Introduction

Obligations

Auckland Physiotherapy Ltd provides and maintains a safe and healthy workplace for all staff, and to providing the information, training and supervision needed to achieve this. Management is firmly committed to a policy enabling all work activities to be carried out safely, and with all possible measures taken to eliminate (or at least minimise) risks to the health, safety and welfare of staff, clients, visitors, contractors or anyone else attending Auckland Physiotherapy services.

Auckland Physiotherapy Ltd will take responsibility for health and safety procedures, however, employees need to be aware of their responsibilities and comply with the business’ health and safety policy.

We are committed to ensuring we comply to the most recent Work Health and Safety Act, and the Work Health and Safety Regulations.

Scope

This policy applies to all organization’s employees, management, contractors, student interns, and volunteers.

Related Documents

KP Privacy Policy

Health and Safety at Work Act (2015)

External Providers/Venues Health and Safety Policies

Contactors Health and Safety Policies

 

Policy Statements

The Health and Safety at Work Act (2015) requires employers to take all practicable steps to ensure the health and safety of staff members at work.

 

AP Management aims to:

  • provide a safe and healthy work environment

  • identify and control actual and potential hazards

  • establish and maintain communication on health and safety

  • demonstrate a commitment to the accurate reporting and recording of health and safety matters

  • comply with legal and organizational obligations

 

This will be achieved through

  • ensuring health and safety discussions are a key part of AP’s bi-monthly meetings with staff.

  • making certain all incidents, injuries and near misses are recorded in the appropriate place

  • investigating incidents, near misses and reducing the likelihood of them happening again

  • discussing hazards and risks so everyone can work safely

  • making sure clients, visitors or contractors working with AP operate in a safe manner

 

Each employee is encouraged to play a vital and responsible role in maintaining a safe and healthy workplace through:  

  • being involved in the workplace health and safety system

  • following correct procedures and equipment

  • wearing protective clothing and equipment as and when required

  • discussing hazards and risks so everyone can work safely

  • reporting any pain or discomfort as soon as possible.

  • ensuring all accidents and incidents are reported.

  • helping new employees, trainees and visitors to the workplace understand the right safety procedures and why they exist.

  • telling your manager immediately of any health and safety concerns.

  • keeping the work place tidy to minimise the risk of any trips and falls.

 

Application of this policy

We seek the co-operation of all workers, customers and other persons. We encourage suggestions for realizing our health and safety objectives to create a safe working environment.

This policy applies to all business operations and functions at all sites, namely Auckland Physiotherapy in Newmarket clinic and Auckland Physiotherapy in Greenlane Clinic.

Health and Safety

Cardiac Arrest / CPR

Policy

The clinic will ensure all staff attends a formal CPR training session a minimum of once every two years to renew certificate.

Procedure

  1. All staff shall attend a minimum of once every two years to a formal CPR training session to renew certificate. This will be recorded on the google sheets CPR log.

  2. Auckland Physiotherapy will promote PNZ CPR courses.

  3. If a person collapses, assess consciousness (shake them and shout “are you OK”). If unresponsive then call for help. Send someone to the phone or do it yourself first if you are alone. Dial 111. Ask for ambulance. Give your address.

  4. Open and clear airway.

  5. Look, listen and feel for breathing or signs of life (no more than 10 seconds).

  6. Locate correct hand position (middle of chest).

  7. Compress chest to correct depth (adult 4-5cm, child and infant 1/3 of chest).

  8. Compress chest at correct speed (rate approximately 100/min, start singing Staying a live to get the correct tempo).

  9. Compressions to breath rate approximately 30:2. Always use a barrier between your mouth and the collapsed person. If there is vomit or any lesions around mouth of collapsed person, compressions will be enough to sustain life until paramedics arrive.

  10. Continue CPR until ambulance arrives

  11. Once patient is breathing put into recovery position.

 

Reference:

Clinical Emergency

ISSUE DATE: June 2017

AUTHORISED BY: Helen Dudley

REVIEW DATE: June 2019

 

Adverse Reactions to Treatment & Incident Reporting

Policy

The practice acknowledges the occurrence of adverse reactions to treatment or incidences by keeping an accurate record of these events. Adverse reactions are defined as reactions to treatment administered. Accidents are defined as events which occur causing harm as a consequence of the physical environment of the practice. This includes infection risks.

Procedure

  1. In the event of an adverse reaction, the physiotherapist shall complete an incident form (This is located on Google Sheets in the H&S folder) which accurately describes the event, as shortly after the event as is practical (within the next few hours).

