HCPro.com - Safety - DO NOT USE Top Stories

Tip of the week: Look to NFPA 96 for help with kitchen fire prevention

Wed, 18 Nov 2009 18:16:00 GMT

A cooking fire at a New Jersey hospital serves as a reminder that grease can be a hazard.

The fire stared in an eatery at Jersey Shore University Medical Center in Neptune on Saturday, according to the Asbury Park Press.

Fire traveled through a duct to the roof, but didn’t spread to other parts of the hospital, the Press reported. An immediate cause wasn’t known, although in our review of past incidents in other medical facilities, grease and hot cooking appliances can lead to trouble without proper precautions.

The 2000 edition of the Life Safety Code generally requires hospitals to comply with the 1998 edition of NFPA 96, Ventilation Control and Fire Protection of Commercial Cooking Operations.

NFPA 96 sets a variety of provisions for fire protection and employee training in hospital kitchens, including but not limited to the following:

A fire extinguishing system must protect grease removal devices, hoods, and duct systems
Activation of the extinguishing system must trip the fire alarm system
Class K portable fire extinguishers must be available in cooking areas
Conspicuous signs must tell workers to activate the hood suppression system fire before using an extinguisher

Joint Commission surveyors have long been known to question fire protection and related maintenance of kitchen hoods.

Mac’s Safety Space: With OR humidity, follow CMS and risk assessment findings

Wed, 18 Nov 2009 17:43:00 GMT

Join Steve MacArthur, safety consultant for The Greeley Company, as he offers advice and best practices on a variety of hospital safety topics on his blog, Mac’s Safety Space.

Mac writes in today’s posting that when it comes to assessing OR humidity, look to the Centers for Medicare & Medicaid Services’ Conditions of Participation.

Large EPA settlement points to common problems with hazardous waste

Wed, 18 Nov 2009 17:31:00 GMT

The Environmental Protection Agency’s (EPA) actions as part of a $533,570 hospital settlement should give all safety committees a reason to review hazardous waste concerns.

The U.S. Department of Veterans Affairs’ (VA) Eastern Kansas Health Care System settled with the EPA over violations to the Resource Conservation and Recovery Act (RCRA) allegedly found at Dwight D. Eisenhower Veterans Medical Center in Leavenworth, KS, and Colmery O’Neil Veterans Medical Center in Topeka, KS.

Civil fines totaled $51,501. On top of that, the VA agreed to invest nearly $482,069 for new systems to better track and manage chemical wastes in the two hospitals.

Some of the alleged violations included no-nos such as incinerating hazardous materials on-site, says Ed Buckner, compliance officer in the RCRA enforcement branch at the EPA’s Region 7 office.

Even though many hospitals probably know better than to incinerate on-site, Buckner says, they still could be vulnerable to similar fines because they don’t know exactly what is hazardous and what isn’t -- and how to store and transport hazardous materials properly once they’re identified.

The VA’s national headquarters in Washington declined any comment on the record for this article.

Buckner offers the following three tips to help you stay ahead of RCRA problems:

Conduct a hazardous waste determination for all solid wastes. The main problem with the Kansas VA hospitals’ handling of wastes was that they didn’t know what was hazardous material under RCRA, Buckner says. Hazardous wastes require special handling and transport. If you don’t know what’s hazardous in your building and covered under RCRA, you may be racking up fines without knowing it.
Make certain to ship hazardous wastes using a qualified transporter. Not just anyone can haul away hazardous wastes. Make sure your hauler has a federal ID number.
Do not collect chemicals in storerooms and laboratories. Do you know what’s been forgotten about on shelves in the landscaping shed? Labs -- especially those connected to universities -- are also vulnerable to storing chemicals past their allowed RCRA time frame, usually 90 or 180 days depending on facility size. Abandoning or ignoring stored chemicals past that period is a way of creating waste. Containers of waste oil and gasoline, old batteries in the maintenance sheds, and fluorescent bulbs may fall under RCRA.

Read seven more RCRA tips from Buckner in the December 2009 Briefings on Hospital Safety, part of all subscriptions to the Hospital Safety Center.

