RISK MANAGEMENT Rosaura L. Albert

RISK MANAGEMENT Rosaura L. Albert

Assignment for partial fulfillment

Of the Subjects

SIBBHRS705A

APPLY INTENSE PULSE LIGHT

AND LASER SAFETY PROTOCOLSHLTIN402B

MAINTAIN INFECTION CONTROL STANDARDS

IN OFFICE PRACTICE SETTINGS

RISK MANAGEMENTBy

Rosaura Luminita Albert

12th May 2014

The Australian College

MHM EDUCATION & TRAINING

BROADWAY

Introduction Customer is a key valuable factor in a company. Dealing with people seems to be the most challenging task for management. Most of companies are moving from product oriented strategy to customer oriented strategy. They focus on customers needs and wants as well as provide the better services to satisfy customers. Customer satisfaction or dissatisfaction can decide the existence or death of a company. If possible to measure and improve customer satisfaction, a company can keep customer stay longer period of time.

Measuring customer satisfaction with products is hard but it is even more difficult to know how happy they are with services. Due to the fact that service is intangible, customers cannot directly measure the quality of service. Therefore, they usually evaluate services based on the tangible clues associated to services such as service facilities, communication, etc. Any direct interaction between Beauty Therapist and clients is followed by a chain of elements of client satisfaction and sometime a number of issues or risk have to be acknowledged and identified.

Risks and hazards

A hazard is something with the potential to cause harm. A risk is the likelihood that the harm will occur from exposure to the hazard. For example, if you have identified electricity as a potential hazard in your workplace, the risk is the likelihood that a worker might be electrocuted because of exposure to electrical wires that are inadequately insulated.

Hazards involving the risks of illness or injury may include: chemicals and substances hazards - such as hazardous substances and dangerous goods, asbestos, lead and waste management biological hazards and infectious diseases - such as legionella and swine influenza physical hazards - such as equipment, confined spaces, electrical hazards and working at heights manual tasks hazards - such as the use of the human body to perform any kind of manual task environmental hazards - such as noise, lighting, surrounding environment (including uneven floor surfaces, etc.), cold, dust and heat stress psychosocial hazards - such as fatigue, mental stress, workplace harassment and occupational violence.

Background information:

There are six steps in a formal risk management process within the Beauty Industry. Such as:1. Establish the context:Rosaura is the new owner/manager of a clinic which is offering comprehensive treatments for hair removal and hair reduction. The clinic has 2 locations and the operating program is:

Monday to Thursday 9:00am to 17:00pm

Friday 9:00am to 15:00pm

Sunday 9:00am to 12:00

The treatments you offer include:

Waxing

Electrolysis

Laser and intense pulsed light (IPL).

Rosauras Beauty Salon is a new-fashioned, traditional salon located in the heart of Cooranbong. Most of Rosauras clientele are women aged 35 to 85, but the median age in Lower Hunter is now 52.

Rosaura.s provides hair services to both women and men, but the vast majority of its clients are women.Customers are mostly local elderly neighborhood women who have been loyal to the salon since it opened. The only marketing tool is word-of-mouth. As the majority of customers are retirees on a fixed income, they are highly price sensitive. Any direct interaction between Beauty Therapist and clients is followed by a chain of elements of client satisfaction and sometime a number of issues or risk have to be acknowledged and identified.

Taking over the business I decide to undertake a full risk management analysis in relation to the treatment only. This will include infection control risks and that surround the use of laser and IPL treatment for hair reduction. Risk management is a process that is undertaken to undermine if there is a risk to the business and then developing approaches that avoid, reduce or control that risk. Some risks can be insured against some cannot. For this reason it is wise for the small business t o develop procedures to firstly identify the risk and then decide how they can be minimize or avoid it.

Risk management:

It is a statement of plans, and an allocation of individual responsibilities, for translating collective decisions into actions. This process should name all the relevant people involved in the treatment and support, including the individual service user and appropriate informal carers. It should also clearly identify the dates for reviewing the assessment and management plans.

Ignoring risks means that the health and safety of employers and clients can be threatened; the reputation of the business may suffer as clients lose their confidence in the clinic and this can affect the financial viability of the clinic.

