Biomedical Engineering Reference
In-Depth Information
(
B
)
(
A
)
Figure 17.10
(
A
) Turbo and (
B
) plume pen: examples of plume evacuation system and capture device for electrosurgery.
employee, to ensure of a tight seal, and must be secured and
worn properly at all times if they are to be effective, and in
compliance with OSHA regulations on respiratory protection.
If a facility is going to follow standard precautions (blood-
borne pathogens standard), then high-fi ltration masks should
be worn for all surgical plume producing cases, that is, about
95% of all procedures. This can be a costly and relatively inef-
fective control measure, and it is recommended that infection
control nurses work with facility managers to develop a rea-
sonable policy and procedure for the use of protective face
masks.
Wall suction lines should always be protected with in-line
fi lters that are placed between the wall inlet and the fl oor can-
ister. Though these fi lters may decrease suction strength, they
will prevent the buildup of particulates and debris in suction
lines in the wall, which often results in expensive repairs to the
central vacuum system.
All materials used to collect and handle surgical plume
should be considered as biohazard, and disposed of according
to infection control procedures. Staff must wear masks, gog-
gles, and gloves to change and handle fi lters, and should place
all used materials in biohazard bags.
the need for additional control measures. Audits should always
be done when new systems or procedures are initiated.
Audit requires completing each of the following steps:
1. Inventory all equipment and develop a checklist
2. Inspect every item on the checklist, assessing its con-
dition, placement, and handling
3. Interview staff working with the laser systems
4. Observe laser procedures (setup, testing, and intra-
operative management)
5. Document results
6. Remedy defi ciencies identifi ed
7. Monitor outcomes and follow-up
An inventory/checklist includes laser unit, keys, and storage
system; delivery devices, signs, protective eyewear, window
barriers, logs, tanks, supply carts, plume evacuation systems,
lens fi lters for microscopes and endoscopes, cleavers and strip-
pers for fi bers, operation manuals, adapters, and policy/proce-
dure manuals. Include all lasers and all systems in all areas of
the facility, including ophthalmology clinics, hospital owned
professional offi ces, emergency room, day surgery, cardiac cath
lab, dental unit, physiotherapy, or any other clinical or research
area. If the facility operates a mobile service or satellite centers,
all lasers in those areas must be included as well.
Questions to ask during an audit are as follows:
risk management step 4:
audit for safety program monitoring
Safety audits monitor compliance with facility policies and
procedures. The LSO will determine the frequency of the
audit, which is based on the number of lasers, number of users,
case numbers, and number of people involved. The greater the
numbers and heavier the use, the more frequent the audit
should be. Audit should be done at least once a year.
A laser safety audit, for those that have not done one, is sim-
ply an assessment of staff compliance, equipment, supplies,
and documents involved in performing laser treatments in a
facility. It can be performed by anyone familiar with the sys-
tems, but must be supervised by the LSO, who is ultimately
responsible. Audits help identify areas of defi cit requiring fur-
ther education and training, purchase of new equipment, or
1. Is it where it should be? (stored, covered, cleaned)
2. Does it work properly? (test all delivery systems and
controls)
3. Is it being handled and used properly? (observe staff,
sign posting, eyewear etc.)
4. Is it safe? (all parts present and correct policies pres-
ent, etc.)
5. Is it intact?
6. Does it need repair or replacement?
7. Has it been misused or abused?
Results should be documented and reported to the program
administrator, for action. The purpose of an audit is to identify
