HLTWHS002 Follow Safe Work Practices For Direct Client Care Learner Resource

UNIT INTRODUCTION

This resource covers the unit HLTWHS002 Follow safe work practices for direct client care.

This unit describes the skills and knowledge required for a worker to participate in safe work practices to ensure their own health and safety, and that of others in work environments that involve caring directly for clients. It has a focus on maintaining safety of the worker, the people being supported and other community members.

This unit applies to all workers who require knowledge of workplace health and safety (WHS) to carry out their own work, in both centre-based and home-based service provision.

The skills in this unit must be applied in accordance with Commonwealth and State/Territory legislation, Australian/New Zealand standards and industry codes of practice.

ABOUT THIS RESOURCE

This resource brings together information to develop your knowledge about this unit. The information is designed to reflect the requirements of the unit and uses headings to makes it easier to follow.

Read through this resource to develop your knowledge in preparation for your assessment. You will be required to complete the assessment tools that are included in your program. At the back of the resource are a list of references you may find useful to review.

As a student it is important to extend your learning and to search out text books, internet sites, talk to people at work and read newspaper articles and journals which can provide additional learning material.

Your trainer may include additional information and provide activities. Slide presentations and assessments in classNameto support your learning.

ABOUT ASSESSMENT

Throughout your training we arecommitted to your learning by providing a training and assessment framework that ensures the knowledge gained through training is translated into practical on the job improvements.

You are going to be assessed for:

• Your skills and knowledge using written and observation activities that apply to your workplace.

• Your ability to apply your learning.

• Your ability to recognise common principles and actively use these on the job.

You will receive an overall result of Competent or Not Yet Competent for the assessment of this unit. The assessment is a competency based assessment, which has no pass or fail. You are either competent or not yet competent. Not Yet Competent means that you still are in the process of understanding and acquiring the skills and knowledge required to be marked competent. The assessment process is made up of a number of assessment methods. You are required to achieve a satisfactory result in each of these to be deemed competent overall.

All of your assessment and training is provided as a positive learning tool. Your assessor will guide your learning and provide feedback on your responses to the assessment. For valid and reliable assessment of this unit, a range of assessment methods will be used to assess practical skills and knowledge.

Your assessment may be conducted through a combination of the following methods:

• Written Activity

• Case Study

• Observation

• Questions

• Third Party Report

The assessment tool for this unit should be completed within the specified time period following the delivery of the unit. If you feel you are not yet ready for assessment, discuss this with your trainer and assessor.

To be successful in this unit you will need to relate your learning to your workplace. You may be required to demonstrate your skills and be observed by your assessor in your workplace environment. Some units provide for a simulated work environment and your trainer and assessor will outline the requirements in these instances.

ELEMENTS AND PERFORMANCE CRITERIA

4. Contribute to safe work practices in the workplace

3.2 Recognise situations when additional infection control procedures are required

3.3 Apply additional precautions when standard precautions alone may not be sufficient to prevent transmission of infection

3.4 Identify risks of infection and report them according to workplace procedures

4.1 Raise WHS issues with designated persons according to organisational procedures

4.2 Participate in workplace safety meetings, inspections and consultative activities

4.3 Contribute to the development and implementation of safe workplace policies and procedures in own work area

5. Reflect on own safe work 5.1 Identify ways to maintain currency of safe practices work practices in regards to workplace systems,

equipment and processes in own work role

5.2 Reflect on own levels of stress and fatigue, and report to designated persons according to workplace procedures

5.3 Participate in workplace debriefing to address individual needs

PERFORMANCE EVIDENCE AND KNOWLEDGE EVIDENCE

This describes the essential knowledge and skills and their level required for this unit.

PERFORMANCE EVIDENCE

The candidate must show evidence of the ability to complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the job role.

There must be demonstrated evidence that the candidate has completed the following tasks at least once in line with state/territory WHS regulations, relevant codes of practice and workplace procedures:

• Contributed to a workplace WHS meeting or inspection

• Conducted a workplace risk assessment and recorded the results

• Consistently applied workplace safety procedures in the day-to-day work activities required by the job role, including:

o Infection control o Hazardous manual tasks o Use of personal protective equipment o Reporting incidents

• Followed workplace procedures for at least one simulated emergency situation

KNOWLEDGE EVIDENCE

The candidate must demonstrate knowledge of:

• State/territory legislation and how it impacts on workplace regulations, codes of practice and industry standards, including:

o State/territory WHS authorities

o Rights and responsibilities of employers and workers, including duty of care

o Hazardous manual tasks o Infection control

• Safety symbols and their meanings, including signs for:

o Poisons o Emergency equipment o Personal protective equipment (PPE) o Specific hazards such as sharps, radiation  Hazard identification, including:

o Definition of a hazard

o Common workplace hazards relevant to the industry setting including hazardous manual tasks, infection control risks and personal safety risks

o Workplace procedures for hazard identification o Strategies minimising risk

• Safety considerations when working in a home-based environment, including:

o Rights and responsibilities of workers and clients

o Basic home fire safety including high-risk groups, behaviour that contributes to fire injury and fatalities, and smoke alarm placement, installation and maintenance.

o Risks to personal safety

o Common sources of infection and means to minimise transfer of infectious diseases

o Fundamentals of the musculoskeletal system and practices to minimise injury to self and clients

• Workplace emergency procedures

• Workplace policies and procedures for WHS

ASSESSMENT CONDITIONS

Skills must be demonstrated:

• In the workplace

OR

• In an environment that provides realistic, in-depth industry-validated scenarios and simulations to assess candidates’ skills and knowledge.

In addition, assessment must ensure use of:

• Current workplace policies and procedures for WHS

• PPE relevant to the workplace and job role of the worker

Assessors must satisfy the Standards for Registered Training Organisations (RTOs) 2015/AQTF mandatory competency requirements for assessors.

PRE-REQUISITES

This unit must be assessed after the following pre-requisite unit:

There are no pre-requisites for this unit.

TOPIC 1 – FOLLOW SAFE WORK PRACTICES FOR DIRECT CLIENT CARE

FOLLOW WORKPLACE POLICIES AND PROCEDURES FOR SAFE WORK PRACTICES AND IDENTIFY EXISTING AND POTENTIAL HAZARDS IN THE WORKPLACE, REPORT THEM TO DESIGNATED PERSONS, AND RECORD THEM ACCORDING TO WORKPLACE PROCEDURES AND IDENTIFY RISKS OF INFECTION AND REPORT

THEM ACCORDING TO WORKPLACE PROCEDURES

In a healthcare environment, there are many risks or hazards that you will need to be aware of. The most common one will be the risk of infection.

Infection is found in and spread via:

• Airborne droplets

• Contact with faeces and then with the mouth skin contact

•

Contact with blood and other body secretions

This means that the transmission of infection can come from a variety of sources using direct contact or via airborne droplet contact.

The ways in which infection may be transmitted from an infected source such as another person is through:

• Direct contact

• A vehicle

• A vector

• Airborne transmission

CONTACT TRANSMISSION OF INFECTION

Direct transmission contact is the actual touching of an infected person causing the infection to spread, for example, the direct touching of wound dressings or body fluids and infection.

The indirect transmission means that touching of the content and added object such as clothing, dressings, personal care equipment, will cause the infection to spread. For example, staff uniform, other clothing, pillows, communal hand towel, charts and forms, thermometers, bath.

Droplet transmission means that when an infected person sneezes, coughs, or talks, airborne droplets containing mucous membrane, or skin particles from the infected person may be projected during that process. Talking may project droplets for up to one metre, and sneezing may project droplets for up to 10 metres.

