OSHA's New Reporting Rule Impacts the Health Care Industry

New OSHA Injury Reporting Rules

The U.S. Occupational Safety and Health Administration (OSHA) recently issued a final rule that becomes effective January 1, 2017 requiring healthcare industry employers to electronically submit to OSHA injury and illness data from their OSHA logs. This information will then become publicly available on the OSHA website.

As a corollary, and “to ensure the completeness and accuracy of injury and illness data,” the final rule also:

• Creates an explicit requirement that employees must be informed of their right to report work-related injuries and illnesses free from retaliation;
• Specifically requires that an employer's procedure for reporting work-related injuries and illnesses must be reasonable and not deter or discourage employees from reporting; and
• Explicitly prohibits retaliation against employees for reporting work-related injuries or illnesses.

The requirement to report data applies to: (1) work locations with 250 or more employees, and (2) work locations with 20 to 249 employees in specific “high-risk industries” identified in the rule. The rule includes several types of healthcare industries in its definition of high-risk industries. Specific healthcare industries that must comply with this rule if they have 20 or more employees at a particular work location are:

• Ambulatory healthcare services;
• General medical and surgical hospitals;
• Psychiatric and substance abuse hospitals;
• Specialty (except psychiatric and substance abuse) hospitals;
• Nursing care facilities;
• Residential mental retardation, mental health, and substance abuse facilities;
• Community care facilities for the elderly; and
• Other residential care facilities.

Businesses with 250 or more employees at a work location in industries covered by the new recordkeeping regulation must submit information from their 2016 Form 300A by July 1, 2017. These employers will also be required to submit information from all 2017 forms (300A, 300, and 301) by July 1, 2018. Starting in 2019, the information must be submitted by March 2 each year. Businesses with 20-249 employees in high-risk industries, including those healthcare industries mentioned above, must submit information from their 2016 Form 300A by July 1, 2017, and their 2017 Form 300A by July 1, 2018. Starting in 2019, the information must be submitted by March 2 each year.

OSHA will make the injury and illness data public. After removing any Personally Identifiable Information that could be used to identify individual employees, OSHA will post the data on its website, and anyone will be able to download it. Employers in the above-referenced high-risk industries (and those with 250 or more employees) should begin planning now to ensure compliance with the January 1, 2017 reporting deadlines.

The new rule also emphasizes that employees who report workplace related injuries and illnesses may not be discriminated against or retaliated against because they have reported such injuries or illnesses. It provides OSHA with the authority to cite an employer for retaliation even in the absence of any employee complaint. The commentary to the rule says:

• Employers must have a reasonable procedure for employees to report work-related injuries and illnesses.
• Employers’ reporting procedures cannot deter or discourage reasonable employees from accurately reporting a workplace injury or illness.
• Blanket or automatic post-accident testing policies are prohibited and will be viewed as taking an adverse action against, retaliating against, or discouraging employees from reporting accidents.
• Employers need not specifically suspect drug use before testing, but there should be a reasonable possibility that drug use by a reporting employee was a contributing factor to the reported injury or illness in order for an employer to require testing, and, even then, the testing should be limited to only the employee who caused the accident rather than everyone involved.

Although the new rule does not prohibit all post-accident/post-injury drug testing policies, OSHA’s position is that the circumstances of some accidents make it unlikely that drug use was a contributing factor, and therefore testing employees in these situations would be viewed as retaliation. OSHA provides these examples of circumstances where required drug testing would be suspect:

• After an employee reports a bee sting;
• When an employee has a repetitive strain injury;
• After an injury caused by a lack of machine guarding; or
• When a machine or tool malfunctions.

The rule acknowledges many employers implement post-accident/post-injury drug testing policies because they are located in states that offer workers’ compensation premium reductions for enacting Drug Free Workplace Policies. Compliance with these workers’ compensation programs or other state or federal laws or regulations requiring post-accident/post-injury or reasonable suspicion testing are still permitted.

Employers must also specifically inform employees: (i) they have the right to report work-related injuries and illnesses; and (ii) the employer is prohibited from retaliating against employees for reporting work-related injuries or illnesses. Employers also must establish a reporting procedure that does not deter or discourage an employee from reporting work-related injuries and illnesses. These posting and reporting requirements are effective as of November 1, 2016.

