Safety

SAFETY

Laboratory Safety

Safe laboratory practices will be employed by all MEG staff and MEG Users to preclude any preventable accidents or occurrences.

All MEG users:

1. Must attend MEG orientation and training before being allowed to operate any MEG lab equipment. Each person will be responsible for familiarizing themselves with the safe operation of all MEG equipment used in their experiment.

2. Must adhere to MEG Core Facility policies and procedures. The Policy and Procedures Manual will be located at the Analysis Console for reference and also on the NIH MEG website.

3. May not bring any “unapproved” or “special” equipment into the lab for use unless first approved by the Director and/or Staff Scientist. In addition, before any user’s equipment can be used in the lab it must be tested for electrical safety.

4. Must familiarize themselves with the properties of helium gas / liquid helium. Information on the safe handling of Helium is included in the:

a. P&P Manual (P&P 10.30, 10.31 and 10.32) and

b. Material Safety and Data Sheet Manual located at the Analysis Console for reference.

5. Will be responsible for reporting any hazard or potential hazard.

a. Immediately notify MEG Core staff of any defective equipment, malfunction or any improperly working equipment or medical devices used for patient / subject testing.

b. All events, occurrences or variances to normal operations, policies, procedures, and practices involving any users, subjects / patients and / or equipment must be documented via the Variance Report.

c. Users are responsible for identifying and labeling any hazardous equipment with an “Out of Service / Do Not Use” sticker.

6. Are encouraged to participate in the MEG Quality Assurance / Quality Improvement Program. Suggestions and recommendations for improvement (changes, upgrades, advancements) in equipment, processes or procedures may be submitted via the “QA/QI Variance Reporting System”.

7. Are responsible for subject / patient safety while conducting studies in the MEG Core Facility.

a. When scanning, subjects must be observed at all times.

b. Two (2) operators are required when scanning, one of which is capable of operating the equipment.

c. The subject must never be left alone in the MSR for any reason; two persons must be available for assistance if the subject were suddenly to take ill or if something unexpected were to happen.

8. Must provide a safe environment for all patients and employees.

9. Must adhere to the Clinical Center’s policies and procedures regarding safe laboratory practices.

All MEG Staff:

1. The MEG Core Facility staff will provide a safe working environment for all patients, users and employees.

2. Will maintain a clean, neat, and safe work environment.

3. All employees are constantly alert for unsafe conditions within the work area. If unsafe conditions are discovered, employees initiate immediate corrective action.

4. Will report unsafe conditions beyond the capability of the employee to correct to the proper authorities for remedy.

5. Some measures to be taken to eliminate hazards and prevent accidents are:

a. All passageways, doorways and exits are clear at all times.

b. All power cords are kept in good condition.

c. When in use, all electrical cords are unwrapped.

d. Power strips are kept at least 2 inches off the floor.

e. All cords and equipment cables are covered or routed to minimize the potential for falls or accidents.

f. All file cabinet drawers are closed when not in use.

g. Spills are cleaned immediately after they occur.

h. All employees are informed about the location and use of the Material Safety Data Sheets (MSDS).

i. All employees know the fire safety and evacuation plans.

Emergency Contact Information / Numbers

In case of an emergency contact:

Director: Dr. Allison Nugent, 301/451-8863

Staff Scientist: Dr. Tom Holroyd, 301/402-2362

Emergency Numbers

Fire / Ambulance	call 911
Police	call 911
Chemical / Biological / Radiological	call 911
Engineering	call 108
Bdg 10 Employee/Visitor life threatening emergency*	call 111

*otherwise report to OMS 10/6C306 496-4411 7:30am – 4:00pm

NIH Non-Emergency Numbers

Fire Department	301 / 496-2372
Police	301 / 496-5685
Occupational Medical Service / Work Related Injuries	301 / 496-4411

Emergency Evacuation Coordinator

Building 10/4A13 – Jim Wilson X62862

INFECTION CONTROL

In order to interrupt the spread of infection at the point of transmission between the source and host, the following policies and procedures have been established. All staff, MEG Lab users and subjects are required to comply with NIH Clinical Centers infection prevention / infection control policies and procedures, in addition to MEG Lab practices.

