Health & Safety

The Disability Discrimination Act (DDA) 1995

Under the DDA Act 1996 as a provider of goods, facilities and services your workplace has the duty to ensure that clients are not discriminated against on the grounds of disability. Therefore because of the DDA Act it is unlawful without justification to:

·    Provide a service to a lesser standard

·    Provide a service on worse terms

·    Fail to make reasonable adjustments to the way the services are provided

·   Service can be denied to a disabled person if the denial is justified and if any other client would be treated in the same way. Your employer has a responsibility under the DDA Act to ensure that you receive adequate training to prevent discrimination practice and responsible for your own actions they must also make reasonable adjustments to the premises to facilitate access for disabled persons.

Treatment of minors

Dermal filler treatments are only available to those over 18 . In some exceptional circumstances you may treat someone under the age of 18, however, they should be accompanied by a parent or guardian who must sign a consent form.

Health and Hygiene

Cross Infection occurs through the spread of disease from one person to another through poor hygiene practices. Secondary Infection can occur as a result of further injury to the client during treatment or if the client already has a skin abrasion, if bacteria  penetrates the skin and cause infection. Sterilisation and sanitisation procedures are used in order to minimise or destroy harmful micro-organisms which could cause infection.

Hygiene of the treatment area

Hygiene is very important, not only to prevent cross infection but also to give a professional image to the client.  Below is a list of what is required as a therapist:

·     Always wash hands with medical grade disinfectant soap before and after each client.

      Always where gloves & change at regular intervals where cross contamination could occur

·     Sterilise all tools and equipment.

·     Change towels in the washroom/kitchen area regularly.

·      Use and provide liquid soap (anti-bacterial).

·      Have a separate sink available for clients.

·      Paper towels must be provided at all times.

·      Avoid touching your face & hair whilst working.

·       Do not place tools or implements in your pockets, behind your ears or in your mouth.

·       Use spatulas to remove products from pots.

·       Make sure all bottles and pots are labeled correctly.

·       Sanitise treatment area with cleaning products such as Clinel or Barbicide,

·        Any cuts or abrasions on the hands should be covered & gloves worn

Method Description:

Disinfecting The second stage of decontamination and greatly reduces the pathogenic bacteria on a non-living surface. This method is not suitable for hair, skin or nails. Disinfection is used on walls, floors, work stations, chairs, treatment bowls.

Sterilising Is the total destruction of all living micro-organisms on an object. Items that can be sterilised include metal implements such as a cuticle knife, nippers, tweezers and plastic tools.

Effective methods of sterilisation include a glass bead steriliser, an autoclave and chemical solutions.  The best method is Autoclave.

Accidents

Any accidents that occur in the workplace must be recorded on a report form and entered into an accident book to see where improvements to working practices can be made. The report form requires more details than the accident book – you must note down :

·    The date and time of accident

·    The date entry into the accident book

·    The name of the person or people involved

·    The injury sustained

·    The action taken

·    The signature of the person taking the entry

Practitioners Professionalism and Code of Ethics

In order to have a long standing career in Aesthetics is vital to present the correct impression. Make sure you are well presented and have good communication skills and always carry out treatments to a high standard.

Practitioner Insurance

You must be insured in order to carry out treatments after completion of this course you will receive a diploma certified The Enhance Me Academy which will allow you to get your insurance, we recommend Insync https://insyncinsurance.co.uk/

Health, Safety & Hygiene: 

Safety and hygiene standards should always be as high as possible whenever any form of treatment is carried out.  It is vital that hygiene and cleanliness are prime considerations; not only for the satisfaction of the client but also to comply with legal requirements.  These are laid down by the Health and Safety at work Act and the local Environmental Health Office.  Business premises are inspected annually and must conform to various hygiene requirements.  Regulations may vary from area to area.

Cross infection must be avoided at all times.  By thoroughly checking for contraindications it is possible to avoid working on people who have obvious infections.  However, clients are not always aware that infection is present.  It is therefore necessary for the safety and well-being of both client and practitioner that sound hygiene measures are strictly adhered to.

