I’m no healthcare security expert; I just write about it. So, someday, someone is going to have to explain to me how this stuff works.
Why is it that in this day of heightened security, it seems to be more difficult for me to get an appointment with my primary care doctor than it is for me to walk into a hospital with a gun, ask for a doctor by name, and then be able to walk into an exam room with him for a one-on-one meeting and shoot him?
The ease with which something like that can occur became startling clear to me earlier this week in my own city of Boston, when a man walked into Brigham and Women’s Hospital, and shot dead a cardiologist before turning the gun on himself and committing suicide.
Apparently the man was not happy with treatment that his mom had gotten at the hospital some time ago. Apparently, she had died despite the best efforts of doctors. This happens every day: it’s not lost on you as a healthcare professional that you can’t save everyone.
I was listening to the news on the radio on the way into work the morning after and the anchor asked the head of a Boston hospital association about metal detectors in hospitals.
“Do hospitals across the nation use metal detectors, and should Boston follow suit?” he asked.
I listened to the man say that no, no other hospitals across the nation use them, and Boston hospitals are looked at by others as a model.
That’s baloney. I can point you to hospital security experts in my source list in major metropolitan cities (Detroit is one of them) who have told me that metal detectors are a major step in the process of admitting patients and visitors, and making sure they don’t have weapons on them.
So I ask you – what’s your opinion? Is it time for a major overhaul of hospital security? Is it time to lay off the idea that hospitals shouldn’t have the feel of a fortress and start doing a better job protecting our healthcare workers?
I have to believe their lives are just as important as the patients’ lives.
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.
As I was getting ready to head to New York City for a quick vacation, I was at the train platform wondering if I was in the right place. There were no clear signs. There wasn’t anybody around to answer questions. When the first train came in, it was a commuter train, not the long distance one I needed to be on. When the second went by, it was on track 3, on the other side of the tracks next to where I was standing. By the time the third (and correct) train arrived, I was a nervous wreck. While I admit part of that has to do simply with my personality, I believe much of the anxiety could have been resolved with proper signage.
That applies to the laboratory as well. Not only is it anxiety-reducing, but certain signage for laboratory safety is required. We know the CAP requires signage for chemical labels, signs indicating the location of eyewash stations, and explicit instructions for spill clean-up and emergency treatment of employees should an accident or exposure occur. This specific safety information is meant to be clearly posted in the laboratory to circumvent any confusion, especially during a safety incident. Imagine being a new employee and having to lead a co-worker to an emergency eyewash station. Or worse- imagine you were splashed in the eyes with formaldehyde and your co-worker does not know what steps to take to help you. That is a bad time to be confused or unclear. Safety training to handle such occurrences is important, but instructions and signage will help in an emergency as well.
There are other lab safety signs that should be considered. Laboratories use chemical and biohazard spill kits with supplies to help clean up in the event of a spill. Don’t assume all staff knows where these spill supplies are kept. Post large signs designating the locations of each of the types of spill kits you may have in your lab.
When it comes to personalities, it is generally accepted that laboratory technologists prefer clear instructions and direction. Labs tend to write and utilize more policies and procedures than most other hospital departments. If you are a lab safety professional, you have policies and procedures you are managing, but don’t forget to manage the other communication pieces of lab safety. Keep your lab free from confusion during every day work, and especially during times of crisis.
You get told all the time that you should prepare for that rare time that OSHA may come in to inspect your facility, but do you know how?
Join HCPro on Wednesday, Jan. 14 from 1-2:30 p.m. Eastern Time for a special live webinar, “OSHA Mock Inspections: How to Assess and Improve Staff and Facility Safety.”
This program will help supervisors and managers ensure employee safety compliance in physician offices, clinics, and other facilities.
Speaker Sarah Alholm, the author of the new HCPro book OSHA Mock Inspection Made Simple, will explain what to look for in areas with and without direct patient care. She will also provide guidance on maintaining proper documentation for safety-related plans and training.
At the conclusion of this program, participants will be able to:
- Increase employee input and create safety cultures to reduce the likelihood of employee complaints and subsequent OSHA inspections
- Explain the most common OSHA citations at medical facilities
- Take the steps necessary to avoid the most common OSHA citations
- Comply with OSHA’s General Duty Clause, which requires employers to provide a safe place of employment regardless of whether OSHA has issued a standard on a particular hazard
- Develop and implement an action plan for a no-notice on-site OSHA inspection
For more information or to register click here to access the HCPro Marketplace.
In this guest blog, Linda Gylland, MLS (ASCP) QLS, a lab safety officer for Sanford Health in Fargo, North Dakota, discusses the dangers and policies she faces daily working with chemicals in the laboratory, and offers some suggestions for dealing with spills.
Some of our local medical news headlines have recently focused on the “Multistate Outbreak of Listeriosis Linked to Commercially Produced, Prepackaged Caramel Apples.” As of 12/22/14 the case count was 29, involving 10 states, 5 deaths and 29 hospitalizations. Another headline read “Outbreak of Cryptosporidiosis among Responders to a Rollover of a Truck Carrying Calves.” The laboratory identifies both organisms in these outbreaks.
