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  • Take the guesswork out of OSHA compliance with Quality America's OSHA Manual, OSHA Training Video and OSHA Watch Newsletter. Busy practice managers across the nation rely on our Compliance Products to avoid stiff OSHA fines and provide a safe workplace.
  • Avoid costly misinterpretation of regulations. Let the experts at Quality America provide you with accurate, cost-effective templates for compliance.
  • Save time and money by customizing our proven pre-written plan for your practice. Avoid hours plowing through Federal Registers to distill information pertinent to your practice. Don't waste money by overcomplying!
  • Avoid still fines and sanctions Gain peace of mind that your facility is in compliance. Don't live in fear of surprise inspections.
  • Keep up with new regulations as they arise. Use our time-tested checklists, fill-in-the-blanks worksheets, and other simple tools to meet new government regulations.
  • Minimize workplace accidents by providing a safe and healthy workplace. Our Total Compliance Package shows you how!


OSHA Seminars

Dr. Sheila Dunn


OSHA Compliance Products
OSHA Safety Program Manual
Protect your staff and comply with OSHA requirements with our fill-in-the-blanks Exposure Control Plan. Two-inch binder contains everything needed for compliance with OSHA's Bloodborne Pathogens, Hazard Communication, and TB regulations. Includes required forms, copies of actual OSHA regulations, eyewash sign, OSHA posters, compliance checklist, sample tests for training sessions, two-inch MSDS binder, and much more. Includes PC disk for Microsoft® Word® 6. ($179)
OSHA Yearly Retraining Video Learning System.
Have lunch with the folks at Dr. Vascular's office who just found out that the OSHA inspector is on his way. Luckily, a Quality America consultant arrives to show them how to pass an OSHA inspection with flying colors. Comical vignettes throughout this interactive video prompt your staff to identify "what's Wrong With this Picture"? Painless full full OSHA's yearly retraining requirements. Covers Bloodborne Pathogens, Hazard Communication and TB regulations. $179.00.
OSHA Watch Newsletter
Eight page newsletter keeps you informed of current OSHA regulations and most recent changes. Latest breaking news and practical tips to ensure medical practice compliance. Includes helpful Q & A section. Six issues/year $79.
Complete Compliance Package
Simply the best. Get in compliance and stay in compliance with our Manual, Video and Newsletter. Only $349.00. Save $88.00!!

NEW Sharps Injury Reduction Video Program

Includes: OSHA Manual, Annual Training Video "I Can't Believe They Do That!", facilitator's guide, workbook, eyewash sign, MSDS binder, OSHA Watch Newsletter (1 yr) & new Sharps Injury Reduction Program "Point of No Return!" video, w/ guide.

NEW Sharps Plus -  Complete Compliance Program

Includes: 15 minute "Point of No Return!" video, w/ guide. The guide includes detailed instructions for performing sharps evaluation and forms to document these evaluations. Also includes Sharps Injury log.

Any of the above products may be purchased now.
Click Here To Order.

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Save time and money by calling in the experts to perform OSHA-mandated yearly retraining of employees. Quality America offers three kinds of OSHA training seminars, a beginners session, an annual retraining session, and a "train the trainer" session. Please contact us for availability and pricing.

OSHA Basic Training Seminar

Two-hour session teaches employees how to apply OSHA's Bloodborne Pathogens, Hazard Communication and TB regulations to their workplace. Your employees learn how and when to utilize personal protective clothing and equipment, how to handle biohazardous waste, and general safety regulations such as fire, exits, electricity, etc. P.A.C.E. Continuing Education Credits and Certificates of Attendance are awarded to all participants at the end of the session. Fulfills OSHA training requirements.

OSHA Yearly Retraining Seminar

Meet OSHA's annual retraining requirements in your facility during lunch hour. Prior to the annual training session, we work closely with your facility's safety coordinator to determine areas of concern or emphasis. Two one-hour interactive training sessions are provided that include several exercises and a written test. Instructor demonstrates and reinforces the concepts of personal protective equipment and reviews the basic concepts of universal precautions, chemical safety and TB precautions. P.A.C.E. Continuing Education Credits and Certificates of attendance are awarded to all participants at the end of the session. Fulfills OSHA requirements for annual retraining.

