22 1 Introduction o Preparation of the exam

22 -1 Introduction o Preparation of the exam room and treatment area n n o Common layouts Cleanliness and supplies Comfort of room Safety Accessibility based on the Americans with Disabilities Act © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -2 The Medical Assistant’s Role in Preparing the Examination Room o Maintain neatness and cleanliness of the room o Ensure that all supplies and equipment needed are present for the physician’s use o Make certain that potential safety hazards are eliminated © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -3 The Medical Assistant’s Role in Preparing the Examination Room (cont. ) o Main concerns are © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -4 Apply Your Knowledge What are three tasks the medical assistant should do to prepare the examination room? ANSWER: The medical assistant should v Maintain neatness and cleanliness of the room v Ensure that all supplies and equipment needed are present for the physician’s use v Make certain that potential safety hazards are eliminated © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -5 The Examination Room o The area where the physician: n n n Observes the patient Listens to patient symptoms Performs a general physical examination o Used to confirm health or diagnose a medical problem © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -6 The Examination Room (cont. ) o Number and size of rooms n Depends on the number of physicians in the medical practice n Average size room is 8 × 12 ft n Rooms should be large enough for patient, physician, and medical assistant, yet small enough to have supplies within reach © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -7 The Examination Room: Furnishings o Should be arranged for: n n n o Efficiency Patient comfort Physician convenience Items commonly found in examination rooms Ø One or more chairs Ø A rolling stool Ø Weight scale Ø Biohazard container Ø Wastebasket with lid Ø Puncture-proof containers Ø Wall brackets Ø High-intensity lamp © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -8 Special Features o The 1990 Americans with Disabilities Act (ADA) n Requires “reasonable accommodations” n Compliance requires that medical office be accessible to patients with disabilities o Accessibility – the ease with which people can move in and out of a space © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -9 Special Features Doorway must be at least 36 inches wide ADA Guidelines Grab bars in lavatories Clearance space in rooms and hallways at least 60 inches wide Door-opening hardware can be grasped with one hand does not require twisting of the wrist to use Door closers must be adjusted to allow entry and exit time Slip-resistant floors © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -10 Apply Your Knowledge When arranging an examination room, what three things should you consider? ANSWER: You need to consider efficiency, patient comfort, and physician convenience when arranging an examination room. Right! © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -11 Cleanliness in the Examination Room o Strict housekeeping standards o Adherence to government guidelines o Infection control n Make hand washing a priority n Keep examining table clean n Disinfect all work surfaces © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -12 Cleanliness in the Exam Room (cont. ) o o Clean hands – first step in preventing infection transmission Wash hands n n n n At the beginning of the day Before and after contact with each patient Before and after using gloves Before and after eating After coughing or blowing your nose Before handling clean or sterile equipment Before leaving for the day © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -13 Cleanliness in the Exam Room (cont. ) o Examining table n Change the disposable paper covering the examination table after each use o n Dispose of paper coverings soiled by body fluids in a biohazardous waste container Also place soiled linens and pillowcases in biohazardlabeled bags. © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -14 Cleanliness in the Exam Room (cont. ) o Surfaces n n 10% bleach solution or product approved by the EPA Disinfect work surfaces if visibly contaminated and at end of shift o Sink and countertops o Examination table o Patient lavatory o Storage n Store biohazardous specimens properly n Store testing kits properly © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -15 Cleanliness in the Exam Room (cont. ) o Putting the room in order n n o Straighten room between patients Boosts patient confidence in efficiency and abilities of medical personnel Housekeeping n Janitorial services for after-hours cleaning o n Monitor for lapses in cleanliness Medical assistant may do some housekeeping chores © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -16 Good Job! Apply Your Knowledge A medical assistant at a busy pediatrician office notices a foul odor in two of the patient examination rooms. After careful inspection, the medical assistant finds soiled diapers in the biohazardous containers of both rooms. How would you handle this situation? ANSWER: The first priority is to remove the source of odor, then to decontaminate the area. It may also help to designate a separate location in the office for soiled diapers so that parents will know how to dispose of them. Many pediatrician offices have a system in place to prevent such odors in treatment room areas. © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -17 Room Temperature, Lighting, and Ventilation o Maintain examination room temperature at about 72°F o Eliminate drafts from windows and doors © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -18 Room Temperature, Lighting, and Ventilation (cont. ) o Good lighting needed n Accurate diagnoses n Perform medical procedures n Read orders and instructions n Prevent accidents © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -19 Room Temperature, Lighting, and Ventilation (cont. ) o Examination area should smell clean and fresh o Eliminate source of odors o If opening