Other types of “breaks,” specifically thermometers and spills also occur in laboratory and other medical settings. If a chemical spills in the lab, we clean it up following procedure in our Spills policy if it is a “minor spill” (less than 300 mL). We have spill kits and PPE with instructions for each type of spill (acids, bases, and organics). Depending on the nature of the spill, if it is small and can be maintained by lab staff, they would refer to the SDS for instructions on spill cleanup and emergency procedures. Baking Soda, sand, absorptive pillows are some of the items in our spill station. The most common scenario is to absorb the spill with paper towel, cover with 10% bleach, absorb for 10 minutes, and dispose into biohazard bag or appropriate container. If it is a larger spill (greater than 300 mL) and exceeds the limits of the personal protection available and for which staff is trained, we would contact:
- The local fire department hazmat team to verify measures to be taken
- Our hospital safety department
- Emergency preparedness department
- The poison control center
Depending on the chemical, (a hazardous chemical with toxic vapors), we would immediately evacuate staff to a place of safety and then contact outside help. The majority of lab tests now come in kits with small amounts of reagents and foil packs that are placed in analyzers, so large amounts of chemicals are not used like in the olden days! Histology and Cytology labs use large amounts of xylene, alcohols and formalin. They are all prepared with spill kits (including formalin solidifier) and also have extra PPE including face shields.
If a chemical spills in someone’s eyes, they would immediately go to the eye wash station, flush their eyes for 15 minutes and seek medical attention.
We had a mercury thermometer break inside a reagent refrigerator a few years ago and had to evacuate our department, including leaving our shoes in the lab (to be checked with a mercury scanning device later) and going home wearing disposable “surgical booties.” Luckily this happened in the fall before any snow was on the ground! The PM shift could not enter that department until the hazmat team finished their work about 4 hours later! All was well; the mercury was contained in the Ziploc bag with the broken thermometer. It was later decided that these extra steps of caution may not have been necessary, but it was better to be safe than sorry. Policies were re-written to include banning of all mercury thermometers. Most labs use thermometers with mercury substitutes now.
Our ER department also experienced a similar problem when a mercury thermometer broke. The area was closed off, an outside company came in to check for mercury in the room, the carpeting and furniture was replaced, and everything (including the walls) was cleaned. They got an acceptable “reading” from the company and were then able to resume normal activity.
Mercury thermometers are seldom used anymore, and this problem should not be occurring. In the past we heard about events such as:
- Dec 2006 – a mercury spill in a Minnesota secondary school (a student dropped a barometer). The school was closed for 3 days with $150,000 cleanup costs.
- Dec 2006 – a mercury spill in LA subway stop. It was closed 1 day: A questionable terrorist activity or just another accident.
- Jan 2008 – Michigan prohibited the sale of mercury containing GI devices and blood pressure devices
- Aug 23, 2011 – Houston area family medical practice had a blood pressure device fall- one ounce of mercury was on the floor, staff evacuated, called hazmat and cleaned up within one hour.
- Nov 17, 2011 – Morganton, N.C. Developmental Center storage room had a blood pressure device fall from a cart. A few drops of mercury fell on the floor. The room was sealed off; the facility was closed for 2 days.
- Dec 14, 2011 – Oregon, OH Medical Clinic had the same situation with a blood pressure cuff falling from a cart, mercury leaked onto the carpet. The clinic was evacuated, closed for the remainder of the day and a private company called in to clean.
So why the worry about mercury when we used to clean nickels with it in our childhood? It is now known to be an unwanted hazard in the workplace and one bead exposed to air will vaporize immediately. It may reach harmful levels; the greatest risk is with accidental spills which can result in mercury poisoning from inhalation, ingestion, injection and absorption. The vapors can penetrate the Central Nervous System and cause hand tremors, shyness, insomnia and emotional instability.
It is important to always remember “safety first” in all aspects of life. It might be safer to make your own caramel apples, take extra precautions when handling calves and think twice about the types of thermometers you are using.
Of all the new technologies emerging in the fight against healthcare-acquired infections, the one that has caught my eye quite a bit lately has been these machines that disinfect a hospital room by bathing it in ultraviolet (UV) light.
Since the Ebola scare broke back in October, there isn’t a day that goes by that my inbox isn’t bombarded with ads and press releases about these so-called “germ-zapping robots” that promise to eradicate all infections in the healthcare environment.
Hardly new technology, UV technology has been used for quite some time in healthcare as an effective addition to a robust infection control program. Essentially, by exposing the bugs to energy equivalent to more than 25,000 times the energy that we would get in a day in the sun at the beach, the machines give them a really bad sunburn and keep the bugs from reproducing.
Considering that by some estimates, human housekeepers can only get about 50 percent of exposed surfaces and that the UV “terminators” boast success rates of up to 80 percent or more when it comes to reducing the rate of pesky infections such as C.difficile, it seems to me that this technology deserves more than a passing glance.
They are not cheap tools, and with a price tag of about $100,000, only the more well-financed hospitals seem able to afford it. Smaller medical clinics, however, are being viewed more and more as the front lines in healthcare and infections before only seen in hospitals are increasingly creeping into the clinics.
That being said, it’s important to make sure clinics are also following strict infection control protocols, and some manufacturers are making smaller UV robots that can be attained for as low as $20,000, or rented on a temporary basis.
I’d like to know if your facility has taken advantage of this technology, or has considered it. What are the advantages and disadvantages, and what are the things that are driving your decisions or holding you back? I’d like to hear your success stories.
As always, feel free to drop me a line at firstname.lastname@example.org.
Happy New Year!