In light of OSHA’s new rule, employers in the health care industry should review drug testing policies as well as accident/injury reporting policies to ensure they do not violate OSHA's new rules.

Also See: Provisions call for employers to electronically submit injury and illness data that they already record.

Source(s): https://www.osha.gov, http://www.jdsupra.com, http://www.hcsiinc.com

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Am I a Good Compliance Officer?

What Does It Take To Be A Good Compliance Officer?

What makes a good Compliance Officer?  It’s a question every hiring manager, General Counsel and Board must consider when faced with the need or opportunity to bring that critical person into the business. 

The compliance profession is still in its infancy.  A couple of decades ago it started in the United States in the financial services and health care sectors, growing out of legal and audit and into its own role.  As the UK Bribery Act came into force and more multi-national organizations were stung with fines for failing to comply with all sorts of laws, companies began to hire compliance officers in order address the ever-increasing legal and regulatory expectations placed on them from all angles.  As compliance departments grow throughout Europe, Asia and South America, businesses must evaluate who to hire and how to determine what makes a good compliance officer.

What are the primary roles a compliance officer must undertake?

In many businesses, compliance is in charge of both compliance and ethics.  Compliance tends to deal with the policies and procedures that are put in place in order for the business to ensure compliance with the law.  Ethics revolves around doing the right thing, corporate values and training people to behave in a way that creates a culture of compliance.  While some organizations, particularly in financial services, separate the ethics and compliance elements, for most businesses compliance and ethics go hand-in-hand in one role. 

Compliance Officers are generally charged with three tasks: awareness, advice and reporting.  The Compliance Officer creates the compliance program and ensures that people throughout the organization are aware of it, which includes ensuring understanding of the law, rules and procedures enforced by the company.  Compliance Officers must also be able to advise on legal and compliant ways of conducting business, and then report to the business about program implementation and specific issues requiring resources or response.

What skills does a Compliance Officer need to have?

The most important thing a Compliance Officer needs is a deep understanding of the business.  Without a desire to know the business, the Compliance Officer will not be able to give helpful solutions to problems. 

Communication skills are also vital for a Compliance Officer.  Most Compliance Officers perform training or give updates to the employee population, managers or Board, so clear, compelling communication is essential.  Compliance Officers also need to be terrific listeners so that they can hear and understand the pressure points between the business and the law.  Compliance Officers must be persuasive and able to influence the business, especially when the procedures or policies may be unpopular or difficult but necessary. 

Lastly, Compliance Officers need to be skilled at designing simple and understandable procedures in order to mitigate the risks identified by the business.

How important is independence for a Compliance Officer?

Capacity for independent thought is crucial, as is a strong moral compass.  Although it is very important that the Compliance Officer be able to get along well with others in the business, there will invariably be times when the Compliance Officer must stand up for what is right, and not what is popular.  Ideally the Compliance Officer will have a direct reporting line to the Board and C-suite, so that any highly-contentious issue is dealt with at the highest levels of the business without the dilution of another function speaking for Compliance.  There is a strong trend right now in Financial Services and in U.S. enforcement actions to demand that the Compliance Department function outside the Legal Department.  This trend is likely to continue and is likely to become best practice throughout the world.

What else can a Compliance Officer do to be effective?

The best Compliance Officers are those who can embrace change.  The regulatory environment is an ever-evolving one, and just when a Compliance Officer thinks that the program is perfect, another law will come into force or an enforcement action will require the program to shift.  Compliance Officers need to be naturally curious with a can-do attitude.  If a Compliance Officer learns to say “no” effectively to the business using empathy and giving an explanation, it will go a long way toward building the trust that is critical for the Compliance Officer to maintain with management.

What role does enthusiasm or charisma play in becoming a good compliance officer?

Ideally Compliance Officers come to the job with a belief that what they are doing is important, valuable and helpful to the business.  It’s been said that the Compliance Department’s job is to protect the business in five years.  Therefore, short-term sales goals and actions which may create reputational risk must be eschewed in favour of long-term thinking about what is going to make the business sustainable and profitable in the future.  Compliance Officers who maintain a sense of mission, justice and proportionality will be successful.  A sense of purpose, enthusiasm for the job and natural charisma will draw people within the business to listen to the Compliance Officer, which can be helpful.

