Intro to Sonography (Week 2)

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General Measures

General Measures

To keep health care workers, patients and the environment clean to prevent the spread of germs

Isolated precautions

That are carried out to confine disease-producing germens

Standard Precautions and Infection Control

Previously termed universal precautions

Precautions competed by the Centers of Diseases Control and Prevention (CDC) and other federal agencies.

To provide safety to both patients and caregiver and to reduce exposure to blood and other body fluids

NOSOCOMIAL INFECTIONS

A nosocomial infection is acquired in a health care facility and was not present at the time of admission.

The most common nosocomial infection is the UTI.

Standards Precaution apply to

✓ Blood and all body substances (except sweat)

✓ Acutely or chronically non-intact skin and

✓ Mucous membranes including eyes

You must use Standard Precautions when:

Handling blood or body substances

There is risk of splash to mucous membranes

Providing care which induces coughing

Performing invasive procedures such as cannulation and catheterisations

There is risk of hands being contaminated with blood or body substances

Before and after patient contact, perform hand hygiene

The use of Standard Precautions includes:

Hand hygiene practices including washing of hands before patient contact and after gloves are removed.

Cover any cuts before commencing work

Gloves are worn when touching blood, body fluid, secretions, excretions, non intact skin, mucous membranes or contaminated items.

Masks, eye protection or face shields are worn if patient care activities may generate splashes or sprays of blood or body fluid.

Using PPE (personal protection equipment) for risk of splash to clothes with blood and body substances

All sharp instruments and needles are discarded in a puncture resistant container.

Patient care equipment is properly cleaner and reprocessed and single-use items are discarded

Contaminated linen is placed in leak proof bags to prevent skin and mucous membrane exposure

The use of aseptic technique

• Getting vaccinated and check your immunity

to vaccine preventable diseases

• Reporting all occupational exposures

• Keeping a clean environment

Aseptic techniques

Ways of working that seek to eliminate cross contamination of people and materials. The main point of aseptic technique is to protect the work and the person doing the work.

IMMUNIZATIONS, INJURIES & Employee Health

-HEPATITIS B VACCINE

-ANNUAL TB RISK ASSESSMENT

-Other vaccinations

- REPORT ALL INJURIES

Bloodborne pathogens

SPREAD THROUGH CONTACT WITH BLOOD & BODY FLUIDS ( HIV, HEPATITIS B AND HEPATITS C)

ISOLATION

The goal of isolation is to prevent the spread

of diseases among patients, personnel and

visitors.

Isolation precautions based on route of

transmission

- Airborne - Contact - Droplet

Types of isolation

◆Strict isolation ◆Respiratory isolation ◆Enteric isolation ◆Reverse isolation ◆Wound skin isolation

Strict isolation

•to protect others from patient's germs. To prevent the spread by air or contact of highly contagious diseases (streptococcal pneumonia, smallpox). A private room is required, and gowns, gloves and mask must be worn before entry.

Respiratory isolation

•is used to protect others from germs in the patient's nose, mouth, throat and lungs (chickenpox, mumps, TB). A private room is required but if two patients have the same disease, they may be housed in the same room.

Enteric isolation

is used to prevent infections transmitted by direct or indirect contact with feces (hepatitis A and enterovirus). A private room is required, and gowns and gloves for direct contact are necessary.

Reverse isolation

are used to protect patients severely immunocompromised (chemotherapy, steroid therapy, neutropenia). Wash and disinfect hands before entering the room. Cleansing of the ultrasound equipment and the use of sterile transducer covers are indicated.

Wound-skin precautions

to protect others from germs in patient's wounds or any other heavily contaminated areas. Hand washing is required, and gowns and gloves must be worn.

Informed Consent

Informed consent is a phrase often used in the law to indicate that the consent a person gives meets certain minimum standards. As a literal matter, in the absence of fraud, it is redundant.

If the patient is capable, informed consent must be obtained from patient:

Prior to sedation.

In language understood by patient, use approved interpreter if necessary.

