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Risk Assessment at: Assessor: F Assessment date:

Review date:

No

Issues

Observations Hazards Existing control measures

Severity of harm FA [4] SE [3] SI [2] MI [1]

Risk Assessment Likelihood of Risk occurrence rating VL LI PO UN [4] [3] [2] [1]

Recommendations

Blood borne Pathogens

Identify employees who have occupational exposure to blood, and then establish and implement a written Exposure Control Plan (ECP), designed to eliminate or minimize employee exposure. Employer should ensure that employees with occupational exposure to blood borne pathogens receive

Electrical

appropriate training Electrical equipment shall be free from recognized hazards Listed or labeled equipment shall be used or installed in accordance with any instructions included in the listing or labeling Sufficient access and working space shall be provided and maintained around all electric equipment to permit ready and safe operation and maintenance of such equipment Ensure that all electrical

service near sources of water is properly grounded. Tag out and remove from service all damaged receptacles and portable electrical equipment. Repair all damaged receptacles and portable electrical equipment before placing them back into service. Ensure that employees are trained not to plug or unplug energized equipment when their hands are wet. Use safeguards for personnel protection and electrical

protective equipment. Select and use appropriate work practices Follow requirements for Hazardous Classified Locations. Employers should use RCD

Ergonomics

Minimizing manual lifting of patients in all cases and eliminating lifting when possible. Areas that should be addressed a facility's safety and health program include:

Management Leadership/Employee Participation

Workplace Analysis Accident and Record Analysis Hazard Prevention and Control Training

Fire Hazards

y y

Fire Safety requirements include: A safe means of egress from fire and like emergencies. A minimum of 2 exits or means of egress are required Exits must be clearly marked. Access to exits must remain clear of obstructions at all time. Construction or Maintenance Operation Areas:

Any area under construction or under maintenance must: Continuously maintain existing exits and any existing fire protection, or other measures which provide. Not be occupied in whole or in part until all exits required for that part are completed and ready for use. Have travel from exits to outside continuously free and clear of obstruction Wiring methods, components, and equipment for general use should be of approved

standard.
y

The employer shall control accumulations of flammable and combustible waste materials and residues so that they do not contribute to a fire emergency.

5.

Hazardous Chemicals Employee exposure to hazardous chemicals, such as

If employees are to fight fires, the employer must decide if all employees or just designated employees will fight fires, or if a Fire Wardens will be trained and equipped. Provide for worker training, warning labels, and access to Material Safety Data Sheets (MSDSs).

pesticides, disinfectants, and hazardous drugs in the workplace.

Provide appropriate PPE: (e.g., gloves, goggles, splash aprons).

6.

Inappropriate PPE Employee exposure to hazardous processes or infectious materials or chemicals due to inappropriate or lack of PPE

General PPE y for eyes, y face, y head, an y extremities, y protective clothing, y respiratory devices, and y protective shields and barriers y Throat protection y Ear protection
y y

7.

Slips/Trips/Fa lls Employee exposure to wet floors or spills and litter that can lead to slips/trips/fall

Keep floors clean and dry. Provide warning signs for wet floor area. Where wet processes are used, maintain drainage and provide false

s and other possible injuries.

floors, platforms, mats, or other dry standing places where practicable, or provide appropriate waterproof footgear.
y

Keep aisles and passageways clear and in good repair Keep exits free from obstruction. Access to exits must remain clear of obstructions at all time

8.

Workplace Violence
y

Workplace violence such as physical assaults, or threatening or

establish and maintain a violence prevention program as: Creates and

violent behavior, are a growing problem in the workplace.

disseminates a clear policy that violence, verbal and nonverbal threats, and related actions, will not be tolerated.
y

Ensures that no reprisals are taken against employees who report or experience workplace violence.

Encourages prompt reporting of all violent incidents and recordkeeping of incidents to assess risk and to measure progress. Establishes a plan for maintaining security in the

9.

Lack of Universal Precautions Blood borne pathogens are pathogenic microorganis ms that are present in human blood and can cause disease in humans. Some infections that can be transmitted through contact with blood and body fluids include: HIV, Hepatitis A, B, C, Staph

workplace which includes law enforcement officials and other specialists. Standard precautions include the use of: hand washing, appropriate personal protective equipment such as gloves, gowns, masks, whenever touching or exposure to patients' body fluids is anticipated.
y

Airborne Precautions used for infections spread in small particles in the air such as chicken pox. Droplet Precautions used for infections spread in large

and Strep infections, Gastroenteriti s-salmonella, and shigella, Pneumonia, Syphilis, TB, Malaria, Measles, Chicken Pox, Herpes, Urinary tract infections, and Blood infections. The greatest risks are from HIV and Hepatitis B and C

droplets by coughing, talking, or sneezing such as influenza.

