There are occupational hazards that the hospital workers have to follow. A great variety of jobs are performed in health care facilities. Workers in these settings can face many hazards. It is important for them to determine which hazards affect them and what can be done to prevent illness and injuries. It is the employer’s responsibility along with the Workplace Health and Safety Committee to have a written, proactive health and safety plan that includes an effective way to hear and respond to the concerns of front line workers.
Whipps Cross carries out its own risk assessments to indicate where such use would represent a threat to patient safety or others. They will also highlight where the operation of electrically sensitive medical devices in critical care situations could be affected. The Department of Health introduced a new guidance in January 2009 on the use of mobile phones in NHS hospitals. This was initiated in order to reflect the rapidly developing principles of patient choice and widespread use of mobile phones.
Some of the departments of the Whipps Cross Hospital do not allow mobile phone use. Departments such as radiology department do not allow mobile phone use for the safety of patients that comes in for X-rays, MRI scans, CT scans and ultrasound. This is because mobile phones are electronic devices and this will distract the X-ray machines and the other machines that are involved in the radiology department. Cell phones emit radiofrequency energy which is a form of non-ionizing radiation, unlike ionizing radiation used in x-rays and CT scans.
Below shows an example of the type of risk assessment that would be written for the phlebotomy department in Whipps Cross. This risk assessment shows the hazards of taking blood tests and who can be harmed.
The services provided
The department I have researched at Whipps Cross Hospital is the Pathology department. This department consists of four main departments which are automated blood sciences, Histopathology, Clinical Microbiology and Administration. Each of these departments are sub-divided into different departments, so the automated blood sciences is sub-divided in to Haematology, Transfusion, Biochemistry, Central Reception and Phlebotomy. The Histopathology department is sub-divided into Histology and cytology. The clinical microbiology department is subdivided into Bacteriology, Virology, Parasitology and Mycology.
Automated Blood Sciences
Haematology is concerned with diseases of the blood (e.g. Anaemia’s and leukaemias) and disorders of blood clotting (e.g. haemophilia). Anaemia occurs for a number of reasons such as few red blood cells being made or too many red blood cells being destroyed or bleeding. High leukocyte count is a type of white blood cell and leukaemia is caused by this.
Blood Transfusion ensures that there is enough blood available in the case of emergency such as road traffic accidents and operations and that the correct blood group is matched to the patient due to receive the donation. This department is very important as if there’s not enough blood for a person that was in a road traffic accident, and then this department has to call up different hospitals for the blood group in order to match with the patient.
Biochemistry carries out tests on blood and other biological materials to help in the diagnosis of diseases such as diabetes and cystic fibrosis. It monitors how the major body organs e.g. heart, lungs and kidneys, are functioning to help the doctor decide what might be wrong. Biochemists are responsible for different types of tests such as drug tests, toxicology tests, liver tests, lung tests and surgery. Toxicology test is done to see how much alcohol a person has had and this is done by doing a urine test instead of a blood test, because urine tests are usually easier to do than blood tests and many drugs show up in the urine. Also, traces of a drug may remain in urine for longer than in blood. For example: if there’s a road accident, then a toxicology test may be done for the person that has driven the car to see if there’s a positive result for alcohol consumption.
Below shows a hierarchy of what happens if a person has a Urine infection and how it is processed.
Central Reception is where you take your specimen, if you are bringing it yourself, or where you collect specimen containers e.g. for 24-hour urine samples.
