Archive for: Lab Safety

Our expert answers a couple of reader questions related to waste disposal

By: February 19th, 2018 Email This Post Print This Post

When you’ve got healthcare safety or standards questions, we’ve got answers. More specifically, we’ve got a stable of industry experts who are only an email away and are willing and able to give you the guidance you are seeking.

This time, we turned to Dan Scungio, MT(ASCP), SLS, the laboratory safety officer for Sentara Healthcare in Virginia, to answer a pair of waste disposal questions recently posed by our readers. Scungio, aka “Dan, the Lab Safety Man,” writes a monthly column for our monthly Medical Environment Update newsletter.

Question No. 1, from a blog commenter named Sarah Winters: “I am the nursing supervisor for a school district. At the end of every year, the nurses at the schools close and seal their full sharps boxes and transport them in their vehicles to [our] central office, where I then take them to EMS for disposal. A safety/health inspector has told us this is unsafe and violates the OSHA standard. I cannot find how that violates any OSHA regulation. Suggestions? Resources? Thanks.”

Answer from Dan, the Lab Safety Man: “OSHA does not directly regulate the transport of hazardous waste, but the U.S. Department of Transportation does. The DOT states that if you are not in the business of transporting hazardous materials, the process of sharps transport for the schools falls under the DOT’s Materials of Trade exemption. That means it is acceptable to transport used sharps in your private vehicle provided they are packaged in containers constructed of a rigid material that is resistant to punctures and securely closed to prevent leaks. That said, individual state regulations may supersede federal DOT rules, so it is important to know what the transport laws are in your specific state.”

Question No. 2, submitted anonymously via email: “Can we dispose of irrigation fluid from the anterior chamber of the eye in the regular garbage if not visibly contaminated with blood and is self-contained in a sealed bag?”

Answer from Dan, the Lab Safety Man: “Eye irrigation fluid may not be considered an infectious waste if it does not contain blood, but it is probably not a good idea to place it into the regular (non-hazardous) waste stream. It is important to consider those who handle the trash after it leaves your site. If there is breakage of a sealed container or bag that creates an exposure, that would create a scenario that will raise questions for the person exposed and a situation that should be avoided.”

Got a question you’d like answered? Shoot us a note at mvensel@hcpro.com.

High-reliability healthcare, ‘preoccupation with failure’ and a valuable workshop

By: February 1st, 2018 Email This Post Print This Post

Gary L. Sculli, MSN, ATP, brings a unique perspective to safety in healthcare. In addition to being a registered nurse for more than three decades, he has served as an officer in the United States Air Force Nurse Corps and for many years worked as a pilot for a major U.S. airline.

Three years ago, Sculli shared some of his experiences and many of the insights gained during a diverse career in an HCPro book, “Building a High-Reliability Organization: A Toolkit for Success,” which was coauthored by Douglas E. Paull, MD, MS, FACS, FCCP, CHSE. Below is a book excerpt from a chapter on failure, in which the authors urged healthcare leaders, in the pursuit of high reliability, to embrace the concept of “preoccupation with failure.”

At the core, much of patient safety is dealing with uncertainties and unexpected events, the cardiac arrest being a prime example. In moments like these, not only do organizations rely on the technical expertise of staff and best practice guidelines, but also benefit from teams that are flexible, can adapt, and in essence, are resilient. Organizations themselves must be resilient to deal effectively with the changing face of healthcare.

Let’s examine a disaster from forest firefighting history—the Mann Gulch Fire in 1949. Young firefighters parachuted into Mann Gulch, near Helena, Montana, to combat what they believed was a rather routine forest fire. They were led by foreman Wag Dodge. But when the fire jumped from the south to the north side of the gulch, the firefighters were trapped and isolated from their escape route to the Missouri River. There were two possible routes for survival; either join Wag Dodge in his newly devised “circle of fire” or run to the top of the north ridge. This was the first time the circle of fire had been utilized during forest firefighting. Essentially, Dodge lit the grasslands on fire depriving the oncoming fire of any fuel to spread, thus protecting anyone within the circle. Whether due to a lack of trust, leadership, or communication, none of the other firefighters joined Dodge within the circle, despite his efforts to encourage them to do so. In addition, the young firefighters would not drop their heavy backpacks, slowing their ascent to the top of the north ridge. Thirteen firefighters died with their backpacks on and within sight of safety in the circle of fire or beyond the ridge. Dodge survived because he was able to pivot and adjust to rapidly changing and unexpected conditions.   