The definition of what makes a “good” Compliance Officer different when the person is working in a multi-national business?

Compliance roles inevitably become more complex when the business is multi-national.  Not only does the Compliance Officer have to manage differing, and sometimes competing laws, but there will also be questions of language and culture that can make the job more difficult.  Compliance Officers working in multi-national environments need to be incredibly attuned to the cultural differences within the countries in which their business operates.  A strong desire to learn about the other cultures will make a big difference.  People tend to listen to people who listen to them.  A good Compliance Officer in a multi-national company will be one who is aware that everyone comes with a set of expectations created by their culture of origin, and that listening and being aware is critical to the success of the compliance program in a multi-national environment.

What’s the number one way to determine whether or not you are, or have hired, a good Compliance Officer?

You know you are a good Compliance Officer if members of the business frequently come to you to proactively seek your advice.  If you’re providing smart, helpful counsel and engaging with them so that they trust you, then you are likely doing your job effectively.

Source(s): Kristy Grant-Hart, http://www.ethic-intelligence.com, http://complianceandethics.org

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OSHA Slams Northridge Hospital for Health and Safety Violations

OSHA COMPLIANCE IS CRITICAL

State workplace safety regulators fined the operator of Northridge Hospital Medical Center about $44,125 for violations that potentially exposed the hospital’s 1,700 employees to non-compliance health hazards.

Dignity Health was cited after Cal/OSHA determined that the hospital failed to record information in over a dozen cases where hospital workers were stuck with needles, and failed to provide closeable containers in emergency rooms that would keep biohazard waste from spilling, according to the state agency.

Northridge Hospital said in a statement that it is working “diligently” to address the agency’s findings.

“We have a longstanding relationship with Cal/OSHA and appreciate the regulatory body working with us to ensure the safety of our employees,” according to the hospital.

Cal/OSHA’s Van Nuys office opened an investigation in June after receiving a complaint, resulting in 13 health code violations, regulators said.

“California’s health and safety requirements are some of the strongest in the nation, and they’re meant to prevent hospital workers from becoming hospital patients,” Cal/OSHA Chief Juliann Sum said.

The findings included violations of bloodborne pathogens precautions, which require employers to protect workers from coming into contact with blood or other disease-carrying body fluids, according to Cal/OSHA.

Cal/OSHA also issued general and regulatory violations because Dignity Health kept broken gurneys in the working area, skipped essential elements of training employees in safe patient handling, and failed to take corrective action after accidents occurred, regulators said.

In summary, there were four serious violations of the bloodborne pathogens standard, which requires employers to protect workers from coming into contact with blood or other disease-carrying body fluids. A serious violation is cited when there is a realistic possibility that death or serious harm could result from the actual hazardous condition. In this case, the serious violations included:

• Failure to gather information required by the Sharps injury log, such as type and brand of needles involved in the 18 injury cases. The employer had no procedure in place to review the log, or to solicit required input from employees about factors contributing to contaminated needle injuries. Well-kept injury logs, and their regular review, help to identify the causes of injuries and prevent future occurrences.

• Failure to provide containers that would prevent spillage or protrusion of contaminated needles in emergency treatment and trauma rooms. Additionally, the employer did not provide readily accessible hand washing facilities for emergency room employees.

• Failure to provide appropriate sizes of gloves for employees using the medication cart in the trauma room and the after-hours intake area.
Cal/OSHA also issued eight general and regulatory violations because Dignity Health kept broken gurneys in the working area, skipped essential elements of training employees in safe patient handling, and failed to take corrective action after accidents occurred. 