OSHA Train the Trainer Seminar

One two hour session teaches your OSHA safety officer how to present an interactive, informative OSHA yearly retraining seminar that meets OSHA requirements. Includes sample handouts, exercises, training documentation log and a test. Covers general health and safety requirements, Bloodborne Pathogen standard, Hazard Communication standard, and TB requirements. A basic knowledge of OSHA requirements and a medical background (preferably nursing or laboratory) required.


  • According to American National Standards Institute, (ANSI Standard Z358.1, 1998), an eyewash must supply a controlled flow of water to both eyes simultaneously at a velocity low enough not to injure the user. It must deliver at least 3 gallons per minute for 15 minutes at a minimum of 30 psi of flow pressure. It must be large enough to provide room for the eyelids to be held open with the hands while the eyes are in the stream of water. If a nozzle has a protective cover, it shouldn't require a separate action by the operator to activate the wash and remove the cover. The water flow must remain on without requiring the use of the operator's hands and remain on until it is intentionally shut off. The valve that provides water and the sink itself must be resistant to corrosion. The eyewash should supply tepid water. Squeeze bottle-type eyewashes may be used at a workstation to support plumbed units, but cannot be used as a substitute for a plumbed eyewash.


  • Provide an emergency eyewash where employees can easily access it, in a well-lighted area identified with a sign. Be sure that no sharp projections are present in the area of the eyewash. When installing the eyewash, locate it in an area that requires no more than 10 seconds for employees to reach*. This area must be on the same floor (level) as the area where employees are exposed to hazardous chemicals. Be sure the eyewash is protected from freezing and that the nozzles are protected from airborne contaminants. Locate the nozzles at least 33-35 inches from the floor and 6 inches from the wall or nearest obstruction.


  • Activate weekly to flush the line and verify proper operation.

Approx 100 feet. Closer distances are advised for greater hazards such as caustic chemicals and harsh acids.

    to FAQ list
    Food/Drink Policies for Medical Offices
    Should food and drinks be allowed at nurse's stations?
    OSHA Consideration
    OSHA is concerned only with the health and safety of employees, so regarding food and drink at nurses stations, the issue is whether or not employees could be harmed from contamination of their food/drink with either infectious materials (blood, body fluids) or hazardous chemicals. If even a remote possibility of contamination exists, then food and drink should be prohibited by the employer.
    This is a judgement call that must be made at each particular facility by management. One consideration for establishing policy is whether or not lab specimens pass through the area.

    Other Considerations
    OSHA compliance is not the only issue. Each medical practice must establish policies and procedures regarding employee dress, demeanor, etc. These policies are formulated by the management, and are based on a combination of OSHA, infection control, usual and customary behavior for medical offices, and common sense. Insurance company auditors often cite medical practices for having food/drink in the business area. Aesthetic issues are also a factor, e.g., do front office personnel appear professional to customers (patients) when eating/drinking? Does the sound/odor offend others? Could drinks spill on computer keyboards or patient records? Consider employees' viewpoint when deciding on an office food/drink policy. Are employees who wish to eat/drink at their workstation provided with adequate break times? Formulate conservative policies and discipline those who do not comply.

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    Store all prescription drugs, including samples and prescription pads in a secured area with controlled access to minimize the risk of theft or unauthorized use.

    Keep DEA ordering forms and controlled substances in a secure and locked area. Limit access to these forms and drugs to specific staff selected by management.
    Maintain a record of the date, name, strength, and amount of controlled drugs ordered.
    Keep a dispensing record that includes date, patient name, drug name and strength of drug, amount dispensed, physician name, and name and signature of person who dispensed the drug.
    Take inventory at regular intervals and resolve discrepancies between the inventory record and the dispensing record.

    Check prescription drugs periodically for expiration. Remove expired drugs from stock. Check package insert or Material Safety Data Sheets for any special disposal requirements. Document how expired drugs are disposed of after removal from stock (e.g., biohazard bag, etc.)

    Special handling may be required for toxins, biological and cytotoxic drugs. As above, check the MSDS sheet and have proper disposal containers available. Write a policy for disposal of these hazardous substances.
    Appoint one staff person to have overall responsibility for ensuring proper disposal of expired medications.

    Reference: COLA's Accreditation Manual for Medical Practices. COLA is an accreditation agency recognized by JCAHO and NCQA.

