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Assessments in a care environment Essay Although there are many hazards that could be potential risks in the food environment in a hospital, there are a few which have the highest risk of  occurring and could then cause the most harm to both the service users and service providers. Whilst preparing and cutting vegetables, there is a risk that someone could cut themselves with a sharp knife or cutting equipment. Although the likelihood of this happening could be quite high when there is a lack of training involved, the severity of the injury or damage to health would be quite low considering many injuries that occur this way would be easily seen to and treated by the first aider or the person in charge. However, to prevent this risk occurring at all, all staff should be supplied with the appropriate equipment they should use and training so they are aware of how to handle the equipment in the right manor. A low level of sanitation in a food environment could cause there to be a wider and much quicker spread of bacteria through the food and surfaces which could prove to be harmful, especially in a hospital environment. Due to health and safety regulations being followed by all caring establishments, the likelihood of this happening would be a 2. However if there weren’t regulations being followed by the hospital and this was to occur then the severity could potentially be a 4/5 as the spread of bacteria in a hospital setting would be made worse when considering the weaker people in the hospital and those whose immune systems wouldn’t be able to fight off bad bacteria as well as other and could get sick or their condition could worsen if they already are sick. To prevent this all supervisors should ensure legislations, policies and procedures are being followed at all times to ensure maximum sanitation and cleanliness. Due to the wide variety of people consuming the food in the hospital, it would be vital to take into consideration allergies some people may have and to ensure they are not given food that contains or has been made in the same area as the food they are allergic to. Although the likelihood of this happening is just a 3 due to the fact all staff should adhere to procedures and take into consideration peoples allergies anyway, the severity of this if it occurs could be a 4/5 due to the fact allergic reactions could potentially severe and some cases could even lead to death. To ensure all precautions are taken with these activities and to minimise the risks which could occur from the hazards there are many things that can be done or put into place and thus prevent patients, staff or visitors from  harm. Firstly, to prevent somebody cutting themselves while they are preparing food they should be given training before hand to ensure they are aware of how to use the equipment appropriately and make sure they know which piece of equipment is the most appropriate for the type of food they are preparing. Under the Personal Protective Equipment (PPE) policy it states that all employers have duties concerning the provisions and use of PPE at work and should provide safety training to ensure no members of staff come to any harm (hse.gov.uk, 2015). To prevent the spread of bacteria and ensure the safety of everyone who is to consume the food available, all staff should also be given training on the appropriate ways and places to store food at the right temperatures to ensure the risk of bacteria growth is minimised. Managers of businesses or areas dealing with food have a duty to ensure all food is safe to eat, all harmful or out of date food is removed and unable to be consumed and records should be kept of where the food was bought from to provide evidence if needed. This emphasises the importance of how the Food safety act 1990 should be put into place to ensure the employers and employees stick to their duties to ensure maximum safety for service users. Also hand sanitiser should be provided and available around the hospital including the kitchen to prevent cross contamination that way (legislation.gov.uk, 2015). Finally, to ensure the safety of patients and minimise the risk of something fatal happening to them, all allergies they have to foods should be recorded down and available to all kitchen staff who will be preparing food. These records should be checked regularly and all food should be prepared on separate work surfaces or chopping boards to reduce the risk of cross contamination and any allergic reactions occurring. Physical exercise class Although many form of exercise and physical movement for many patients would be greatly beneficial to their health and wellbeing, it could also prove to provide more harm to health than good if precautions are not taken. Spilt water on the floor where someone may be exercising could prove to be harmful and cause damage to their health if it isn’t seen and cleaned up by someone. Although there is just a likelihood of just 2, the severity could potentially be 3 as an injury to someone in a hospital who could be elderly  could be fatal and cause serious damage to their weak bones and skin. To minimise to risk you could put control measures into place including not allowing any food or drink to be consumed in the exercise area and to have a separate room for them to be stored. Too much exercise for some patients could over work them and cause an injury to their health if it is repeated. Exercise can cause a vast increase in both heart rate and blood pressure and could lead to ma ny serious problems if an elderly patient is doing too much. The likelihood of this causing harm to patients is 1 as both patients and staff should be aware of when too much exercise is being done and if they’re working too hard. However, if this was to occur, the severity would be 5 as weaker elderly patients could suffer from a heart attack or stroke over time if they aren’t being monitored on what exercise they’re doing and the effect it is having on their health. To control this all service providers involved in the physical activities and wellbeing of the patients should know and keep records of any conditions the patients may have which could lead to adverse effects or weaken them. All patient files should have records of what exercise patients have done to ensure they do enough to stay health but not too much that they cause themselves harm or injury. There should also be multiple members of staff observing exercise sessions to keep an eye on those more likely to over work themselves. If patients are showed how to warm up and down properly then they could injure themselves more then what they would if they warmed up. Also, if the exercise is too harsh and causes patients to have to put a lot of effort in just to complete tasks then the severity should be decreased to allow them better health. This would also help prevent a majority of excess aches and pains that would come from treating their body too harshly. Because of possible high severity of an incident is water was spilt during an exercise class, precautions should be put into place to minimise this risk and decrease the likelihood of it ever happening and injuring a patient. If drinks are restricted to one particular area or room away from where the exercise is taking place then there would be a decrease in the risk of anything being spilt in certain areas. Also if patients doing the exercise were given regular breaks to have a drink and a rest they would prevent spillages as well as prevent any pains occurring by doing too much exercise.  