It has often been said that the telephone is the lifeline of the physician's office. Communication over the telephone requires understanding on the part of each communicator. Each medium uses the proper tools to get the job done. Speaking on the telephone is much like a conversation between two blindfolded individuals. The facial expressions cannot be seen, there is no eye contact, and there is no visual feedback. The listener will interpret mood by the tone and pacing of voice and the words spoken. When speaking on the telephone, quick conclusions are drawn. Often, we jump to conclusions, and the communication is misinterpreted.
The old, cold, aloof, formal business greeting comes across like frostbite in the medical office setting. It sounds curt, bored, and uncaring. Think of welcoming a new acquaintance into your homethen practice the same characteristics when speaking on the telephone. Speaking clearly, use words that will be easily understood and ask questions to verify that the patient has understood the message being conveyed. Concentrate on enunciating and being understood. If you hear, "What? I didn't understand you. I can't hear you," slow down and speak a little louder with distinct enunciation directly into the mouthpiece. The mouthpiece should be held one to two inches away from the mouth. Project your voice at the mouthpiece and then project another foot further. Your voice is the delivery system for your words and thoughts. Speak with confidence and conviction.
Have you ever called an office and had the firm name clipped off? The name of the office is important. To avoid clipping off the office name, practice using buffer words. Buffer words are expendable; if you clip them off, at least the office name remains intact. Use buffer words before the office name and before you identify yourself. "Good morning, this is Inner City Health Care. This is Walter, how may I help you?" Good morning and this is are buffer words.
All the techniques for effective face-to-face communication must be more intentionally observed when the communication is over the telephone because you cannot see the person with whom you are speaking. You must listen with full attention to make certain that the message sent and received is correct.
To close a telephone conversation to schedule an appointment, for example, consider the following:
1. Use the patient's name if it can be done without announcing the name to persons in the reception area.
2. Confirm the date and time of the appointment.
3. Identify which physician if there is more than one physician in the office.
4. Give any specific instructions that may be necessary.
5. Say goodbye.
Telephone Techniques For Medical Assistants
Biases and Prejudices Of Medical Assistants
Personal preferences, biases, and prejudices will enter into many physician-patient relationships. Such biases affect the types of communication possible. When individuals are not aware of their biases or prejudices, hostile attitudes may prevail. For therapeutic communication to take place, biases must be examined, a person's comfort level with each bias determined, and measures taken to ensure that a hostile attitude is not present. Bias is defined as a slant toward a particular belief. Prejudice is defined as an opinion or judgment that is formed before all the facts are known; prejudice is a preconceived and unfavorable concept. Common biases and prejudices in today's healthcare society of certified and non-certified medical assistants include:
a) A preference for Western style medicine
b) Choosing physicians according to gender
c) Prejudice related to a person's sexual preferences
d) Discrimination based on race or religion
e) Hostile attitudes toward persons with a value system opposite your own
f) A belief that persons who cannot afford health care should receive less care than someone who can pay for full services
Medical assistants must recognize such biases and prejudices so that their own culture with its biases does not prevent them from responding therapeutically in communications with patients. Such recognition requires being aware of the differences among human beings and willingly accepting the uniqueness of each person.
Universal Precautions By Centers for Disease Control and Prevention (CDC)
In an effort to curb the transmission of AIDS, hepatitis B, and other infectious diseases, in 1985 the CDC issued guidelines known as Universal Blood and Body Fluid Precautions or simply universal precautions. It is now known that consistent use and adherence to these guidelines greatly minimizes the risk of infectious disease transmission. At the recommendation of the CDC, health care providers were to consider every patient potentially infectious for AIDS, hepatitis B, and other bloodborne pathogens and to routinely and consistently use the techniques of universal precautions as a means of infection control.