Several authors have discussed resilience, flexibility, innovation, and adaptability as attributes of successful organizations, including those in healthcare. Healthcare organizations must be able to learn from their mistakes. They must be able to face reality, “drop their old tools,” and accept the fact that the landscape can and will change suddenly and that unexpected events will occur. They must also accept that the best solutions to navigate the unexpected may be found in high-reliability industries. When viewed in this manner, leaders are not afraid to actively demand, even when faced with obstacles, such things as perpetual team training, mass standardization, briefings and handoffs, situational awareness support, just culture, staffing increases, and other patient safety initiatives. Leaders model open-mindedness and embrace innovation when unforeseen or novel situations arise. They talk with and listen to staff at the frontline when it comes to identifying and solving systemic challenges and failures. In many ways, current healthcare leaders are in a position similar to Wag Dodge. They must be resilient, prepared to build a circle of fire, and change course in order to solve unexpected and complex problems.

This spring, Sculli is again partnering with HCPro to give healthcare leaders the needed tools and guidance to create a culture of high reliability and safety within their organizations.

On April 16, Sculli will lead an intensive one-day workshop at Renaissance Orlando at SeaWorld® in Orlando, Florida. For more information on this upcoming HCPro workshop — which targets healthcare safety professionals, CEOs, COOs, VPMAs, risk managers, and quality/performance improvement professionals — please check out the event page at hcmarketplace.com.

Fact sheet unveiled to protect lab workers from Zika virus

By: October 3rd, 2017 Email This Post Print This Post

A new OSHA Fact Sheet has been published to help employers protect biomedical laboratory workers from the Zika virus, which has been blamed for infants being born with Microcephaly and other brain and eye abnormalities.

For lab workers, the most likely sources of exposure to Zika include needlesticks and similar cuts or puncture wounds, as well as areas of compromised skin that come into contact with contaminated materials, according to the four-page fact sheet. Workers also face risks of exposure through the eyes, nose, and mouth; mosquito bites; and coming into contact with blood or other body fluids.

“Employers and workers in laboratories should follow required and recommended infection prevention and biosafety practices to minimize the risk of infection,” the document states, noting that employers must comply with relevant regulations and standards, such as OSHA’s Bloodborne Pathogens standard.

“In all cases, employers should assess and control their workers’ Zika virus exposure risk, consider relevant advisory documents, and review new information as it becomes available, including from the Centers for Disease Control and Prevention (CDC),” the document states.

For more, download the fact sheet from OSHA’s website.

OSHA3917_Page_1

Seeking input on lab safety training book

By: December 15th, 2015 Email This Post Print This Post

Hi folks –

We are working on a rewrite of a popular book with our lab folks, Lab Safety Made Simple, that was done in 2006 by Terry Jo Gile.

If you know the book, you know that it helps laboratory directors facing increasing pressure from OSHA, the Joint Commission, COLA,  and CAP to train frontline staff on safety compliance every year. Safety compliance training not only fulfills annual regulatory requirements, but also helps to maintain a safe work environment, protect your facility’s bottom line, and avoid fines or fees from major regulators.

http://hcmarketplace.com/lab-safety-training-made-simple

The book is packed with tips, tools, games, activities, and case studies, Lab Safety Training Made Simple features training methods culled from lab experts in the field. It provides guidance on how to design successful training for employees of various ages, learning styles, levels of education, and job experience.