Contact Precautions used for infections spread by skin to skin contact or contact with other surfaces such as herpes simplex virus.

10

Stress Hospital work often requires coping with some of the most stressful situations found in any workplace.

Educate employees and management about job stress. Address workrelated stressors, such as inadequate work space, unreasonable

work load, lack of readily available resources, inadequate and unsafe equipment.

Establish regular staff meetings and discussions to communicate feelings, gain support, and share innovative ideas. Establish stress management programs.

Provide readily available counseling Provide adequate staffing.

Provide reasonable shift schedules for house staff to allow adequate time for sleep each day. Provide group therapy for staff with particularly difficult professional problems such as dealing with cancer patients, chronic illness, and death.

Provide an organized and efficient work environment. Recognize and take action on legitimate complaints regarding overbearing physicians and supervisors.

The use of individual approaches such as relaxation exercises and feedback to relieve symptoms of stress until the sources are identified and evaluated. Provide frequent inservice educational sessions and other opportunities to improve skills and confidence. Provide more flexibility and worker participation in scheduling (possibly a 10 hr, 4-day workweek).

y 11 Mercury

Provide scheduled rotation of unit assignments.


y

Employee exposure to mercury from accidental spills that can occur during repair of broken thermometers, sphygmoman ometers, or during sterilization and centrifugation of thermometers in maintenance areas.

All mercury containing equipment should be replaced. Use mercury spill kits to help clean up small spills of 25ml or less. Kits should contain gloves, protective glasses, Hg absorb powder, mercury sponges, and a disposal bag.

Put in place procedures to isolate the contaminated area. Medically

12

Cuts & Burns Employee exposure to burns or cuts that can occur from handling or sorting hot sterilized items or sharp instruments when removing them from autoclaves/ste rilizers or from steam lines that service the autoclaves.

monitor the respiratory track, nervous system, kidneys, and skin of any worker who may be exposed to mercury. Establish work practices to prevent hazards such as:
y

Do not remove items from sterilizers until cooled. Avoid handling sharp ends of instruments. Use forceps or other devices to remove sharp instruments from baskets and autoclaves. Provide appropriate Personal Protective Equipment (PPE).

13

Compressed Gases Potential hazards associated with compressed gas will vary based on the chemicals; however, they may include fire, explosion, and toxicity.

All cylinders whether empty or full must be stored upright. Secure cylinders of compressed gases. Cylinders should never be dropped or allowed to strike each other with force.

14

Laser Hazards Severe eye injuries from direct or reflected laser beams. Skin burns from the direct beam of surgical lasers when

Transport compressed gas cylinders with protective caps in place and do not roll or drag the cylinders Use laser protective eyewear that provides adequate protection against the specific laser wavelengths being used. Display warning signs conspicuously on all doors entering the Laser Treatment

misdirected. Respiratory hazards when breathing lasergenerated airborne contaminants (LGAC).

Controlled Area (LTCA). Maintenance on lasers and laser systems must be performed only by facility-authorized technicians trained in laser service Provide local exhaust ventilation with a smoke evacuator or a suction system with an in-line filter to reduce lasergenerated airborne contaminants (LGAC) levels in laser applications.

15.

Radiation Exposure Acute: Erythema and dermatitis. Large wholebody exposures cause nausea, vomiting, diarrhea,

Film badges or their equivalent should be used for long-term monitoring. Examples include: y Film Badge: Passive dosimeter for personal exposure monitoring should be worn whenever

weakness, and death. Chronic: Skin cancer and bone marrow suppression. Genetic effects may lead to congenital defects in the employee's offspring.

working with x-ray equipment, radioactive patients or radioactive materials. Depending on the work situation, body badges may be worn at collar level, chest level or waist level. y Double-Badging: Personnel who work in high-dose fluoroscopy settings may be asked to wear two badges for additional monitoring. Ring badges: (used for measuring beta and gamma doses to the hand) should be worn on the hand which is closest to the radiation source. y Lead plated glass is also used as a barrier to protect against radiation exposure

when procedures must be done close to the patient. y Lead strips provide some protection from radiation exposure for employee running fluoroscopy procedures. y Lead aprons and lead gloves offer some protection for employees and patients and should be worn in the direct x-ray field. Opaque goggles are to be worn in the direct x-ray field. y Some procedures like those that use remote fluoroscopy can be run from controls in an adjacent room, free from radiation exposure. In addition staff should undergo medical

surveillance

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