Secondly, the amount of exercise each individual patient is able to do would be subjective on the individual and therefore not all the patients should be forced into doing as much as others may do if they are less capable. Each patients amount of exercise should be monitored and recorded to ensure they get the right amount but are not getting too much. Also by monitoring them it would be easier to identify if any of the patients are struggling with any of the exercise methods or are in too much pain to carry on. This also applies to the third point made. The patients shouldn’t be doing exercise which is too harsh for them to carry out or if they don’t completely understand what they are doing because they could do it wrong and injure themselves severely. By allowing them to warm up and down before and after they carry out exercises and by showing them how to carry it out appropriately would lower the risk of injury and allow them to enjoy it instead of being in pain. Visiting Times Visiting hours are the busiest times in a hospital and so could potentially have many hazards involved in allowing people in and out of the hospital without appropriate precautions taken. Poor sanitation from new visitors could potentially be a big problem in a hospital as bacteria will be being bought into the wards and could enhance the spread of infections or diseases. Due to the fact a hospital has a wide variety of patients including elderly and those who have recently had surgery (meaning they may also have open wounds) the spread of bacteria could be hazardous to their health and the healing process of their injuries/wounds. The Likelihood of this happening would be 2 which is significantly low considering the change of law in 1995 which ‘provided specific recommendations to promote improved hand-hygiene practices and reduce transmission of pathogenic microorganisms to patients and personnel in health-care settings’ (Cdn.gov,2014). However the severity of a lack of sanitation would potentially be a 4/5 as the spread of bacteria and therefore infections and diseases could be harmful to people’s health and if unable to fight it off, it could possibly even shut down some peoples immune systems. To minimise the risks of this there should be hand sanitizer and hand was stations placed all around the hospital with signs so the visitors remember to clean their hands and kill off unwanted  bacteria. Security is a vital party of a hospital to ensure the safety of everyone in the building. Without a high level of security around the hospital anyone would have access into and out of the building that may not be authorised. This could mean unwanted visitors may come in and read documents they are unauthorised to, or even confused elderly patients may get out without realising it and end up injuring themselves outside without anyone there to help. This hazard would have a likelihood of 1 and a severity of a potential 4/5 because, although it is very unlikely to happen in a hospital, if a patient were to get out they could get themselves into all sorts of trouble and not realise the danger of traffic outside causing fatal injuries or maybe even death. CCTV should be in place to monitor people in the hospital and all wards should be locked so only authorised people are able to enter and exit. Damage to property could occur during visiting hours as the hospital will be crowded with a variety of people, patients and staff which could cause some things to be damaged or broken, especially when there are a large number of visitors at one time. Although this would not directly affect the health of service users or service providers, it is a hazard to the hospital and would cost a lot of money in repairs each year if there are no control measures in place. CCTV would help monitor any damage that would occur and the person behind the damage; however there should also be signs around the hospital reminding visitors to stay orderly and respectful at all times on the wards and around the building. Due to the fact that so many different people will be entering and leaving the hospital, they could be carrying many different types of bacteria into the hospital which could cause a higher risk of the spread of infection. By providing hand sanitiser and making it widely available around the hospital and wards, all visitors and people who enter the hospital will be able to reduce the amount of bacteria they are bringing in and reduce the risk of infection. There is a hand hygiene policy which should be put into place in the hospital to ensure the safety of patients and visitors. It is well known that hand hygiene is one of the most important factors in preventing the spread of infection and the unwashed hands of all healthcare professionals and visitors is the most important route of cross-infection in the  healthcare environment (Ayliffe at al, 2000). Secondly, there should be an appropriate amount of security in and around the hospital to ensure only authorised people are getting in and out of the building. CCTV cameras should be working and placed all around the building and there should be security systems put in places at all of the entrances and exits to ensure the risk of unwanted visitors or patients getting out is minimised. This would also lower the risk of any property being damaged and if it does occur it would allow the staff to look back over the footage and identify who was at fault for any damages that occur. Although the likelihood of these occurring is predictably low, it would decrease the severity of incidents which occur as it would allow people to be identified and things could be managed before they get out of hand. Dispensing of medicines Prescribing and dispensing medicine is a vital role in hospitals to ensure all patients get the medication they need to help them recover, however there could be many possible hazards involved with dispensing medicines that could cause harm to patients and their health. Prescribing patients with the wrong dosage of medication is a possible hazard as it could lead to the patient having an overdose or having serious health problems afterwards. Although the likelihood is low the severity if this does occur is high as the health effects would be very negative and put patients health into a decline. To prevent this all