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This course is designed for the BBCBC system of care. ... do not apply to feces, nasal secretions, sputum, sweat, tears, urine, and ... – PowerPoint PPT presentation

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Title: Safety

Safety Security
  • Big Bend Community Based Care, Inc.
  • 2009

Welcome Expectations
  • This course is designed for the BBCBC system of
  • To move through the course you will need to
    manually click your mouse to advance the slides.
  • At the conclusion of the course you will be asked
    to submit an email of completion to the BBCBC
    training department.
  • In addition to the PowerPoint presentation
    successful completion of this course requires
    that each participant familiarize themselves with
    the following BBCBC Operating Policies which can
    be accessed on the site
  • Policy 1400 General Health Safety
  • Policy 1404 Building Maintenance
  • Policy 1405 Conflict Resolution De-Escalation
  • Policy 1406 Driver Safety
  • Policy 1407 Maintenance of a Safe, Hygienic
  • Policy 1409 Custody Issuance of Keys

Course Objectives
  • Participants will be able to recognize and
    diffuse potentially violent/hostile situations.
  • Participants will be able to identify how to
    intervene, seek assistance, make appropriate
    contacts and document situations that affect
    worker safety.
  • Participants will develop an understanding of
    universal precautions and infectious diseases and
    learn how to incorporate prevention and
    appropriate responsiveness in the workplace.
  • Participants will gain an overview of Office
    Ergonomics and be able to identify causes and
    solutions for Cumulative Trauma Disorders .

Violence Threats
Workplace Violence
  • Violence can strike from the outside or from
  • The perpetrator can be a stranger or someone
    known to all.
  • It can be the result of a robbery, jealous spouse
    or over a disgruntled employee or angry client.
  • The policy at BBCBC is one of zero tolerance
    toward violence. Because of this, all acts or
    threats of violence will be taken seriously.

Workplace Violence (cont.)
  • BBCBC defines a threat or act of violence as
  • Including, but not limited to, any act or gesture
    intended to harass or intimidate another person.
  • Any act or gesture likely to damage company
  • Any act or gesture likely to leave another person
    injured or fearing injury.
  • All employees are responsible for helping to
    maintain a violence free workplace. To that end,
    each employee is asked to report the act or
    threat to his or her immediate supervisor and/or
    a member of the Administrative Management Team.
    An incident/accident report form should be
    utilized for this purpose. Reports may be made
    confidentially or anonymously if the employee
    feels the need.
  • Each act or threat of violence will be
    investigated and appropriate action will be
    taken. Any such act or threat by an employee may
    lead to discipline, up to and including

Precautions and Warning Signs
  • There are certain precautions that employees of
    both BBCBC and its contract agencies can use to
    help protect themselves from danger.
  • There are warning signs and signals that, when
    observed and understood, assist in preventing
    disruptions or physical violence in the

Stages and Level of Violence
  • Stage 2/Level 2 (Escalated potential for
  • Ignoring or refusing to obey company policies and
  • Stealing from the agency or co-workers,
    sabotaging equipment, client files or agency
  • Making threats verbally, in writing, by E-mail or
    voice mail
  • Blaming others for all problems, sees self as
    victimized by management
  • Stage 1/Level 1 (Early potential for violence)
  • Dehumanizing other people, name calling, racial
    insults or sexual harassment, other verbal abuse
  • Challenging authority, insubordination, refuses
    to cooperate with immediate supervisor
  • Regularly being argumentative, alienating client
    or co-workers, consistently argues with
    co-workers or management
  • Spreads rumors or gossip
  • Stage 3/Level 3 (Potential for violence is
  • Displaying or brandishing a weapon (knife, gun,
  • Physical fights, punching, kicking, slapping
  • Committing assault, arson, murder, suicide

De-Escalating Hostile/Violent Situations
  • Use effective listening and communication
    techniques such as
  • negotiation and mediation
  • remain calm and listen attentively
  • maintain eye contact
  • be courteous and patient
  • Keep the situation in your control
  • Involve the person in regaining control and
    encouraging self-calming behaviors
  • Separate individuals involved in an altercation
  • Offer a voluntary escort to guide the person to a
    safe location
  • Employ a time out period to allow the person to
    calm down
  • Signal a co-worker or supervisor that you need
  • Do not make any telephone calls yourself (this
    could be perceived as threatening and escalate
    the situation)
  • Keep talking, but follow instructions of the
    person with the weapon
  • Don't risk yourself or others
  • Never try to grab a weapon
  • Watch for a safe chance to escape to a safe area