Phlebotomy is concerned with the collection of blood. This is carried out at various sites in the community. Phlebotomists are given training to draw blood from a live person or animals for tests, transfusions or donations. They use hypodermic needles in order to do a blood test. When a person gives blood, the needles that are used to get the blood are disposed safely in a yellow bin bag to avoid the risks from the person’s blood. There are different hazards of doing a blood test such as needle-stick injury, sharps injury and exposure or infection with HIV and Hepatitis B and C. If the phlebotomist takes a blood sample from a person and they have HIV, then they would be harmed as well, so in order to avoid that, there are special equipment that are used to dispose the needles that are used. Also the needle is only used once for a person and then when a different person arrives for a blood test, a different needle is used to avoid the risks of infections from one person to another person. After collecting the blood samples, it is sent to the lab to be assessed very quickly in order to see what problem the person has got. The sharps and hypodermic needles are disposed of in special containers to avoid contact. Specialist waste disposable companies provide a service to collect and dispose of waste materials in sharp boxes. Similar services exist for the disposable of other clinical waste that might be contaminated with blood-borne viruses, such as swabs and other soiled waste from the treatment area. The clinical waste can be disposed of finally by incineration. Pathology laboratories produce large quantities of clinical waste. This will include: Microbiological cultures, Antibody testing kits including ELISA plates and potentially infected waste. Many of the systems used are disposable and are collected and disposed of in the way
The scientific relevance of the service that is provided by the pathology department at Whipps Cross Hospital is that the staffs that are part of the department provide the doctors with the results of the tests that are carried out. This will help the doctors and nurses to identify what is wrong with the person and what further actions they need to take in order to avoid any further risks. The biomedical scientists and the people that are part of this department is to only give scientific advice but not medical advice, so their job is to find the problem; not treat the patients.
The role of the organisation within the community
Whipps Cross Hospital employs around 3,400 employees in a wide range of roles and they work really hard to make sure that every individual part that is employed feels supported and encouraged to deliver the best patient care, in line with their Patient Experience Revolution Manifesto.
Other than direct employment, Whipps Cross Hospital makes other contributions to the local economy and they have local companies. While researching and exploring Whipps Cross hospital around, I have found that they have a restaurant to provide food for the staffs, patients and the people that visit the hospital. Also they have WHSmith Store for the employees, patients and the people that visit the hospital.
Whipps Cross Hospital makes contributions to the local community so for example they do charity events to raise money for local charities. Whipps Cross Hospital Charity supports the patients and staff and work of the hospital. Whipps Cross Hospital Charity raises money to complement funds provided by the NHS, benefiting their staff, their patients and the patient’s families. The charity is a separate body to the NHS Trust and has had registered charity status since 1995. Donations have been made to the hospital and I have found that the different types of donations that have been made to the hospital such as three incubators for their Special Care Baby Unit - £29,202, complimentary therapies as part of palliative care in the Margaret Centre - £6,925 and a laser system for the operating theatres - £20,968.
As you can see on the left, there’s a picture of a league table showing the overall experience of the hospitals. I have circled the Whipps Cross Hospital in the league table. 85.98% of people have rated that they felt that they gave been treated with respect and dignity while they were at the hospital. 72.45% have rated how well the doctors and nurses worked together, 71.32% of people have overall rated the care that they have received. During the hospital stay, some people were asked to give their views on the quality of the care and they have rated 4.68% for this. Also people in the local area were asked, while in the hospital, did they ever see any posters or leaflets explaining how to complain about the care that they have received and the response rate for this were 27.22%. These response rates shows that people in the local area of Waltham Forest have given a high response rate and it shows that they have positive thoughts towards the hospital and they are satisfied with the service that Whipps Cross provides.
Whipps Cross Hospital manages its waste materials/emissions by many different ways. The needles that are used for blood tests have to be disposed off so that there won’t be any harm to the patients and the people in the hospital, as if a needle is left somewhere, it might be used for another person without notice and this person is more likely to be in risk, as the person that used the needle before might have HIV or Hepatitis and it will affect them as well. Also bed sheets and linen have to be clean to keep up their high standards. For example, if a patient has left their ward and a new patient arrives to the same award, then they cannot use the same bed sheets and linen that the previous patient has used because it might cause the patient infections and it’s unhygienic for the patient. An autoclave is used to manage the waste materials. An autoclave is an instrument used to sterilize equipment and supplies by subjecting them to high pressure saturated steam at 121oC for around 15-20 minutes depending on the size of the load and the contents. Autoclaves are widely used in the pathology department at Whipps Cross Hospital. Typical loads include laboratory glassware, surgical instruments, patient pair utensils, animal cage bedding and lysogeny broth. Autoclaves are the pre-disposal treatment and sterilization of waste material, such as pathogenic hospital waste. At Whipps Cross Hospital, autoclaves are used every two weeks to get rid of the waste materials. Whipps Cross Hospital manages the amount of energy that it consumes so they keep within the budget for the lighting and the food.
