Reduce Hospital Employee Injuries

Hospital medical workers face varied and numerous health and injury risks while at work, including strains and sprains from lifting, chemical hazards, radiation, blood borne pathogens and infectious diseases, sharps, and security problems.  A comprehensive injury prevention program must involve a customized, in-depth survey and analysis of all significant exposures at your particular hospital.  This article will provide some steps to get you started on controlling the more common injury risks to medical workers.  These are vital in reducing injuries and workers' compensation insurance.

Implement a safe lifting and back safety program. Exposure to injury and strains is caused by the need to lift, assist, or transfer patients. Elements to consider in the program include:

• Teach proper body mechanics and lifting at new hire orientation and then periodically throughout employment.
• Implement a lift policy. Most hospitals have a maximum lift weight of 25 to 35 pounds; employees who must lift over that amount require assistance from a lift team or a mechanical device.
• Evaluate each patient on admission and determine whether the patient is able to move without assistance. Place an order above the patient’s bed defining what lift procedures, if any, must be used for that person. These may range from simple assistance, such as offering an arm to steady the resident, to a requirement for mechanical assistance or a team lift at all times.
• Ensure an adequate number of employees are available for team lifts on each shift.
• Ensure mechanical devices such as Hoyer lifts, gait belts, and transfer belts or sheets are available in every unit. Employees should not have to search these out because they may decide it is too much trouble and not use them.

Implement an infection control plan.  Employees are potentially exposed to blood borne diseases or other biological agents.  Consider these elements in your plan:

• Screen all new employees for tuberculosis and hepatitis and offer the hepatitis B vaccine.

• Implement protocols for universal precautions, proper use of personal protective equipment, hand washing procedures, equipment sterilization, waste management, and good housekeeping.  A sample Infection Control Plan is included under Resources.

• Implement a Blood Borne Pathogen Exposure Control Plan.   This is required by OSHA regulations and must include an exposure determination, methods of compliance, post exposure evaluations and follow-up, employee training, and proper record keeping.  A sample Blood Borne Pathogen Exposure Control Plan is included under Resources.

• Ensure that all departments have a sharps handling and disposal program in place and employees receive annual training.

Implement a chemical hazard handling plan. Your medical workers may be exposed to compressed and anesthetic gasses; cleaning agents such as glutaraldehyde, bleach, disinfectants; chemotherapeutic agents; and other organic compounds.

• Provide chemical hazard communication training at new hire orientation and then periodically as required by law.

• Make spill kits available for chemical or biological spills and train employees in appropriate clean-up procedures.

• Employees who work with cytotoxic or anti-neoplastic (cancer fighting) drugs must be specially trained to handle these carcinogens. These drugs and other potentially hazardous chemicals or substances must be prepared under fume hoods.

Implement a Radiation control plan.   Ensure that employees who may be exposed to ionizing radiation wear lead aprons and follow strict protocols to ensure that they are behind partitions that shield them from harmful exposure.  Require the use of radiation badges.   Ensure that female employees who are pregnant are assigned other duties that do not expose them to the risk of ionizing radiation.  Sample control plans are provided in the Resources box.

Improve security. Employees are potentially exposed to attacks from patients who are suffering from dementia or other psychiatric illness, or from intruders who enter the hospital searching for drugs. Some employees report to or leave work during the night and are exposed to attacks from persons outside the hospital. Hire a private security company to provide on-site personnel to patrol the grounds between dusk and dawn, and assign some to permanent stations in the main hospital lobby and near entrances. Provide a security office from which they may be summoned by an alarm if there is an emergency.

Provide special training to employees who work in Alzheimer or psychiatric units. Ensure they know how to avoid such patients, but know how to protect themselves from assault.  Develop a written policy regarding use of restraints with violent, demented, or psychotic patients. Enforce the requirements uniformly.