  2. A copy of the form is placed in the Health and Safety Folder, a copy scanned into the patients file, a copy to the practice manager and a final copy is sent to PNZ (PO Box 27 386, Wellington, 6141, fax: 04 801 5571 or email: nzsp@physiotherapy.org.nz.) for national collation.

  3. The same physiotherapist is responsible in following up on action which is further required.

  4. If there is an accident affecting an employee or a patient, then the OSH form Notice of Accident (see on Google Sheets) is filled in. A copy is kept with the Accident Register, the staff members file, scanned into the patients’ file and a copy given to the practice manager who sends a copy to OSH within a week of the accident occurring.

  5. If the accident affects a physiotherapist, then the Self Injury to Physiotherapist Reporting Form (see attached) is completed and one copy put in the Accident Register and the other is given to the practice principal.

  6. Matters arising from the Incident Reporting File, the Accident Register and any “near misses” will be periodically discussed at bi-monthly staff meetings (H+S section in agenda of bi-monthly meeting).

Adverse reactions/incidents will include such events as:

  1. Skin reactions

  2. Reaction to acupuncture including reported after effects

  3. Burns/blisters

  4. Fainting/dizziness

  5. Nausea/vomiting

  6. Headache

  7. Subluxation/dislocation

  8. Severe aggravation of symptoms

  9. Significant new symptoms

 

Accidents can include:

  1. Slipping on wet floor

  2. Falling over furniture

  3. Tripping on electrical cords/mats

  4. Injury from contact with sharps that have been contaminated with body fluid/blood

  5. Direct splash of body fluid/blood onto a mucous membrane or fresh cut or burn (<24 hours old)

  6. In these events, the GP of the physiotherapist is to be contacted

 

Adverse reactions are defined as treatment effects which cause the following

  1. cessation of the treatment causing the reaction, or

  2. follow-up observation, or

  3. treatment of the adverse reaction, or

  4. referral to another health practitioner Incidents are defined as accidents which involve the staff or patients because of the practice environment.



Reference:

Patient Communication During Treatment

Patient Rights

Informed Consent

Health & Disability Code

Infection Control

ISSUE DATE: June 2017

AUTHORISED BY: Helen Dudley

REVIEW DATE: June 2019

Civil Defense Emergency

Policy:

The practice will respond appropriately in the case of a Civil Defense Emergency (CDE).

Procedure:

  1. The CDE will be announced on the radio and instructions issued.

  2. The CD headquarters will be established in the nearest primary school, which will be announced on the radio.

  3. Get the Survival Kit that from the store cupboard.

  4. The Survival Kit contains bottled water, muesli bars, a radio, torch and spare batteries and is updated every 6 months.

  5. Electricity is turned off.

  6. The phone is used in emergencies only.

  7. The procedures in accordance with the policies on CPR, Clinical Emergency, Fire and Earthquake are followed.

  8. If it is safe, then proceed to the nearest CD Reporting Centre as outlined on the radio.

 

Reference:

Fire

Earthquake

Cardiac Arrest/CPR

Clinical Emergency

ISSUE DATE: June 2017

AUTHORISED BY: Helen Dudley

REVIEW DATE: June 2019


Clinical Emergency/ Critical Incidents

Policy

All staff will be able to recognize a clinical emergency and/or critical incident and will be prepared to act appropriately.

All critical incidents are to be appropriately reported, investigated, analyzed and recorded.

Objective

  • To determine what is a clinical emergency or critical incident.

  • To outline a procedure for the effective management of a clinical emergency.

  • To outline a process for the investigation, analysis and reporting of critical incidents.

  • To improve quality, minimise risk and ensure the safety of Practice staff and patients.

  • To contribute to the ongoing maintenance of standards of excellence, agreed practice, competency and accountability.

Definitions

Clinical Emergency is a serious, unanticipated incident which occurs during treatment or a visit to the Practice and which poses a risk to the health and safety of the patient and / or the staff such as:

  • Burn – apply ice pack

  • Stroke – recognise signs and call for Nurse/Doctor/Ambulance

  • Fainting – place in recovery position/lie them down and sit with them

  • MI – recognise signs, start CPR if required and call for Nurse/Doctor/Ambulance

  • Shock – sit/lie them down, sit with them, keep them warm

  • Electrocution – turn off power supply and place in recovery position

In addition to Clinical Emergencies, the Practice may experience a Critical Incident which could include:

  • an event which has the potential for serious adverse media attention

  • an event which has the potential to seriously undermine public confidence

  • major system failure

  • grievous bodily harm

  • serious threat e.g. a bomb threat, armed robbery

Procedure – Clinical Emergencies

All staff will be involved in the development of a plan for clinical emergencies, including identifying potential clinical emergencies and how each type of emergency will be managed.

