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MEVE-002: Health Care

MEVE-002: Health Care

IGNOU Solved Assignment Solution for 2022-23

If you are looking for MEVE-002 IGNOU Solved Assignment solution for the subject Health Care, you have come to the right place. MEVE-002 solution on this page applies to 2022-23 session students studying in PGDEOH, MAEOH courses of IGNOU.

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Assignment Code: MEVE-002/TMA-01/2022-23

Course Code: MEVE-002

Assignment Name: Health Care

Year: 2022-2023

Verification Status: Verified by Professor


Maximum Marks 100

Attempt Any five questions. All questions carry equal marks.




1. Enumerate the common routes of transmission of infections. Explain the routes with the help of suitable examples.

Ans) The common routes of transmission of infections are:


Air Borne Infections

The organisms come out of a sick person's mouth or nose when they cough or sneeze. When these organisms are mixed with water droplets, the water evaporates, and the organisms become droplet nuclei that are usually 1 to 5 microns in size. These nuclei may stay in the air for a long time. When droplet nuclei (evaporated droplets) smaller than 5 microns are spread through the air, airborne transmission can happen. Droplets can also be made when doctors do things like suctioning the trachea. Diseases like pulmonary tuberculosis (TB), measles, chicken pox, Severe Acute Respiratory Syndrome (SARS), bird flu, pneumonia, etc. can be spread this way.


Example: Tuberculosis is a very serious problem for public health in many developing countries. Nearly a quarter of all new TB cases found in the world are in India. Droplet nuclei are how the bacteria get from one place to another. When a person with TB coughs, sneezes, or shouts, the bacteria leave through their nose. The people most likely to get TB are health care workers who work in chest OPD and indoors. Active cases of pulmonary tuberculosis should ideally be kept away from other people. The room should have good air flow. But this isn't always possible in public health facilities that are too full. Because of this, health care workers are often infected with TB. With more cases of multidrug-resistant tuberculosis (MDR-TB), the situation is getting harder. Primary MDR-TB is hard to treat, and the results are not very good.


Blood Borne Infections

Blood-borne diseases like HIV, HBV, and HCV can be passed on depending on the type of injury and how often it happens. In over 650 accidents, there is only one case of HIV/AIDS seroconversion. In contrast, 20–30% of people who get hepatitis B get sick from it. This could be because there isn't much HIV in the blood.


Example: Human Immunodeficiency Virus: The HIV epidemic has made us realise how dangerous health care workers' jobs can be, and it has made all health care workers rethink the kinds of procedures they do. It has shown how people in the past didn't take basic steps to keep themselves safe and stop the spread of many possible pathogens. This dreaded modern pandemic, which is caused by HIV, can be spread in health care settings by contaminated needles used for injections or by blood or body fluids coming into contact with damaged skin or mucous membranes. The risk of seroconversion after parenteral exposure has been estimated to be between 1.3 per 1000 and 3.9 per 1000.


Infections Acquired through Fomites

Pathogens can be spread in different ways when a person's hand touches a dirty surface just once. It is well known that touching these contaminated environmental surfaces with bare hands or gloves can cause severe skin infections (cellulitis) that don't respond to treatment. Pathogens can also be spread to patients who are vulnerable to them. The contamination of surfaces in the environment may be a major source of infections that are eaten.


Example: This includes the hepatitis A virus, E. coli, Salmonella typhi, Clostridium difficile, etc.


2. List and discuss the steps for management of occupational exposure.

Ans) The steps for management of occupational exposure are:


Step I: Management of Exposure Site

Use water and soap to clean the wound and the skin around it. But you shouldn't scrub, wash your skin, or use antiseptics (bleach, chlorine, alcohol, betadine). If body fluids get into the eye, wash the eye out right away with water or normal saline. For the mouth, spit out the liquid right away. Rinse your mouth well with water or saline, and then spit it out again. Do the same thing several times. Talk to the institution's designated doctor right away about how to handle the exposure.


