Jason Leonard, Safety Officer

1. Safety TrainingSafe Home Environment; Personal Safety; Workplace Violence; Emergency ManagementInfection ControlUniversal PrecautionsBlood borne Pathogens Jason Leonard, Safety Officer

2. PURPOSE: TO PROVIDE SAFE WORKING CONDITIONS THAT PROTECT EMPLOYEES FROM BEING UNNECESSARILY EXPOSED TO HEALTH HAZARDS

3. INTRODUCTION OSHA ESTIMATES 5.6 MILLION WORKERS IN HEALTH CARE AND OTHER FACILITIES ARE AT RISK OF EXPOSURE TO BLOODBORNE PATHOGENS SUCH AS HUMAN IMUNODEFICIENCY (HIV) AND HEPATITIS B (HBV).

4. ALL TYPES OF PEOPLE HAVE THE VIRUSES 280,000 PEOPLE ARE INFECTED WITH HBV ANNUALLY 8,700 ARE healthcare workers 200 will die as result WHO HAS HBV?

5. General Terms HIV: HUMAN IMMUNODEFICIENCY VIRSUS ATTACKS THE BODY’S IMMUNE SYSTEM, CAUSING THE DISEASE KNOWN AS AIDS OR ACQUIRED IMMUNE DEFICIENCY SYNDROME HBV:HEPATITIS MEANS INFLAMMATION OF THE LIVER. HEPATITIS B VIRUS IS THE MAJOR INFECTIOUS BLOODBORNE HAZARD YOU FACE ON THE JOB

6. NURSES HEALTH AIDES THERAPISTS PHYSICIANS DENTISTS OPERATING ROOM PERSONNEL EMERGENCY ROOM PERSONNEL LAUNDRY HANDLERS LAW ENFORCEMENT FIREFIGHTERS PARAMEDICS EMT’S FIRST RESPONDERS CPR PROVIDERS EXPOSURE TO BLOODBORNE PATHOGENS INCLUDE:

7. Even though you don’t see it • HIV AND HBV AND OTHER PATHOGENS MAY BE • PRESENT IN: • BODY FLUIDS SUCH AS SALIVA, SEMEN, VAGINAL • SECRETIONS, CEREBROSPINAL FLUID, SYNOVIAL • PLEURAL FLUID, PERITONEAL FLUID, • PERICARDIAL FLUID, AMNIOTIC FLUID, VOMIT, • URINE, FECES • SALIVA AND BLOOD CONTACT IN DENTAL • PROCEDURES • UNFIXED TISSUE OR ORGANS OTHER THAN • INTACT SKIN FROM LIVING OR DEAD HUMANS

8. MODES OF TRANSMISSION • ACCIDENTAL INJURY BY CONTAMINATED SHARPS • CUTTING YOURSELF WITH INFECTED OBJECTS • CONTACT WITH OPEN CUTS, NICKS AND • ABRASIONS • CONTACT WITH MUCOUS MEMBRANES • MOUTH, NOSE AND EARS

9. TRANSMISSION OF VIRUSES: HIV IS TRANSMITTED PRIMARILY THROUGH SEXUAL CONTACT BUT MAY ALSO BE TRANSMITTED THROUGH CONTACT WITH BLOOD AND SOME BODY FLUIDS. HIV IS NOT TRANSMITTED BY TOUCHING, FEEDING OR WORKING AROUND PATIENTS WHO CARRY THE DISEASE

10. IF YOU BECOME INFECTED WITH HBV: YOU MAY FEEL LIKE YOU HAVE THE FLU YOU MAY BE SICK ENOUGH TO BE HOSPITALIZED YOUR SALIVA AND OTHER BODY FLUIDS MAY BE INFECTIOUS

11. CONTROL OF BLOODBORNE PATHOGENS • EMPLOYEE WORK PRACTICES • KNOW YOUR PATIENTS DIAGNOSIS • PERSONNEL PROTECTIVE EQUIPMENT • HOUSEKEEPING (SHARPS) • HEPATITIS B VACCINE

12. TRAINING SHALL CONTAIN: • ENGINEERING CONTROLS (looking at incidents) • ADMINISTRATIVE CONTROLS (guidelines) • PPE • POST EXPOSURE EVALUATIONS • RECORD KEEPING

13. UNIVERSAL PRECAUTIONS: TREAT ALL BLOOD AND BODY FLUIDS AS POTENTIALLY INFECTIOUS

14. CONTAMINATED SURFACES • SURFACES CAN BE CONTAMINATEDWITHOUT • VISIBLE SIGNS • HBV CAN SURVIVE ON SURFACES AT ROOM • TEMPERATURE FOR AT LEAST A WEEK • . KNOW HOW TO DISINFECT YOUR EQUIPMENT

15. EXPOSURE PREVENTION AND CONTROL • PLACE CONTAMINATED SHARPES IN APPROVED CONTAINERS • WASH HANDS AFTER CONTAMINATION • DO NOT KEEP FOOD OR DRINK ON COUNTERS WHERE INFECTIOUS MATERIALS MAY BE PRESENT

16. PERSONAL PROTECTIVE EQUIPMENT • PPE INCLUDES: • GLOVES • MASKS • APRONS • FACESHIELDS • MOUTHPIECES • GOWNS • EYEWARE • CPR POCKET MASKS • OTHER EQUIPMENT WHICH MAY REDUCE CONTACT • WITH SKIN OR OTHER POTENTIALLY INFECTIOUS • MATERIAL

17. Hand Washing/Hygiene When do we wash hands After coming in contact with patients skin After contact with body fluids/dressings After contact with medical equipment After removing gloves After using Toilet After Smoking • Hands are Visibly Dirt or soiled • Been in contact with contaminants • Before direct Patient contact • Before applying Sterile gloves to perform a procedure