The Practice will have a plan for clinical emergencies which includes ensuring:

  • On-going staff training in clinical emergency management

  • All Physios have current first aid certification

  • Staff have current CPR certificates

  • First aid and emergency equipment are up-to-date, and readily accessible.

  • Signage on the location of first aid and emergency equipment, and warning signs are up-to-date, brought to the attention of patients and readily noticed by all patients and visitors (including other language options, if appropriate).

  • Patients and staff know how to summon support quickly

  • A current list of emergency contacts – practitioners, hospitals, agencies, etc is readily accessible for patient referral.

  • Support, if necessary, for staff involved in the incident.

  • Systems for follow-up after the event, including learning points and residual risk(s).

Procedures for reporting an emergency / critical incident

The safety of those involved is of foremost importance. Once this has been assured the staff member involved or with first knowledge of the emergency / incident is required to verbally report the incident to a Manager or Principal as soon as possible.  

All critical incidents involving serious harm must be reported in line with the Health and Safety in Employment Act 1992, s25. and PNZ requirements for reporting adverse events.  This may also necessitate “securing the site” of the emergency/incident for later investigation by OSH.

If the critical incident affected an individual patient’s care, it must be recorded in their clinical health record.  This should include details of the incident, the action taken, and any follow up.

Depending on the nature of the incident, the following additional actions may be required:

  • Seeking legal advice or assistance from a Communications consultant on key messages for staff and media.

  • Notifying the Practice’s Public Liability Insurance Brokers.  

  • Notifying the individual physiotherapist’s professional liability insurer, if applicable

  • Notifying other applicable agencies, e.g. Energy Safety Service, Ministry of Consumer Affairs – for electrical adverse events

  • Reviewing and updating the Practice’s Quality Policy and Plan

Refer to Practice’s Risk Management Register and Health and Safety Plan

Reference:

Cardiac Arrest/CPR

Adverse Reactions and Incident Reporting

Infection Control

Health and Safety

Human Resource Policies

Business Continuity Planning

Complaints Management Policy

Consumer Rights

Risk Management

ISSUE DATE: June 2017

AUTHORISED BY: Helen Dudley

REVIEW DATE: June 2019

Disaster Plan

Policy

That the Practice shall attempt to minimise disasters and the personnel shall respond appropriately in the event of an emergency.

Procedure

  1. In the event of a hold-up hand over the money in the draw.

  2. At the end of each day the receptionist shall place the money in the small safe in the reception draws.

  3. In the event of a break in, inform Helen Dudley/ Katy Street or Mark Quinn and the Police immediately.

  4. The Practice maintains the appropriate insurance to minimise the risk of potential disasters.

  5. A Hazard Audit (see Google Sheets H&S document) is done annually by the Health & Safety Officer (Helen Dudley).

  6. The Practice is a smoke free environment.

Reference

Security

Civil Defense Emergency

Cardiac Arrest/CPR

Earthquake

Fire

Clinical Emergency

Adverse Reactions and Incident Reporting

ISSUE DATE: June 2017

AUTHORISED BY: Helen Dudley

REVIEW DATE: June 2019

Earthquake

Policy

That the practice personnel shall respond appropriately in the event of an earthquake.

Procedure:

  1. The staff and patients should shelter in doorways or under reception desk in the event of an earthquake until the tremors stop.

  2. Once the tremors have stopped, the building should be evacuated.

  3. Switch off all electrical devices but leave the lights on and close all windows and doors.

  4. Physiotherapists are to help patients get dressed and leave the premises.

  5. The Physiotherapists must check the toilets and waiting areas, and ensure all people have left the premises. If it is safe, retrieve the Survival Kit.

  6. Assemble at the designated point. The directions of these points are located on the walls by the exit doors of each building.

  7. The drill will be practiced annually. This will be organized by the building management.

Reference

Civil Defense Emergency

Cardiac Arrest/CPR

Fire

Clinical Emergency

ISSUE DATE: June 2017

AUTHORISED BY: Helen Dudley

REVIEW DATE: June 2019

Fire

Policy

The practice complies with appropriate legislation and in the event of a fire there is swift and appropriate action.

Procedure:

  1. The staff will know where the nearest fire exit is and that they ensure there is never any obstruction to access them. These exits are marked with an illuminated EXIT sign.

  2. These exits will have signs on them.

  3. In the event of a fire, call 111 and ask for help.

  4. Raise the alarm within the practice by shouting “FIRE”.

  5. Switch off all electrical devices but leave the lights on and close all windows and doors.

  6. Physiotherapists are to help patients get dressed and leave the premises.

  7. The most senior Physiotherapist must check the toilets and waiting areas and ensure all people have left the premises.

