Medical Office Management II Study Notes

THE MEDICAL OFFICE ENVIRONMENT Print this pageLesson ChecklistTo complete each lesson: Read the Overview below. Read the Learning Objectives below. Read A Note From Your Instructor. Read the Reading Assignments. Answer the Review Questions. Compare your responses to the Review Questions to the Answers to Review Questions provided. After you have completed the reading assignments for this lesson and feel comfortable with the material presented, go to the Exams & Quizzes tool on the left navigation panel underneath the QUICK LINKS section and complete Online Exam 1_01. OverviewIn this lesson you will learn how disease is transmitted and the specific steps to take to prevent its transmission. You will examine techniques for controlling the spread of disease via medical instruments and equipment and how to recognize signs and symptoms of common infectious diseases. You will also look at blood-borne pathogens (i.e., HIV and hepatitis, among others) and how you can take precautions to protect yourself, your coworkers, and your patients from becoming infected. Finally, you will study the techniques used to clean and prepare the office, examination room, medical equipment, and medical instruments.Learning ObjectivesAfter completing this lesson, you should be able to: Discuss the disease process and explain how the human body protects itself against infection. Describe the various types of disease transmission and how you can help break the cycle of infection. Cite OSHA regulations associated with the aseptic duties of a medical assistant. Explain the levels of infection control and the measures necessary to implement them. List the medical assistant's role in educating patients about immunizations and the potential dangers they can pose to some patients. Define the ways in which blood-borne pathogens can be transmitted and the occupations that are at the highest risk for exposure. Identify the signs and symptoms of hepatitis and AIDS. Compare and contrast drugs used to treat AIDS and HIV infection. Outline the layout and features of an examination room. Describe the procedures necessary to prevent the spread of infection in the examination room. Discuss some of OSHA's rules and regulations concerning normal activities that take place in a medical office. Identify instruments and supplies used in a general physical examination. Outline precautions you can take to eliminate hazards and keep the examination room safe for all patients.