Sources: Northridge-Chatsworth Patch, stateofreform.com

For more information on this and other healthcare compliance topics related to HIPAA, OSHA, Medicare and HR, simply email your questions to support@hcsiinc.com, 
visit our website at http://www.hcsiinc.com or post a question on our LinkedIn group at: http://bit.ly/1FWmtq6

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Proper Sharps Disposal and Containers

Handling Sharps and Needles

Sharps Containers (also referred to as Sharps Disposal Containers, Medical Waste Disposal Containers, Biomedical Waste Disposal Containers, etc.) are specially made containers used to contain hazardous "piercing" instruments and reduce the chance of spreading infection. It is standard practice in developed and even underdeveloped countries for used needles to be placed immediately into a sharps container after a single use, with only a few exceptions to the general rule. Needles are dropped into the container without touching the outside of the container. Needles should never be pushed or forced into the container, as damage to the container and/or needlestick injuries may result. Proper use of a sharps container includes pick up by or delivery to an approved "red bag" or medical waste treatment site. In addition to this pre-existing safety measure, all U.S. medical and educational staff are federally required to be tested on their knowledge of bloodborne pathogens.

A sharps container is a term for a specially-made container that is predominantly used for medical needles and any other sharp medical instruments, such as an IV catheter. They are available in one of two types:

Single-use sharps containers - which are disposed of with the waste inside.

Reusable sharps containers - which are robotically emptied and sterilized before being returned for re-use.

Sharps is the term used to describe any item that is capable of puncturing the skin such as syringes, needles, lancets, broken glass with blood on it, scalpels, etc. Because these 'sharps' potentially have disease-carrying blood or other potentially infectious materials on them, they are capable of 'injecting' that blood or fluid into anyone who comes in contact with them. Examples of sharps include:

• Needles, syringes, lancets, broken glass with blood on it
• Suture needles, scalpel blades, butterflies (both traditional and safety)
• Vacutainer tubes (both plastic and glass)
• Phlebotomy needles with vacutainer tube holder attached
• Capillary tubes (both plastic and glass)
• IV catheters
• Dental anesthetic carpules with blood
• Dental wires and endodontic files
• Other sharp objects contaminated with blood such as box cutters and broken glass

For regulated businesses, such as healthcare faculties, in addition to sharps, regulated medical waste is defined by OSHA as:

• Pathology and microbiological waste
• Liquid or semi-liquid blood or other potentially infectious materials (OPIM*)
• Items caked with dried blood or OPIM
• Items that could release blood or OPIM

*OPIM: semen, vaginal secretions; fluids from around the spine, brain, joints, lungs, heart, and abdomen; saliva in a dental procedure; any body fluid with visible blood; any unidentifiable body fluid; and unfixed tissue.

Examples of non-sharps regulated medical waste include Tubing with blood in it and Blood-soaked gauze. Regulated medical waste does not include urine, feces, sputum, sweat, tears, or saliva or any items containing or once containing these fluids such as urine cups, incontinence pads, or diapers.

Preventing Injuries

Before you use a sharp object, such as a needle or scalpel, make sure you have all the items you need close by. This includes items like alcohol swabs, gauze, and bandages.

Also, know where the sharps disposal container is. Check to make sure there is enough room in the container for your object to fit. It should not be more than 2/3 full.

Some needles have a protective device, such as a needle shield, sheath, or blunting, that you activate after you remove the needle from the patient. This allows you to handle the needle safely, without the risk of exposing yourself to blood or body fluids. If you are using this kind of needle, make sure you know how it works before you use it.

Follow these guidelines when you work with sharps.

• Do not uncover or unwrap the sharp object until it is time to use it.
• Keep the object pointed away from you and other persons at all times.
• Never recap or bend a sharp object.
• Keep your fingers away from the tip of the object.
• If the object is reusable, put it in a secure, closed container after you use it.
• Never hand a sharp object to someone else or put it on a tray for another person to pick up.
• Tell the people you are working with when you plan to set the object down or pick it up.

Sharps Disposal

Make sure the disposal container is made for disposing of sharp objects. Replace containers when they are 2/3 full.

Other important tips include:

• Never put your fingers into the sharps container.
• If the needle has tubing attached to it, hold the needle and the tubing when you put it in the sharps container.
• Sharps containers should be at eye level and within your reach.
• If a needle is sticking out of the container, do not push it in with your hands. Call to have the container removed. Or, a trained person may use tongs to push the needle back into the container.
• If you find an uncovered sharp object outside of a disposal container, it is safe to pick it up only if you can grasp the non-sharp end. If you cannot, use tongs to pick it up and dispose of it. 

According to OSHA, healthcare employees must have access to sharps containers that are easily accessible to the immediate area where sharps are used (29 CFR 1910.1030(d)(4)(iii)(A)(2)(i)).

