properly handled within the clinic setting, even before it is taken for incineration, burial or other disposal, to protect clients, staff, and the community Contaminated waste potentially infectious or toxic, if not disposed of properly. Contaminated waste include, blood, body fluids, secretions and excretions and items that have come in contact with them, such as sharps and used dressings, as well as medicines, medical supplies or other chemicals that may be toxic. M. 56

57. Cont… Contaminated and non-contaminated wastes should be separated at origin, to reduce the volume of contaminated waste and minimize the cost to the institution for more expensive procedures required for managing and disposing of contaminated waste properly. When possible, use separate containers for combustible and non-combustible waste. Never sort through contaminated wastes (e.g., do not try to separate non-contaminated waste from contaminated wastes, or combustible from non-combustible, after they have been combined). M. 57

58. Cont… STEPS OF WASTE MANAGEMENT Segregation Collection Transportation Disposal M. 58

59. How to Dispose of Solid Waste Dispose of contaminated wastes separately from non-contaminated waste, because contaminated wastes needs special handling as follows: Wear heavy duty or utility gloves when handling and transporting solid wastes. Dispose of solid wastes by placing them in a plastic or galvanized metal container with a tight fitting cover. Collect the waste containers on a regular basis and transport the burnable ones to the incinerator or area for burning. Remove gloves and wash and dry hands or use an antiseptic hand rub. N.B Contaminated wastes should be disposed of during or immediately following a procedure, using non-corrosive leak proof containers with lids. M. 59

60. How to Dispose of Hazardous Waste All hazardous waste material—chemical, pharmaceutical and one containing heavy metals—should be incinerated or buried if the quantity is very small. The large quantity of such materials should be sent back to the original supplier. M. 60

61. Waste Disposal Tips Use heavy duty utility gloves and appropriate personal protective equipment when handling wastes. Decontaminate and clean gloves between use. Handle wastes carefully to avoid spills or splashes. Always wash hands after removing gloves and handling contaminated wastes. Avoid transferring contaminated waste from one container to another. Incineration is the preferred method for waste disposal, as the heat will generally be sufficient to destroy infectious microorganisms and will also prevent scavenging and reuse of discarded items. If incineration is not possible, then careful burial is the next best alternative. Dispose of used toxic chemicals or medicine containers properly: Rinse glass containers thoroughly with water; glass containers may be washed with detergent, rinsed, dried and reuses . M. 61

62. Cont… For plastic containers that contained toxic substances such as glutaraldehyde , rinse three times with waster and dispose by incineration and/or burial; these containers may be used for sharp disposal containers, but do not reuse them for any other purpose Equipment that is used to hold and transport wastes must not be used for any other purpose in the clinic or healthcare facility, and contaminated waste containers should be labeled clearly. Contaminated waste containers should be cleaned each time they are emptied and non contaminated ones when they are visibly soiled M. 62

63. LO2 Establish and Maintain Participative Arrangements Participative arrangements are designed so that stakeholders are able to be involved in decision making that affects their health and safety. The processes may include employee and supervisor involvement in OHS activities, such as inspections and audits. M. 63

64. Basic requirements for Participative Arrangements Reviewing policies and procedures Consultation and issue resolution process Budding new staff or voluntaries M. 64

65. Definition of terms HAZARD AND RISK HAZARD - any source of potential damage, harm or adverse health effects on something or someone under certain conditions at work. RISK - the chance or probability that a person will be harmed or experience an adverse health effect if exposed to a hazard. WORKPLACE HAZARDS Safety Hazards working conditions where harm to the workers is of an immediate and violent nature result in broken bones, cuts, bruises, sprains, loss of limbs, etc M. 65

66. Classification of hazards 1. Chemical Hazards Routes of entry into the body Inhalation Ingestion Skin Contact Routes of excretion Gastro-intestinal (feces) Renal (urine) Respiratory (exhalation) Skin (sweat, hair, nails) M. 66

67. Cont… Chemical Hazards Classification of Toxic Effects Local toxicity- occurs at the site of chemical contact Systemic toxicity- occurs distant from point of contact, may involve many organ systems Acute toxicity- occurs almost immediately (hours/days) after an exposure Chronic toxicity- represents cumulative damage to specific organ systems; occurs many months or years to have recognizable clinical disease M. 67

68. Chemical Hazards Health Effects Renal Diseases Respiratory Diseases Skin Diseases Hematologic Diseases Cardiovascular Diseases Neurologic Diseases Carcinogenic Teratogenic M. 68

69. 2. PHYSICAL HAZARDS Noise Vibration Extreme Temperature Illumination Radiation M. 69