Vehicle transmission of infection occurs when water, food, milk, or any biological products introduced by ingestion, inoculation, or by being deposited on the skin or mucous membrane will cause the infection to spread.

Vector transmission of infection occurs when insects transmit infection by biting or by depositing infected materials onto the skin, on food or other objects causing the infection to spread.

Airborne transmission of infection occurs when infected small particles that have been in an infected environment such as water droplets, dust particles, are inhaled or settle on the body surfaces causing the infection to spread. For example, in a residential care facility where a number of residents may have infections, coughing, sneezing, talking, and the flapping of bedding may transmit infection.

To avoid contamination, wear disposable gloves when performing direct care functions involving blood, semen, vaginal fluid or other body fluids contaminated with blood. Consult the policy and procedure documents of your organisation to ensure you are following the correct procedures.

IDENTIFY RISKS OF INFECTION

To successfully identify and respond to infection risks, we must understand and follow safe work practices that prevent the transmission of infections. There are a great number of interesting websites relating to infection control. A good site to go to is: www.vicniss.org.au ^[1]

IDENTIFYING A HAZARD

A hazard is anything with the potential to cause harm to you, the patients, clients, your co-workers or visitors to the work area. In the sterilisation setting this includes chemicals, sharps such as needles, soiled instruments, power, water, steam, noise, and heat.

In developing procedures or buying new equipment, identify these risks early so that work practices can be developed that ensure the hazard is eliminated as much as possible. Regular safety inspections and audits can help identify and manage hazards.

All employees, patients, volunteers, contractors and visitors that enter the workplace have a responsibility to behave in a safe and responsible manner and report any hazards or near accidents.

If you have identified any hazards or risks in the workplace you must ensure you report them to the designated person. The designated person could be your:

• Supervisor

• Manager

• Health and safety officer

• Any other designated person elected by your workplace

IDENTIFY ANY CLIENT-RELATED RISK FACTORS OR BEHAVIOURS OF CONCERN, REPORT THEM TO DESIGNATED PERSONS, AND RECORD THEM ACCORDING TO WORKPLACE PROCEDURES

The behaviour of other people can put you at risk of injury or harm. It is, therefore, important for you to identify any behaviours of concern in the workplace and follow organisation procedures to minimise risk.

Community service workers are particularly at risk of injury and harm from the behaviour of their clients because they often work with high-risk client groups and a lot of their work is carried out in less predictable environments (for example, the client's home). Clients can be aggressive and even violent at times.

Factors that may contribute to workplace violence include:

• Poor management of mental illness antisocial/ borderline personality traits

• Neurological disorders, head injuries

• Confusion, disorientation or dementia

• Epilepsy

• Drug and alcohol withdrawal

• Clients feeling powerless or ignored (e.g. Perceived delays or poor quality service)

• Frustration from requests that are not adequately handled

• Difficulty communicating humiliation, rejection

• Anxiety

• Homophobia

• Racism

Violent acts may include:

• Verbal abuse, in person or over the telephone

• Written abuse

• Bullying and harassment

• Spitting

• Stalking

• Threats

• Ganging up, bullying and intimidation

• Physical or sexual assault

• Malicious damage to the property of staff, clients or the organisation

Some organisations will have violence prevention and management policies, and these should be followed by employees at all times. Employees have a duty to report incidents and to comply with organisational procedures to control the risk of violence.

The possibility of an aggressive outburst exists when working closely with people, and so care needs to be taken. Workers should not be wary of the people they are assisting or accept other workers' statements without question, that aggression is part of any disability. You must treat everybody as an individual. Aggression is a typical human behaviour that results from a person's reaction to other people, their environment, past experiences or poor social skills.

Everyone is capable of an aggressive outburst with the most common causes being frustration or fear. Workers can be the target for an individual's frustration or fear.

Frustration results most frequently when an individual is unable to achieve a goal, cannot perform the task you have asked them to do, want to leave a situation but are required to wait, etc.

A variety of behaviours including increased volume of speech are associated with frustration. The person may rock from side to side and make sudden explosive actions such as banging their fist on walls, tables or the palm of their hand. Everybody has their own unique pattern of signals to let you know their tolerance is being stretched. Speech frequently becomes louder as the frustration increases along with increasing colour in the face.

In these situations, you should assist the person to regain self-control and find alternatives to achieve their goal. Encourage the person to slow down their physical behaviour, sit down, take a deep breath, or pause so you can find out and deal with what is bothering them.

Miscommunication is also a source of increasing frustration. The need for effective communication skills when assisting people with their personal care is a vital element of care provision and preventing aggressive incidents.

When does violence occur:

• Work - Violence at work may be internal to work or external. Violence may be verbal, physical and psychological

• Dissatisfaction with a service - It is generally experienced by staff providing social services

• Disturbed people - Includes violence committed by those with a mental or intellectual impairment. Workers in health and community services are particularly vulnerable

• Domestic violence - Violence may also occur in an extremely disturbing social setting, for example, domestic setting, marriage break up

• Drug-related - violence may occur by people under the influence of drugs

(including alcohol) or as a result of withdrawal

• Occupational violence - Refers to violence occurring between any people at work and includes bullying, abuse of power, isolation, etc

• Indirect violence - Indirect violence refers to a situation that is witnessed by a person; that is, a third party but not actually involved

IDENTIFYING SOURCES OF VIOLENCE

Identify the tasks, work areas, instances and environments where employees or others are likely to be exposed to some form of violence. Procedures for identification may include:

Performing a workplace violence audit:

• Review existing accident and incident reports

• Gather additional information from people at the workplace on current or potential incidents

• Gather information from the industry on potential incidents

• Provide information to staff to increase awareness of violence and to encourage reporting of incidents

• Provide a confidential method of reporting violent incidents

From your violence audit you will need to:

• Analyse information gathered on violent incidents to assess the underlying cause of the violent behaviour

• Group those incidents which have similar features, e.g. Place, time of incident, who was involved, possible causes and outcome

• The details may show a pattern of violence or threats, which will help in developing preventive measures

• Regularly review the effectiveness of violence control strategies. Assess changes to the workplace for their potential to make a violent occurrence more likely. Consultation with workplace participants is likely to lead to a more comprehensive result

RISK REDUCTION STRATEGIES

While control measures may reduce the potential for violence, it can still occur. Being prepared for a violent incident can reduce the effects of the violence, particularly the long- term effects of trauma which may result. Developing procedures to reduce the number and severity of violent incidents can help to make the workplace a safer and healthier place for employers, employees and visitors.

The following is an example of an incident report form.

FOLLOW WORKPLACE POLICIES AND PROCEDURES TO MINIMISE RISK

Organisations have policies, procedures and performance standards. The procedures you follow in order to do your work should be compliant with, and take into consideration any health and safety legislation and requirements. Your workplace should also have, in place, specific policies on how to handle incidents and accidents and clear procedures to be followed if either an accident or incident occurs. An incident is a distinct event or occurrence that carries the possibility of causing harm. An accident is an event or occurrence where harm has actually occurred. WHS is concerned with the prevention of both incidents and accidents.

These should be communicated to employees, initially via the induction process that all employees should receive when starting work, and through ongoing WHS training and information sessions. The employer has an obligation to provide information on WHS legislation plus WHS training for all employees. These policies and procedures should be followed when working in new or unstable environments.

Health and safety policies are not legal requirements. They are, however, a method that organisations use to communicate their commitment to a safe and healthy workplace and the responsibilities of everyone in the workplace to achieve this end.^[2]

IDENTIFY AND REPORT INCIDENTS AND INJURIES TO DESIGNATED PERSONS ACCORDING TO WORKPLACE PROCEDURES

REPORTING INCIDENTS

Any incidents and injuries that you identify in your workplace must be reported. This report will trigger an investigation immediately and if it does not you will need to follow up with the approriate person.

