Workplace Accident Prevention Checklists (626) Professional Liability and Workers Compensation Checklist

The following self-inspection sheet should assist in the identification of hazards common to many veterinary clinics. The checklist is by no means all-inclusive and various sections may not apply to your practice. However, each clinic should review the list in its entirety and determine which questions are applicable.
Interior Hazards
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24.

Yes

No

Are exits clearly identified by illuminated exit signs? Are exits free from obstructions? Is emergency lighting available? Has it been tested within the last month? Is sufficient space provided in the waiting area to accommodate clients and your patients? Are all seats in good condition with no sharp edges or potential for collapse? To prevent slips and falls do you quickly mop up urine, water or other liquids? Are floor mats maintained and used at the entranceways of the clinic? Is adequate lighting provided in waiting areas? Are extension cords free from fraying or other signs of wear? Do extension cords present a trip and fall hazard? Can extension cords be adequately taped to the floor to minimize trip hazards? Are other alternatives available to eliminate the use of extension cords? Are electrical switches and outlets in good repair and adequately covered? Are ground fault circuit interrupter (GFI) outlets used near water sources? Is the clinic reasonably equipped to prevent patients from escaping? Are aggressive patients adequately separated? Are adequate trash receptacles available and emptied regularly? Are product displays secured to prevent tipping? Are toxic products, such as cleaning agents, pills or sprays, kept away from areas where children or patients could come in contact with them? Are employees instructed to prohibit clients from restraining their animals during examination? Are prescribed drugs clearly labeled and provided with cautionary statements? Are prescribed drugs dispensed in child-resistant packages? Are clients provided with written instructions for administering medications? Are clients instructed on alternative methods of treatment and allowed to make an informed decision on the care of their animal?

Professional Liability and Workers Compensation Checklist (continued)

The following self-inspection sheet should assist in the identification of hazards common to many veterinary clinics. The checklist is by no means all-inclusive and various sections may not apply to your practice. However, each clinic should review the list in its entirety and determine which questions are applicable.
Exterior Hazards
1. 2. 3. 4. 5. 6. 7. 8. 9.

Yes

No

Is exterior lighting sufficient to adequately illuminate the parking areas and walkways? Is the parking lot adequately marked with clearly defined parking spaces? Is the parking area well maintained and free from deterioration such as potholes? Are there excessive amounts of debris or other materials present that could cause a slip and fall or other incident? Are walkways level and free of cracks or other hazards that could lead to trips and falls? Does the parking area adequately drain after rainfall? Has snow or ice accumulated? Is there an effective plan to have walkways shoveled and salted when needed? Have plans been made to have the parking areas plowed after significant snowfall?

Name (print)

Signature

Date

Self Inspection Checklist

The following self-inspection sheet should assist in the identification of OSHA required record-keeping common to veterinary clinics. The checklist is by no means all-inclusive and various sections may not apply to your practice. However, each clinic should review the list in its entirety and determine which questions are applicable.

EMPLOYER POSTING
1. 2. 3.

Yes

No

4. 5.

Is the required OSHA workplace poster displayed in a prominent location where all employees are likely to see it? Are emergency telephone numbers posted where they can be readily found in case of emergency? Where employees may be exposed to any toxic substances or harmful physical agents, has appropriate information concerning employee access to medical and exposure records and Material Safety Data Sheets been posted or otherwise made readily available to affected employees? Are signs posted concerning: exiting from buildings, room capacities, floor loading, biohazards, exposures to x-ray, microwave, or other harmful radiation or substances? Is the Summary of Occupational Illnesses and Injuries (OSHA Form 200) posted in the month of February? (Only required for clinics with 11 or more employees)

RECORDKEEPING
1. 2. 3.

Yes

No

Are all occupational illnesses or injuries, except minor ones requiring only first aid, or illnesses, being recorded, as required, on the OSHA 200 log? Are employee medical records and records of employee exposure to hazardous substances or harmful physical agents maintained and up-to-date? Are employee training records kept and accessible for review by employees?

SAFETY AND HEALTH PROGRAM

1. 2. 3. 4. 5.

Yes

No

Do you have an active safety and health program that deals specifically with your clinic? Is one person clearly responsible for the overall activities of the safety and health program? Do you have safety meetings on a monthly or routine basis? Do you have a working procedure for handling in-house employee complaints regarding safety and health? Are you keeping your employees advised of the safety efforts and accomplishments to assure them that their workplace is safe?

Name (print)

Signature

Date

New Employee Orientation Checklist

The following new employee orientation checklist may assist in reviewing the basic safety practices within your clinic. The checklist is by no means all-inclusive. Some questions may not apply to your practice. Prior to using the checklist, each clinic should review the questions in their entirety and determine whether the question is applicable. Yes A review of the emergency exit location(s) and operation was completed. The following were discussed with the employee: Special needs in the event of an emergency The flammable liquids used and their storage needs Proper lifting techniques Specific needs associated with the type and use of personal protective equipment The level of first aid knowledge required of the position Chemicals known to be present within the clinic The specific routes of entry pertaining to the chemicals Results of industrial hygiene tests, such as noise level surveys or radiation monitoring. Emergency procedures Animal handling techniques Controlled substance storage. 3. The employee was informed of the areas requiring personal protective equipment. 4. The following personal protective equipment was provided: Safety Glasses Face Shield Cloth Aprons and Gowns Lead Apron and Gloves Latex Gloves Leather Gloves Boots Slip Resistant Footwear Personal Monitoring Equipment (film badges, pocket chambers, pocket dosimeters, film rings, etc.) Type provided: ______________________________________ Other types provided: _________________________ 5. Proper fit tests were completed in accordance with manufacturer instructions.
1. 2.

