This document discusses health and safety in hospitals. It outlines the roles and responsibilities of leaders in ensuring various aspects of patient and staff safety. This includes providing education and training, implementing safety protocols for medications, blood transfusions, falls prevention, and more. Leaders are responsible for proper use and maintenance of equipment, use of personal protective equipment, and understanding emergency codes. The goal is to create a safe work environment and reduce risks and errors to provide safe patient care.

1. HEALTH & SAFETY IN HOSPITAL
:CREATING A SAFE WORK PLACE
MUHAMMAD HAMZIHADI BIN HAMRAH
CLINICAL NURSE
HOSPITAL TUANKU JAAFAR SEREMBAN
2023

2. Contents
1. MALAYSIAN PATIENT SAFETY GOAL 2.0
2. HEALTH AND SAFETY
• EMERGENCY CODE
• SAFETY EQUPMENT
• VISITOR/ PATIENT
• HANDLING HAZARDS

3. What is health?
Health is a state of complete physical,
mental and social well-being and not
merely the absence of disease or
infirmity.
A healthy workplace is one where workers and
managers collaborate to continually improve the
health, safety and wellbeing of all workers and by
doing this, sustain the productivity of the business (World
Health Organisation, 2019).

4. SAFETY DEFINITION
Safety is a state in which hazards and conditions
leading to physical, psychological or material
harm are controlled in order to preserve the health
and well-being of individuals and the community.
Definition safety in workplace: The process of
protecting employees from work related illness
and injury.

5. HUMAN
- Who involved:
- Patient
- Nurse, Dr and others allied health
- Visitor
- Other stakeholder
NON HUMAN
- Building eg:
hospital, clinic
- Equipment
- Facilities
Health and safety workplace

6. PATIENTS
FALL + MEDICATION ERROR +
BLOOD TRANSFUSION ERROR + UNINTENDED RETAINED
SURGICAL ITEM + NOSOCOMIAL INFECTION and many
more
=
MALAYSIAN PATIENT SAFETY GOAL
REVISE IN 2021 VERSION 2.0

7. MALAYSIAN PATIENT
SAFETY GOAL 2.0
NURSE’S/LEADER’S
ROLE AND
RESPONSIBILITY

8. INTRODUCTION
“Nurses spend 24 hours
a day with patients providing direct patient care. They have
a huge responsibility to ensure compliance to the
Malaysian Patient Safety Goals. Therefore, having sound
knowledge of patient safety in the healthcare setting is a
vital importance to ensure patient safety at all times.”
-DG Dr. Noor Hisham Bin Abdullah

18. ROLES AND RESPONSIBILITIES OF LEADERS
1.Education And Training
1.1 Orientation and Mentor-Mentee program to new nurses who report duty
1.2 CME / CNE in the unit/ department/hospital
2.Practicing Standard Of Precaution (SOP)
3. Monthly surveillance audit sent to State Health Department and
Ministry.
- Properly anchor after insertion
- Change dressing every 7 days / necessary
- Clean the hub of the catheter properly
- Cohort or isolate infected patients
- Strictly 5 moment hand hygiene
- Follow 4 key component
• Maximal Barrier Precaution,
• Skin antiseptic,
• Catheter site selection,
• Daily review CVC

26. ROLES AND RESPONSIBILITIES OF LEADERS
1.Education And Training
1.1 Orientation Program to new staff
1.2 CNE Hospital / Department and Unit level
1.3 Mentor-mentee Program to all new staff or staff that just join the team.
2. The use of related forms such as PERI-OPERATIVE CHECK
LIST(SSSL_POCL_09 Version 2.0).
3. National Operating Room Nursing Audit (NORNA) to be practiced
in order to upgrade knowledge and be competent nurses in the
Operating Room.
4. All staff nurses in OT should be credentialed and privileged.

27. SSSL Form
PRIMARY TEAM CHECKLIST MULTIDISIPLINARY TEAM
CHECKLIST

31. ROLES AND RESPONSIBILITIES OF LEADERS
1.Education And Training
1.1 CNE/CME at Hospital / Department / Unit level
2. Implement Principle of 7R's when administering medication
3. Use 2 identifier of patient before administering medication
4. Implement proper medication storage system
4.1 Label High Alert Medication for example Potassium Chloride
4.2 For Look Alike Sound Alike (LASA) medication use TALL MAN lettering.
4.3 Separate LOOK ALIKE medications further from each other.
5. Ensure that there are written instructions from doctor before serving medicine
6. Use ‘medication nurse’ vest to avoid interference from others while
administering medication.
7. Report and learn from medication errors.