  8. Assemble at the designated point.

  9. The drill will be practiced annually and organized by the building management.

  10. The practice is a smoke free environment.

Reference

Civil Defense Emergency

Earthquake

Clinical Emergency

ISSUE DATE: June 2017

AUTHORISED BY: Helen Dudley

REVIEW DATE: June 2019

First Aid

Policy

The Practice personnel shall be able to administer simple first aid in the event of an accident within the Practice.

Procedure

  1. All Physios are to have basic first aid knowledge.

  2. A comprehensive first aid kit is kept in the filing cabinet in the treatment area.

  3. The first aid kit contains a list of its contents and the person who uses the last of any material should notify Helen Dudley.

  4. Annual CPR training is marketed through Auckland PNZ Branch.

  5. Follow the Clinical Emergency procedure as necessary.

  6. Record as per policy for accident and incident reporting.

Below is the First Aid Supplied that should be in each of the kits available.

Kit Qty

Description

Product Code

Replenishment Qty

2

Triangle Bandage With 2 Safety Pins

2808005

1

1

Eye Pad

2298228

1

1

Medium Wound Dressing (120mm x 120mm)

2393301

1

1

Large Wound Dressing (180mm x 180mm)

2393336

1

2

Non-Adherent Dressing 7.5 x 10cm (Wound Pad)

2887215

1

1

Non-Adherent Dressing 5 x 7.5cm (Wound Pad)

2887207

1

1

Combine Dressing 10 x 9cm

2393247

5pk

3

Gauze Swab 2s 7.5 x 7.5cm 12ply

2395584

5pk

4

Irrigation Solution 30ml

2899892

1

3

Antiseptic Wipes

2393263

10pk

1

Crepe Bandage 5cm

2807815

1

1

Crepe Bandage 7.5cm

2807823

1

1

Fabric Plaster Roll 2.5cm (strapping Tape)

2298597

1

1

1m Dressing Strip

2807998

1

25

Plasters 7.2 x 1.9cm

2395576

50pk

1

First Aid Tweezers

2807955

1

1

Blue Medium Scissors

2807947

1

1

CPR Face Shield

2807831

1

2

Examination Gloves (pair)

2390485

3 pairs

1

First Aid Tips



1

Clean up Bags



1

Aids Hepatitis Warning Label



1

Carry Pouch



Reference

Civil Defense Emergency

Cardiac Arrest/CPR

Earthquake

Fire

Clinical Emergency

Adverse Reactions and Incident Reporting

ISSUE DATE: June 2017

AUTHORISED BY: Helen Dudley

REVIEW DATE: June 2019

Health and Safety of the Workplace Environment

Policy

The Practice provides a safe environment to maintain the Health and well-being of those who come in contact with it.

Procedure

  • Identify hazards

  • The Health & Safety Officer (Helen Dudley or reception manager) will initiate a hazard audit every year and document it in the Health & Safety folder on Google Sheets.

  • Remedy, remove or minimise hazards identified.

  • Educate the staff regarding their responsibility and in the identification and reporting of hazards.

  • Report incidences as outlined in the Adverse Reaction and Incident reporting procedure including “near misses”.

  • To discuss these findings periodically in staff meetings.

Reference

Adverse Reactions to Treatment and Incident Reporting.

Occupational Health & Safety Act

Hazard Checklist

ISSUE DATE: June 2017

AUTHORISED BY: Helen Dudley

REVIEW DATE: June 2019

Security

Policy

There will be adequate security measures to protect both property and people within the Practice.

Procedure:

  1. The last staff member working will ensure all windows are shut and locked before locking up.

  2. Both Reception Desks and all staff members will have access to the Newmarket and Ascot security phone numbers.

  3. Valuables such as handbags of patients are to be kept within their sight during treatment.

  4. Valuables of the staff need to be kept out of sight in the designated cupboard.

  5. The front door of the Practice is to be locked after the receptionist leaves and the patients need to be told to knock on the door when they arrive (This is only applicable to Newmarket).

  6. If a staff member feels unsafe, they are to lock themselves in the treatment room and call security straight away.

Reference

Opening and closing clinic

ISSUE DATE: June 2017

AUTHORISED BY: Harley Matthews

REVIEW DATE: June 2019

Smoking

Policy

The Practice is a smoke free environment.

Procedure

No patient or staff member is permitted to smoke within the Practice.

