Accreditation

Don't get in a sticky situation with bloodborne pathogens

Accreditation Connection, March 22, 2004

Ambulatory center staff are often exposed to hazardous materials and situations that have the potential to cause injury. The number-one risk for staff is exposure to bloodborne pathogens, says Dionne Williams, MPH, senior industrial hygienist with the Occupational Safety and Health Administration (OSHA).

Other common OSHA violations in ambulatory centers include improper handling and labeling of hazardous chemicals, slippery floors, and blocked aisles or exits, says Williams. Although it doesn't warrant violations, OSHA inspectors have also noticed that ambulatory workers are often in situations that pose ergonomic challenges or increase fatigue and discomfort.

A center's top priority for OSHA.compliance should be to assess the risks in various areas or departments, says Williams. Organizations can visit the OSHA Web site at www.osha.gov  and use an electronic tool to help them identify their biggest potential problems. Staff can use the tool to improve employee safety and comply with OSHA guidelines. The following are tips for each of OSHA's top problem areas:

Bloodborne pathogens

In surgical areas, it is crucial to have an up-to-date exposure-control plan, says Williams. One person should be in charge of the plan, and he or she should understand the requirements and watch for new devices that can further reduce exposure to pathogens.

OSHA requires organizations to have a plan in place that outlines the following:

  • Potential areas for exposure to bloodborne pathogens

  • Tasks in which employees will be involved that will increase their exposure

  • How the organization plans to address these situations

    Tip: Organizations also need a system to ensure that employees who are exposed to bloodborne pathogens are offered hepatitis-B vaccinations, says Williams.

    Other elements of the plan should include

  • what engineering devices the organization selected

  • how they made that selection

  • how employees are trained on the device

    Use devices employees like

    The exposure plan needs to be updated annually, but this doesn't mean organizations need to adopt new devices every year. Organizations just need to record in the plan that they searched for new products, says Williams.

    There are many devices designed to improve safety, but employers need to ask for feedback from the employees who actually use the devices. Organizations need to invest in devices their staff will actually use, says Williams. Whenever centers change products, leaders need to make sure employees are properly trained on how to use the devices.

    "I have seen people get needlesticks even when they are using safe devices," says Williams. "It is usually because they are lacking in training, or the facility switched to a new device without asking for input from the department which will use the device."

    Hazardous chemicals and wet floors

    Ambulatory centers often use hazardous chemicals to sterilize equipment. Employees need to

  • train staff on how to properly handle these chemicals. Some require stronger gloves or extra precautions. For example, employees need to know whether latex gloves are suitable protection against some of the chemicals.

  • make sure products are properly labeled. If the sterilization chemicals come in large containers, organizations might want to put them into smaller, easier-to-manage containers. The new containers must be labeled with the contents, says Williams.

  • keep material safety data sheets available so employees can check any possible side effects from exposure to the chemical or what they should do if they come in direct contact with the product.

    People can easily slip if floors are wet. Organizations should make sure they put warning signs in areas with wet floors.

    Blocked aisles pose another risk. Staff should also perform regular checks to ensure that doorways aren't blocked and that equipment in hallways doesn't limit access to the space.

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