Following is a summary of the CDC's universal precautions and guidelines for control of AIDS, hepatitis B, and other infectious diseases:
a) Consider all (patients') blood and body fluids to be contaminated.
b) Always wash hands before and after (patient) contact.
c) Always wash hands if contaminated with blood or body fluids.
d) Wear gloves when handling or touching blood, body fluids, body tissue, mucous membranes, nonintact skin, or contaminated equipment and supplies.
e) Wear gloves when performing venipuncture and other blood access treatments or procedures.
f) Change gloves after each patient contact.
g) Wash hands after glove removal. Gloves do not replace handwash technique.
h) Wear gloves, gown, mask, goggles/face shield if splashing of blood or body fluids can occur or if exposure to droplets of blood or body fluids is a possibility. Examples of this are wound care and endoscopy.
i) Use extreme caution when handling needles, scalpels, and other sharp instruments (sharps) during procedures and when handling them after procedures are completed. Dispose of sharps in an approved puncture-proof container that should be located as close as practical to the work area.
j) Use a mouthpiece if performing cardiopulmonary resuscitation although saliva has not been implicated in transmission of human immunodeficiency virus (HIV), the virus that causes AIDS.
k) Clean blood and body fluid spills with agency disinfectant or a 10 percent solution of sodium hypochlorite (household bleach).
l) Report needlesticks, splashes, and contamination by wounds or body fluids. Follow up with employee health services, physician, and other appropriate personnel.
m) Health care workers with open lesions (injury or wound) or dermatitis (skin rash) should avoid direct contact with patients and their supplies and equipment until healed.
n) Laboratory specimens and their containers are modes of disease transmission and gloves should be worn during handling.
o) Pregnant health care providers should be especially careful to adhere to the guidelines so as to protect themselves and the unborn child.
Above are the fifteen Universal Precautions By Centers for Disease Control and Prevention (CDC) for a medical assistant's medical safety!
Centers for Disease Control and Its Role In Infection Control
The Centers for Disease Control and Prevention (CDC) is responsible for studying pathogens and diseases in an effort to prevent their spread. A division of the United States Public Health Department, the CDC has issued a number of guidelines over the past twenty-five years that have enabled health care professionals to practice responsible infection control. As diseases evolve, and as new diseases are introduced into our society, the CDC revises and updates existing guidelines or issues new control measures to contain the spread of infection.
In 1970, the CDC developed a system of seven isolation categories for patients with infectious diseases. This category system included strict isolation, respiratory isolation, protective isolation, enteric precautions, wound and skin precautions, discharge precautions, and blood precautions.
In 1985, the agency released a set of guidelines known as Universal Blood and Body Fluid Precautions, or simply universal precautions. These infection control practices were written in response to an increase in acquired immunodeficiency syndrome (AIDS) and hepatitis B, both bloodborne diseases, and to other infectious diseases as well.
Beginning in 1991, the CDC infection control guidelines were reviewed and subsequently revised. In 1996, a new set of guidelines was released. Standard precautions reflect improved recommendations intended to protect all health care providers, patients, and visitors from a wide range of communicable diseases. At the same time that the CDC issued the new standard precautions, they also released a second tier of precautions called transmission-based precautions. These are intended to be used in addition to standard precautions when caring for specific categories of patients. To understand the evolution and intent of these various CDC infection control guidelines, universal precautions, standard precautions, and transmission-based precautions will be examined in more detail in our medical assistant's blog.
STANDARD PRECAUTIONS For Infection control for medical assistants
The STANDARD PRECAUTIONS For Infection control for medical assistants in a hospital or health care center are,
1) Wash Hands (Plain soap)
a) Wash after touching blood, body fluids, secretions, excretions, and contaminated items.
b) Wash immediately after gloves are removed and between patient contacts.
c) Avoid transfer of microorganisms to other patients or environments.
2) Wear Gloves
a) Wear when touching blood, body fluids, secretions, excretions, and contaminated items.
b) Put on clean gloves just before touching mucous membranes and nonintact skin.
c) Change gloves between tasks and procedures on the same patient after contact with material that may contain high concentrations of microorganisms. Remove gloves promptly after use, before touching noncontaminated items and environmental surfaces, and before going to another patient, and wash hands immediately to avoid transfer of microorganisms to other patients or environments.
3) Wear Mask and Eye Protection or Face Shield
Protect mucous membranes of the eyes, nose and mouth during procedures and patient-care activities that are likely to generate splashes or sprays of blood, body fluids, secretions, or excretions.
4) Wear Gown
Protect skin and prevent soiling of clothing during procedures that are likely to generate splashes or sprays of blood, body fluids, secretions, or excretions. Remove a soiled gown as promptly as possible and wash hands to avoid transfer of microorganisms to other patients or environments.