Step II: Establish the eligibility of PEP

The exposure report should include the following information, which should be written down in the exposed person's private medical record and made available to qualified HCP3:

  1. Exposure date and time.

  2. What happened and when it happened.

  3. Information about the type of exposure, the amount of fluid or material, and how bad the exposure was. For a percutaneous injury, details would include the depth of the wound, the gauge of the needle, and whether fluid was injected. For a skin or mucous membrane exposure, details would include the estimated volume of material, the length of contact, and the condition of the skin (e.g., chapped, abraded, or intact).

  4. Details about the exposure source, such as whether the patient was infected with hepatitis B virus (HBV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV), and, if the source was infected with HIV, the stage of disease, history of antiretroviral therapy, and viral load, if known. If the information isn't known, serologic testing for these infections should be done on the patient who got the infection.

  5. Information about the person who was exposed; Evaluation of the person who was exposed (e.g., hepatitis B vaccination and vaccine-response status).


Step III: Counselling for PEP

People who are exposed to infectious body fluids must be told about the PEP that will be put in place, as well as the risks and benefits, so that they can give informed consent. This information would help them feel less worried and scared. It is important to keep records of counselling. Before starting PEP, a person who has been exposed to HIV should give their consent. (Note: In the case of HIV, counselling is done after the tests to talk about the results.)


Step IV: Prescribe PEP

Check to see if source patients are taking anti-retroviral drugs (ARVs). Check for pregnancy in HCP women who have been exposed. Explain the side effects of PEP drugs or vaccines (as in hepatitis B).


Step V: Follow up and Monitor Adherence

Whether or not PEP is started, it is important to do follow-up to check for possible infections and give emotional support. In the weeks after exposure, the person who was exposed must be watched for symptoms and signs of diseases like HIV, HBV, HCV, and rabies. For example, symptoms of a primary (acute) HIV infection show up in 50–70% of people 3–6 weeks after being exposed to the virus. There should also be follow-up in the lab (particularly in case of HIV). In the case of HIV, testing at the end of PEP may give a first idea of how the sero-conversion process will go. But sometimes testing at 4 to 6 weeks isn't enough because PEP can make the seroconversion take longer. For this reason, it's best to test at 3 and 6 months.


3. Discuss the sources and health effects of mercury, dioxins and furans.

Ans) The sources and health effects of mercury, dioxins and furans are:



Mercury-containing tools like sphygmomanometers and thermometers often break by accident in HCF, causing mercury to spill out. Mercury is a gas at room temperature and is everywhere in the air as a vapour. Mercury can also be found in places where sterilisation and repair of equipment that contains mercury is done. If spilled mercury isn't cleaned up quickly, it will build up in cracks and on lower surfaces, vaporise, and be breathed in by workers who don't know what's going on. Dental amalgam is a major source of mercury in the workplace and environment of health care facilities. Mercury can also be found in some devices that measure pressure, like barometers and sensors in machine rooms. It can also be found in some electronic devices and older medical devices. HCFs are one of the main places where mercury gets into the air because they burn medical waste, which releases mercury into the air. In December 2002, the Environment Minister for the Canadian province of Ontario said that mercury from incinerators was the fourth biggest source of mercury.


Health Effects:

  1. Acute Exposure: Breathing in mercury vapour for a short time can make you sick, giving you symptoms like chills, nausea, general malaise, tightness in the chest, chest pains, shortness of breath, cough, sore mouth, gingivitis, salivation, and diarrhoea.

  2. Chronic exposure: Most of the mercury in HCF gets into the body by being breathed in. Only about 0.01% of the elemental mercury that is eaten is absorbed, so eating elemental mercury is not a major way to get exposed to it. When the nasal cavity is contaminated, mercury can get into the brain through the olfactory nerve pathway. Mercury in its elemental form mostly hurts the brain and kidneys. It dissolves in fats and can get into the brain because of this. On the other hand, inorganic mercury compounds, like mercury chloride, are not lipid-soluble, so they can't get into the brain.