No

N/A

Yes Training on bloodborne pathogens and universal precautions was completed. Training on the labeling of hazardous materials was completed. The employee was provided written rules and attendance policies. The employee was provided a copy of the written hazard communication program. 10. A tour of the facility was conducted, including the location and discussion of: Emergency phone numbers Material Safety Data Sheets Surgical gases Boarding areas Surgical areas Radiation exposure areas Emergency exits The type and use of fire extinguishers, alarms and other signaling devices Eye wash stations Hazard communication stations First aid stations OSHA safety notice and 200 Logs Other safety equipment. 11. Record-keeping requirements were discussed, pertaining to the following areas: Documentation procedures Client consent forms Exposure to ionizing radiation Occupational Safety and Health Act Notice Annual summary of accidents/OSHA 200 Log Exposure to bloodborne pathogens Exposure to communicable diseases Controlled substances use Animal identification (cage cards or collars). 12. Accident reporting and investigation was discussed: Workers Compensation Public Liability Professional Liability Property Trainers name (print) Trainees name (print) Signature Signature Date Date
6. 7. 8. 9.

No

N/A

Radiology Checklist
The following radiology checklist may assist in reviewing basic safety practices within your clinic. The checklist is by no means all-inclusive and various sections may not apply to your practice. However, each clinic should review the list in its entirety and determine which questions are applicable. Yes
1. 2.

No

N/A

3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13.

Are clients prohibited from the x-ray room? Is the following protective equipment available to employees? Personal Monitoring Equipment (film badges, pocket chambers, pocket dosimeters, film rings, etc.) Type provided: ______________________________________ Lead Aprons Lead Gloves Lead Arm Sleeves Has the Personal Protective Equipment been inspected for signs of wear or damage? Have employees been instructed to never put their hand in the beam path, regardless of whether the beam is on or not? Are signs bearing the wording "Caution, Radiation Area" prominently displayed where necessary? Has the radiographic machine been inspected for possible radioactive leakage? Have electrical warnings, signals, and/or interlocks been tested to ensure they are in proper working condition? Has the fluoroscope been inspected and calibrated to ensure that the radiation output is correct? Has the x-ray room been constructed to provide sufficient shielding, such as lead lining or the equivalent protection in concrete blocks? Have authorized employees been provided with sufficient training on the effects of ionizing radiation and on the safe operation of x-ray machines? Are adequate records maintained on employee exposure to ionizing radiation? Are persons under the age of 18 prohibited from being exposed to ionizing radiation in excess of 5% of the allowed dose in a calendar quarter? Are cassette-holders used when taking radiographs of large animals?

Trainers name (print) Trainees name (print)

Signature Signature

Date Date

JOB SAFETY ANALYSIS (sample)

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of

Job Title / Description:

Veterinary Technician

Location / Department:
Exam Rooms/Surgery

Supervisor:
Xxxxx Xxxxxx, CVT

Prepared By
Xxxxxxx Xxxxxxx, DVM

Date:
01/01/99

Key Job Process Steps

1. Patient Lifting

Tools/ Material Used

Potential Hazards: Conditions or Actions Which Could Cause an Injury/ Affect Health
Strains from lifting Twisting back while lifting Slips and falls from debris on floor Improper lifting technique

Recommended Safe Practices: Personal Protective Devices, Special Clothing, Procedures

Exercise correct lifting practices Use cart to assist in moving the patient Request help from other employee(s)

Cart or Two Person Lift

2. Animal Restraint

Cat bags, blankets, gloves, muzzles,

Bites and scratches from patient Potential exposure to zoonoses, infection, etc. Strains from improper restraint techniques

Use appropriate animal restraints, personal protective equipment, obtain assistance from other employees Wear appropriate footwear with slip resistant soles Remove or cleanup spilled debris

3. Surgery Assistance

Surgical instruments, anesthetics, bandages, etc.

Slips and falls from debris on floor Overexposure to anesthetic Cuts and punctures from surgical instruments

4.

AVMA PLIT

P.O. 1629 Chicago, IL 60690-1629

JOB SAFETY ANALYSIS (sample)

page

of

Job Title / Description:

Location / Department:

Supervisor:

Prepared By

Date:

Key Job Process Steps

Tools/ Material Used

Potential Hazards: Conditions or Actions Which Could Cause an Injury/ Affect Health

Recommended Safe Practices: Personal Protective Devices, Special Clothing, Procedures

AVMA PLIT

P.O. 1629 Chicago, IL 60690-1629