2. Identify the risks:Risk management legislation

Under the How to Manage Work Health and Safety Risks Code of Practice 2011, to properly manage exposure to risks you must:

1. look for the hazards

2. determine who might be harmed and how

3. decide on control measures

4. put controls in place

5. review the controls. Control measures should be implemented in the following order:

1. Get rid of the harm or prevent the risk.

2. If this is not possible

replace with something less harmful

separate people from the harm

change work processes or the physical work environment (e.g. by redesigning work, plant, equipment, components or premises)

apply administrative arrangements (e.g. limit entry or time spent in a hazardous area)

Each consultation has to be followed by a proper documentation procedure and a fact test.

Health risks associated with the beauty therapy industry

There are a number of health risks associated with the beauty therapy industry, including;

Viral infections (hepatitis B and C, HIV/AIDS)

Bacterial infections (Staphylococcus aureus, Staphylococcus epidermidis)

Fungal infections (Candida albicans).

Waxing

A person who uses wax for the purposes of hair removal:

No double dipping (new spatulas)

No rollers

Complaints re: infections from Brazilian Bikini Wax must dispose of that wax immediately after completion of the hair removal procedureReuse of depilatory wax (semi-critical procedure)

Body hair can accumulate microorganisms on the skin. Removing hair with the use of wax also removes these microorganisms, contaminating the wax as a result of this process.

Simply melting down the wax does not destroy these micro-organisms and the reuse of this wax could lead to the transmission of diseases such as HIV/AIDS.

The importance of separating unused wax and used wax (semi-critical procedure)

It is important to separate unused wax from wax to be used on a client. This will prevent the cross contamination of microorganisms from a clients skin to the unused wax stock.After waxing the pores in the skin may be open for up to 48 hours after, making the skin more sensitive to ultraviolet light. It is recommended that clients who have had waxing done should be advised not to do any of the following until 48 hours after the procedure;

Sunbathe

Have a solarium treatmentElectrolysis (critical procedure)

During the electrolysis hair removal procedure, the needle enters the skin surrounding the hair follicle which may result in the contamination of the needle with small amounts of blood and body substances. The transmission of blood borne infections is then possible.

Only single use electrolysis needles are permitted. Only sterile needles are to be inserted into the electrolysis equipment at the start of the treatment. The same needle can be used for removing as many hairs necessary from one client at a single session. Used needles must be disposed of into a sharp

container upon completion of the procedure. The needle used for one client cannot be stored and then used again for the same client at following electrolysis sessions. A sterile needle must be used for each treatment session.Risk management:

It is a statement of plans, and an allocation of individual responsibilities, for translating collective decisions into actions. This process should name all the relevant people involved in the treatment and support, including the individual service user and appropriate informal carers. It should also clearly identify the dates for reviewing the assessment and management plans.

Static electricity hazards in the workplaceThe rubbing of towels or clothes against each other or walking over a floor covered in synthetic carpet can generate electrostatic sparks. This can cause a number of problems:

Electrostatic shocks are unpleasant. Even if not painful, such sparking is not likely to induce the feeling of calm essential in ensuring the client leaves the salon in a relaxed state of mind. The smaller the contact surface area, the more concentrated the discharge and the larger the spark size. Fingertips have a relatively small surface area so any discharge will result in large, unpleasant sparks.

Electric sparks are hot enough to make a mixture of flammable gas and air ignite. Various solutions used in the salon as part of services or for cleaning and disinfection purposes are volatile and will burn if sparks are generated in their vicinity. Common flammable substances are methylated spirits, acetone and turpentine.

Electrostatic discharges can damage micro-electronic equipment.

Electrostatic charges on surfaces and glass can make them very difficult to clean. The build up of charge on a surface can attract dust particles to it.

Prevention Avoid having synthetic carpet in the salon, as walking on it will cause a build up of static charge. (Carpet is undesirable in a salon anyway, as its cleanliness cannot be maintained at an adequate level. Its use must be confined to the reception area only.) Select floor coverings, materials and clothing that miminise electrostatic buildup. Applying antistatic solutions and sprays will help reduce static.

Wear rubber soled shoes which act as good insulators.

