What can we learn from the CDC’s mistakes?

By: July 23rd, 2014 Email This Post Print This Post

If the big lab can’t get it right, we’ve got problems.

It goes without saying that the CDC was right to shut down some of the nation’s top biohazard labs as they investigate what’s going on there, and why they can’t stop exposing their workers – and us – to some of the world’s most lethal germs.

The CDC admitted this week it “may never know” how a fairly harmless form of bird flu was cross-contaminated with a dangerous bird flu strain before it was sent to a laboratory to be studied by poultry researchers at the U.S. Department of Agriculture in March, according to a report from Reuters News Service.

Government officials quoted by Reuters said most of the materials used in the experiment to culture the virus were discarded shortly after they were used by the scientists performing the work, who discovered the mistake after all of their chickens died.

I’ll tell you what’s going on. They aren’t following what should be second nature protocols. Things like keeping accurate records, wearing the proper protection when working with dangerous stuff, and not keeping Anthrax and Smallpox in a fridge.

Yes, these are the things coming out in the news about the CDC: Lab workers walking from one end of the building to another carrying live spores of deadly Anthrax without proper breathing protection, sending through the mail a live strain of deadly H5N1 Avian flu to another lab, and 60-year-old vials of smallpox sitting in a refrigerator where employees might also keep their lunch.

I’ll be really interested to see what the investigation, which will be conducted by an outside consultant, will dig up on this.

In the meantime, I’d like to know from you – what can we learn about lab safety and medical clinic safety from the CDC’s mistakes?

Drop me a line at jpalmer@hcpro.com.

 

Take a lesson about chemicals from janitor’s death

By: July 9th, 2014 Email This Post Print This Post

We hear it every day like a broken record – wear your PPE and know what you are doing when you are working with hazardous chemicals in the workplace. Unfortunately, too many people don’t listen and they end up paying the ultimate price.

I’m reminded of this today as I read more about the janitor in an elementary school in Plymouth, Massachusetts who was apparently overcome and died from exposure from an as-yet unknown chemical on Monday morning.

If you’re just learning about this, 53-year-old Chester Flattery, the head custodian at Manomet Elementary School, was found dead by the school secretary at about 8 a.m.  That employee and 12 other people – many of them police officers, firefighters and other first responders who were exposed – had to also be taken to the hospital for treatment.

The investigation is still ongoing, but reports say Flattery had been at work for an hour before anyone else and that he may have been applying a floor sealant at the time of his death. School is not in session and there is a lot of maintenance work that goes into getting the building ready for next year.

Now, we all in workplace safety world know he was supposed to be wearing a respirator, eye protection, and other protective equipment. I have been a teacher in an elementary school, and I have seen these guys hard at work getting the school ready, even as I was getting my own classroom ready for students.

Most of the time, they are in regular street clothes as they go about their duties and I am willing to bet Flattery was no exception. As someone who had been working there since 2007, he was probably just doing what he always did – this time the fumes were too much for him and no one was there to help him until it was too late.

It almost happened to me. Back in college, I worked as a pool director at a country club in Connecticut, responsible for maintaining the proper chemical levels. One morning, I went into the supply closet looking for chlorine pellets, not knowing that one of my lifeguards hadn’t tightened the cover of the bucket properly the night before, allowing rain water to seep in. When I took the cover off, I got hit with a cloud of chlorine gas that knocked me off my feet and burned my throat. Happily, I was able to get to fresh air quickly and was fine. But no one was around and I was not wearing any kind of protection. I was lucky, and I never made the same mistake twice.

In the healthcare field, you can take a lesson from this tragedy. Don’t assume that just because you have done a job for a long time, you can ignore the rules. OSHA has bloodborne pathogens and hazardous chemical standards for a reason. If you are working with patients, wear your gloves, use your safety sharps, and lift safely.

If you are in a lab and work with chemicals, make sure you know the hazards of what you are working with and how to handle it properly, as well as any first aid information – it’s why OSHA says you must have SDS safety sheets on site. And always be sure someone is around, because it may save your life.

Guest Column: Be Personally Protected

By: July 8th, 2014 Email This Post Print This Post

The following is an occasional series of guest blogs by experts in the medical clinic safety field. If you would like to be featured in this blog as a guest columnist, please email Managing Editor of Safety John Palmer at jpalmer@hcpro.com.

In some laboratories, the use of Personal Protective Equipment (PPE) may be confusing to staff. However, a look at OSHA’s Bloodborne Pathogens and Chemical Hygiene Standards should make clear the requirements for proper PPE selection and use.

Both standards speak clearly to the necessity of PPE when working in the laboratory. Different PPE is needed for different tasks. Lab coats are always necessary in the lab for protection against blood and body fluid splashes or chemical splashes. Plastic aprons may also be used as extra protection in areas where gross tissue work is performed. Lab coats should be buttoned, the sleeves should not be rolled up, and they should be knee-length.

Gloves are needed when handling blood, body fluids, or chemicals, but different gloves may be used for different tasks. Many labs are turning away from using latex gloves because of allergic reactions by staff. Nitrile gloves have become the norm in recent years. However, make sure you have the correct gloves for the duties being performed. Some manufacturers make nitrile gloves that act as a barrier against blood and body fluids, but they do not provide protection against chemicals.  While these will be fine while running a CBC in hematology, they won’t provide enough protection when changing the stainer. Be sure to use chemical-resistant gloves for this and other tasks (gram stains, handling chemistry reagents, pouring acids, etc.). Check the package if you are not sure about the proper use of gloves.