18. How do we wash our hands Rinse hands under running water and keep pointed down Dry hands on CLEAN PAPER TOWEL Turn off water with used paper towel Hand Sanitizer (alcohol based) Put in palm enough for both hands. Rub hands together covering all areas until DRY • Protect clothes from splashing • Nails short & no polish in Patient care • Turn on water to desired temperature Avoid to HOT • Wet hands and apply soap • Lather vigorously at least 15 seconds don’t forget finger nails and tops of hands

19. COMMON SENSE RULES • BE SURE TO WASH HANDS AND REMOVE PROTECTIVE CLOTHING BEFORE: - EATING - DRINKING - SMOKING - APPLYING COSMETICS - HANDLING CONTACTS

20. Biohazard Label & SHARPS

21. Sharps Requirements Based on level of care Closable Constructed to prevent leakage of fluid. Labeled and color coded Closed prior to transport Double bagged if needed OFFICE staff is responsible for insuring sharps are placed in container for destruction • According to OSHA • Sharps containers must be easily accessible to employees and located as close as feasible to the area where sharps are being used. (Patient Care Area) • Sharps accessibility is based on level of care

22. WEAR RUBBER GLOVES RESTRICT AREA USE DISPOSAL TOWELS FOR CLEANUP PUT CONTAMINATED BLOOD IN APPROVED CONTAINERS SAFE HOUSE KEEPING

23. BE PREPARED • ALWAYS WEAR GLOVES WHEN AT RISK • BE ALERT FOR SHARP OBJECTS • DO NOT PICK UP GLASS WITH BARE HANDS • PLACE SHARPS IN APPROVED CONTAINERS

24. STANDARD THAT APPLIES: • Occupational safety and health administration • OSHA General Industry Standard • 29 CFR 1910.1030 • 29 CFR 1910.1200 • 29CFR 1904

25. Know Your Rights under OSHA • OSHA gives workers many important rights • Right to a safe and healthy workplace • Right to file an OSHA complaint • Right to information • Right to OSHA inspection • Right to know about hazards • Right to health and safety training • Right to not be discriminated against for health and safety activity WWW.OSHA.gov 1-800-321-OSHA

26. Workplace Safety Primary responsibility is to perform your duties in a safe manner in order to prevent injury to yourself or others

27. Patient lifting • Assist devices and equipment reduce excessive lifting hazards when assisting patients while: • Bathing and toileting • -Moving from room to room • -Moving from the bed to a wheelchair and vice versa • -Repositioning in bed

28. Plan the move before lifting Test the weight If heavy, use an aid like a Hoyer, dolly, cart, etc. Position your feet 6-12 inches apart Face the load Bend at knees Keep your back straight Hold close to your body Stand while keeping the weight of the load in your legs Perform lifting movements smoothly and gradually If you must change direction, pivot your feet and turn Set down objects in the same manner as you picked them up, except reverse Do not lift an object from floor to above your waist in one motion Never lift anything with greasy or wet hands Wear protective gloves when lifting objects with sharp corners Body Mechanics/ Lifting

29. Fire Prevention and Safety Severe Weather • Remove from immediate hazard • Sound alarm / call 911 • Notify office • Seek Cover • As always NO Smoking

30. Hazard Communications • MSDS Material safety data sheet • Chemical content • Hazards • Safe Handling • O2 Signage

31. Work Place Violence • If you have a reason to believe an event in your personal life can follow you to work. • 2 million workers are victims of work place violence annually. • Highest risk: working alone, late night, early hours, high crime area, community areas and homes.

32. RUN > HIDE > FIGHT

33. Personal Safety Techniques • Well lit locations • Aware of your surroundings • Time of day • Area of Danger • Alert Supervisor of concerns • Cell phone use

34. FALL RISK & ICE • Foot wear is essential. Good rubber tread or rubber over shoe. • Take short steps • slower pace • so you can react to change in traction.

35. Motor Vehicle Safety • Every 12 minutes someone dies, 10 second injured, 5 seconds crash. • Aggressive driving (speeding, tailgate) • Distracted driving (Cell Phone use) • Fatigued driving (Drowsy Driving) • Impaired driving (alcohol & drug use) • Seatbelt use

36. General Rules • Conduct (Behavior) • Drug and alcohol use • House Keeping (spills, exits) • Injury reporting and return to work program

37. Incident reporting • OSHA reports that 5 million workers have an Occupational injury or illness on the job ANNUALY. • Guidelines for reporting -24 hours • Random drug screen • Plan to return to work

38. Complete and sign a report of Injury form. Obtain a return to work evaluation form from physician for each practitioner visit. Nightingale will not accept a general form. Temporary light work is available for up to sixty days with a review of your progress every 30 days. If you are unable to return to your regular job, but are capable of performing transitional duty, you must return to transitional duty. Failure to do so will result in a reduction in benefits available and disciplinary action. If you are unable to return to your regular job, or transitional duty, your absence must be approved under the FMLA program. For this purpose, you need to complete a Family Medical Leave Request form Employees who are not eligible for leave under FMLA must return to light duty or regular work if at all possible. You must keep us regularly informed of your status if you are unable to do this. Employees must provide a return to work form indicating they are capable of returning to full duty. Cooperate with our third-party administrator and provide accurate information to the HR department Return to work program

39. This years Stats WE CAN DO BETTER Falls & Ice related Strains due to lifting Exposures Auto accidents Assaulted Pet Bite Miscellaneous 2011 2012 22 3 12 7 4 1 8 3 3 0 3 4 3 1

40. Thank you! • Complete the written test • Drive home safely!