Before touching a client, touch something metal (a conductor) connected to the earth, as this will allow any built up static to be discharged. A metal tap is ideal. The pipes are connected to the earth, which effectively drains away the charge.

Place sensitive electronic equipment on an anti-static mat and ensure the equipment is properly earthed.

Note that it is the discharge of static electricity, not its build-up, which is of concern.

In nature, static electricity builds up in the atmosphere due to friction between ice particles in the clouds. When there is a sufficient build up of charge, a discharge occurs, producing a flash of lightning and a roll of thunder. This is, of course, called lightning. Lightning discharges can cause death, damage property and start fires.

Identify safety considerations when using electricity in the workplace

Risks from electrocution

Most electrical equipment designed for use on clients in the salon operates on 240 V mains power outlet and may expose the client and the therapist to one or more of the following risks.

Electric shock:

The human body is a very good conductor of electricity and contact with live electrical conductors may cause severe, often fatal, electric shocks. Nerves and blood vessels are particularly good conductors. Nerve injury, with resultant motor and sensory impairment, often occurs as a result of an electrical shock. However, of all the tissues of the body that are affected by electricity, muscles are the most sensitive. Regardless of whether a muscle is under voluntary or involuntary control, the nerve impulses that control the muscle are electrical and can be affected by the application of an external current.

Normally, current flow in the human body is expressed in the order of milliamperes (mA). At 240 V, currents in excess of 15 to 20 mA flowing for a few seconds or longer can be fatal. If a 50 Hz AC current is applied to the skin of the hand, the lowest current that can be felt is about 1 mA. If the current is between 1 and 10 mA, a tingling sensation can be felt as sensory neurons are stimulated. Currents between 10 and 16 mA will cause the muscles of the hand and arm to contract, locking the fingers around the conductor being touched. There may also be violent muscle contractions in other parts of the body. Currents between 16 and 80 mA result in extreme pain and possibly fainting. The chest muscles contract and breathing may stop, causing death in a matter of minutes. Currents between 80 and 100 mA result in ventricular fibrillation during which the muscles of the heart contract in an uncoordinated manner, resulting in an interference with blood supply. Death will follow shortly unless medical assistance is received.

Burns:

As the frequency of the current increases above 100 Hz, the likelihood of electric shock diminishes and burns become the dominant hazard. Serious burns may occur from an electric shock at the resistance of the skin, resulting in the conversion of electrical energy into heat energy.

Mechanical injury:

While not electrical in nature, mechanical injury can occur from sharp objects and rotation parts on electrical equipment. The moving parts of electrical equipment, if not secured in place, may shift during operation (just like a washing machine with an unbalanced load often moves from its original position).

Radiation:

Radiant energy in the ultraviolet to infrared range (that is, from UV lamps and solariums, lasers and infrared lamps) can cause damage, possibly permanent, to the tissues of the eye or the skin. Electromagnetic radiation can interfere with cardiac pacemakers and similar devices, thereby presenting a definite risk to life.Factors affecting the severity of an electric shockFor an electric shock to occur, contact must be not only with a live conductor but also with another conductor, the earth return wire, or be in some way connected to the earth via conductive materials (for example, on the ground or in contact with metal pipes, conductive building materials). The severity of an electric shock is not determined by the voltage alone, but depends on the intensity of the current, the path of the current through the body, the length of time the current is flowing and the type and frequency of the current.

Time of current flow:

The shorter the time the current flows through the body, the greater the chance of survival (thus the importance of earth leakage circuit breakers).

Path of current flow:

If the current flows through the hands, the arm muscles controlling the hands will contract, causing clenching of the fist and possibly an inability to let go of the live contact. If the current flows through the chest, the diaphragm and muscles of the chest may become paralysed and breathing may stop. The heart may also be affected, resulting in ventricular fibrillation or complete cardiac arrest.

Amount of current flow:

The amount of current flowing into the body will depend on the resistance. Body resistance varies considerably. The skin has much more resistance than internal tissues and dry skin has a greater resistance than skin that is wet or sweaty (the normal resistance of a sweating palm to mains electricity is about 1500 ohms). The danger of electric shock is therefore much greater when electrical appliances are in the vicinity of water.

