INTRODUCTION OF NURSING 1.5 Ergonomic for Nurse

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1. Needle prick injury

Nurse and 2. Fall




3. Cross infection

Environment 4. Environmental


products

a. Needlestick Injury









• Common occurrence in the health care profession








What are the primary pathogens transmitted?



1. Human Immunodeficiency Virus (HIV)



2. Hepatitis B Virus (HBV)

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3. Hepatitis C Virus (HCV)

What protocol should be followed after any needlestick?


• The following measures also should be taken

a. The site should be immediately washed with soap and
water.


b. The incident should be reported and an exposure report
sheet completed.

a. Needlestick c. The exposure should be assessed (type of fluid, type of
needle, amount of blood on the needle, etc).


Injury d. The exposure source should be evaluated:

HIV, HBV, and HCV status of the patient;
i.
ii. Consent and testing of the patient for these diseases
if the status is unknown;

iii. Likelihood of infection based on the community
served by the hospital if the patient is not available

to be tested.

iv. Appropriate management of any positive exposure is
necessary

• A fall is defined as an unplanned descent to a lower level,

with or without injury. (MOH, 2019)






• A prevalence study done in a large tertiary hospital in

Malaysia in 2011 showed

➢majority of falls occurred in the period between

midnight and noon. This may have been associated
with toileting at night and higher activity in the

mornings.
b. Fall ➢21.5% occurred in the toilet




➢51.6% occurred by the bedside

➢47.5% of fallers had a previous history of falls

➢41% occurred in the general medical wards


➢The psychiatry, radiotherapy and oncology, and
orthopaedic wards together contributed to 25% of the

falls.

b. Fall






















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• The transfer of infection,

especially to a hospital

patient with a different

infection or between

Cross infection different species of animal


or plant. (Oxford)






• Other name is nosocomial

infection


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REFERENCE

ABOVE

• Nosocomial infection sites

classified into 13 types, with

50 infection sites, which are

specific on the basis of


biological and clinical
c. Cross criteria.



➢common include urinary
infection tract infections (UTI),



surgical and soft tissue

infections,


gastroenteritis,

meningitis and

respiratory infections

• Health care provider usually

will do either minor or major

procedures on hospitalised
c. Cross patient, this if they do not


practice the prevention of
infection nosocomial infection, patient



may get infected that will

end to morbidity or


mortality.

Ten Principal



Causes of



Hospitalisation in



MoH Hospital,



2017

Ten Principal




Causes of




Deaths in MOH



Hospital, 2017

Lack of concern, knowledge


SCAN THE and sense of responsibility

REFERENCE can lead to nosocomial
d. Environmental BELOW infections.



products / Below are the easy potential



diseases cause of injury or infection
either nurses or patient.







1. Dirty linen



2. Clinical waste


3. Airborne disease

Tackling Antimicrobial Resistance









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1. MRSA Infection


2. Esbl-Klebsiella Pneumonia Infection



3. ESBL- E- Coli Infection

Education and training - by Infection control


nurse, link nurse to tighten infection control


Roles And practices.



Responsibilities



of Nurse on



Tackling



Antimicrobial When the lab calls or when the results are



Resistance traced, the nurse must ensure the following :





Document Inform Practice
Inform the accurately and infection contact
doctor
completely control nurse precaution

• Action by infection control

nurse :
Roles And ➢Receive laboratory result



Responsibilities ➢Identify case and patient


location
of Nurse on ➢Do ward rounds



Tackling ➢Verification from a


doctor to determine the
Antimicrobial case of infection or



Resistance colonizer


➢Practice contact

precaution

• Documentation and
Roles And Reporting every month to :



Responsibilities ➢Hospital Director


➢Head of Department
of Nurse on ➢Chief Matron / Area



Tackling Matron


➢Department of State
Antimicrobial Health



Resistance ➢Ministry of Health


Malaysia

1. Hand washing



2. Hand rub
Nurse and Safety 3. Musculoskeletal




Injury

Hand transmission is one of the


most important methods of

spread of infectious agents in

health care facilities.
a. Hand




washing


Proper hand hygiene is an

effective method for preventing


the transfer of microbes

between staff and patients

Must be practiced promptly after touching

blood, body fluids, secretions or excretions
whether or not gloves were worn.












a. Hand Must be practiced after gloves are




washing removed and between patient contacts.













Must be practiced when tasks or

procedures on the same patient involve
different body sites in order to prevent

cross contamination between body sites.

Five (5) Moments in Hand Hygiene





1. Before and after having direct contact with patients

➢ A single act of hand hygiene (with an alcohol hand-rub or an

antimicrobial soap) after one patient and before the next patient
suffices to decontaminate your hands if you are not re-contaminating

your hands in-between patients (as in talking on the telephone,
handling objects, etc.).

➢ A good rule of thumb is that if you apply an alcohol hand-rub as you
leave one patient and are still rubbing your hands together as you

arrive at the next patient then there is no need to repeat hand
antisepsis.












a. Hand washing

Five (5) Moments in Hand



Hygiene





• Before handling an invasive device for


patient care, regardless of whether or not

gloves are used.
a. Hand

• After contact with body fluids or

washing excretions, mucous membranes, non-


intact skin, or wound dressings.



• If moving from a contaminated body site


to a clean body site during patient.


• After contact with inanimate objects


(including medical equipment) in the


immediate vicinity of the patient.



PROCEED TO PRACTICAL SESSION AFTER THIS TOPIC

PROCEED TO PRACTICAL SESSION AFTER THIS TOPIC

c. Musculoskeletal Injury In Nurses










• Nurses exposure many risk factors in the SCAN THE REFERENCE BELOW

hospital setting. Musculoskeletal disorders

(MSDs) is a common health problem

between work related disabilities and injuries


in nurses

Techniques to Minimize Risk






of Injury From Transferring /






Repositioning Patients

Techniques to • Why can patient handling activities be hazardous?



Risks related to the task
Minimize Risk 1. ➢Force: The amount of physical effort required to




of Injury perform the task (such as heavy lifting, mulling

and pushing) or to maintain control of equipment

From and tools


➢Repetition: Performing the same motion or series
Transferring / of motions continually or frequently during the

working day

Repositioning ➢Awkward positions: Assuming positions that


place stress on the body, such as leaning over a
Patients bed, kneeling or twisting the trunk while lifting

Techniques to




Minimize Risk 2. Risks related to the patient


➢Patients can not be lifted like loads; so safe
of Injury lifting “rules” do not always apply




From ➢Patients can not be held close to the body

➢Patients have no handles

Transferring / ➢It is not possible to predict what will happen


while handling a patient
Repositioning ➢Patients are bulky




Patients

Techniques to




Minimize Risk




of Injury 3. Risks related to the environment

➢Slip, trip and fall hazards

From ➢Uneven work surfaces




Transferring / ➢Space limitations (small rooms, lots of

equipment)

Repositioning




Patients

Techniques to




Minimize Risk




of Injury 4. Other risks

➢No assistance available

From ➢Inadequate equipment




Transferring / ➢Inadequate footwear and clothing

➢Lack of knowledge or training

Repositioning




Patients

1. Always seek the help of assistants where necessary

Basic 2. Before starting any kind of handling activity, the


caregiver should position himself as close as possible to
principles for the patient, also by kneeling on the patient's bed if

necessary

adequate 3. Before starting any kind of handling operation, explain


the procedure to the patient while also encouraging him
patient to cooperate as much as possible in the course of the

handling activity

handling 4. Keep a correct posture during patient handling


operations
techniques 5. Get a good grip during patient handling operations




6. Wear suitable footwear and clothing