When performing any type of therapy treatment where very little equipment is used, and the range of the hygiene measures that had to be implemented are reduced:

Tools should always be sterilised

Floors should be hoovered and cleaned daily with medical grade disinfectant

Couch roll used as protective bib when treating your client

Couch covers should be wipeable

First aid kit should be available

Disposeable kidney bowls used for all consumables & prepped before the clients arrival.

Washbasins & all surfaces should be cleaned daily with the appropriate chemical

All surfaces within you treatment room should be wipeable

Disposable gloves should be available

Use antibacterial hand wash between each treatment

Spray  treatment couch with medical grade antibacterial spray after each treatment

 Personal Hygiene:

The practitioner should also adopt high standards of personal image to avoid cross infection at all times:

Always wash hands, preferably with an antibacterial soap prior to the treatment and ensure nails are clean

Long hair should be tied back

Keep fingernails short and wear understated polish.

Wear minimal make up and jewellery

Wash hands with anti-bacterial soap between each treatment.

Client Hygiene & Prep

Provide washing facilities and hand wash for the clients to use before and after treatment.

Avoid working over any obvious skin abrasions

Try to avoid breathing over a client wear a face mask &  encourage them to breathe normally during the treatment

Ensure chewing gum is removed prior to laying your client back for treatment

Preparation of your Work Area:

It is most important that you present the best impression of yourself, whether that is in your own treatment room, in a salon or at a client’s home.  The following information should help you to ensure the best impression is always provided.

Reception

The first impression your client receives will depend upon the way she/he is greeted and the surroundings they are placed into.  A professional atmosphere should always be presented,  front of house staff should be warm and engaging. A private space should be available  to discuss the consultation form and write observations.  Your client should feel comfortable, warm and relaxed.

Calm efficiency and organisation should be clearly apparent to the client from her first contact with you as this will instil confidence in the professional skills you will be offering.    It is essential that you have an excellent consultation technique, together with a sound knowledgeable response to any questions the client may raise.

A tentative enquiry, if dealt with in a calm, efficient and knowledgeable manner, can become a regular client booking.  Client satisfaction will result from fulfilling the requirements of the client in a professional and efficient manner.  You should always refrain from pressurising a client into taking treatments or buying product, you should always offer a cooling off period where appropriate,.

Work Area

Preparation of the working area prior to the client’s arrival is vital, not only to provide the right impression to the client, but also to ensure that the treatment provided can be completed in the given time frame.  It also minimises the risk of cross contamination.

A therapy room should be relaxing yet clinical & spotlessly clean. The working area should preferably have a good supply of natural light. The environment quiet.

Windows should be adequately screened with binds/curtains so that the client feels they have total privacy

Ensure you are not interrupted during the client’s treatment time

Turn mobile phones to silent

The room you work in should be adequate in size and allow you to walk freely around your client.

The floor & all surfaces should be of a material that is wipeable. Your treatment room will not meet council guidelines if this is not the case

Always make sure that the room you’re working in is sterilised & clean. Remember, first impressions last

A couch with a wipeable cover should be provided with suitable support for your client

Temperature and ventilation – Your room must be warm enough for the client not to become chilled but not so warm that it’s uncomfortable for you to work or to compromise the clients comfort.

Preparation of the client:

Many clients will feel a little nervous and apprehensive on their first visit to you, it is important to reassure the client and make her feel at ease in unfamiliar surroundings.

Complete a client consultation with the client and gain written consent for the treatment to go ahead. This is essential and may invalidate your insurance if you do not obtain written consent.

When the client is laying comfortably on the couch, explain the treatment procedure again to the client.

Use this check list as a guide:

Syringes

Magnification Lamp

Hair Nets

Gloves

Skin sterilizing spray

Gauze/Wipes

Chosen Product

Medical Waste Bin

Face Mask

Numbing Cream

Consultation and timings including Data protection, medical history and client consent

Consultation:

With any new client a full and thorough consultation must take place before any treatment can go ahead.  It is important to make a good impression on the client and to create an air of confidence.  This gives the client the reassurance that you are a professional therapist/ aesthetician.  Clients are often unsure of the treatment’s they actually need, so will ask for your professional advice, enforcing how vitally important it is that they trust you, your skill set and knowledge within your qualifications.  Consultation is the first stage where the client can see your expertise & the client / practitioner relationship is formed.

