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NURSING HOME SAFETY

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NURSING HOME SAFETY John W. Hicks, OHST Texas Mutual Insurance NURSING HOME SAFETY AGENDA History, etc. OSHA Requirements Management Commitment Safety & Health ... – PowerPoint PPT presentation

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Title: NURSING HOME SAFETY


1
NURSING HOME SAFETY
  • John W. Hicks, OHST
  • Texas Mutual Insurance

2
NURSING HOME SAFETY AGENDA
  • History, etc.
  • OSHA Requirements
  • Management Commitment
  • Safety Health Programs and Other Programs
  • Life Safety Code
  • Senate Bill 1525
  • Lifting and Ergonomics In Nursing Homes
  • Lifting Issues/Problems Corrective Actions
  • Resources

3
WHY Nursing Home Safety?
  • Why
  • Benefits

4
Injuries in Nursing Homes
  • Nursing Homes are ranked fifth among all
    industries for low back injuries
  • 17 Injuries For Every 100 Full Time Workers
  • Nursing Home Workers Have the Most Injuries
    Related to Overexertion of Any Industry (no. 1
    for overexertion)
  • Injuries Rose 55 in the Last Decade

5
Why Injuries Are Increasing
  • Pressure in the Industry to Drive Down the Price
    of Health Care
  • Nursing Home Sector Seeing More Acutely Ill
    Patients - Hospitals Move Patients Out Faster
  • More Acutely Ill Patients Means More Dependant
    Patients who Requires More Handling

6
Other Injury Risks
  • Nursing (in general) has the highest rate of
    Falls to the Floor on the Same Level of any Group
    of Workers
  • 96 Cases per 10,000 workers
  • Lack of Adequate Housekeeping Staff Contributes
    to Slipping/Falling Problem

7
Risks for Injury Patient Handling Tasks
  • Frequent Manual Lifting of Patients is the
    Primary Risk
  • Two-person Manual Lift is the most common patient
    transfer method
  • Average Nursing Home Worker Lifts More Than
    10,000 Human Pounds Per Day

8
Staff to Patient Ratio
  • Inadequate staffing is a major obstacle to injury
    prevention efforts
  • Many transfers require two workers, but are
    performed by one worker
  • Lifting Teams have been used successfully in
    hospital settings to dramatically reduce workers
    compensation losses

9
Standards and Regulatory
  • OSHA Launched an Initiative To Improve Conditions
    for Nursing Home Workers in 1996
  • Unions Pushing for Enforceable Staffing Standards
  • OSHAs Proposed Regulation on Ergonomics Could
    Stimulate Dramatic Improvement - If Made Into Law

10
Nursing Home Jobs with the Most Injuries
  • BLS data showed that nursing aides, orderlies,
    and attendants accounted for 70 of nursing home
    injuries that resulted in days away from work.
  • Female employees had more injuries that resulted
    in lost workdays than did male employees.

11
OSHAs Role in the Nursing Home Industry
  • OSHA has begun an outreach and enforcement
    initiative aimed at reducing injuries and
    illnesses among nursing home workers.
  • This initiative emphasizes taking a
    comprehensive safety and health program approach
    to address all causes of injuries and illnesses
    in the industry.

12
Injury and Illness Topology
13
What Nursing Home Jobs Have the Most
Injuries/Illnesses with Days Away from Work?
Total number of injuries/illnesses resulting in
days away from work 83,450
14
Number of Injuries/Illnesses by Type of Event,
Nursing and Personal Care Facilities
15
Source of Injury or Illness Event, Nursing and
Personal Care Facilities
16
Creating a Safety Culture
17
Safety Pays Off in Nursing Homes
  • Working safely helps protect employees
  • Working safely affects the bottom line
  • Increases EMPLOYEE MORAL
  • Decreases potential injuries to residents

18
OSHA VS- Nursing Homes
  • Requirements
  • Guidelines
  • Various Program Requirements
  • Etc.

19
OSHAs Purpose
  • . . . to assure so far as possible every working
    man and woman in the Nation safe and healthful
    working conditions and to preserve our human
    resources . . .

20
General Duty Clause
  • Section 5(a)(1) of the OSH Act requires that
    Each employer shall furnish to each of his
    employees employment and a place of employment
    which are free from recognized hazards that are
    causing or are likely to cause death or serious
    physical harm to his employees.

21
General Duty Clause (Contd)
  • The general duty clause is used only where there
    is no OSHA standard that applies to the
    particular hazard involved. Examples of
    workplace hazards to which the general duty
    clause may apply include occupational exposure to
    TB and workplace violence.

22
General Duty Clause (Contd)
  • Four elements are required for issuing general
    duty clause violations
  • The employer failed to keep the workplace free of
    a hazard to which employees of that employer were
    exposed
  • The hazard was recognized
  • The hazard was causing or was likely to cause
    death or serious physical harm
  • There was a feasible and useful method to correct
    the hazard

23
Elements of an Effective Safety and Health Program
  • Management Leadership and Employee Participation
  • Trend Analysis
  • Recordkeeping
  • Accident and Record Analysis
  • Hazard Prevention and Control (Inspections)
  • Employee Safety and Health Training
  • Periodic Review and Revision

24
Additional Elements of an Effective Safety and
Health Program
  • Infection Control
  • Bloodborne Pathogen
  • Fleet Safety
  • Hazard Communication
  • Ergonomic and/or Back Safety Team
  • Emergency Response and/or Disaster Plan
  • Others?