The role of scientists within the organisation
There are many employees that work under the Pathology department. Some of the job titles of employees within the organisation that have a scientific role or use science are the trainee manager. This person gives training to the graduates that want to work in the department at the hospital. Biomedical scientists and consultant grade staff supports the pathology department. Biomedical scientists carry out laboratory tests on body fluids and tissue samples and the results give doctors the information from which to diagnose illnesses and prescribe treatment. For example they measure glucose levels to check for abnormalities such as diabetes, diagnose viral diseases such as hepatitis and HIV, group and cross match blood for transfusion and the provision of the cervical screening program. Investigations are complex and diverse requiring in-depth scientific knowledge of anatomy, physiology and pathology coupled with highly skilled practical, analytical and interpretive expertise. Some tests are routine whereas others require sophisticated equipment and automated methods.
The graduates that come into the hospital to work have various degrees in science. Degrees include Biomedical Science. To be a biomedical scientist, you need a wide range of qualifications and you need to have a high standard as there is a lot of competition. First of all, if a person chose biomedical science as a career option, then they will need to have good GCSE grades especially in Maths, English and Science. A-levels must be chemistry, biology, physics or maths and preferably two science a-level subjects must be chosen. Grade As and Bs are required from most universities to be a biomedical scientist and a degree in biomedical science or microbiology will lead to working in Whipps Cross Hospital or any other hospitals.
The work of a biomedical scientist must be accurate and efficient because patients' lives may depend on their skills. They are continually increasing their knowledge as laboratory techniques develop and research transforms the cutting edge of science and medicine. Scientists learn to work with computers, sophisticated automated equipment, microscopes and other hi-tech laboratory equipment.
The scientists have to undergo specialist training in order to keep up with the skills and the scientific knowledge that is required. Specialised training is given by the trainee manager for 2 years and in these 2 years; the employees will learn a range of skills and will gain scientific knowledge that will help them during work. It is important for the scientists that work within Whipps Cross Hospital to keep up to date with new scientific advancements because employees should know if there’s any new equipment, then they will need to be trained in order to use it appropriately. In order to avoid any risks of using new equipments, Whipps Cross Hospital gives all employees training regularly so that they will be up to date with scientific advancements,
The work carried out and the science involved
There are specialist scientific equipments that are required for the scientists to carry out their work as this will help them with the different types of tests that they have carried out. Some of the equipments are microscope, semi-auto analyser, digital incubator and centrifuge. A microscope is an instrument used to see objects that are too small for the naked eye. The science of investigating small objects using such as instrument is called microscopy. Scientists use microscopes to help them carry out their work as they are better than magnifying glasses. Microscopes are more stable and it can be built with greater magnifying power so smaller structures can be seen and studied.
The work that is involved in the Pathology department at Whipps Cross Hospital is lab based as biomedical scientists are trained to work in the lab with substances and the different types of tests that they need to carry out. The scientific knowledge and skills will help the Whipps Cross Hospital to provide a good service as they will get graduates to work in the hospital and all of them are well qualified and they need to be trained in order to work in the hospital safely. Also the scientific knowledge that they have gained will be used in the lab in order to carry out their work. This will help them as they will gaining more scientific knowledge by doing work in the lab and the different tests that they carry out and they will be able to identify what is wrong with a specific person by looking at the test results.
Whipps Cross Hospital is involved in Biological, Chemical and Physical. It’s physical because Radiography is involved in physics as they have to do X-ray and Ct scans and the organisation is also biological and chemical because the biomedical scientists carry out different tests to find out the problem of the patient and the doctor identifies the problem and take further actions.
Whipps Cross Hospital uses enzymes in their work and they use it for testing blood for alcohol and these are performed by hospitals through enzymatic assay testing. The whole blood is drawn from the arm via a syringe and then injected into a test tube or a Vacutainer, which allows the needle to draw directly into the test tube. If the hospital tests your blood for alcohol, it is to determine any reactions with necessary medicine or procedures.
Enzymes are biological catalysts. There are optimum temperatures and pH values at which their activity is greatest. Enzymes are also proteins, and usually denatured above about 45ºC. Enzymes are important in respiration. Aerobic respiration releases energy from glucose. Enzymes are proteins that speed up chemical reactions in the cell. A special region o the enzyme, called the active site, has a shape that fits with specific substrate molecules. An enzyme works by binding to one or more specific molecules called reactants or substrates. Binding occurs at the active site. The enzyme and substrate form an enzyme-substrate complex. The interaction between the substrates and the enzyme stresses or weakens some of the chemical bonds in the substrates. These stresses encourage a link between the two substrates leading to the formation of a different molecule. As a result of the chemical interactions within the active site, a new product is formed. The product is released from the active site; the enzyme assumes its original shape and is free to work again.
