Young Worker Safety and Health Training for the Healthcare Industry

1. Young Worker Safety and Health Training for the Healthcare Industry Training Module 4 This material was produced under grant number SH-22227-11 from the Occupational Safety and Health Administration, U.S. Department of Labor. It does not necessarily reflect the views or policies of the U.S. Department of Labor, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.

2. Acknowledgement of Sources http://www.cdc.gov/niosh/talkingsafety/ Introduction to OSHA http://www.osha.gov/dte/outreach/construction_generalindustry/teachingaids.html Work Safe, Work Smart: Health and Safety Awareness for Working Teens curriculum. University of Washington: Dept. of Environmental and Occupational Health Sciences. Washington State Dept. of Labor and Industries. OSHA’s 11 – An OSHA 10 Hour General Industry Curriculum: University of Washington: Dept. of Environmental and Occupational Health Sciences. Washington State Dept. of Labor and Industries.

3. Course Agenda & Objectives • In this session you will learn: • Bloodborne Pathogens (BBP) • What is a bloodborne pathogen? • How are healthcare workers exposed to BBP? • How do you prevent exposure to BBP and what do you do if you are exposed at work? • Respiratory Protection • What is a respirator? • When do you need to wear a respirator (hazards in healthcare settings most likely to require the use of a respirator)? • What are the limitations of a respirator?

4. Course Agenda & Objectives (continued) • Ergonomics • What does “ergonomics” mean and how does it affect healthcare workers? • How do I prevent an ergonomic-related injury? • Workplace Violence • Why are healthcare workers at risk of workplace violence? • What are the risk factors and how do you minimize them? • Emergency Response • What are examples of the types of emergencies experienced in a healthcare setting? • How does your employer prepare for these types of emergencies?

5. Tying it All Together • The Puzzle piece represents an activity that participants can do individually or as a group • The Movie reel represents ways to integrate media into training • The Microphone represents ways to encourage participation

6. Healthcare Industry Includes: • Public and Private Hospitals • Nursing and residential care facilities • Offices of physicians, dentists, etc. • Home healthcare services • Outpatient care centers • Ambulatory health care services • Medical and diagnostic laboratories

7. How is healthcare different from other jobs? • In the healthcare setting there is a: • diversity of job titles and duties • unique "business" of caring for the ill • societal behaviors related to caregiving role • exotic and unique exposures • suspension of usual self-protection behaviors • emphasis on confidentiality

8. Did You Know? • Healthcare is the largest industry in the American economy (EEOC, 2011) • Slips, trips and falls are among the leading cause of injury in healthcare facilities • 600,000 – 800,000 needlestick injuries annually • Nurses sustain the most needlestick injuries Source: CDC, 2004

9. Healthcare isn’t always healthy…. • Risk of infection • Exposure to chemicals and drugs • Injuries from lifting and repetitive motion • Stress

10. Bloodborne Pathogens and Infection Control Information Provided under OSHA Susan Harwood Capacity Building Grant: #SH-20848SHO

11. What’s a Pathogen? • Infectious microorganisms present in blood that can cause disease in humans. • Viruses • Cold & Flu • Hepatitis B & C • HIV • Bacteria • Staph infections • Tuberculosis

12. Did you know? • The Hepatitis C virus can live in dried blood for up to 30 days. • Hepatitis C is the leading cause of liver failure in the U.S. • Up to 4 million Americans are infected with Hep C • There is no immunization for Hepatitis C

13. Bloodborne Pathogens • At work, most biological pathogens are transmitted from: • Accidental puncture from a contaminated sharp object • Contact between broken skin and infected body fluids • Contact between mucous membranes and infected body fluids REMEMBER:Blood or body substances do not have to be visible for an infection to be transmitted

14. Injuries • 600,000 – 800,000 needlestick injuries annually • Nurses sustain the most needlestick injuries • 1/3 all sharps injuries occur during disposal • CDC estimates 60 – 80% can be prevented • Other exposure incidents • Splashes • Contact with mucous membranes or non-intact skin