patients records should be checked beforehand to ensure they are being prescribed the right amount, also the medication should be double checked before being handed to the patient to ensure no mistakes have been made. If medication is left on the side it could be consumed by someone who doesn’t need it, by a visitor not knowing what it is or even by a child who mista kes them for sweets. This could cause great harm as someone who takes them could overdose and it would have negative effects on their health if taken in large quantities, especially to a child. All medication should be locked away in a cupboard or be handled/observed by a nurse or doctor at all times to ensure no one can take them when they don’t need to or accidently. Needles could be a hazard in a hospital if not used correctly or if a nurse slips while holding one. If found left lying around someone could use one and pierce their skin injecting themselves with  something they don’t know about, or even risking infection by finding a dirty needle and using that. Also if a nurse slips whilst holding on they could injure themselves or the patient by accidently stabbing the skin. This isn’t very likely to happen as all nurses should be provided the appropriate training on how to handle needles and dangerous equipment so they don’t make a mistake. Also, all needles should be di sposed of immediately after use so they cannot be used again and cause cross-contamination. The severity for all hazards which could occur for dispensing medicines are all high and so to reduce the risk of anything serious happening or anyone being injured, policies and procedures must be put into place to ensure people’s safety in the hospital. All patient records must be checked before they are prescribed with a medicine to ensure they are provided with the right type of medicine and the right dosage. If this is done wrong it could potentially eventually lead to death for an unfortunate patient and so the dispensing of medicines policy should be put into place. The policy states that all medication should be stored, administered and disposed of appropriately to ensure minimum harm and training must be given to staff to make sure they understand how vital and critical their role could be (oxfordshireccg.nhs, 2013). All medication must be locked away and not left lying around the hospital to ensure only the appropriate staff members who have had training are able to access it and no children or vulnerable people are able to pick it up off the side and take medication which could make them sick. Finally, it is evident that needles are dangerous pieces of equipment if mishandled or in the wrong hands and so the dispensing of medicines policy should be ensured and put into place because of this fact also. All used and unwanted needles should be disposed of immediately instead of being left lying around and all staff should have training before they start in their role to ensure they know how to handle a needle and to make sure they don’t injure themselves or anyone else with one (goshospital, 2015). Moving patients between wards Naturally there would be many risks involved with carrying out this activity as there are a lot of precautions that would needed to be adhered to to make  it successful. There could also be many complications to consider if you were moving an elderly, weak or disorientated patient. The likelihood of any of the hazards occurring is low due to training the staff have and regulations they follow to ensure safety. Using the appropriate equipment is vital when moving a patient between wards as it would assist to lift and transport the patient without causing any harm to the health of either the patient or the member of staff. If a nurse is moving a patient on their own without a hoist or any help, they could injure their back by not lifting properly or injure the patient if they’re lifted in the wrong way. According to the manual handling regulations 1992 all staff should be provided with PPE and training on how to carry out tasks like these to avoid injuries or harm. The likelihood of any harm occurring is low if the regulation is followed however the severity could be 3 as the damage it could cause may need special attention. Dropping patients would be a risk if they are heavy or awkward to lift between one place to another. The severity of this if it happens would be quite high depending on the state of the patient, especially if the patient being moved is elderly or fragile, they could easily break a bone or more damage would be caused if they are dropped. Busy corridors during visiting hours could cause complications when moving a patient as it would make it a lot harder. If some of the corridors or lifts are busy you would not be able to move the patient as quickly and efficiently as liked/needed. Also, if there are people milling about the corridors it would be easier for the patient to be knocked over or injured by accident. The severity of something happening while a patient is being moved between the hospital is on average 2.5 which could be severe in the wrong situations and so staff must be provided with the right equipment and training to prevent the risk of injury or the likelihood of anything happening. Under the personal protective equipment policy it states that all staff members should be provided with the correct equipment to carry out tasks to prevent injury to themselves and the other person involved (hse.gov.uk, 2015). This could include someone like a hoist to prevent injury to the staff members back and to ensure that the patient is being lifted properly. Although dropping a patient has a low likelihood and may not happen easily, if it  does it could be severely fatal to the patient and cause them a lot of injuries. The risk of this happening would also be minimised if the correct equipment was provided to ensure the staff member doesn’t assert strain on their back/ body and it ensure that there is enough power to lift the patient, especially if the member of staff isn’t very strong. Finally to make it easier to move patients it should be done when the hospital isn’t busy so there are no visitors mulling around and getting in the way. References Hse.gov.uk, (2015). Personal Protective Equipment (PPE). [online] Available at: http://www.hse.gov.uk/toolbox/ppe.htm [Accessed 15 Jan. 2015]. Gov.uk, (2015). Food safety your responsibilities GOV.UK. [online] Available at: https://www.gov.uk/food-safety-your-responsibilities/food-safety [Accessed 15 Jan. 2015]. Legislation.gov.uk, (2015). Food Safety Act 1990. [online] Available at: http://www.legislation.gov.uk/ukpga/1990/16/contents [Accessed 15 Jan. 2015]. Hospital, G. (2015). Sharps: disposal of used sharps Clinical guidelines Health professionals Great Ormond Street Hospital. [online] Gosh.nhs.uk. Available at: http://www.gosh.nhs.uk/health-professionals/clinical-guidelines/sharps-disposal-of-used-sharps/ [Accessed 15 Jan. 2015].