Health & Safety
Questions Received:
Responses:
Have you any information regarding health and safety of the day surgery patient undergoing surgery?
3rd April 1999
The Workplace (Health, Safety and Welfare) Regulations 1992 replace a number of old and rather detailed laws, and cover a wide range of basic health, safety and welfare issues. They are intended to apply to most workplaces, including hospitals. The following list gives a flavour of the main concerns of this legislation:
Ventilation - workplaces need to be adequately ventilated. Fresh, clean air should be drawn from a source outside the workplace, and circulated through the workrooms
Temperature - normally at least 16 degrees celsius, and probably higher in a hospital environment
Lighting - sufficient to enable people to work and move about safely
Cleanliness and waste materials - furnishings and fittings should be kept clean and the removal of waste should be carried out as necessary by an effective method
Room dimensions and space - there should be enough free space to allow people to move about with ease
Workstations and seating - workstations should be suitable for the people using them and for the work
Maintenance - the workplace, equipment, devices and systems should be maintained in efficient working order
Floors and traffic routes - there should be sufficient traffic routes, of sufficient width and headroom, to allow people and vehicles to circulate safely with ease
Falls and falling objects - people should be protected from risks of falls and from falling objects
Transparent or translucent doors, gates or walls and windows - these should be made of safety material or be protected against breakage if there is a danger of people coming into contact with them, and marked accordingly
Openable windows - these should be capable of being opened, closed, adjusted, and cleaned safely
Doors and gates - these should be suitably constructed and fitted with safety devices if necessary
Sanitary conveniences and washing facilities - these should be suitable and accessible
Drinking water - an adequate supply should be provided
Accommodation for clothing and facilities for changing - for staff and patients
Facilities for rest and to eat meals - these facilities should be suitable, sufficient, and readily accessible
We have not yet been able to find any regulations or advice applying specifically to day surgery patients, although we shall continue to try. It might be expected that such patients are, apart from their condition, relatively fit and healthy, so presumably the standard health and safety issues apply, but there may well be additional considerations. In the meantime, you may wish to visit the Health & Safety Executive’s web site at www.open.gov.uk/hse/hsehome.htm where you will find a facility to search their resources and obtain contact details if you wish to find out more.
20th April 1999
It is generally accepted that achieving and maintaining an optimum state of health can be facilitated by:
Primary Prevention
This involves adopting measures aimed at reducing the probability of a disease or dysfunction occurring. Common practices are:
Exercise - taking regular, daily, exercise which actually taxes the cardiovascular system by binging about an increase in pulse rate and respiratory rate. Sustained aerobic exercise has undoubted benefits: jogging, running, swimming and cycling are all popular activities for achieving this. Exercising also has positive psychological benefits - people who take regular exercise can experience feelings of well-being. This is partly due to the effects of endogenous opiates (neuropeptides - enkephalins & endorphins) that are released in response to the stress on the body which exercise provokes
Diet - consuming a 'balanced' diet which contains carbohydrates, protein and fat (preferably not animal fat), minerals and vitamins. Fibre should be included in the diet to promote intestinal movements. Salt should not be added to food because this could lead to an increased risk of hypertension in later life. A fluid intake of around 3 litres over 24 hrs would be appropriate for an average adult living in a temperate climate. It is advisable to consult a height/weight chart in order to determine whether weight needs to be lost or gained, and from then on regular weight checks are good practice Public concern about food quality and safety is at an all-time high. Several countries have been able to produce a shift in their population’s eating patterns - reduced fat and particularly saturated fat, reduced salt, more fruits, more vegetables, more fish, and the benefits have been reflected in asignificant reduction in cancer and heart disease.
Sleep - opinions differ on the amount of sleep that an average person should take over a 24 hr period. Generally, though, it is felt that 7-8 hrs is the most beneficial. Frequently-broken sleep can lead to poor concentration and feelings of fatigue and exhaustion
Mental Health - a positive self concept, a sense of achievement, the desire to integrate and contribute to a society are just some of the qualities that enable individuals to obtain pleasure and satisfaction from life. A person must also perceive a sense of value and that they are not being denied their self respect. These are just a few examples of how, if achieved, the risk of experiencing mental suffering becomes less. Or if not lessened at least more tolerable!
The main behaviours associated with the maintenance of health and the prevention of disease are (Belloc and Breslow, 1972):
Sleeping regularly 7 - 8 hours per night
Eating breakfast
Eating regular meals with minimal or no snacking
Eating moderately to maintain an ideal weight
Exercising moderately
Drinking no more than a moderate amount of alcohol
Not smoking (best if have never smoked)
"These behaviours help people to maintain good health regardless of their sex,
age, and economic status. These behaviours are also cumulative; that is, the
greater the number of these factors habitually practiced by individuals, the
better their health." (Strauss et al, 1984)
Secondary Prevention
These are measures which are aimed towards early diagnosis and treatment. A good example is screening. Attending screening clinics helps towards the early detection of disease. Cervical screening, breast self-examination, testicular self-examination, blood pressure checks, dental checks are all examples of measures which are taken to detect the early onset of disease and instigate early treatment if required. The aim is to return the person to full health as soon as possible.
References
Belloc, N.B., and Breslow, L. (1972) Relationship of physical health status and health practices. Preventive Medicine, 1, 409.
Strauss, A.L. et al. (1984) Chronic illness and the quality of life (2nd edition). St Louis: The CV Mosby Co.
Suggested further reading
Edelman, C.L., and Mandle, C.L. (1990) Health promotion throughout the life span (2nd edition). St Louis: Mosby.
Seedhouse, D. (1986) Health: the foundations for achievement. Chichester: John Wiley & Sons Ltd.