Occupational Safety and Health Course for Healthcare Professionals

 Identify the general requirements for personal protective equipment.  Describe the requirements for eye, respiratory, hand, head, and foot protection.  Discuss the implications of these requirements for healthcare settings.

“ Specialized clothing or equipment, worn by an employee for protection against infectious or other hazardous materials/objects.

 PPE for eyes, face, hand, extremities, protective clothing, respiratory devices, protective shields and barriers: * Shall be provided, used, and maintained in a sanitary and reliable condition, * Wherever it is necessary by reason of hazards or processes or environment.

 Must provide PPE at no cost to employee.  Must assess all work environments for potential hazards.  Must provide training to any employee who uses any PPE.  Must pay for replacement of any required PPE, unless the employee has lost or intentionally damaged the item.

Chemical Radiological Thermal Mechanical Blood and OPIM (other potential infectious material) Encountered by an employee in a manner capable of causing injury or impairment in any function/body part through absorption, inhalation, or physical contact.

 Employer shall assess the workplace to determine if hazards are present that require the use of PPE.  Communicate presence of hazards to employees.  Select the appropriate PPE – must fit each employee.

 Engage supervisors and employees in the process.  Assess in all work locations: support service areas, patient care areas, specialty areas, facility management areas, external areas, etc.  Need to have a written certification that identifies what was evaluated, who did it, the date.  Reassess when appropriate - if services change, locations change.

 Locations/situations in healthcare where this is needed?  Must ensure that each affected employee uses eye protection that provides front and side protection from flying objects/materials.  If they wear prescription lenses, the eye protection can incorporate the prescription in the design, or be worn over the prescription lenses – must not disturb the prescription lenses or the protective lenses.

 Does everyone who should wear this, do so, every time?  Are they fit properly?  Are they checked to be sure they are in good condition?  What could we do differently?

 First Priority: Engineering Controls.  Includes: enclosure or confinement, general or local ventilation, or substitution of less toxic materials.  When engineering controls are not adequate or feasible: Face masks or Respirators should be used!

 Provided by the employer.  Must be applicable and suitable for the purpose and potential hazards involved.  Must establish and maintain a respiratory protection program.

 Identify when and where respiratory PPE needs to be used by employees and what type.  Provide Medical evaluations prior to fit-testing and use.  Follow standards on fit-testing procedure.  Documentation requirements!  N95 or higher NIOSH certified respirators.

 Employer must select and provide appropriate hand protection for employees that are exposed to hazards: * skin absorption of harmful substances * severe cuts, lacerations, or abrasions * punctures * chemical or thermal burns * harmful temperature extremes

 When and where: patient care, environmental services, engineering, laboratory, other areas.  Glove material: vinyl, latex, nitrile, other.  Sterile and nonsterile.  Single use or reusable.  Critical to train employees on appropriate use, putting on, and taking off of gloves.

 For employees working in areas where there is a potential for injury to the head from falling objects.  When would this apply in healthcare settings?

 Employees use protective footwear when working in areas where there is: * danger of foot injuries due to falling or rolling objects; * objects that can pierce the sole; * where employee’s feet are exposed to electrical hazards.

 Not too often do we encounter such hazards.  Be aware – particularly if there is construction, reconstruction going on in the work setting.  CFR (h)(1-6) – specifies when the employer does and does not have to pay for protective equipment.

 Gown first  Mask or respirator  Goggles or face shield  Gloves  Combination of PPE will affect sequence – be practical !

Select a fit tested respirator Place over nose, mouth and chin Fit flexible nose piece over nose bridge Secure on head with elastic Adjust to fit Perform a fit check – –Inhale – respirator should collapse –Exhale – check for leakage around face

 Gloves  Face Shield or goggles  Gown  Mask or respirator  And always wash hands thoroughly after removal of PPE!

 Must train before they use the PPE.  Need to know at least the following: * when PPE is necessary * what PPE is necessary * How to properly put on, take off, adjust, and wear PPE * the limitations of the PPE * proper care, maintenance, useful life, and disposal of PPE. Resources available: OSHA and CDC/NIOSH

 Before using any PPE.  Document training.  Do not make assumptions about prior knowledge of the use of PPE!

 When do you want employees to use hand protection?  What are some of the most important “engineering controls” we need to provide?  Gloves/all PPE must be easily accessible, in good condition, good fit for every employee.  Monitoring practices.  Current state of our art?

 Monitoring  Reminders – examples?  Easy access  Good role models/teachers

 Hazard in healthcare and first responder situations.  Must control contact with blood and OPIM.  Provide hand, eye, face, full body protection – easily accessible and good fit.  Teach employees how to use, when to use, how to put on and take off, how to dispose.

 To improve employee safety.  To enhance our care of patients, keeping them and their families safe.