Just Keep Swimming…

By: August 24th, 2016 Email This Post Print This Post

The following is a guest blog by Dan Scungio, MT (ASCP), SLS, a Laboratory Safety Officer for Sentara Healthcare, a multi-hospital system in the Tidewater region of Virginia.

I don’t watch sports often, but I must confess I enjoy watching the Olympic Games when they come around. This year there was a heated rivalry between swimmer Michael Phelps and South Africa’s Chad le Clos that ended with Phelps defeating le Clos in a 200m butterfly final meet. In one particularly good photograph of the event, the two rivals are side by side. Michael Phelps is staring straight ahead while le Clos is watching Phelps. On social media, the caption on that picture often read, “Winners focus on winning, losers focus on winners.” I don’t know if I agree with that philosophy in general, but it definitely does not apply to laboratory safety.

I was a lab manager for 11 years when I decided to apply for the role of Lab Safety Officer for the hospital system that was my employer. I did not have a strong lab safety background. I managed a lab in which the staff food refrigerator was located near hematology (yes, right in the lab), and many of the staff did not wear lab coats regularly. When our hospital integrated with the larger system, I met the Lab Safety Officer and over time learned more about the importance of lab safety.  When I took over the safety role, my goal was to continue learning about lab safety and to improve the culture in the lab system. I wanted to be a winner. Who would I look to in order to make that happen?

Even though my role as a Lab Safety Officer was full-time (something that is very rare in the field), I knew I would need help to learn more and to know how to make a measureable difference in the safety culture. The first step was learning to look to the many resources available to me.  I met with my internal references- Occupational (Employee) Health, Infection Prevention, Facilities, Environmental Services, and Security. Then I began meeting some external references- the chemical waste handlers, the hood service company, the vapor monitor contractors, and the PPE vendors. All of these people had much they could tell me, and over time they have provided a great deal of lab safety knowledge regarding regulations and best practices. I also became familiar with other external references such as the EPA, OSHA, and the CDC.

Now let’s go back to that Olympic swimming – what does that have to do with safety resources? I have found over the years that because of the myriad regulations and guidelines it is very difficult for a safety professional to stay current without help. As a group, we need to rely on each other as sources of information, or as a support network. Networking is important so that safety professionals can focus on the best practices and successes we are achieving in our labs regarding safety. While it is important to concentrate always on improving our lab safety cultures- to focus on winning- it is also necessary to look at each other, and to learn how to apply those safety best practices in our own labs. If you are focusing on other labs and how they are winning the lab safety Olympics, that doesn’t make you a loser- it makes you smart. Not everyone is able to find the answers they need in their own back yard…or swimming pool.

If you are not part of a lab safety network, I highly recommend becoming a member of one. The Safety Academy group I host every year is a great group of people who help each other out all the time. Try a Linked In® group or maybe a Facebook page on lab safety and ask your questions. Subscribe to my free monthly newsletter and be connected to over 1500 others who are focusing on lab safety across the nation. No matter how you swim the race of lab safety, you don’t have to swim alone, there are other winners out there who can help you win that race in your laboratory.

NIOSH will offer respirator webinar

By: August 18th, 2016 Email This Post Print This Post

If you’re looking for training ideas for your staff, it might be time to train them on how to properly use a respirator.

NIOSH will offer a webinar, “The Science Behind Respirator Fit Testing in the Workplace: Past, Present, and Future,” on N95 Day, Sept. 6, 2016.

In this three-part webinar, participants will first learn the initial science behind the OSHA requirements to better explain why they are what they are, including why initial respirator fit testing is so important.

Next, findings of a recent NIOSH study that supports the need for annual fit testing will be discussed, and lastly, recent NIOSH developments toward improved headforms used for studying respirator fit of N95 filtering facepiece respirators will be presented.

For more information, register at the NIOSH website here.

Featured webcast: Clarifications of the Most Common Joint Commission Safety Findings

By: August 15th, 2016 Email This Post Print This Post

Learn everything you need to know to stay ahead of Joint Commission surveyors.

If you missed expert Brad Keyes, CHSP, owner of Keyes Life Safety Compliance on July 21 for his discussion of the most commonly cited life safety and environment of care violations found when Joint Commission surveyors inspect hospitals, you’re not too late!

Joint Commission officials have expressed public frustration with what they say are repeated violations of crucial items such as fire safety, maintaining a sterile environment, means of egress, and proper documentation.