This is vitally important in the case of needlestick injuries and other sharps. Your organisation will have policies and procedures that outline the steps you will need to take in this situation.

You will need to complete an incident form if this situation arises and ensure you include the following information:

• Date and time of exposure

• How the incident occurred

• Name of the source person (if known)

• Site of injury

• Any witnesses to the incident

Always make sure you provide enough detail in your report so that follow-up can be made and investigation will be thorough and take less time. Information is vital in these reports so don’t leave anything out.

TOPIC 2 – FOLLOW SAFE WORK PRACTICES FOR MANUAL HANDLING

FOLLOW MANUAL HANDLING PROCEDURES AND WORK INSTRUCTIONS FOR MINIMISING MANUAL HANDLING RISK

Manual handling is a large part of working with clients in a healthcare setting. You will be required to not only lift people but assist them to sit, stand and walk. Each of these tasks come with their own risks and hazards.

Ways you can minimise the risks of manual handling activity are:

• Use correct manual handling principles

• Know the load

• Determine the best technique

• Prepare the area

•

Arrange assistance or aid

• Use manual handling mechanical aids communicate with your assistant

• Maintain a minimum standard of fitness

• Wear appropriate clothing

• Refer to any instructional guidelines provided

PRINCIPLES OF MANUAL HANDLING

Principle 1:

• Identify and understand manual handling plan

• Ensure you are appropriately dressed to safely carry out the lift, you will need to have loose clothing that does not restrict your movement and flat, non-slip shoes for good balance and grip

• Locate the lifting/ manual handling plan that has been endorsed by the manager, and check the manual handling/ lifting care plan for the person

• Test the load to determine if you feel strong enough to manage on your own, or whether you will need assistance

Note: no one should lift the full weight of another adult without assistance.

Principle 2:

• Prepare for transfer or procedure

Principle 3:

• Communicate with client and assistant

• Plan the lift. You should plan the execution of the lift prior to commencing, including the position you are going to finish in, this is essential to avoid the motion of bend, lift, and twist, which can result in torsion shear; in planning the lift, you should ensure that there is sufficient room to move, that your feet are pointing in the appropriate direction thus avoiding the lifting and twisting problem, and that the conditions such as the floor and lighting are favourable, this may include discussing the procedure with the resident and/or the second care worker Principle 4:

• Correct (strong) posture achieved by correct foot positioning, base of support, maintenance of spinal curves, eye contact, grip, and bending of knees

Principle 5:

• Correct (safe) coordinated movement, weight is transferred, body weight and legs are used, spine is not twisted, counterbalancing

• Concentrate on the lifting task

• Approach the lift with confidence, as hesitancy can lead to tension and a jerky, dangerous lifting pattern

• Start from a good base of support and with the feet hip-width apart, get as close to the person (or object) as possible, and keep the load close to your body with your elbows tucked in, lifting the load between your knees assists in keeping the load as close to the body as possible

• Bend your knees to go down to the load, keeping your back upright and bottom out in order to maintain the hollow in your lower back

• Support the load firmly with the whole of the hand surface (do not grip with fingers only)

• When lifting, brace the abdominal muscles tight, but do not hold your breath

• Lift by using the powerful muscles of the legs (not the back)

• Lift by using the transfer of your own body weight, and do so in a smooth, coordinated manner

Principle 6:

• Ensure that the dignity, privacy, comfort, skin integrity, and self-esteem of the client are upheld at all times

IDENTIFY MANUAL HANDLING HAZARDS AND REPORT IN LINE WITH WORKPLACE PROCEDURES

Lifting and handling procedures are commonplace in any work environment. There are very few jobs that do not pose a risk when performing them, things like bending and twisting when assisting clients or standing for long periods.

The main issues for lifting and handling you need to be aware of are provided in the Code of Practice for Manual Handling. In summary these are:

• Specific training is necessary for safe lifting techniques.

• Determine the best technique including:

o Suitable balance. o Avoid bending, twisting and reaching. o Lift efficiently and rhythmically. o Bend your legs, not your back and use your legs to lift. o Grip the object securely.

o Pull the load close to the body.

• Wherever possible, vary heavy tasks with lighter loads.

• Use team lifting if possible.

• Use lifting aids if possible.

WHAT IS THE CORRECT TECHNIQUE FOR LIFTING?

Proper Lifting Techniques

RISK FACTORS FOR BACK INJURY

WHAT ARE THE CAUSES OF OCCUPATIONAL OVERUSE SYNDROME?

A major cause of injury in warehouses is caused by ‘occupational overuse syndrome’. This has previously been known as ‘Repetitive Strain Injury’ or RSI. This form of injury rarely happens quickly. Occupational overuse syndrome tends to be caused by continuous wear and aggravation to the body over a period of time when carrying out incorrect working methods. Such actions would include:

• Repetitive (frequently repeated) actions, especially involving twisting and bending

• Poor posture such as: Bending, Stooping, Bent shoulders, Lowered head

• Working at heights that are not suitable to the task, such as bench heights that are too low or too high. Reaching and stretching

• Moving items or loads over excessive distances on a regular basis.

Occupational overuse syndrome can be avoided or reduced by following some simple procedures

WORKSTATION DESIGN (ERGONOMICS)

Ergonomics can be defined as ‘the design of work processes and equipment to suit workers and the job’. Poor ergonomics can cause, or at least contribute to workplace injury, especially overuse syndrome. This is because the way a worker performs his or her tasks can be affected by such things as:

• The layout of the workplace

• The design of tools

• The design of equipment or machinery if it does not suit the worker or the job

• Job design, that is, the way the actual job is done. This can cause stress  The amount and type of manual handling

This potential hazard can be solved by:

• Job redesign, for example, something as simple as introducing a one-way circuit can reduce hazards and distances

• Use of manual handling aids

• Training

• Providing the right tools or designing better tools for specific tasks

• Replacing old, damaged or worn out equipment and furniture

• Ensuring that equipment and machinery is adjustable to allow individual workers to achieve a ‘best fit’

MANUAL HANDLING INJURIES

APPLY CONTROL MEASURES FOR MINIMISING MANUAL HANDLING RISK

HIERARCHY OF CONTROL

Controlling risks in the work area might include application of the hierarchy of control such as eliminate, reduce or minimise the risk through:

• Engineering controls

• Administrative controls including training personal protective equipment (PPE)

Controlling manual handling risks in the work area might include:

• Minimising amount of handling

• Provision of equipment/ mechanical aids to lift/ move objects (e.g. Using hoists to lift

• Patients in and out of bed) changes to workplace layout

• Changes to work organisation or work practices

• Changes to the load (e.g. Reducing its weight)

• Ensure that heavy items are stored at a height that is between the hip and shoulder of most workers

• Store goods where they are needed so there is no need to move them

• Install ramps so that goods can be moved across levels using trolleys put frequently moved items on wheels

• Task-specific training in manual handling

The hierarchy of control is a sequence of options which offer you a number of ways to approach the control of hazards. Work your way down the list, and implement the best measure possible for your situation. Notice that the use of protective equipment is the last resort, to be used when all other control measures have been ruled out in the shortterm.

• Elimination – Completely removes the hazard or risk of exposure to the hazard.

• Substitution – All staff and management involved in replacing a hazardous substance, machinery or work process with a non-hazardous or less hazardous one.