35. ROLES AND RESPONSIBILITIES OF LEADERS
1.Education And Training
1.1 CNE/CME at Hospital / Department / Unit level
1.2 Orientation and mentoring program , bedside teaching
1.3 National Nursing Audit according to KKM schedule.
2. Ensure blood transfusion procedure follows the Standard
Of Procedure (SOP)
3. Identify the correct patient with 2 identifier
4. Notify all incidents.

39. ROLES AND RESPONSIBILITIES OF LEADERS
1.Education And Training
1.1 CNE/CME at Hospital / Department / Unit level
1.2 Orientation and mentoring program , bedside teaching
2. Patient Assessment
2.1 Risk assessment of the patient should be done on admission/transfer in using
the Morse Fall Scale (Modified Fall Scale), daily and whenever necessary.
2.2 Put proper signage on patient’s bed based on Fall Risk Assessment Score:
(i) Low risk – Score 1 - 24 (No signage)
(ii) Moderate risk – Score 25 - 44 (Yellow signage)
(iii) High risk – Score > 45 (Red signage)
3. Implement Fall Prevention action and document in nursing report
4. Report incidence and conduct RCA

43. ROLES AND RESPONSIBILITIES OF LEADERS
1. Once the patient is admitted, prepare patients printed wristband that states her/his
name, identification number or registration number.
2. Put the wristband on patient’s wrist. Ask patient full name using identification card. If
the patient is unable to tell their name (unconscious patient, babies, children, mentally
disable or patient with dysphasia) ask the caregiver or relatives or check any available
identification.
3. Replace immediately previous patients name on the bed.
4. Ensure correct patient by using 2 identifiers. Ask patients names, Date of birth or IC
number.
5. DO NOT state their name first and then ask to confirm or deny by yes/no response.
6. The inability to identify patient accurately by using methods given, must be documented
properly in the Patient’s Record (BHT)
7. Any incorrect patient information registered need to report to Quality Unit ASAP.

48. ROLES AND RESPONSIBILITIES OF LEADERS
1. All nurses must understand the policies and procedures
regarding “Incident Reporting And Learning System”.
2. Take immediate action following incident
3. Assist in communication with patient/ family when
incident happen.
4. Report incident.
5. Inform supervisor
6. Involve in investigation as part of team member

50. WORKPLACE
INJURIES
STATISTIC

51. INJURIES AND ILLNESS RELATED
INDUSTRY

52. How workers
getting hurt
INJURIES
RELATED

53. AGE RELATED

54. Ergonomic

56. • Equipment, which can range from ceiling-
mounted lifts to simple slide sheets that facilitate
lateral transfer
• Minimal-lift policies and patient assessment tools
• Training for all caregivers or for dedicated lifting
teams
ROLES AND RESPONSIBILITIES OF LEADER

57. VISITOR/ PATIENT

58. VISITOR/ PATIENT
• Visitor age,
mobility and
alertness
• In house patient
with multiple
cause of
admission

60. ROLES AND RESPONSIBILITIES OF
LEADERS
• Assess visitor/ patient condition
• Reminding staff on possible hazards
• Keep on educate staff regarding possible
hazards might occurs
• Work with various department to ensure the
hazards can be avoid.
• Flowchart if hazards occurs in the department

61. EQUIPMENT

62. SAFETY IN HANDLING EQUIPMENT
1. EQUIPMENT has electric and non electrical
2. Safety and maintained of particular equipment
3. Proper placed at the specific place

63. WHAT ARE CONSIDERED AS
HOSPITAL DEVICE AND
EQUIPMENT
• Medical device” means any instrument,
apparatus, implement, machine, appliance,
implant, in vitro reagent or calibrator, software
• Diagnosis, prevention, monitoring, treatment or
alleviation of disease or compensation for an
injury.
• Investigation, replacement, modification, or
support of the anatomy or of a physiological
process.

64. WHAT ARE CONSIDERED AS
HOSPITAL DEVICE AND
EQUIPMENT
• Supporting or sustaining life
• Disinfection of medical devices
• Providing information for medical
purposes by means of in vitro
examination of specimens
derived from the human body

65. WHY EQUIPMENT SAFETY?
• Era of cost intensive medical care.
• Demand for improving diagnostic
facilities.
• Sophisticated equipment’s with
modern technology.
• Progress in surgical procedure

66. WHY EQUIPMENT SAFETY?
• Physicians becoming more
investigation oriented
• Introduction of computer science
and robotics in medicine
• Use of medical instruments in
specific procedures, diagnostic
evaluation, treatment and
rehabilitation.
• These devices/ equipment’s might
directly affect the lives of patients.

67. WHO IS RESPONSIBLE FOR
THE SAFETY OF PATIENT?

68. ROLES OF EACH STAKEHOLDERS
TOWARDS SAFETY OF
EQUIPMENTS/DEVICE
• The Manufacturer, as the creator of the device, must
ensure that it is manufactured to meet or exceed the
required standards of safety and performance. This
includes the three phases design/development/testing,
manufacturing, packaging and labelling) that lead to a
product being ready for the market.