During the consultation there are a number of areas which must be covered, firstly consultation allows us to establish whether the treatment can go ahead or whether it is contra indicated.

Consultation is carried out in a private place where it cannot be overhead, seated next to our client is the most appropriate.  All the information obtained should be recorded on the clients consultation record

If you suspect the client has a condition that you are unsure of always refer her to a GP and where necessary ask for a doctor’s note confirming if treatment can go ahead

The client must be given the opportunity to ask any questions regarding what the treatment involves, every effort must be made to accommodate the client needs however awkward they may seem.

The client should be made aware of any additional treatment costs involved so they are not surprised at the end. If the client expresses concerns or is unsure as to wether they wish to proceed with the treatment, they must not be co-erced in to proceeding and should be given a cooling off period to allow time to consider their options.

Once you have discussed the clients expectations, agreed a treatment plan and explained the possible reactions the consultation card can be updated accordingly.  Obtain, signed and written informed consent from the client prior to carrying out the treatment.  This ensures the client has no contraindications to the treatment, which including massage and that they are the legal age of consent for treatment obtaining signed, written & informed consent.

Consent & After Care forms

 Ensure your client carefully checks, signs and dates the record at the end of the consultation, stating that all the information is true and to the best of their knowledge.  It is imperative that the therapist also dates and signs the entry on every client visit, this is also a legal requirement.  It is advisable to ask the client to sign and date the statement that they have were happy with the results of their treatment & they have been given aftercare advice and that they will adhere to this advice.  For example I agree to follow the written and verbal aftercare advice which has been given.  Some insurance companies stipulate this as a legal requirement of your policy and in the event of a claim being made against you, if this wasn’t completed it would invalidate your insurance.

Failure to keep up to date, accurate, complete, legible and signed records could result in an unsafe treatment and possibly legal action being taken against you and or the Clinic.

The information on the client record should be rechecked every time they visit your premises to ensure record are up to date and there are no changes, for example if a client has stated medication it may affect their skin and make it hypersensitive to products.

The Data Protection Act 2018 is the UK’s implementation of the General Data Protection Regulation (GDPR).

Everyone responsible for using personal data has to follow strict rules called ‘data protection principles. You must make sure the information is:

·        used fairly, lawfully and transparently

·        used for specified, explicit purposes

·        used in a way that is adequate, relevant and limited to only what is necessary

·        accurate and, where necessary, kept up to date

·        kept for no longer than is necessary

·       handled in a way that ensures appropriate security, including protection against unlawful or unauthorised processing,               access, loss, destruction or damage

There is stronger legal protection for more sensitive information, such as:

·         race

·         ethnic background

·         political opinions

·         religious beliefs

·         trade union membership

·         genetics

·         biometrics (where used for identification)

·         health

·         sex life or orientation

There are separate safeguards for personal data relating to criminal convictions and offences.

Your rights

Under the Data Protection Act 2018, you have the right to find out what information the government and other organisations store about you. These include the right to:

·         be informed about how your data is being used

·         access personal data

·         have incorrect data updated

·         have data erased

·         stop or restrict the processing of your data

·         data portability (allowing you to get and reuse your data for different services)

·         object to how your data is processed in certain circumstances

You also have rights when an organisation is using your personal data for:

·         automated decision-making processes (without human involvement)

·         profiling, for example to predict your behavior or interest

 Preparation of Needles:

Dermal filler syringes are all sealed, the method of attachment is known as lock and load.

Safe handling of needles, before, during and after treatment: 

Needles are all sterile, always handle wearing gloves, they are single use only.

Disposal of needles:

Immediately after use the entire unit must be placed into the sharps bin.  The trolley must be sanitized and gloves changed

Disposal of waste

All waste should be disposed of in an enclosed pedal operated waste bin fitted with a polystyrene bin liner durable enough to resist tearing. The bin should be regularly disinfected in a well-ventilated area. Hazardous waste must be disposed of following the COSHH procedures and training by the employer.

Clinical Waste

Clinic waste is derived from human tissues this can include blood and tissue fluids. This should be disposed of as recommended by the environmental agency. In accordance to the Waste controlled regulations (1992).