5) Patient-Care Equipment
Handle used patient-care equipment soiled with blood, body fluids, secretions, or excretions in a manner that prevents skin and mucous membrane exposures, contamination of clothing, and transfer of microorganisms to other patients and environments. Ensure that reusable equipment is not used for the care of another patient until it has been appropriately cleaned and reprocessed and single use items are properly discarded.
6) Environmental Control
Follow hospital procedures for routine care, cleaning, and disinfection of environmental surfaces, beds, bedrails, bedside equipment and other frequently touched surfaces.
7) Linen
Handle, transport, and process used linen soiled with blood, body fluids, secretions, or excretions in a manner that prevents exposures and contamination of clothing, and avoids transfer of microorganisms to other patients and environments.
8) Occupational Health and Bloodborne Pathogens
Prevent injuries when using needles, scalpels, and other sharp instruments or devices; when handling sharp instruments after procedures; when cleaning used instruments; and when disposing of used needles.
9) Never recap used needles using both hands or any other technique that involves directing the point of a needle toward any part of the body; rather, use either a one-handed "scoop" technique or a mechanical device designed for holding the needle sheath.
10) Do not remove used needles from disposable syringes by hand, and do not bend, break, or otherwise manipulate used needles by hand. Place used disposable syringes and needles, scalpel blades, and other sharp items in puncture-resistant sharps containers located as close as practical to the area in which the items were used, and place reusable syringes and needles in a puncture-resistant container for transport to the reprocessing area.
Use resuscitation devices as an alternative to mouth-to-mouth resuscitation.
Standard Precautions By Centers for Disease Control and Prevention (CDC)
The CDC spent several years researching, improving, and developing recommendations to protect health care providers, medical assistants, patients, and their visitors from infectious diseases. This intensive period of research resulted in standard precautions, a set of infection control guidelines that should now be utilized by all health care professionals for all patients.
Standard precautions combine many of the basic principles of universal precautions with techniques known as body substance isolation (BSI), a system that maintains that personal protective equipment should be worn for contact with all body fluids whether or not blood is visible. Although BSI was developed not by a federal or state agency but by a private hospital, its techniques nonetheless have been adopted by many health care facilities and medical assistants.
The rationale behind developing the new standard precautions was that while universal precautions and body substance isolation provide a good degree of protection, the CDC recognized that both could be improved upon. Advantages of the new standard precautions are that they include all of the major recommendations of universal precautions and body substance isolation, while incorporating new information; they simplify medical terminology to be as user-friendly as possible; they use new terms to avoid confusion with existing infection control and isolation systems; and they are intended to protect all patients, all health care providers, and all visitors.
According to the CDC, standard precautions are ''designed to reduce the risk of transmission of microorganisms from both recognized and unrecognized sources of infection in hospitals (CDC, 1994)." They apply to:
1. blood;
2. all body fluids, secretions, and excretions regardless of whether or not they contain visible blood;
3. non intact skin;
4. mucous membranes.
To be effective, standard precautions must be practiced conscientiously at all times by all certified medical assistants. Although standard precautions were intended primarily for use in acute care facilities such as hospitals, they can and should be applied in other types of facilities including the ambulatory care settings where many medical assistants are likely to be employed.
Precautions For HIV and HBV for medical assistants
In any of the acute viral hepatitis diseases, the liver becomes inflamed; in healthy persons, destroyed hepatic cells will regenerate except in elderly patients. There are five types of acute viral hepatitis, including hepatitis A (HAV); hepatitis B (HBV); hepatitis C (HCV); hepatitis D (HDV); and hepatitis E (HEV). The hepatitis B virus (HBV) represents the greatest risk to health care providers. While a new type B vaccine that confers 96 percent immunity is available for high-risk groups, it is nonetheless critical to practice standard precautions to curtail the transmission of this very preventable disease.
Hepatitis B (HBV) is easier to contract than HIV in perimenopause symptoms. Symptoms of HBV include loss of appetite, fatigue, nausea, headache, fever, and jaundice, a yellow discoloration of the skin. The liver function is impaired and, in severe cases, may even be lost. It is important to note that in some individuals HBV may be asymptomatic and can still damage the liver and possibly lead to cancer of the liver. Usually, once patients become infected, they remain so for life, and are capable of transmitting the virus to others.
