Precautions for Practitioners When Treating Cancer Patients
As Physiotherapists, our top goal is to help patients recover and heal through movement by creating a safe, effective, and efficient environment for healing to take place.
It is the responsibility and goal of all Allied Healthcare workers to keep their patients safe while completing treatment.
In this blog post, we will touch on the steps they take to achieve this. We will also touch on how Allied Healthcare workers keep themselves safe when working with a patient undergoing cancer treatment. OncoLink provides the following Standard Precautions to Keep Patients Safe.
Standard Precautions to Keep Patients Safe
Hand Hygiene: Hand hygiene is the easiest and most important way to prevent the spread of infections. Healthcare providers should perform hand hygiene when entering and when exiting the patient care area (eg. exam room, hospital room, chemotherapy administration room), before and after touching you, and after removal of gloves. It is important that patients (or patient visitors) perform hand hygiene frequently to prevent the spread of pathogens. Proper hand hygiene can be performed using an alcohol-based hand gel or foam, or by using soap and water.
Respiratory Hygiene: Respiratory hygiene is used to prevent the transmission of pathogens that can cause respiratory infections. Respiratory hygiene includes covering your nose and mouth while sneezing and coughing, with either your elbow or a tissue. If you use a tissue, it should immediately be thrown away in the trash. After contact with any secretions from a cough or sneeze, hand hygiene should be performed.
Personal Protective Equipment (PPE): PPE is the equipment worn by health care professionals to protect them from contact with infectious agents, which in turn helps prevent the possible spread of pathogens from patient to patient. PPE includes gloves, face shields, surgical masks, goggles, respirator masks, and gowns. Your health care provider will put these on depending upon the type of situation. Gloves should always be worn when there is the possibility of hands coming in contact with bodily fluid from the patient. A gown, face shield, and goggles may be used if there is a chance that a bodily fluid could be splashed on to the health care provider. After removal of any PPE, proper hand hygiene should be performed.
Medical Equipment, Environmental Cleaning, Waste Disposal: It is important that standards are set in every facility regarding the cleaning of equipment, linens, and patient care settings, including exam rooms and hospital rooms. Visibly soiled equipment and spaces should be properly cleaned with an appropriate chemical agent or detergent. One-time use equipment, such as probes placed on thermometers, should be thrown away after use. Linens should be changed after use in an exam room and as often as needed (at a minimum, daily) in a hospital room. Trash should be thrown away properly. Any trash soiled with bodily fluid should be thrown away in a trash can meant for clinical waste. Trash cans to be used for clinical waste will be marked and are often red.
Feeling Ill: If you are feeling ill or someone in your family is currently under the weather, monitor your symptoms closely and do not come into work if you are sick. Most patients receiving cancer care and treatments have a lowered immune system. Your immune system is a diffuse, complex network of interacting cells, cell products, and cell-forming tissues that protects the body from pathogens and other foreign substances, and destroys infected and malignant cells. Most cancer treatments lower the effectiveness of this important bodily system. A viral or bacterial infection like the common cold, which a healthy person’s body can fight off, may be very difficult for a person’s body undergoing cancer treatment to fight off. Staying away when you are sick is the most responsible action.
Removing Tripping Hazards: With certain types of cancer treatments, a patient's balance may be negatively affected. Your Allied Healthcare professional will clear the room of tripping hazards and set up your exercise area prior to your treatment time in order to prevent any mis-steps or falls.
Contact Precautions: Contact precautions are used when caring for patients with a potential or confirmed infection that is spread by direct or indirect contact with the patient or the patient’s environment. Contact precaution techniques may differ between inpatient and outpatient facilities, depending on the protocols at the institution where you are being treated. Some of the most common organisms requiring a patient to be placed on contact precautions include:
MRSA – Methicillin-resistant Staphylococcus aureus.
VRE – Vancomycin-resistant enterococci.
C. diff – Clostridium difficile (Hand hygiene must be performed with soap and water. C. diff is a spore that cannot be removed with use of an alcohol-based gel or foam).
Droplet Precautions: Droplet Precautions are used to prevent the spread of pathogens found in respiratory secretions or by coming in contact with mucous membranes. The pathogens are not infectious over a long distance, so no special handling of the air is necessary. However, a private room is suggested, along with the use of a disposable mask by all visitors and health care providers. Some of the most common organisms requiring a patient to be placed on droplet precautions include:
fluenza (Flu).
Viral Respiratory tract infections including adenovirus, parainfluenza, rhinovirus, and RSV.
Pertussis.
Rubella.
Mumps.
Airborne Precautions: Airborne precautions are used for patients who have an infection that remains infectious over long distances when suspended in the air. Patients placed on airborne precautions will be moved to a negative pressure room. A negative pressure room is equipped with a ventilation system in which the air removed from the room is not introduced into the hallway or into any other rooms. The door to the room must remain closed. This prevents the spread of pathogens that can remain in the air for long distances. Some of the most common organisms requiring a patient to be placed on airborne precautions include:
Measles – Rubeola.