Goggles or face protection is important PPE that is widely under-utilized. Do you carry open specimens in the lab? What about carrying a rack of specimen tubes to or from an analyzer? That is a task that creates a risk for exposure, and face protection should be used. Are you pouring a chemical? Protection is necessary. Help your staff avoid all exposures to the eyes or mucous membranes.

The OSHA standards mentioned above also require that PPE is removed before leaving the laboratory. Do not wear lab coats or gloves to another location outside the laboratory. Does a procedure need to be performed in another area that requires PPE? If so, bring fresh PPE with you for use in the treatment area and dispose of it before returning to the lab.

In a laboratory, all areas should be considered hazardous, bio-hazardous, or contaminated. Do you have a desk area in the lab where only paperwork is done? I have always said that if there is an area in the lab where there are no patient specimens or chemicals, then one could consider the area “clean.” However, that does not mean that food or drink can be consumed there or that no PPE is needed. Remember, you are still in the walls of a laboratory, and accidents may occur. It is acceptable to label the area as “clean” so that gloves are not needed for the computer or phone, but a lab coat would still be required.

Remember, if an OSHA inspector arrives, he will be looking to see that all aspects of safety regulations are being followed. Keep your employees safe and keep your facility from unnecessary fines by using PPE where and whenever needed.

Dan Scungio, MT (ASCP), SLS, also known as “Dan the Lab Safety Man,” is a Laboratory Safety Officer for Sentara Healthcare, a multi-hospital system in the Tidewater region of Virginia.

Start fresh with safety!

By: July 7th, 2014 Email This Post Print This Post

I hope this finds you all safe and refreshed after the July 4 holiday.

As I went about my celebrations this past weekend, I was reminded of how safety is – or at least should be – a very basic and common sense thing. Unfortunately, too many people don’t see it that way.

We could start with the tree that came down on power wires in my neighborhood during Hurricane Arthur on Friday, and the woman who got out of her car and tried to move it out of the way despite the sparks flying above her head.

Then there was the person who was killed when a firework went off prematurely, striking him in the chest and exploding. At an afternoon barbecue on Saturday, I had to remind my friend about the fire hazard that was present because her landlord had decided to leave a dishwasher in front of the door, blocking the rear exit of her third floor apartment.

Sunday, it was about the small child who was lost when she wandered away from her family picnic and was found a short time later, drowned in a local lake. And this morning while driving to work, I watched as yet another motorcyclist darted in and out of traffic carelessly without his helmet on.

There is a reason schoolchildren are taught safety lessons early on – “Stop, drop, and roll” as well as “Look both ways before crossing” are still fresh in my head. The idea is that children are impressionable and we hope safety lessons are learned and followed throughout their lives.

But maybe it’s time we start fresh as adults and rethink some of the basic safety lessons we should be following in healthcare. I could – and will – continue to follow and post any new standards and information from the Joint Commission, OSHA, and other regulatory agencies.

But until common sense prevails – and workers remember to put on their PPE, use their safety sharps, lift their patients properly, and don’t go near power wires – there will continue to be avoidable injuries and deaths in the healthcare field.

Maybe now is the time to get some bagels and have a quick safety meeting with your staff to remind them of this.

Top safety myths – and the truth

By: June 30th, 2014 Email This Post Print This Post

Hi folks -

It’s that time of month when I’m finalizing stories for Medical Environment Update, and I thought I’d share a snippet of what I am writing for the August issue. Our safety experts shared with us some of the most common safety misconceptions, and the truth behind them:

Healthcare air is squeaky clean – With so many engineering standards out there requiring different levels of air exchanges and airborne infectious diseases, it would be easy to assume that air quality in healthcare offices are among the cleanest you can find, right?

You’d be surprised how wrong you’d be, say some experts, who say great air quality in healthcare is somewhat of a myth, especially in small clinics in older buildings that might not have updated filtration systems.

“Air quality is a nightmare for safety people, because people expect that air inside a building is sterile, and that it is being filtered out,” says Bruce Cunha, RN, MS, COHNS, manager of employee health safety, Marshfield Clinic, Marshfield, WI. “They do a good job, but you have doors opening, and people walking in and out every day. You’re never going to have the environment that people say they want.”

I use those cleaning supplies at home, so they’re safe – There are so many kinds of cleaning materials that we bring into our homes, and something like bleach is considered a common staple of household cleaning. Yet, in the medical world, they are considered hazardous chemicals. What does that mean for you? Make sure you have the proper PPE to handle them, make sure your staff is trained, and for hazardous chemical in your facility, you better know where that all-important SDS sheet is.

OSHA won’t come here – Even the most seasoned veteran safety officials who have never experienced an OSHA inspection in their many years on the job keep in the back of their heads that an inspector could walk in at any time.

Even if you don’t have a complaint lodged against you, OSHA can be sneaky. An inspector could be keeping an eye on our facility for safety violations if he happens to be on site for one of many other reasons.

“They have probably been to your facility more than you think,” said Dan Scungio, MT (ASCP), SLS, Laboratory Safety Officer for Sentara Healthcare, a multi-hospital system in the Tidewater region of Virginia. “If an inspector goes there to look at a construction site or worker injury – someone who cut their finger off or something – you’re not going to know that if you are working in the lab. They could take a look at worker records, etc., and you may not even know they are in the building. All it takes is one little trail that leads into the lab.”

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