• Engineering Controls – If a hazard cannot be eliminated or substituted the next preferred measure is to control the risk. For example:

o Modification of tools and equipment o Using enclosures (e.g. sound barriers) o Guarding

o Local exhaust ventilation

o Automation – e.g. forklifts pallet lifters etc

• Administrative controls – These are about introducing new work practices which reduce risk. For example:

o Training (e.g. manual handling, equipment, safety legislation, procedures) o Job rotation

o Adopting policies which take account of health and safety o Special safety measures to be followed for use of materials handling equipment

o Lock-out and tag-out procedures

• Personal Protective Equipment (PPE) – The Last Resort o PPE should only be used where other measures are not practicable. Using this control solely is less reliable than using controls higher up on the hierarchy of control and will require more management effort by the user and their supervisors

TOPIC 3 – FOLLOW SAFE WORK PRACTICES FOR INFECTION CONTROL

FOLLOW STANDARD PRECAUTIONS AS PART OF OWN WORK ROUTINE TO PREVENT THE SPREAD OF INFECTION

Infection control policies established and followed in a health care organisation should provide the foundation for a safe environment for patients, staff and visitors.

Policies and procedures should be based on local regulations, State legislation and National Standards. In the sterilisation area, there are policies for department structure, organisation, and management.

DEFINITIONS

You should understand the following infection control terms:

• Aseptic technique - practice that prevents access of microorganisms onto a sterile work surface, or into human sterile tissue

•

Cross contamination - any event that permits the transfer of microorganisms from one person to another, or from one item to another item

• Sharps - any sharp object that could easily pierce the skin, for instance, surgical cutting instruments and needles

• Source of infection - sick people, healthy carriers, contaminated equipment or instruments, contaminated food or water

• Susceptible person - person who may develop an infection when subjected to a source of infection

Why don’t you spend some time having a look through the following guidelines?

Department of Health and ageing (2004) Infection control guidelines for the prevention of transmission of infectious diseases in the health care setting. Department, Canberra http://www.health.gov.au/internet/wcms/Publishing.nsf/content/icg-guidelinesindex.htm

Although this is a large document, you find some very useful and interesting information about the types of policies and procedures that can put in place in Health Care Settings.

Refer back to the table we discussed previously. We have said that when sharps are being disposed of there is a high risk of an injury occurring. If we wear the correct PPE then that will lessen the risk of an injury occurring. If we follow the latest guidelines for sharps disposal as well, then that will lessen the risk of an injury occurring even more.

We will look at the correct procedure to follow for this particular situation later.^[5]

FOLLOW PROCEDURES FOR RISK CONTROL AND RISK CONTAINMENT FOR SPECIFIC RISKS

All patient care items require cleaning after use on, or by a patient. However, some items require further treatment such as disinfection or sterilisation. How do you determine this? In looking at instruments processed by CSSD a rule called Spaulding’s rule is generally used.

In 1968 in the USA, Earle Spaulding developed some rules to make this decision making process easy, called Spaulding’s classification. It is a simple system and is used daily in most clinical settings. There are three rules governing situations of:

• Non-critical o Non-critical - If used instruments are to come into contact with intact skin they need to be cleaned with detergent and water. It is called a non-critical situation.

• Semi-critical o Semi-critical - For instruments that come in contact with intact nonsterile mucosa or non-intact skin, sterilisation is always preferred. However, in many situations this cannot be done, and disinfection or high-level disinfection is required. This is called a semi-critical situation.

• Critical o Critical - For items that enter sterile tissue, other body cavities or the blood stream, sterilisation is the only option. These are called critical situations.

Used surgical instruments and medical equipment are a source of infection in the healthcare setting.

PROTOCOLS FOR CARE FOLLOWING EXPOSURE

Environmental surfaces in the health care settings can become contaminated with blood and body fluids, possibly containing harmful micro-organisms.

In the sterilisation department, this may happen in the instrument decontamination area where soiled instruments are received. Australian Standards AS4187–2003 recommends that instruments should be rinsed or wiped as close as possible to the point of use. Some sterilisation departments have taken over the role of rinsing instruments in the theatre. Others have them rinsed in theatre or the wards prior to transfer or collection by CSSD.

If heavily soiled instruments come into contact with environmental surfaces they must be cleaned and the surface cleaned immediately. Your workplace will have procedures and protocols for this type of contamination.

PROCEDURES FOR THE ACCIDENTAL EXPOSURE TO BODY FLUIDS

After exposure to blood or other body substances you should as soon as possible do the following:

• Encourage bleeding if exposure involves a cut or puncture, then wash with soap and water

• Wash with soap and water where the exposure does not involve a cut or puncture

• If eyes are contaminated then rinse them, while they are open, gently but thoroughly with water or normal saline

• If blood or other body substances get in the mouth, spit it out and then rinse the mouth with water several times

• If clothing is contaminated remove clothing and shower if necessary

• Inform, an appropriate person, to ensure that necessary further action is taken

Factors which need to be documented:

• Nature and extent of the injury

• Nature of the item which caused the injury e.g. Gauge of needle

• Nature of body substance involved

• Volume of blood and body substances to which how was exposed

All occupational exposures must be fully documented to meet legal requirements to ensure that workers are able to obtain the support to which they are entitled.

PROCESS FOLLOWING A SHARPS INJURY

'Sharps' is the terminology used for the items that can cut or penetrate the skin, and in doing so, potentially cause cross-infection of micro-organisms.

These include syringes, razors, scalpels, etc.

• Sharps must NOT be passed by hand between people but in a puncture resistant tray.

• Syringes should not be re-sheathed (unless it is specifically required, e.g.

dental practice)

The following must be arranged immediately upon exposure

• Management will ensure that you get counselling quickly

• Management should ensure you are tested for HIV, Hepatitis and any other testing required

• Follow-up counselling and testing must continue throughout the process.

There is a 24hour needle stick Hotline in NSW 1800 804823. Your employer should also provide you with a local number which can be called at any time for advice in the event of a significant exposure to body fluids.

Contact ANCA (Australian national Council on AIDS) or the representative in the state where you work to set up a procedure for your workplace. A suggested protocol is:

• Encourage the bleeding

• Wash the area with soap and water

• Report immediately to a supervisor or OH&S officer

• Make sure you workplace has a policy/protocol in the event of a sharps injury and make sure every staff member knows what to do

REMOVING SPILLS

Therrre are some steps that you should take for the management of blood and body substance spills. These include:

• Put on protective apparel including gloves

• Confine and contain the spill

• Cover the spill with paper towels to absorb the bulk of the blood or body substances

• Treat debris as clinical waste

• Clean the spill with a neutral detergent and water

Spills kit

You should have a dedicated 'spills kit' readily available in a bucket with a fitted lid. The kit should contain:

• Protective equipment – eye protection, plastic apron, disposable rubber gloves, respiratory protection (for high-risk spills)

• Containers (such as leak-proof bags) for disposing of the material spilt

• A 'pooper scooper' – type scraper and pan  Sachets of granular chlorine

NON-HAZARDOUS SPILLS

Size of spills – up to 10cm

For small spills, wipe immediately with paper towel. Clean with water and detergent. Use the following steps when cleaning up a small spill.