We also are planning to take the book electronic, and provide a lot of the tools in e-reader format for those of you who like to take your information mobile on a tablet or phone.

A lot has changed in 9 years, including GHS and a bunch of things related to waste management and other things.

What I’d like to know is what you want to see in the book? Is there a need for it? What would help you do your job better?

Please drop me a line at jpalmer@hcpro.com with any feedback. Thank you!

John Palmer

October is time to review fire safety

By: October 6th, 2015 Email This Post Print This Post

Dan Scungio, MT(ASCP), SLS, is a laboratory safety officer for Sentara Healthcare, a multihospital system in the Tidewater region of Virginia and otherwise known as “Dan, the Lab Safety Man.”

Every year I love to use autumn as the time to discuss fire safety. After all, many other organizations promote fire safety ever since October was designated as National Fire Prevention Month in 1922. This year, as always, I do want lab safety professionals to be “fired up” about safety, but there have been some questions about regulations in this area that need special discussion.

The College of American Pathologists (CAP) is the accrediting agency for many labs in the United States, and they have specific regulations about fire safety on their General Checklist.

One regulation states: “If the fire safety plan includes laboratory staff use of fire extinguishers, personnel are instructed in the use of portable fire extinguishers.”

If fire extinguishers are present in your laboratory, their purpose is to be used by the staff in the department, whether or not the safety plan includes staff using them or not. OSHA has something to say about this as well:

“If fire extinguishers are available for employee use, it is the employer’s responsibility to educate employees on the principles and practices of using a fire extinguisher and the hazards associated with fighting small or developing fires.”

The CAP checklist strongly recommends that staff have hands-on fire extinguisher operation that includes the actual use of the device (or a simulator). They do not indicate how often this training should occur. Many labs I have inspected only provide the training once, but OSHA states that it must be provided upon hire and annually thereafter. That makes sense, and lab staff should be ever-ready and able to extinguish a small fire should that become necessary.

Some facilities offer fire extinguisher training as they need to empty out their refillable extinguishers (typically CO2 extinguishers). However, if that does not happen where you are, you have other options. One is to contact your local fire authority. They may happily provide fire extinguisher training for your staff. Another option is to provide the training yourself. You may be able to obtain a test extinguisher or you may simply have to use a full extinguisher without actually discharging it. The important thing is to go through all of the steps of PASS (Pull, Aim, Squeeze, and Sweep) and to let the staff actually handle the fire extinguisher.

If you are providing the training, make sure you give some information about fires that people may not know. Describe the different classes of fires (A, B, and C) and the types of fire extinguishers used to fight them. Remind them not to use more than one extinguisher at a time so they do not blow a small fire onto another person. Tell them to always keep themselves between the fire and the exit. If the fire gets too big or out of control, make sure they leave the firefighting to the professionals.

Inspect your lab for fire risks. Are electrical cords frayed? This is a major cause of fires in the laboratory. Are items stored too close to the ceiling? This may block the action of your sprinkler system. Are ceiling tiles missing or out of place? This disrupts an important fire and smoke barrier. Who performs these inspections? You can, or your local fire authority can as well.

Autumn is a great time to raise fire safety awareness in your laboratory, but this is something that must be done all year. Drill your staff, make sure they know how to react to a real fire. Train them in the use of fire-fighting equipment. Walk your evacuation routes annually. Your staff truly cannot be too prepared.

Have you performed fire drills this year? Have your staff had hands-on fire extinguisher training? If not, it’s a great time to perform these tasks. Many people in history have lost their lives to fires, and laboratory fires are more common than you may think. Be aware, be ready, and ensure your staff remains safe if a fire situation does occur in your workplace.

 

 

 

MGH settlement underscores drug diversion problems

By: September 30th, 2015 Email This Post Print This Post

If you’ve been paying attention to the news, Massachusetts General Hospital (MGH) just got hit with the largest fine ever involving allegations of drug diversion at a hospital. In the settlement, MGH agreed to pay the United States $2.3 million to resolve allegations that lax controls enabled MGH employees to steal controlled substances for personal use. MGH has also agreed to implement a comprehensive corrective action plan to prevent, identify, and address future diversions.