15. Prevention Strategies Example: single-use, disposable equipment (needles, scalpels, patient gowns) Remove/Substitute/Isolate the hazard • Examples: • Training on infectious disease and transmission • “Universal Precautions” rule • Handwashing rules • Hepatitis B vaccination Improve Work Policies & Procedures • Example: • Disposable gloves for use during procedures and cleaning equipment Use Protective Clothing & Equipment

16. Cleaning & Disinfecting Strategies • Autoclave • Heat & Steam • Good for objects • Ultrasonic cleaner • Vibration & disinfectant • Hospital grade disinfectants • “Quats” (Quaternary ammonium compounds) • Glutaraldehyde • Ethyl Alcohol • Bleach solutions • Must be made daily The products and chemicals used to clean and disinfect can be dangerous if you are not trained on their use and use them properly Your employer is required to train you on the hazards of working with chemicals on the job.

17. What to do if you are exposed to a bloodborne pathogen • Flush area with water • Irrigate eyes with water or saline • Report to teacher or employer immediately • Seek counseling/care (time makes a difference)

18. Proper Glove Removal Practice

19. Hand washing • Lather well; rub hands vigorously for at least 20 seconds. • Hand sanitizer is NOT a replacement for washing hands with soap and water! • Hand sanitizer does NOT remove chemicals from your hands

20. Respiratory Protection in the Healthcare Industry Information Provided under OSHA Susan Harwood Capacity Building Grant: #SH-20848SHO

21. Respiratory Protection • Is a filtering face piece a respirator? • How about a one-strap mask? • How about a two-strap mask? • What about a surgical mask? • Why would you wear a respirator?

22. Respiratory Protection • Mask vs. respirator 1 2 3 • Dust mask (not NIOSH approved) • Surgical mask (not a respirator and not PPE) • NIOSH approved filtering face piece respirator

23. What is a Respirator? Respirators are devices that protect workers from inhaling harmful airborne substances. Some respirators also ensure that workers do not breathe air that contains dangerously low levels of oxygen (O2). (OSHA’s Small Entity Compliance Guide, 9/30/98)

24. When do we need respirators? • Engineering or administrative controls are not always possible: • Confinement of infectious agent may be difficult or impossible • Improved ventilation may not be practical or feasible • Employees may be exposed to a widevariety of air contaminants • infectious agents • chemical agents • Environmental controls may not befeasible

25. Limitations of Respirators • All respirators have limitations: • improper fit • improper donning • damage • contamination

26. Respiratory Concerns • SARS • Smallpox • Measles • Varicella (Chicken Pox) • Tuberculosis (TB) • Chemical agents The minimal acceptable level of respirator protection for TB is the N95 respirator REMEMBER: Surgical masks are not considered respirators and are not approved to protect from infectious disease or chemicals.

27. Ergonomics in the Healthcare Industry Information Provided under OSHA Susan Harwood Capacity Building Grant: #SH-20848SHO

28. High prevalence of musculoskeletal complaints: • Awkward, prolonged working postures • Elevated arms (stocking supplies) • Bent back (making a bed) • Bent head (microscope work) • Repetitive movements • Heavy, awkward lifting • Lifting patients • Positioning patients • Transferring patients

29. An Exercise in Strength

30. What is Ergonomics? • Fitting the task to the person BEST FIT

31. Questions to ask yourself… • Are you gripping or squeezing any of the implements too tightly? • What types of repetitive motions are you doing throughout the day? • Are you holding your arms away from you body for extended periods of time? • Do you find yourself bending forward or twisting into awkward positions to reach the patient? Graphic used courtesy of VCU

32. Prevention Strategies Workplace Example: Transferring a Patient • Example: • Use patient lifting devices Remove/Substitute/Isolate the hazard • Examples: • Allow for stretching intervals • Keep neck and back straight • Lift with legs • Move patient as close as possible before lifting Improve Work Policies & Procedures • Example: • Choose appropriate footwear that is non-slip and supportive Use Protective Clothing & Equipment

33. Workplace Violence in the Healthcare Industry Information Provided under OSHA Susan Harwood Capacity Building Grant: #SH-20848SHO

34. Workplace Violence • 48% of all non-fatal injuries from occupational assaults occurred in health care and social services • Nurses, aides, orderlies and attendants suffered the most non-fatal assaults.

