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OCCUPATIONAL SAFETY AND HEALTH
Instructions on labor protection for a dressing nurse. Full Document
Occupational Safety and Health / Standard instructions for labor protection Safe Operation General safety requirements Paramedical personnel not younger than 18 years of age who have undergone special training, including group I electrical safety, who do not have contraindications for health reasons, are allowed to work independently as a dressing nurse. Dressing room nurses must undergo a mandatory medical examination upon entry to work. Dressing room nurses who, by the nature of their work, have contact with blood and its components, are subject to examination for the presence of HBsAg upon admission to work, and then at least once a year. If HBsAg is detected, an in-depth clinical and laboratory examination is carried out by an infectious disease doctor. Dressing nurses with identified HBs antigenemia, belonging to risk groups, are required to observe personal hygiene rules aimed at preventing infection of patients with hepatitis B. All parenteral manipulations should be carried out with rubber gloves. Dressing nurses who have violations of the integrity of the skin are temporarily suspended from work. These restrictions are removed with repeated negative blood tests for the presence of HBsAg by highly sensitive methods. All newly hired employees must undergo an introductory briefing by an occupational safety engineer. The results are recorded in the registration log of the introductory briefing on labor protection. After that, the personnel department makes the final registration of the newly arriving employee and sends him to the place of work. Each newly hired person must undergo an initial briefing at the workplace with registration in the briefing log, an internship of 14 shifts. Dressing room nurses are re-instructed at least once every 6 months. The briefing is carried out by the head of the unit with registration in the briefing log. Upon admission to work and periodically at least once every 12 months, dressing nurses must pass a knowledge test on occupational safety issues according to a program approved by the head physician. When performing one-time work that is not related to their direct duties, dressing nurses must undergo targeted training. Dressing room nurses are required to comply with the internal labor regulations, work and rest regimes. When carrying out work on dressing room nurses, the following hazardous harmful production factors are possible:
Dressing room nurses should be provided with free sanitary and special clothing, special footwear and other personal protective equipment:
The administration is obliged to ensure regular disinfection, washing and mending of clothes. Washing overalls at home and in work areas outside a specialized laundry is prohibited. Dressing room nurses are required to follow their job descriptions in their work, comply with the requirements of this labor protection instruction, as well as the requirements of manufacturers for the operation of the equipment and tools they use in the process of work. Dressing room nurses should know how to provide first aid for injuries, burns, poisoning, know the location and contents of the first aid kit, and be able to use the means contained in it. Dressing room nurses must be aware of and comply with personal hygiene requirements. They should be provided with soap, towels and skin softeners. Smoking, eating is allowed only in a special place. Dressing room nurses must know and comply with fire safety rules, know the location of fire extinguishing equipment, and be able to use them. The victim or eyewitness of the accident must immediately notify the manager about each accident related to production. The head organizes the provision of first aid, transportation of the victim to a medical institution, reports the incident to the head doctor, the trade union committee and the labor protection engineer. To investigate the causes of the accident before the arrival of the commission, it is necessary to maintain the situation at the scene of the accident as it was at the time of the accident, if this does not threaten the lives of other workers, does not aggravate the emergency. Dressing room nurses who have failed to comply with or violate labor protection instructions are subject to disciplinary action in accordance with the internal labor regulations and, if necessary, an extraordinary knowledge test. Safety requirements before starting work Turn off the germicidal lamps in the dressing room. Check the serviceability of sanitary clothing, the integrity of gloves, masks. Wear sanitary clothing. All manipulations in which contamination of hands and mucous membranes with blood or serum is possible should be done with rubber gloves. If there is a risk of splashing blood or serum, you should work in masks and goggles. Dressing nurses should not have jewelry (rings, bracelets) on their hands. Nails should be cut short and not varnished. All damaged areas of the hands should be covered with plaster or fingertips. Prepare the workplace, check the availability of detergents, disinfectants, sterile instruments, specifying the period of their sterilization, the availability of trays for sterile materials, dishes with disinfectant for used instruments and materials. Before performing dressings, you must:
When washing, disinfecting and sterilizing instruments, the requirements of the sanitary regime should be followed. Safety requirements during work Medicines for parenteral use, internal use and for external use are stored separately on separate shelves. Medicines in the dressing room should come in ready-made form with inscriptions on the signature or label "Internal", "External". In the absence of the listed designations on the packages of medicines, storage and use of medicines is not allowed. Packaging, scattering, hanging, shifting and transfusion of drugs into the container of the dressing room, as well as replacing labels is prohibited. The stock of medicines should not exceed 10-day requirement. Toxic and narcotic medicines are stored in safes (metal steel cabinets), on the inside of which the inscription "Group A" is made and a list of poisonous and narcotic medicines is placed. Stocks of toxic agents should not exceed 5-day, and narcotic 3-day needs. Washing and rinsing of medical instruments that have come into contact with human blood or serum should be carried out after preliminary disinfection. Work is carried out in rubber gloves. Disinfection (disinfection) of needles and syringes is carried out to destroy pathological microorganisms. When disinfecting products with internal channels, a disinfectant solution in a volume of 5-10 ml is passed through the channel to remove blood residue immediately after use, after which they are completely immersed in a disinfectant solution. Disposable items: syringes, dressings, gloves, masks must be subjected to pre-sterilization treatment followed by sterilization and disposal. The dressing nurse is prohibited from:
Safety requirements in emergency situations If the overalls are contaminated with blood, they should be immediately removed, the contaminated areas should be treated with a disinfectant solution, then the overalls should be soaked in it. If gloves are contaminated with blood and other liquids, they are wiped with a swab moistened with a 6% hydrogen peroxide solution or a 3% chloramine solution. In case of contamination of the skin with blood, they should be treated with a swab abundantly moistened with 70% alcohol for two minutes, washed under running water with soap and wiped with an individual swab. If blood gets on the mucous membranes, they are immediately treated with a stream of water, then with a 1% solution of boric acid, or a few drops of silver nitrate are injected. The nose is treated with a 1% solution of protargol, the mouth and throat are rinsed with 70% alcohol or a 1% solution of boric acid. In case of injury of any stage, poisoning, burns and other accidents, first aid is provided to the victim on the spot, if necessary, sent to a medical institution. In the event of a fire, it is necessary to call the fire brigade, organize its meeting, report the fire to the head of the organization, and proceed with the evacuation of people. Prior to the arrival of the fire brigade, take measures to extinguish the fire with improvised means in accordance with the fire safety instructions. In case of other emergencies (accidents of water supply, sewerage, heating systems) that impede the performance of work, stop work and inform the manager about it. All cases of accidents, microtraumas, as well as those taken in connection with. these measures are subject to registration in a special journal. Safety requirements at the end of work At the end of each shift, the surfaces of manipulation tables and instrument tables must be treated with a XNUMX% solution of chloramine. Rooms are cleaned at least twice a day (shift) with the obligatory use of disinfectants. Garbage is removed as it accumulates. The cleaning equipment of the dressing room should be marked and stored in a specially designated place separately from the cleaning equipment of other rooms. At the end of the dressing room nurses should remove sanitary clothing, change of shoes in individual cabinets.
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