Type and frequency of current flow:

DC currents produce similar effects to AC currents by the minimum DC current that will cause each of the effects mentioned is usually higher than the corresponding values for AC. The severity of AC shocks will be affected by the frequency of the current, as only low frequency AC will produce muscle contractions. Unfortunately, an AC current of 50 Hz is well within this range and is an excellent inducer of muscle contraction.

Precautions to be observed when using electrical equipment

The operator must be familiar with the correct operation of equipment. This means they must read the manual provided by the manufacturer and familiarise themselves with all aspects of the operation of and safety procedures for the equipment.

The variable output of the electrical equipment (the intensity setting), particularly equipment having electrical connections to the clients body, must be adjusted to minimum levels before use.

Possible danger signs must be recognised and the equipment should be immediately disconnected from the power supply and tested by qualified personnel (an authorised repairer for the manufacturer, importer or agent for the equipment). An electric shock from any equipment is an extreme danger sign. Other indication of abnormal operation of electrical equipment would include:

a client complaining of discomfort or pain

tingling sensations when touching a metal casing

erratic or abnormal behaviour of equipment

smoke, smell, heat or abnormal buzz or hum from equipment.

Always switch off and disconnect an appliance from the mains supply before investigating an electrical fault.

Equipment should be inspected regularly and checked for worn insulation around any wires. This frequently occurs in the appliance cord near the plug. If two bare wires touch, a short circuit will result. Things to watch for include:

flexible cords which are cut, frayed or damaged. These should be replaced.

damaged plugs or unprotected wires at the plug entry. These require urgent attention.

cords and plugs that are hot to the touch during use. They could indicate an electrical overload or a loose connection within the plug or equipment.

Ensure that plugs are correctly wired (brown: live, blue: neutral and green yellow: earth). The earth wire must always be connected to the longest pin of the three pin plug marked E or earth. Should any doubt exist about the safety of any electrical equipment or wiring, a qualified person should be referred to as soon as possible.

Check that the fuse size is correct for a given appliance or circuit. Serious damage can result if the fuse chosen has a higher rating than the wire it is supposed to protect.

Never handle plugs, switches or any electrical appliance with wet hands. The bulk of the bodys resistance is in the epidermis. As the skin becomes wet, the resistance drops because water is a good conductor (as long as it contains electrolytes, which all water except distilled water, does).

Never overload a socket or powerboard with too many appliances. Piggy back double adapters can be dangerous.

When you have finished using an appliance, switch it off and pull out the plug.Electrical firesIn general, three factors must be present for a fire to occur and continue burning:

1. A fuel (something which will burn).

2. A source of oxygen.

3. Heat to ignite the fuel and sustain the fire.

The removal of any one of these three factors reduces the possibility of a fire outbreak or can stop a fire that has already started from continuing to burn. This simple principle should be borne in mind when attempting to extinguish a fire or when planning the construction or layout of a salon. Electrical faults may contribute the heat required to ignite the fuel and cause a fire.

The following guidelines can reduce the risk of starting an electrical fire and decrease the severity of a fire once it has begun:

Good workmanship is good fire prevention. Always ensure that all electrical work is carried out and completed by a qualified electrician.

Broken strands, loose fitting plugs and sockets and improperly secured terminals can cause sparking or arcing (visible, curved electrical discharge), which can lead to heat build-up and fires.

Check connections and wiring regularly. Use good quality fuses and circuit breakers. All insulation and installations should be constantly checked for ageing, mechanical damage or moisture.Some electrical equipment is designed to produce heat. Even ordinary electric lights can cause fires. Ensure that hot objects cool down before placing them near combustible materials or putting them away in enclosed spaces.

Dont overload circuits. A circuit should not be made to take more current than it is meant to (15 amps for power, 10 amps for one power point, 8 amps for lighting). The heat resulting from an overload can melt insulation. Too many plugs or adapters connected to one power point can also generate excessive heat.

Look for warning signs, such as smoke, smells or hot plugs, which may indicate a faulty appliance. Immediately turn the appliance off and have it repaired by an authorized repairer.

Be careful of static charges. When such charges accumulate, they jump out as an arc and can cause a fire. Follow all procedures that prevent accumulation of static electricity.

