OSHA and Worker Safety in Hospitals

Many of our emergency care instructors are based in the broader healthcare field, especially in hospital settings, and today’s blog post is for you and your fellow caregivers.

One of the most challenging environments to work in, hospitals are a common venue for worker injuries. According to OSHA:

"In 2011, U.S. hospitals recorded 253,700 work-related injuries and illnesses, a rate of 6.8 work-related injuries and illnesses for every 100 full-time employees. This is almost twice the rate for private industry as a whole."

Why are hospitals so tough on their workers? OSHA explains:

"Hospitals have serious hazards—lifting and moving patients, needlesticks, slips, trips, and falls, and the potential for agitated or combative patients or visitors—along with a dynamic, unpredictable environment and a unique culture. Caregivers feel an ethical duty to "do no harm" to patients, and some will even put their own safety and health at risk to help a patient."

Let’s look today at some of those typical hospital-related injuries.

Lifting and moving

OSHA offers a PDF to download to educate hospital management and safety teams about the inherent risks of hospital work. According to the overview, lifting and moving patients is at the top of the risk list:

"Nearly half (48 percent) of injuries resulting in days away from work are caused by overexertion or bodily reaction, which includes motions such as lifting, bending, or reaching. These motions often relate to patient handling. The resulting injuries are often musculoskeletal in nature."

OSHA’s suggested approach to educating caregivers on proper patient handling equipment use and the benefits of always using safe handling practices is actually great advice for any organization seeking to implement good safety practices, and it all revolves around training:

• • Make sure that all relevant workers are trained on using the mechanical lift equipment.
  • Refresh, remind, and require ongoing training.
  • Consider mentors and peer education champions. In addition to monitoring new employees, nurse managers and other "safety champions" can serve as mentors and peer coaches in every unit, reminding their colleagues how and when to use safe patient handling procedures and equipment.
  • Train caregivers to check each patient's mobility every time.
  • Engage patients and their families. Patients may not understand the need for mechanical equipment at first. You can engage them in safe handling by explaining to them and their families that it is for their safety as well as the workers' safety.

Needlesticks

The CDC estimates that about 385,000 needlestick or “sharps” injuries occur annually in hospital settings and that nurses are the most frequently injured. Laboratory staff, physicians, housekeepers, and other healthcare workers also injured.

In April 2001, Congress passed the Needlestick Safety and Prevention Act, directing OSHA to revise the Bloodborne Pathogens Standard:

• • The revised standard states that “safer medical devices, such as sharps with engineered sharps injury protections and needleless systems must be used where feasible.”
  • Since the act’s implementation, there has been a 31.6% decrease in sharps injuries in non-surgical settings.

For more information, see the Hospital eTool (HealthCare Wide Hazards Module) at https://www.osha.gov/SLTC/etools/hospital/hazards/hazards.html.

Recommendations for safe needle handling practices include:

• • Do not bend, recap, or remove contaminated needles and other sharps unless such an act is required by a specific procedure or has no feasible alternative [29 CFR 1910.1030(d)(2)(vii)].
  • Do not shear or break contaminated sharps. (OSHA defines contaminated as the presence or the reasonably anticipated presence of blood or other potentially infectious materials on an item or surface) [29 CFR 1910.1030(d)(2)(vii)].
  • Have needle containers available near areas where needles may be found. [29 CFR 1910.1030(d)(4)(iii)(A)(2)].
  • Discard contaminated sharps immediately [29 CFR 1910.1030(d)(4)(iii)(A)(1)] or as soon as feasible into appropriate containers.

Slips, trips, and falls

A 2010 study published in Injury Prevention lists some interesting statistics about the common slip, trip, and fall (STF) injuries among hospital workers. Of 153 workers interviewed who had reported one of these sorts of injuries:

• • One hundred and thirty-six workers (89%) fell: 55% after slipping, 32% after tripping.
  • Liquid contaminants (e.g., water, cleaning solutions) were involved in 35% of events.
  • Forty-five percent of workers fell forward, 29% fell to the side and 23% fell backward.
  • While the wrists/hands, knees and buttocks were most often the points of impact, the knees, back, ankles/feet were most frequently injured.
  • For injured workers (93%), strains and sprains (28%), contusions (28%) and non-specific pain and soreness (24%) were typical.
  • Fifty-nine percent of workers who experienced STF were involved in direct patient care occupations (e.g., nursing, therapy).

CDC and NIOSH put together a downloadable PDF to help hospitals better prevent STF injuries. Some of their recommendations include:

• • Make cleaning and safety supplies and products easily accessible to all staff.
  • Incorporate slip, trip, and fall awareness and prevention into routine safety training.
  • Conduct General Awareness campaigns within the healthcare facility (i.e., booths, posters, emails, paycheck inserts, and incentives) educating employees about the risk of STFs at work and what they can do to prevent injuries. — Consider making key chains or something employees can carry with them that have emergency numbers for housekeep to quickly report floor contaminations or hazards.
  • Reinforce the use of prevention equipment (handrails and appropriate footwear for example) frequently with staff.
  • Track Success: Provide feedback to employees on how the facility is doing with regard to STF injury rates.

Additional resources

Summit Training Source offers some caregiver-specific training to help you put these good practices into play at your facility or for your healthcare industry customers.

Needlesticks: Avoiding Exposure

Train caregivers on best safety practices to avoid needlestick injuries and their associated consequences. Create a safe work environment for your employees by providing them with the tools to keep them safe and informed.

This program covers:

• • Diseases and exposure routes
  • Exposure control plan
  • Best work practices
  • Safer needle devices
  • Exposure procedures
  • Sharps injury log

Patient Lifting and Transfer

Any time you are handling a patient; you are opening yourself up to a number of risks that could contribute to you hurting yourself, particularly your back.

Summit's healthcare industry training program, Patient Lifting and Transfer in video and DVD teaches workers to prevent these risks and reduces the immense stress on a body that may result in injuries.

This program covers:

• • Common injuries & hazards
  • Body mechanics
  • Assessment & algorithms
  • Lift techniques
  • Equipment aides

We hope today’s blog inspires our healthcare readers to keep their own safety and well being in mind, just as they do their patient’s. Thank you for everything you do in our hospitals around the nation and around the world.