Injury may occur to employees from improper training or use of equipment (e.g., defibrillators). Electric shock may also occur as a result of lack-of maintenance or misuse of equipment
and/or its controls. Oxygen-enriched atmospheres and water may also contribute to hazardous conditions.
Each ED should have a program that routinely monitors the status of equipment and proper training of employees to use equipment safely.
According to the Centers for Disease Control and Prevention (CDC), about 385,000 sharps injuries occur annually to hospital employees.
Exposure to blood and other potentially infectious materials (OPIM) because of:
- unsafe needle devices
- improper handling and disposal of needles and other sharps
- Use safer needle devices and needleless devices to decrease needlestick or other sharps exposures.
- Properly handle and dispose of needles and other sharps according to the Bloodborne Pathogens Standard.
- 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)].
Sharps containers [29 CFR 1910.1030(d)(4)(iii)(A)(1)], must be:
- closable, puncture-resistant, and leak-proof on sides and bottom
- accessible, maintained upright, and not allowed to overfill
- labeled or color coded according to 29 CFR 1910.1030(g)(1)(i)
- colored red or labeled with the biohazard symbol
- labeled in fluorescent orange or orange-red, with lettering and symbols in a contrasting color [29 CFR 1910.1030(g)(1)(i)(C)]
Studies suggest work stress may increase a person's risk for cardiovascular disease, psychological disorders, workplace injury, and other health problems. Early warning signs may include
headaches, sleep disturbances, difficulty concentrating, job dissatisfaction, and low morale.
All hospital employees, especially ED employees, are exposed to many stressors at work that can cause workplace stress and burnout. These stressors are due to factors such as:
- shift work
- long hours
- intense emotional situations (e.g., the suffering and death of patients)
- Educate employees and management about job stress.
- Establish programs to address workplace stress, such as: Employee Assistance Programs (EAP) or Organizational Change Programs.
- An Employee Assistance Program (EAP) can improve the ability of workers to cope with difficult work situations. Stress management programs teach workers about the nature and sources of stress, the effects of stress on health, and personal skills to reduce stress (e.g., time management or relaxation exercises).
- EAPs also provide individual counseling for employees for both work and personal problems.
- Organizational Change Programs change hospital policies and procedures to reduce organizational sources of stress. This is done by bringing in a consultant to recommend ways to improve working conditions. This approach is the most direct way to reduce stress at work. It involves the identification of stressful aspects of work (e.g., excessive workload, conflicting expectations) and the design of strategies to reduce or eliminate the identified stressors. Some strategies include:
- Ensure the workload is in line with workers' capabilities and resources.
- Design jobs to provide meaning, stimulation, and opportunities for workers to use their skills.
- Clearly define workers' roles and responsibilities.
- Give workers opportunities to participate in decisions and actions affecting their jobs.
ED staff and other hospitals workers to patients can be exposed to biological agents, chemical agents, and mass causalities as a result of terrorist attacks or events.
Provide and plan for emergency response for health care employers and emergency responders.
Emergency Response Plan
OSHA’s HAZWOPER standard requires hospitals to plan for emergencies if they expect to assign their employees to respond to emergencies involving hazardous substances. A hospital designated by a
hazardous waste site as a decontamination facility must have an Emergency Response Plan (ERP) which addresses, among other things, decontamination, personal protective equipment, and the roles and
functions of trained personnel.
OSHA also recommends the development of an ERP for any other hospitals that may receive and treat victims whose treatment may present decontamination issues, even if they have not been designated
as decontamination facilities.
Elements of a Hospital Emergency Response Plan
The hospital’s ERP should address the following elements:
- pre-emergency drills implementing the ERP
- personnel roles and responsibilities, including who will be in charge of directing the response, training, and communications
- description of the hospital’s system for immediately accessing information on toxic materials
- plan for managing emergency treatment of non-contaminated patients
- prevention of cross-contamination by airborne substances via the hospital’s ventilation system or other means
- post-emergency critique and follow-up of drills and actual emergencies
Anthrax is an acute infectious disease caused by a spore-forming bacterium called Bacillus anthracis. It is generally acquired following contact with anthrax-infected animals or
anthrax-contaminated animal products.
- Health care workers in occupational settings such as hospitals, clinics, and medical laboratories may be exposed to anthrax as a result of contact with patients whose skin, clothing, or personal
effects are contaminated with anthrax spores, or through contact with contaminated equipment.
- Anthrax is not a contagious disease.
- Because the most likely exposure route for health care workers is dermal contact, take normal health and safety precautions (such as wearing latex/nitrile examination gloves) to protect yourself
against cutaneous anthrax exposure.
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