Safe Practices and Procedures to follows to prevent transmission of HIV/AIDS

2. Safe Practices and Procedures – is intended to prevent transmission of HIV/AIDS from patient to staff, staff to patient, staff to staff and patient to patient.

a. Wash hands thoroughly as often as needed.
b. Follow the disinfection and sterilization guidelines faithfully.
c. Wear gloves, gown, mask and protective eyewear during surgery, child delivery and other procedures where contact with blood or body fluids are likely.
d. Protect any skin disease or injury with gloves or any impermeable dressing to avoid contamination with body fluid.
e. Cover with household bleach (dilution of 1:10) for 30 minutes any spill of blood or potentially contaminated materials then have it carefully wiped off by personnel wearing gloves.
f. Discard immediately used needle and other sharp objects in punctured proof containers marked BIOHAZARDS. Do not bend break needles hand, do not recap used needles.
g. Reusable needles and syringes should be handled with extreme care and safely stored prior to cleaning and sterilization or disinfection.
h. Linen soiled with blood or other body fluids should be handled as little as possible. Gloves and protective apron should be worn while handling soiled linen.
i. Specimens of blood and body substances should be handled as potentially infectious.

Policies on Reporting Cases of Communicable Diseases

1. All cases of immediately notifiable diseases, syndromes and events seen at the OPD or admitted at the hospital should be reported immediately to MHO, PHO/PESU, CHD/RESU and NEC, with 24 hours of detection by the fastest means possible.

The immediately notifiable diseases, syndromes or events include:
 Acute Flaccid Paralysis
 Adverse Events Following Immunization(AEFI)
 Anthrax
 Human Avian Influenza
 Measles
 Meningococcal Disease
 Neonatal Tetanus
 Paralytic Shellfish Poisoning
 Rabies
 Severe Acute Respiratory Syndrome (SARS)

2. Specific ER Personnel should be assigned to attend, to suspected cases, to minimized closed contact and prevent transmission of disease.

3. Initial report can be verbal using the telephone or written via facsimile or e-mail.

4. Fill-up a hospital case-based reporting form using the standard PIDSR case investigation form which will be forwarded immediately to PESU/RESU/NEC.

5. Communicable diseases admitted for some emergency measures should not be kept longer than necessary in the hospital.

6. Arrangement must be made for their transfer with all the necessary precautions.

Policies and Procedures regarding Telephone Orders

1. When the order is given through telephone, the nurse should call the physician on duty to receive the order. It is the physician on duty who should write on the order sheet.
And let the doctor sign the order immediately when he/she visit the patient.

2. Verbal order through telephone made by the doctor shall be written in patients chart with the date and time of order.

Policies and Procedures on time intervals to act on orders for treatment – Doctors Order, Time Interval for IV Medication

1. Doctors’ order must be carried out 30 minutes after rounds.

2. All orders prior to treatment and medication should be completely and clearly stated in writing, dated and signed by the Physician.

3. For any doubt or need for further clarification of an order or direction, refer to the physician who issued the order.

4. Be sure that the right of patient to receives the right dose of the right drug via the right route of the right time.

5. Give IV Meds with 30 minutes interval to the other IV Meds.

6. Carefully monitor the patient for any adverse effect for at least 15 minutes after administration of any medication.

Policies on Proper Housekeeping Procedure basically in Hospital

Basically, Housekeeping involves many tasks and one of that is Lauderings.

In Hospital we need to manage and follow the right and proper housekeeping techniques.


Here are some tips to be follows:

• Proper segregation of infectious to non infectious linen.
• Infectious linen should be treated with hot water and bleach using heavy duty gloves, eye protector and mask to protect against splashes.
• Washing and Ironed the linen every day.
• Proper maintenance and arrangement of linen should be properly maintained.
• Cabinet should be cleaned and inspect regularly specially space under shelves.
• The premises should always be kept clean and free from dust.
• Cleanliness of the whole promises should always be maintained.
• Washing machine should be washed with disinfectant every after used.
• Cleaning of the toilet every day and well maintained. technique
• Mop the floor with water and disinfectant every day.