70. Cont… NOISE ◦ Temporary loss of hearing acuity after exposure to loud noise ◦ Recovery within 16-48 hrs Permanent Threshold Shift ◦ Irreversible loss of hearing Vibration: Health Effects : Hand Arm Vibration Syndrome (HAVS) Tingling, numbness, blanching of fingers Pain Disorders of the spine M. 70

71. Cont… Illumination Health Effects ◦ Visual Fatigue ◦ Double Vision ◦ Headaches ◦ Painful irritation ◦ Lacrimation ◦ Conjunctivitis M. 71

72. Cont… RADIATION Non-ionizing Ultraviolet Skin redness Premature skin ageing Skin cancer Corneal and conjunctival burns Retinal injury Cataract and eye problem Health Effects of Ionizing X-rays Gamma rays Cancer congenital defects death M. 72

73. 3. BIOLOGICAL HAZARDS VIRUSES FUNGI BACTERIA PARASITES M. 73

74. Cont… Selected infectious diseases like colds, influenza, pneumonia, tuberculosis, ringworm, rabies and COVID19 can be introduced into workplace through workers, suppliers, clients, visitors, public and contaminated objects; It can be transmitted between workers or between them and suppliers, clients, visitors and public during within workplaces during work activities; It can be transmitted out of the workplaces through workers, suppliers, clients, visitors, public and/or contaminated objects NB . COVID-19 is also an OSH issue. M. 74

75. 4. ERGONOMIC HAZARDS It is a factor in a work or other environment that could cause damage to the human musculoskeletal system ERGONOMICS The tool The workstation The task (job content & context) The organization The environment M. 75

76. Risk Factors Static posture Forceful exertion Repetitive movement Extreme range of motion Awkward posture M. 76

77. Create an effective safety team and facilitate productive safety meetings A meeting is the act or process of two or more people coming together to discuss issues or events and coming to a consensus. The main purpose of a meeting is to discuss issues, provide information, and to form consensus around common issues. M. 77

78. Types of Meetings 1. Safety Committee Meeting is a regularly scheduled meeting of safety committee members 2. Safety Training is a formal training on a specific subject, such as confined space entry, respiratory protection, hazard communication/right-to-know, etc. 3. Management level safety meetings are meetings with management regarding safety-related issues. 4. New Employee Orientation is a meeting where new employees are introduced to the organization, and typically learn about its culture, mission, vision, policies, and values. M. 78

79. Education and training Education and training provide individuals with the basic theoretical and practical knowledge required to carry out their trade or occupation successfully and to fit into the working environment. Because of the importance of occupational safety and health, measures should be taken to include these subjects in education and training at all levels in all trades and professions, including higher technical, medical and professional education. OHS training should meet the needs of all workers, and should be promoted in a manner that is appropriate to national conditions and practice. M. 79

80. Cont… A national OHS system comprises all the Infrastructures mechanisms and Specialized human resources required to translate the principles and goals defined by the national policy into the practical implementation of national OHS programmers. In turn, one of the main aims of national OHS programmers should be to strengthen national OHS systems. M. 80

81. Cont…. A national system must include at the least the following key elements: Laws, regulations, collective agreements where appropriate An authority or authorities responsible for occupational safety and health Arrangements to promote, at the level of the undertaking, cooperation between management, workers and their representatives as an essential element of workplace-related prevention measures; M. 81

82. Cont… Information and advisory services on occupational safety and health The provision of OHS training The provision of occupational health services Research on occupational safety and health support mechanisms for a progressive improvement of occupational safety and health conditions M. 82

83. Tips for effective safety meetings Peoples with management experience organize our safety meetings Build an agenda Don’t look backward Vary techniques Tell stories and use real life examples M. 83

84. LO3 Assess And Control Risk And Hazards Risk assessment is a term used to describe the over all process or methods where you analyze and evaluate the risk associated with that hazard. Determine appropriate ways to eliminate the hazard or control the risk when the hazard can not be eliminated. M. 84

85. How to do a risk assessment Identify the hazards Evaluate the risk and deicide on control measures Record your findings and implement them Review your assessment and update if necessary M. 85

86. Principles of occupational safety and health Occupational safety and health: is one of the most important aspects of human concern. It aims an adaptation of working environment to workers for the promotion and maintenance of the highest degree of physical, mental and social well being of workers in all occupations. Is an area concerned with protecting the safety, health and welfare of people engaged in work or employment. The goals is fostering a safe and healthy work environment. It includes the Laws, standards and programs that are aimed at making the work place better for workers, customers, family members and other stakeholders. M. 86

