2. Objectives:
As a result of successfully completing this
chapter, students will be able to:
Discuss common safety hazards applicable
to Central Service functions and work areas,
and explain how employee injuries can be
prevented
Describe special safety precautions for
handling Ethylene Oxide
Review procedures to report employee
accidents and injuries
3. Objectives: (continued)
Explain the importance of ergonomics
and health awareness for Central Service
Technicians
Discuss procedures to prevent patient
accidents and injuries and to report them if
they occur
Explain basic procedures which address
three occupational hazards: fire, hazardous
substances, and bloodborne pathogens
Discuss the basics of internal and
external disaster plans for a healthcare
facility
4. “Safe”
Freedom from danger, risk or injury
Central Service Technicians are responsible
for working safely after they have been ,made
aware of workplace hazards
5. Accidents and Injury:
Are not funny
Can happen to anyone
“It will never happen to
me.” is a dangerous
attitude
8. Biohazard
Prevent Biohazard
exposures (Blood Borne
Pathogens) and exposures
to chemicals, by wearing
appropriate Personal
Protective Equipment (PPE)
If you are exposed to body
fluids or chemicals notify
your supervisor
immediately
9. Safety Tips for Working in Soiled Receiving
and Decontamination Areas:
Never put your hands into a basin
or container holding contaminated
objects that you cannot see
Never put your hands into a trash
container; instead remove the
inner bag and pour its contents
onto a surface, or use an
instruments to sort through the
contents
Pour out any solution that
prohibits visual examination of
basin or container contents
Place all disposable sharps
(needles, blades, etc.) in an
appropriate sharps container
11. Safety Tips for Working in Soiled
Receiving and Decontamination Areas:
Use extreme caution when
disarming scalpel blades. Never use
your hands. Use needle holder or
other tool and wear eye protection
When reprocessing reusable sharps,
separate them from other
instruments and position them in a
way that will avoid injury to others
Follow manufacturers’
recommendations for safe use of
chemicals
Always wear PPE to protect yourself
from chemical exposures
12. Safety Tips for Working in Soiled
Receiving and Decontamination Areas:
Follow manufacturers’
recommendations for safe operation
of cleaning and testing equipment
Use caution when walking in areas
with wet floors
Utilize mats or nonskid footwear
when appropriate
Use care when loading or unloading
carts from dumbwaiters and
elevators
Sinks and work surfaces should be at
appropriate levels to reduce back
and arm strain
13. Safety Tips for Working in Soiled
Receiving and Decontamination Areas:
When scrubbing instruments in a sink,
always scrub below the surface of the
water to prevent aerosols
Use the concentration of detergents
and water recommended by the
manufacturer
Use thermal insulated gloves when
handling washer baskets, sterilizer
carts and other hot objects
Move sterilizer carts to low or no
traffic areas to reduce the chance
passersby will come in contact with
the hot cart and be burned
14. Safety Tips for Working in Preparation
and Sterilization Areas:
Inspect all equipment for
frayed electrical cords
Use caution when using
heat sealers
Use caution when using a
cutting edge
When lifting instrument
sets, size up the load and lift
with the larger muscles in
your legs and arms
Hold the item as close to
your body as possible
15. Safety Tips for Working in Preparation
and Sterilization Areas:
Follow all procedures for the
handling and disposal of biological
tests
Continuously check sterilizers for
obvious damage to doors
Only authorized service personnel
should access control panels and
inner parts of sterilization equipment
for repairs and adjustments
Only those people who have been
trained to operate sterilizer should
do so
Unauthorized hospital personnel,
visitors, or visitors should not enter
an area that contains sterilizers
16. Safety Tips for Working in Preparation
and Sterilization Areas:
Ensure that proper signs
are warning labels are
posted to warn of hot
surfaces and other hazards
Use only secure and sturdy
shelving
Use safety ladders and
stools to reach high items.