• Collect cleaning materials and equipment (e.g. spills kit)

• Wear disposable gloves. Eyewear and a plastic apron should be worn where there is a risk of splashing occurring

• Wipe up the spill immediately with absorbent material (e.g. paper hand toweling). Place any contaminated absorbent material into an impervious container or plastic bag for disposal

• Clean the area with warm water and detergent using a disposable cleaning cloth or sponge

• Where contact with bare skin is likely, disinfect the area by wiping with sodium hypochlorite 1,000 ppm available chlorine (or other suitable disinfectant solution) and allow to dry. (To make up 1,000 ppm, 5 litres of water can be added to 125 ml of any in-date household bleach)

• Discard contaminated materials (absorbent toweling, cleaning cloths, disposable gloves and plastic apron) in accordance with state/territory Regulations

• Wash hands

• Clean and disinfect reusable eyewear before reuse

For larger spills, scrape the bulk of the spill into a pan for disposal, and then clean the residue. Then complete the following steps:

• Collect cleaning materials and equipment

• Wear approriate PPE

• Cover the area of the spill with granular chlorine releasing agent (1,000 ppm available chlorine) or other equivalent acting granular disinfectant and leave for three to ten minutes, depending on formulation and labelling instructions

• Use a disposable scraper and pan to scoop up granular disinfectant and any unabsorbed blood or body substances

• Place all contaminated items into impervious container or plastic bag for disposal

• Wipe the area with absorbent paper toweling

• Use ward cleaning materials to mop up with water and detergent

• Discard contaminated materials in accordance with state/territory Regulations

• Wash hands

• Wash the mop and bucket with detergent and hot water.

• Rinse and allow to dry

• Clean and disinfect reusable eyewear before reuse

RECOGNISE SITUATIONS WHEN ADDITIONAL INFECTION CONTROL PROCEDURES ARE REQUIRED AND APPLY ADDITIONAL PRECAUTIONS WHEN STANDARD PRECAUTIONS ALONE MAY NOT BE SUFFICIENT TO PREVENT TRANSMISSION OF INFECTION

Control guidelines have been developed to minimise the transmission of blood-borne infections. There are a number of procedures that, when used with teamwork and commitment, can allow for the control of infections and the maintenance of a high level of personal hygiene.

The application of these procedures is the responsibility of all members of the team. Today, most employers ensure that infections are controlled through the use of standard precautions in the workplace. Following standard precautions means that you consider every person to be infected.

Standard precautions include:

• Treat everyone (both staff and clients) as if they are infected, regardless of whether they are or not consider blood and bodily fluids as infectious  Assess possible contact, and take appropriate measures

Standards include:

• Hand washing

• Protective wear

• Environmental control

• Waste disposal

• Immediate response to any exposure to blood or bodily fluids

Everyone has germs. Our bodies are covered with germs that help us stay healthy. In addition to the germs that are usually present on our skin, we also pick up germs from contact with other people or objects in our surroundings. These germs are easy to pick up and transfer. In this way, they can cause you, or others, to get sick. Although people usually think that germs are spread through the air, the fact is that germs are most easily spread through hand contact.

One of the best ways to stop the spread of germs is to wash OR decontaminate your hands. Hand hygiene is a new term to describe washing or decontaminating hands. Washing hands helps to physically remove germs by friction, and to rinse them down the drain. Decontaminating hands reduces the amount of germs present on hands through the use of special alcohol based preparations, in the form of solutions, gels or foams.^[6]

Alcohol-based preparations have two distinct advantages over soap and water:

• They kill many more germs

• They are less drying to your skin

While alcohol-based preparations reduce the germs on your hands, they cannot remove visible soil or contamination. It is always important to WASH hands with soap and water anytime they are visibly dirty.

WHEN SHOULD YOU WASH YOUR HANDS WITH SOAP AND WATER?

Adults and children should wash their hands:

• When hands are visibly dirty

• Before you eat

• Before you prepare food items

• After touching raw meats like chicken or beef

• After contact with any body fluids like blood, urine or vomit

• After changing infant or adult nappies

• After touching animals or pets

• After blowing your nose or sneezing  After going to the toilet

WHEN CAN YOU USE ALCOHOL-BASED HAND RUBS?

Adults and children can rub hands:

• For routine cleaning of hands anytime they are visibly clean

• If you have contact with contaminated objects in the environment e.g. dirty tissues/nappies

• Before and after you care for or have contact with someone who is very sick, very old or very young

• Whenever you want to decontaminate your hands

Hand washing is one of the main ways of preventing the transfer of infection. Therefore, it is extremely important to learn the correct procedure for when and how to clean hands.

PROTECTIVE EQUIPMENT

Always assess protective equipment prior to possible contact with bodily fluids and blood.

This equipment can include:

• Gloves

• Glasses

• Gowns/ aprons

• Rubber boots

If using protective equipment, make sure it is suitable for the task, and that it fits. If the equipment is ill-fitting, it might not be worth wearing, as it will not offer the protection necessary.

Other factors to consider are: cleanliness of equipment

• Only using equipment once

• The covering of cuts, sores, and lesions prior to wearing gloves

• The wearing of gloves if contact with blood and bodily fluids is possible

• Making sure that hand washing takes place prior to and after use of gloves

HOUSEKEEPING

Housekeeping can include:

• Safe work conditions

• Protection from insects and flies

• Regular cleaning of all surfaces

• Cleaning up and disposing of contaminated clothing and items immediately, following correct policies and procedures

• Using paper towel to wipe up spills, as it can then be disposed of  Using water and detergent for cleaning waste disposal

Linen usage:

• Do not share

• Heavily soiled linen should be bagged separately

• Solid material should be cleared before bagging linen

Sharps (razors/ needles): single use

• Dispose of into sharps bin immediately after use

• Fill sharps container two-thirds full

• Store correctly, to prevent accidental injuries

Urine bags:

• Contents are to be emptied prior to putting them into a plastic-lined bin

Sanitary bags:

• Place into sanitary bins if available or dispose of inside a plastic bag before putting in the bin

Response after contact with bodily fluids or blood:

• Encourage bleeding from site of injury

• Wash with soap and water

• Thoroughly wash eye with water, or saline if available

• Wash mouth with water after spitting out blood report all incidents immediately

CUTS AND LESIONS

All broken sores/wounds are to be kept covered at all times with waterproof dressing used for hands. If you have a skin condition on your body, arms or hands, consult your doctor.

DISPOSAL OF SHARPS (NEEDLES, SYRINGES, BROKEN GLASS) NEEDLES AND SYRINGES

If, as an employee, you are dealing with needles and syringes, you are to receive appropriate training for the disposal of sharps into the sharps container.

All employees are to ensure that they adopt the organisation's policies and procedures to avoid needle stick injuries.

• Never re-cap lancets/ syringes after use

• Never throw lancets/ syringes into normal garbage bins/ bags. Never empty the unit yourself

BROKEN GLASS

Ensure that all broken glass is wrapped in newspaper prior to being disposed of in the bins.

Cleaning contaminated articles and surfaces:

• Put items in detergent solution and rinse thoroughly, and then soak in White King solution (or other recommended household bleach) for 30 minutes, at a ratio of 50 ml to one litre of water, rinse thoroughly, and then drain, discard solution after use

• Metal items and surfaces must be cleaned with methylated spirits, wipe down and allow to dry, do not use White King, as it damages metal, use gloves when using chlorine solutions

HEPATITIS B

If not already immunised, employees should make enquiries where they are employed as to what the policy is regarding Hepatitis B vaccinations. This is a personal safety issue, and, for your own protection, it is recommended that you follow this action through.

BED LINERS (DISPOSABLE PRODUCTS)

Check the organisation's requirements on rubbish disposal, and have a sound knowledge on the appropriate disposal of all rubbish.

Safe workplace summary You should:

• Undertake safe work practices, as stipulated by procedures/ policies/ regulations/ codes

• Of practice

• Be responsible for safe and healthy work practices

• Report and eliminate hazards where possible, and minimise them where it is not

• Avoid affecting the health and safety of any employees

• Use safeguards, safety devices, and personal protective equipment as deemed necessary by the organisational policies/ procedures

• Follow reasonable instructions from an employer in relation to health or safety at work

• Assist workplace auditors and inspectors

• Report accidents and injuries to supervisors and health and safety representatives as soon as possible after the event (including near miss incidents)

• Ensure that you do not consume alcohol or drugs at work

• Report to your supervisor if emergency equipment needs maintenance

EXTRA PRECAUTIONS

Extra precaution is required when standard precautions are not enough to stop the spread of specific conditions such as TB, SARS, MRSA (in some cases), and other unusual or exotic diseases.