Separate electrical equipment from inflammable liquids.

Store all products away from heat sources.LASER

Laser is an acronym for light amplification by stimulated emission of radiation. There are many uses of laser ranging from medical applications to military applications. Types of equipment may include :

laser systems, such as:

normal mode alexandrite

ruby

diode

Nd:Yag

IPL systems with some of the following characteristics:

programmable

manual

multiple pulsed shots

single pulsed shots

chilled sapphire head

one or minimal choice of filters

multiple filters.Laser devices are classified according to an international and Australian standard.

Class 1 laser are completely safe to view and pose no risk to the eyes. Common examples would be laser disc players or laser printers.

Class 2 lasers do not pose any risk under normal viewing conditions. They emit radiation in the wavelength between 400 nm to 700 nm and could cause damage if directly viewed over a period of 15 minutes. Laser pointers and grocery food scanners are included in this category.

Class 3 lasers are potentially hazardous if viewed directly. These devices require special training to operate and require special procedures to be taken in the workplace where they are used. Lasers used by beauty therapists fall into this category and are used for skin rejuvenation, hair removal.

Class 4 lasers are the most hazardous and can cause injury from a direct, scattered or reflected laser beam to the eyes. These are the lasers that are used in cosmetic surgery and are tissue destroying.Risks may include:

incomplete hair removal or regrowth

darkening of the skin (hyperpigmentation)

lightening of the skin (hypopigmentation)

blistering and scarring

changes in the skin texture

crusting or scabbing

hair changes.

Safety measures required to protect clients may include:

pre-treatment patch testing

adequate eye protection

filtering and exhausting airborne contaminants

adequate ventilation.

Safety measures required to protect operators may include:

adequate eye protection

wearing masks

adequate ventilation

appropriate draping of areas surrounding treatment site.

Workplace laser safety procedures may include :

laser safety protection plan addressing:

access to laser treatment areas

flammability hazard and fire safety

handling of fibre optic delivery systems

laser-generated airborne contaminants

ocular safety.

Preventive maintenance must include:

documentation, including:

relevant equipment safety standards

equipment service history

schedule for recommended testing and maintenance

regular testing.

Control panel may include:

power settings

pulse settings

time settings

emergency control

delivery systems.

Procedures checklists and records may include:

pre-treatment

intra-treatment

post-treatment

monthly

six-monthly.

Potential hazards may include :

particular hazards of delivery systems

ocular and skin hazards

client-specific hazards

reflected beam hazards

fire, explosion, electrical and environmental hazards.

Safe ventilation may include :

exhaust systems

filters

masks.

Intense Pulsed light (IPL)

IPL is a more recent development and in 1995 the first no coherent, filtered flash lamp became available. IPL is particularly suitable for treatment of photo damaged skin but recently has also become popular and effective for hair removal. IPLs are increasingly thought of as equivalent to cosmetic laser systems.

Both IPL and LASER equipment require advanced training for use by Beauty Therapists.3. Analyze the risks:I. Extreme - Laser and intense pulsed light (IPL).

II. High -

Electrolysis, Laser and intense pulsed light (IPL).

III. Medium - WaxingIV. Low -

Waxing -

4. Evaluate the risks:Risk assessment:

A gathering of information and analysis of the potential outcomes of identified behaviors. Identifying specific risk factors of relevance to an individual, and the context in which they may occur. This process requires linking historical information to current circumstances, to anticipate possible future change.

SAFETY RULES FOR ALL LASERS, REGARDLESS OF OUTPUT POWER LEVEL

1. Avoid looking directly into any laser beam or at its reflection.

2. Remove all unnecessary specular (shiny) reflecting surfaces from the work area.

3. Operate lasers in well-defined areas to which access can be controlled. The area should be

posted with appropriate signs to alert persons passing by the area that a potential hazard

exists.

4. The laser system should be operated only by or under the direct supervision of a person

knowledgeable of the hazards and control methods for both beam and non-beam

conditions. This individual is usually the laser safety officer (LSO) who is designated by

the administration of the company, hospital, or educational institution. The LSO shall

have the authority and the responsibility to effect monitoring and enforce the control of

laser hazards and to achieve the knowledgeable control of laser hazards.