Transmission of HIV and HBV:
HIV and HBV are transmitted essentially through the same means. Contracting either disease requires direct contact with the virus living in infected blood and body fluids. The viruses are transmitted primarily through the following means:
a) Sexual contact with an infected person (heterosexual, homosexual, or bisexual). The virus enters through the vagina, rectum, penis, or mouth.
b) Sharing needles for intravenous (IV) drug use with an infected person.
c)Receiving blood or blood products from an infected person (all blood collected for transfusions is routinely checked for HIV and HBV; therefore, risk from this source is now rare).
d)Intrauterine infection of the fetus by a pregnant infected woman.
Despite the similarities between HIV and HBV, the risk of contracting HBV is greater than contracting HIV. For example, HIV infection following an accidental needlestick is approximately 1 percent, while HBV infection following an accidental needlestick can be as high as 30 percent (Lane, 1993). Medical assistants and all other health care providers must understand the importance of protect-ing themselves from the viruses that cause AIDS and hepatitis B and other pathogenic microorganisms as well. Through strict adherence to standard precautions and routine infectious disease control measures such as those found in medical asepsis the risk of contracting an infectious disease is minimized for medical staff.
Personal Protective Equipment (PPE) For Medical Assistants
Universal, standard, and transmission-based precautions all make use of barriers or personal protective equipment (PPE). The barriers consist of gloves, mask, gown, and goggles/face shield. Gloves reduce the risk of contamination to hands but do not prevent needles or other sharp instruments from penetrating the skin. Masks and protective eyewear reduce the contamination risk to mucous membranes of the eyes, nose, and mouth. Gowns protect clothing from contamination. Barriers are used in various combinations depending upon the procedure or treatment being performed on patients. As a medical assistant, you may be exposed to infected blood and/or body fluids and must wear PPE!
Special Precautions must be taken by medical assistants while handling these equipments, they must wear personal protective equipment (PPE) at the time of handling,
1) Needlestick
One of the most common reasons for exposure to blood is caused by accidentally sticking oneself with a dirty (used) needle after performing invasive procedures such as injections and venipuncture. In the past, needlesticks were common due to the practice of needle recapping. Needles are no longer recapped, broken off, removed from syringes, or manipulated by hand in any way. They are disposed of in the approved puncture-proof container designated for sharps (Figure 4-2A). The risk to a health care provider of HIV infection caused by a needlestick is very slight; however, the risk for HBV infection caused by a needlestick can be significantly higher. (Additional information regarding specific procedures to follow should an accidental needlestick occur as well as other safety procedures will be found later in this chapter and are included in the OSHA and CLIA rules and regulations).
2) Disposal of Infectious Waste
Infectious waste (contaminated items) is described as any item that has come in contact with patient blood or body fluids. These items must be handled with gloves and disposed of by placing them in the appropriate biohazard containers that are provided by an agency with which your employer has contracted (Figure 4-2B). Infectious waste is either incinerated (burned) or subjected to sterilization by autoclave to render it harmless before it is disposed of in a sanitary landfill. The medical assistant should be placing a sturdy disposable plastic bag marked with the biohazardous waste symbol into a durable cardboard box for collection of infectious waste material. When full, these boxes are picked up by an agency for incineration or for autoclaving before disposal in a public landfill.
Methods to Prevent Exposure By Occupational Safety and Health Administration (OSHA)
The Methods to Prevent Exposure By Occupational Safety and Health Administration (OSHA) for medical assistants are,
There are seven major strategies mandated by OSHA for the prevention of exposure to bloodborne pathogens and OPIM.
1. Standard Precautions
Adherence to the CDCs Standard precautions is required; i.e., treating ALL bodily fluids and materials as if they are infectious. Handwashing is stressed and employers must provide handwashing facilities and must ascertain that employees use them frequently and especially following exposure to blood or OPIM.
2. Engineering Controls and Work Practice Controls
Engineering controls and work practice controls consist of the physical equipment and mechanical devices an employer provides in an attempt to safeguard and minimize employee exposure. A common example of an engineering control is sharps disposal containers (Figure 4-16). Others are mechanical pipettes, fume hoods, and splash guards. If and when occupational exposure continues after the engineering controls are in place, PPE must be used. Handwashing facilities or appropriate antiseptic hand cleanser (when handwashing facilities are unavailable) must be readily available. If antiseptic hand cleanser is used, hands must be washed with running water and soap as soon as possible. Employers must ascertain that employees wash their hands as soon as possible following the removal of gloves or other PPE, that employees wash hands and other skin surfaces with soap and water, flush eyes at the eyewash station, and flush mucous membranes with water as soon as possible following contact of these body parts with blood or OPIM.
