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22-1
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
Preparing the ExaminationPreparing the Examinationand Treatment Areaand Treatment Area
PowerPoint® presentation to accompany:
Medical AssistingThird Edition
Booth, Whicker, Wyman, Pugh, Thompson
22-2
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
Learning Outcomes22.1 Explain the medical assistant’s role in preparing
the examination room.
22.2 Describe the layout and features of a typical examination room.
22.3 Describe steps to prevent the spread of infection in the examination room.
22.4 Explain how and when to disinfect examination room surfaces.
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© 2009 The McGraw-Hill Companies, Inc. All rights reserved
Learning Outcomes (cont.)
22.5 Describe the importance of such factors as temperature, lighting, and ventilation in the examination room.
22.6 Identify instruments and supplies used in a general physical examination, and tell how to arrange and prepare them.
22.7 Explain how to eliminate hazards to physical safety in the examination room.
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© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
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© 2009 The McGraw-Hill Companies, Inc. All rights reserved
The Medical Assistant’s Role inPreparing 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
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© 2009 The McGraw-Hill Companies, Inc. All rights reserved
The Medical Assistant’s Role inPreparing the Examination Room (cont.)
Main concerns are
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© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
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© 2009 The McGraw-Hill Companies, Inc. All rights reserved
The Examination Room The area where the
physician: Observes the patient Listens to patient
symptoms Performs a general
physical examination Used to confirm health or diagnose a medical problem
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© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
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© 2009 The McGraw-Hill Companies, Inc. All rights reserved
The Examination 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
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© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
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© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
22-13
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
Apply Your Knowledge
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!
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© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
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© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
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© 2009 The McGraw-Hill Companies, Inc. All rights reserved
Cleanliness in the Exam Room (cont.)
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.
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© 2009 The McGraw-Hill Companies, Inc. All rights reserved
Cleanliness in the Exam Room (cont.)
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
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© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
Cleanliness in the Exam Room (cont.)
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© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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!
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© 2009 The McGraw-Hill Companies, Inc. All rights reserved
Room Temperature, Lighting,and Ventilation
Maintain examination room temperature at about 72°F
Eliminate drafts from windows and doors
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© 2009 The McGraw-Hill Companies, Inc. All rights reserved
Room Temperature, Lighting,and Ventilation (cont.)
Good lighting needed
Accurate diagnoses
Perform medical procedures
Read orders and instructions
Prevent accidents
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© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
22-23
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
Apply Your Knowledge
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!
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© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
22-25
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
Medical Instruments and Supplies (cont.)
Instruments used in a general physical exam
22-26
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
Medical Instruments and Supplies (cont.)
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© 2009 The McGraw-Hill Companies, Inc. All rights reserved
Instrument PurposeTape 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
Medical Instruments and Supplies (cont.)
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© 2009 The McGraw-Hill Companies, Inc. All rights reserved
Medical Instruments and Supplies (cont.)
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
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© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
Medical Instruments and Supplies (cont.)
22-30
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
Medical Instruments and Supplies (cont.)
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
22-31
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
22-32
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
stethoscope
nasal speculum
reflex hammer
otoscope
penlight
laryngeal mirror
ophthalmoscope
tape measure
sphygmomanometer
tuning fork
anoscope
Apply Your KnowledgeA 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!
22-33
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
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© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
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© 2009 The McGraw-Hill Companies, Inc. All rights reserved
Physical Safety in the Exam Room (cont.)
Special safety concerns 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
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© 2009 The McGraw-Hill Companies, Inc. All rights reserved
Physical Safety: 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
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© 2009 The McGraw-Hill Companies, Inc. All rights reserved
Physical Safety: 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
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© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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?
Apply Your Knowledge
ANSWER: Impressive!
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© 2009 The McGraw-Hill Companies, Inc. All rights reserved
In Summary Room readiness
Clean
Orderly
Adequate lighting, heat,
and ventilation
Safety precautions
Fire safety guidelines
Reasons for preparing room Reduce chance of
infection
Efficiency
Contribute to comfort and safety