Review QuestionsTo complete these Review Questions, you are encouraged to refer back to the Reading Assignment. Use the space provided beneath each question to type your answers.When you have completed a question, compare your answer to the sample answer by clicking on the link "Click here to check your answer." Your answers should be similar, but not identical to the ones below. 1. Discuss the contributions of Hippcrates, Lister, Holmes, Pasteur, and Semmelweis to the prevention of infectious disease. Click Here to check your answer. The following people contributed to the prevention of infectious disease. Hippcrates discovered that treating wounds with coal tar was effective in controlling infection. Centuries later, it was revealled that coal tar contains carbolic acid, which is still used today as an antiseptic and disinfectant. Joseph Lister discovered how to use chemical antiseptics to control surgery-related infections caused by microorganisms. Louis Pasteur performed scientific experiments that led to the conclusion that microorganisms, which he called germs, cause particular types of fermentation in certain liquids. Oliver Wendell Holmes concluded that puerperal fever (a disease that was, at the time, responsible for the deaths of many women in childbirth) was carried from patient to patient by their doctors. Ignaz Semmelweis drew the same conclusions as Holmes and had the students on his hospital ward scrub their hands with a chlorinated solution between the treatments of patients. (Page 7) Did your answer match up with the correct answer? If not, click here to try again. 2. Identify the five parts of the cycle of infection. Click Here to check your answer. The parts of the cycle of infection are as follows.(Page 11) Did your answer match up with the correct answer? If not, click here to try again. 3. Explain the difference between medical and surgical asepsis. Click Here to check your answer. Medical asepsis is based on maintaining cleanliness to prevent the spread microorganisms by reducing the numbers of microorgansims in the medical environment. Surgical asepsis depends on a completely sterile environment that eliminates all microorganisms. (Pages 26-31) Did your answer match up with the correct answer? If not, click here to try again. 4. List and discuss the three levels of infection control. Click Here to check your answer. The three levels of infection control are sanitization, disinfection, and sterilization. Sanitization involves cleaning and scrubbing instruments and equipment by washing with detergents. Sanitization eliminates contaminated materials and some microorganisms from surfaces. It is most often the first procedure necessary for preparing instruments for the next two levels of infection control: disinfection and sterilization. Disinfection is applied to instruments and equipment that come into contact with intact mucous membranes and other non-sterile surfaces. Disinfection kills many, but not all, microorganisms. Sterilization completely destroys all microorganisms from the surface of instruments and equipment. It is required for all instruments that penetrate the skin or that come into contact with sterile areas of the body. (Pages 27-32) Did your answer match up with the correct answer? If not, click here to try again. 5. While a patient is in the examination room, you notice that her friend, who is sitting in the waiting area, seems to be in pain. The friend is holding her hand against one side of her face. You notice that both sides of her face near her ears appear swollen. What, if anything, should you do? Click Here to check your answer. If you witness a patient (or in this case, a patient���s friend) exhibiting the described symptoms, you should first politely inquire about her symptoms and explain that she is displaying some of the signs of mumps, a contagious viral infection. Ask her to move away from the other patients, and suggest that she be examined by a doctor in your office right away. If she is examined by a doctor and found to have mumps, you must report the case to the state or county health department. You should also alert her friend to the possibility of having been exposed to the mumps. (Page 42) Did your answer match up with the correct answer? If not, click here to try again. 6. Discuss five situations in which blood-borne pathogens may be transmitted. Click Here to check your answer. The following examples are just some situations in which blood-borne pathogens can be transmitted. Needlesticks from used needles Blood transfusions with infected blood Dental cleanings that can include blood in saliva Transmission of a pathogen from an infected mother to her fetus Unprotected sexual intercourse (Pages 56-57) Did your answer match up with the correct answer? If not, click here to try again. 7. How are hepatitis A, B, and C spread? What makes hepatitis C so dangerous? Click Here to check your answer. Hepatitis spreads in the following ways. Hepatitis A is spread through the fecal-oral route by drinking contaminated water, eating contaminated food, and intimate contact with an infected person. Hepatitis B is spread through contact with contaminated blood or body fluids and through sexual contact. Hepatitis C is also spread through contact with contaminated blood or body fluids and through sexual contact. Hepatitis C is so dangerous because carriers often experience no symptoms, and if symptoms do occur, they likely will resemble the flu. There is no cure for hepatitis C, which has resulted in more deaths than the combination of hepatitis A and B. (Pages 58-61) Did your answer match up with the correct answer? If not, click here to try again. 8. Discuss the three tests used to diagnose HIV infection and the confidentiality issues regarding test results. Click Here to check your answer. The three tests used to diagnose HIV infection are the ELISA test, the Western blot test, and the IFA test. The ELISA test is used first to confirm the presence of antibodies. Because a false positive may occur, the other tests are used to confirm the presence of antibodies. The ELISA and Western blot tests can be run on oral body fluids as well as blood. In all cases involving testing for HIV, you must follow measures to ensure protection of the patient���s confidentiality. Knowledge about a patient���s test results should be limited to those who will be treating the patient and appropriate authorities as required by law. The patient���s decision on whether or not to reveal test results to family and friends should be respected at all times. (Page 62-64) Did your answer match up with the correct answer? If not, click here to try again. 9. List the three types of exposure that can lead to the spread of disease and ways that each might occur. Click Here to check your answer. The three types of exposure that can lead to the spread of disease are inhalation (breathing), ingestion (swallowing), and transcutaneous absorption (through a cut or crack in the skin). Diseases can be spread through inhalation simply by breathing the same air as the infected person. The process of spreading diseases through ingestion can occur when, for example, a person drinks out of the same glass that another person carrying a disease recently drank from. Finally, a cold might be spread if a carrier sneezes in his hand and touches a doorknob, which is in turn touched by a person with a cut on his hand (transcutaneous absorption). (Page 86) Did your answer match up with the correct answer? If not, click here to try again. 10. According to Table 4-1 (p. 89), what are the general guidelines for cleaning a stethoscope, a nasal speculum, and a syringe? Click Here to check your answer. The general guidelines for cleaning various instruments are given below. To clean a stethoscope, you must sanitize it by using a detergent or a solution suggested by the manufacturer. However, you must disinfect it if it becomes contaminated with blood or body fluids. To disinfect a nasal speculum, you must use an EPA-approved chemical or a 10% bleach solution to destroy microorganisms outside the body. This procedure applies to all instruments that come into contact with intact mucous membranes, but do not penetrate the patient���s body surfaces. A syringe must be sterilized using an autoclave or other approved method to completely destroy all microorganisms. Sterilization must be administered to instruments that penetrate the skin or contact otherwise sterile areas of the body. (Page 89) Did your answer match up with the correct answer? If not, click here to try again.

Reading AssignmentIn your textbook, carefully study Chapter 1 (4-22), Chapter 2 (pages 23-53), Chapter 3 (pages 54-79), and Chapter 4 (pages 80-95).