windows, monitor room temperature o Room deodorizer or spray © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -20 Apply Your Knowledge Why is it important to have good lighting in the examination room? ANSWER: Good lighting is needed for making accurate diagnoses, performing medical procedures, reading orders and instructions, and preventing accidents. Excellent! © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -21 Medical Instruments and Supplies o Tasks to maintain instruments and supplies n Order and stock all needed supplies n Sanitize, disinfect, and/or sterilize instruments as needed n Instruments and supplies should be placed within easy reach for the physician © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -22 Mayo Stand or Tray © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -23 Medical Instruments and Supplies (cont. ) o Instruments used in a general physical exam Instrument Purpose Anoscope Used to open the anus for examination Examination Light Provides additional lighting Laryngeal Mirror Nasal Speculum Reflects inside of mouth and throat Used to enlarge the opening of the nose Ophthalmoscope Used to examine the inner eye surfaces © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -24 Medical Instruments and Supplies (cont. ) Instrument Purpose Otoscope Used to examine the inner ear Penlight Small flashlight used to view a small area Reflex Hammer Used to check patient’s reflexes Sphygmomanometer Used to measure blood pressure Stethoscope Used to listen to body sounds © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -25 Medical Instruments and Supplies (cont. ) Instrument Tape Measure Purpose Thermometer Used to measure size or development of an area Used to measure body temperature Tuning Fork Used to test patients’ hearing Vaginal Speculum Used to enlarge the vagina for specimens from cervix and vagina © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -26 Medical Instruments and Supplies (cont. ) o Inspecting and maintaining instruments n o Be sure instruments are in good working order Arranging instruments n Keep instruments in same location, either: o o o Mounted on wall Out on countertop Set on a clean towel or tray o Preparing instruments n o Some instruments require warming Cleaning instruments n Place used instruments in a container and always handle carefully © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -27 Medical Instruments and Supplies (cont. ) Curettes Cervical scraper Disposable needles Cotton balls Disposable syringes Cotton-tipped applicators Glass slides Sterile and clean gloves Paper tissues Specimen containers Gauze, dressings, and bandages Occult blood test slides Tongue depressors © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -28 Medical Instruments and Supplies (cont. ) o Consumable supplies n Supplies that are used up o o o n Fixative – chemical spray used for preserving a specimen Isopropyl alcohol Lubricant – a water-soluble gel Be sure patients do not have access to o Prescription blanks Drugs Needles © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -29 Medical Instruments and Supplies (cont. ) o Storing supplies in cabinets and drawers n Label so items can be easily located n Routinely straighten and clean o Restocking supplies n Reorder when the first half of a box, tube, or bottle has been used © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -30 Apply Your Knowledge A medical assistant is preparing the treatment room for a local ENT specialist. Which of the following instruments might be used in this office to assess patient ear, nose, and throat functioning? ANSWER: stethoscope *penlight *nasal speculum *laryngeal mirror *tuning fork reflex hammer *ophthalmoscope anoscope *otoscope tape measure sphygmomanometer Good Choices! © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -31 Physical Safety in the Exam Room o Floor n n n Wipe up spills immediately Pick up dropped items Be sure carpets and rugs are intact o Cabinets and drawers n Keep closed o o Prevents injury Supplies not exposed to patients © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -32 Physical Safety in the Exam Room (cont. ) o Furniture n n o No rough edges or sharp corners Pull from service and check with supervisor Cords and cables n n Taped or fastened down Replace if worn © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -33 Physical Safety in the Exam Room (cont. ) o Special safety concerns n Children o Keep medication and dangerous items out of reach o Toys should be washable and safe o Be sure toys do not have any sharp surfaces n Patients with disabilities o Fall precautions o Safe flooring and handrails © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -34 Physical Safety: Fire Safety Fire Prevention • Store and dispose of hazardous substances correctly • Post “No Smoking” signs in office areas • Check electrical cords, plugs, and outlets • Have functional smoke detectors © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -35 Physical Safety: Fire Safety (cont. ) o In case of fire n Using safety equipment o n Fire extinguisher – “PASS” system Have a safe evacuation route o o Locate fire alarms, fire doors, and fire escapes Stage fire drills © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -36 Apply Your Knowledge The medical assistant has received the recently ordered office cleaning supplies. When unpacking the cleaning solutions for storage, he finds two new disinfectant solutions that he is unfamiliar with. How should the medical assistant handle this? ANSWER: Impressive ! A. Store the solutions with the other cleaning solutions in the usual cabinet. B. Lock the new solution up in a separate cabinet. C. Read the label carefully and check the MSDS information before storing the liquids. © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved

22 -37 In Summary o Room readiness n Clean n Orderly n Adequate lighting, heat, and ventilation n n o Reasons for preparing room n Reduce chance of infection n Efficiency n Contribute to comfort and safety Safety precautions Fire safety guidelines © 2009 The Mc. Graw-Hill Companies, Inc. All rights reserved