Disposal of sharps:

Category ‘B’ Waste

The procedure for ‘Category B’ waste (e.g. tattoo needles and lancets) should include the following measures:

·         Category B’ waste must never be placed in container used for the storage of other waste particularly not in plastic sacks.

·         Category B’ waste must be put into properly constructed ‘sharps’ containers which are usually yellow in colour and made of hard material such as plastic. The containers must meet the requirements of BS7320: 1990 and/or be UN type-proved.

·         While in use ‘sharps’ containers must be kept out of reach of members of the public small children and people who may not appreciate the risks associated with this type of waste.

·         To avoid the risk associate with over-filling ‘sharps’ containers should be removed when three-quarters full, sealed and labelled. They should not be placed in regular white sacks.

What are sharps?

In the UK proximately 100,000 Needlestick injuries reported every year.

Suffering from an accidental sharp’s injury could have significant consequences, including leaving you susceptible to contracting various blood borne virus’s Many of which are incurable.

Therefore, it is important that you understand how to handle and dispose of needles and sharps in accordance with best practice guidelines and in a manner that allows you to conform to your legal duties.

What are sharps?

The definition of a sharp is any item that could result in a cut or puncture wound to an individual. The type of sharps you may encounter include:

• Needles and hypo dermic needles
• Syringes
• Scalpels
• Blades including knives insoles
• Broken glass
• Nails and screws

Who is at risk of a sharps injury?

In the healthcare sector the high number of needle stick and sharps related injuries continues to be a problem. NHS nurses are of particular high risk of sharps related injuries as many of their daily activities involve the use of needles and sharps.

Many other health professionals, and those who work in healthcare settings are also at risk, including: Dentist and dental nurses & aesthetic practitioners

Also :

• Doctors
• Paramedics
• Laboratory workers and technicians
• Cleaners
• Veterinary staff

Though the use of needles, scalpels and other medical sharps is closely tied with work in the health service industries, these workers are not the only ones at risk.

Other workers who are at risk include:

• Police officers
• Prison offices
• Customer offices
• Social workers
• Waste refuse collectors and street cleaners
• Body piercing and body art specialist

Any worker who comes into contact with sharp materials that could be contaminated with blood or other bodily fluids is also at risk.

The main risk associated with sharps injuries

There are several health risks associated with sharps injuries. Accidental punctures can have serious mental and physical repercussions. Even very small amounts of bodily fluids for the sharps can transmit diseases.

The health risks associated with the sharps injury include:

• Exposure to blood-borne viruses (bbv) including human immunodeficiency virus (HIV), hepatitis B (HBV) and hepatitis C (HCV)
• Exposure to other pathogens. Sharps injuries can transmit a number of bacteria, fungi and parasites. These include malaria, tuberculosis and cuntaneous gonorrhea.
• Psychological stress on the person and they close family. This stress could extend for several months as testing is carried out in the seriously impact on people ‘s lives.

If an employee Suffers sharps injury, it can also have a large impact on the company they work for, such as:

• Lost Working time. This could be a result of stress, anxiety or contracted illness that results in extended sick leave.
• Carrying out investigations. After an incident, investigations must be carried out to understand how and why the incident occurred. These investigations come because in.
• Replacing a staff member. It can be very costly to a business if they need to recruit and train new staff.

Human immunodeficiency virus (HIV) is a virus that damages the cells in your immune system, weakening your ability to fight infections and diseases.

Presently, there is no cure for HIV. However, by using the effective drug treatments available, most people with HIV can continue to live long, healthy lives.

If left untreated the HIV virus can severely damage, your mean system and can lead to aids (acquires immunodeficiency syndrome). Aids occurs when your immune system is so weak that you are unable to fight off infections and cancers, or your CD4 cell count drops to under 200.

HIV is one of the most serious risks associated with receiving an accidental puncture from a used shark. HIV is a transmitted through blood and other body fluids, therefore, there is a risk of contracting the virus if you have a sharps injury. It’s important to seek medical advice as soon as possible if you have a sharp syndrome.