Dioxins and Furans

Dioxins and furans is the name for a group of 210 very dangerous chemicals that are made when wastes with chlorinated organic compounds, like plastics, PVC, chlorinated pesticides, etc., are burned. All dioxins have the same basic chemical structure, which is made up of chlorine atoms. Furans are similar but have a different "skeleton". TCDD, which stands for 2,3,7,8-TetraChloroDibenzo-p-Dioxin, is the most dangerous chemical.


Effects on health: Dioxins are some of the most dangerous chemicals we know about. Dioxins are seen as a major threat to public health, and their effects on health are similar to those of DDT. According to a report by the US Environmental Protection Agency (EPA), not only does there not seem to be a "safe" level of dioxin exposure, but levels of dioxin and chemicals similar to dioxin have been found in the general US population that are "at or near levels associated with adverse health effects." Exposure to dioxin may lead to problems with reproduction and development, damage to the immune system, problems with hormones, and cancer. When people are exposed to dioxin at work, they are also exposed to a lot of other chemicals, like chlorophenols, chlorophenoxy acid herbicides, and solvents. Because of this, it has been hard to show that dioxins are a cause. Adults may experience liver damage, changes in heme metabolism, serum lipid levels, thyroid function, diabetes, and effects on the immune system.


5. List the physical hazards. Describe the risks associated with physical hazards.

Ans) The physical hazards are:

  1. Slippery floors

  2. Sharp injury

  3. Fire

  4. Electricity

  5. Heat and/or Cold

  6. Noise

  7. Vibration

  8. Inadequate lightning

  9. Radiation

  10. Inadequate ventilation


Risks Associated with Physical Hazards

Slippery floors: Contaminants on the floor are the most common reason why people slip, trip, or fall in healthcare facilities. Soap, water, and other liquids that build up on floors can make them slippery. Poor lighting can sometimes make these things happen. When chemicals are mixed wrong, the floors become slippery, which makes accidents more likely. Some custodians think that if a small amount of cleaner works well, then a large amount will work even better. This idea is a big risk factor in and of itself.


Sharp injury: Health workers, especially nurses who work with patients who have serious health problems, are more likely to get injured by sharp objects or needle sticks. But doctors, dentists, and other support staff like paramedics, phlebotomists, laundry workers, operation theatre assistants, etc. are also thought to be at risk, though not as much. As shown in the literature, these kinds of injuries can sometimes be caused by unplanned patient reactions. Most of the time, healthcare workers get hurt from overworking themselves or from lifting and moving patients. Nurses and aides who work in home care could get sick from blood-borne pathogens like Hepatitis B, C, and HIV if they get stuck by a needle or cut by another sharp object.


Fire: Hospitals need to be built in a certain way to prevent fires. When it comes to fire safety in health care settings, the number and design of safe exits should be top priorities. A good plan for dealing with health care disasters, being ready for emergencies, and making sure that healthcare groups are connected well, among other things, can help set up healthy ways to fight fires.


Noise: These days, noise in Intensive Care Units (ICUs) is getting a lot of attention as a major source of stress and fatigue for nursing staff. There are a lot of buzzers, pagers, phones, alarms, and beeps in an atypical ICU. The air is also full of the sounds of doctors, nurses, patients, and their families talking. Staff conversations and alarms from medical equipment seem to be the noisiest things in the ICU. Noise also comes from building ventilation systems, closing and opening doors and drawers, phones, mobile phones, pagers, overhead speakers, televisions, closing metal dust bins, squeaking wheels on patient beds or wheelchairs, vacuum cleaners, and the pneumatic tube systems used to deliver drugs, documents, and specimens between the laboratories and ICU.