The FDA recommends that used needles and other sharps be immediately placed in FDA-cleared sharps disposal containers. The FDA has evaluated the safety and effectiveness of these containers and has cleared them for use by health care professionals and the public to help reduce the risk of injury and infections from sharps.

FDA-cleared sharps disposal containers are made from rigid plastic and come marked with a line that indicates when the container should be considered full, which means it’s time to dispose of the container.

How do the Bloodborne Pathogens standard and the Needlestick Safety and Prevention Act apply to you?  OSHA's Bloodborne Pathogens standard (29 CFR 1910.1030), including its 2001 revisions, applies to all employers who have an employee(s) with occupational exposure (i.e., reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials (OPIM) that may result from the performance of the employee's duties). These employers must implement the requirements set forth in the standard. Some of the new and clarified provisions in the standard apply only to healthcare settings, but other provisions, particularly the requirements to update the Exposure Control Plan and to keep a sharps injury log, apply to non-healthcare as well as healthcare settings. Make sure your staff are properly trained in OSHA compliance standards and have the required tools to perform their job safely.

Sources: www.osha.gov, www.fda.gov, U.S. National Library of Medicine and http://www.sharpscontainers.org/

For more information on this and other topics related to HR, HIPAA, OSHA, and Medicare, please email support@hcsiinc.com or visit our website at http://www.hcsiinc.com 
Become a member of our LinkedIn group at: http://bit.ly/1FWmtq6

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Double Gloving Can Protect You

Benefits of Double Gloving

                                                           

Healthcare providers observed blood on their hands after surgery more frequently when they wore a single pair of gloves than when they wore two pairs of gloves and generally had a favorable opinion on double gloving, according to a recent study.

                                                           

The study, appearing in a recent article of the AORN (Association of periOperative Registered Nurses) Journal, examines the effect of double gloving with inner indicator gloves on the durability of inner gloves and the detection of glove tears or perforations during surgery.

                                                           

“Double gloving by itself may protect the wearer’s skin from needle sticks because breaches are more likely to occur to the outer gloves than the inner gloves,” according to the study’s authors, Denise Korniewicz, PhD, RN, FAAN, and Maher El-Masri, PhD, RN.

                                                           

The study also found that healthcare providers who wore dark-colored gloves under light-colored gloves changed them during surgery with significantly more frequency than those who wore two pairs of the same color. 

OSHA Introduces Early Resolution Whistle Blower Program

An Early Resolution Program for Whistle-Blower Claims

In an attempt to save money and time, the federal Occupational Safety and Health Administration (OSHA) has introduced an early resolution program for whistle-blowers and employers to settle disputes without investigations and litigation. State OSHA plans are strongly encouraged to also adopt the process.

The early resolution process offers whistle-blower parties the opportunity to negotiate a settlement with the assistance of a neutral, confidential OSHA representative with subject matter expertise in whistle-blower investigations, the agency said. It’s an expansion of a pilot program that’s been in place in selected OSHA regions since late 2012.

OSHA enforces the whistle-blower provisions of 22 statutes protecting employees who report violations of various securities laws; trucking, airline, nuclear power, pipeline, environmental, rail, maritime, health care, workplace safety and health regulations; and consumer product safety laws.

“The number of retaliation claims filed under the various statutes has risen steadily each year and the cost of investigating them has placed a tremendous strain on OSHA’s fiscal and physical resources,” said Valerie Butera, a labor and employment attorney. OSHA accepted 3,060 new whistle-blower cases in fiscal year 2014.

The pilot of the early resolution process proved to be a very effective and viable alternative to the investigative process, and an invaluable asset to OSHA’s whistle-blower protection programs, the agency said. “The process demonstrated that adding staff dedicated to the coordination and facilitation of settlement negotiations provides valuable relief to OSHA’s whistle-blower investigative staff, and provides a highly desired service.”

Workers or employers from the targeted regions made 289 requests to attempt to reach a settlement using the early resolution process during 2013, the first fiscal year it was available, according to OSHA. Both parties agreed to attempt a settlement in 87 of those cases. In the end, 54 cases were settled.