At the conclusion of this program, participants will be able to:

  • Identify and eliminate life safety issues such as stained ceiling tiles, improperly stored medical gas cylinders, and potential ligature issues in behavioral health units
  • Properly use CMS categorical waivers to help stay in compliance
  • Eliminate corridor clutter in hospital suites
  • Manage common infection control violations such as air pressure relationships, air exchange rates, temperature and humidity issues, and inappropriate workflow in central sterile processing departments
  • Maintain proper means of egress for emergency evacuations. Provide proper documentation to surveyors, including thorough life safety drawings and complete inventories of testing documentation

Don’t miss this opportunity to hear practical advice and have complex regulations simplified in this program suitable for your whole organization. To order the webcast on demand, call HCPro customer service at 800-650-6787 or visit the HCPro Marketplace.

Available now: The PPE Handbook for Healthcare Facilities

By: August 11th, 2016 Email This Post Print This Post

Too often healthcare organizations find themselves unprepared for a hazardous situation or patient. It is in these tense moments that proper PPE training is put to use in order to protect staff and patients while minimizing risk. The only way to ensure your staff is ready for such a situation is through awareness and training on an organization-wide level. The PPE Handbook for Healthcare Facilities, sold in packs of five, is the perfect tool to give staff the knowledge and know-how of proper PPE usage. This handbook clarifies confusing PPE situations as well as when and how to properly implement PPE best practices.  Don’t wait to train your staff after a hazardous situation has already occurred. The time for training and best practices is now!

The handbook is authored by Marjorie Quint-Bouzid, MPA, RN, NEA-BC, vice president of nursing at Parkland Hospital and Health System in Dallas, Texas, and formerly vice president of patient care services/chief nurse executive at Fort Washington Medical Center (FWMC). Quint-Bouzid has more than 30 years of experience as a registered nurse and more than 16 years of progressive experience in hospital administration.

This handbook offers front-line staff:

  • The proper techniques involved with using personal protective equipment (PPE)
  • Detailed diagrams that clearly demonstrate how to don and doff, as well as identify different kinds of PPE, and in what situations each type would be used
  • Multiple government resources, such as the CDC and OSHA to help facilities decipher information in an easy-to-use, one-stop reference tool

For more information and to purchase the handbook, call HCPro customer service at 800-650-6787 or visit the HCPro Marketplace.

Sublimation Anticipation

By: August 8th, 2016 Email This Post Print This Post

The following is a guest blog by Dan Scungio, MT (ASCP), SLS, a Laboratory Safety Officer for Sentara Healthcare, a multi-hospital system in the Tidewater region of Virginia.

Many years ago I worked in a lab that often received dry ice in boxes with our blood product deliveries. The habit in the lab was to dump the excess frozen carbon dioxide into one of our stainless steel sinks. The staff would get excited each time there was a delivery because they liked to run tap water onto the ice to make a “waterfall” of smoke flow onto the floor when they were bored. Before too long, this repeated incorrect placement of dry ice resulted in severe damage to the sink and pipes below. The stainless steel basin cracked and the sink fell down onto the broken pipes below. That particular plumbing is not designed to handle such a low temperature, and the repair was not cheap. Luckily, no one was injured.

Dry ice sublimates at room temperature. That means it transforms from a solid state directly into a gas. Too much of this gas in a small space will reduce the normal oxygen levels in the area potentially causing dizziness and asphyxiation. Letting dry ice sublimate in the work place is a dangerous practice. If you have dry ice to dispose of, the best practice is to set it outside (where other could not have access to it) so it can dissipate into the open air.

Dry ice is often used in the transport of specimens, blood products, and certain lab reagents. The Department of Transportation considers it a dangerous good, and it must be used and labeled specifically if it is to be shipped by land or by air. If dry ice is used in shipping, an additional Class 9 miscellaneous hazard label also must go to the right of the Class 6.2 infectious substance label. In addition to the Class 9 label, the outer box must be labeled with the net quantity of dry ice used.

Another common use of dry ice is with the transport of outreach or clinic lab samples in courier vehicles. Certain samples must be kept frozen for testing, and the use of dry ice provides a convenient method for maintaining the necessary temperatures. Dry ice is placed in a cooler in the courier vehicle, and samples are placed until delivery to the reference laboratory. With that, there are specific safety practices that should be adhered to when using dry ice for this purpose. Couriers are often overlooked when considering safety training, but they are an important piece of the lab sample and testing process. Be sure couriers have complete safety training, including training for the proper handling of dry ice.