69. ROLES OF EACH STAKEHOLDERS
TOWARDS SAFETY OF
EQUIPMENTS/DEVICE
• The Vendor provides the interface between the product and
the user. He/she should ensure that the products sold comply
with regulatory requirements.
• They should be careful to avoid making misleading or
fraudulent claims about their products or issuing false
compliance certificates.
• the vendor should make training a condition to the
manufacturer or importer in accepting to sell the device

70. ROLES OF EACH STAKEHOLDERS
TOWARDS SAFETY OF
EQUIPMENTS/DEVICE
• The User should make sure that he/she has qualifications
and training in the proper use of the device, and is familiar
with the indications, contra-indications and operating
procedures recommended by the manufacturer.
• It is crucial that experience gained with medical devices be
shared with other users, the vendor and manufacturer to
prevent future problems.

71. SCOPE TOWARDS DEVICE
SAFETY
• Planning and implementation of a maintenance program
in the facility.
• Optimal operational efficiency.
• Maintaining an up-to-date inventory of each and every
equipment, their distribution in the facility.
• Anticipating the requirement of commonly required spare
and arranging for their adequate stocking. Ensuring break
down maintenance to promote uninterrupted services.
• Ensure safe and hazard free working place.

72. EQUIPMENT LIFE SPAN AFTER
PROCUREMENT

73. EQUIPMENT SAFETY
PROGRAMME

74. PLANNING
• PLANNING INVENTORY/ RESOURCES : It includes
getting contracts of devices, financial resourcing and
manufacturer, manpower resources programme,
independent services, physical resources
organizations.
• FINANACIAL RESOURCES (Initial cost operation):
Financial resources required for Physical resources
like space, tools, test equipment, computer
resources, vehicles. Human resources like recruiting,
initial training.

75. PLANNING
• PHYSICAL RESOURCES: Workspace, Tools and test
equipment investments reduce the maintenance cost
and increase reliability, Supplies like cleaning and
lubricating supplies, Spare parts and Operation and
service manuals.
• HUMAN RESOURCES: Biomedical engineers,
Biomedical technicians, Medical personnel’s and
service providers.

76. MANAGEMENT

77. OPERATIONAL MANAGEMENT

78. CONSTRAINS OF EFFECTIVE
MAINTENANCE
• Inadequate training of staff.
• After sales services by supplier is not satisfactory.
• Facilities backup on power supplies is inadequate.
• Patients are less aware of the high tech facilities in the
hospitals.
• Utilization of the special facility or skill requires staff
motivation and cost to the patient.

79. CONSEQUENCES
• Only 50-60% of equipment are in usable condition(according
to a survey done by deptt.of exp)
• Common factors contributing for wastage are
– Purchase of equipment which is never used due to lack of
technical expertise to use and maintain.
– Reduce lifetime due mishandling and lack of maintenance
and repair.
– Non availability of spares, accessories.
– Excessive downtime due to lack of preventive
maintenance.

80. CONDEMNATION

81. EQUIPMENT IN HOSPITAL/CLINIC

82. ROLES AND RESPONSIBILITIES OF LEADER
1. All leader must understand the policies and procedures
regarding “safety equipment handling”.
2. Should take immediate action following incident if
3. Report incident.
5. Get information from staff
6. Involve in investigation as part of team member

83. PERSONAL PROTECTIVE EQUIPMENT

85. ROLES AND RESPONSIBILITIES OF
LEADERS
• Equipment is adequate for staff
• Ensure staff follows protocols and policies
handling hazards environments and equipment's
• Training for all staff in donning and doffing PPE

86. EMERGENCY COLOUR CODE

87. 1.All leader must
understand and remember
every color code meaning.
2. Should take immediate
action following incident
happens.
3. Able to define role and
responsibility of nurses
during code event.
ROLES AND
RESPONSIBILITIES

93. ROLES AND RESPONSIBILITIES OF
LEADERS
• Ensure all staff understand their role during code
• Ensure staff follows protocols and policies of the
code
• Plan a drill for all staff at certain point of time.

94. CONCLUSION
Safety and Health procedures in the
workplace can reduce the employee
illnesses and injuries which leads to
minimizing potential death to be
happened.
Safety and Health procedures also can
prevent and reduce risks, errors and harm
that occur to patients during provision of
health care.

95. References
1. Caring for Our Caregivers (2013) Facts About Hospital Worker Safety . US department of labor.
Occupational safety and health administration
2. Malaysian Patient Safety Goal (2021) version 2.0

96. THANK YOU