Blood borne virus (BBV)

Hepatitis B is a virus that can affect the liver and can result in serious liver damage. It’s transmitted through blood and other bodily fluids, so there is a risk of contracting hepatitis B if you have a sharps related accident.

Many people will not experience any symptoms and might fight off the virus without ever knowing they were infected. However, the consequences can be serious, you should seek medical advice if you believe you’ve been exposed.

Hepatitis B is also a virus that can Infect the liver. It is transmitted through blood and, if left on treated, can result in serious damage to the liver.

Hepatitis C can usually be cured, with the infected individual often retaining a normal lifespan. However, like hepatitis B, hepatitis C often does not have any symptoms. Therefore, if you have had a sharps related injury, it is important you are tested as soon as possible.

The facts

In 2008, the Royal College of nursing card out a survey or 4407 nurses about needlestick injuries. It found that coat on

• 48% of those asked had been injured with a used needle at some point in their career
• 10% had received an injury in the last year
• 28% of those that Had sustained an injury was given no advice on the risk of BBV’s post injury

The publication also highlighted the lack of training that those work in the sharps are provided with. It was found that only 55% of nurses have been provided with some former sharps training bother employer.

Training is essential for ensuring that those at risk of an injury are provided with the knowledge needed to carry out their work safely.

As we have seen, injuries can have a serious impact on the life of the infected individual and on the company, they work for. Therefore, it’s vital that you’re aware of how to reduce your risk of a sharps injury and ensure your safety.

Exercise

Which one of the following is a sharp?

A wrench

A pen

A hammer

A screw

Sharps and the law

Sharps are dangerous. Improper use can have serious mental, physical and monetary consequences. Therefore, it’s important that sharps use is carried out safely and in accordance with the law.

There are several pieces of legislation that cover the use of sharps and provide guidelines and guidance for implementing safe systems of work in the workplace.

This module is designed to help you understand the responsibilities that healthcare Employers have to protect their workers from sharps related injuries, the duties placed on employees and the consequences of not complying with the law.

Topics to be covered

Health and safety (sharp instruments in healthcare regulations 2013)

Employers who organise, manage or provide healthcare have a legal responsibility to comply with the health and safety regulations 2013. This includes:

• NHS providers
• GP practices
• Independent health care providers including Aesthetic Practioners
• Hospices
• Nursing homes
• Healthcare workers who visit patients at home

These regulations also cover contractor organisations that provide services for the healthcare industry. In this situation, the healthcare employer has the responsibility of cooperating with the contractors and providing any relevant sharps information.

However, there are some healthcare professionals who are not covered by the regulations, including:

• Prison nurses
• School nurses
• Local authority nurses

The regulations implement the principles of the EU Council directive 2010/32/EU and place several duties on the employers to ensure the safety of the workers. Employers must:

Assess the risk of sharps injuries under the control of substances hazardous (COSHH)to health regulations.  Employers should attempt to avoid the use of sharps but, if this is not reasonably practicable, they must introduce other controls. This includes the use of safe sharps when the principal, presenting the recapping of needles and ensuring secure disposable containers, alongside the implementation of other safe work systems.

Appropriately train all employees and provide them with information on the risks associated with sharps injuries, employer and employee legal responsibilities, good working practices, the benefits and drawbacks of vaccination and what support is available for rent an injury.

Have a set of procedures in place for what employees must do in the event of an injury

Record the details of the incident, carry out an investigation and decide what actions should be taken to prevent a reoccurrence.

Periodically review their health and safety procedures and controls.

Employee duties

As an employee you have the following responsibilities:

• protect the health safety and welfare of yourself and others, as far as is reasonably practical.
• Adhere to the safety procedures, policies, risk controls and safety systems of work set out by your employer
• Work safely and responsibly. You must cooperate with your employer and follow all health and safety advice.
• Cooperate with the periodic reviews of control measures and risk assessments that your employer must carry out.
• Attend all relevant training opportunities and read the safety information provided to you.
• Report any defective equipment workspaces or unsafe systems of work to the responsible person. You should be made aware of who the responsible person is.

Additionally, you have a legal responsibility to inform your employer of any sharps related injuries and near misses soon as you can.

