CHAPTER © 2011 The McGraw-Hill Companies, Inc. All rights reserved. 35 Preparing the Examination and Treatment Area.

CHAPTER

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.

35Preparing the

Examination and Treatment Area


35-2

Learning Outcomes

35.1 Explain the medical assistant’s role in preparing the examination room.

35.2 Describe the layout and features of a typical examination room.

35.3 Describe steps to prevent the spread of infection in the examination room.

35.4 Explain how and when to disinfect examination room surfaces.


35-3

Learning Outcomes (cont.)

35.5 Describe the importance of such factors as temperature, lighting, and ventilation in the examination room.

35.6 Identify instruments and supplies used in a general physical examination, and tell how to arrange and prepare them.

35.7 Explain how to eliminate hazards to physical safety in the examination room.


35-4

Introduction

• Preparation of the exam room and treatment area– Common layouts– Cleanliness and supplies– Comfort of room– Safety

• Accessibility based on the Americans with Disabilities Act


35-5

The Medical Assistant’s Role in Preparing the Examination Room

• Maintain neatness and cleanliness of the room

• Ensure that all supplies and equipment needed are present for the physician’s use

• Make certain that potential safety hazards are eliminated


35-6

The Medical Assistant’s Role in Preparing the Examination Room (cont.)

• Main concerns are


35-7

Apply Your Knowledge

What are three tasks the medical assistant should do to prepare the examination room?

ANSWER: The medical assistant should Maintain neatness and cleanliness of the room Ensure that all supplies and equipment needed are present for the physician’s use Make certain that potential safety hazards are eliminated


35-8

The Examination Room

• The area where the physician:– Observes the patient– Listens to patient

symptoms– Performs a general

physical examination to confirm health or diagnose a medical problem


35-9

The Examination Room (cont.)

• Number and size of rooms– Depends on the number of

physicians in the medical practice

– Average size room is 8 × 12 ft

– Rooms should be large enough for patient, physician, and medical assistant, yet small enough to have supplies within reach


35-10

Exam Room Furnishings

• Should be arranged for:– Efficiency– Patient comfort– Physician convenience

• Items commonly found in examination rooms

One or more chairs A rolling stool Weight scale Biohazard container

Wastebasket with lid Puncture-proof containers Wall brackets High-intensity lamp


35-11

Special Features

• The 1990 Americans with Disabilities Act (ADA)

– Requires “reasonable accommodations”

– Compliance requires that medical office be accessible to patients with disabilities

• Accessibility – the ease with which people can move in and out of a space


35-12

Special Features

Doorway must be at least 36 inches wide

Clearance space in rooms and hallways at least 60

inches wide

Slip-resistant floors

Door-opening hardware can be grasped with one hand and does not require twisting of

the wrist to use

Door closers must be adjusted to allow entry and exit time

Grab bars in lavatories

ADA Guidelines


35-13


ANSWER: You need to consider efficiency, patient comfort, and physician convenience when arranging an examination room.

When arranging an examination room, what three things should you consider?

Right!


35-14

Cleanliness in the Examination Room

• Strict housekeeping standards

• Adherence to government guidelines

• Infection control

– Make hand washing a priority

– Keep examining table clean

– Disinfect all work surfaces


35-15

Cleanliness in the Exam Room (cont.)

• Clean hands – first step in preventing infection transmission

• Wash hands– 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


35-16


• Examining table– Change the disposable paper

covering the examination table after each use

• Dispose of paper coverings soiled by body fluids in a biohazardous waste container

– Also place soiled linens and pillowcases in biohazard-labeled bags.


35-17


• Surfaces

– 10% bleach solution or product approved by the EPA

– Disinfect work surfaces if visibly contaminated and at end of shift

• Sink and countertops

• Examination table

• Patient lavatory

• Storage

– Store biohazardous specimens properly

– Store testing kits properly


35-18


• Putting the room in order– Straighten room between patients– Boosts patient confidence in efficiency and

abilities of medical personnel

• Housekeeping– Janitorial services for after-hours cleaning

• Monitor for lapses in cleanliness

– Medical assistant may do some housekeeping chores


35-19

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.

Apply Your KnowledgeGood Job!


35-20

Room Temperature, Lighting, and Ventilation

• Maintain examination room temperature at about 72°F

• Eliminate drafts from windows and doors


35-21

Room Temperature, Lighting, and Ventilation (cont.)

• Good lighting needed

– Accurate diagnoses

– Perform medical procedures

– Read orders and instructions

– Prevent accidents


35-22

Room Temperature, Lighting, and Ventilation (cont.)

• Examination area should smell clean and fresh

• Eliminate source of odors

• If opening windows, monitor room temperature

• Room deodorizer or spray


35-23


ANSWER: Good lighting is needed for making accurate diagnoses, performing medical procedures, reading orders and instructions, and preventing accidents.

Why is it important to have good lighting in the examination room?

Excellent!