3. Personal Protective Equipment (PPE)
When workplace exposure still exists after using engineering and work practice controls, employers must provide PPE at no cost to the employee. PPE is used to place a barrier between the employee and blood and/or OPIM that can contaminate skin, mucous membranes, or non-intact skin. PPE consists of such items as latex gloves, masks, goggles, face shields, gowns, laboratory coats, and plastic mouthpieces used during cardiopulmonary resuscitation (Figure 4-18). PPE provides protection only if it prevents blood or OPIM from permeating through it onto clothes, eyes, skin, mouth or other mucous membranes.
4. Cleanliness of Work Areas
The employer must maintain a work site that is clean and sanitary and have a written schedule for cleaning and decontaminating the work area after contact with blood and/or OPIM. Work surfaces that can become contaminated with blood or OPIM must be decontaminated after the work procedures are completed, after surfaces are contaminated, or at the end of the work shift. Some of the areas include counter tops, floors, examination tables, and wastepaper baskets. When cleaning a work surface where there is the possibility of blood or OPIM present, latex gloves must be worn. A 10 percent solution of household bleach is used; alcohol is ineffective. Gloves should be worn when the spill is wiped with paper towels.
5. Hepatitis B Vaccine
Hepatitis B vaccine must be made available free of charge to every employee, full-time, part-time, or temporary within ten days of work assignment. (This refers to employees who have the potential for occupational exposure, and who can "reasonably" be expected to have skin, eye, mucous membrane, or parenteral contact with blood or OPIM. The vaccine is given in three doses over a six-month time period and is used to protect the employee from infection with the hepatitis B virus. It is an intramuscular injection with an approximate 96 percent rate of effectiveness. An employee has the right to decline taking the vaccine, but must sign a declination form. There is the option to reconsider receiving the vaccine at a later time.
6. Follow Up After Exposure
An accidental exposure is broadly defined as one in which blood, blood-contaminated body fluids, or body fluids or tissues to which standard precautions apply are introduced onto a mucous surface, onto nonintact skin, or to the conjunctiva via a needlestick, skin cut, or direct splash. If an incident exposes an employee to any of these, the employer must make available a confidential medical evaluation in which is documented:
1) The circumstances surrounding the event
2) The route or routes of exposure
3) The identification of the person who was the source of the exposure
7. Medical Records
Medical records of an employee who has suffered an occupational exposure must be kept for the length of employment plus thirty years and confidentiality must be guaranteed. The following information is to be included in the employee's record: name and social security number, HB vaccination status with dates, results of any examinations or tests, a copy of the health care provider's written opinion, and a copy of the information that was provided to the health care provider. The records must be available to the employee, to OSHA, and anyone with the written consent of the employee, but not the employer.
Medical Assistants And Asepsis
All health care providers continually come into contact with patients who are ill. Some patients have communicable or contagious diseases; others may have a suppressed immune system that does not protect them from infection. In the course of performing your duties as a medical assistant, you will be in contact with blood and body fluids that may be highly infectious. It is of extreme importance to a medical assistant's health and safety as well as the health and safety of your patients be protected.
There are a number of infection control measures that can be used to reduce the transmission of bloodborne and other pathogens. Medical asepsis, also known as infection control, consists of procedures and practices that health care professionals use to prevent the spread of infection. State and federal agencies also have established policies, procedures, and guidelines for health care providers and employers to follow in order to reduce the risk of transmission of infectious diseases.
The Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, a division of the United States Public Health Department, is an agency that investigates various diseases in an attempt to control them and makes recommendations on how to prevent the spread of disease. The CDC issued the system of seven isolation categories for patients with infectious diseases; it recommended the guidelines known as universal precautions; and, in 1996, it released standard precautions, which represent the most current and comprehensive approach to infection control.