Protection in Parking Areas/Outside Buildings
  • Park within the designated parking areas,
    especially when working after dark
  • Do not leave purses, briefcases, or other
    valuables in sight, as thieves can easily smash a
    window and steal these items in seconds
  • Be aware of surroundings at all times when
    leaving the building, especially in late evening,
    attempt to leave with another staff member

Visitors and ID Badges
  • Visitors should check in with the receptionist
    and should be escorted while in the building and
    not allowed to wander freely. This too applies to
    children as well as adults, clients and
    professionals in the service centers as well as
    the BBCBC administrative office.
  • Employees should carry their BBCBC picture ID and
    business cards for presentation when requested
    for security reasons.

(No Transcript)
Additional Materials-Worker Safety
  • Visit the Child Welfare Information Gateway
  • http//

Domestic Violence
  • Although this is a sensitive area, it is
    important for BBCBC and its contract providers to
    know if an employee has reason to fear the
    non-employees significant other, or if there has
    been any previous physical altercations or
    threats. With this knowledge, BBCBC and its
    provider agencies can assist the employee in
    designing a safety plan to reduce the likelihood
    of a problem occurring.

Medical Issues
Infectious Diseases
  • An infectious disease is a disease caused by
    bacterial, viral, fungal, or protozoan infection.
    Though some infectious diseases are not
    contagious, others may be transmitted from animal
    to person (bird flu and cat scratch disease) or
    from person to person. Examples include viral
    illnesses, HIV/AIDS, meningitis, whooping cough,
    pneumonia, and tuberculosis.

Local Infectious Diseases
  • The most frequent local infections, including the
    common cold, occur in the upper respiratory
    tract. A serious and usually local infection of
    the respiratory tract is tuberculosis, which is a
    problem worldwide.

Sites for Infectious Diseases
  • Other common sites of infection include the
    digestive tract, the lungs, the reproductive and
    urinary tracts, the eyes or ears. Local
    infections can cause serious illnesses if they
    affect vital organs such as the heart, brain or
    liver. They also can spread through the blood
    stream to cause widespread symptoms.

Infectious Diseases and the Immune System
  • The outcome of any infection depends on the
    virulence of infectious agents, the number of
    organisms in the infecting inoculum and the
    response of the immune system. A compromised
    immune system, which can result from diseases
    such as AIDS or treatment of diseases such as
    cancer, may allow organisms that are ordinarily
    harmless to proliferate and cause
    life-threatening illness.

Transmission of Infectious Diseases
  • Transmission of an infectious disease may occur
    through one or more of diverse pathways including
    physical contact with infected individuals.
  • These infecting agents may also be transmitted
    through liquids, food, body fluids, contaminated
    objects, airborne inhalation, or through
    vector-borne spread. Vectors may be mechanical or

Mechanical Vectors and Infectious Diseases
  • A mechanical vector picks up an infectious agent
    on the outside of its body and transmits it in a
    passive manner. An example of a mechanical vector
    is a housefly, which lands on cow dung,
    contaminating its appendages with bacteria from
    the feces, and then lands on food prior to
    consumption. The pathogen never enters the body
    of the fly.

Biological Vectors and Infectious Diseases
  • In contrast, biological vectors harbor pathogens
    within their bodies and deliver pathogens to new
    hosts in an active manner, usually a bite.
    Biological vectors are often responsible for
    serious blood-borne diseases, such as malaria,
    and viral encephalitis,. Biological vectors are
    usually, though not exclusively, arthropods, such
    as mosquitoes, ticks, fleas and lice.