TB - Tuberculosis.
Herpes Zoster – Disseminated Shingles (Actively open skin sores. If the sores are crusted and healing, only contact precautions are required).
These precautions are of the highest priority to Allied Health Care workers and are used to keep patients safe. On the flip side, if you are an Allied Healthcare worker at a hospital or a private or public clinic, it is important that you keep in mind that there are precautions when treating and working with patients undergoing cancer treatment.
Precautions for Allied Healthcare Professionals
Barriers: Chemotherapy is strong medicine, so it is safest for people without cancer to avoid direct contact with the drugs, or making repeated skin to skin contact with someone undergoing chemotherapy treatment without barriers. A Focused Review of Safety Considerations in Cancer Rehabilitation states “Physiotherapists are advised to wear gloves during treatment if soft tissue work is part of the treatment plan. Oncology nurses, doctors, physiotherapists, and occupational therapists may wear gloves, goggles, gowns or masks because they are exposed to chemotherapy drugs and patients undergoing treatment every day. When the treatment session is over, these items are disposed of in special bags or bins”.
Burn out: The MayoClinic describes “Job burnout is a special type of work-related stress. It is a state of physical or emotional exhaustion that also involves a sense of reduced accomplishment and loss of personal identity. Although ‘burnout’ isn't a medical diagnosis, some experts think that other conditions, such as depression, are behind burnout. Job burnout can affect your physical and mental health”.
Symptoms/ Consequences
Excessive stress
Fatigue
Insomnia
Sadness, anger or irritability
Alcohol or substance misuse
Heart disease
High blood pressure
Type 2 diabetes
Vulnerability to illnesses
Self- Assessment Questions
Have you become cynical or critical at work?
Do you drag yourself to work and have trouble getting started?
Have you become irritable or impatient with co-workers, customers or clients?
Do you lack the energy to be consistently productive?
Do you find it hard to concentrate?
Do you lack satisfaction from your achievements?
Do you feel disillusioned about your job?
Are you using food, drugs or alcohol to feel better or to simply not feel?
Have your sleep habits changed?
Are you troubled by unexplained headaches, stomach or bowel problems, or other physical complaints?
If you answered yes to any of the above questions, you might be experiencing job burnout. Consider talking to a doctor or a mental health professional because these symptoms can also be related to health conditions, such as depression.
Focus on one problem at a time: When you have a full caseload, are part of a multidisciplinary team, and are providing the best possible care for your patients, it is easy to become overwhelmed. Being able to effectively prioritize your daily tasks and focusing on one task at a time will help practitioners stay on track and give each interaction the necessary care and attention it needs.
Adequate Rest: The importance of adequate rest can not be emphasized enough. It is just as important as exercising and eating a healthy diet. Getting less than 6 hours of sleep a night for 3 nights in a row is considered sleep deprivation.
Here are a few reasons why sleep is so important.
Good sleep improves productivity and concentration.
Good sleep can maximize athletic performance.
You are at a greater risk of heart disease and stroke if sleep is poor.
Less sleep exposes you to a greater risk of Type 2 Diabetes.
Poor sleep is linked to depression.
Quality sleep improves your immune function.
Sleep affects your emotional and social interactions.
Nutrition: Having a balanced diet is vitally important in maintaining health and longevity. Nutritionists use ideas from molecular biology, biochemistry, and genetics to understand how nutrients affect the human body.
An article in Medical News Today notes “nutrition focuses on how people can use dietary choices to reduce the risk of disease, what happens if a person has too much or too little of a nutrient, and how allergies work. Nutrients provide nourishment. Proteins, carbohydrates, fat, vitamins, minerals, fiber, and water are all nutrients. If people do not have the right balance of nutrients in their diet, their risk of developing certain health conditions increases”.
Exercise: The MayoClinic notes “health benefits of regular exercise and physical activity are hard to ignore. Everyone benefits from exercise, regardless of age, sex or physical ability”.
Exercise controls weight.
Exercise combats health conditions and diseases.
Stroke
Metabolic syndrome
High blood pressure
Type 2 diabetes
Depression
Anxiety
Many types of cancer
Arthritis
Falls
Exercise improves mood.
Exercise boosts energy.
Exercise promotes better sleep.
As you can see, your allied healthcare provider takes on substantial precautions and responsibilities to keep their patients and themselves safe when interacting with patients undergoing cancer treatment.
Refrences
OncoLink: Standard Precautions
Mayo Clinic: Job Burnout, How to Spot it and Take Action
Mayo Clinic: 7 Benefits of Exercise
NCBI: A Focused Review of Safety Considerations in Cancer Rehabilitation
Physical Therapy in Patients with Cancer