Archive for: General Safety and Health
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.
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 firstname.lastname@example.org.
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.
According to the Leapfrog Group, U.S. hospitals are only incremental progress when it comes to dealing with accidents, errors, injuries and infections that hurt or kill their patients.
The national, independent non-profit assigns letter grades to about 2,500 hospitals across the nation, a grade known as the Hospital Safety Score, based on hospital safety data and reviewed by a panel of eight hospital safety professionals.
Maine edged out Massachusetts in the 2013 survey as the state with the safest hospitals, as 80 percent of that state’s hospitals received a grade of “A.” Completing the top five states were Minnesota, Virginia, and Illinois.
Read the entire article:
Many healthcare workers are at risk of being bullied, harassed, demeaned, ignored, or physically assaulted or injured when providing care, making it difficult to provide safe healthcare for patients, according to a new whitepaper from the Lucian Leape Institute at the National Patient Safety Foundation. The paper notes that both emotional and physical harm occur at higher rates in the healthcare workforce than in other industries, and disrespectful treatment of healthcare employees increases the risk of patient injury.
The authors of the report recommend the following strategies to shape safety culture and bring meaning to workers’ daily activities:
- Strategy 1: Develop and embody shared core values of mutual respect and civility; transparency and truth telling; safety of all workers and patients; and alignment and accountability from the boardroom through the front lines.
- Strategy 2: Adopt the explicit aim to eliminate harm to the workforce and to patients.
- Strategy 3: Commit to creating a high-reliability organization (HRO) and demonstrate the discipline to achieve highly reliable performance. This will require creating a learning and improvement system and adopting evidence-based management skills for reliability.
- Strategy 4: Create a learning and improvement system.
- Strategy 5: Establish data capture, database, and performance metrics for accountability and improvement.
- Strategy 6: Recognize and celebrate the work and accomplishments of the workforce, regularly and with high visibility.
- Strategy 7: Support industry-wide research to design and conduct studies that will explore issues and conditions in health care that are harming our workforce and our patients
When was the last time you reviewed your facility’s policies on the proper precautions for using alcohol-based hand rub (ABHR)? An unusual case in Oregon might encourage you to do so. A young girl was injured in a Portland (Ore.) children’s hospital due to an accidental fire caused by ABHR, olive oil and static electricity.
According to the state fire marshal, the patient had undergone an EEG exam and olive oil was used to remove the glue holding the electrodes to the scalp. The patient’s father speculates that the patient put ABHR on her shirt to remove olive oil that had dropped from her hair. When the girl attempted to create static electricity using her bed sheets, a spark ignited the fire.
Although this seems to be a once-in-a-blue-moon kind of case, it’s never a bad idea to review policies about ABHR placement, proper ventilation, and so on, and inform all staff members of potential hazards. ASHE, which reported on the incident, recommends that staff members ensure that ABHRs are used only as intended by patients and visitors.
The holiday season has begun, and (for some of you) winter weather is either here or on its way. As you look ahead to all that the holidays and cold temperatures bring, we’re wondering what your top safety-related concerns are for the weeks and months ahead.
Do increased patient loads put a strain on your staff? What about staff vacations or illnesses– does being short-staffed, or simply changing the routine, put you at a greater risk for safety issues? Is the main concern Old Man Winter, and how it affects your facility’s systems? Take the survey below; answers will be compiled in a future issue of the Hospital Safety Insider ezine and the Medical Environment Update newsletter.
Create your free online surveys with SurveyMonkey, the world’s leading questionnaire tool.
For ground-breaking research, translation and best practices of integrative approaches to protecting and promoting health in the workplace, follow a new NIOSH Twitter feed, @NIOSH_TWH.
The nation’s obesity epidemic has healthcare workers, especially nurses and nursing aides, bearing the brunt of injuries from unsafe handling of patients.
“In the course of an eight-hour day, a nurse will typically lift 1.8 tons, which is pretty astronomical,” said Amy Williamson, a workplace safety coordinator for Baptist Hospital, Nashville, TN, reports USA Today, July 19.
Checking the political pulse of OSHA Healthcare Advisor Readers, are you pleased with the decision of the U.S Supreme Court to uphold the constitutionality of the Affordable Care Act, or in the parlance of our time, Obamacare.
Take the OSHA Healthcare Advisor Weekly Poll and let us know.
Usually the only fireworks that one equates with workplace safety is of the interpersonal type, but with Independence Day coming up, OSHA reminds employers, employees, and regular consumers of the danger inherent in fireworks displays, both public and private.
The American Industrial Hygiene Association (AIHA) has released a white paper which highlights the emerging roles and issues facing OSHA.
“Perspective on the Role of OSHA in Advancing Occupational Safety and Health for the Nation” makes 17 recommendations addressing OSHAs current approach and opportunities for improved effectiveness in key areas enumerated in the agency’s strategic plan and the 2011–2016 strategic plan, including f the Department of Labor (DOL), including the modification of OSHA penalties.
AIHA calls the current maximum penalty structure—$70,000 per violation for willful or repeat violations, $7,000 per day for failure to abate hazards, and $7,000 per violation for other violations—”woefully inadequate” compared to fines from other regulatory agencies. For example, employer fines for breaking environmental laws can be as high as $25,000 a day. Also, OSHA’s maximum criminal penalty for a willful violation leading to the death of a worker is six months compared to 15 years in jail for the serious violation of environmental laws.
“AIHA supports amending OSHA criminal penalties so that they are at least as stringent as penalties for violations of environmental laws.” according to the white paper.
Other recommendations include:
- Having primary authority for all safety and health issues in workplaces that the agency regulates
- Reforming the standard-setting process
- Applying standards to all workers, including municipal, state and federal
- Promoting occupational safety and health programs for small and medium-sized employers
- The continuation of the general duty clause to enforce employer responsibility to provide safe and healthful working conditions.
- Updating the Permissible Exposure Limits (PELs)
At a rate of 18%, nurses are twice as likely to experience depression as the general public, according to a study published recently in the journal Clinical Nurse Specialist.