This issue of Briefings also discusses how to run more effective safety fairs for employees and explores a recent Joint Commission visit to a hospital in Survey Monitor.

Don’t forget, you can always take a 14-day, free trial of all the Hospital Safety Center’s features by clicking here.

Medical chopper crash may bolster FAA regulation proposal

Wed, 18 Nov 2009 17:28:00 GMT

Yet another medical helicopter crashed has killed people, this time near the California-Nevada state line.

A pilot, nurse, and paramedic on board the aircraft perished in the crash, which occurred in Hallelujah Junction, CA, on Saturday. The helicopter fell shortly after taking off from Renown Regional Medical Center in Reno, NV, according to the Reno Gazette-Journal. No patient was aboard the chopper at the time.

As of earlier this week, the National Transportation Safety Board (NTSB) had not determined the cause of the crash, the Gazette-Journal reported.

This past spring, the Federal Aviation Administration (FAA) announced it intends to publish new rules for hospital emergency medical service flights. The FAA hopes to have a preliminary version of the rulemaking available for public comment by late 2009 or early 2010.

At least 10 fatal medical flight accidents have occurred since December 2007, killing 38 people, including the Reno crash. The NTSB has been pushing the FAA to enforce more aggressive medical flight regulations.

Hospital Safety Center subscribers can read more about the FAA’s plans by clicking here.

Q&A: Qualifications for a bloodborne pathogens trainer

Tue, 17 Nov 2009 18:41:00 GMT

Q: Who is qualified to train employees in bloodborne pathogens?

A: Section 1910.1030(g)(2)(viii)of the standard gives a broad answer, merely stating that the trainer “shall be knowledgeable in the subject matter covered by the elements contained in the training program as it relates to the workplace that the training will address.”

Read the “Ask the expert” post for more details on interpreting this section of the standard and other OSHA documents relating to it, especially as it pertains to medical and dental practices.

IC experts urge H1N1 respiratory protection change

Tue, 17 Nov 2009 18:33:00 GMT

Three leading IC organizations issued a letter to President Obama urging a change in respiratory protection regulations, including an immediate moratorium on OSHA enforcement on current requirements.

The experts contend that the current CDC guidelines do not reflect the best scientific evidence due to a flawed Australian study on respirators and H1N1 protection included in an Institute of Medicine (IOM) report that was reviewed by the CDC before making its current recommendation.

The IOM and the CDC, however, say that the Australian study was not a key factor in making their recommendations.

For more on this controversy, read “Whoa there a minute; IOM stands by its N95 recommendation.”

Emergency Management Tip: Transportation during disasters

Tue, 17 Nov 2009 11:47:00 GMT

Because fuel becomes a precious commodity in a disaster, identify what contingencies are in place to support your staff's transportation needs. Some hospitals allow staff members who travel long distances or who can't support high fuel fill-ups to stay over night the hospital during disaster periods to ensure they have a work force. Other hospitals have additional fuel storage capacity to resupply their shuttles and other vehicles as needed.

If your hospital's emergency plan dictates that staff members park offsite, keep in mind that you'll need to provide transportation. Also consider the needs of patients who are ready to be discharged home but do not have a way to get there.

For more emergency management tips, check out HCPro's book, The Emergency Management Coordinator's Handbook for Hospitals.

OSHA posts H1N1 protection advice

Tue, 17 Nov 2009 11:45:00 GMT

Following the lead of the recent CDC flu guidance on infection control and healthcare worker protection, OSHA has posted commonsense fact sheets to promote safety during the current H1N1 influenza outbreak through its Workplace Safety and H1N1 Web page. The Web page includes advice to workers and employers in both healthcare and non-healthcare settings.

Click here for a quick analysis for what healthcare employers should be doing to protect staff members.

Also, for advice on respirator usage, read “OSHA tips on dealing with N95 respirator shortages.”

OSHA Healthcare Advisor Poll

Tue, 17 Nov 2009 11:44:00 GMT

Last April, OSHA Healthcare Advisor asked whether H1N1 was a lot of hype or a legitimate concern. At that time “too much hype” won out 59% to 41%. Now that flu season is in full swing and H1N1 cases have escalated, have you changed your mind? This week’s poll wants to know.