5. Any accident should immediately be reported to the responsible medical authority. If there

is an accidental exposure to the eye, the services of an ophthalmologist should be sought.5. Treat the risks:

I. Avoid the risk

II. Control the risk

III. Transfer the risk

IV. Retain the risk

6. Monitor the risk

Standard precautions Sterilizes all appropriate equipment Do not recap needles

Do not reuse liquids or gels

Do not redip use single use sachets Change all linen between customers

Use single use gloves and

WASH your hands frequently

Public Health (Skin Penetration) Regulation 2000

Mandatory requirements -you must comply with these government regulations

Penalties ($)apply for non-compliance

Equipment must be clean & dry& in good working order

There MUST be a Hand wash basin(potable water 40C, soap, single use towels or hand drying equipment) . Hands should be washed immediately before and after attending a client and before attending the following client, or if a procedure is interrupted. There MUST be a Sink for cleaning equipment (water 40C, waste disposal bin, sharps bin). Instruments that penetrate the skin MUST be sterilized or single use Sterilization records MUST be kept Common bacteria such as Staphylococcus and Pseudomonas can also cause serious infection and may prevent healing of the site. These bacteria may be transmitted by not hygienic practices. The risk minimization strategies that should be used in the skin penetration industry require the operator to:

Wash hands immediately before and after attending a client and before attending the next client, or before resuming a procedure if interrupted (eg. answering the telephone)

Wear clean disposable gloves when contact with blood or body fluid is anticipated

Wear protective eyewear and clothing whenever there is a risk of splattering from blood or body fluids

Use aseptic (non-touch) operating techniques

Use fittings and equipment that have been properly cleaned and where necessary sterilized before use

Maintain the premises in a clean condition

Handle and dispose of sharps in a safe manner

Consider being vaccinatedWork safelyIn order to reinforce your professional image you should always be well groomed and wear clean clothing. You will need to protect your clothing, particularly when using oils during treatments. Consider using a towel between say the clients foot and your leg if the massage routine involves the client resting their foot on your leg during foot reflexology. Different workplaces will have different requirements and you should always make sure that you follow your workplace policies and procedures or accepted or expected practices.

You should always ensure that both you and your service areas are prepared according to all workplace policies and procedures and hygiene and occupational health and safety requirements.

Occupational health and safety (OH&S) is an integral component of the beauty industry. Employers have a responsibility to provide both their staff and clients with a safe environment. Staffs are also responsible for contributing to their own health and safety and that of clients and fellow staff.Action PlanSummarise actions listed above, area(s) responsible and target dates.

NoActionResponsibilityCommentsTarget DateStatus

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2

3

4

5

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Nguyen Le Huyen , CUSTOMER SATISFACTION SURVEY FOR ACTILIFE FITNESS CENTER - KOKKOLA , Thesis , CENTRAL OSTROBOTHNIA UNIVERSITY OF APPLIED SCIENCES, Degree Programme in Business Management May 2010

Preparing a risk management plan and business impact analysis

Laser Safety Management. Kenneth Barat. CRC, Taylor & Francis, 2006 ISBN: 0 824 72307 4 http://www.laserinstitute.org/PDF/pubs/pub209toc.pdf

Beauticians carry out a variety of different procedures, many of which involve 'skin penetration'. Because 'skin penetration' carries a risk of infection, the premises and procedures where skin penetration is conducted must comply with the Public Health Regulation, 2012.

Steve Morgan, Clinical Risk Management, The Sainsbury Centre for Mental Health 2000, pg. ii

Failure to comply with the Public Health Act 2010 and the Public Health Regulation, 2012 can result in the issue of a penalty infringement notice. Penalties range from $110 - $1100 for an individual and $220 - $2200 for a corporation. Maximum penalties are higher for prosecutions and may include a daily penalty.

Preparing a risk management plan and business impact analysis

The International Commission on Non-Ionising Radiation Protection (ICNRP) publications. http://www.icnirp.org/pubOptical.htm

Steve Morgan, Clinical Risk Management, The Sainsbury Centre for Mental Health 2000, pg. ii

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