87. Cont… The basic principles for the development of occupational health and safety services are as follows: a) The service must optimally be preventive oriented and multidisciplinary. b) The service provided should integrate and complement the existing public health service. c) The service should address environmental considerations M. 87

88. Cont… d) The service should involve, participation of social partners and other stakeholders e) The service should be delivered on panned approach f) The service should base up to date information, education, training, consultancy, advisory services and research findings g) The service should be considered as an investment contributing positively towards ensuring productivity and profitability. M. 88

89. Cont… The functional principles are recognized; Prevention Promotion Adaption and adjustment of working conditions to the worker, Rehabilitation Curative services and acute response M. 89

90. Prevention and control methods Occupational diseases and injuries are, in principle, preventable. Among the approaches to prevent these include, Developing awareness of occupational health and safety hazards among workers and employers assessing the nature and extent of hazards, Introducing and maintaining effective control and evaluation measures. These approaches are undertaken by employers, workers and the government. M. 90

91. Cont… There are five major categories of prevention and control measures: Elimination Substitution Engineering controls Administrative controls and Personal protective equipment M. 91

92. Cont… 1. Elimination Eliminating the hazard completely is the ideal solution, but it is seldom easy to achieve. It is important to consider workers health and safety when work processes are still in the planning stages. For example, when purchasing a machine, safety should be the first concern but not cost. M. 92

93. Cont… 1. Substitution If a practically dangerous chemical or work processes cannot be completely eliminated, then it should be applied with a safer substitute. This could involve, for example, using less hazardous pesticides such as those based on pyrethrins which are considered to be less toxic to humans than some other pesticides. M. 93

94. Cont… 3. Engineering controls An engineering control may mean changing a piece of machinery (for example, using proper, machine guards) or A work process to reduce exposure to a hazard; working a limited number of hours in a hazardous area ; and there are number of common control measures which are called engineering control. M. 94

95. Cont… 3.1. Enclosure If a hazardous substance or work process cannot be eliminated or substituted, then enclosure the hazard is the next best method of control. Many hazards can be controlled by partially or totally enclosing the work process. Highly toxic materials that can be released into the air should be totally enclosed, usually by using a mechanical handling device or a closed glove system that can be operated from the outside. M. 95

96. Cont… 3.2. Isolation Isolation can be an effective method of control If a hazardous material can be moved to a part of work place where fewer people will be exposed or If a job can be changed to a shift when fewer people are exposed (such as weekend or midnight shift). The worker can also be isolated from hazardous job for example by working in an air-conditioned control booth. M. 96

97. Cont… 3.3. Ventilation Ventilation in work place can be used for two reasons: 1) to prevent the work environment from being too hot, cold, dry or humid. 2) to prevent contaminates in the air from getting into the area where workers breathe. M. 97

98. Cont… Generally there are two categories of ventilation. General or dilution Ventilation This adds or removes air from work place to keep the concentrations of an air contaminant below hazardous level. This system uses natural convection through open doors or windows, roof ventilators and chimneys, or air movement produced by fans or blowers 2. Local Exhaust ventilation Is considered the classical method of control for dust, fumes, vapors and other airborne toxic or gaseous pollutants. The ventilation system captures or contains the contaminants at their source before they escape into the workroom environment. M. 98

99. Cont… 4. Administrative Controls Administrative controls limits the amounts of time workers spend at hazardous job locations. Administrative control can be used together with other methods of control to reduce exposure to occupational hazards. 5. Personal protective equipment PPE is the least effective method of controlling occupational hazards Should be used only when other methods cannot control hazards sufficiently. PPE can be uncomfortable, may decrease work performance may create new health and safety hazards. M. 99

100. Environmental health hazards It is any thing in the environment that endangers human health and life. Like occupational health hazards may include Biological Chemical Physical Biomechanical and Psychological in nature M. 100

101. Cont… It include traditional hazards of poor sanitation and shelter as well as agricultural and industrial contamination of air, water, food and land. M. 101

102. LO4 Establishment of an OHS induction and training program The Station Manager will conduct a training needs analysis and arrange for appropriate OHS training to be undertaken by workers as required. Is committed to providing appropriate training to ensure workers have the skills and knowledge necessary to fulfil their WHS obligations. OHS training is a fundamental requirement for to achieve a safe workplace. M. 102