Couriers should limit the amount of dry ice placed inside the cooler that will rest in the vehicle. No more than three pounds of dry ice should ever be placed in that cooler. The cooler should never be completely sealed (remember the ice sublimates to gas, and the volume of the gas in the cooler will expand). Also, if dry ice is kept inside of a vehicle, the windows should be left opened, even a tiny bit. There have been incidents where too much dry ice in a closed vehicle has caused a driver to become dizzy or even become unconscious. Obviously this is a potentially dangerous or even deadly situation and should be avoided completely.

In the laboratory or outreach settings, employees are asked to work with many dangerous substances, bloodborne pathogens, chemicals, and sometimes dry ice. Inherently, these departments are not safe, but OSHA requires that employees be able to work safely in those places, and it can be done. Proper training and oversight of safety are the keys to ensuring your employees can collect, transport, and process lab samples in such a way in which all involved in these processes are kept safe.

OSHA fines will dramatically increase in August

By: July 5th, 2016 Email This Post Print This Post

In case your July 4 barbecues have been taking your attention away from OSHA matters, the agency announced that minimum fines for violations will increase on August 1 for the first time in 25 years.

Healthcare facilities should take note, as the maximum fines will increase by 78%.

For a serious violation, the maximum fine will go up more than $5,000 from the current $7,000 fine. A serious violation will now cost you $12,471 per incidence. If you fail to fix it, your fine gets increased by $12,471 per day past the abatement date.

For willful or repeated violations, maximum fines will go up more than $50,000. Currently, a willful violation will run you $70,000, and after August 1, it will go up to $124,709 per violation.

State OSHA plans will be required to adopt a fine schedule at least as effective as the federal OSHA.

See more at the OSHA website here.

 

 

Test your safety knowledge and win $100 off HCPro products!

By: June 2nd, 2016 Email This Post Print This Post

The National Safety Council, a safety advocate group that promotes safety in homes, workplaces, and communities across the country, has designated the month of June as National Safety Month. Specifically, the group has dedicated Safety Month 2016 to several safety subjects relevant to healthcare, including emergency planning and response in the workplace, medication safety, worker wellness and health, and reducing hazards in the workplace such as distractions and improperly secured furniture that can lead to falls and other injuries.

We’re celebrating Safety Month by offering giveaways, raffles, and discounts on all your favorite safety products. Win a $100 gift certificate good for any Safety product on the HCPro Marketplace by answering the following five trivia questions correctly.

Send your responses to Managing Editor John Palmer at jpalmer@hcpro.com by Friday, July 1. Winners will be chosen randomly from the responses received.

  1. List three injury reporting requirements, according to OSHA’s website.
  2. Name two things OSHA says employers must train workers required to use personal protective equipment to know.
  3. Name three components of a compliant chemical label, according to the OSHA GHS labeling requirements for hazardous materials.
  4. How many facility inspections were conducted by OSHA in 2015?
  5. Name three risk factors in healthcare facilities that can lead to workplace violence.

Take our 2016 Safety Month survey and win $100 off HCPro products!

By: May 24th, 2016 Email This Post Print This Post

The National Safety Council, a safety advocate group that promotes safety in homes, workplaces, and communities across the country, has designated the month of June as National Safety Month. Specifically, the group has dedicated Safety Month 2016 to several safety subjects relevant to healthcare, including emergency planning and response in the workplace, medication safety, worker wellness and health, and reducing hazards in the workplace such as distractions and improperly secured furniture that can lead to falls and other injuries.

We’re celebrating National Safety Month this year by offering free giveaways, raffles, and discounts on all your favorite safety products.

We’d like to invite you to take a short survey that will help us know what topics are on your mind, what information you need, and what products will help you do your job better. In return for taking the survey, we’ll enter you in a random drawing for a $100 gift certificate good for any Safety product on the HCPro Marketplace.

Please click here for the survey.

CMS adopts 2012 Life Safety Code®

By: May 3rd, 2016 Email This Post Print This Post

In a highly-anticipated move expected to significantly affect the regulatory rules that hospitals and other healthcare facilities are held to, the Centers for Medicare & Medicaid Services (CMS) has officially adopted the 2012 edition of the Life Safety Code® (LSC).

CMS has confirmed that the final rule adopts updated provisions of the National Fire Protection Association’s (NFPA) 2012 edition of the LSC as well as provisions of the NFPA’s 2012 edition of the Health Care Facilities Code.

Healthcare providers affected by this rule must comply with all regulations by July 4—60 days from the publication date of the rule in the Federal Register.

