Archive for: OSHA – Citations & Fines

TB screening, OSHA, and applicable chapter and verse

By: January 19th, 2012 Email This Post Print This Post

Steve MacArthur, safety consultant for The Greeley Company, is taking on all comers lately, especially  OSHA compliance. And as Father Lonergan from The Quiet Man would say: “What do you expect?”

Last week MacArthur tackled emergency eyewash stations with the seductive headline: “In your eyes – the light, the heat … the chemicals?” This week: The intricacies of TB screening for contract staff and OSHA compliance.

Here is the post, courtesy of Mac’s Safety Space:

From the muddy banks of compliance

Let’s break from form a little bit and start with a question:

How often are you (and by you, I mean your organization) screening contracted staff, including physicians, physician assistants, nurse practitioners, etc.?

A recent TJC survey resulted in a finding under the HR standards because the process was being administered on a biannual cycle. The finding vaguely referenced OSHA guidelines in identifying this deficiency, but the specific regulatory reference point was not provided (though apparently a call to Chicago validated that this was the case). Now, anyone who’s worked with me in real time knows that I have an exhaustive (and, at times, exhausting) curiosity about such matters. The deficiency “concepts” are usually sourced back to a “they;” as in, “they told me I had to do this” “they told me I had to that.” I am always, always, always curious as to who this “they” might be and whether “they” were good enough to provide the applicable chapter and verse. The answer, more often than not, is “no.” Perhaps someday we’ll discuss the whimsical nature of the” Authority Having Jurisdiction” (AHJ) concept, but we’ll save that for another day.

At any rate, I did a little bit of digging around to try and locate a regulatory source on this and in this instance, the source exists; however, the standard is not quite as mandatory as one might first presume (If you’re thinking that this is going to somehow wrap around another risk assessment conversation, you are not far from wrong). So, a wee bit of history:

Back in 1994, the CDC issued their Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Facilities, (http://www.cdc.gov/mmwr/pdf/rr/rr5417.pdf) which, among other things, advises a risk-based approach to screening (Appendix C speaks to the screening requirements for all healthcare workers, regardless of who they work for. The guidance would be to include contract folks. The risk level is determined via a risk assessment (Appendix B of the Guidelines is a good start for that). So, for a medium exposure risk environment, CDC recommends annual screening, but for a low exposure risk environment, they recommend screening at time of hire, with no further screening required (unless your exposure risk increases, which should be part of the annual infection control risk assessment).

But, in 1996, OSHA issued a directive that indicates annual screening as the minimum requirement , even for low-risk exposure risks, and even while referencing the CDC guidance: (http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=DIRECTIVES&p_id=1586) with medium risk folks having semi-annual screening and high-risk folks being screened on a quarterly basis. So, friends, how are you managing folks in your environment, particularly the aforementioned contracted staff? Do you own them or is it the responsibility of their contracted employer? Does this stuff give you a headache when you think about it too much? It sure gives me one…occupational hazard, I guess. At any rate, it’s certainly worth checking to see whether a risk assessment for TB exposure has been conducted. The OSHA guidance document clearly indicates that if you haven’t, it’s the responsibility of the surveyor to conduct one for you, and I don’t know that I’d be really keen on having that happen.

I especially liked the they references. Do you encounter the vague but seemingly ominpotent and omniscient they reference? If so, or for other observations, post a comment below.

Ask the expert: Who does OSHA fine for not using safety needles, the worker or employer

By: December 30th, 2011 Email This Post Print This Post

Q: If an employee refuses to use available safety devices, such as safety needles and sharps, who would pay the fine if an OSHA inspector cites such a situation? The employee or the employer?

A: The employer is responsible and bears the burden of any citations or fines. OSHA only has the power to fine the employer, not the employee.

OSHA would expect the employer to modify the safety education program and training to achieve compliance among staff. Documented progressive disciplinary actions could mitigate the issuance of a citation or the severity of a fine.

Last year the average initial OSHA fine to medical practices for not providing or ensuring the use of safety devices was $1,306, according to Medical Environment Update.

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Safety officer tip: Small practices hardest hit by bloodborne pathogens fines

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

A reader liked my post on OSHA citations of small medical practices, but thought that an analysis of the dollar amount of bloodborne pathogens fines would better ensure compliance by hitting practice owners in the pocketbook.

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Safety officer tip: Small practices not immune to OSHA citations

By: November 21st, 2011 Email This Post Print This Post

Do you hear the excuse from management that your practice is too small to worry about OSHA compliance? Or do you believe that practice size gives you immunity from citations? If you do, you’re wrong—look at the numbers.

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Weekly poll: OSHA and healthcare national emphasis programs

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

Because of the high rate of injuries among support healthcare workers, OSHA announced last week a National Emphasis Program directed toward nursing homes and residential care facilities that would increase the number of inspections conducted on those types of facilities, and focusing on hazards from patient handling, bloodborne pathogens, workplace violence, and slips, trips and falls. Are you in favor of more OSHA National Emphasis Programs directed toward healthcare? Take our OSHA Healthcare Advisor Weekly Poll and let us know.

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OSHA initiates national program on safety and health in nursing homes

By: November 10th, 2011 Email This Post Print This Post

Non-fatal occupational injuries among healthcare workers are too high, says OSHA. And nursing homes are the first places the agency to going scrutinize.

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More ambulatory surgery centers taking OSHA hits

By: November 3rd, 2011 Email This Post Print This Post

With more than half of the surgeries in the U.S. performed in ambulatory care settings, ambulatory surgery centers (ASC) and physician offices are under higher scrutiny from OSHA to protect healthcare workers from bloodborne pathogens hazards, according to a two-part series of articles published in October and November editions of the AORN Journal.

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Hospitals seeing red, as in more bloodborne pathogens violations

By: October 12th, 2011 Email This Post Print This Post

OSHA has hit hospitals with more and higher fines for bloodborne pathogens violations compared to last year, according to October issue of Briefings on Infection Control. The report uses data from the OSHA Office of Management System, from July 2010 through June 2011. Here is an excerpt.

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OSHA sues dental practice for firing workers voicing safety concerns

By: September 22nd, 2011 Email This Post Print This Post

Capped needles, not capped teeth, has a Beverly, MA, dental practice, in whistleblower trouble with OSHA.

OSHA is suing N. Terry Fayad, and his dental practice “for allegedly firing an employee for raising concerns about needlestick hazards and filing a health hazard complaint, according to a September 21 OSHA news release.

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The OSHA man cometh, for nursing homes

By: September 16th, 2011 Email This Post Print This Post

Hazardous work conditions have OSHA targeting nursing homes for inspections this year.

The agency announced its annual inspection plan under the Site-Specific Targeting 2011 (SST-11) program which directs enforcement resources toward workplaces where high rates of injuries and illnesses occur.

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A quick look at frequent and expensive OSHA fines, July 2010 to June 2011

By: September 11th, 2011 Email This Post Print This Post

Medical Environment Update acquired a detailed report of citations by standard for medical practices (which include clinics, ambulatory surgery centers, and various outpatient settings) and dental practices from the OSHA Office of Management System, from July 2010 through June 2011. Here is an excerpt.

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Medical Environment Update, September 2011—Come and get it: Fresh data on OSHA violations

By: September 11th, 2011 Email This Post Print This Post

The September issue of Medical Environment Update reports frequent and expensive OSHA fines for medical and dental practices last year.

Here is an excerpt from that article:

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