Two other governmental agencies that serve to regulate the safety of patients and health care workers are the Clinical Laboratory Amendments of 1988 (CLIA '88) and the Occupational Safety and Health Administration (OSHA). CLIA '88 comes under the aegis, or protection of asepsis and of the Health Care Financing Administration (HCFA) of the United States Department of Health and Human Services (HHS) of the federal government. OSHA comes under the United States Department of Labor. Both agencies require that health care settings, including clinical laboratories, adhere to the strict regulations that they set forth.
The purpose of CLIA '88 is to safeguard the public by regulating all testing of specimens taken from the human body. The purpose of OSHA is to require employers to ensure employee safety in regard to occupational exposure to potentially harmful substances. This also applies for medical assistants asepsis regarding the topic of Medical asepsis.
Federal Health and Safety Guidelines
Federal Health and Safety Guidelines For Medical Assistants are,
a) Standard Precautions Issued By Centers for Disease Control and Prevention (CDC), United States Public Health Department, Atlanta, Georgia,
Issued in 1996 to augment and synthesize universal precautions and techniques known as body substance isolation (BSI). Standard precautions contain measures intended to protect all health care providers, patients, and visitors from infectious diseases.
b) Transmission-based Precautions By CDC,
Designed to reduce the risk of airborne, droplet, and contact transmission of pathogens. These are used in addition to standard precautions and are intended for specific categories of patients.
c) Universal Blood and Body Fluid Precautions (Universal Precautions) By CDC,
Released in 1985 to assist health care providers to greatly reduce the risk of contracting or transmitting infectious diseases, particularly AIDS and hepatitis B.
d) Clinical Laboratory Amendments of 1988 (CLIA '88) By Health Care Financing Administration (HCFA), United States Department of Health and Human Services (HHS),
Safeguards the public by regulating all testing of specimens taken from the body!
e) Occupational Safety and Health Administration (OSHA) Guidelines By OSHA, United States Department of Labor,
Requires employers to ensure employee safety in regard to occupational exposure to potentially harmful substances!
Communication therapeutic skills for medical assistants
Of all the tasks and skills required of the medical assistant in the ambulatory care setting, none is quite so important as communication. Communication is the very foundation for every action taken by health care professionals in the care of their patients. Because medical assistants are often the liaison between patient and physician, it is critical to be aware of all the complexities of the communication process. A medical assistant shold describe effective communication principles, apply those principles to face-to-face communication as well as telephone communication, and describe the basic roadblocks to communication. The key word to all communication in the medical setting is therapeutic. In all conversation with patients, the more therapeutic the conversation, the more satisfied the patient will be with the care provided.
Importance of Communication
Communication in the health setting is the foundation for all patient care and is of the utmost importance. The majority of this communication in the ambulatory care setting will be therapeuticit will utilize specific and well-defined professional skills. Patients' satisfaction with their medical care is as much related to the effectiveness of the communication between themselves and their chosen health care provider as it is to the actual care itself.
A patient choosing a physician wants a clear understanding of the physician's professional and technical skills as well as the physician's ability to communicate. The patient may question family members and friends regarding their personal physician's professional manner and communication skills. Questions often asked include: ''Will your doctor talk with me so that I understand what is being said?" "Will your doctor listen to what I have to say?" "Can I talk to your doctor honestly and openly?" When communication is therapeutic, patients feel validated and respected. Therapeutic communication skills create a feeling of comfort for patients even when difficult or unpleasant information must be exchanged.
Cultural Influence on Therapeutic Communication
For true therapeutic communication to take place, the influence of culture must be considered. Cultural influences include one's ethnic heritage, geographic location and background, genetics, economics, educational experiences, life experiences, and value system.
Any or all of these influences may exhibit themselves when health care is sought by patients. A patient's ethnic heritage may indicate a slant toward the Eastern influence in medicine as opposed to the traditional Western style more commonly taught and practiced in the United States today. Geographic location and background may reveal that a person is more comfortable with a family physician in a very small clinic than in a large metropolitan multispecialty practice. The influence of economics may reveal a discomfort if the office staff and patients have a different perception about how billing is managed and when and how payment is expected.
Educational and life experiences will, in part, determine how patients react to their care. Patients with family members being treated for a chronic illness will have more knowledge and understanding of that illness in their own lives. Individuals who have already suffered a great deal of loss and grief in their lives may handle the information of a life-threatening illness more easily than someone who has experienced little grief.