How will you get to know about this? Your supervisor will inform you, it will be written in case notes, care plans or another health professional will inform you. Sometimes the client will disclose information about this, and you will need to report it to your supervisor or other health care professional so the correct care plan and procedures can be implemented. Precautions include appropriate worker rostering (taking into consideration pregnancy), use of stop signs, single rooms, masks, and gowns.

TOPIC 4 – CONTRIBUTE TO SAFE WORK PRACTICES IN THE WORKPLACE

RAISE WHS ISSUES WITH DESIGNATED PERSONS ACCORDING TO ORGANISATIONAL PROCEDURES

WHAT IS A HAZARD?

The meaning of the word hazard can be confusing. Often dictionaries do not give specific definitions or combine it with the term "risk". For example, one dictionary defines hazard as "a danger or risk" which helps explain why many people use the terms interchangeably.

There are many definitions for hazard but the more common definition when talking about workplace health and safety is:

 A hazard is any source of potential damage, harm or adverse health effects on something or someone under certain conditions at work

Basically, a hazard can cause harm or adverse effects (to individuals as health effects or to organizations as property or equipment losses).

Sometimes a hazard is referred to as being the actual harm or the health affect it caused rather than the hazard. For example, the disease tuberculosis (TB) might be called a hazard by some but, in general, the TB-causing bacteria would be considered the "hazard" or "hazardous biological agent".^[7]

EXAMPLES OF A HAZARD?

Workplace hazards can come from a wide range of sources. General examples include any substance, material, process, practice, etc. that has the ability to cause harm or adverse health effect to a person under certain conditions. See below table:

WHAT SHOULD I DO IF I NOTICE A HAZARD?

You should report it immediately to your supervisor. You do not need to wait for an inspection team to come by. In fact, health and safety legislation requires employees to report hazards to their supervisor.

The immediate hazard reporting process allows employees to report hazardous conditions or practices as they notice them. This procedure allows for prompt reporting and subsequent corrective action without waiting for the next round of regular inspections.

Hazards can be reported verbally and by filling a simple form available at bulletin boards or other conspicuous places. The following is an example of such a form.^[8]

PARTICIPATE IN WORKPLACE SAFETY MEETINGS, INSPECTIONS AND CONSULTATIVE ACTIVITIES

It is important to have workplacce safety meetings so that everyone knows what is going on. They understand the hazards, the risks and the control measures used to modify the risks. Without meetings this information is less likely to be provided and therefore more accidents could occur.

They also provide the opportunity for new skills and knowledge to be gained and given and provides a forum for discussion on control measures.

Here are some areas that might be discussed in a workplace meeting that you attend:

• Work duties

• Work rosters

• New equipment

• New workplace procedures

• Health and safety

• Work progress

Workplace meetings can range from short informal discussions to formal meetings with a written agenda, a chairperson and someone to record the Minutes.

PROVIDING SUPPORT

Workers may need our assistance at times to cooperate and contribute to workplace safety. We can encourage this cooperation and contribution to workplace safety by:

• Encouraging attendance at regular team meetings where workplace safety is always on the agenda

• Actively seeking each staff members opinions on safety issues

• Ensuring our policies and procedures are based on up to date safety information from reputable sources.

• Checking that staff know who to report ohs concerns to and how this is done

i.e. verbally and/or written

• Considering and valuing all suggestions provided by the team

• Encouraging staff to discuss any concerns even where they are not sure it is a safety issue.

Contributing to safety meetings and other safety activities in the workplace is vital to ensuring all staff members and visitors to the facility are safe and free from any risk to themselves.

CONTRIBUTE TO THE DEVELOPMENT AND IMPLEMENTATION OF SAFE WORKPLACE POLICIES AND PROCEDURES IN OWN WORK AREA

WHAT IS PARTICIPATION IN WORK HEALTH AND SAFETY PRACTICES?

Any type of method used in a workplace to get employees to take part, or contribute to or take responsibility for some action or function about WHS/OHS. The method could be a regular monthly meeting or daily meetings, perhaps before work starts. Suggestions made during the work day, requests for suggestions from supervisors, reports that are circulated in work are all part of the participation process.

Safety is everyones responsibility in a workplace and ensuring policies and procedures are up-to-date and effective is a vital step in ensuring safety.

It is partly your role to contribute to the development and updating of policies and procedures to ensure not only your safety but those around.

There are many ways that you can contribute to the health and safety of yourself and others in the workplace.

• Attend meetings

• Provide input into control measures for identified risks

• Assist with the development and updating of policies and procedures  Join a health and safety committee

EMPLOYEE AND EMPLOYER WHS RIGHTS AND RESPONSIBILITIES

Employees (workers) and employers (bosses) both have WHS rights and responsibilities. Find out more about what the law says you and your employer must do to keep the workplace safe.

Employees must:

• Work safely to protect themselves and others from injury and follow all WHS instructions, for example:

o Wear all personal protective equipment provided o Follow safe work procedures

o Not interfere with or misuse anything provided by the employer

(equipment, signs, etc.) That is used to keep the workplace safe o Not remove or change machine guards

o Not behave in a way that puts themselves or others at risk o Respond to a reasonable request to provide assistance or first aid to an injured person at work

• Report any WHS issues, including hazards, injuries, illnesses and near misses.

Employers must:

• Properly orientate, train and supervise staff to ensure safe work practices are understood and followed by all employees

• Consult with all employees, including YW, about decisions that will affect safety in the workplace

• Provide suitable personal protective equipment (PPE) to make sure workers can do their job safely and train workers how to use PPE correctly

• Regularly check WHS systems and procedures to make sure that workers are adequately protected from workplace hazards

• Provide adequate facilities for the welfare of employees. This covers everything from providing suitable toilet facilities to conducting risk assessments on premises and procedures

• Be aware of employers’ legal obligations under the NSW Work Health and Safety Act 2011 and the NSW Work Health and Safety Regulation 2011 and meet those obligations in full^[9]

TOPIC 5 – REFLECT ON OWN SAFE WORK PRACTICES

IDENTIFY WAYS TO MAINTAIN CURRENCY OF SAFE WORK PRACTICES IN REGARDS TO WORKPLACE SYSTEMS, EQUIPMENT AND PROCESSES IN OWN WORK ROLE

Remaining current and up-to-date on health and safety issues, workplace systems, equipment and processes in your workplace it extremely important.

There are many methods that you can use to remain current with the information required for safety in the workplace including:

• Internet/intranet

• Workplace policies and procedures

• Maintenance and operational manuals

• Workplace training

• Government and safety websites

• Health and safety representatives

Knowing and understanding your workplace procedures and guidelines for staying safe will ensure your remain safe and healthy and will assist others to remain the same.

REFLECT ON OWN LEVELS OF STRESS AND FATIGUE, AND REPORT TO DESIGNATED PERSONS ACCORDING TO WORKPLACE PROCEDURES

STRESS AT WORK

Everyone feels a level of stress at some time or another and most people respond better whhhen ttthere is a level of stress related to their job role however, excessive stress is not conducive to a good working environment.

Too much stress can interfere with your working environment and can lower productivity and effectiveness. It can also affect your mental health.

Finding ways to manage workplace stress isn’t about making huge changes or rethinking career ambitions, but rather about focusing on the one thing that’s always within your control: You!

You emotions can rub off on others, if you feel stressed other colleagues can also feel that stress. It is vital that you manage your stress levels so that everyone remains effective in the workplace.