25
Management Leadership and Employee Participation
  • Management Leadership
  • Employee Participation
  • Implementation Tools
  • Contractor Safety

26
Management Leadership
  • Visible management leadership provides the
    motivating force for an effective safety and
    health program.

27
Employee Participation
  • Employee participation provides the means
    through which workers identify hazards, recommend
    and monitor abatement, and otherwise participate
    in their own protection.

28
Implementation Tools
  • Implementation tools, provided by management,
    include
  • budget
  • information
  • personnel
  • assigned responsibility
  • adequate expertise and authority
  • means to hold responsible persons accountable
    (line accountability)
  • program review procedures

29
Contractor Safety
  • An effective safety and health program
    protects all personnel on the worksite, including
    contractors. It is the responsibility of
    management to address contractor safety.

30
Workplace Analysis
  • Survey and Hazard Analysis
  • Inspection
  • Hazard Reporting

31
Survey and Hazard Analysis
  • An effective, proactive safety and health
    program will seek to identify and analyze all
    hazards. In large or complex workplaces,
    components of such analysis are the comprehensive
    and analysis of job hazards and changes in
    conditions.

32
Inspection
  • To identify new or previously missed hazards and
    failures in hazard controls, an effective safety
    and health program will include regular site
    inspections.

33
Hazard Reporting
  • A reliable hazard reporting system enables
    employees, without fear of reprisal, to notify
    management of conditions that appear hazardous
    and to receive timely and appropriate responses.

34
Accident and Record Analysis
  • Accident Investigation
  • Data Analysis

35
Accident Investigation
  • An effective program will provide for
    investigation of accidents and near miss
    incidents, so that their causes, and the means
    for their prevention, are identified.

36
Data Analysis
  • An effective program will analyze injury and
    illness records for indications trends, and
    locations of hazards, and jobs that experience
    higher numbers of injuries. By analyzing injury
    and illness trends over time, patterns with
    common causes can be identified and prevented.
  • Analysis should also include inspection report
    findings.

37
Hazard Prevention and Control
  • Hazard Control
  • Maintenance
  • Medical Program

38
Hazard Control
  • Workforce exposure to all current and potential
    hazards should be prevented or controlled by
    using engineering controls, wherever feasible and
    appropriate, work practices and administrative
    controls, and personal protective equipment.

39
Periodic Review and Revision
  • Purpose
  • What to review
  • Frequency

40
Maintenance
  • An effective safety and health program will
    provide for facility and equipment maintenance,
    so that hazardous breakdowns are prevented.

41
Medical Program
  • An effective safety and health program will
    include a suitable medical program where it is
    appropriate for the size and nature of the
    workplace and its hazards.

42
Emergency Response
  • Emergency preparedness - There should be
    appropriate planning, training/drills, and
    equipment for response to emergencies. First
    aid/emergency care should be readily available to
    minimize harm if an injury or illness occurs.

43
Safety and Health Training
  • Safety and health training should cover the
    safety and health responsibilities of all
    personnel who work at the site of affect its
    operations. It is most effective when
    incorporated into other training about
    performance requirements and job practices. It
    should include all subjects and areas necessary
    to address the hazards of the job to be performed
    and exposures at your site.

44
Safety and Health Hazards in Nursing Homes
  • Bloodborne Pathogens
  • Tuberculosis
  • Workplace Violence
  • Fire
  • Slip/Trip/Fall
  • MSDs
  • Cut/Punctures
  • Bites
  • Etc.

45
Bloodborne Pathogens
  • Pathogenic organisms that are present in human
    blood and can cause disease in humans. These
    include, but are limited to, hepatitis B virus
    (HBV) and human immunodeficiency virus (HIV).

46
29 CFR 1910.1030 Bloodborne Pathogens Standard
  • Scope and Application
  • Definitions
  • Exposure Control Plan
  • Methods of Compliance
  • HIV and HBV Research Laboratories and Production
    Facilities
  • Hepatitis B Vaccination and Post-Exposure
    Follow-up
  • Communication of Hazards to Employees
  • Recordkeeping
  • Effective Dates

47
Highlights of 29 CFR 1910.1030
  • The standard applies to all employees with
    occupational exposure to blood and other
    potentially infectious materials.

48
Highlights of 29 CFR 1910.1030 (Contd)
  • Exposure Control Plan includes
  • The written exposure determination
  • The procedures for evaluating the circumstances
    surrounding an exposure incident and
  • The schedule and method of implementing other
    sections of the standard.

49
Highlights of 29 CFR 1910.1030 (Contd)
  • Methods of Compliance
  • Universal Precautions
  • Engineering and Work Practice Controls
  • Personal Protective Equipment
  • Housekeeping

50
Highlights of 29 CFR 1910.1030 (Contd)
  • Hepatitis B Vaccination
  • HBV vaccination must be made available within 10
    working days of initial assignment to all
    employees who have occupational exposure.
  • HBV vaccination must be made available without
    cost to the employee, at a reasonable time and
    place, and by a licensed health care professional.
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