The directive does not prohibit OSHA whistle-blower offices from offering complainants and respondents other alternative dispute-resolution processes, such as third-party mediation.

The process involved in the early resolution program is outlined below.

●        Upon receiving a timely complaint—within 30 days of the retaliatory act—OSHA will send opening letters to both the respondent and the complainant informing the parties about OSHA’s early resolution program and the option to use it.

●        If both parties agree to seek early resolution at any time after an investigation begins, the investigation will be suspended and the case handed over to the regional alternative dispute-resolution coordinator. The coordinator will work with the parties to explore whether there is common ground for settlement but will not judge the merits of the complaint.

●        OSHA can terminate the process if either party violates the ground rules for participation, including engaging in abusive behavior or failing to participate in good faith, or if the parties cannot come to an agreement within a reasonable amount of time. “Parties must come to the process fully prepared to discuss resolution of the whistle-blower complaint and have full authority to settle the dispute,” Butera said.

●        Either party can also end the process, as participation is voluntary.

●        If the parties agree upon a framework for settlement, the coordinator may draft a proposed settlement agreement or the parties may draft and submit an agreement for OSHA’s approval. After the agency approves and both parties sign the settlement agreement, OSHA will close its investigation. If a settlement is not reached, the investigation will resume.

Butera advised employers to consider these core concepts:

●        The early resolution process is confidential. The coordinator will not discuss the merits of the complaint or the content of the early resolution discussions with OSHA’s investigators, but “keep in mind, however, that the terms of an OSHA whistle-blower settlement agreement, whether agreed upon during the early resolution process or by other means, will be disclosed to OSHA and may be made public by OSHA in response to a [Freedom of Information Act] request or otherwise,” Butera said.

●        Early resolution may significantly reduce the cost of responding to a whistle-blower complaint. “An investigation may disrupt your business, affecting productivity, and can lead to full-blown federal litigation,” Butera said. “It costs nothing to attempt to agree upon a resolution that satisfies the parties. OSHA even offers early resolution conferences by telephone in the event that travel to attempt early resolution would be too costly or create hardship for either party.”

(SHRM website)

Create a Culture of Safety and Avoid OSHA Fines

Boosting Employee Safety and Avoiding OSHA Citations

Although it’s impossible for employers to mitigate against every conceivable hazard in the workplace, there are five critical steps that every employer should take to improve safety in the workplace—and avoid costly OSHA citations.

●        Conduct an Internal Safety and Health Audit

One of the most effective ways for an employer to identify and eliminate safety hazards in the workplace is to conduct a safety and health audit. Employers should closely examine every aspect of their workplace to ensure they’re in full compliance with OSHA standards and best practices.

Employers must take care, though, in the way they conduct and document such audits.

In an inspection, OSHA may demand to see audit reports and use them to identify potential hazards in the workplace, essentially using the employer’s proactive audit against it and issuing citations based on hazards identified but not yet remedied.

Employers can protect their internal audit reports from disclosure to OSHA by working with counsel in conducting their audits. The audit report is then protected from disclosure to OSHA by the attorney-client communication privilege.

●        Create a Strong Safety Culture

A robust and authentic safety culture is critical for ensuring employee health and safety. Management at all levels should be involved in creating this culture, actively communicating with employees and being physically present where employees do their jobs. Such actions demonstrate to employees that employers are serious about safety, increasing employees’ commitment to safety and their overall job satisfaction. By doing this, employers have the opportunity to observe potential hazards with their own eyes and discover other potential hazards through conversations with employees.

Employers should assure employees that safety is a priority and that suggestions for improving safety in the workplace are not only welcome, but encouraged. By providing open lines of communication with employees, employers again encourage a commitment to safety at all levels of the organization and significantly improve the odds they will learn of a potential problem.

Employees are often the first to identify a potential hazard, and having regularly worked in a particular area, they have insightful suggestions about how problems can best be resolved. When an employee identifies a potential hazard, the employer should assess the situation promptly and respond to the issue in a timely manner.

●        Ensure That Safety and Health Documentation Is Current and Well Communicated

All employers must provide to their employees essential safety information, such as how to evacuate in an emergency. OSHA also requires employers to provide a range of written guidance to employees regarding the essentials of safely performing their work.