Reference:

Fire

ISSUE DATE: June 2017

AUTHORISED BY: Helen Dudley

REVIEW DATE: June 2019

Visitors to the Practice

Policy

All visitors (including tradesmen) must fill in the visitor’s book on arrival to reception. (This is only applicable to Newmarket)

Procedure

  1. On arrival, the visitor signs the visitor book and is given an identification badge.

  2. All visitors are advised of patient safety and privacy. They are advised not to enter treatment areas without permission from the physiotherapist or patient.

  3. When leaving the practice, the visitor is to re-sign the visitor book.

Reference

Security

Patient Privacy and Confidentiality

ISSUE DATE: February 2017

AUTHORISED BY: Harley Matthews

REVIEW DATE: February 2019

Electrical and Equipment

Electrical Safety

Policy

The Practice complies with current Electrical Safety Legislation and does the utmost to provide a safe environment.

Procedure

  1. To use electrical sockets fitted with Surge Protectors.

  2. The Physiotherapists checks each RCD switch at the beginning of each week by pushing the blue button – on / off button goes out, then push the green (reset) button back in – on / off light comes back on.

  3. Physiotherapist’s signs wall chart to show a successful test.

  4. If the test is not successful, tape a warning to the switch and call electricians.

  5. All Practice electrical equipment is checked, calibrated and fixed (if need) annually.

ISSUE DATE: June 2017

AUTHORISED BY: Helen Dudley

REVIEW DATE: June 2019

Maintenance and Disposal of Equipment

Policy

As part of the maintenance regime of Auckland Physiotherapy, the existing condition of the equipment will be checked annually. When unsafe or irreparable equipment is identified, it will be disposed of safely.

Procedure

  1. Electrical equipment will be checked annually by a test and tag company.

  2. All other equipment (crutches, braces, exercise equipment) will be checked prior to use/loan.

  3. Pilates machines/ equipment will be checked as per the equipment check sheet that is located on google Sheets under the Health and Safety section.

  4. Unsafe equipment should be effectively disabled prior to disposal (cutting electrical cords, breaking/removing vital components)

  5. If equipment cannot be disabled, it should be labelled unsafe.

  6. Any equipment should be disposed of by Practice Principal at the nearest Refuse Transfer Centre.

  7. If any IT equipment is damaged or to be disposed of, Think IT (IT Providers) are to be contacted for removal and destruction of IT equipment.

Reference

Health and Safety / Incident Reporting

Hazard Checklist

Electrical Safety

ISSUE DATE: June 2017

AUTHORISED BY: Helen Dudley

REVIEW DATE: June 2019

Infection Control

Acupuncture Safety

Policy

The Practice provides a safety policy regarding a needle stick injury.

Procedure

  1. Physiotherapist to check all needles are immediately disposed in sharps bin at the end of each acupuncture treatment.

  2. Any needles not properly disposed of and if found by cleaner, cleaner is to notify the practice as soon as possible (next morning following night time clean).

  3. If a needle stick injury is sustained by the cleaner, the cleaner is to attend A & E clinic or doctor and inform the Practice immediately.

  4. Physiotherapist is to complete an injury report and file in incident report folder.

  5. Physiotherapist to complete Hazard Audit Form (wall behind work station).

Handling and Disposal of Sharps Protocol

  1. Sharps shall be handled with extreme care at all times.

  2. All persons generating sharps shall be responsible for the immediate safe disposal.

  3. The sharps container (labelled as a biohazard) shall be brought as close as possible to the use area.

  4. The sharp shall be disposed of at the point of use.

  5. Double handling shall be avoided.

  6. Contaminated glass and other sharp objects shall also be disposed of in the sharps container.

  7. Disposable needles and disposable razors (for taping procedures) should be mandatory.

  8. Do not overfill a sharps container.  The container should be disposed of when three-quarters full.

THE FOLLOWING STEPS SHALL BE FOLLOWED IF THERE IS EXPOSURE TO BLOOD/BODY FLUIDS.

  • Allow the wound to bleed freely and cleanse with plenty of water and soap.

  • Remove contact lenses if worn and rinse the eyes thoroughly with water.

  • If blood gets in the mouth, spit it out and rinse thoroughly with tap water several times.

  • Complete an Accident/Incident form and a Needlestick injury form.

  • Report the injury to the Manager.

Additional protocols

Not currently applicable to day-to-day physiotherapy practice:

  • Syringes with needles attached shall be disposed of intact into the sharps container.

  • Needles shall not be bent, broken or removed from a disposable syringe prior to disposal.

Reference

The Physiotherapy Acupuncture Association of New Zealand (PAANZ) Protocols

Adverse Reactions to Treatment and Incident Reporting.