POLICIES AND GUIDELINES ON PASSLIP

All Government Employees are requires to follows some guidelines relating to pass slip. These are:
1. Employees are entitled only for one (1) pass slip within a week, four (4) times in a month, but not to exceed five (5) times in a month.

2. Pass Slip shall be given only to any employee if it is on official business, stating the time, e.g.: 8:00am to 12:00noon (morning session half day) or 1:00pm to 5:00pm (afternoon session half day) or most probably pass slip is given during 2:00pm-5:00pm or either 3:00pm-5:00pm; indicating the reasons and purposes of pass slip. If it is one (1) day official business, it should be supported by Travel Order (TO) not Pass Slip. Official business means out-on-post in relation to your jobs, duties and responsibilities or any related works pertaining to the assigned tasks given to any employee.

3. Employee is required to file his/her leave of absence instead of having a pass slip if his/her business is personal. Personal business means out-on-post in relation to his/her personal transactions.

4. Before an employee can avail a pass slip, it should be first signed by him/her, initialed and recommended by the Department Head Section, approved by the Administrative Officer and noted by the Chief of Hospital.

Policies and Procedures for the safe and efficient direction of Patients their families and visitors and staff traffic.

1. Clear signage and proper directions should be posted in all areas.

2. Limitations of visitors, visiting hours should be posted in the entrance of hospital.

3. Consultation time of OPD cases, flow chart of emergency cases should be posted in waiting areas for proper direction of treatment.

4. Maintain emergency entrance clear at all times, wheelchairs, stretchers should be placed in appropriate area.

5. Proper endorsement of patient should be utilized by all health professionals so that continuity of care is not delay.

PROCEDURES TO FOLLOW ON WORKERS SAFETY AT WORK

UTILITY SYSTEM SAFETY
• Should be trained for proper packing, handling and storing of hazardous health care waste
• The need to wear protective gloves, shoes and aprons when handling waste containers
• Operation of on-site treatment and disposable methods such as single chamber furnace operation, encapsulation and safe burying
• Technicians and utility in charge of chemical disinfection should be trained to implement appropriate safety precautions and emergency measures and be informed about chemical hazards. Nurses and cleaning personnel should be aware of the occupational risk linked to handling sharps.

ELECTRICAL SAFETY
• The most important consideration for electrical safety in any hospital area is the power line and electrical grounding system
• All electrical design and installation must follow the implementing rules and regulation given by national electrical code and meet safety standards
• Inspect wiring of equipment before each use. Replace damaged of frayed electrical cords.
• Know the location and how to operate shut-off switches and /or CKT breakers panels
• Use safe work practices every time electrical equipment is used
• Limit the use of extension cord
• An electrical cords and wires have sufficient insulation to prevent direct contact
• Only equipment with 3 prong plugs should be used in Lab., OR, DR and ER. The third prong provides a path to ground for internal electrical short circuits thereby protecting the user from a potential electrical shock hazard. Circuit protection devices should be installed for automatically limit or shut off the flow of electricity in the event of ground fault, over load or short circuit in the wiring system

MECHANICAL SAFETY
• Be sure that all of the safety devices with which a machine is equipped are in the proper location and order before using the machine
• Safety goggles or face shield of an approved type should be worn at all times in shop or laboratory
• Avoid touching, moving parts of mechanical machinery
• When you approach someone who is operating the machine, wait until he has finished that particular operation or process before you attract his attention.
• If more than one person is assigned to work on a certain machine, only one person should operate the controls or switches
• Never leave a machine while it is running or in motion
• Request help from fellow worker when it is necessary to lift heavy machine accessory or heavy objects
• Know the operations principles, method of use and safety precautions of machines, tools and equipment before attempting to use them

MEDICAL EQUIPMENT SAFETY
• Planned preventive maintenance should be done for every electro-medical apparatus to make health care equipment available, clean and effective and safety for the use of patients and operators
• Electrical and mechanical safety tests are performed by qualified service personnel or technician on every piece of equipments to ensure safety
• All patient care equipment as well as clinical laboratory instruments, diagnostic imaging equipment and a variety of other devices used for medical purpose has passed for electrical safety procedures and international standards for safe current limits for electro medical devices.
• Perform corrective maintenance on a piece of equipment to restore it to its proper condition
• Ensure performance verification and calibration, verified that the equipment is fully operational and performing within reasonable and previously specified limits.

