Lecture Clinical procedures for medical assisting (4/e): Chapter 4 – Booth, Whicker, Wyman

CHAPTER

4

Preparing the Exam
and Treatment
Areas
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4­2

Learning Outcomes
4.1

Explain the medical assistant’s role in
preparing the examination room.

4.2

Describe the layout and features of a typical
examination room.

4.3

Describe steps to prevent the spread of
infection in the examination room.

4.4

Explain how and when to disinfect

examination room surfaces.

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4­3

Learning Outcomes (cont.)
4.5

Describe the importance of such factors as
temperature, lighting, and ventilation in the
examination room.

4.6

Identify instruments and supplies used in a
general physical examination, and tell how to
arrange and prepare them.

4.7

Explain how to eliminate hazards to physical
safety in the examination room.

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4­4

Introduction
• Preparation of the exam room and
treatment area
– Common layouts
– Cleanliness and supplies
– Comfort of room
– Safety

• Accessibility based on the Americans with
Disabilities Act

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The Medical Assistant’s Role in Preparing the
Examination Room

4­5

• Maintain neatness and
cleanliness of the room
• Ensure that all supplies
and equipment needed
are present for the
physician’s use
• Make certain that
potential safety hazards
are eliminated

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The Medical Assistant’s Role in Preparing the
Examination Room (cont.)

4­6

• Main concerns are

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4­7

Apply Your Knowledge
What are three tasks the medical assistant
should do to prepare the examination room?
ANSWER: The medical assistant should
 Maintain neatness and cleanliness of the room
 Ensure that all supplies and equipment needed are
present for the physician’s use
 Make certain that potential safety hazards are eliminated

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4­8

The Examination Room
• The area where the

physician:
– Observes the patient
– Listens to patient
symptoms
– Performs a general
physical examination
to confirm health or
diagnose a medical
problem

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4­9

The Examination Room (cont.)
• Number and size of rooms
– Depends on the number of
physicians in the medical
practice
– Average size room is
8 × 12 ft
– Rooms should be large enough for patient,
physician, and medical assistant, yet small
enough to have supplies within reach

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4­10

Exam Room Furnishings
• Should be arranged for:
– Efficiency
– Patient comfort
– Physician convenience

• Items commonly found in examination rooms





One or more chairs
A rolling stool
Weight scale
Biohazard container






Wastebasket with lid
Puncture-proof containers
Wall brackets
High-intensity lamp
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4­11

Special Features
• The 1990 Americans with Disabilities Act
(ADA)
– Requires “reasonable accommodations”
– Compliance requires that medical office be
accessible to patients with disabilities
• Accessibility – the ease with which people can
move in and out of a space

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4­12

Special Features
Doorway must be at
least 36 inches wide

ADA
Guidelines

Clearance space in rooms
and hallways at least 60
inches wide

Door closers must be adjusted
to allow entry and exit time

Grab bars in
lavatories

Door-opening hardware can be
grasped with one hand and
does not require twisting of
the wrist to use

Slip-resistant floors

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4­13

Apply Your Knowledge
When arranging an examination room, what three
things should you consider?
ANSWER: You need to consider efficiency, patient
comfort, and physician convenience when arranging
an examination room.

Right!
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4­14

Cleanliness in the Examination Room
• Strict housekeeping standards

• Adherence to government guidelines
• Infection control
– Make hand washing a priority
– Keep examining table clean
– Disinfect all work surfaces

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4­15

Cleanliness in the Exam Room (cont.)
• Clean hands – first step in preventing infection
transmission
• Wash hands
– At the beginning of the day
– Before and after contact with each
patient
– Before and after using gloves
– Before and after eating
– After coughing or blowing your nose
– Before handling clean or sterile equipment
– Before leaving for the day

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4­16

Cleanliness in the Exam Room (cont.)

• Examining table
– Change the disposable paper
covering the examination
table after each use
• Dispose of paper coverings
soiled by body fluids in a
biohazardous waste container

– Also place soiled linens and pillowcases in
biohazard-labeled bags.

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4­17

Cleanliness in the Exam Room (cont.)
• Surfaces
– 10% bleach solution or
product approved by
the EPA
– Disinfect work
surfaces if visibly
contaminated and at
end of shift

• Storage
– Store biohazardous
specimens properly
– Store testing kits

properly

• Sink and countertops
• Examination table
• Patient lavatory

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4­18

Cleanliness in the Exam Room (cont.)
• Putting the room in order
– Straighten room between patients
– Boosts patient confidence in efficiency and
abilities of medical personnel

• Housekeeping
– Janitorial services for after-hours cleaning
• Monitor for lapses in cleanliness

– Medical assistant may do some housekeeping
chores

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4­19

Good 

Job!

Apply Your Knowledge

A medical assistant at a busy pediatrician office notices a
foul odor in two of the patient examination rooms. After
careful inspection, the medical assistant finds soiled diapers
in the biohazardous containers of both rooms. How would
you handle this situation?
ANSWER: The first priority is to remove the source of odor, then to
decontaminate the area. It may also help to designate a separate
location in the office for soiled diapers so that parents will know
how to dispose of them. Many pediatrician offices have a system in
place to prevent such odors in treatment room areas.

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Room Temperature, Lighting, and
Ventilation

4­20

• Maintain
examination room
temperature at
about 72°F
• Eliminate drafts
from windows and
doors

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Room Temperature, Lighting, and
Ventilation (cont.)

4­21

• Good lighting needed
– Accurate diagnoses
– Perform medical
procedures
– Read orders and
instructions
– Prevent accidents

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Room Temperature, Lighting, and
Ventilation (cont.)

4­22

• Examination area should smell
clean and fresh
• Eliminate source of odors
• If opening windows, monitor
room temperature

• Room deodorizer or spray

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4­23

Apply Your Knowledge
Why is it important to have good lighting in the
examination room?
ANSWER: Good lighting is needed for making accurate
diagnoses, performing medical procedures, reading orders
and instructions, and preventing accidents.

Excellent!
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4­24

Medical Instruments and Supplies
• Tasks to maintain instruments
and supplies
– Order and stock all needed
supplies
– Sanitize, disinfect, and/or
sterilize instruments as needed
– Instruments and supplies should be placed
within easy reach for the physician

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Instruments for a General Physical
Exam
Instrument

4­25

Purpose

Anoscope

Used to open the anus for examination

Examination light

Provides additional lighting

Laryngeal mirror

Reflects inside of mouth and throat

Nasal speculum

Used to enlarge the opening of the nose

Ophthalmoscope

Used to examine the inner eye surfaces

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