Do not climb on shelves
17. Safety Tips for Working in Supply
Receiving, Breakout, and Storage Areas:
Use appropriate containers for waste
Use specialized containers for
storage and disposal of hazardous
materials
MSDS Sheets should be available for
reference
Use caution when removing items
from storage units or shelves
Insure there is time and space to
safely retrieve items
Use care when using box-cutting
tools
Scalpel blades should NEVER be
used to open boxes or containers
MSDS
18. Safety Tips for Working in Supply
Receiving, Breakout, and Storage Areas:
Handle paper products with care to avoid skin lacerations
Do not handle broken glass
Avoid twisting and jerking movements when moving objects
Inspect work areas for objects left in pathways. Aisles and
doorways must be kept clear at all times
When working in small areas be aware of traffic patterns
To avoid injury perform appropriate stretching exercises before
lifting, pushing or pulling
When transporting patients, supply carts, or equipment be sure
the path in front and on each side of the cart is clear
Ensure clearance on each side of objects you are carrying to avoid
injury to arms and hands
19. Safety Tips for Working in Equipment
Distribution and Central Transport Areas:
Inspect floors for uneven surfaces to
ensure equipment being rolled is not
thrown off balance
Use caution when approaching automatic
doors
Use caution when approaching corners or
intersections; use safety mirrors when
available
Use caution when pushing objects up or
down inclines
Do not ride or step on supply carts or
other vehicles
Consider the acquisition and use of
powered carts for moving heavy or
awkward loads
20. Safety Tips for Working in Equipment
Distribution and Central Transport Areas:
Consider the acquisition and use of
powered carts for moving heavy or
awkward loads
Assembly work should be performed
at levels that will least fatigue and
strain employees
Floors in work areas where employees
must stand should have fatigue mats
to relieve leg strain
Appropriate chairs should be used at
computer, clerical, and instrument
work stations to properly support
employees backs
Computer screens should be used to
reduce eyestrain
21. Safety Tips for Working in Clerical and
other Work Stations:
Items used frequently to
perform routine tasks should
be stored within easy reach
Caution should be used when
working with filing cabinets.
Open upper drawers increase
the risk of the cabinet tipping
and open lower drawers
increase the risk of someone
tripping
22. Handling Compressed Gas Cylinders
Central Service Technicians
must understand and follow
basic safety precautions
when handling,
transporting, and storing
compressed gas cylinders
23. Compressed Gas Cylinder
Safety Precautions
Do not dispense gas cylinders that are not labeled
Make sure that gas cylinders are secured at all times to prevent
tipping
Handle carefully when transporting. Do not roll, drag, or drop.
Use a cover cap during transport
Cylinder regulators are not interchangeable. Be sure to use the
correct regulator for the gas you are handling
Inspect all fittings for damage before connecting
Cylinders should be clearly labeled as ; Full, In Use, or Empty
Empty cylinders should not be store with full cylinders
Gas regulator stem valves require a key. That key should be kept
with the regulator at all times
33. EtO exposure may be possible:
In the front of the sterilizer by
the door
In the rear of the sterilizer by
the drains
Near emission control devices
In the tank changing area
When cylinders or
connections leak
34. EtO Safety Precautions:
When transferring sterilized items to aeration cabinets, wear gloves
made of neoprene or other appropriate protective material
Do not hold sterilized items that have not been aerated close to your
body
When transporting a from the sterilizer to the aerator, pull it instead
of pushing to avoid inhaling EtO fumes
Avoid working in areas immediately adjacent to the EtO sterilizer
during its cycle. When possible, EtO sterilizer should be located in a
separate room
Facilities must have a dedicated ventilation system to remove fumes
exhausted during the cycle
Audible and visual alarms should be installed to alert workers to the
presence of EtO in the work area
35. EtO Safety Precautions:
Facilities must comply with federal,
state, and local requirements for:
Air Quality
Worker Safety
Discharge
Air Monitoring
Recordkeeping
36. EtO Safety Precautions:
With some sterilizers the door of the sterilizer must be opened 6
inches after the cycle is complete and the load must sit in the
chamber for 15 minutes before transfer to the aerator. (Check
manufacturer’s instructions for specific guidelines)
Once items have been placed in an aeration cabinet, the cycle
should not be interrupted and the door of the aerator should not
be opened
No items should be removed from the aerator until the aeration
cycle is complete
Do not mix loads in the aerator. Do not add newly sterilized
items to an aerator that has other items in it
Report EtO exposures immediately
Observe out of order and electrical lock out signage
37. Employee Accident and Injury
Reports
All employee accidents and
injuries must be reported
Page 409 in the text
provides an example of an
employee injury report
38. THE PROCESS OF CHANGING
WORK, OR WORKING CONDITIONS
TO REDUCE EMPLOYEE STRESS.