Emergency declared for New Jersey coast

Tue, 17 Nov 2009 11:42:00 GMT

New Jersey Gov. Jon Corzine declared a state of emergency for Cumberland County due to last week's nor'easter, reports TheDailyJournal.com.

South Jersey received persistent rain and strong winds over three tide cycles, flooding roadways and causing power outages throughout the state. The emergency declaration will likely allow the state to receive federal money to help pay for repairs. Barrier islands off the coast were hit especially hard.

Source: The Daily Journal.com.

Editor's Choice: Flu absenteeism

Tue, 17 Nov 2009 11:36:00 GMT

NIOSH is studying healthcare worker absenteeism from influenza and is interested in hearing about the details of any hospital-based systems in which absences can be tracked.

For more information or to send responses, contact CarenGinsberg@westat.com.

Michigan community launches text message alert system

Tue, 17 Nov 2009 11:34:00 GMT

Lansing, MI, will soon offer information during emergencies and disasters via text message, according to the LSJ.com.

The system will go live December 14 and will be free. Nixie LLC a company that offers secure texting services, is hosting the system. Participants sign up by going to the provider's Web site. Authorized city personnel can then send out important messages, from city emergency to snow plowing information and traffic accidents. There is an option for residents to receive non-emergency alerts as well.

Source: LSJ.com

Tip of the week: Consider more than one person to monitor emergency drills

Wed, 11 Nov 2009 19:10:00 GMT

When performing emergency management exercises under Joint Commission requirements, EM.03.01.03 requires the hospital to appoint at least one person to monitor the performance of staff members during the drill. Realistically, more than one person should be used for this function, and here’s why:

At least one person should monitor the incident command center
Another should monitor the location of the drill activation (e.g., the ED, nursing unit)
At least one person should monitor each key area as identified by your emergency operations plan

Members of your safety or emergency management committee are ideal for filling these roles, but whomever you choose, they should be knowledgeable of the goals of the exercise.

If an actual emergency is used as an exercise, it is not always possible to have one person whose sole job is to monitor performance. In this case the hospital may get input from others involved in the incident command structure and those who provided services during the incident.

Editor’s note: This tip comes from HCPro’s Emergency Management Compliance Manual: A Guide to the Joint Commission Standards.

Mac’s Safety Space: Digging into why LS.02.01.20 tops the most cited standards list

Wed, 11 Nov 2009 18:54:00 GMT

Join Steve MacArthur, safety consultant for The Greeley Company, as he offers advice and best practices on a variety of hospital safety topics on his blog, Mac’s Safety Space.

Mac writes in today’s posting about what elements of performance he thinks got surveyors’ attention under LS.02.01.20.

Infectious disease groups appeal to Obama to pull back on N95 enforcement

Wed, 11 Nov 2009 18:46:00 GMT

Three infectious disease professional associations have written to President Obama, asking him to stop OSHA from enforcing N95 respirator provisions on hospitals providing H1N1 swine flu care.

In a letter sent November 5, the Society for Healthcare Epidemiology of America, Infectious Diseases Society of America, and Association of Professionals in Infection Control and Epidemiology asked Obama to:

Modify Centers for Disease Control and Prevention (CDC) guidance to instead promote the use of surgical masks for routine H1N1 patient care
Issue an immediate moratorium on OSHA’s enforcement of N95 provisions for healthcare facilities treating H1N1 patients

There has considerable back-and-forth debate among infection control professionals, scientists, and public health officials about whether N95s are any better than surgical masks for protecting healthcare workers during routine contact with H1N1 patients.

The CDC recently re-affirmed its recommendation that healthcare workers wear N95s when within 6 ft. of patients with suspected or confirmed H1H1. OSHA subsequently issued a statement saying that facilities treating H1N1 patients must follow the CDC’s recommendations and make good faith efforts to obtain and use N95s in the face of limited supplies.

Life safety concerns top The Joint Commission’s citation list

Wed, 11 Nov 2009 18:42:00 GMT

In sobering news for hospital safety professionals, four of the top 10 most cited Joint Commission standards in the first half of 2009 involved fire safety concerns.

