What is Occupational Health and Safety?
This is a service that is rendered with the ultimate goal to maintain the health and safety of all employees at work
Times and location
Monday – Friday: 07:00 – 16:00 on the 9th floor of the new hospital
Telephone: 012 354-1596/1487
Facsimile: 012 354-2201
Initial Medical Examinations
Done by appointment by the specific departmentThe total amount of persons to be done on the same day.
Exit medical examinations
Done when an employee leaves the services of the hospital to determine the health status at termination of service.
The aim is to monitor the effect of risks employees are exposed to at regular intervals:
- Done through periodic medicals e.g. ETO workers, radiation workers, Foodhandlers, etc.
- Biological monitoring e.g. blood tests, ETO monitoring, etc.
Examinations for medical boarding
- Done by appointment when a person can no longer perform the normal duties required by the specific post.
- A full report, with recommendations is submitted to the relevant departments.
- Notification of all injuries-on-duty must be done at the Occupational Health Department.
- The Hospital only does the paperwork for the GSSC ands ubsequently forwards it to the Johannesburg office.
- Occupational diseases are usually reported after medical surveillance or during the process of immunisation.
- Placements done if necessary.
Done on a regular basis to identify health and safety risks and to ensure health and safety in the workplace.
Control of absenteeism
The EA Group examine all sick certificates and keep record of all absenteeism.
Immunisation against Hepatitis B and flu vaccinations are given to health care workers.
Direct-observed treatment (DOTS)
Any employee treated by Local Government and is arranged with us – medicine given at prescribed times.
Monitoring of chronic diseases
Monitoring of hypertension, etc done by the clinic and referred when necessary.
- Done by the OH&S Department with help from the Nursing Personnel department.
- HIV/AIDS management.
There are two safety committee’s SHER (Safety, Health, Environment) and Risk Management.
- Inspections get done by the trained Hasreps and the Safety Officer.
- Waste Management.
Training for Hasreps and Unit managers regarding safety and health matters.
What Dieticians do
Dieticians play an important role with maintenance and improvement of health through good nutrition. Their work requires knowledge of food, nutrients, eating habits and their involvement with the development and treatment of diseases. Their field of expertise involves the following areas:
This involves planning and implementing nutritional care plans, for individuals and groups, as part of the treatment of specific diseases. Feeding ranges from oral intake to tube feedings or intravenous feeding where required.
Developing and implementing nutrition education programs for specific groups in the community to prevent diseases associated with unhealthy lifestyles e.g. diabetes, heart diseases, hypertension and malnutrition
Food Service Administration
Dieticians ensure that patients in hospitals or institutions receive quality food that complies with all their specific nutritional requirements.
The Work Environment
The public sector
Clinics, hospitals and community health centers
The private sector
Private practice, hospitals and companies e.g. pharmaceutical industries and food service companies
Food industries, universities, Medical Research Council and CSIR
At Steve Biko Academic Hospital
Dieticians play an active and important role as part of the multi-disciplinary team in ensuring patients nutritional needs are met and maintained to ensure optimal nutritional status. At Steve Biko Academic Hospital the dieticians deliver their services in the following disciplines:
In-patients (ICU’s and wards)
- Pediatric, Neonatal and Maternity wards
- Surgical and Neuro-surgical wards
- Internal Medicine e.g. cancer, cardiology, nephrology etc.
- Ear-nose-and throat (ENT)
Dietary counseling is conducted in the following clinics: Diabetic, Neuro Developmental Intervention, Cystic Fibrosis, High Risk Baby, Nephrology, Encopresis and general outpatient clinics.
The role of the dietician in the multi-disciplinary team
The dietician attends medical ward rounds on a daily basis with other members of the medical team where patient treatment and progress are discussed.
- The multi-disciplinary team attends meetings to discuss patient care
- The dietician gives valuable input in terms of nutritional care of the patient
- The dietician plays a role in educating fellow team members / colleagues concerning current nutritional trends and developments through lectures and workshops
- The dietician is also consulted by fellow team members to educate patients on regarding their dietary needs on discharge thus ensuring maintenance of optimal nutritional status
Medical School interaction
The dieticians are involved with the training of dietetic students of the University of Pretoria. Pre-graduate students are trained yearly at hospital level. Students from Belgium visit the department for supervisory guidance
The Cerebral Palsy Clinic at Steve Biko Academic Hospital is held every Wednesday and Friday morning. Children, 12 years and under, with neurological problems eg. cerebral palsy or spina bifida attends the clinic. It is staffed by a multidisciplinary team, which includes physiotherapists, occupational therapists, speech therapists, a dietician, a social work and a paediatrician.
The children and their caregivers attend the clinic once a month. All members of the team assess the child and a home programme is planned in collaboration with the caregiver. The team give advice about assistive devices, such as wheelchairs, orthotics and walking aids, and the caregivers are helped where possible to obtain these.
The caregivers / parents are encouraged as far as possible to become advocates for their children. They are given information about resources within the community eg. crèches, schools, support groups and how to apply for care dependency grants.