DIFFERENT STEPS ON CHEMICAL SAFETY CONTROL

ENGINEERING CONTROLS
• Substitution of a less toxic materials
• Change in process to minimize contact with hazardous chemicals
• Isolation or enclosure of a process or operation
• Use of wet methods to reduce generation of dusts or other particulates
• General dilution ventilation
• Local exhaust, including the use of fume hoods

WORK PRACTICE AND ADMINISTRATIVE CONTROL
• Good practices can help to reduce the risk of exposure to chemicals
• Administrative controls involves rotating job assignments and adjusting work schedules so that workers are not over exposed to a hazardous chemical

USE OF PERSONAL PROTECTIVE EQUIPMENTS
• Safety goggles
• Face shields/ mask
• Protective clothing and foot wear
• Gloves

SAFE WORK PRACTICES AND PROCEDURES FOR FLAMMABLE AND COMBUSTIBLE LIQUIDS AND SOLID
Flammable and combustible liquids – vaporize and form flammable mixtures with air when open containers, when leak occurs or when heated.
STORAGE OF FLAMMABLE AND COMBISTIBLE LIQUIDS
• Flammable and combustible liquids should be stored only approved containers. A safety can is an approved container of not more than 5 gallons capacity that has a spring closing lid and spout cover.
• Flammable liquid storage cabinet is an approved cabinet that has been designed and constructed to protect the contents from external fire.
Storage cabinets must also be conspicuously labeled.
• Handling precautions the main objectives in workings safety with flammable liquids is to avoid accumulation of vapors and to control source of ignition
• Flammable aerosols
Flammable liquids in pressurized containers may rapture and aerosolize when expose to heat, creating a highly flammable vapor cloud as with flammable liquids, these should be stored in a flammable storage cabinet.
• Flammable and combustible solid
Many flammable solids react with water and cannot be extinguished with conventional dry chemical or carbon dioxide extinguishers.
 Ensure class “D” extinguishers where flammable solids are used or stored.
 Sand can usually be used to smother a fire involving flammable solids keep a container of sand near the area.

Policies and Procedures in determining admissibility of patients on the need for referral to other organizations

1. Emergency service must be given at any hour of the day or night or any one brought to the hospital in any emergency condition.

2. The patient must be examined carefully. Initial assessment must be including the V/S and soaping. The personnel data and registration of the patient can be taken when the patient’s condition is stable.

3. All needed laboratory and ancillary procedure must be required of “STAT” if such procedure/s is/are needed for the final disposition of the patient.

4. When in doubts as to diagnosis or treatment do not hesitate to consult the other member of the medical staff and/or consultation.

5. If the patient requires hospitalization but the patient refuse to be hospitalized the patient will be requested to sign the release paper and properly witnessed.

Policies and Procedures on Proper Handling and Safe Disposal of Sharps/Needle Sticks

1.      Sharps/needle sticks should be stored in a puncture-proof containers and fitted with covers.

2.      Containers should be rigid and impermeable to retain or contain residual liquids from syringes.

3.      Needles should not be removed from the syringes because of the risk of injury, however if removal is required, special care should be taken.

4.      The sealed sharps/needle stick container must be properly labeled.

5.      Satisfactory treatment prior to disposal of sharps/needle wastes is necessary to maximize safety and protection of environment.

6.      Use incinerators for disposing used needles or sharps.

7.      In case there’s no available incinerator, bury the used sharps and needles as deep as possible.

      8.   The burial site should be lined with a material of low permeability such as clay to
             prevent ground waste contamination.

