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service near
sources of water
is properlygrounded.
y Tag out and
remove fromservice all
damagedreceptacles and
portable
electricalequipment.
y Repair all
damagedreceptacles and
portableelectrical
equipment before placingthem back into
service.y Ensure that
employees aretrained not to
plug or unplug
energizedequipment whentheir hands are
wet.y Use safeguards
for personnel protection and
electrical
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protective
equipment.
y Select and useappropriatework practices
y Followrequirements for
HazardousClassified
Locations.y Employers
should use RCD
3 Ergonomics y Minimizingmanual lifting
of patients in allcases and
eliminatinglifting when
possible.y Areas that
should beaddressed a
facility's safety
and health programinclude:
Management
Leadership/EmployeeParticipation
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Workplace Analysis
Accident and RecordAnalysis
Hazard Prevention and
Control
Training
4 Fire Hazards y Fire Safetyrequirements
include:y A safe means of
egress from fireand like
emergencies.y A minimum of
2 exits or meansof egress are
requiredy Exits must be
clearly marked.y Access to exits
must remainclear of
obstructions atall time.
y Construction or Maintenance
OperationAreas:
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y Any area under
construction or
under maintenancemust:
y Continuouslymaintain
existing exitsand any existing
fire protection,
or other measures which provide.
y Not be occupiedin whole or in
part until allexits required
for that part arecompleted andready for use.
y Have travelfrom exits to
outsidecontinuously
free and clear of obstruction
y Wiringmethods,
components,and equipment
for general useshould be of
approved
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standard.
y The employer shall controlaccumulations
of flammableand combustible
waste materialsand residues so
that they do not
contribute to afire emergency.
y If employees are
to fight fires, theemployer must
decide if all
employees or just designated
employees willfight fires, or if
a Fire Wardenswill be trained
and equipped.
5. HazardousChemicals
Employeeexposure to
hazardouschemicals,
such as
y Provide for worker training,
warning labels,and access to
Material SafetyData Sheets
(MSDSs).
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pesticides,
disinfectants,
and hazardousdrugs in theworkplace.
y Provide
appropriate
PPE: (e.g.,gloves, goggles,splash aprons).
6. Inappropriate
PPE
Employeeexposure to
hazardous processes or
infectiousmaterials or
chemicals dueto
inappropriateor lack of PPE
General PPE
y for eyes,y face,
y head, any extremities,
y protectiveclothing,
y respiratorydevices, and
y protectiveshields and
barriersy Throat
protectiony Ear protection
7. Slips/Trips/Fa
lls
Employeeexposure to
wet floors or spills and
litter that canlead to
slips/trips/fall
y K eep floors
clean and dry.y
Provide warningsigns for wetfloor area.
y Where wet processes are
used, maintaindrainage and
provide false
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s and other
possible
injuries.
floors,
platforms, mats,
or other drystanding placeswhere
practicable, or provide
appropriatewaterproof
footgear.
y K eep aisles and passageways
clear and ingood repair
y K eep exits free
from
obstruction.Access to exits
must remainclear of
obstructions atall time
8. WorkplaceViolence
Workplaceviolence such
as physicalassaults, or
threatening or
y establish andmaintain a
violence prevention
program as:y Creates and
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violent
behavior, are
a growing problem in theworkplace.
disseminates a
clear policy that
violence, verbaland nonverbalthreats, and
related actions,will not be
tolerated.
y Ensures that no
reprisals aretaken againstemployees who
report or experience
workplaceviolence.
y Encourages
promptreporting of all
violent incidentsand
recordkeepingof incidents to
assess risk andto measure
progress.y Establishes a
plan for maintaining
security in the
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workplace
which includes
lawenforcementofficials and
other specialists.
9. Lack
of UniversalPrecautions
Blood borne pathogens are
pathogenicmicroorganis
ms that are present in
human bloodand can cause
disease inhumans.
Someinfections that
can betransmitted
throughcontact with
blood and body fluids
include:
HIV,
Hepatitis A,
B, C, Staph
y Standard precautions include
the use of: handwashing,
appropriate personal protective
equipment such asgloves, gowns,
masks, whenever touching or
exposure to patients' body fluids
is anticipated.
y Airborne
Precautionsused for
infectionsspread in small
particles in theair such as
chicken pox.y Droplet
Precautionsused for
infectionsspread in large
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and Strep
infections,
Gastroenteritis-salmonella,and shigella,
Pneumonia,Syphilis, TB,
Malaria,Measles,
Chicken Pox,
Herpes,Urinary tractinfections,
and Bloodinfections.
The greatestrisks are from
HIV and
Hepatitis Band C
droplets by
coughing,
talking, or sneezing such asinfluenza.
y ContactPrecautions
used for infections
spread by skinto skin contact
or contact withother surfaces
such as herpessimplex virus.