Radiation: Radiation dangers are common in radiology and imaging science labs all over the world. But there is evidence that people who work with X-rays, CT scans, and radiotherapy could be at risk for their health. In radiological labs, workers' total time spent there, maintenance distance from the source, personal protective equipment (PPE), and shielding systems may cut risks by a lot.


Insufficient Ventilation: In healthcare, it's important to create a comfortable microenvironment to protect against any expected risks. As the spread of airborne diseases can be dangerous, poor ventilation can put patients, visitors, and health workers at greater risk. With a good air exchange system and a steady supply of fresh air, you may be less likely to be exposed to chemicals, dust, pathogens, etc. So, poor ventilation should be treated as a health risk, and the risks it poses should not be ignored.


8. List the steps for psychosocial risk management and describe the first two steps.

Ans) The process of psychosocial risk management consists following steps:

  1. Identifying psychological and social risks (data collection and data analysis)

  2. Risk Assessment

  3. Stressor Intervention (Risk management)

  4. Periodic Risk Assessment and Risk Management (periodic risk assessment, modification of action plan and implementation).


Identification of Psychosocial Hazards

Data collection is done through a questionnaire survey and an examination of medical records and other records that are directly or indirectly related to psychosocial problems, such as reports of violence, sexual harassment, bullying, being absent from school because of illness, etc.

  1. Evaluation of psychosocial risks through a questionnaire survey.

  2. Questionnaire survey: OSH has a plan in place to deal with psychological risks.

  3. Information from human resource development about absenteeism, staff turnover, quality and quantity of health care, work shifts, hiring policy (job security), performance incentives, arrangements in place (including policies and guidelines) to deal with issues related to psychological and sexual harassment (bullying), discrimination, third-party violence, and the physical work environment.

  4. The occupational health services have records that can be looked at.


Identifying the Risk: A psychosocial hazard is anything that affects the worker's mental and social health. Psychosocial risks are caused by the following:

  1. The number of corporate hospitals has grown across the country, which is good news for job security. The people who work in these hospitals are hired on a temporary or contract basis, which makes their jobs uncertain. Anxiety and depression have been linked to not being sure about your job.

  2. Most government hospitals don't have enough staff, so there is always a lot of work to do. This difference between how much work needs to be done and how much each person can do leads to stress and mistakes.

  3. Strange work hours: Health care facilities have to be open all the time. Some staff members have to work in shifts, at night, on fixed schedules, or for long or unsociable hours. They also have to be available 24 hours a day, 7 days a week.

  4. Inability to manage workload: People who work in critical care areas like intensive care units, trauma centres, emergency services, etc., often have this problem.

  5. When equipment isn't available, isn't the right fit, or isn't well-kept, work quality suffers, and the specialist's skills aren't used to their full potential. This makes people angry and tired.


Risk Assessment

  1. Step 1: Figure out what could go wrong. The first step in a risk assessment is to find any possible risks that, if they happened, would make it hard for the organisation to do business. During a risk assessment, hazards like natural disasters, utility outages, cyberattacks, and power failure could be thought about or found.

  2. Step 2: Figure out who or what could get hurt. After figuring out what the risks are, the next step is to figure out which business assets would be hurt if the risk came true. Critical infrastructure, IT systems, business operations, the company's reputation, and even employee safety can all be at risk from these risks.

  3. Step 3: Look at the risks and come up with ways to deal with them. A risk analysis can help figure out how risks will affect business assets and what steps can be taken to reduce or get rid of these risks' effects on business assets. Property damage, business interruption, financial loss, and legal penalties are all things that could go wrong.

  4. Step 4: Write down what you find. The company should write down the results of the risk assessment and keep them in official documents that are easy to find. The records should have information about potential hazards, the risks they pose, and plans to stop them.

  5. Step 5: Look over the risk assessment often and make changes to it. In a modern business setting, potential hazards, risks, and the controls that come from them can change quickly. Companies need to keep their risk assessments up to date so they can keep up with these changes.

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