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  • 1. An exposure control plan must be established in writing -Determine exposures -Procedure’s for evaluating exposures -How and when the exposure methods are to be used. -The plan must be reviewed annuallyIdentify employees at risk -Exposure through daily task, nurses, medical assistants, and physicians -Exposure through incidental control, laundry, housekeepers, office workersEmployees must be aware of all the different hazards inthe workplace at all times.Hepatitis B vaccine, offered at no cost to the employees. 1
  • 2. Bloodborne Pathogen Engineering ControlsConstantly seek ways to improve control methods in workpractice, such as needleless devices.No food, drink or use of cosmetics in area where blood is kept.Use proper hand washing, handle needles correctly.Personal protective equipment (PPE) must be supplied byemployers.Sharps container for disposal of used needles must be providedand maintain by employer.Treat all body fluids and soiled linens as they arecontaminated.Have a post exposure plan which may include counseling andgetting blood sample from source is possible.Any exposures must be documented.All records must be kept for at least 3 years. 2
  • 3. Sharps containerCloseablePuncture resistant.Leak-proof on sides and bottom.Labeled or color coded -Fluorescent orange, or orange-red“Biohazard” must be displayed.Easily accessible to employees within work area.Maintain upright when in use.Replaced routinely. 3
  • 4. Needle sticksHazards -Infection from a contaminated needlePrevention -Never remove a needle cap using your mouth. -Do not recap in hand “scoop” the cap on ifneeded. -Dispose of all needles and syringe in approve sharpscontainer.Develop communication and enforce safety standards -Employees must be trained on safe way to handle needles.Sharp injury logDocumentation and report every needle stick injury. 4
  • 5. Ergonomics of Lifting and Repetitive TaskCoordinate, have one employee manage all ergonomicsprogram.Train, show employees the proper lifting techniques, computerworkstation design and ways to make adjustments, also be surethat they know the early warning signs of any problems.Report, if the employee does not report that something iswrong or that they were hurt then it can’t be fixedAnalyze; look over the work station so that the hazard can beseen before something happens.Identify, make any and all adjustments within the work stationto control hazard. 5
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  • 7. Product identification, it tells you who make it and what the products name is. The ingredients of the chemical. The physical and chemical properties, such as the specific gravity, boiling point, appearance and odor, and melting point. The fire and explosion data, as what type of extinguisher to use, and what the flash point is. -Flashpoints less than 115 degrees are considered flammable. The protective precaution. -where you find the personal protective equipment needed to work safely with the product. The health hazards associated with the product and the first aid procedures in case you are over exposed to the product. The reactivity data. - If the product will react with other materials to cause afire, explosion, or gas. - Tells you what not to mix it with. How to store the product. The transportation procedures. Every chemical must have their own MSDS All MSDS must be keep in a binder Easily accessible to all employees 24 hours 7 days a week 7
  • 8. Hazard communicationA written hazard communication plan in place.Assign accountability, for compliance to ensure training,labeling, and MSDS maintenanceis done.Inventory of all the hazardous chemicals within the building.Ensure hazardous chemicals are safely stored and labeledcorrectly.Documentation of the communication plan.Review annually or when needed. 8
  • 9. Hazardous drugsA written safety plan in place for the drug, preparation,handling, administration, and safe disposal of when done.Warning signs shouldbe placed in area where the hazardousdrugs are used or stored.Good work practices to prevent spraying.Use proper PPE and wash hands after handling drugs.Clean spills up immediately with spill kit.Use biological safety cabinets of class II or class III that arecertified and vented properly.Dispose of such drugs in accordance with EPA regulation.Label item such as syringes with warning label and any specialinstruction.Investigational drug should only be administered by the personinvolved with the drug research.Emergency procedures should be posted on what to do in aspill or release of a hazardous drug.Medical monitoring program for those employees exposed.Report and document all hazardous drugs to proper personal. 9
  • 10. Respiratory hazards Chemicals, drugs, and diseases that can become airborne may be inhaled, or ingested. Written program in place where respirator use is required. Respirators, training and medical evaluation at no cost to employees. Quantitative fit testing.-Fit factor of 100 for tight fitting -Fit factor of 500 for full faced Every respirator should be checked before use and during cleanup. Any damaged respirator must be reported and documented to ensure it is fixed. Must be certified monthly though approved agency. 10