The adoption of the rule has long been anticipated, as the LSC, which governs fire safety regulations in U.S. hospitals, is updated every three years, and CMS has not formally adopted a new update since 2003, when it adopted the 2000 edition. As a result, CMS surveyors have been holding healthcare facilities to different standards to other regulatory agencies that have gradually adopted provisions of the new LSC in their survey requirements.

Some of the main changes required under the final rule include:

  • Healthcare facilities located in buildings that are taller than 75 feet are required to install automatic sprinkler systems within 12 years. after the rule’s effective date.
  • Healthcare facilities are required to have a fire watch or building evacuation if their sprinkler systems is out of service for more than 10 hours.
  • The provisions offer long-term care facilities greater flexibility in what they can place in corridors. Currently, they cannot include benches or other seating areas because of fire code requirements limiting potential barriers to firefighters. Moving forward, LTC facilities will be able to include more home-like items such as fixed seating in the corridor for resting and certain decorations in patient rooms.
  • Fireplaces will be permitted in smoke compartments without a one-hour fire wall rating, which makes a facility more home-like for residents.
  • For ASCs, alcohol-based hand rub dispensers now may be placed in corridors to allow for easier access.

Visit https://s3.amazonaws.com/public-inspection.federalregister.gov/2016-10043.pdf to read the full final rule.

 

View the CMS press release here: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2016-Press-releases-items/2016-05-03.html

The OSHA Consequences

By: March 24th, 2016 Email This Post Print This Post

The following is a guest blog by Dan Scungio, MT (ASCP), SLS, a Laboratory Safety Officer for Sentara Healthcare, a multi-hospital system in the Tidewater region of Virginia.

Many lab managers and safety professionals tell me they cannot get staff to maintain compliance with the safety basics in the lab. There tends to be several different possible reasons for this, and you may encounter one or more of these in your work area:

-No management/medical director support of the lab safety program.

-No time for leadership to focus on safety.

-No safety education for staff/leadership.

-No understanding of consequences of unsafe behaviors.

There are safety savvy solutions for each of these areas, and they vary, but today we will focus on the last entry:  No understanding of consequences of unsafe behaviors. This can be a powerful educational tool in many ways when used to improve the lab safety culture. There are physical consequences, emotional consequences, and financial consequences for unsafe behaviors in the lab. Teaching any of these is beneficial, but things have changed in 2016, and the financial consequences to labs and hospitals have increased.

The Federal Civil Penalties Inflation Adjustment Act of 1990 allowed many federal agencies to review and adjust their civil penalties once every five years. One exemption that was made at the time was that OSHA would be excluded from any penalty-adjusting authority. 25 years later, OSHA has been granted the ability to adjust its fines to match inflation rates. That means that OSHA fines could potentially increase in 2016 by up to 80%. That means a $7,000 fine goes up to $12,600, and that’s just for one violation. A “willful” violation charge will move from $70,000 to $126,000.

These rate increases must be put in place by August of this year, and they can and will affect laboratories. This is information that can be used to explain to lab staff the importance of following safety guidelines. OSHA is visiting hospitals and labs in increasing numbers, especially since hospitals have been on their “high risk workplace” list for the past few years. Because of high worker injury rates, OSHA inspectors are coming for hospital visits, even without complaints or cause. Many hospitals have already been visited and inspected this year.

This is education that needs to be explained to staff, and should be connected to the importance of safety compliance in the lab. A sharps container with no lid is a single violation with a fine of $12,600. An employee working with open specimens and no face protection is a fine of $12,600. If a review of training records shows the employee was trained on PPE use, the fine becomes categorized as “willful,” and it increases to $126,000. If multiple violations are seen, the fines are multiplied as well. This can get very expensive, and in some cases it could close the facility. If personal safety doesn’t create compliance for your staff, use these numbers. They are real, and they can be quite impactful.

The fines levied by an OSHA inspector can vary. The actual amounts are at the discretion of the individual inspector, and it can be many weeks after an inspection before the exact fines are known. However, the inspector will not leave the lab without notifying them of what violations were recorded. Does your lab staff wear gloves when necessary? Do they button up their lab coats and keep their sleeves rolled down? Are they wearing shoes made of non-absorbent material? Is anyone chewing gum? These are the violations that can close the lab down if the circumstances are right.

Enforcement of lab safety practices is a constant job, and education is an important piece of it. Educate the staff on consequences as well. Help them to understand and appreciate the role they play in the continued safe operation of the laboratory.

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Just Keep Swimming…

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