Institutions exam 1
what are 3 classes of institutions?
Health care
child care/educational
correctional
Define Microcosm
a tiny community within the large community, one that has similar environmental concerns
List the 5 elements of institutional EH&S
General EH
Radiation protection
infection control
safety
IH
What are the areas of concern in EH
Air and water quality, waste mgmt,food protection, sanitation and pest control, env mgmt
Name the tenets of IH
Anticipate, Recognize, Evaluate, control
Describe unique issues in health care facilities
Differences in worker/pt exposure
unique sources for air and water contamination
frequent renovations and technology changes
Describe some medical legal issues.
you may not be aware of special risk factors due to confidentiality,
conflict between malpractice and responsibilities to inform
Describe some medical legal issues.
you may not be aware of special risk factors due to confidentiality,
conflict between malpractice and responsibilities to inform
What is cradle to grave concept
being responsible for the repurcussions of the effect of our material use, proper mgmt from the point of entry into a building until final disposal
What are some examples of hazards affecting HCW’s?
ergonomics, biological hazards, Toxic chemicals, Radiation, Stress
Why is there a serious problem with hospital hazards
industry is slow to protect workers, primary concern is pt safety, nursing homes have the highest rate of lifting injuries
Compare injury rates for all workers to HCW
total industry rates are lower than hospital and nuring home. this is LARGELY preventable
Why are HCW’s at risk
Assumption that HCW are responsible for their own health, ex hazcomm, bloodborne pathogens
What are some factors that will determine whether a chemical will have acute or chronic toxicity?
Dose (conc.+duration), Route of exposure, physical and chemical properties, host factors, possibly synergistic
Asbestos
Causes scar tissue, lung cancer, mesothelioma
used in pipe lagging, floor anf roof tiles, cieling tiles, insulation, siding
MONITOR, EXPOSURE CONTROL (removal, encapsulation)PPE, work practices
Cryogenic agents (Nitrous)
Formaldehyde
severe irritant, sensitizer suspect carcinogen,
embalmers, ventilation
glutaraldehyde
irritant sensitizer susstitution enclosure isolation
phenolics
mild to severe irritant bleach substitution
ethylene oxide
irritant carcinogen reproductive toxin, explosive found in antifreeze, dermal resp., monitoring, engineering, work practices
antineoplastics/hazardous drugs
wide range, suspect carcinogen, cancer treatments, engineering, administrative, ppe dilution ventilation
mercury
dermal senstizer
mercury
dermal sensitizer monitoring exposure engineering
anesthetic gases
liver and kidney effects, judgement and oordination lags monitor engi
sme concerns regarding biological hazards in HC
biological (viable and non viable) agents pose a risk
many HC personnel at risk
Some concerns associated with antibiotic resistant strains
multi drug resistant organisms, potential nosocomial spread
whats a problem with legionella
23% of yearly infections are nosocomial.
why so many nosocomial infections
ppl in hospitals are sick, compromised immune system, generates aerosols so its easier to breathe
what are the risk factors for legionella
middle age smokers compromised immune systems
surveillance
the systematic collection of pertinent data,the orderly consolidation and current evaluation of the data, and the prompt dissemination of the data to those who need it
colonizaiton
presence of microorganisms in or on a host with growth and multiplication but without tissue invasion or damage
carrier
a person that harbors a specific infectious agent in the absence of discernible clinical disease and serves as a potential source of infection
most costly infeciton
surgival site infections
causing the highest fatality rate
pneumonias
what was the percentage of preventable infections?
32%
sentinel event
focus on process, not outcome
root cause analysis
competant people proper technique proper procedures
three necessary elements for disease transmission
source, host , means of transmission
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