Use of ICT within the organisation
The use of ICT is very important at Whipps Cross Hospital. ICT is used for communication within the organisation and it is used in many different ways. One of the ways is that it is used to store patient’s details. Patient details include their name, surname, address, date of birth and medical history. This will help the organisation as if a patient comes into the hospital for an emergency, then they can get the patient’s details immediately if their details are stored into the system. This will be less time consuming and much easier for the doctors and nurses to obtain the details. At Whipps Cross Hospital, there are large numbers of patients that come in and go out of the hospital and they can be identified from a NHS number and this number will help the doctor identify the medical history of the person and the doctor can treat the patient immediately if it’s an emergency such as road traffic accidents.
Whipps Cross Hospital also uses computerised systems to book and cancel appointments for the patients. Booking appointments on manual based system can cause several problems as not everyone can read the staff’s handwriting. When booking appointments, employees are more likely to make mistakes because they might be writing fast when booking appointments and they might miss out specific details about the patient if their details are not on the computer system. Also it is time consuming as the patient has to wait for a longer time to see if there any appointments available and if it’s computerised then it will be much each easier for the employee and the patient as they don’t have to write any details down for security reasons. Manual-based systems are not always a reliable method to do as papers can be lost or misplaced and this means that it would take a long time to find the patient’s details and the appointments that they have booked and if it’s computerised then it will be easier for the patients, as when they arrive they do not have to wait longer, the staffs at the reception can just get the details from the system and the letter that the patient has came along with.
The organisation uses specialist software and this software is customised in order to store the data of the patients details. These are maintained by private companies. There are certain levels of permissions that are given to certain people and this is due to confidentiality.
There are various uses of computer in the medical field as it plays a vital role in every medical office. The administrative processes are computerized. For example, staff records, recording incoming and outgoing time of the staff, and the holiday records of the staff. Another vital role of computers in Whipps Cross is conducting various clinical and biological laboratory tests in hospitals that help in correct diagnosis of the disease. Many critical patients, whose heart rate, pulse rate, and brain readings, etc., need be recorded and monitored continuously, are observed through computers.
The data that is collected by the hospital is not stored for a certain length of time as the details are always needed for them to see the medical history of the patient. For example: if a patient goes in for emergency, then they will be asked to fill out the details, but the hospital will have their previous medical history and in order to store the new details of the patient, they will use the form that the patient has filled out and these details will be automatically updated on to the system.
ICT is used in many different ways to analyse and present data. The main use of computer control in hospitals is in life-support systems. The sensors attached to a patient monitor the pulse, temperature, blood pressure and breathing rate. The readings from sensors are taken at regular intervals and used as input to a computer. If any of these readings goes outside acceptable levels an output signal sets off an alarm to alert the nurse staff. Life Support systems are often used for patients in intensive care or for prematurely born babies. This type of system has several advantages such as monitoring can be continuously done 24 hours a day, no chance of human errors and frees the nursing staff to carry out other duties. The hospital uses the computer system for life support system and this will be much easier for the doctors and the nurses, as the monitoring is done through the ICT system and it will also be accurate and you can see what is wrong with the patient immediately.
Another way of presenting data through ICT is the MRI scanner. MRI stands for Magnetic Resonance Imaging. This is a radiology technique that uses magnetism, radio waves and a computer to produce images of the body structure. A huge circular magnet is in the tube that surrounds the patient. When the magnet is switched on, the detection of change in magnet resonance is picked up by radio waves and this change can be modelled by a computer to produce an image. Different tissues change the resonance of the magnetic waves, the image and the resolution of the image produced is quite detailed and can detect tiny changes in the body. By changing the reading of the magnetic resonance and by measuring the change, it can focus the image on different aspects of the patient, producing some results.
Whipps Cross Hospital has an intranet site. Increasing number of organisations are now using an internal network known as an intranet to communicate via internal email and other methods like newsgroup. The individuals have access to the intranet where documents and templates that are used frequently can be accessed.