Hand Hygiene

Hand Hygiene is one of the most important steps in infection control in order to prevent the spread of germs. Cleaning your hands often using either soap and water or alcohol hand gel is required by the NIH Clinical Center and the MEG Lab.

In general, it is important to wash / clean your hands in each of these situations:

•After reporting to work (at the beginning of your shift);

•Before and after subject / patient contact;

•Before donning gloves;

•After removing gloves and other personal protective equipment;

•After touching objects that are likely to be contaminated with microorganisms (e.g., equipment or other items, keyboards, telephones / cell phones, doorknobs, stair banister, elevator buttons, etc.;

•Whenever hand are visibly soiled;

•After sneezing, coughing or blowing your nose;

•After contact with blood, or other potentially infectious material and equipment or articles.

In addition when in the MEG Lab, it is important to wash / clean your hands in each of these situations:

•At the beginning and end of each MEG scan;

•After a EEG/ EMG set up and clean up;

•After abrading the skin;

•After applying, handling and processing electrodes;

•When hands are likely to be contaminated with blood, body fluids, secretions or excretions;

•After handling any equipment that comes in contact with subjects with a known infection.

*If you use Alcohol Hand Gel to clean your hands, you must wash your hands with soap and water after every 10 uses of hand gel.

Use of Personal Protective Equipment (PPE) / Protective Barriers

Personal Protective Equipment (PPE) - gloves, gown, plastic apron, masks, protective goggles and impervious barrier will be used, if transfer, aerosolization or splattering of particulate matter is likely to occur. If item(s) are visibly soiled dispose of in a Medical Pathological Waste (MPW) Box otherwise disposed in the trash.

•Gloves will be used when:

-abrading skin.

-handling, cleaning or disinfecting equipment used on abraded skin.

-handling all soiled instruments and equipment.

-in contact with a patient/subject with a known infectious disease.

-in accordance with Universal / Standard Precautions, Transmission Based Precautions and CC Infection Control guidelines.

•Protective Impervious Barrier will be used when:

-items used on abraded skin, i.e., electrodes, electrolyte, Q-tips, gauze, etc.

-items used on a subject/patient with a known infectious disease, the physical work area surface will be covered with a barrier which will be used to place “contaminated/used” equipment or supplies.

*Any items placed on this barrier will be considered contaminated and must be disposed of or cleaned using Dispatch or Asepti-Wipe II.

**The barrier will be discarded after each use and the physical work surface will be disinfected using Dispatch or Asepti-Wipe II.

Studies Requiring A Blood Draw during a MEG Scan

During an MEG scan that involves drawing blood MEG infection control procedures must be followed. All nurses participating in drug studies / protocols must follow all MEG Lab Infection Prevention / Infection Control Policies and Procedures (9.00, 9.20, 9.30, 9.40) which are posted in the Policy & Procedures Manual located in the MEG lab and also on the MEG lab website (http://kurage.nimh.nih.gov/meglab). In addition, nurses and staff must comply with all Clinical Center Infection Control Policies and Procedures.

Policy:

• All nurses participating in drug studies in the MEG Lab must attend MEG Lab specific Infection Control training.

• Gloves will be used when drawing blood or whenever touching the blood draw syringe or any potentially contaminated items.

• “Contaminated” gloves will be discarded before touching any other items in the MEG lab.

• After gloves are removed, hands must be washed / sanitized before touching any other “clean” items including MEG equipment, telephone and any computer keyboards.

• All surfaces (prep table, cabinets) will be wiped with Dispatch after use.

• All MEG Lab staff will monitor participants for compliance.

*Anyone who has not received MEG lab Infection Control training should contact the MEG Lab Manager as soon as possible. Please refer to MEG P&P on Infection Control posted on the MEG Lab website: http://kurage.nimh.nih.gov/meglab/ under “User Information”.

Non-Disposable Electrodes / EEG Caps / Other Non-Disposable Equipment

All non-disposable electrodes, EEG caps and other equipment that comes in contact with skin that has been abraded will be considered “contaminated” and sent to Central Hospital Supply (CHS) for disinfection / sterilization. It is the responsibility of the MEG User to place any used / "contaminated" equipment in a hospital approved transport container, fill out the appropriate CHS form and them place the container on the CHS cart in the MEG lab. MEG staff will then transport and pickup all MEG equipment.