Every employer should regularly review its OSHA documentation requirements, which may change from time to time. Recently, for example, OSHA updated the Hazard Communication Standard to align with the GHS. Having determined the extent of their documentation requirements, employers should review their documents and ensure that they are thorough and up to date. Finally, employers should make sure that employees fully comprehend the documentation, know how and when to use it, and understand the reason for maintaining it. This helps to ensure employee safety and gives employees another opportunity to provide suggestions and point out information that’s missing from the documents.

●        Train Employees in Safety and Health, Regularly and Comprehensively

OSHA standards include a number of training requirements. OSHA often cites employers for failure to train employees on relevant safety and health information and failure to ensure that employees understand the training. This is avoidable.

Employers must provide comprehensive training to employees in a way that employees can fully comprehend. A simple way to ensure compliance with this requirement is to administer a quiz at the conclusion of the training, requiring employees to demonstrate their comprehension of the information that was relayed to them. Many employers require employees to achieve a high score on such quizzes (e.g., 90 to 100 percent). If employees are unable to reach the required score on the first try, they should be given the opportunity to be retrained and take the quiz again. Employers should keep records of all safety and health training provided to employees and should keep quizzes and other related materials on file. Simply being able to provide these documents to OSHA in the event of an inspection will go a long way toward proving that the employer has complied with OSHA’s training requirements.

●        Protect Contractors and Temporary Workers, Too

Employers should make every effort to ensure that all employees working in their facilities are safe – contractors and temporary workers included. Many tragic incidents can be avoided by ensuring that everyone is on the same page when it comes to safety. Although this task may sound daunting, it is another essential element of creating a truly safe working environment.

OSHA has instructed its compliance officers to expand the scope of inspections to include temporary workers who may have been exposed to a hazard identified by OSHA. This instruction led to a 322 percent increase in inspections involving temporary employees in 2014. In only 15 percent of those inspections, citations were issued to the temporary agencies—but countless citations were issued to host employers, often for failing to train temporary workers properly or to provide them with the safety gear provided to permanent employees, leaving temporary workers at an increased risk of harm.

(EBGL website)

Top Hazards in OSHA Healthcare Inspections

OSHA Announces Key Hazards for Healthcare Inspections

Targeting some of the most common causes of workplace injury and illness in the healthcare industry, OSHA announced it is expanding its use of enforcement resources in hospitals and nursing homes to focus on: musculoskeletal disorders related to patient or resident handling; blood-borne pathogens; workplace violence; tuberculosis and slips, trips and falls.

U.S. hospitals recorded nearly 58,000 work-related injuries and illnesses in 2013, amounting to 6.4 work-related injuries and illnesses for every 100 full-time employees: almost twice as high as the overall rate for private industry.

“Workers who take care of us when we are sick or hurt should not be at such high risk for injuries — that simply is not right. Workers in hospitals, nursing homes and long-term care facilities have work injury and illness rates that are among the highest in the country, and virtually all of these injuries and illnesses are preventable,” said Dr. David Michaels, assistant secretary of labor for occupational safety and health. “OSHA has provided employers with education, training and resource materials, and it’s time for hospitals and the healthcare industry to make the changes necessary to protect their workers.”

OSHA has advised its staff through a memorandum that all inspections of hospitals and nursing home facilities, including those prompted by complaints, referrals or severe injury reports, should include the review of potential hazards involving musculoskeletal disorders related to patient handling; blood-borne pathogens; workplace violence; tuberculosis; and slips, trips and falls.

“The most recent statistics tell us that almost half of all reported injuries in the healthcare industry were attributed to overexertion and related tasks. Nurses and nursing assistants each accounted for a substantial share of this total,” added Dr. Michaels. “There are feasible solutions for preventing these hazards and now is the time for employers to implement them.”

(DOL website)

Safety in the Laboratory

Laboratory OSHA Safety Culture

                                                           

The safety culture varies greatly from laboratory to laboratory. Most lab employees these days know that eating food or drinking in the lab is against most, if not all, lab regulatory agency rules and guidelines. However, it is surprising that many do not seem to understand that gum chewing or using hard candy or throat lozenges is also not permitted in a laboratory setting.