Types of laws

- Statutory laws

- Administrative law

Statutory laws:

are enacted and enforced by federal or state legislators

Administrative law

is a form of law may by administrative agencies appointed by the president or government. Ex: OSHA (Occupational Safety and Health Administration)

Most cases brought against sonographers are called

TORT ACTIONS.

Torts can be divided into two categories:

intentional and unintentional

Intentional torts

Assault: intentional attempt or threat to inflict injury upon a person. EX: assault is to say to an uncooperative patient "if you don't stop moving and start cooperating during the exam, I will have to restrain you"

Battery

is the harmful, intentional touching of another person (directly or with an object) in a harmful or offensive manner without his or her concern. EX: If a patient consents to a vaginal examination but changes her mind during the course of the study, any sonographer who continues the exam could be found liable for battery.

Invasion of privacy:

confidentiality and the right of privacy, which respect to one's personal life, are basic concerns in our society. All information regarding a patient belongs to the patient.

False imprisonment

The illegal detention of a person without his or her consent constitutes false imprisonment. All patients have the right to make decisions for themselves, regardless of the consequences. EX: As a sonographers you must be careful about what you say to patients who refuse an exam to try to convince them to change their minds.

Unintentional torts:

the most common type of unintentional tort is negligence.

Negligence

is the failure to use reasonable care.

Generally, this occurs when a negligent act or omission by a medical professional results in harm to the patient.

HIPAA

Health Insurance Portability and Accountability Act

HIPAA was created for

to protect individual's medical records and other personal health information.

CAAHEP

•Commission on Accreditation of Allied Health Education Programs.

It is the largest program accreditor in the health science field

JRC-DMS:

•Joint Review Committee on Education in Diagnostic Medical Sonography.

In charge of maintain and promote appropriate standards of quality for educational programs.

Evaluate ultrasound programs to be sure the programs meet or exceed the standards (appropriated sites, curriculums, laboratories)

ARDMS:

•American Registry of Diagnosis Medical Sonographers

Promotes patient safety by administering sonography certification programs and awards to eligible professionals.

ARRT:

•American Registry of Radiologic Technologists

To assess the knowledge and cognitive skills underlying the intelligent performance of the tasks required of staff sonographers at entry into profession.

Upon entering the room, the sonographer should:

1.Identify yourself, the procedure ordered and your role in the procedure

2.Identify the patient by checking the patient's wristband

3.If wristband is absent, identify patient in an appropriate manner. It is preferable to involve the patient in this process. For example ask them what is your name and date of birth? Do not use room number to identify patient

You enter a hospital room only to find that the patient does not speak English.. Which of the following is the best to obtain information?

a.Call for a hospital interpreter

b.Use sign language

c.Obtain it from a bilingual family member who is in the room

d.Point to the signature line of the consent form and have the patient sign it

You enter a hospital room to perform an ultrasound exam. Which of the following should you do first?

a.Check the room number

b.Ask a nurse to confirm the patient name

c.Ask the patient if they speak English

d.Check the patient’s wristband for identification

When the patient look at you and says. Well, what do you think? The most appropriate answer is:

I have completed your exam and will forward it for your physician. Following review , your physician will discuss their interpretation

A patient speak only Portuguese. What is the best way to obtain consent to treat from this patient?

Obtain the consent of the patient using a bilingual family member to translate.

When practicing universal precautions, you should do all of the following except:

a.Wear gloves when there is a potential for contact with patient bodily fluids

b.Changes gloves when moving from one patient to another

c.Wear face masks or eye protection whenever there is a possibility of blood splashing into your face

d.Wash gloves between exams for re-use from one patient to another

A nosocomial infection is defined as one that is:

a.Resistant to antibiotics

b.Restricted to the respiratory system

c.Hospital acquired

d.Not contagious

e.Requires isolation

What should you do to avoid nosocomial and cross-infection with sonographyc probes?