Universal Precautions
  • Work practice controls are designed to change the
    way in which a task is performed to reduce the
    likelihood of exposure to bloodborne pathogens.
  • The most important work practice control is
    implementation of "universal precautions" which
    are a set of precautions recommended by the CDC
    which are designed to prevent transmission of
    human immunodeficiency virus (HIV), hepatitis B
    virus (HBV), and other bloodborne pathogens when
    providing first aid or health care.
  • Under universal precautions, blood and certain
    body fluids of all patients are considered
    potentially infectious for HIV, HBV and other
    bloodborne pathogens.
  • Body Fluids requiring the use of Universal
  • Universal precautions apply to blood, other body
    fluids containing visible blood, vaginal
    secretions and semen. Universal precautions also
    apply to tissues and to the following fluids
    cerebrospinal, synovial, pleural, peritoneal,
    pericardial, and amniotic fluids.
  • Universal precautions do not apply to feces,
    nasal secretions, sputum, sweat, tears, urine,
    and vomit unless they contain visible blood.
  • Universal precautions do not apply to saliva
    except when visibly contaminated with blood or in
    the dental setting where blood contamination of
    saliva is predictable.
  • General infection control practices are used to
    further minimize the already minute risk for
    salivary transmission of HIV. These infection
    control practices include the use of gloves for
    digital examination of mucous membranes and
    endotracheal suctioning, hand washing after
    exposure to saliva, and minimizing the need for
    emergency mouth-to-mouth resuscitation by making
    mouthpieces and other ventilation devices
    available for use in areas where the need for
    resuscitation is predictable.

Prevention Efforts in BBCBC Offices
  • Each one of our service centers have a constant
    flow of traffic by professionals, caretakers and
    children. An exaggerated effort is made to keep
    the lobby area clean as well as door handles,
    phones and conference areas. Special attention is
    paid to toys in the common areas. Cleaning and
    good hygiene can also prevent
  • Influenza
  • The common cold
  • Strep throat
  • Intestinal disorders
  • Pneumonia

Preventing Infectious Diseases
  • Wash your hands often/use an alcohol-based hand
    sanitizer, especially
  • After using the bathroom
  • Before preparing food or eating
  • After changing diapers
  • After blowing your nose and/or using hands when
    sneezing or coughing
  • After caring for a sick person
  • After playing with or handling your pet

Pandemic Flu
  • BBCBC is dedicated to ensuring that employees
    needs are met should there be threat of such an
    event as a Pandemic Flu. The following is an
    excerpt from the Department of Health regarding
    an outbreak of a Pandemic Flu (such as Bird Flu).
    This checklist will help to gather the
    information and resources you may need in case of
    a flu pandemic.

Flu Precautions Response
  • 1. To plan for a pandemic
  • Store a two week supply of water and food. This
    can be useful in other types of emergencies, such
    as power outages and disasters.
  • Have any nonprescription drugs and other health
    supplies on hand, including pain relievers,
    stomach remedies, cough and cold medicines,
    fluids with electrolytes, and vitamins.
  • Volunteer with local groups to prepare and assist
    with emergency response.
  • Get involved in your community as it works to
    prepare for an influenza pandemic.
  • 2. To limit the spread of germs and prevent
  • People with respiratory illness should stay home
    from work or school to avoid spreading
    infections, including influenza.
  • Avoid close contact with people who are coughing
    or otherwise appear ill.
  • Avoid touching your eyes, nose and mouth.
  • Wash hands frequently to lessen the spread of
    respiratory illness.
  • People experiencing cough, fever and fatigue,
    possibly along with diarrhea and vomiting, should
    contact their physician.
  • If you think you have influenza, please call your
    health care provider and discuss whether you need
    to be seen in their office, emergency department
    or stay home.

Medical Emergencies
  • If the injury is minor, provide first aid as
    necessary with a departmental First Aid Kit.
  • If the injury or condition is not minor call
    (9-1-1). Give the operator the following
  • Location of victim
  • Type of injury
  • Your name and call back number
  • Notify your supervisor of the situation.
  • Follow any further instructions the 911
    dispatcher or you supervisor gives you.
  • Comfort victim until EMS arrives.

Office Ergonomics
Office Ergonomics
  • Ergonomics is the science of designing the job
    to fit the worker, not forcing the worker to fit
    the job. Ergonomics covers all aspects of a job,
    from the physical stresses it places on joints,
    muscles, nerves, tendons, bones and the like to
    environmental factors which can affect hearing,
    vision, and general comfort and health.

Cumulative Trauma Disorders
  • To understand CTDs, it is necessary to understand
    how the body works. Body Movements are produced
    by contracting and relaxing muscles. The muscles
    are attached to bones by tendons. Tendons are
    smooth, and in some parts of the body they glide
    back and forth inside tubes called synovial
    sheaths. The sheath produces a lubricant called
    synovial fluid to help the tendons glide easily.
    CTDs result when repeated stress is placed on the
    tendons, muscles, or nerves causing inflammation
    or damage.