                                                           

OSHA’s Bloodborne Pathogen Standard specifically states “Eating, drinking, smoking, applying cosmetics or lip balm, and handling contact lenses are prohibited in work areas where there is a reasonable likelihood of occupational exposure.” Obviously, the goal of this regulation is to prevent employees from obtaining infection via ingestion. A secondary goal is to limit hand to mouth contact while working in the laboratory. So far there has been no mention of gum or cough drops in the standards.

                                                           

In the National Research Council’s Prudent Practices in the Laboratory (1995), it states “Eating, drinking, smoking, gum chewing, applying cosmetics, and taking medicine in laboratories where hazardous chemicals are used should be strictly prohibited.” In the Clinical and Laboratory Standards Institute’s document Clinical Laboratory Safety (GP-17 A3, 2012), it states “Food, drink and substances that provide potential hand-to-mouth contact (including chewing gum and lip balm) are prohibited in technical work areas.”

                                                           

Most inspectors of the laboratory will cite the lab for gum chewing or the like. An employee may respond that the gum was placed into their mouth outside the lab, but proving that would be difficult at best. It is an inappropriate and unsafe practice, and it should not be allowed.

                                                           

Again, limit hand-to-mouth or hand-to-face contact in the laboratory. What about telephone use? There are speaker options for phones that can help, but some labs are too noisy for that type of use. Disinfect phones often if that is the case.

As with any other safety regulation, if you explain it to staff, and if you make it easy to comply, your safety culture will improve. Educate your staff about these guidelines and standards and why they exist. Unfortunately, many workers fell victim to harmful infectious diseases before these regulations were developed. Don’t let your staff become another part of those unfortunate lab safety statistics.

5 Areas Requiring Bio-Hazard Labels

Five Areas that Require OSHA Bio-hazard Labeling

The Blood-borne Pathogens Standard outlines the regulations for bio-hazard labeling and color-coding. Three signals can alert you to the presence of a bio-hazard or bio-hazardous waste: the word “bio-hazard”, the bio-hazard symbol, or the fluorescent orange or orange-red color-coding.

These five areas are ones to watch for bio-hazard labeling in your facility:

●       Regulated medical waste containers and other containers

      According to OSHA, warning labels must be affixed to:

○     Containers of regulated waste,

○     Refrigerators and freezers containing blood or other potentially infectious material; and

○     Other containers used to store, transport or ship blood or other potentially infectious materials.

EXCEPTIONS include:

○     Containers of blood, blood components, or blood products that are labeled and have been released for transfusion,

○     Individual containers of blood or other potentially infectious materials that are placed in a labeled container during storage, transport, shipment or disposal, or

○     Regulated waste that has been decontaminated.

●       Sharps Containers

Sharps containers must also be labeled or color-coded in accordance with the requirements of the Blood-borne Pathogens Standard.

●       Contaminated Laundry

The Blood-borne Pathogens Standard also requires contaminated laundry to be placed and transported in labeled or color-coded bags. When a facility utilizes Universal Precautions in the handling of all soiled laundry, alternative labeling or color-coding is sufficient if it permits all employees to recognize the containers as requiring compliance with Universal Precautions.

When a facility ships contaminated laundry off-site to a second facility which does not utilize Universal Precautions in the handling of all laundry, the facility generating the contaminated laundry must place such laundry in labeled or color-coded bags or containers.

●       Specimens

Specimens of blood or other potentially infectious materials must be placed in a container which prevents leakage during collection, handling, processing, storage, transport, or shipping. The container for storage, transport, or shipping must be labeled or color-coded and closed prior to being stored, transported, or shipped.

●       Equipment

Equipment that may become contaminated with blood or other potentially infectious materials shall be examined prior to servicing or shipping and shall be decontaminated as necessary, unless the employer can demonstrate that decontamination of such equipment or portions of such equipment is not feasible, according to OSHA. A readily observable bio-hazard label shall be attached to the equipment stating which portions remain contaminated.

Ensure that you have bio-hazard labeling or color-coding, as necessary, in these five areas and in other areas of your facility that fall under the guidelines of OSHA’s Blood-borne Pathogens Standard 1910.1030.  In practice, most facilities typically use BOTH bio-hazard labeling AND color-coding in most cases.

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