Environmental ManagementCarol P. WisemanNurse Educator

Objectives At the end of this session students will be able to:

1. Explain the importance of environmental management in the healthcare setting.

2. Identify factors in the healthcare environment that pose a threat to patient safety.

Objectives 3. List the important measures

that can help prevent accidents in the healthcare setting.

4. Discuss the relationship between housekeeping procedures and patient safety.

Healthcare Environment

1. Physical environment interior (inside the ward)

and exterior (hospital grounds)

2. Emotional environment

Environmental Management

Purpose:

1. Ensure the safety of patients, visitors and staff.

2. Prevent spread of nosocomial or

healthcare associated infection (HCAI).

Environmental Management

Environmental Health is the measurement, evaluation and control of factors within our environment that have an effect on the health and well being of the public.

Environmental Management

Prevention is the key!

Prevent accidents among patients, staff and visitors.

Prepare for emergency situations.

Environmental Assessment Environmental Assessment (Macro)Fire Exits/ extinguishersMuster PointsEvacuation PlanNumber of beds

(occupied/unoccupied)Equipment

Environmental Assessment

Environmental Assessment (Micro) Condition of ward space –

tidiness, smell, repairs.

Patient care Equipment – B/P apparatus, IV poles, trolleys ….

Cleaning – floors, bedside lockers, beds, drapes, sluice

Classification of Hazards

1. Physical: Falls Noise Electricity Fire

Classification of Hazards

2. Chemical:Cleaning agentsToxic fumesCytotoxic drugs

Classification of Hazards

3. Biologic:

The patient (as host for or a source of pathogenic microorganisms)

Infectious waste

Cuts or needle stick injuries

Physical Hazards Falls

Bedrails

Restraints

Wet Floors

Loose tiles

Furniture

Placement

Back Injury Body

mechanics Lifting and

handling

Physical Hazards

Fire/ Electrical Safety : Fire Triangle 1. fuel2. oxygen3. heat

Preventing Falls and Fires

1. Keep exits, stairways, storage

areas, staff rooms and work

areas free from debris.

2. Keep floors dry and clean

3. Get adequate assistance to

move and walk patients

Preventing Falls and Fires

4. Provide adequate lighting

5. Use side rails for patients who

are elderly, very young,

disoriented, confused or sedated.

6. Check all equipment routinely to

ensure it is working properly.

Preventing Falls and Fires

7. Allow air to circulate around

heat producing equipment.

8. Replace electrical cords that

have cracked insulation or

broken connectors.

Preventing Falls and Fires

9. Do not overload electrical circuits.

10. Never run extension cords where

they can be stepped on or cause

falls. 

11. Visible No Smoking signs and

regular reminders to patients and

visitors.

Chemical Hazards

Misuse may result in:

Chemical burns

Inhalation of toxic fumes

Eye irritation

Skin irritation

Chemical Hazards

Source:

Cleaning agents

Cytotoxic agents

Expired medication

Chemical Hazards All chemicals used in the workplace

should come with manufacturers guidelines which state the following:

The composition and common

name of the chemicals.

Chemical and physical

properties.

Chemical Hazards

Known acute and chronic health

effects – carcinogenic, mutagenic, or

allergenic

Exposure limits

Protective measures – PPE, mixing,

ventilation etc

Antidote or First Aid measures

Preventing Chemical Hazards

1. Do not leave medication

carts unattended.

2. Check the expiration dates of

all medications and

chemicals to be used in

patient care.

Preventing Chemical Hazards

Double check medications with

another RN before

administration.

Wear appropriate PPE when

handling chemicals with toxic

fumes.

Biologic Hazards

Patient Protection: HCAI ControlMinimizing adverse outcomes

of health care for inpatients.

A very significant indicator of quality care is the nosocomial infection rate.

Biologic Hazards

Patient Protection: HCAI Control

Ward Cleaning

Waste Management

Care of equipment

Positioning of beds

Biologic Hazard Management

1. Pay attention to proper hand washing.

2. Wear appropriate PPEs when performing routine care involving blood and body fluids.

3. Utilize universal precautions when handling non infectious cases.

Biologic Hazard Management

4. Utilize expanded precautions as indicated when dealing with infectious cases.

5. Ensure proper disposal of biomedical waste in appropriate color bags.

Biologic Hazard Management

6. Nurse infectious cases in isolation area.

7. Ensure adequate ventilation on the ward.

8. Dispose of hypodermic needles and other sharps in puncture resistant containers.

Biologic Hazard Management

9. Timely removal of spillages – blood and body fluids (urine, faeces, vomitus…)

10.Appropriate cleaning, disinfection and sterilization of bedpans, urinals, wash basins, suction bottles, oxygen humidifiers...

Biologic Hazard Management

11.Cleaning and disinfection of

beds and lockers between

patient uses.

12.Routine changing of bed

linens.

13.Turning and inspection of

mattresses for cracks and

tears.

Biologic Hazard Management

14.Utilize sterile packages and gloves when performing aseptic procedures.

15.Ensure that sterile packages are intact and not expired before utilizing them.

Conclusion Recap major points.

Questions?

Inspiration

Our circumstances do not cause us to act the way we do. They only expose the true condition of our hearts, revealed in our words and actions.