Cumulative Trauma Disorders (cont.)
  • The following are some of the most common CTDs
  • Tendonitis inflammation of the tendons
  • Ttensynoitis inflammation of the synovial
  • Carpal Tunnel Syndrome results when the median
    nerve is compressed either form the swelling of
    tendons and sheaths or from repeated bending of
    the wrist.
  • Some of the conditions that my lead to CTDs are
  • Repetition long or concentrated hours of typing
    or using a mouse.
  • Posture long hours of sitting in the same
    position while typing, especially if it is in an
    uncomfortable or poorly supported position, or if
    the wrists are bent.
  • Lack of Rest - intensive hours at the keyboard
    with few breaks

Cumulative Trauma Disorders (cont.)
  • Symptoms of CTDs
  • Tingling or numbness in the hands or fingers
  • Pain in fingers, hands, wrists, or even shooting
    up into the arms or forearms
  • Loss of strength or coordination in the hands
  • Numbness or discomfort in the hands which wakes
    you up at night.
  • Carpal Tunnel Syndrome
  • Carpal Tunnel Syndrome is a common problem that
    affects the hand and wrist. This condition, or
    syndrome has become the focus of much attention
    in the last few years due to suggestions that it
    may be linked to occupations that require
    repetitive use of the hands such as typing.

Preventing CTDs to hands and wrists
  • One of the keys to preventing CTDs is to keep
    your hands and wrists in a neutral position as
    possible. In other words, you want to avoid
    typing with your wrist bent to either side, or up
    or down. You do not want your wrists to be
    flexed in any direction.
  • The neutral position may be obtained by adjusting
    your desk height, chair height, or keyboard
    position. Here are some tips for preventing hand
    and wrist CTDs
  • The keyboard should be slightly lower than normal
    desk height. If it not low enough, try raising
    your chair height. Prevent your legs from
    dangling by using a footrest.
  • Home row of keys should be at elbow level

Preventing CTDs to hands and wrists (cont)
  • While typing, it is best not to rest your wrists,
    and they should not be bent up, down or to the
    side. This may be easier if they back edge of
    the keyboard is tilted down slightly, away from
    you. The knuckle, wrist, and top of forearm
    should form a straight line. Wrist supports or
    rests give you a place to rest your hands only
    when pausing from typing, not while you are
  • Do not pound the keys. Use light touch.
  • Use two hands to perform double key operations
    like Ctrl-C or Alt-F instead of twisting one hand
    to do it.
  • The elbows should form a 90 degree angle while
    hanging at the sides from the shoulders. They
    should remain relaxed in a lowered position while
  • Take lots of breaks to stretch and relax. Take
    frequent micro-breaks (lasting few seconds or
    so) as well as longer (several minute) breaks
    every hour or so.
  • Hold the mouse lightly
  • Keep your hands and arms warm.

  • Eyestrain is another ergonomic problem frequently
    associated with the use of computers and Video
    Display Terminals (VDTs). Keep in mind that the
    solutions presented here are only
  • If following these recommendations seem to make
    matters worse, try something else!
  • If you arent experiencing headaches or eyestrain
    while you work on the computer, dont worry
    about making changes obviously your setup works
    for you.

Symptoms of Eyestrain
  • Sore, tired, itchy, dry, or burning eyes.
  • Headaches
  • Difficulty focusing between the VDT and source
  • Blurred or double vision
  • Color fringes/after images
  • Increased sensitivity to light

Causes of Symptoms
  • Glare Glare can be caused by sources of light
    such as windows, lamps , or overhead lighting.
  • Look at your monitor screen to see if there are
    any blotches of light. While you may not be
    conscious of this irritation, it can cause
    eyestrain over the course of a long day. Glare
    can also be caused by too much contrast between
    the screen background and the displayed text.
  • Solution Adjust your monitor so that it is not
    reflecting the light sources. Tilt the monitor
    down so that it doesnt reflect overhead light,
    or move it perpendicular to windows. Close
    shades or blinds if the computer cannot be moved.
    Move lamps so that they are not reflected
    directly in the monitor. Use glare screens.
  • Improper Lighting if the light in the work area
    is too bright or too dim, the human eye has to
    work extra hard to compensate for these harsh
    environmental factors. People may not even be
    aware that their eyes are under duress, but over
    time they may develop symptom of eyestrain.
  • Solution use indirect, ambient lighting and an
    adjustable light source at the desk, where extra
    illumination is required.