103. Cont.. Categorized into three : Generic OHS Training —skills and knowledge which is commonly required, e.g. induction training, OHS risk management training, evacuation procedures. Risk Specific OHS Training —training required for those persons conducting activities with a specific risk to health and safety, e.g. first aid training, hazardous substances training, manual handling training. Task Specific OHS Training —skills and licensing which are required depending on the specific hazards and risk, e.g. high risk work licenses such as for driving forklifts/cranes . M. 103

104. Training need identification is a systematic approach under taken by organizations to understand their employees existing knowledge and kills draw parallels with the ideal skill level. It helps organizations gauge skill gaps and training needs based on which organization can develop training plans to plug in the gaps. It also known as training need analysis Is the structured process of understanding organizations and employees training requirements. M. 104

105. Cont… It involves methodically recognizing your organizational work forces training and development needs to design a training program that provides excellent returns. M. 105

106. Process Problem identification Design if collection of needs Data analysis Providing feed back Developing action plan M. 106

107. Cont… Problem identification firstly the problem or problem areas need to be identified for appreciate training intervention at a later stage. Design of need analysis To be determined in order to identify appropriate method for training and development intervention. Data collection needs Data collection need expertise of part of the investigator & therefore training executive or consultants are to be engaged for this task. M. 107

108. Cont… Data analysis After collection of data, it needs to be carefully analyzed. Providing feedback Feedback should be provided to management. Developing action plan action plan is developed to meet the identified needs of training and development of employees. M. 108

109. Cont…. Levels of training identification At the individual level At the organizational level M. 109

110. Methods Document view Specific analysis Observation Surveys Interview Suggestion box Meeting , reports, newsletter M. 110

111. Rationales of training Improve employee skills Attract, motivate, and retain talented employees Allows any organization to gain a competitive advantage For better financial performance M. 111

112. Safety orientation program Is the process of introducing new experienced or transferred workers to; Organization Their supervisors Co workers Work areas Jobs and especially the health and safety requirements of their work environment M. 112

113. Cont… Provides employees with necessary safety information about their job and tasks, informs them of specific details about workplace hazards and provides an opportunity to learn about the company and their colleagues, ask questions and to clarify new or confusing information. M. 113

114. THE BENEFITS OF ORIENTATION The benefits of providing new employees with a comprehensive orientation are numerous: •Employees become aware of the health and safety hazards on the job, controls for these hazards and how they can affect their safety and the safety of others. •Helps reduce the risk of potential injuries and accidents. •Meets legislative requirements (demonstrates due diligence). M. 114

115. Cont… • Helps balance the company’s need for productivity with the employee’s need for safety and security. •Increases efficiency of the new employee. •Contributes to building a retention culture within the organization, thereby reducing turnover. •Demonstrates the company’s moral obligation to protect the employee from harm. M. 115

116. Who needs an orientation All new employees who meet any of the following definitions need an orientation. The Occupational Health and Safety (OHS) Act defines new employees as any person who is: •New to a position or place of employment. •Returning to a position or place of employment in which hazards have changed during the employee’s absence. •Under 25 years of age and returning to a position or place of employment after an absence of more than six months. •Affected by a change in the hazards of a place of employment M. 116

117. How do develop an orientation Orientation and job-specific training must be completed by the company/organization before a new employee starts work. M. 117

118. Cont… If your company does not currently have an orientation model, you may develop one using the following process: Step 1: Evaluate the employee’s training needs Step 2: Develop a plan to deliver the orientation information Step 3: Evaluate the employee’s progress Step 4: Recognition or correction Step 5: Documentation M. 118

119. Evaluation of the training program Refers to the process of collecting the outcomes needed to determine if training is effective. M. 119

120. Rationales of training evaluation To determine the effectiveness of a training program. To justify the existence of the training department by showing how it contributes to the organizations’ objectives and goals. To decide whether to continue or discontinue training programs. To gain information on how to improve future training programs. M. 120

121. Measuring Training Effectiveness and Impact I. Prior to training •The number of people that they need it during the needs assessment process. •The number of people that sign up for it. II. At the end of training •The number of people that attend the session. •The number of people that paid and attended. •Customer satisfaction at the end of training •A measurable change in knowledge •Ability to solve a “mock” problem at the end of training • Willingness to try/ to use the skill at the end of training. M. 121

122. Cont… III. Delayed Impact (non-job) •Customer satisfaction at X weeks after the end of training •Customer satisfaction at X weeks after the training when customers know the actual costs of training •Retention of knowledge at X weeks after the end of training. •Ability to solve a “mock” problem at X weeks after the end of training. •Willingness to try the skill at X weeks after the training. M. 122