Each User/Research Assistant	- will be responsible for preparing the “used / contaminated” item(s) for disinfection/sterilization by CHS after each use.
Central Hospital Supply (CHS)	- will provide disinfection and sterilization services in compliance with standard operating procedures.
MEG Core Staff	- will provide each user instructions regarding preparing “used”/contaminated MEG equipment for disinfection/sterilization. -will be responsible for transporting the equipment to CHS for disinfection/sterilization.

Non-Disposable Electrodes:

Silver/Silver Chloride Disc Electrodes, Gereonics Silver /Silver Chloride Electrodes, Grass Gold Electrodes and all non-disposable electrodes that comes in contact with skin that has been abraded will be considered “contaminated” and sent to Central Hospital Supply (CHS) for disinfection / sterilization.

Procedure:

1. Latex rubber gloves must be use whenever handling and/or processing electrodes used on abraded skin. For individuals sensitive to latex, nitrile rubber gloves may be used.

2. Place the disk end of the electrode in the zippered section of the 2 pocket zip lock plastic bag.

3. Place the cable / wire end in the un-zippered pocket of the zip lock plastic bag.

4. Place the plastic bag containing the “contaminated” electrode(s) in the top tray of the three (3) piece amber OSHA approved Biohazard Container.

5. Place the lid on the Biohazard Container.

6. Place the Biohazard Container on the top shelf of the CHS Processing Cart.

7. Fill out a “Central Hospital Supply Steam/Gas Sterilization Request Form” for each container and place the form on the top of the appropriate closed Biohazard Container.

8. MEG staff will transport the Biohazard Container to CHS for disinfection/sterilization.

9. Biohazard Containers with “contaminated” equipment will be logged in and out according to CHS procedures.

Non-Disposable EEG Cap – i.e., Easy Cap

All EEG caps, including the EasyCap, that come in contact with skin that has been abraded will be considered “contaminated” and sent to Central Hospital Supply (CHS) for disinfection / sterilization.

Procedure:

1. Latex rubber gloves must be used whenever handling and/or processing an EEG Cap that has been used on abraded skin. For individuals sensitive to latex, nitrile rubber gloves may be used.

2. All electrodes will be removed from the cap and processed separately from the electrodes.

3. The cap will be placed in the top tray of the three (3) piece amber OSHA approved Biohazard Container.

4. The Biohazard Container will then be placed on the top shelf of the CHS processing cart.

5. Place the lid on the Biohazard Container.

6. The Central Hospital Supply Steam/Gas Sterilization Request form will be filled out for each container and placed on top of the appropriate closed container.

7. MEG staff will transport the Biohazard Container to CHS for disinfection / sterilization.

Other Non-Disposable Equipment

All Electrode Bars / Stimulating Bars / Twisted Pair / Ground Electrodes that come in contact with skin that has been abraded will be considered “contaminated” and sent to Central Hospital Supply (CHS) for disinfection / sterilization.

Procedure:

1. Latex rubber gloves must be use whenever handling and/or processing electrodes used on abraded skin. For individuals sensitive to latex, nitrile rubber gloves may be used.

2. Place the disk / bar / electrode end in the zippered section of the 2 pocket zip lock plastic bag.

3. Place the cable / wire end in the un-zippered pocket of the zip lock plastic bag.

4. Place the plastic bag containing the “contaminated” electrode(s) in the top tray of the three (3) piece amber OSHA approved Biohazard Container.

5. Place the lid on the Biohazard Container.

6. Place the Biohazard Container on the top shelf of the CHS Processing Cart.

7. Fill out a “Central Hospital Supply Steam/Gas Sterilization Request Form” for each container and place the form on the top of the appropriate closed Biohazard Container.

8. MEG staff will transport the Biohazard Container to CHS for disinfection/sterilization.

9. Biohazard Containers with “contaminated” equipment will be logged in and out according to CHS procedures.