Causes Of Transmission Based diseases and Precautions
The Causes Of Transmission Based diseases and Precautions For Medical Assistants are,
When the CDC was in the process of developing a new guideline for isolation precautions in hospitals, the agency arrived at what it terms two tiers of precautions. The first tier is called the standard precautions, discussed earlier in this chapter, designed for all patients regardless of their diagnosis or presumed infection status. The second tier of precautions is intended for patients diagnosed with or suspected of specific highly transmissible diseases. These are known as transmission-based precautions.
Transmission-based precautions condense the seven existing categories of isolation precautions developed by the CDC in 1970 into three sets of precautions based on routes of infection. Released in 1996 to complement standard precautions, transmission-based precautions reduce the risk of airborne, drop-let, and contact transmission of pathogens and are always to be used in addition to standard precautions. These airborne, contact, and droplet precautions also list specific syndromes that can appear in adult and pediatric patients who are highly suspicious for infection. They identify the appropriate transmission-based precautions to be used until a diagnosis can be made.
Causes of Disease and Disease Transmission
When providing patients with health care, medical assistants run the risk of contracting, or acquiring, an infection from pathogens that are causing patients' illnesses. Such pathogens are viruses, bacteria, fungi, and others that can be found in patients' blood and body fluids. In medical offices, ambulatory care centers, and hospitals, many ill patients are seen every day. Pathogens can be easily transmitted to another person if care is not taken to prevent such an occurrence. Consistent use and adherence to infection control measures significantly reduce the risk of disease transmission. The CDC recommends that health care providers consider each patient to be potentially infectious for AIDS, hepatitis B, and other bloodborne pathogens and to routinely and conscientiously apply the techniques of standard precautions as a means of infection control.
Avoiding Exposure to Chemicals For Medical Assistants
Students may come into contact with harmful chemicals when doing procedures that can cause such problems as burns to the skin and eyes. Students will be made aware of these through information packaged with kits and MSDS. If the chemical comes in contact with the skin, it must be washed with water immediately and continued for five minutes. Chemicals that get into the eye must be rinsed for fifteen minutes (unless contradicted on the label). Eyewash stations and showers should be available in case of accidental exposure to hazardous chemicals with a follow-up in the emergency room.
Chemical spills should be carefully cleaned following the procedure for the particular chemical. Spill clean-up kits that consist of various items such as a shovel, cardboard, PPE, neutralizing agent, and/or absorbent material should be available.
Toxic fumes can occur with certain chemicals and certain tests can cause lung irritation and damage. This type of chemical should be handled under a fume hood that will take the fumes away by means of a ventilation mechanism.
A student safety laboratory manual outlining an exposure control plan with emphasis on standard precautions, PPE, work practice controls, lists of hazardous chemicals, and MSDS should be compiled and accessible. Students should be thoroughly familiar with its contents. Additionally, students should be educated as to the location and identification of hazardous chemicals just as employees are.
It is of utmost importance that students learn about and understand the OSHA standards and comply with them. In so doing, they will safeguard themselves from harmful chemicals and bloodborne pathogens.
Airborne Precautions For Medical Assistants
Airborne Precautions in the Category of Transmission-based Precautions for medical assistants are,
1) Patient Placement:
a) Use private room that has:
b) Monitored negative air pressure,
c) 6 to 12 air changes per hour,
d) Discharge of air outdoors or HEPA filtration if recirculated.
e) Keep room door closed and patient in room.
2) Respiratory Protection
a) Wear an N95 respirator when entering the room of a patient with known or suspected infectious pulmonary tuberculosis.
b) Susceptible persons should not enter the room of patients known or suspected to have measles (rubeola) or varicella (chickenpox) if other immune caregivers are available. c) If susceptible persons must enter, they should wear an N95 respirator. (Respirator or surgical mask not required if immune to measles and varicella.)
3) Patient Transport
a) Limit transport of patient from room to essential purposes only.
b) Use surgical mask on patient during transport.
4) Patient Placement
a) Private room, if possible. Cohort if private room is not available.
5) Gloves
a) Wear gloves when entering patient room.
b) Change gloves after having contact with infective material that may contain high concentrations of microorganisms (fecal material and wound drainage).
c) Remove gloves before leaving patient room.
6) Wash
a) Wash hands with an antimicrobial agent immediately after glove removal. After glove removal and handwashing, ensure that hands do not touch potentially contaminated environmental surfaces or items in the patient's room to avoid transfer of microorganisms to other patients or environments.