There are a variety of steps you can take to reduce both your overall stress levels and the stress you find on the job and in the workplace. These include:

• Taking responsibility for improving your physical and emotional well-being

• Avoiding pitfalls by identifying knee jerk habits and negative attitudes that add to the stress you experience at work

• Learning better communication skills to ease and improve your relationships with management and coworkers

TIP 1: RECOGNIZE WARNING SIGNS OF EXCESSIVE STRESS AT WORK

When you feel overwhelmed at work, you lose confidence and may become irritable or withdrawn. This can make you less productive and less effective in your job, and make the work seem less rewarding. If you ignore the warning signs of work stress, they can lead to bigger problems. Beyond interfering with job performance and satisfaction, chronic or intense stress can also lead to physical and emotional health problems.

Signs and symptoms of excessive job and workplace stress

• Feeling anxious, irritable, or depressed

• Apathy, loss of interest in work

• Problems sleeping

• Fatigue

• Trouble concentrating

• Muscle tension or headaches

• Stomach problems

• Social withdrawal

• Loss of sex drive

• Using alcohol or drugs to cope

Common causes of excessive workplace stress

• Fear of being laid off

• More overtime due to staff cutbacks

• Pressure to perform to meet rising expectations but with no increase in job satisfaction

• Pressure to work at optimum levels—all the time!

TIP 2: REDUCE JOB STRESS BY TAKING CARE OF YOURSELF

When stress at work interferes with your ability to perform in your job, manage your personal life, or adversely impacts your health, it’s time to take action. Start by paying attention to your physical and emotional health. When your own needs are taken care of, you’re stronger and more resilient to stress. The better you feel, the better equipped you’ll be to manage work stress without becoming overwhelmed.

Taking care of yourself doesn’t require a total lifestyle overhaul. Even small things can lift your mood, increase your energy, and make you feel like you’re back in the driver’s seat. Take things one step at a time, and as you make more positive lifestyle choices, you’ll soon notice a reduction in your stress levels, both at home and at work.

• Get moving - Regular exercise is a powerful stress reliever

• Make food choices that keep you going - Low blood sugar can make you feel anxious and irritable while eating too much can make you lethargic.

• Drink alcohol in moderation and avoid nicotine

• Get enough sleep - Not only can stress and worry can cause insomnia, but a lack of sleep can leave you vulnerable to even more stress

TIP 3: REDUCE JOB STRESS BY PRIORITIZING AND ORGANIZING

When job and workplace stress threatens to overwhelm you, there are simple steps you can take to regain control over yourself and the situation. Your newfound ability to maintain a sense of self-control in stressful situations will often be well-received by coworkers, managers, and subordinates alike, which can lead to better relationships at work. Here are some suggestions for reducing job stress by prioritizing and organizing your responsibilities.

Time management tips for reducing job stress

• Create a balanced schedule

• Don’t over-commit yourself

• Try to leave earlier in the morning

• Plan regular breaks

Task management tips for reducing job stress

• Prioritize tasks

• Break projects into small steps

• Delegate responsibility

• Be willing to compromise

TIP 4: REDUCE JOB STRESS BY IMPROVING EMOTIONAL INTELLIGENCE

Even if you’re in a job where the environment has grown increasingly stressful, you can retain a large measure of self-control and self-confidence by understanding and practicing emotional intelligence. Emotional intelligence is the ability to manage and use your emotions in positive and constructive ways. When it comes to satisfaction and success at work, emotional intelligence matters just as much as intellectual ability. Emotional intelligence is about communicating with others in ways that draw people to you, overcome differences, repair wounded feelings, and defuse tension and stress.

Emotional intelligence in the workplace has four major components:

• Self-awareness – The ability to recognize your emotions and their impact while using gut feelings to guide your decisions

• Self-management – The ability to control your emotions and behaviour and adapt to changing circumstances

• Social awareness – The ability to sense, understand, and react to other's emotions and feel comfortable socially

• Relationship management – The ability to inspire, influence, and connect to others and manage conflict

There are five key skills that you need to master in order to raise your emotional intelligence and manage stress at work.

• Realize when you’re stressed, recognize your particular stress response, and become familiar with sensual cues that can rapidly calm and energize you

• Stay connected to your internal emotional experience so you can appropriately manage your own emotions

• Recognize and effectively use nonverbal cues and body language

• Develop the capacity to meet challenges with humor

• Resolve conflict positively

TIP 5: REDUCE JOB STRESS BY BREAKING BAD HABITS

As you learn to manage your job stress and improve your work relationships, you’ll have more control over your ability to think clearly and act appropriately. You will be able to break habits that add to your stress at work – and you’ll even be able to change negative ways of thinking about things that only add to your stress.

Eliminate self-defeating behaviours

Many of us make job stress worse with negative thoughts and behaviour. If you can turn around these self-defeating habits, you’ll find employer-imposed stress easier to handle.

• Resist perfectionism

• Clean up your act. If you’re always running late, set your clocks and watches fast and give yourself extra time. If your desk is a mess, file and throw away the clutter; just knowing where everything is, saves time and cuts stress

• Flip your negative thinking. If you see the downside of every situation and interaction, you’ll find yourself drained of energy and motivation

• Don’t try to control the uncontrollable. Many things at work are beyond our control—particularly the behaviour of other people

Four Ways to Dispel Stress

• Take time away

• Talk it over with someone

• Connect with others at work

• Look for humor in the situation

TIP 6: LEARN HOW MANAGERS OR EMPLOYERS CAN REDUCE JOB STRESS

It's in a manager's best interest to keep stress levels in the workplace to a minimum. Managers can act as positive role models, especially in times of high stress, by following the tips outlined in this article. If a respected manager can remain calm in stressful work situations, it is much easier for his or her employees to also remain calm.

Additionally, there are a number of organizational changes that managers and employers can make to reduce workplace stress. These include:

Improve communication:

• Share information with employees to reduce uncertainty about their jobs and futures

• Clearly define employees’ roles and responsibilities

• Make communication friendly and efficient, not mean-spirited or petty

Consult your employees:

• Give workers opportunities to participate in decisions that affect their jobs

• Consult employees about scheduling and work rules

• Be sure the workload is suitable to employees’ abilities and resources; avoid unrealistic deadlines

• Show that individual workers are valued

• Offer rewards and incentives

• Praise good work performance, both verbally and officially, through schemes such as Employee of the Month

• Provide opportunities for career development

• Promote an “entrepreneurial” work climate that gives employees more control over their work

Cultivate a friendly social climate

• Provide opportunities for social interaction among employees

• Establish a zero-tolerance policy for harassment

• Make management actions consistent with organizational values

SHIFTWORK

Shiftwork (working shifts) can affect health. The body is synchronised to night and day by a part of the brain known as the circadian clock. A shift worker confuses their circadian clock by working when their body is programmed to be sleeping. Common health problems include sleep disorders, digestive upsets, obesity and heart disease.

The sleep-wake cycle appears to have evolved for humans to be awake during the day and to sleep for approximately eight hours at night. There is a small part of the brain called the ‘circadian clock’, which monitors the amount of light you see, moment by moment. In the evening, when the light starts to wane, your clock notices and prompts a flood of a brain chemical called melatonin, which gives the body the signal to fall asleep. Overnight, melatonin levels remain high. They drop at daybreak and remain low during the day.

During the day, other chemicals (neurotransmitters) – such as noradrenaline and acetylcholine – increase in the body and keep you awake. This system keeps you synchronised through the day-night cycle. Many other functions of the body – including temperature, digestion, heart rate and blood pressure – fluctuate through the day, tuned by the activity of the circadian clock.

This changing rate of activity over each 24-hour period is known as the circadian rhythm. A person who works nights, or starts their working day before 6 am, is running counter to their circadian rhythm. This may put them at risk of health problems. Research findings are beginning to show that shift work can be hazardous to your health.