Hazard Checklist

ISSUE DATE: June 2017

AUTHORISED BY: Helen Dudley

REVIEW DATE: June 2019

Cleaning Protocol

Procedure

  1. Spills (refer Spills Protocol for definition) shall be cleaned up immediately.

  2. Staff doing cleaning duties shall wear gloves.

  3. Protective eyewear shall be worn if splashes are likely to occur.

  4. Cleaning procedures shall minimize dispersal of micro-organisms into the air, e.g. damp dusting.

  5. Detergent and warm water shall be used for routine cleaning.

  6. Floors shall be cleaned weekly.

  7. Surfaces that require a higher level of cleanliness shall be cleaned with disinfectant and warm water at a strength determined by the manufacturer’s instructions.

  8. Surfaces shall be cleaned and dried following the use of disinfectants.

  9. Buckets and mops shall be cleaned thoroughly with detergent and warm water and stored dry.

  10. Buckets and mops should be colour coded: i.e. different colours for clean (kitchen) and dirty (e.g. toilets) areas

Equipment

Pilates machines/ mats

cleaned after every use


Hot packs, towels, foam and ice packs

These are to be separated from the patient by a fresh paper towel for each new patient.

Patient preparation

Prior to acupuncture, when obvious soiling is apparent, attention should be paid to the patient’s skin cleansing by utilizing both soap and water or isopropropyl alcohol skin wipes.  A sterilizing solution such as 2% iodine in 70% alcohol must be used in preparation for all needling into joint spaces and on ear cartilage.

Cleaning Instructions

 

PROCEDURES

1. Daily Cleaning

As Required

2. Linen and Rubbish

Removal as required or at least once a day using double bag technique.

3. Furniture and Fixtures

Gloves - use hot water and detergent.  Damp dust all surfaces. Bathroom, ensure the toilet is cleaned last by cleaner.

4. Floors

Wipe floors with detergent and hot water.  (If applicable: use cotton mop with detachable head.  When completed, place mop head in linen bag and send to the laundry for cleaning.  Use a clean mop head each day.)

Do not leave wet mops soaking or drying in patient areas.  If a disposable sponge mop is used, these should be rinsed thoroughly after use and soaked in appropriate solution 60 ppm for one hour.  Them remove and leave to dry head up.

Dirty water should be discarded immediately.  Buckets must be cleaned and dried by cleaner.

6. Walls

These do not routinely require cleaning except for areas visibly soiled.  These areas should be spot cleaned as soon as possible with detergent and hot water.  If contaminated with blood or body substances, clean with appropriate solution - 4 Milton tablets to 110mls water.

7. Beds

Beds should be wiped down with detergent and water on a daily basis. Wiping after each patient with alcohol or hand spray is not necessary for infection control purposes but may be a practice that the clinic wishes to adopt for patient comfort.

ISSUE DATE: June 2017

AUTHORISED BY: Helen Dudley

REVIEW DATE: June 2019

Handwashing Protocol

Handwashing is the single most effective mechanism to reduce the incidence of acquired infection.

STANDARD

All staff having patient contact will:

  • Perform a thorough hand-washing before patient contact.

  • Wash hands after any patient contact.

  • Wash hands before and after any procedure.

  • Wash hands after going to the toilet.

  • Remove jewellery if there is any risk of bacteria gathering under the surface of rings.

SIGNIFICANT CONTACT

This includes:

  • Attending to the changing of a bandage.

  • Contact with a patient with lowered immunity.

  • Touching the mouth or face of a patient.

  • Touching body fluids

  • Delivering an injection (in specified/supervised settings)

ALCOHOL-BASED HAND RUBS

These can be used when there is no visible soiling and can be used up to six times before washing hands in the usual manner.  The hand rub must have alcohol content of 70% or greater.

Handwashing

WET HANDS THOROUGHLY LATHER WITH SOAP VIGOUROUSLY RUB HANDS TOGETHER FOR AT LEAST 10 – 15 SECONDS CLEANING PALMS, BETWEEN FINGERS, THUMBS, UNDER FINGERNAILS, THE BACK OF HANDS AND WRISTS RINSE UNDER WARM RUNNING WATER

HOLD HANDS UP TO RINSE TURN TAPS OFF WITH ELBOWS OR DRY PAPER TOWEL DO NOT TOUCH THE TAPS

DRY ALL SURFACES THOROUGHLY ESPECIALLY BETWEEN FINGERS AND THUMBS, USING A DISPOSABLE PAPER TOWEL DO NOT USE A PATIENT’S TOWEL

PAT DRY RATHER THAN RUB TO PREVENT CHAPPING


REMEMBER:WASH HANDS BEFORE AND AFTER GIVING CARE.


ISSUE DATE: February 2017

AUTHORISED BY: Helen Dudley

REVIEW DATE: February 2019

Infection Control

Policy

The control of infection within the practice will observe the highest standards.

