Ask the expert: Eyewash stations and expectorating the unexpected

By: March 23rd, 2011 Email This Post Print This Post

Q: Are hospitals required to have eyewash stations in areas where patients are cared for? I work at a hospital and a patient with mouth MRSA spit directly into my eye. I am now permanently partially blind in that eye due to the infection that set in. Immediately after the incident, I yelled at a nurse to direct me to an eyewash station. The nurse responded that the hospital does not have eyewash stations. I had to find a sink, take my gloves off, wash my hand, and then splash as much water as possible into my eye. It apparently didn’t help. Any advice would be appreciated!

A: Hospitals, similar to all businesses/employers, are required to have suitable emergency facilities for quick drenching or flushing of the eyes and body within the immediate work area where an employee may be exposed to injurious corrosive materials, according to the Medical and First Aid standard (1910.151). The interpretation of suitable facilities usually means plumbed emergency eyewash stations or showers.

The specific requirement for plumbed facilities under 1910.151 is not, however, applied by OSHA to blood or OPIM exposures. The Bloodborne Pathogens standard would apply to in those situations, and the standard does have provisions requiring employers to provide protection from and training for responding to exposures, when there is reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other OPIM that may result from the performance of an employee’s duties. This include flushing mucous membranes, according to 1910.1030(d)(2)(vi) of the standard, but there is no specific requirement for a plumbed eyewash station.

Whether it is reasonably anticipated that a MRSA-infected patient would spit in your eye is the matter up for interpretation.

My opinion is that it is not, and that the absence of an emergency eyewash station in that patient care area is not an OSHA violation.

Now, it is another matter if spitting and assaults were associated with that patient or in that patient care area. OSHA could analyze that chain of facts and determine the employer was not compliant in taking measures to protect workers.

Your employer, however, should have on hand personal eyewash devices—squeeze bottles, for example—for such exposures and provide training for how to use them. After such an event, the exposure control plan should be amended to address even such an unusual situation.

Comments

By Jim Kenidg on March 23rd, 2011 at 10:35 am

There is not sufficient information regarding the event – for exmaple – if this was the ED why wasn’t the employee wearing appropriate PPE to cover the eyes? I agree with the comment regarding placement of eyewash stations as it relates to bloodborne pathogens.

By Jon Rudin on March 24th, 2011 at 5:03 pm

But aren’t chemicals used in the patient care areas of hospitals which would require the presence of eyewash stations? I can’t conceive of a location where bloodborne pathogen exposure is probable that would NOT have chemicals present for disinfection. That being the case, it seems that an eyewash station would have to be available.

To me, however, the operative question is would an eyewash station be effective in preventing a microbial infection?

Second try.

If the patient is mentally stable and just being obnoxious, then I feel there are some grounds for civil action and possibly criminal prosecution. Also the workers comp carrier whould be trying to recover some of its losses. It should never be acceptable for a caregiver or an organization to remain passive in the face of assaultive behavior and its aftermath.

Yes- you have to have a plumbed eyewash station with in 10 secs of distance from exposure to “hazardous chemicals”. But, our safety officer & I disagree on exactly what this is. We have them where the chemical disinfectants are mixed (EVS) as well as where there are a lot of them (labs, surgery, etc.). Thus far at my current location I have not been able to get them placed in each soiled utility like I feel they shuld be.
As to PPE- it is related to the task at hand and not the location where you work. I could see the spitting as being a random, unanticipated event that unfortunately had disasterous consequenses in this instance. We don’t know enough about the incident like the first responder to the article noted.

Some state OSHA agencies do have broader language then the federal OSHA rules so review your situation carefully. Oregon- OSHA in their Medical and First Aid rule(437-002-0161) requires the following
(5) Emergency Eyewash and Shower Facilities.
(a) Where employees handle substances that could injure them by getting into their eyes or onto their bodies, provide them with an eyewash, or shower, or both based on the hazard.

Also, the College of American Pathologists includes body fluids in their eye wash requirement for lab accreditation (GEN.72500)

Mark good point and also correct- luckily, our state follows the federal OSHA guidelines. THere are a few states that don’t. I was not aware of Oregon but I believe that California, who does have a stricter state plan, has a stricter standard on this.
CAP only regulates the lab on this issue – when we have our CAP surveys, they do go to units where point-of-care testing is done but only look for these in the lab

By Alice Freund on March 29th, 2011 at 1:07 pm

visited hospital that installed emergency showers in doorways so they would never have obstructions. interesting idea

It seems to me the worker was not indoctrinated properly. Not knowing where the eye wash station was located should have been a part of new employee orientation just as knowing where the nearest fire extinguisher and fire alarm pull station locations. Also the person walked into a MRSA patient without a PPE? I don’t want to hear that it takes too much time.

By Bruce Cunha on January 24th, 2012 at 12:45 pm

Would agree that eye wash stations are needed. We have been adding in units in all areas where the potential for splashes with blood or body fluids may occur.

As for the issue of chemcicals? Not sure what others are using, but the disinfecting solutions that our employees use for routine cleaning may cause mild eye irritation but not cause chemical damage.

By Carol Hoffmann on January 25th, 2012 at 12:17 pm

pharaceutical hazardous waste.

Are there guidelines for hospitals on how to correctly han dle this type of waste.
We are just placing these bins in areas to collect this type of waste. Do these areas have to have eye wash stations. Doi the bins have to be secured to the wall?

By Shannon Hilliard on October 29th, 2012 at 11:48 am

can a eyewash station be located on a “dirty” sink?

Re: Shannon’s question– here’s your answer, from Steve MacArthur, a safety consultant with The Greeley Company, a division of HCPro, Inc.:

“It really depends on the setup of the environment. The overarching concern is making sure that the eyewash is appropriately accessible (within 10 seconds of unimpeded travel time – which means no intervening doors). ‘Dirty’ areas are generally the locations with the greatest potential for an exposure, and if that area has only one sink, then that’s in all likelihood where the eyewash would best be installed.

“If the area has a clean sink _and_ a dirty sink, then the clean sink would be the better option. Eyewash stations are designed with protective covers (which should be intact and in place at all times) that help ensure the eyewash doesn’t become contaminated along with the workers.”

 

Leave a Comment

*

« | Home | »

Subscribe - Get blog updates via e-mail

Popular

OSHA tightens up reporting rules

September 29, 2014
by: John Palmer • Uncategorized

Scary close calls in healthcare safety

September 23, 2014
by: John Palmer • Uncategorized

Guest column: Developing a Safety Committee

September 16, 2014
by: John Palmer • Uncategorized

Please take our HCPro 2015 safety book survey!

August 22, 2014
by: John Palmer • Uncategorized

Lessons learned in healthcare safety

August 18, 2014
by: John Palmer • Uncategorized

Guest Column: Should docs carry guns?

August 11, 2014
by: John Palmer • Uncategorized

  • HCPro Broadcast Events Calendar

hcpro.com