YOUR METABOLISM AT NIGHT

An important body function, which follows the circadian rhythm, is the internal body temperature. This temperature increases through the day. It reaches the lower level in the early hours of the morning and reaches the maximum level late in the afternoon.

The tendency to fall asleep and stay asleep occurs during the decreasing phase of the temperature circadian rhythm (between midnight and 4 am). As the body temperature rises, it is more difficult to stay asleep. This is one of the reasons why night workers who try to fall asleep at 8 am find it very difficult and also find it difficult to remain asleep through the day.

INCREASED RISKS

A person working night shift, which causes disruption to the circadian rhythm, is at greater risk of various disorders, accidents and misfortunes, including:

• Increased likelihood of obesity

• Increased risk of cardiovascular disease

• Higher risk of mood changes

• Increased risk of gastrointestinal problems, such as constipation and stomach discomfort

• Higher risk of motor vehicle accidents and work-related accidents

• Increased likelihood of family problems, including divorce

• Probable increased risk of cancer, especially breast cancer

In addition:

• Sleep deprivation caused by shift work may increase the risk of epilepsy in pre-disposed people

• Shift workers with diabetes can experience difficulties in controlling their blood sugar levels

SLEEP PROBLEMS

Shift workers get, on average, two to three hours less sleep than other workers. They often sleep through the day in two split periods, a few hours in the morning and then an hour or so before going to work at night. Night workers can find it difficult sleeping during the day (particularly in Australia). It’s difficult to keep the sleep environment dark, free of noise and relatively cool.

ROTATING SHIFTS

The best rotating shift pattern is still undecided. For the most people, rotating forward through the day, afternoon and night shift is better than backwards (night, afternoon then day). The frequency of rotation is also controversial. Some people advocate prolonged rotation, such as two to three weeks. Others advocate short rotations of two to three days. Both have advantages and disadvantages.

It takes about 10 days for the body to adjust to night shift work. However, it is common for night shift workers to revert to daytime routines for a day or two during days off, which tends to make the circadian rhythm unstable.

The amount of hours (8-hour versus 12-hour shifts) is also controversial. It can be said that 12-hour shifts stretch the body’s tolerance as far as possible. It’s very important that no overtime should be allowed during a rotation of 12-hour shifts. Another risk to sleep is when a worker on seven 12-hour shifts a fortnight uses their free time for another, almost full-time job.

A proportion of shift workers may have marked daytime sleepiness, called Shift Work Sleep Disorder. In certain circumstances, they may be helped by the careful use of stimulant therapy, on the advice of their doctor.

PARTICIPATE IN WORKPLACE DEBRIEFING TO ADDRESS INDIVIDUAL NEEDS

Debriefing is the best tools that can be used in the workplace. It provide a method for people in the workplace to voice their oppinions with fall back of negative consequences.

A debrief includes every person in a team that was involved in the execution of a task. Usually small groups work better than large ones and it must be free from position, in other words, everyone holds the same rank in a debrief.

A debrief provides the following:

• It shows all employees that their opinions count and that they are a valuable member of the team;

• It allows for clear and unhindered information flow and experience sharing between team members;

• It promotes transparency and integrity; and

• It provides immediate feedback both up and down the chain, which can enable small problems to be solved easily before they become large problems.

Your organisation should have its own method or format for debriefings but if they don’t then you should consider suggesting debriefings as a method of communication in your workplace.

The standardised debrief flow consists of the following four-step procedure:

• Re-state the Objectives

• Determine the facts of what happened

• Compare the outcome to the plan

• Debrief the Focus Points

At the conclusion of the debrief, the facilitator or leader of the group must ensure that the session concludes on a positive note.

Debriefs are considered to be the best way that leaders can display the “lead by example” method. It allows them to state mistakes made and take on board any positive suggestions from colleagues. It also provides a venue for training and education of staff members and provides an opportunity for coaching or mentoring of more junior members of staff.

Organisations that successfully implement regular debriefing sessions into their workplace will achieve better outcomes both in actual performance and in employee satisfaction.

SAFETY SYMBOLS

This sign means that there are poisonous chemicals or substances in the area

This sign means that emergency equipment is located in that area or cupboard.

This sign means that PPE should be worn.

This sign means that sharp objects such as syringes are in the area.

This sign means that there is radiation in use in the area.

SUMMARY

Now that you have completed this unit, you should have the skills and knowledge required for a worker to participate in safe work practices to ensure their own health and safety, and that of others in work environments that involve caring directly for clients.

If you have any questions about this resource, please ask your trainer. They will be only too happy to assist you when required.

REFERENCES

https://sielearning.tafensw.edu.au/MCS/9362/sterilisation%20disk%201/lo/7383/73

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http://poly - csw - cert3 - flex -

2012.wikispaces.com/file/view/HLTOHS300A+learning+gui... http://oehs.vcu.edu/fire/safetytech.html http://www.safetycare.com/health - and - safety - training/manual - handling - safety - trai...

http://www.hha.org.au/ForConsumers/FactSheets.aspx http://www.ccohs.ca/oshanswers/hsprograms/hazard_risk.html http://www.ccohs.ca/oshanswers/hsprograms/report.html http://th4.ilovetranslation.com/CnSHM2x8BDB=d/

GLOSSARY

Duty Holder – refers to any person who owes a work health and safety duty under the WHS Act including a person conducting a business or undertaking (PCBU), designer, manufacturer, importer, supplier, installer of products or plant used at work (upstream duty holders), an officer and workers. More than one person can concurrently have the same duty in which case the duty is shared. Duties cannot be transferred.

Health and safety committee (HSC) – a group established under the WHS Act that facilitates cooperation between a PCBU and workers to provide a safe place of work. The committee must have at least 50 per cent of members who have not been nominated by the PCBU, that is workers or HSRs.

Health and safety representative (HSR) – a worker who has been elected by a work group under the WHS Act to represent them on health and safety issues.

Officer – an officer within the meaning of section 9 of the Corporations Act 2001(Cth) other than each partner within a partnership. Broadly, an officer is a person who makes, or participates in making, decisions that affect the whole, or a substantial part, of the organisation’s activities. This does not include an elected member of a municipal council acting in that capacity or a minister of a state, territory or the Commonwealth. An officer can also be an officer of the Crown or a public authority if they are a person who makes, or participates in making, decisions that affect the whole, or a substantial part, of the business or undertaking of the Crown or public authority. Each partner within a partnership is not an officer but a PCBU in their own right. For further information on officers, please refer to the interpretive guideline on officers available at www.safeworkaustralia.gov.au.

Person conducting a business or undertaking (PCBU) – a person conducting a business or undertaking alone or with others, whether or not for profit or gain. A PCBU can be a sole trader (for example a self-employed person), each partner within a partnership, company, unincorporated association or government department of public authority (including a municipal council). An elected member of a municipal council acting in that capacity is not a PCBU. A ‘volunteer association’ that does not employ anyone is not a PCBU. If it becomes an employer, it also becomes a PCBU for purposes of the WHS Act. A ‘strata title body corporate’ that does not employ anyone is not a PCBU, in relation to any common areas (it is responsible for) used only for residential purposes. For further information on the meaning of PCBU please refer to the interpretive guideline on PCBUs available at www.safeworkaustralia.gov.au.

Plant – includes any machinery, equipment, appliance, container, implement or tool, and any component or anything fitted or connected to these things.

Structure – anything that is constructed, whether fixed or moveable, temporary or permanent and includes buildings, masts, towers, framework, pipelines, transport infrastructure and underground works (shafts or tunnels). Includes any component or part of a structure.

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