35-24

Medical Instruments and Supplies

• Tasks to maintain instruments and supplies

– Order and stock all needed supplies

– Sanitize, disinfect, and/or sterilize instruments as needed

– Instruments and supplies should be placed within easy reach for the physician


35-25

Instrument Purpose

Anoscope Used to open the anus for examination

Examination light Provides additional lighting

Laryngeal mirror Reflects inside of mouth and throat

Nasal speculum Used to enlarge the opening of the nose

Ophthalmoscope Used to examine the inner eye surfaces

Instruments for a General Physical Exam


35-26

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

Instruments for a General Physical Exam (cont.)


35-27

Instrument Purpose

Tape measure Used to measure size or development of an area

Thermometer 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



35-28


• Inspecting and maintaining instruments

– Be sure instruments are in good working order

• Arranging instruments– Keep instruments in

same location, either:• Mounted on wall

• Out on countertop

• Set on a clean towel or tray

• Preparing instruments

– Some instruments require warming

• Cleaning instruments

– Place used instruments in a container and always handle carefully


35-29

Cervical scraper Cotton balls

Cotton-tipped applicators

Curettes

Disposable needles Disposable syringes

Gauze, dressings, and bandages

Glass slides

Sterile and clean gloves Paper tissues

Occult blood test slides

Specimen containers

Tongue depressors

Supplies for a General Physical Exam


35-30

Consumable Supplies

• Supplies that are used up– Fixative – chemical spray used for

preserving a specimen – Isopropyl alcohol– Lubricant – a water-soluble gel

• Be sure patients do not have access to– Prescription blanks– Drugs– Needles


35-31

Medical Instruments and Supplies (cont.)

• Storing supplies in cabinets and drawers

– Label so items can be easily located

– Routinely straighten and clean

• Restocking supplies

– Reorder when the first half of a box, tube, or bottle has been used


35-32

stethoscope

nasal speculum

reflex hammer

otoscope

penlight

laryngeal mirror

ophthalmoscope

tape measure

sphygmomanometer

tuning fork

anoscope


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?

*nasal speculum

*otoscope

*penlight

*laryngeal mirror

*ophthalmoscope

*tuning fork

ANSWER:

Good Choices!


35-33

Physical Safety in the Exam Room

• Floor– Wipe up spills

immediately– Pick up dropped items– Be sure carpets and

rugs are intact

• Cabinets and drawers– Keep closed

• Prevents injury• Supplies not exposed

to patients


35-34

Physical Safety in the Exam Room (cont.)

• Furniture– No rough edges or sharp

corners– Pull from service and check

with supervisor

• Cords and cables– Taped or fastened down – Replace if worn


35-35

Special Safety Precautions

• Children

– Keep medication and dangerous items out of reach

– Toys should be washable and safe

– Be sure toys do not

have any sharp surfaces

• Patients with disabilities– Fall precautions

– Safe flooring and handrails


35-36

Fire Safety

• Store and dispose of hazardous substances correctly

• Post “No Smoking” signs in office areas

• Check electrical cords, plugs, and outlets

• Have functional smoke detectors

Fire Prevention


35-37

Fire Safety (cont.)

• In case of fire– Using safety equipment

• Fire extinguisher – “PASS” system

– Have a safe evacuation route• Locate fire alarms, fire doors, and fire

escapes• Stage fire drills


35-38

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.

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!


35-39

In Summary

35.1 It is the medical assistant’s responsibility to ensure that the examination room is neat, clean, and appropriately stocked.

35.2 A typical examination room is about 8 by 12 feet, large enough to accommodate the physician, the patient, and one assistant. Instruments and equipment in the room should be easily accessible.


35-40

In Summary (cont.)

35.3 Steps involved in preventing the spread of infection in the examination room include covering the examination table with a paper cover and changing the cover between each patient. It is also important to disinfect all surfaces that come in contact with blood or body fluids after each patient, and at the beginning and end of the day.


35-41

In Summary (cont.)

35.4 Examination room surfaces should be disinfected after an examination or treatment during which surfaces have become visibly contaminated, immediately following accidental blood or body fluid spills or splatter, and at the end of the medical assistant’s work shift.

35.5 It is important that patients feel comfortable in the examination room. A room that is comfortably warm, well lit, and properly ventilated will help the patient feel comfortable during the examination.


35-42

In Summary (cont.)

35.6 A variety of instruments and supplies are used in a general physical examination. To ensure that the examination room always has the necessary instruments and supplies, the medical assistant should order and stock all supplies needed for examinations and treatment procedures, keep the instruments sanitized, disinfected, or sterilized and in working order, and place all instruments and supplies where the doctor can easily reach them.


35-43

In Summary (cont.)

35.7 To eliminate hazards to physical safety in the examination room, the medical assistant should be alert for any physical hazards in the area, including spills, dropped objects, open cabinet doors, damaged furniture, or improperly secured cords and cables.


35-44

Safety is something that happens

between your ears, not something you hold in your hands.

~ Jeff Cooper

End of Chapter 35

CHAPTER © 2011 The McGraw-Hill Companies, Inc. All rights reserved. 35 Preparing the Examination and Treatment Area.

Documents

typical examination

examination room surfaces

mcgrawhill companies

examination rooms

medical problem slide

exam room furnishings

general physical examination

reach slide