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Young Worker Safety and Health Training for the Healthcare Industry Training Module 4 Information Provided under OSHA Susan Harwood Capacity Building Grant: #SH-22227-11-60-F-13

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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. 2

Center for Young Worker Safety and Health at Georgia Tech Research Institute


Course Agenda & Objectives In this session you will learn:

Bloodborne Pathogens (BBP)   

Respiratory Protection   

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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? 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?

Center for Young Worker Safety and Health at Georgia Tech Research Institute


Course Agenda & Objectives (continued) Ergonomics

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What does “ergonomics” mean and how does it affect healthcare workers? How do I prevent an ergonomic-related injury?

Workplace Violence

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Why are healthcare workers at risk of workplace violence? What are the risk factors and how do you minimize them?

Emergency Response

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What are examples of the types of emergencies experienced in a healthcare setting? How does your employer prepare for these types of emergencies? Center for Young Worker Safety and Health at Georgia Tech Research Institute


Tying it All Together

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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

Center for Young Worker Safety and Health at Georgia Tech Research Institute


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

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Center for Young Worker Safety and Health at Georgia Tech Research Institute


How is healthcare different from other jobs? 

In the healthcare setting there is a:      

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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

Center for Young Worker Safety and Health at Georgia Tech Research Institute


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

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Center for Young Worker Safety and Health at Georgia Tech Research Institute


Healthcare isn’t always healthy….

Risk of infection Exposure to chemicals and drugs Injuries from lifting and repetitive motion Stress

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Center for Young Worker Safety and Health at Georgia Tech Research Institute


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

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What’s a Pathogen?  

Infectious microorganisms present in blood that can cause disease in humans. Viruses   

Cold & Flu Hepatitis B & C HIV

Bacteria  

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Staph infections Tuberculosis

Center for Young Worker Safety and Health at Georgia Tech Research Institute


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

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Center for Young Worker Safety and Health at Georgia Tech Research Institute


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:

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Blood or body substances do not have to be visible for an infection to be transmitted Center for Young Worker Safety and Health at Georgia Tech Research Institute


Injuries 

600,000 – 800,000 needlestick injuries annually 

1/3 all sharps injuries occur during disposal 

Nurses sustain the most needlestick injuries

CDC estimates 60 – 80% can be prevented

Other exposure incidents  

Splashes Contact with mucous membranes or non-intact skin

Center for Young Worker Safety and Health at Georgia Tech Research Institute

February 2, 2013


Prevention Strategies Example: single-use, disposable equipment (needles, scalpels, patient gowns) Examples: •Training on infectious disease and transmission •“Universal Precautions” rule •Handwashing rules •Hepatitis B vaccination Example: •Disposable gloves for use during procedures and cleaning equipment

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Remove/Substitute/Isolate the hazard

Improve Work Policies & Procedures

Use Protective Clothing & Equipment

Center for Young Worker Safety and Health at Georgia Tech Research Institute


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

hazards of working with chemicals on the job. 16

Must be made daily

Center for Young Worker Safety and Health at Georgia Tech Research Institute


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)

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Proper Glove Removal Practice

Center for Young Worker Safety and Health at Georgia Tech Research Institute


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 19

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

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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?

Center for Young Worker Safety and Health at Georgia Tech Research Institute


Respiratory Protection ď ˝

1 2 3

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 Center for Young Worker Safety and Health at Georgia Tech Research Institute


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 (O 2). (OSHA’s Small Entity Compliance Guide, 9/30/98)

Center for Young Worker Safety and Health at Georgia Tech Research Institute


When do we need respirators? 

Engineering or administrative controls are not always possible:  

Employees may be exposed to a wide variety of air contaminants  

Confinement of infectious agent may be difficult or impossible Improved ventilation may not be practical or feasible

infectious agents chemical agents

Environmental controls may not be feasible 24

Center for Young Worker Safety and Health at Georgia Tech Research Institute


Limitations of Respirators 

All respirators have limitations:    

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improper fit improper donning damage contamination

Center for Young Worker Safety and Health at Georgia Tech Research Institute


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. 26

Center for Young Worker Safety and Health at Georgia Tech Research Institute


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

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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 

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Lifting patients Positioning patients Transferring patients

Center for Young Worker Safety and Health at Georgia Tech Research Institute


An Exercise in Strength

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Center for Young Worker Safety and Health at Georgia Tech Research Institute


What is Ergonomics? ď ˝

Fitting the task to the person

Center for Young Worker Safety and Health at Georgia Tech Research Institute


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

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Prevention Strategies Workplace Example: Transferring a Patient Example: •Use patient lifting devices Examples: •Allow for stretching intervals •Keep neck and back straight •Lift with legs •Move patient as close as possible before lifting Example: •Choose appropriate footwear that is non-slip and supportive

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Remove/Substitute/Isolate the hazard

Improve Work Policies & Procedures

Use Protective Clothing & Equipment

Center for Young Worker Safety and Health at Georgia Tech Research Institute


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

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Workplace Violence ď ˝

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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.

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Center for Young Worker Safety and Health at Georgia Tech Research Institute


Risk Factors ď ˝

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What are some reasons that healthcare settings have a higher risk for workplace violence than other workplaces?

Center for Young Worker Safety and Health at Georgia Tech Research Institute


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) 36

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

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Types of Emergencies

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Center for Young Worker Safety and Health at Georgia Tech Research Institute


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?

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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. 40

Center for Young Worker Safety and Health at Georgia Tech Research Institute


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 41

Center for Young Worker Safety and Health at Georgia Tech Research Institute


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

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Building Resources National Resources   

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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 Center for Young Worker Safety and Health at Georgia Tech Research Institute


Building Resources Georgia Local 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/

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Center for Young Worker Safety and Health at Georgia Tech Research Institute


For More Information    

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Email: youngworker@gtri.gatech.edu Website: www.youngworker.gatech.edu Twitter: @youngworker Facebook: http://www.facebook.com/#!/Young.Worker.at.GT RI Phone: 404-407-8089 Address: Center for Young Worker Safety and Health at GTRI 260 14th Street Atlanta, GA 30332-0837 Center for Young Worker Safety and Health at Georgia Tech Research Institute


Module 4: Young Worker Safety and Health Training for the Healthcare Industry