The settlement stems from a 2013 investigation following an MGH disclosure to the Drug Enforcement Administration (DEA) that two of its nurses had stolen large volumes of prescription medications from the hospital. Altogether, the two nurses stole nearly 16,000 pills, mostly oxycodone, an addictive painkiller, from automated dispensing machines that MGH used to store and dispense prescription medications.

Read the rest of the story here.

The settlement drives home the idea that drug diversion is a huge problem in America’s healthcare facilities, and we’d like to help you prevent such problems in your facility.

We’d like to know what precautions your clinic or hospital has in place to monitor and control prescription medication. We are considering producing a book that would help healthcare facilities in their fight against drug thefts.

Please drop me a line at jpalmer@hcpro.com with your comments, and a few words about what you would like to see in such a book. What information would help you out in a book about drug diversion prevention?

Have a great day!

John Palmer

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.

How do you store, manage, and access your MSDS?

By: November 14th, 2012 Email This Post Print This Post

Many workplaces are going paperless with their MSDS, storing them as PDFs or relying on fax-on-demand services. Others are sticking with paper, or are using a combination of electronic and paper files. How does your facility acquire, store, and manage access to your MSDS?

Create your free online surveys with SurveyMonkey, the world’s leading questionnaire tool.

CDC proposes safer work practices in medical labs

By: January 9th, 2012 Email This Post Print This Post

Experts convened by the CDC have produced guidelines that reinforce a common-sense approach to biosafety in day-to-day laboratory activities.

A supplement to Morbidity and Mortality Weekly Report, January 6, “Guidelines for Safe Work Practices in Human and Animal Medical Diagnostic Laboratories” address safe work practices in human and animal diagnostic laboratory, including microbiology, chemistry, hematology, and pathology with autopsy and necropsy guidance.

The US Bureau of Labor Statistics estimates that there are approximately 500,000 human and animal diagnostic lab workers, and that “any of these workers who have chronic medical conditions or receive immunosuppressive therapy would be at increased risk for a laboratory-acquired infection (LAI) after a laboratory exposure.” But post exposure infection risks are unknown because of the difficulty in determining the source or mode of transmission and non national surveillance system is available.

Bacteria account for more than 40% of laboratory-acquired infection (LAI), with more than 37 species “as etiologic agents,” says the report, but other microbes also present risks. For example, “Hepatitis B has been the most frequent laboratory-acquired viral infection, with a rate of 3.5–4.6 cases per 1000 workers, which is two to four times that of the general population,” according to the report. “Any laboratorian who collects or handles tubes of blood is vulnerable,” it adds.

Also, LAI surveys have found that laboratory staff “were three to nine times more likely than the general population to become infected with Mycobacterium tuberculosis.”

OSHA posts guidance document for laboratory safety

By: October 14th, 2011 Email This Post Print This Post

OSHA has added new educational resources, including Laboratory Safety Guidance, for protecting workers from hazards found in laboratories to its Laboratory safety web page, according to an agency announcement, October 13.

The Guidance document, describes how chemical, biological, electrical, fire, explosive, and slip, trip and fall hazards, can be minimized or eliminated through safety plans, worker training, engineering controls, and personal protective equipment.

Read the rest of this entry »

Lab accreditor changes CJD-related guidelines

By: July 29th, 2011 Email This Post Print This Post

I want to make readers aware of a change involving labs and the safe handling of cerebrospinal fluid (CSF) specimens when Creutzfeld-Jacob Disease (CJD) is suspected.

CJD is a fatal and degenerative brain disease and because CJD prions resist routine sterilization and decontamination procedures, the Laboratory Accreditation Program (LAP) of the College of American Pathologists (CAP) requires special handling procedures for autopsies in suspect cases of CJD.

Read the rest of this entry »

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