Ergonomics
39. AN INJURY TO, OR DISORDER OF THE
MUSCULOSKELETAL SYSTEM WHERE
EXPOSURE TO WORKPLACE RISK FACTORS
MAY HAVE CONTRIBUTED TO THE
DISORDER’S DEVELOPMENT OR
AGGRAVATED A PRE-EXISTING CONDITION
Work-related Musculoskeletal
Disorder
(WMSD)
40. Ergonomic Stressors:
Force - Such as heavy lifting or manipulating equipment
or tools
Repetition – Using the same motion continually or
frequently
Awkward Positions – Assuming positions that place
stress on the body
Vibration – Rapid oscillation of the body or a body part
Contact Stress – Pressing the body or a body part
against a hard or sharp edge
41. Reducing WMSDs
Management and Staff must commit to
implementing and following work procedure
and equipment changes that reduce the risk of
WMSDs
All employees must be trained properly
An evaluation of the training programs must
be assessed
42. Reducing the Risk of Injury
Central Service employees
should also maintain their
physical health in a manner
consistent with the physical
demands of their work
43. Preventing Patient Injuries
Central Service Technicians
help keep patients safe from
injuries, accidents, and
infections
44. Preventing Patient Injury
Patient Care Equipment
Test and document all patient care equipment according to manufacturer’s
guidelines
Ensure that all equipment has been properly decontaminated
Ensure that all equipment is free from visible defects, such as bent parts,
frayed electrical cords, etc.
Track and control equipment, document its use
Ensure that regularly scheduled preventive maintenance is performed and
documented
Ensure that the facility’s Biomedical Engineering Department is involved in
equipment testing as required
Assure that safety guards are placed over items as required
Always cover contaminated equipment being transported to Central Service to
prevent cross-contamination
45. Preventing Patient Injury
Contaminated Supplies and Reusable Medical Devices
Ensure that all items are thoroughly disassembled, cleaned,
inspected, prepared, packaged, and sterilized according to
protocol
Test processing equipment
Ensure that everyone is properly trained on the equipment
they use
Insure that all instruments are complete and functional
before use
Monitor all sterilization equipment
46. Preventing Patient Injury
Chemical Residues
Ensure that all items sterilized with EtO are thoroughly
aerated before dispensing them for patient use
Ensure that all items placed in the EtO sterilizer are dry
before they are sterilized
Thoroughly rinse items soaked in glutaraldehyde or other
chemicals
47. Preventing Patient Injury
Supply and Equipment Transport
Use caution when approaching doors, hallway
intersections, elevators and high traffic areas
Do not use a transport vehicle to prop open or
push open automatic doors
Do not block hallways with carts and equipment
Do not block doors with carts and equipment
48. Reporting Patient Accidents, Injuries, and
Incidents
ALL accidents, injuries or incidents involving
patients must be reported and investigated
All healthcare workers should report unsafe
practices or hazards that could pose a threat
to patients
49. Sterilization Process Malfunctions:
If a sterilization process
malfunctions, all items in
any loads that are thought
to be unsterile must be
recalled
All Central Service
Technicians must be aware
of their department’s recall
policy
50. Basic Steps in the Load Recall Process:
Obtain a list of all supplies known to be in the load
Verify the sterilization controls
Notify the Central Service Supervisor, Manager, or
Director
Notify areas (user units) where unsterile items may be
located
Retrieve as many items as possible
Notify Infection Control, the Operating Room, and the
administration according to policy
51. Basic Steps in the Load Recall Process:
Notify physicians if unsterile items were used in any
procedures they preformed
Document all steps taken
Notify Risk Management Department
Ensure that qualified service personnel inspect the
malfunctioning equipment and that a comprehensive
report is developed
Consult ANSI/AAMI ST79 for specific information
regarding testing before the sterilizer is placed back
into service
53. Fire and Explosions
All healthcare employees
must take precautions to
minimize the risk of fire and
explosions in the healthcare
facility
54. THE WEIGHT OF COMBUSTIBLE
MATERIALS PER SQUARE FOOT OF AREA
IN WHICH THOSE MATERIALS ARE
LOCATED
Combustible Loading
55. Healthcare Fire Safety Programs Must
Include:
Minimization of the Combustible Load
Fire Response Plans
Early Detection
Removal of Persons in Danger
Containment of Fire and Combustible
Products
Extinguishment
Evacuation
57. Many Facilities Use the RACE Plan
Remove persons in
danger
Alarm Call 911 or
activate alarms
Contain the fire. Close
doors in the area
Extinguish the fire if
safe or Evacuate the area
58. Hazardous Substances
Healthcare facilities must
develop a plan to safely
handling chemicals and
other hazardous substances
Original and secondary
containers of chemicals
must be clearly labeled
59. MSDS Sheets
The chemicals used in
Central Service are very
different from the ones
you use at home.