Coronary Artery Disease
The cause of coronary artery disease (CAD) has not yet been fully established but several risk factors have been identified:
- Cigarette Smoking
Please Note! There are no safe cigarettes
- High blood pressure
The higher the blood pressure the greater the risk for CAD. It is therefore very dangerous to stop treatment once the blood pressure has been controlled by medication
- High blood cholesterol
The most common blood fat is cholesterol. The body manufactures it own but a lot are taken in by food. You can also inherit high blood cholesterol for your parents
Each kilogram of extra weight carried by a person means that the heart has to pump blood through extra 3 kilometres of blood vessel. An overweight person often has high blood pressure and blood fat disorders.
- Lack of exercise
Exercise has many benefits on the heart.
Stress may aggravate angina in patients’ with CAD, which may lead to a heart attack
People with diabetes are inclined to develop CAD more easily and it is therefore essential that their diabetes be controlled as soon as possible
The goals of Cardiac Rehabilitation
Cardiac rehabilitation is divided into 3 phases:
During this phase the patient is in the hospital and receives physiotherapy in a group or on an individual basis. Most have already experienced phase 1 rehab and have been issued a walking programme to continue with while you were in hospital.
This is conducted on an outpatient basis after discharge from hospital and the goals are:
- Increase exercise capacity and endurance in a safe and progressive manner.
- To help patients continue with their exercise programme and progress to an independent exercise programme.
- Continue with patient education on risk factors and life-style changes.
- Relieve on anxiety and depression. It has been proven that patients after a bypass or heart attack go through a period of denial, anger and depression and thus cardiac rehab is a process that directs and supports physical, emotional and physiological recovery.
- Patient education on signs and symptoms and contra-indications to exercise.
This is an ongoing exercise programme that the patient is able to continue independently at home.
Phase 2 helps and prepare the patient for this stage.
Exercise as part of a comprehensive rehabilitation programme has many benefits. This is the good news; the bad news is that these benefits are only as long as you continue to exercise.
When starting an exercise programme you need to start slowly and simply, your body requires time to adapt after your bypass.
Exercise has the following benefits:
- It increases the breathing rate and therefore improves oxygenation in the body.
- It strengthens the hearts’ ability to pump, maintains and improves coronary artery flow and encourages the development of new vascular pathways.
- Weight loss is improved
- High-density lipoproteins are increased (lipoproteins carry cholesterol from blood to the tissue and are good for the body)
- Insulin, which converts glucose (sugar) into glycogen, is improved. Exercise is one way in controlling sugar imbalances in diabetic patients.
- It releases “happy hormones” which reduce stress levels and therefore improves self-esteem
- It decreases the desire to smoke
- Stickiness of platelets is reduced thus; the incidence of blood clot formation in the arteries is also reduced
- It promotes collagen formation so the ligaments and bones become stronger
- It reduces sudden cardiac death by 25% (according to research)
Contra-indications to Exercise
Certain contra-indications to exercise should be noted, as this may be dangerous to patients. The following are a list to serve as a guideline:
- Chest pain
- Heart failure
- Irregular heart beats (cardiac arrhythmia)
- Unstable blood pressure
- Unstable pulse speed
- Heart rate > 120 beats/ min (tachycardia)
- Heart rate < 50 beats/ min (bradycardia)
- Recent angiogram or angioplasty
- Flu symptoms
Concerning your pulse speed:
It may not increase by more than 20 beats/ min from rest pulse during any stage of exercising. It will increase initially because you might be scared and overcautious. If this happens, deep breathing exercises will help a lot.
When to stop exercising immediately
- Sudden drop in pulse speed
- Irregular heart beats
- Shortness of breath
- Chest pains
- If you are cold and clammy
- Irritable or angry
- Sudden continuous rise in pulse speed
Please note! The above serves as a guideline and you should stop exercising if you feel unsure about your health or condition and seek professional advice.
General guidelines regarding your medication
- You and your spouse/ next of kin should have knowledge of your medication (dosage and how many times/ day you need to take medication)
- Should you consult another doctor/ dentist/ specialist/ pharmacist inform him/ her of your present condition and medication
- Do not change your medication without doctor’s consultation
- You will probably need to take medication for the rest of your life, do not stop taking your medication when feeling better
- All medication must be taken with water and after meals (unless stated otherwise)
- All medication must be taken regularly and on time (do not take extra pills if you forget to take medication)
- Medication have side effects, read insert before taking any medication
- If you do experience side effects, consult your doctor/ pharmacist
- Make sure you have enough medication, do not run out
- If you are on dispirin, aspirin or anti-coagulation therapy
- Panado, Dolorol or Paracetamol should be taken for a headache
- No additional medication should be taken without approval (doctor, pharmacist, etc)
- Be very careful when taking medication for arthritis, gout and influenza (it may strengthen the action of “Aspirin”)
- Patients on anti-coagulation therapy must keep the intake of alcohol to a minimum
- Be aware of signs and symptoms of nosebleed, blood in urine and stools
A summary of the main and additional services with some general information. More details can be found under Out Patients Services.
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