Transcript 9 Examination and Treatment Areas CHAPTER

CHAPTER
9
Examination and
Treatment Areas
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9-2
Learning Outcomes (cont.)
9.1 Describe the layout and features of a typical
examination room.
9.2 Differentiate between sanitization and
disinfection.
9.3 List steps to prevent the spread of infection in
the exam and treatment rooms.
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9-3
Learning Outcomes (cont.)
9.4 Describe the importance of temperature,
lighting, and ventilation in the exam room.
9.5 Identify instruments and supplies used in a
general physical exam and tell how to arrange
and prepare them.
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9-4
Introduction
• Care and maintenance of exam room
– Equipment
– Supplies
– Infection control
practices
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9-5
The Exam Room
• Number and size of rooms
– Two per physician
– Accommodate the physician, patient, and one
assistant
– Supplies and equipment must be in reach
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9-6
Furnishings
• Arrangement
– Efficiency
– Patient comfort
– Physician
convenience
• Examining table
– Step
– Drawers
– Adjustable
positioning
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9-7
Furnishings
• Items commonly found in exam rooms
 One or more chairs
 Wastebasket with lid
 A rolling stool
 Puncture-proof
 Weight scale
 Biohazard container
containers
 Wall brackets
 High-intensity lamp
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9-8
Special Features
• The 1990 Americans with Disabilities Act
(ADA)
– Requires “reasonable accommodations”
– Accessibility
– Guidelines
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9-9
Apply Your Knowledge
When arranging an examination room, what three
things should you consider?
ANSWER: You need to consider efficiency, patient
comfort, and physician convenience when arranging
an examination room.
Right!
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9-10
Sanitization and Disinfection
• Sanitization
– For cleaning items that touch only healthy,
intact skin
– First step in disinfection and sterilization for
other equipment
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9-11
Sanitization (cont.)
• Collect items for sanitization
– PPE
– Separate sharps from other equipment
• Scrub items
– Small brush
– Neutral pH detergent
– Dry
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9-12
Sanitization (cont.)
• Rubber and plastic items
• Ultrasonic cleaning
– For delicate instruments and those with
moving parts
– Sound waves generated through a cleaning
solution to loosen contaminants
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9-13
Disinfection
• Adequate for some instruments
• For others, it is the second step prior to
sterilization
• Sterilization is necessary for visible
contamination with blood
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9-14
Disinfection (cont.)
• Using disinfectants
– Cleaning products for inanimate materials
– Reduce or eliminate infectious organisms
– Manufacturer’s guidelines
– Effectiveness
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9-15
Disinfection (cont.)
• Choose the correct disinfectant
• Handling disinfected supplies
– Prevent contamination with other surfaces
– Use sterile transfer forceps
– Wear gloves
– Store in clean,
moisture-free environment
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9-16
Apply Your Knowledge
What is sanitation and for what items is sanitation
adequate for cleaning?
ANSWER: Sanitation is scrubbing with a
brush and detergent to remove blood,
mucus, and other contaminants or media
where pathogens can grow. It is adequate
for cleaning items that touch only healthy,
intact skin.
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9-17
Preparation of the Exam and Treatment
Areas
• Clean and well organized
• Safeguards
– Making hand hygiene a priority;
– Keeping the examining table clean; and
– Disinfecting all work surfaces.
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9-18
Infection Control
• Hand hygiene
– Handwashing
– Alcohol-based hand
cleaners
• Examining Table
– Paper cover
– Linens
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9-19
Infection Control (cont.)
• Disinfect surfaces
– Visibly contaminated with tissue, blood or
other body fluids
– At end of shift
– Per office schedule
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9-20
Infection Control (cont.)
• Storage
– Store biohazardous specimens properly
– Work practice controls
– Store testing kits properly
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9-21
Putting the Room in Order
• Straighten and put items away
• Contributes to physical safety
• Housekeeping
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9-22
Apply Your Knowledge
Other than at the end of your shift, when should
you disinfect the surfaces in the examination
rooms?
ANSWER: Whenever there is visible
contamination with blood, body fluid, or body
tissue.
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9-23
Room Temperature, Lighting, and
Ventilation
• Maintain
examination room
temperature at
about 72°F
• Eliminate drafts
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9-24
Lighting
• Accurate
diagnoses
• Perform medical
procedures
• Read orders and
instructions
• Prevent accidents
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9-25
Ventilation
• Examination area should smell clean
and fresh
• Eliminate source of odors
• If opening windows, monitor room
temperature
• Room deodorizer or spray
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9-26
Apply Your Knowledge
Why is it important to have good lighting in the
examination room?