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    Limit use of high level disinfectants to instances where the heat or pressure of an autoclave would damage the device to be disinfected. Always sterilize (autoclave) any instrument or device that enters a patient's vascular system or other normally sterile areas of the body.

    Prolonged exposure to glutaraldehyde is dangerous so protect employees from its vapors which irritate eyes, skin, and the respiratory system. Although OSHA's permissible exposure limit of 0.2 parts per million of glutaraldehyde was invalidated by court order in 1992, it remains in effect in some states. In any case, a few covered soaking solutions in a medical practice is surely below that limit. If you use glutaraldehyde extensively, employee exposure may exceed these limits. At that point, employees would be required to wear monitors and sophisticated ventilation systems may be necessary.

    1. Rinse and clean instruments to be disinfected prior to soaking. Many bacteria and viruses (including the HIV virus) can survive in device lubricants, so be sure they are removed before disinfecting.
    2. Those who rinse instruments must protect themselves from splashes and sprays by wearing gowns, gloves, and face protection.
    3. Have a Material Safety Data Sheet on file and be sure all employees who use glutaraldehyde have read it.
    4. Place a warning label on the soaking container containing the name of the chemical (glutaraldehyde) and the hazard warning. Call the toll free number in the product instructions to obtain a free label.
    5. Follow the manufacturer's instructions to a "T."
    6. Use in a well-ventilated area or, if this is not possible, specify that the soaking container is to be covered at all times except when workers are inserting or removing objects from the solution.
    7. Periodically test the solution for potency and discard on or before the expiration date.

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    Gas Cylinder Safety

    Compressed gas cylinders are potential hazards, no matter what the size, and correct handling and use are required. If the guidelines below are followed, small compressed gas cylinders are not an undue hazard. Therefore, the most important safety guideline is to ensure that all staff who come in contact with or use compressed gas know and follow these policies.

    • Have material safety data sheets (MSDS) for every compressed gas. Review these sheets for the chemical hazard present in a particular gas. Oxygen gas, for example, is flammable and should be kept away from heat and electricity. Its fittings must not be lubricated with oil or grease.

    • Gases in cylinders are also under pressure, and if the cylinder is punctured or broken, the gas is released explosively propelling the cylinder with dangerous force. Use, transport and store cylinders in an upright position, and secure by a chain, collar, or transport cart to prevent them from falling over. Keep valve covers on cylinders when they are not in use.

    • Regulators are specifically designed for each type of gas to prevent incompatible gases from mixing, therefore, never interchange regulators. Regulators must be tightly secured on full cylinders before the valve is opened. Release the valve slowly, away from the face and eyes. If any hissing is heard, shut the valve immediately. Do not use regulators or fittings that leak. Soapy solutions will form bubbles over leaks and can be used to check fittings. Because gas leaks often cannot be seen, heard, or smelled, it is crucial that faulty fittings not be used.

    • When gas cylinders are replaced, tightly shut the valve even if the cylinder is believed to be empty. The pressure and flow rate on the regulator should read zero before it is removed. Train all staff who manipulate cylinders to discriminate the cylinder pressure gauge from the flow rate gauge and interpret their readings. Replace regulators with faulty gauges immediately.

    • Manage inventory so that only a minimal amount of cylinders required are kept at the facility. If cylinders are used infrequently, post received dates and expiration dates. Do not store cylinders indefinitely; return old or expired cylinders to the manufacturer. Do not remove identification labels on cylinders even if the cylinder is believed to be empty.

    • Clearly mark empty cylinders and store as carefully as the full ones because residual gas may be present. Store empty cylinders separately from full cylinders and dispose of properly. Never place in ordinary trash, particularly if trash is to be incinerated.

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    Glass Capillary Tube Advisory

    OSHA's second advisory warns about the risk of injury and infection from accidental breakage of glass capillary tubes which can occur during centrifugation and when sealing them in putty. One physician even contracted HIV as a result of an injury related to breakage of a glass capillary tube, and has since died of AIDS.