A Note From Your InstructorPrint this pageDisease PreventionThe five types of microorganisms that cause disease are viruses, bacteria, protozoans, fungi, and very small multicellular organisms, including parasites. These microorganisms are very common and live all around us: in and on our bodies, in the air, in the water, and on almost every surface. People don’t get sick from them as often as you’d think because the human body has a wide variety of defenses that allow us to resist infection. One distinction your text makes between a pathogen and other types of organisms is that pathogens are microorganisms capable of causing disease. These microorganisms damage the body by depleting nutrients the cells need, by reproducing themselves within body cells, and by making the body cells the target of the body’s own defenses by producing toxins.Diseases can be prevented from spreading through cleanliness, good hygiene, using disinfectants, and observing appropriate precautions when touching infected people. The medical office can be literally a Petri dish for collecting disease-causing organisms. Other patients and staff members are prime candidates at risk for picking up these diseases in a medical office.OSHA’s Blood-borne Pathogen StandardThe purpose of the OSHA Blood-borne Pathogen Standard of 1991 is to protect health-care workers from health hazards on the job, especially infections. An interesting point to remember is that Standard Precautions are stricter than Universal Precautions because Standard Precautions are used in hospitals to prevent the transmission of disease in the hospital setting, where many seriously ill patients are congregated for long periods. Universal Precautions are used in medical offices, where fewer and, usually, less sick people visit for brief periods. It is essential to observe both types of precautions to prevent cross-contamination.OSHA’s Blood-borne Pathogen Standard also specifies what to do in case of an exposure incident. The most common type of incident is the puncture exposure. If a puncture exposure occurs, you should notify your employer immediately and get the proper treatment. Prompt action can help prevent the development of many diseases and can also prevent the worker from exposing others to a potentially acquired infection. One of the most serious exposure incidents is that of exposure to HBV (hepatitis B). It is important to respond to this exposure with an evaluation and vaccination if necessary.Controlling InfectionThere are many ways that infectious diseases can be transmitted in a medical office or hospital. Ways that pathogens can be transmitted from one host to another in these settings include the following. Direct contact, such as shaking hands with or administering treatment to an infected person Airborne pathogens, as when an infected person sneezes or coughs Contact with surfaces, instruments, and pieces of equipment that are not sterile Medical assistants often play a vital role in breaking the cycle of infectious-disease transmission. One very simple, yet effective, approach to preventing the spread of infection in a medical office is to provide liquid hand sanitizer and tissues at several key spots in the office and encourage patients to use these as needed. You will also learn how to recognize signs and symptoms of common infectious diseases and how medical assistants participate in immunization.A particularly useful portion of Chapter 2 concerns the levels of infection control (sanitation, disinfection, and sterilization) and which instruments and equipment are subject to these levels. Specifically, sanitation (for instruments and equipment that touch only healthy, intact skin) is required for items such as blood pressure cuffs, ophthalmoscopes, otoscopes, penlights, reflex hammers, stethoscopes, tape measures, and tuning forks. Disinfection (for instruments that do not penetrate a patient’s skin or that come in contact only with a patient’s intact mucous membranes or other non-sterile surfaces) is required for enamelware, endotracheal tubes, glassware, laryngoscopes, and nasal speculums. Sterilization (for use with all instruments or supplies that penetrate a patient’s skin, come in contact with a sterile part of the body, and will be used in a sterile field) is required for such instruments as curettes, needles, syringes, and vaginal speculums.Blood-Borne PathogensChapter 3 discusses blood-borne pathogens, including HIV and Hepatitis. Although HIV is perhaps the best known and most feared of the pathogens discussed, other diseases covered include cytomegalovirus, listeriosis, malaria, syphilis, and toxoplasmosis. You will learn about how these diseases are transmitted and how you, as a health-care professional, can take precautions to protect yourself, your coworkers, and your patients from becoming infected. Blood-borne pathogens may be transmitted in the following ways. Needlesticks from used needles Blood transfusions with infected blood Dental cleanings that can include blood in saliva Transmission from an infected mother to her fetus Unprotected sexual intercourse Other body fluids and products, such as feces, perspiration, and saliva are ordinarily not vehicles for transmitting blood-borne pathogens because these products do not normally contain blood and so do not transmit blood-borne pathogens.Preparing Examination and Treatment AreasAs a medical assistant, you should make sure the office and examination rooms are clean, tidy, and comfortable for those visitors. Medical assistants must also do what is necessary to ensure the physical safety of patients and staff. Besides patients, however, you should consider the doctor as you ready the examination room. One of the many responsibilities of a medical assistant is to make sure that the instruments, equipment, and supplies the doctor requires are prepared and ready to use. The medical assistant may need to arrange instruments differently for various doctors who share a medical practice.It is important to keep examination rooms clean and tidy not only for the benefit of patients and doctors, but because you are also required to do so by law. Strict government guidelines are in place to help prevent the spread of pathogenic microorganisms. It is important to be familiar with the manufacturers’ directions for care and maintenance of specific pieces of equipment. It is important to know how to clean these various types of instruments to avoid spreading infectious diseases and to avoid doing unnecessary work (e.g., it is not necessary to sterilize a reflex hammer).Remember that readying a room for use includes selecting and then sanitizing, disinfecting, or sterilizing the instruments the doctor will need. You must also remember to remove obstacles to physical safety and follow fire guidelines. By doing this job thoroughly, you will be reducing the chance that infections will spread. Your work will help the examination proceed efficiently and ensure that patients and staff alike are comfortable and safe.

Lesson 1 - Overview

Lesson 1 - Review Questions

Reading/Classroom Assignment(s)

Instructors Notes