ANSWER: Good lighting is needed for
making accurate diagnoses, performing
medical procedures, reading orders and
instructions, and preventing accidents.
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9-27
Medical Instruments and Supplies
• Maintain instruments and supplies
– Order and stock all needed supplies
– Sanitize, disinfect, and/or sterilize instruments
as needed
– Instruments and supplies should be placed
within easy reach for the physician
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9-28
Instruments Used in a General Physical
Exam
Instrument
Purpose
Anoscope
Used to open the anus for
examination
Provides additional lighting
Exam light
Laryngeal mirror
Nasal speculum
Ophthalmoscope
Reflects inside of mouth and
throat
Used to enlarge the opening of
the nose
Used to examine the inner eye
surfaces
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9-29
Instruments for a General Physical
Exam (cont.)
Instrument
Purpose
Otoscope
Used to examine the inner
ear
Penlight
Small flashlight used to view
a small area
Reflex hammer
Used to check patient’s
reflexes
Sphygmomanometer Used to measure blood
pressure
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9-30
Instruments for a General Physical
Exam (cont.)
Instrument
Purpose
Stethoscope
Used to listen to body sounds
Tape measure
Tuning fork
Used to measure size or
development of an area
Used to measure body
temperature
Used to test hearing
Vaginal
speculum
Used to enlarge the vagina for
specimens from cervix and vagina
Thermometer
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9-31
Instruments for a General Physical
Exam (cont.)
• Inspecting and maintaining instruments
• Arranging instruments
– Mounted on wall
– Out on countertop
– Set on a clean
towel or tray
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9-32
Instruments for a General Physical
Exam (cont.)
• Preparing instruments
• Cleaning instruments
– Dispose of supplies in the appropriate
containers
– Use approved procedures for sanitizing,
disinfecting, and sterilizing
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9-33
Supplies for a General Physical Exam
Needles and Syringes
Curettes
Cervical scraper
Sterile and clean gloves
Cotton balls
Cotton-tipped applicators
Gauze, dressings, and bandages
Specimen containers
Paper tissues
Occult blood test slides
Glass slides
Tongue depressors
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9-34
Supplies for a General Physical Exam
(cont.)
• Consumable supplies
– Fixative
– Isopropyl alcohol
– Lubricant
• Be sure patients do not have access to
– Prescription blanks
– Drugs
– Needles
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9-35
Supplies for a General Physical Exam
(cont.)
• Store supplies
• Restocking supplies
– Label drawers
– Put items back in
correct place
– Routinely
straighten and
clean
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9-36
Apply Your Knowledge
A medical assistant is preparing the treatment room for a local
ENT specialist. Which of the following instruments might be
used in this office to assess patient ear, nose, and throat
functioning?
ANSWER:
stethoscope
*penlight
penlight
*nasal
nasal speculum
speculum
*laryngeal
mirror
laryngeal mirror
reflex hammer
*ophthalmoscope
ophthalmoscope
otoscope
*otoscope
tape measure
sphygmomanometer
*tuning
tuningfork
fork
anoscope
Good Choices!
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9-37
In Summary
9.1 A typical examination room is about 8 by 12 feet, large
enough to accommodate the physician, the patient, and
one assistant. Instruments and equipment in the room
should be easily accessible.
9.2 Sanitization is the scrubbing of instruments and
equipment with special brushes and detergent to
remove blood, mucus, and other contaminants or
media where pathogens can grow. Disinfection uses
special cleaning products applied to instruments and
equipment to reduce or eliminate infectious organisms.
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in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
9-38
In Summary (cont.)
9.3 Steps involved in preventing the spread of infection in
the examination room include covering the examination
table with a paper cover and changing the cover
between each patient. It is also important to disinfect all
surfaces that come in contact with blood or body fluids
after each patient, and at the beginning and end of the
day.
9.4 It is important that patients feel comfortable in the
examination room. A comfortably warm, well lit, and
properly ventilated room will help the patient feel
comfortable during his examination.
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9-39
In Summary (cont.)
9.5 A variety of instruments and supplies are used in a
general physical examination. To ensure the
examination room always has the necessary
instruments and supplies, the medical assistant should
order and stock all supplies needed for examinations
and treatment procedures; keep the instruments
sanitized, disinfected, or sterilized and in working order;
and place all instruments and supplies where the
physician can easily reach them.
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9-40
End of Chapter 9
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