  • 11. TuberculosisEmployees should know how to early identify individual withTB.Information and training to ensure staff are aware of thehazards of TB, its signs and symptoms.Free medical screening for those employees at greater risk.Evaluate staff with positive TB.Acid-fast bacilli (AFB) isolation rooms for suspected orconfined patient where high risk procedures are done withHEPA filters.Provide respiratory protection for employees who are at risk.Warning signs must be posted outside of room “Specialrespiratory isolation” or “AFB isolation”.Records of employee exposures to TB must be documented.Label roof outlet and exhaust ducts. 11
  • 12. RadiationA survey to determine radiation hazards - Incident to release. -Disposal or presence of radioactive material. -Physical survey of equipment and measurements oflevels radiation present.Appropriate personal monitoring equipment. - Film badges - pocket dosimetersCaution signs be posted where radioactive material arepresent. -Magenta or purple, yellow backgroundRadiation safety officer and a radiation safetycommittee to oversee process.Radiology department exposures rooms have lead lined protection.Lead-lined PPE should be provided for patient and employees.Survey must be documented by person performing it. 12
  • 13. X-ray hazardsIncrease risk of cancer.Skin burns.Eye damage, doses greater than 200 rad.Equipment must be checked for any radiation leaks.Any leaks must be documented properly.Lead-lined wall must be provided for employees.Warning signs must be in place and visible at all times. 13
  • 14. Lab HazardsAcceptable permissible exposure limits must be posted.Employee exposure determination for those at risk.Chemicals hygiene plan.Employee information, training and proper warning signs.Hazards identification system.Documentation of all hazards within the lab itself.MSDS for all chemical within the lab. 14
  • 15. Emergency PlanWritten emergency plan in place.Evacuation routes and escapes procedure.Procedure for employees to follow before evacuation. -Assignone employee to account for all otheremployees’ safety after.Assign duties to current employees to follow.Contacts of more people to help if needed.Alarm system.Training must be provided and documented. 15
  • 16. Fire PreventionWritten plan in place.Know what and where fire hazards are and how to handlethem properly.Employee communication on potential ignition sources, controlprocedures,and proper PPE.Test fire alarm and maintain suppression system.Train employees on fire evacuation, fire containment, and howto extinguish small fires.Store combustible and flammable item in approved container,with proper warning signsDocumented safety training and update annually. 16
  • 17. Emergency chemical responseWhere chemicals are located, potential for releases, considerleaks, spill and containers that may become punctured.Determine area that can be set up differently to preventuncontrolled release.Know which chemicals may be cleaned by employees or mustbe evacuated.Consider patient that may pass through the areas.Training of all employees.Document and reported any emergency involving chemicals. 17
  • 18. Personal Protective Equipment Employer assessment of hazards which require PPE, documented.  Name of clinic  Person performing assessment  Dates assessment performedEmployer must provide PPE to all employees.Employees shall be trained on use and training must bekept on file with date of any retraining.Updated with new PPE when needed. 18
  • 19. Protect from undue latex exposures.ADA, requires employers make accommodation foremployees with latex sensitivity.Non latex gloves must be provided at no cost toemployees.Provide employees with education and training onoccupational risk of latex.Screen high-risk employees for allergy symptoms.Good housekeeping skills.Document any latex exposures. 19
  • 20. Eyewash/ShowersEmergencyStation shall be located where exposures to corrosives materialare.Station accessible within 25 feet of the know hazard.Highly visible sign identifying its location.Personal eyewash equipment) plastic bottles) may be used forimmediate use, but doesn’t replace the eyewash station.Eyewash station must be capable of flushing eyes for at least 15minutes.Maintenance program checked weekly shower should deliver20 gallons of water per minute for 15 minutes.Shower head must be 82 to 96 in from floor level, eyewashmust be 33 to 45 in from floor level. 20
  • 21. Warning signs Design and colors must be consistent throughout facility. -Danger- immediate danger, red, black and white. -Caution potential hazards, unsafe work practice yellowbackground, with black letters, and a black panel with yellowletters. Safety instruction – green panel with white letters and with white background. Specific signs biological hazardous (orange- red) radiation (purple and yellow). 21
  • 22. Preventive Measures -Initial Assessment -Prevention StrategiesHandling complaints alleging workplace security hazards.Employees should have training to know what kind of violenceto look for and should know who they can tell.Investigate assaults involving death or serious injury.Record and report any workplace violence. 22
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