Reasonably Practiceable

The term reasonably practiceable appears several times when describing both employer and employee duties Regarding sharps safety

What does reasonably practicable mean?

Reasonably practicable means that the money and time required to reduce or eliminate a risk must be weighed against how great the risk is. The greater the risk the more money and time your employer should spend reducing it.

What happens if you don’t comply?

Health and safety laws are criminal law. By ignoring the requirements to prevent sharps injuries, healthcare providers could be liable to face enforcement action, significant fines and compensation payments

Further key sharps related legislation

Control of substances hazardous to health regulations 2002 (medical waste)

Employers are required to identify and assess the risk of, and control and monitor the exposure to, any substances hazardous to health. This includes biological hazards, such as exposure to BBVS.  There is no such way to eliminate exposure completely, employers must implement safety procedures to prevent exposure, including safety engineered devices, safe systems of work and protective clothing.

Employees must also ensure that all staff members receive appropriate training for positions and must have systems in place to carry out follow up health checks in the event of exposure.

Health and safety [first aid] regulations 1981

Employees must Have suitable equipment, facilities and personnel to provide their employees with immediate attention if they suffer a workplace illness or injury.

First aid treatment must be immediately available following a sharps injury and employees must have access to out of our support

Provision and use of work equipment regulations 1998

Employees must provide task appropriate equipment and information on how to safely use it.

Management of health and safety at work regulations 1999

Employees must ensure that their employees are properly trained for their roles. Workers must be provided with the information needed to understand the risks associated with sharps injury and how they can reduce the risk of sustaining an injury.

Personal protective equipment (PPE) regulations 1992

Employers must provide task appropriate PPE for all risks that cannot be reduced or illuminated by other measures. This could include goggles aprons and gloves

You should also have an understanding of:

Reporting of diseases injuries and dangerous occurrences regulations 2013

Employees must formally report any sharps injuries to the health and safety executive where the injured person is known to have been exposed to a BBV, such as where the patient is a known BBV carrier. Employers must also report any cases where a worker is injured by a sharp and develops the BBV.

Safety representative of safety committee reservations 1977

Employers are required to consult with safety representatives to ensure that all control methods, Equipment and PPE are suitable for their intended tasks. Safety representatives must be given paid time off to carry out their duties.

Strategy to reduce sharps related injuries :

Your organisation should be thoroughly invested in reducing shots related injuries in the workplace. Senior management should ensure that the necessary funding and resources are made available to prevent injuries, as prevention is cost-effective.

Sometimes a steering group is created to look at the implementation of sharps regulations across the organization, monitor and review the risk assessment processes and make decisions regarding the purchase of equipment.

This steering group should be made up of:

• Safety representative
• Management
• Procurement staff
• Infection prevention and control committee
• Health and safety committee
• Estates and facilities representatives
• Frontline staff who directly use sharps

Even if your organisation does not have a steering group, safety representatives should be fully involved in all decisions on initiatives to reduce sharps related injuries

Safe use of needles and sharps

Sharps related injuries pose many hazards, including the risk of contracting a BBV and the stress and emotional burden that the aftermath of an injury can cause.

Bad practice cannot only result in an injury to yourself it can also be dangerous to patients and other employees. Therefore, it’s important that you understand how to use and dispose of sharps safely to minimize the risk to yourself and others.

This module will help you to understand the main bad behaviours that result in needlestick injuries and will provide you with the best practice guidelines for safe sharps usage.

Work practices that are likely to result in a sharps injury are:

• Improper use of a sharp. Sharps should always be used according to best practice guidelines and only after appropriate training
• Recapping a used needle. Recapping a needle is dangerous as you can easily miss the cap and puncture your skin you should never recap a needle
• Other post use activities before disposal. This could include dismantling a sharp or when cleaning up after using one.
• Improper disposal. You must always follow the correct procedure to dispose of a needle immediately after you have finished using it. Improper disposal of a needle is not only dangerous for the needle user: by disposing of a needle in a non-sharps bin, you increase the risk of a sharps related injury for anyone removing that refuse.

By following best practice guidelines for sharps you can help to protect yourself and others from the emotional and physical burdens of receiving a sharps injury.