35. Risk Factors • What are some reasons that healthcare settings have a higher risk for workplace violence than other workplaces?

36. Hazard Prevention • Provide better visibility and good lighting • Implement safety measures to deter handguns inside facility • Use of security devices like surveillance cameras, beepers, panic buttons, etc. • Control access to work areas • Use curved mirrors at hallway intersections or concealed areas • Provide adequate staffing even during night shift • Increase staffing in areas where assaults by patients are likely (e.g., ER)

37. Emergency Response in Healthcare Industry Information Provided under OSHA Susan Harwood Capacity Building Grant: #SH-20848SHO

38. Types of Emergencies • Natural Disasters • Human Related • Hazardous Materials • Bioterrorism Emergencies (Anthrax, smallpox, etc.) • Chemical Emergencies (train derailment) • Radiation Emergencies (3 Mile Island) • Mass Casualties (school shooting, plane crash, etc.) • Hurricane • Tornado • Flood • Snow/ice storm

39. Emergencies make a hard job harder • What are some essential services for a medical facility? (electricity, water, supply chain (medications, food)) • Could these be lost during an emergency? • How would this affect their ability to perform their job?

40. What you need to know • Your employer should have a plan • Emergency Management Goals: • Continuity of care • Safety of patients, families, and staff • Support to community • Preservation of vital records and property • OSHA has established standards and regulations that pertain to healthcare during disaster situations.

41. Your Right to a… The creation of OSHA provided workers the right to a safe and healthful workplace. Section 5(a)(1) of the OSH Act states: “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." www.osha.gov or call: 1-800-321-OSHA

42. Building Resources: Healthcare Specific • http://www.health.state.mn.us/index.html • http://www.osha.gov/SLTC/etools/hospital/index.html • http://www.osha.gov/SLTC/etools/nursinghome/index.html • http://www.cdc.gov/nhsn/hps.html • http://www.mtpinnacle.com

43. Building Resources • Occupational Safety and Health Administration (OSHA) www.osha.gov and http://www.youth2work.gov/ • National Institute of Occupational Safety and Health (NIOSH) http://www.cdc.gov/niosh/topics/youth/ • Youngworkers.org http://www.youngworkers.org/home.htm *The California Resource Network for Young Workers’ Health and Safety and home of The National Young Worker Safety Resource Center • United States Department of Labor, Wage and Hour Division (WHD) Youth Rules! http://www.youthrules.dol.gov/teens/default.htm • Gulf Coast Safety Institute www.com.edu/gcsi National Resources

44. Building Resources • Georgia Department of Education http://www.doe.k12.ga.us/http://www.gadoe.org/ • Georgia Department of Education: Career, Technology and Agricultural Education http://www.gadoe.org/ci_cta.aspx • SkillsUSA www.skillsusageorgia.org and www.skillsusa.org • Georgia Technology Student Association www.gatsa.org • Georgia Engineering and Technology Education Association www.getea.org • Georgia Health Occupations Students of America www.georgiahosa.org Construction Education Foundation of Georgia www.cefga.org • Trade and Industrial Educators of Georgia http://tiega.org/ • Project Safe Georgia www.projectsafegeorgia.org • American Society of Safety Engineers (ASSE)- Georgia Chapter http://georgia.asse.org/ • Georgia Local Section- American Industrial Hygiene Association (GLS-AIHA) http://www.georgiaaiha.org/ Georgia Local Resources

45. For More Information • Email: youngworker@gtri.gatech.edu • Website: www.youngworker.gatech.edu • Twitter: @youngworker • Facebook: http://www.facebook.com/#!/Young.Worker.at.GTRI • Phone: 404-407-8089 • Address: Center for Young Worker Safety and Health at GTRI 260 14th Street Atlanta, GA 30332-0837