Procedure

  1. The Infection Control Officer is Helen Dudley.

  2. The patient will be screened for HIV/HBV (Hep B) on registration but disclosure is not mandatory, so the assumption must be made that the patient is positive until otherwise confirmed by the patient.

  3. Physiotherapists will always wash their hands between patients.

  4. Pillows will always have a paper towel covering them.

  5. Physiotherapists with long hair will always have their hair tied back to prevent transmission of head lice.

  6. Patient’s shoes shall be removed before lying on the bed.

  7. Gowns/shorts will be changed daily.

  8. Bed linen will be changed at least once a week or more regularly if soiled.

  9. Pillow slips to be changed at the end of each day.

  10. Acupuncture needles are disposable only and are thrown out in the Contaminated Materials & Sharps Container along with any cotton balls with blood on it.

  11. The clearance form for blood donation is given to those acupuncture patients requesting it.

  12. Needles will always be removed with cotton balls ready in case of bleeding.

  13. The Sharps Container when full will be collected each Friday by the collection agency.

  14. The Sharps Container will be kept away from where a child may access it and with the top on it, if it is potentially accessible.

  15. If blood leaks onto linen, then the linen is soaked for 24 hours in Miltons Solution then it will be placed in a plastic bag and washed as normal.

  16. Physiotherapists will wipe down the beds with Azo wipes especially around the face hole.

  17. There is periodical education on infection control at staff meetings.

  18. Infection risks are included in the Hazard Audit.

Reference:

Infection control NZPAS website: www.physiostandards.co.nz.

ISSUE DATE: June 2017

AUTHORISED BY: Helen Dudley

REVIEW DATE: June 2019

Laundry Protocol

The Laundry Space and Equipment

Auckland Physiotherapy shall ensure that:

  • The laundry is undertaken by our chosen external laundry company.

  • Where the laundry is outsourced the laundry, contractor has appropriate infection control processes in place.

Auckland Physiotherapy shall ensure that:

  1. There is adequate space for the storage of linen.

  2. Clean linen that is removed from the clean linen storage area for use is not returned to the storage area if unused.

  3. Clean linen shall be transported separately to soiled linen.

  4. Soiled linen is double bagged and then place in laundry bag.

  5. Soiled linen does not pass through food preparation or food storage areas.

  6. Soiled linen is stored in a well-ventilated space, free from pests.

  7. Soiled linen is not allowed to accumulate.

  8. Sheets and pillow cases will be changed daily or more often as required.

Staff Work Practice

Auckland Physiotherapy shall ensure that:

  1. Disposable gloves are worn when handling soiled linen.

  2. There is a designated frequency for linen change, taking account of patient turnover, use of facility, patient expectation.

  3. Linen change takes place after any soiling with body fluids or blood.

  4. A visual check is made when folding and/or ironing linen to ensure it is suitably clean.

  5. Staff are trained in safe work practices including manual handling techniques.

  6. Staff do not eat or smoke in the laundry area.

  7. Staff are educated about hazards. The correct procedure for dispensing laundry powder is followed.

  8. The bag in which soiled linen was held, is washed with the laundry before being used again.

Infection Control Process

  1. Staff will be adequately trained in hygiene standards including hand washing and the risks involved if undertaking other tasks within the facility.

  2. Work routines will reduce the risk of transmission of disease-producing organisms.

  3. Staff will wear gloves (and protective clothing, if necessary) when sorting laundry.

  4. Staff with exfoliative skin conditions, unhealed lesions and rashes will not handle linen unless appropriate protective measures are adopted.

  5. Advice about Hepatitis B is available to staff.

  6. All linen shall be visually checked for body fluids and blood.

  7. Linen shall be separated into used/infected and heat sensitive categories, e.g. towels in one wash, clothing in one wash; linen only in one wash.

  8. Items stained with blood or body fluids will be:

Sanitized in hot water and a 1/2 cup of sanitizer in a large bucket for 5 hours, rinsed, machine washed

  1. Contaminated linen with blood or body fluids from a known Hep B, C or HIV positive patient shall be placed in a water soluble, or fluid resistant bag, tagged and washed separately.

Off Site Laundry Management

Auckland Physiotherapy shall ensure that physiotherapists who are working off-site, e.g. making a home visit, sports venue or sports event, or other non-clinic setting that is under the physiotherapist’s control, follow appropriate infection control procedures, to prevent contamination and cross-contamination.

ISSUE DATE: February 2017

AUTHORISED BY: Harley Matthews

REVIEW DATE: February 2019

Notifiable Diseases

Policy

Many diseases are required to be notified to the Medical Officer of Health under the Health Act 1956 and the Tuberculosis Act 1948.  All these diseases have public health importance, and many are infectious and can cause outbreaks.

