All Entries Tagged With: "hazardous materials"

I need to know – the re-rise of glutaraldehyde-based disinfectant

One of the developments of the last few years that pleased me most was the move away from glutaraldehyde-based disinfectants to safer alternatives. But now—and I am at a loss to understand what is prompting this—I am seeing a resurgence in the use of the glutaraldehyde-based disinfectants. As we are more or less familiar, glutaraldehyde is a fairly complicated environmental hazard to manage (not the most complicated, but up there on the list), with requirements regarding monitoring of conditions, ventilation, etc. For the big picture, the following link will do nicely: www.osha.gov/Publications/glutaraldehyde.pdf

So what is pushing us back toward a, oh I don’t know, certainly a more hazardous material? You’ll get absolutely no argument from me when it comes to the importance of properly disinfecting reusable medical devices; the rate of hospital-acquired infections is so much greater than we as safety professionals can live with. I had heard of some instances in which devices like endoscopes were stained following disinfection using OPA-like products, but my understanding was that any discoloring on the surface of devices was residue of proteinaceous materials that weren’t completely removed during the pre-disinfection process. (You can’t really call it staining as these devices are generally impermeable, so if it can’t sink in, it can’t stain.) So, I ask you: What up with this? I want to be able to help folks move in the right direction, and I’m not convinced that moving back toward glutaraldehyde is the right direction. If you folks are privy to something that allows this to make sense, please share. It is, after all, the time of the season. Hope to hear from you soon.

Not quite animal magnetism

Recently I fielded a question from someone who was reviewing an MRI safety plan and was curious about how the four-zone “defense” would work when the MRI is in a self-contained trailer that is not part of the building. Now my first thought on this was whether the MRI service is provided under contract (including staffing) or whether the service was staffed by hospital folks and the trailer under some kind of lease arrangement. My somewhat snotty response would have been to lean on the contract folks to work out how it all fits together, but then I was thinking: What if we had to work it out on our own, for whatever reason?

At first blush, I can see establishing three zones without too much difficulty. It may be necessary to combine Zones 2 and 3, but Zone 1 (i.e., general public) would be outside the trailer and Zone 4 (i.e., screened MRI patients under constant direct supervision of trained MRI personnel) would be in the magnet room, so that’s pretty reasonable. But again, what about Zones 2 (i.e., unscreened MRI patients) and Zone 3 (i.e., screened MRI patients and personnel)? I don’t think there would be enough room in the trailer for screened and unscreened folks, but maybe Zone 1 could be the ground level outside the trailer, Zone 2 could be the area just outside the trailer (on the lift and/or stairs—depends on the configuration of the trailer), which would leave Zone 3 in the control area.

Or I suppose you could do a risk assessment to demonstrate that the risks can be appropriately and reliably managed without adoption of the four-zone setup, but one would need to make sure that all staff in the area (and I do mean “all” staff) can speak to the protection measures in place. Querying of staff has been coming up in recent TJC surveys and if staff cannot speak to the zones and differing levels of safety/protection, it results in citations under the management of hazardous energy sources element of the Hazardous Materials and Waste Management standard. Probably not a bad thing to check on after lunch this afternoon.

Judge the need to lock up cleaning products with common sense

Regarding my prior post about MSDS exemptions for consumer products, someone asked me whether there are any requirements for cleaning products to be locked up when not in use.

Once again, the risk assessment rears its fiery plumage!

There is little specific guidance in this regard because [more]

Stick to required policies in your physical environment program

Sometimes you hear about Joint Commission surveyors requesting to see certain policies in your physical environment program.

Joint Commission standards are not very prescriptive when it comes to the identification of specific policies. The only required policies are [more]

Eyewash stations hinge on chemical use as opposed to a wholesale requirement

Eyewash stations are only required by OSHA in specific instances, and those instances are discerned through a review of the material safety data sheets (MSDS) for the chemicals being used.

If an MSDS indicates that first aid response to an eye exposure requires flushing for 15 or more minutes, then you are looking at an eyewash station. Anything less than 15 minutes, no eyewash is required.

If you remove the chemicals in question [more]

Problem areas within the hospital for chemical risks

When it comes to minimizing chemical risks in the environment of care, the lab and pharmacy are definitely areas that have experienced the greatest improvements over time.

To be fair, those areas should be evaluating [more]

Keep your safety manuals universal and to-the-point

A quick thought about safety manuals, taken from my book, The Hospital Safety Director’s Handbook, Fourth Edition:

To be considered useful, your safety manual needs to strike a balance between the availability of information and [more]

Regulatory gray areas around this series of less-than-best practices

I was asked about a clean utility room that is also an electrical storage closet, which contains electrical panels, many wires, and oxygen cylinder storage against the wires.

It sounds like the organization had to make use of the available space for its network cabling, and while this is not an optimal environment of care practice, there’s no real regulatory language that precludes it. That said, there are a couple of things I would cite as “other environmental concerns” to consider: [more]

Go ahead, ask your haulers about regulated medical waste

A lot of the rules regarding regulated medical waste live at the state level, and generally the most knowledgeable folks in the food chain are the medical waste disposal people — in other words, your vendors and haulers.

My consultative advice would be [more]

Even with electronic water temperature control, an argument for mixing valves

I caught wind of an organization that uses an electronic water temperature control system that keeps the water temp at 110° F. There’s been some pushback from facilities folks about whether they still need to install a mixing valve.

I would suggest that if the organization has a risk assessment finding that indicates a mixing valve is not necessary, [more]