    If you use glass capillary tubes in your practice, consider switching to of the following:

    • Plastic capillary tubes,
    • Glass capillary tubes wrapped in puncture-resistant film,
    • Capillary tubes that are sealed by a method that does not require manually pushing one end into putty to form a plug

    to FAQ list

    OSHA Latex Advisory

    OSHA now recommends limiting health care workers' exposure to latex by wearing latex gloves only in situations that call for them, such as when protection from infectious agents is required. When performing housekeeping duties, wear non-latex gloves. OSHA's bulletin states that the two main routes of exposure to latex are through inhalation and skin contact, and recommends that you select latex gloves with a low protein content and avoid powdered gloves. Finally, OSHA says to offer allergic workers non-latex gloves that have been cleared by the FDA for medical use.

    Establish common-sense precautions for your practice to prevent both employee and patient reactions to latex. Begin by making a list of latex-containing products and suitable alternatives (for both patients and workers). Gloves are not the only item in medical practices that contain latex. Remember to include supplies such as adhesive tape, stethoscope tubing, disposable syringes and blood pressure cuffs.

    To prevent staff members from developing latex allergies, consider substituting latex-free gloves (vinyl, nitrile, neoprene, etc.) or switch to low-allergen, non-powdered gloves. Mandate non-latex gloves for maintenance and housekeeping tasks.

    You may wish to develop a latex sensitivity questionnaire to screen high-risk workers for symptoms and begin early control measures. If you or another staff member is sensitive to latex, consider the following:

    • Double glove, using vinyl next to the skin
    • Use cloth or nylon glove liners
    • Use lipid-barrier hand creams before gloving
    • Get medical treatment but be aware that it may disguise increasing sensitization to latex
    • Get a medical alert tag or bracelet if you have severe symptoms

    Finally, have epinephrine and resuscitation equipment immediately available for those with Type 1 (severe, life threatening anaphylactic) reactions.

    For detailed guidance in developing protocol for latex sensitivity, contact:

    1. National Institutes for Occupational Safety and Health (NIOSH) @ 800-356-4674. Order free publication # DHHS (NIOSH) 97-135 or e-mail @ http:\\www.cdc.gov/niosh/latexall.html.
    2. American Association of Nurse Anesthetists (847) 692-7050 (x3009) or e-mail: http:\\www.aana.com.
    3. Draft Guidelines for Infection Control in Health Care Personnel. Federal Register, Volume 62, Number 173. September 8, 1997.

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    HbsAg Hepatitis B surface antigen.
    Rises first in infection.
    Indicates acute HBV infection.
    HbeAg Hepatitis B envelope antigen.
    Rises first in infection.
    Indicates active virus and infectious state.
    Anti-Hbe Hepatitis B envelope antibody.
    Rises after core antibodies.
    Indicates resolution of infection.
    Anti-HBc Hepatitis B core antibody.
    Measures IgG & IgM.
    Indicates exposure & can be used to monitor chronic infection.
    Anti-HBc, IgM Hepatitis B core antibody, IgM-specific.
    First antibody to appear after infection.
    Indicates acute HBV infection.
    Anti-HBs Hepatitis B surface antibody.
    Appears months after infection or after HBV vaccine inoculations.
    Indicates immunity.
    HBV DNA quantitation Correlates with active virus.
    Used to monitor viral load during treatment.
    Anti-HCV (Enzyme Immunoassay) Indicates infection with HCV.
    Does not indicate immunity.
    Anti-HCV (RIBA, Immunoblot) Used to confirm anti-HCV EIA screen (above).
    HCV RNA, qualitative Correlates with active virus.
    Used to detect HCV in cases where anti-HCV is negative.
    HCV RNA quantitative Correlates with active virus.
    Used to monitor viral load during treatment.

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    NIOSH has created a new publication designed to inform employees of the steps they can take to protect against reproductive health risks in the workplace. These steps include practicing good hygiene and preventing chemical exposures. This publication "The Effects of Workplace Hazards on Female Reproductive Health" lists both chemical and physical agents and disease-causing agents that are reproductive hazards for women in the workplace. This document provides answers to the following questions:
    • What are reproductive hazards for female workers?
    • How does the female reproductive system work?
    • What reproductive problems might be caused by workplace exposures?
    • How are workers and their babies exposed?
    • How are families exposed?
    • How can exposures be prevented?
    • What additional information is available from NIOSH? A copy of this publication can be accessed at www.cdc.gov/niosh

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