According to the November Joint Commission Perspectives, the following life safety and environment of care standards were trouble spots:

LS.02.01.20 (top cited standard, with 45% of hospitals receiving findings), which requires hospitals to maintain their means of egress
LS.02.01.10 (second most cited at 43%), which requires hospitals to design and maintain building features to minimize the effects of smoke and fire
EC.02.03.05 (tied for fourth most cited at 38%), which requires hospitals to inspect, test, and maintain fire protection equipment
LS.02.01.30 (sixth most cited at 36%), which requires hospitals to maintain building features to protect people from smoke and fire

These citations are a culmination of the efforts of Joint Commission life safety specialists, who debuted in 2005 following a scathing report in 2004 from the Government Accountability Office. That report highlighted hospital deficiencies noted by The Centers for Medicare & Medicaid Services that Joint Commission surveyors did not catch in earlier visits, and life safety problems in particular were scrutinized.

If you haven’t yet participated, we still have our anonymous online poll open for those of you who underwent a Joint Commission survey in 2009. We want to hear from you about how surveyors reviewed the physical environment provisions.

Once compiled and analyzed, we will publish the results of our poll in a free online special report at the beginning of 2010.

Emergency Management Tip: Advice for the new emergency management coordinator

Tue, 10 Nov 2009 11:28:00 GMT

If you are new to the role of emergency management, don't assume that there will be someone to mentor you into your role. Be proactive and prepare yourself. There will be a learning curve to begin with, but gradually you will learn the language of emergency management.

Educate yourself in the following ways:

Complete foundation coursework, including disaster awareness training, bioterrorism training, disaster operations-level courses, decontamination courses, etc.
Join disaster training listservs maintained by country or regional emergency management, law enforcement, and EMS. Most are free to join.
Take available online classroom courses.
Make contact by introducing yourself and your role during rounds and at meetings within the hospitals.

For more tips, check out HCPro's book, The Emergency Management Coordinator's Handbook for Hospitals.

Alert system to be installed in Southeastern rural areas

Tue, 10 Nov 2009 11:26:00 GMT

The Alabama Emergency Management Agency has announced they may be potentially hiring Global Security Systems to bring its Alert FRM system to nine Alabama counties, according to Tuscaloosa News.

The technology uses FM radio waves to send out emergency messages to portable receivers. The receivers are programmable for individual use. The first to get the receivers will be hospitals, schools, and fire stations, among other public buildings.

Individuals will also be able to purchase them for $40. Each message can be sent out by local governments via a Web site within the Alert FM network. Messages can be coded to go to only a few receivers in the area or all of them.

Source: Tuscaloosa News.

After Fort Hood shootings, Twitter proves useful for one hospital

Tue, 10 Nov 2009 11:22:00 GMT

Thursday’s shootings at Fort Hood, TX, let one facility rev up its Twitter presence with useful updates and information, according to Mac's Safety Space, HCPro's blog on hospital safety. Scott & White Hospital in Temple, TX, received 10 shooting victims, and kept folks informed through its “SWHealthcare” Twitter account, including the following posts:

A phone number for concerned family members to call
The operating status of the hospital and its ER
Where volunteers could give blood donations (and wait times)
Links to further updates on the hospital’s Web site

In its August 2009 Environment of Care News, The Joint Commission pointed out that emergency management standard EM.02.02.01 requires hospitals to prepare for emergency communications with staff members, external authorities, patients, families, media, vendors, and other healthcare facilities.

Are you using social media as part of your emergency plan? Why or why not? Let us know by commenting on Mac's Safety Space, and for more updates, follow HospitalSafety on Twitter.

Take our anonymous Joint Commission poll; results to be published in free report

Wed, 04 Nov 2009 19:04:00 GMT

If your hospital underwent a Joint Commission survey in 2009, we want to hear from you about how surveyors reviewed the physical environment provisions. We’ve set up an online poll to track which environment of care, emergency management, and life safety standards received the most citations during surveys this year.

Click here to participate in the poll. All responses will remain anonymous.

Once compiled and analyzed, we will publish the results in a free online special report at the beginning of 2010. Watch for updates about the report right here in Hospital Safety Connection.