Vaccines against measles

   No specific treatment exist for measles and because of the extreme infectiousness of the disease, measures to control outbreaks in highly susceptible communities almost invariably fail. Preventative vaccination is the only rational approach to measles control.

   The live, attenuated measles vaccines that are now internationally available have an acceptable safety profile are effective and relatively inexpensive and may be used interchangeably in immunization programmes. Where measles vaccine has been combined with rubella vaccine (MR) or mumps and rubella vaccine (MMR) the protective immune response to the individual components remains unchanged. The use of such combined vaccines is logically and pro-grammatically sound and is recommended is areas where the disease burden of mumps and rubella is high when the vaccine coverage rates can be sustained.

   Immunization against measles is recommended for all susceptible children and adults for whom measles vaccination is not contraindicated. The vaccine should be used to prevent outbreaks rather than to try and control outbreaks. Large-scale vaccination to control ongoing outbreaks is of limited value.

Meclizine HCl (12.5mg) - 100 Caplets

Measles is an extremely contagious disease

 Merck Mmrii Vaccine 0.5Ml Measles Mumps And Rubella - Box of 10 - Model 00000468100
Measles virus is an enveloped, ribonucleic acid virus of the genus Morbillivirus, a member of the Paramyxoviridae family. It is single-stranded, of negative polarity, and is antigenically stable, and only one serotype exists. The envelope of measles virus contains haemagglutinin and fusion protein. The haemagglutinin is responsible for viral binding to the surface of host cells and the fusion protein for viral uptake into the cell. Antibodies to haemagglutinin correlate with protection against disease. Measles virus which is probably the most infectious agent causing human disease is an exclusive human pathogen and it has no animal reservoir.

Measles is an extremely contagious viral disease that affected almost every child in the world, before the widespread use of measles vaccines. Immunization with two doses of measles vaccine is recommended for all susceptible children and adults for whom measles vaccination is not contraindicated. The vaccine should be used to prevent outbreaks before disease occurs rather than large-scale vaccination to control ongoing outbreaks, which is of limited value.

Ilang Contribution po ba sa philhealth ang dapat bago makagamit nito?

ang philhealth ay may kanya kanyang kategorya. dapat mo munang malaman kung saang kategorya ka nabibilang. ito ay ang mga kategoryang dapat mong pagpilian;

1. kapag nagtratrabaho sa gobyerno at sa pribado
2. kapag nagbabayad ng kusa
3. kapag kasapi sa isang grupo
4. membrong di nagbabayad o non-paying members
5. indigents groups

Kung wala pong MDR Members Data Record ano po ang dapat gawin?

Kung wala kang MDR dapat lamang magdala ng Valid Philhealth ID Cards at magfill up ng Members Data Ammendment Form 2 or M2 at iparecived sa pinakamalapit na Philhealth Opis sa inyong lugar o kaya naman ay sa Philhealth Authorized Personnel na nagpupunta sa inyong munisipyo kada isang araw sa loob ng isang linggo.

Sample of Members Data Ammendment Form 2 or M2

Sample PhilHealth Number Cards / Identification Cards / Certificates

Samples of accredited or accepted philhealth Number Cards/Identification Cards / and certifications

• For employed sector government/ private
• Individually Paying Members
• Indigents
• Non-paying Members

Philhealth Cards for Employed Privately, Government and Individually Paying Members

Identification Cards for Non-Paying Members

members that contributes 120 months with ages of 60 years and above

Philhealth Indigent Cards

sponsored by the Government for the indigents families

Sample of Members Data Records Form (MDR)

Here are some samples of MDR

2-WAY REFERRAL SYSTEM

2-WAY REFERRAL SYSTEM

for medical to health center

Flowchart for OPD Cases (Admitted Patient)

Flowchart for OPD Cases

(Admitted Patient)

Flowchart for Emergency Cases (Non - Admitted)

Flowchart for Emergency Cases

(Non - Admitted)