Causes of Symptoms
  • Eyewear Many computer users wear bifocals or
    trifocal lenses fitted for reading print and
    distance viewing. Sometimes these prescriptions
    may not be adequate for computer work.
  • Solution If you wear glasses of any sort and
    frequently experience headaches while working at
    a computer, you should probably check with your
    eye doctor to make sure you are wearing the
    correct prescription for such work.
  • Viewing angle and distance If your monitor is
    too far away, you may have to strain to read the
    print. Likewise, if it is too close, you may
    also strain your eyes. If the monitor is too
    high, you will have to angle your neck to look up
    at it, which could cause your neck to be sore,
    and may contribute to headaches. Also, when you
    are continually looking up, you may not fully
    close our eyes when you blink, and this can cause
    your eyes to dry out.
  • Uninterrupted focus on the screen When people
    concentrate, they blink less often. Sometimes
    they concentrate so hard that they blink only
    once per minute, instead of the normal once every
    five seconds. This, too, will cause the eyes to
    dry out and become irritated.
  • Solution Take micro-breaks! Frequently look up
    from your monitor and focus on an object several
    feet away. Make a conscious effort to blink.
  • Uninterrupted focus on the screen When people
    concentrate, they blink less often. Sometimes
    they concentrate so hard that they blink only
    once per minute, instead of the normal once every
    five seconds. This, too, will cause the eyes to
    dry out and become irritated.
  • Solution Take micro-breaks! Frequently look up
    from your monitor and focus on an object several
    feet away. Make a conscious effort to blink.

Physical Stressors
  • Include repetitive motions such as those caused
    by typing or any continuous motion. This could
    include work that causes vibration or heavy
    lifting, working in an awkward position, or
    holding a telephone to your ear with your
    shoulder. Repetitive motions, vibration,
    excessive force, and awkward positions are
    frequently linked to ergonomic disorders
    however, the majority to Cumulative Trauma
    Disorders (CTDs) or Repetitive Strain
    Injuries (RSIs) are caused by repetitive
    motions that would not result in undue stress or
    harm if only performed once. Carpal tunnel
    syndrome, tendonitis, Tenosynovitis, Dequarvains
    Syndrome, Thoracic Outlet Syndrome, many back
    injuries, and several other conditions may result
    from repetitive motions.

Environmental Stressors
  • Could include such things as indoor air quality
    or excessive noise. Sick building syndrome,
    with its accompanying headaches, congestion,
    fatigue and even rashes, can result from poor air
    quality in a building or office. Excessive noise
    around heavy machinery or equipment can cause
    permanent haring loss. Improper lighting can
    cause eyestrain and headaches, especially in
    conjunction with computer monitors.
  • It is important to listen to the signals your
    body gives you. If you suffer pain in the wrists
    or hands after a long day of typing, examine your
    work area and work practices to see if they may
    be causing the problems. Learn to make
    adjustments. Raise or lower chairs to avoid
    typing with your wrists at an odd angle. Adjust
    computer monitors to avoid glare. Take frequent
    breaks from repetitive tasks to give your body a
    rest. Always use proper lifting techniques.
    Sometimes small modifications to work procedures,
    posture habits, and/or work station design can
    make a big difference in the way you feel at the
    end of a day.

  • http//
  • http//
  • http//
  • http//
  • For More Information
  • Visit
  • The Centers for Disease Control and Prevention
    (CDC) hotline, 1-800-CDC-INFO (1-800-232-4636),
    is available in English and Spanish, 24 hours a
    day, 7 days a week. TTY 1-888-232-6348.
    Questions can be e-mailed to
  • Links to state departments of public health can
    be found at http//

Training Documentation
  • Thank you for completing this online training
  • To document your participation please immediately
    send an email listing your name, position,
    agency, email address, and circuit to the BBCBC
    training department at
  • Please let us know any training topics you would
    like to be provided with in a classroom training,
    online presentation or training resource
  • BBCBC Training Coordinator contact Carol Edwards