7) Gown
a )Wear gown when entering patient room if you anticipate that your clothing will have substantial contact with the patient, environmental surfaces, or items in the patient's room, or if the patient is incontinent, or has diarrhea, an ileostomy, a colostomy, or wound drainage not contained by a dressing. Remove gown before leaving the patient's environment and ensure that clothing does not contact potentially contaminated environmental surfaces to avoid transfer of microorganisms to other patients or environments.
8) Patient Transport
a) Limit transport of patient to essential purposes only. During transport, ensure that precautions are maintained to minimize the risk of transmission of microorganisms to other patients and contamination of environmental surfaces and equipment.
9) Patient-Care Equipment
a) Dedicate the use of noncritical patient-care equipment to a single patient. If common equipment is used, clean and disinfect between patients.
What Is The Job Of Medical Assistant?
The medical field is very wide with different areas to cover when it comes to picking a solid career. If you've always wanted to work in this field without going through the years to be a doctor, and if you simply do not have the interest to be a nurse, then why not try your hand at becoming a medical assistant :)
What exactly is the job of medical assistant ? Well, first of all you need to know that filling this position would mean that you become the wingman to your employer who would be a doctor or surgeon. Your job would revolve around task carried out at the front desk and in the back room as well. At the front desk, you are a little like a secretary but of a higher standard as you won't only be in charge of calls, mails, faxes and making appointments but you would be required to keep in touch with various insurance companies associated with the patients. You would also need to keep track of supplies and put in orders as and when it's called for.
The back room is where all the action takes place, this is where your knowledge comes in handy. Here, you would play the role as the co-doctor by taking down the patients information and basic routine test such as weight and height measurements, blood pressure, filling up medical history forms as well as questioning and listening to the patients. Aside from that, you would also need to assist the doctor in simple medical procedures such as drawing blood, cleaning wounds and removing stitches.
With the right training and enough experience, as a medical assistant, you could be yielding a good salary of about $20,ooo per year. Hence, it is also important for you to be certified or you won't be able to land a good job despite the high demand for the job.
The above article confirms that the job of a medical assistant is worthwhile if you are really interested in it!
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Certified Medical Assistant Salary
Salary of a certified medical assistant may be lesser compared to somebody who has more broad training in health care, for example, a nurse or a doctor, but it is still a very admired and wealthy career choice for both male and female. No one can deny that people who choose a profession in medicine typically draw in a healthy salary per year. This is true regardless if you are a doctor, a lab person or a medical assistant. Even if earnings do differ depending on the level of training and range of responsibilities given, it is always said that working in a medical environment is quite profitable and rewarding!
At the starting point of your job, certified medical assistant salary is normally in the 25,000USD to 30,000USD range. This is the amount that someone “who has completed their Medical Assistant Education and received their certification can look forward to earn” once they take a full-time position at a medical institution. The place where the person works will also verify how high his salary is going to be. A doctor's private office, such as a professional surgeon's office will pay elevated salary than a nursing home or public hospital would. One of the big advantages of working in a private office is the dedicated experience that can be gained.
Working as a medical assistant in a reputed health institute is a career path that many trained assistants chooses to follow. It is common for these types of positions to be concentrated within colleges and universities around us. A certified medical assistant salary is on standard $27,000 for a person who is able to secure a position of responsibility.
Salaries evidently boost as the person gains experience and skills with time and hard work. Also keep in mind that as the demand for skilled and trained medical assistants increases, the salary range will move upwards as well. As we can see that only two years of schooling is required to get a degree, this is an amazing career path for someone wanting a position that promises a worthwhile salary without the additional trouble of spending years in lessons and classes.
We have seen different examples that salary of Medical Assistants differ with locations. For e.g. Comprehensive details of salary of a Medical Assistant by State shows that New York currently has the highest average salary. Number of medical assistant jobs in New York City are also high, according to the Medical Assistant Salary by City chart, the peak average salary medical assistants will find is in the Big Apple. With the recent economic depression, many medical assistants and other health care workers are wondering what steps to take for best possible career expansion. My advice is to amplify your medical assistant education, by completing a medical assistant qualifications program or other Medical trainings to enlarge the scope of your profession and gain a respected medical assistant salary!