123. Cont… IV. On the job behavior change •Trained individuals that self-report that they changed their behavior, used the skill on the job after the training. •Trained individuals who’s managers report that they changed their behavior or used the skill after training. •Trained individuals that actually are observed to change their behavior or use the skill after the training. M. 123

124. Cont… V. On the job performance change •Trained individuals who self-report that their actual job performance changed as a result of their changed behaviour and skill. •Trained individuals who’s manager’s report that their actual job performance changed as a result of their changed behaviour / skill. •Trained individuals whose manager’s report that their job performance changed either through improved performance appraisal scores or specific notations about the training on the performance appraisal forms. M. 124

125. Cont… Types of Evaluation Techniques and Instruments The process of Training Evaluation A training programme , like design, development, and manufacture of a product passes through several stages. Pre-Training Evaluation This is prior to the course and should cover an analyses of the expectations of the trainee and his superior officer. The existing level of knowledge and skills are reassessed. It is carried out through discussions, workshops etc. M. 125

126. Cont… 2. Input and Delivery Evaluation This is done concurrent to the training. It involves long term management programme . It is done individually or in group. Each topic, module is evaluated in terms of its content, presentation, relevance and applicability. Using a questionnaire, soon after the course, invariably on the last day the participants reaction is obtained which generally elicits information about the course inputs and the impressions about the course. M. 126

127. Cont… 3.Post Training Evaluation The objectives of training is to enhance individual effectiveness which helps in improving organizational performance. Thus the process of post-evaluation must have reference to job improvement plan. This cannot be done when the person is training , he needs to go back to his job and demonstrate his newly acquired knowledge and skills. After a lapse of 6-12 months the results obtained are used for evaluating the applicability of training. M. 127

128. Training evaluation Involves Formative evaluation – evaluation conducted to improve the training process. Summative evaluation – evaluation conducted to determine the extent to which trainees have changed as a result of participating in the training program. M. 128

129. Out comes used in evaluating training program Cognitive Outcomes Determine the degree to which trainees are familiar with the principles, facts, techniques, procedures, or processes emphasized in the training program. Measure what knowledge trainees learned in the program. Skill-Based Outcomes Assess the level of technical or motor skills. Include acquisition or learning of skills and use of skills on the job. M. 129

130. Cont… Affective Outcomes Include attitudes and motivation. Trainees’ perceptions of the program including the facilities, trainers, and content. Results Determine the training program’s payoff for the company M. 130

131. LO5. Establishment and maintenance of system for OHS records Uses and benefits of recordkeeping Record; Is a thing constituting a piece of evidence about the past, especially an account kept in writing or some other permanent form. Recordkeeping is the act of keeping track of the history of a person's or organization's activities, generally by creating and storing consistent, formal records. There are two main types Manual record keeping Computerized (or automated) record keeping. M. 131

132. Cont… Health and safety records can include: Health and safety policies and procedures. Standard operating procedures. Organizational code of conduct. Training and induction records. Register of Injuries. Workplace health and safety committee meeting minutes. Equipment records including inspections, maintenance and repair. M. 132

133. Exposure Records Environmental and biological monitoring Personal Workplace Material Safety Data Sheets Medical Records Questionnaires Results of examinations Laboratory tests Medical opinions, diagnoses, etc. First aid records Description of treatments Access to Exposure and Medical Records:

134. Uses and benefits of record keeping Provide reliable evidence and information about, 'who, what, when, and why' something happened. Provide evidence of your proactive health and safety management; Ensure that management is aware of organizational performance; Assist with continuous improvement; M. 134

135. Cont.. Demonstrate a commitment to continuous improvement in health and safety performance. In some cases, the requirement to keep certain records is clearly defined by law, regulation or professional practice. M. 135

136. Types of records in nursing Patients  clinical record   Individual staff records Ward records Administrative records with educational value M. 136

137. Who is responsible? The Manager WHS  has the responsibility for the development of record keeping requirements for the WHSMS. The Workplace Health and Safety (WHS) Advisor has the responsibility for the creation, modification and review of central WHS documentation. M. 137

138. Occupational safety health requirements Requires most employers with more than 10 workers to keep a log of injuries and illnesses. Workers have the right to review the current log, as well as the logs stored for the past 5 years. Workers also have the right to view the annually posted summary of the injuries and illnesses M. 138

139. Cont… Employers  have a legal duty to implement a health surveillance program  if their employees are exposed to certain health risks.  M. 139

140. Cont… Legal Requirements of Occupational Health The work is known to harm health in some way. There are valid ways of detecting the disease or condition. There is a reasonable likelihood that damage to health may occur under the particular conditions at work. The surveillance is likely to benefit the employee. M. 140