MSDS Sheets help us
understand how to use
them safely and what to do
in an emergency.
Understanding our
Chemicals is in your own
best interest.
60. MSDS Sheets
Contain Important Information
Product Identification
List of Hazardous Ingredients
Physical Data
Fire and Explosion Information
Reactivity Data
Health Hazard Data
Storage Recommendations
Emergency and First Aid Procedures
Spill or Leak Procedures
Protection Information and Control
Measures
Special Precautions
61. Healthcare Facilities must:
Make MSDS sheets
available to employees.
Provide training to
employees
Central Service Technicians
are responsible to handle
hazardous substances
according to procedures
62. Hazardous Substances
Pages 421 and 422 in the
text provide lists of common
hazardous materials by
hospital department and a
list of regulated chemicals
and their exposure limits
66. Internal Disaster
Any situation with the
potential to cause harm to
Central Service employees
or where the loss of utilities
may drastically impact
department operations (i.e.
fire, the loss of water, etc.)
67. External Disaster
A situation in which
activities external to the
facility affects departmental
or facility operations (i.e. a
natural disaster, a terrorist
attack, etc.)
68. Elements of a
Central Service Disaster Plan:
An emergency call list
outlining lines of
authority and key
individuals to be
notified in specific
types of disasters
69. Elements of a
Central Service Disaster Plan:
Protocols for inventory
replenishment and delivery
of emergency supplies
70. Posted evacuation plans and
practices drills to ensure
that employees know
alternative ways to leave the
department if their safety is
at risk
Elements of a
Central Service Disaster Plan:
71. A well-known and
understood organizational
structure that presents lines
of authority
Responsibility lists to
identify employees
responsible for certain tasks
during disaster situations
Elements of a
Central Service Disaster Plan:
72. Directions for alternative
communications and
transportation if existing
systems (i.e. telephones,
elevators, etc.) cannot be
used
Elements of a
Central Service Disaster Plan:
73. Directions for locations for
utility and power shut off
points
Plans for prioritizing sterile
processing and supply
distribution based on failing
utilities or internal damage
Elements of a
Central Service Disaster Plan:
74. A facility risk assessment
that assesses the facility’s
current level of
preparedness to help
guide planning efforts
A description of how the
institution's disaster
planning and response
efforts are integrated with
other community
response organizations
Elements of a
Central Service Disaster Plan:
76. Planning for suspected or
confined terrorism events
must be well-organized and
rehearsed
The Threat of
Bioterrorism
77. Factors that Should alert Healthcare Providers to the
Possibility of a Bioterrorism Attack:
A rapidly increasing disease incidence in a
normally healthy population
An epidemic curve that rises and falls in a
short period of time
An unusual increase in the number of people
with respiratory and gastrointestinal
complaints
An endemic disease rapidly emerging at an
uncharacteristic time or in an unusual pattern
78. Lower attack rates among people who have
been indoors, especially areas with filtered air
or closed ventilation systems
A cluster of patients arriving from a single
locale
Large numbers of rapidly fatal cases
Any patient presenting a disease that is
relatively uncommon and has bioterrorism
potential (i.e. tularemia, pulmonary anthrax,
etc.)
Factors that Should alert Healthcare Providers to the
Possibility of a Bioterrorism Attack (cnt’d):
79. Endemic Disease
A disease that occurs
more or less
continuously
throughout a
community
80. Checklist for Disaster Readiness
Page 427 in the text
provides a
checklist for
Disaster
Readiness
81. In All Activities, Central Service
Technicians Must:
Protect the Patient
Protect Fellow Healthcare
Workers
Protect Themselves