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binder, OSHA Watch Newsletter (1 yr) & new Sharps Injury Reduction
Program "Point of No Return!" video, w/ guide. NEW Sharps Plus
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Program Includes: 15 minute "Point of No Return!" video, w/ guide.
The guide includes detailed instructions for performing sharps evaluation
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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
OSHA Yearly Retraining Seminar
OSHA Train the Trainer Seminar
EYEWASH RECOMMENDATIONS
SPECIFICATIONS 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. LOCATION(S)
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. ROUTINE MAINTENANCE
Approx 100 feet. Closer distances are advised for greater
hazards such as caustic chemicals and harsh acids.
Other Considerations
MEDICATION HANDLING : SECURITY AND DISPOSAL
SECURITY FOR PRESCRIPTION DRUGS
SECURITY FOR CONTROLLED SUBSTANCES
DISPOSAL OF PRESCRIPTION DRUGS
DISPOSAL OF HAZARDOUS DRUGS
Reference: COLA's Accreditation Manual for Medical
Practices. COLA is an accreditation agency recognized by JCAHO and
NCQA.
OSHA REQUIREMENTS FOR GLUTARALDEHYDE
WHEN TO USE
EXPOSURE LIMITS
GLUTARALDEHYDE DISINFECTING POLICIES
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.
Glass Capillary Tube Advisory
If you use glass capillary tubes in your practice, consider switching to of the following:
OSHA Latex Advisory
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:
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.
THE ABCs OF HEPATITIS ASSAYS
NIOSH BOOKLET OFFERS INFORMATION ON PROTECTING REPRODUCTIVE HEALTH
OSHA SEMINARS FROM QUALITY AMERICA
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
ASSAY
CHARACTERISTICS & USE
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.
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:
"We Make Compliance Easy."
1-800-946-9956
