Hospital administrators rarely say nice things when faced with an OSHA health safety inspection. OSHA’s (Occupational Safety and Health Administration, OSHA.gov) mission is to protect workers from occupational hazards. Hospitals can be dangerous places to work with many potential sources of injury. OSHA’s mission does not extend to patients or visitors, although these groups may benefit from protective measures put in place for healthcare workers.
Some of the most frequent dangers faced by hospital workers are physical injury and infectious exposures, but there are many other kinds of environmental risks. To help hospitals comply with its various regulations OSHA provides a number of helpful resources, including the “Hospital eTool” on its website. Medical algorithms can also help hospitals identify and avoid hazards to remain in compliance with OSHA regulations. Some examples of algorithms hospitals can utilize are discussed below.
Physical Injury
Musculoskeletal injury can occur in many ways. Of recent concern is the increase in bullying and physical violence, especially in the Emergency Department (ED) and the Intensive Care Unit (ICU). Emotions can run high when someone in the family is sick, and family members may lash out when they do not fully understand what is happening.
- Risk Factors for Workplace Violence Involving Emergency Department Physicians
Lifting injuries are another common problem, especially with the current prevalence of obesity. Special lifting and moving equipment may be needed to move a patient, especially when the patient is unable to assist.
- Patient Assessment Criteria for Safe Transfer and Movement
Some injuries such as carpal tunnel syndrome may be associated with repetitive movements. Falls are another source of injury, whether on a slick surface or from an unsecured ladder.
- Recommendations for Prevention of Carpal Tunnel and Other Wrist Complaints in an Ultrasonographer
Exposure to Infectious Diseases
There are many opportunities to be exposed to a communicable disease in the hospital. Hospitals must take steps to prevent these as much as possible. Interventions may include vaccination against high-risk pathogens and provision of personal protective equipment (PPE) such as gloves, masks and gowns.
- Risk Factors for Occupational Infection of a Health Care Worker with Viral Hepatitis B
- Errors in the Donning of an N95 Mask
- Primary Non responsiveness to Hepatitis B Virus Vaccine HBV
A common hazard for physicians and nurses are “sharps” injuries, as a result of contact with needles, scalpels or other sharp surfaces. A large cost for hospitals is the purchase of devices that reduce the risk of these injuries. Finally, hospitals need to have protocols in place for workers who have had a potential exposure to a pathogen.
Other Environmental Hazards
There are many other environmental hazards in a healthcare facility. Toxic chemicals may be found in the laboratory, pharmacy, central supply and housekeeping. Air quality may be an issue in some facilities, especially related to mold.
- Sick Building Symptom Index
Almost all departments are computerized. Long-term use of a computer can result in a number of problems that need to be avoided.
- Criteria for the Computer Vision Syndrome (CVS)
Operative devices such as lasers can pose a variety of hazards if safety precautions are not followed. Other exposures can lead to thermal burns, electrocution and inhalation injuries. Transport services can be an issue, including the use of helicopters to transfer the critically ill.
- Airway Fire During Laser Surgery in the Upper Airway
Take-Home Message
OSHA health safety regulations help to protect American hospital workers from a broad range of hazards. Meeting all of its regulatory requirements can be a challenge for a healthcare facility.
Medical algorithms can be used to educate and train workers about these hazards. Algorithms can also aid surveillance efforts to identify and avoid potentially dangerous situations. Everyone benefits when hazards can be avoided.