Principals

  • All suspected or confirmed notifiable diseases shall be notified to the Medical Officer of Health and the patient’s GP.

  • Some notifiable diseases require urgent notification – refer to the Ministry of Health website, www.moh.govt.nz, and search for notifiable diseases.

Procedure

The physiotherapist who suspects a notifiable disease is responsible for notifying the case to the Ministry of Health and the patient’s GP,

  • The manager shall be informed of all communicable diseases or suspected communicable diseases to facilitate appropriate precautions monitoring.

  • The decision to notify will be conveyed to the patient.

  • The clinician shall notify the patient’s GP immediately.

  • The notification to the MOH and GP shall be documented in the patient’s record.

ISSUE DATE: February 2017

AUTHORISED BY: Harley Matthews

REVIEW DATE: February 2019

Possible infection and risks to staff and patients

HIV

The HIV virus can be found in body fluids but in number too low to be infective to others.  It is only transmitted through seminal and vaginal fluids, breast milk and blood. It may survive 24 hours outside the body in dried blood and up to 2 weeks if moisture is present. The risk of transmission after significant exposure is 0.3%.

Hepatitis B [HBV]

In New Zealand HBV causes more deaths than any other vaccine preventable disease other than influenza.  Physiotherapists are highly at risk of contracting the disease due to the exposure to body fluids and blood. This is especially the case when performing acupuncture, women’s health, dealing with wounds and TMJ mobilisations.  Hepatitis B can survive up to a week in dried blood. It may be spread from direct contact with blood or indirect contact with contaminated objects. The risk of transmission after a significant exposure is 30%. [This compares with Hepatitis C risk of 1.8%.]

Fungal Infections

Ringworm and athletes foot are perhaps the most commonly encountered fungal infections.  They are usually passed on by direct skin contact with the infection or by sharing towels or clothing.  Using detergent and water for cleaning and hand washing procedures eliminates risk.

Head lice

Lice travel from person to person by swinging from hair to hair on close contact.  They do not jump. Lice found off the hair are always injured or old and will not lay eggs.  In order to protect oneself, therapists with long hair should tie it back. Paper towels on pillows will collect any stray lice for easy disposal.

Scabies

Scabies mites can live for a few days away from the body.  Washing laundry in hot water and detergent will kill all mites and eggs.  Any handling of the infected material should be done with gloves on.

Herpes

Herpes Zoster and Simplex are transmittable by direct contact only.  Hand washing is the most effective means of preventing infection. Normal laundry procedures apply after contact with the affected area.  Washing the ultrasound head with detergent and water after contact with ulcers is essential.

Other Infection Risks

Especially for Respiratory Physiotherapists, include Tuberculosis, community acquired Pneumonias and Influenza

ISSUE DATE: February 2017

AUTHORISED BY: Harley Matthews

REVIEW DATE: February 2019

Work Restrictions Protocol

Policy

To minimise risk via the occupational exposure to potential infectious organisms to healthcare personnel and to protect the patient from exposure to potential pathogens from healthcare personnel.

Procedure

  • Staff with suspected or diagnosed communicable diseases are to identify this to the relevant person in charge where there is the potential for risk to clients or other personnel.

  • The person in charge will manage the situation in consultation with the staff member and the GP.

  • Staff may be referred to their GP for follow-up. It may be necessary for the manager, with the staff member’s permission, to discuss management with the individual's GP.

  • Additional medical advice may need to be sought regarding the management of those communicable diseases encountered less frequently because their management is less clearly defined. Local experts, i.e. Infectious Disease Physicians, Medical Microbiologists, Community Health Services may be consulted.

  • Careful clinical practice can reduce the potential for transmission of infectious diseases from staff to clients, but consideration must be given to the area in which the staff member is working.  Utilising sick leave or redeployment may be advisable. Staff members should be informed of this policy upon commencement of employment.

Immunization of Staff

Staff are to be aware of their immune status, which should be identified on employment for the following:  measles, rubella, mumps, Hepatitis B and tuberculosis (pulmonary)

The following recommendation is made regarding specific vaccination.

Vaccination

Indications


Influenza

Healthcare personnel in contact with high-risk clients or working in chronic-care or those over 65 years


Hepatitis B

For those exposed to blood and body fluids containing blood OR who work with client populations in which Hepatitis B carriage is prevalent.


References

MRSA policy

Notifiable diseases policy

Recruitment policies

ISSUE DATE: February 2017

AUTHORISED BY: Harley Matthews

REVIEW DATE: February 2019