OSHA’s health care crackdown

Agency announces renewed focus on safety for industry workers


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On June 25, the U.S. Occupational and Health Safety Administration issued an inspection guidance for inpatient health care settings, including hospitals and nursing and residential facilities, resulting in more intense scrutiny by the agency’s inspectors.

According to OSHA, inpatient health care settings have some of the highest rates of injury and illness among industries for which nationwide injury and illness rates are kept. In fact, injury rates for U.S. hospitals are almost twice that of any other private industry.

In addition, nursing homes and personal care facilities continue to have one of the highest rates of injury and illness among industries for which lost workday injury and illness rates are calculated.

The U.S. Department of Labor’s Bureau of Labor Statistics and OSHA’s own inspection history have shown that inpatient health care settings consistently have exposures to the following safety and health hazards:

• Musculoskeletal disorders relating to patient or resident handling

• Workplace violence

• Blood-borne pathogens

• Tuberculosis

• Slips, trips and falls

In addition, other hazards inspectors will be on the lookout for include exposure to multi-drug resistant organisms, such as Methicillin-resistant Staphylococcus aureus (MRSA), and exposures to hazardous chemicals, such as sanitizers, disinfectants, anesthetic gases and hazardous drugs.

Inspections are likely to include a detailed review of potential employee exposure to such hazards, safety and reporting logs and the facility’s procedure for such matters as patient handling and securing hazardous materials. 

It is also expected that inspectors will review employee medical records and interview employees regarding the data contained in the employer’s records. All protocols including those around training, supervision and implementation of safety programs will be reviewed. 

Shortly before issuing the guidance, OSHA revised its prior guidance on addressing and reducing violence in health care and social service settings. Recent incidents reported in the media confirm that effective workplace violence prevention programs are essential not only in health care but in all industries.

OSHA will look to determine whether health care employers have established procedures to train employees to recognize risks of violence in patients and others and to respond and diffuse potentially dangerous situations.

Also relevant will be how facilities track and learn from “near misses.”

Like the NH Department of Labor, OSHA will expect participation of both management and employees in establishing safety, reporting and complaint protocols. 

This will all likely result in longer and more complex inspections and potentially a concern of more citations and greater proposed penalties. It can also be anticipated that health care employers may face the same scrutiny. Consequently, ambulatory surgical centers, physician practices and health centers should also be mindful of these workplace safety hazards. 

Employers in the industry should review and update safety procedures and protocols, including safety plans prepared in compliance with New Hampshire law to make certain that these concerns are adequately addressed.

Likewise, the importance of regular safety training cannot be overstated. The employer “to do” list should include the following:

 • Review and update the facility safety plan

 • Pay particular attention to the aspects of the plan which address violence prevention and make sure your employees are adequately trained

 • Review ergonomics policies around patient lifting and mobility

 • Confirm that employees are aware of the hazards associated with chemicals and other materials with which they work

 • Focus on issues of exposure to infectious diseases and blood borne pathogens

 • Confirm that your employees are aware of how to respond to requests from OSHA for inspection or documentation. 

OSHA has a number of detailed web pages that can assist in minimizing safety risks and consequently exposure to civil fines and penalties. For instance, there are safety and health topics webpages for nursing homes and personal care facilities and health care facilities.

As with most workplace issues, clear policies and adequate training and oversight of employees and supervisors are the best risk management measures. Also important is a robust compliance program that gives ample opportunity for reporting and responding to safety concerns. 

Charla Bizios Stevens, chair of the Employment Law Practice Group at the law firm of McLane Middleton, can be reached at charla.stevens@mclane.com or followed on Twitter at @charlastevens.

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