a.Prober cleaning should always precede high-level disinfection

b.Covering a probe with a condom is a sufficient barrier to infection for intracavitary probes

c.Disinfection using a germicide compatible with the transducer is indicated when the probe is in contact with mucous membranes

d.Alcohol soak of each probe should occur between patients

e.A and C

Universal precautions relates to:

a)Standards for ultrasound exams

b)Standards for emergency procedures

c)Standards to reduce exposure to blood and other body fluids

d)Standards to reduce exposure to back injuries

The effects of ultrasound on soft tissue are called:

a)Acoustic proliferation properties

b)Dynamic effects

c)Biological effects

d)Acoustic impedance

Unlawful touching of another person without permission is:

a)Battery

b)Assault

c)Negligence

d)False imprisonment

This ruling marked the first comprehensive federal protection for the privacy of health information.

a)OSHA

b)JRC-DMS

c)HIPAA

d)PQRST

In specific cases of negligence, 'the thing speaks for itself' is a legal term also known as:

a)Responde at Superior

b)Res Ipsa Loquitor

c)Malfeasance

d)Habius Corpus

The act of treating a person as a particular body part

a)Dehumanization

b)Hierarchy

c)Unintentional misconduct

d)Transference

The organization that registers sonographers is the

a)CAHEA

b)SDMS

c)ARDMS

d)RMDS

The accreditation site visits of Diagnostic Medical Sonography programs is a function provided by the

a)AIUM

b)JRC-DMS

c)SDMS Educational Foundation

d)ARRT

All of the following are types of isolation except

a)Sensory

b)Reverse

c)Wound and skin

d)Respiratory

The only bioeffect of diagnostic ultrasound on the unborn fetus is

a)Small amount of hearing loss

b)An active baby

c)Small amount of hair loss

d)There are no known bioeffects

•Four basic types of word parts are used to create complex medical terms:

-Word roots

- Combining forms

- Suffixes

- Prefixes

Word Roots

Word roots usually, but not always, indicate the part of the body involved.

Example: cardi = heart

gastr = stomach

neur = nerve

Combining Forms

•Created by adding a vowel (usually the letter “o”) to the end of a word root.

•It is the root plus combining vowel

Used when connecting word roots or when the word root is joined to a suffix that begins with a consonant.

Examples: cardi/o = heart

gastr/o = stomach

neur/o = nerve

Aden/o = gland (adenoma)

Carcin/o = cancer (carcinoma)

Suffixes

•Suffixes usually, but not always, indicate the procedure, condition, disorder, or disease.

•Examples: •cardiomegaly

•gastralgia

•Neuritis

•Oophorectomy

•Hysterectomy

•Salpingectomy

•Hysterosalpingo-oophorectomy

Prefixes

Prefixes usually, but not always, indicate location, time, number, or status.

•Pericardium (around)

•Epigastric (over, near)

•Polyneuritis (many, much)

•Subgastric (below)

•Transgastric (across)

•Retrogastric (behind)

•Neoplasm (new)

Body systems

A body system consists of a group of tissues and organs that work together to perform specifics functions.

Cells

All the parts of your body are composed of individual u

Tissues

Similar cells together

Organs

Collections of different tissues working together

Systems of the body

Groups of organs working together

•Cardiology

The heart

•Dermatology

The skin

•Endocrinology

The endocrine system

•Gastroenterology

The stomach and intestines

•Gynecology

The women and women diseases

•Hematology

The blood

•Neurology

The nerves, brain and spinal cord

•Oncology

The tumors

Ophthalmology

The eye

•Pathology

The diseases

•Psychology

The mind and mental disorders

•Rheumatology

The joints

Urology

Urinary tract

Abdomen:

Laparo

Diaphragm:

Phrenic

Liver:

Hepato

Stomach:

Gastric

Spleen:

Splenic

Kidneys:

renal or nephric

Bladder:

vesical

Pancreas:

pancreatic

Gallbladder:

Cholecyst

Biliary ducts:

Choledoco

Small intestines:

entero

Red blood cells:

erythro

Blood:

Hem

Pus:

Pyo

Uterus:

hystero

Fallopian tubes:

Salping

Ovaries:

Oophor

Testicles:

Orchy

Gland:

adeno

Bones:

osteo

Eyes:

Ophtalm

Urine:

Uro