10 Stress
Hospital work
often requirescoping with
some of themost stressful
situationsfound in any
workplace.
y Educate
employees andmanagement
about job stress.
y Address work-related stressors,
such asinadequate work
space,unreasonable
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work load, lack
of readily
availableresources,inadequate and
unsafeequipment.
y Establish
regular staff meetings anddiscussions to
communicatefeelings, gain
support, andshare innovative
ideas.
y Establish stress
management programs.
y Provide readilyavailable
counseling
y Provideadequate
staffing.
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y Provide
reasonable shift
schedules for house staff toallow adequate
time for sleepeach day.
y Provide group
therapy for staff
with particularlydifficult professional
problems suchas dealing with
cancer patients,chronic illness,
and death.
y Provide anorganized and
efficient work environment.
y Recognize and
take action onlegitimate
complaintsregarding
overbearing physicians and
supervisors.
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y The use of individualapproaches such
as relaxationexercises and
feedback torelieve
symptoms of
stress until thesources areidentified and
evaluated.
y Providefrequent in-
service
educationalsessions and
other opportunities to
improve skillsand confidence.
y Provide more
flexibility andworker
participation inscheduling
(possibly a 10hr, 4-day
workweek).
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y Provide scheduledrotation of unit
assignments.
11 Mercury
Employee
exposure tomercury from
accidentalspills that can
occur duringrepair of
brokenthermometers,
sphygmomanometers, or
duringsterilizationand
centrifugationof
thermometersin
maintenanceareas.
y All mercurycontaining
equipmentshould be
replaced.
y Use mercuryspill kits to help
clean up smallspills of 25ml or
less. K its shouldcontain gloves,
protectiveglasses, Hg
absorb powder,mercury
sponges, and adisposal bag.
y Put in place procedures to
isolate thecontaminated
area.
y Medically
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monitor the
respiratory
track, nervoussystem, kidneys,and skin of any
worker whomay be exposed
to mercury.
12 Cuts & Burns
Employeeexposure to
burns or cutsthat can occur
from handlingor sorting hot
sterilizeditems or sharp
instrumentswhen
removingthem from
autoclaves/sterilizers or
from steamlines that
service theautoclaves.
Establish work
practices to prevent
hazards such as:
y Do not removeitems from
sterilizers untilcooled.
y Avoid handling
sharp ends of instruments.
y Use forceps or
other devices toremove sharp
instrumentsfrom baskets
and autoclaves.
y Provide
appropriatePersonal
ProtectiveEquipment
(PPE).
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13 Compressed
Gases
Potentialhazards
associatedwith
compressedgas will vary
based on the
chemicals;however, theymay include
fire,explosion, and
toxicity.
y All cylinders
whether empty
or full must bestored upright.
y Secure cylindersof compressed
gases. Cylindersshould never be
dropped or
allowed to strikeeach other withforce.
y Transportcompressed gas
cylinders with protective caps in
place and do notroll or drag the
cylinders
14 Laser Hazards
Severe eye
injuries fromdirect or
reflected laser beams.
Skin burnsfrom the
direct beam of surgical lasers
when
y Use laser protectiveeyewear that
provides adequate protection against
the specific laser wavelengths being
used.
y Display warningsigns conspicuously
on all doorsentering the Laser
Treatment
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misdirected.
Respiratory
hazards when breathinglaser-
generatedairborne
contaminants(LGAC).
Controlled Area
(LTCA).
y Maintenance onlasers and laser
systems must be performed only by
facility-authorizedtechnicians trained
in laser service
y Provide local
exhaust ventilationwith a smokeevacuator or a
suction system withan in-line filter to
reduce laser-generated airborne
contaminants
(LGAC) levels inlaser applications.
15. RadiationExposure
Acute:
Erythema anddermatitis.
Large whole- body
exposurescause nausea,
vomiting,diarrhea,
Film badges or their equivalent should be
used for long-termmonitoring. Examples
include:
y Film Badge:Passive dosimeter for personal
exposuremonitoring should
be worn whenever
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weakness, and
death.
Chronic: Skin
cancer and bone marrow
suppression.Genetic
effects maylead to
congenitaldefects in the
employee'soffspring.
working with x-ray
equipment,
radioactive patientsor radioactivematerials.
Depending on thework situation,
body badges may be worn at collar
level, chest level or
waist level.
y Double-Badging:Personnel who
work in high-dosefluoroscopy settings
may be asked towear two badges for
additionalmonitoring.
y Ring badges: (usedfor measuring beta
and gamma doses tothe hand) should be
worn on the handwhich is closest to
the radiation source.
y Lead plated glass is also
used as a barrier to protect against
radiation exposure
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when procedures
must be done close
to the patient.y Lead
strips provide some protection from
radiation exposurefor employee
running fluoroscopy procedures.
y Leadaprons and leadgloves offer some
protection for employees and
patients and should be worn in the
direct x-ray field.
Opaque goggles areto be worn in thedirect x-ray field.
y Some procedures likethose that use
remote fluoroscopycan be run from
controls in anadjacent room, free
from radiationexposure.
y In addition staff should undergomedical
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surveillance
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