Many of us are well rooted in a safe and proper protocol in our clinics and stores . From time to time , and especially when business is booming , we tend to cut a few corners or forget something important .
The Scenario : You need to take a quick peek at a familiar patient ’ s progress and foot gear . You haven ’ t seen the patient in a while and they ’ re a few weeks late for their follow-up appointment . Without thinking , you sit in front of the familiar patient and grab their foot , doff the shoe gear and socks and start observing and palpating the foot and previously fitted equipment . You ’ re busy and failed to throw on exam gloves for this quick once over . During the evaluation , you mention to the patient that he / she was overdue for the follow-up appointment . The patient replies that they had been in the hospital and was just released for treatment at home . The next question you ask , as most would will be “ why were you in the hospital ”? The patient says , “ The doctor said something about cellulitis ; worse case he had seen in a while ”. Your mind races and it hits you like a ton of bricks ….. GLOVES !!!
What have you done wrong ? First , you allowed distraction and familiarity to prevent you from being proactive in infection control procedures . Secondly , you used poor safety precautions and the absence of gloves just complicated the matter . When working with patients in a clinic or home setting , it ’ s vital to think what you are cross contaminating while you are hands-on with the patient . In many cases , it ’ s not enough just to wear exam gloves . Normally , you have touched other pieces of equipment , rubbed your nose and eye , scratched your ankle , and touched your pen . Then
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UNIVERSAL PRECAUTIONS GUIDELINES
Universal precautions are an approach to infection control . According to the concept of Universal Precautions , all human blood and certain human body fluids are treated as if known to be infectious for Human Immunodeficiency Virus , Hepatitis B Virus , and other blood-borne pathogens . Universal precautions must be used in the care of all patients .
Protective Attire
Gloves
Non-sterile gloves may be used for examinations when touching nonintact skin of all patients . Change after contact with each patient or moving from a contaminated to clean body area . May not be washed or disinfected for reuse .
Protective Aprons / Lab Coats
Aprons or lab coats can be especially important when working on a shoe or orthotic that has had contact with open wounds such as ulcerations , etc . It shall be removed prior to leaving the work area and placed in an appropriately designated area or container for washing , decontamination or disposal .
Protective Eyewear
Eyewear is recommended for pedorthists coming into contact with open , fleshy wounds or while working with orthotics , footwear or other appliances that have come into contact with non intact skin . Must be washed and disinfected between each patient or when visibly soiled
Hand Washing and Care of Hands
Hands must be washed before and after treating each patient and after bare-handed touching of inanimate objects likely to be contaminated . At a minimum , soap and water should be used between patients . Alcoholbased hand rubs may be used for decontamination if the hands are not visibly soiled . Hands should be washed before glove placement and after glove removal . After barehanded touching of inanimate object likely to be contaminated .
Sterilization and Disinfection of Instruments
Before sterilization or high-level disinfection , instruments , such as calipers , monofilaments , Harris mats , Brannock devices or other reusable items and / or equipment that come into contact with skin or other bodily fluids should be cleaned thoroughly by scrubbing with soap and water or detergent solution or with a mechanical devise ultrasonic cleaner .
Housekeeping and Laundry
Surfaces that have become contaminated with patient material shall be cleaned and disinfected after treatment of each patient and the completion of daily work activities .
References
1 . Centers for Disease Control and Prevention
2 . Los Angeles County Department of Health Services
3 . OSHA
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