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Part 4: Occupational and Environmental Safety

Identify Opportunities for Improvement

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Occupational and Environmental Safety Assessment

An occupational and environmental safety assessment focuses on the work environment of the medical office that can potentially cause harm, injury or illness to the staff. Performing this type of an assessment can be used to prevent, eliminate and reduce workplace hazards that directly relate to exposures blood or body fluids, hazardous or chemical spills or exposure, medical equipment failure or malfunction, risks of physical injury, security threats, fires or any other unsafe work condition.

In addition to performing an assessment, an excellent resource for safety is the Medical Office Survey Toolkit which initiates open office dialog about patient safety and quality issues among providers and staff.

Blood and Body Fluid Precautions

Safety policies should reflect the use of universal precautions (visit www.cdc.gov for more information) for the prevention of blood and body fluid exposures. Universal precautions are designed to prevent the transmission of HIV, HBV or any other blood-borne infectious diseases in a healthcare setting.

Universal Precautions include:

  1. Always wash hands thoroughly before and after each patient contact. WASH HANDS IMMEDIATELY UPON CONTACT WITH BLOOD OR BODY FLUIDS
  2. Always wear disposable gloves
  3. Always properly dispose of contaminated materials in properly labeled red bags
  4. Never recap used needles. To avoid needle-sticks, dispose of needles in a properly labeled puncture resistant container
  5. Always report exposures or contamination immediately

Chemical Safety

By law (visit www.osha.gov for more information), employees that work with or near chemicals or other hazardous materials are required to receive proper training to handle a chemical spill or leak. Information should be communicated to the medical office staff regarding the proper safety measures for use, storage and disposal of all hazardous materials.

  1. Personal Protective Equipment (PPE): This includes safety goggles, appropriate gloves and lab coats.
  2. Proper Labeling: Hazardous materials should be never be placed in a unlabeled container. All materials should be listed on a Material Safety Data Sheet (MSDS)and be regularly updated.
  3. Follow Manufactures Guidelines: Use appropriate method for disposal, contact to eyes or skin, or spills.

Medical Equipment Failure or Malfunction

Many procedures are being performed in the medical office the require the use of medical equipment. This makes it important to perform regular inspections and maintenance of equipment as part of the office policies and procedures. Failure to develop written policies and procedures for medical office equipment regarding its use and maintenance can lead to equipment failure or malfunction.

To prevent injury:

  1. All staff must be properly trained in the use of all equipment.
  2. Equipment must only be used by staff for the purpose of performing their job.
  3. All equipment must be tagged with the inspection date, the due date of the next inspection and the inspectors initials.
  4. In the event of failure or malfunction, immediately tag "OUT OF SERVICE"

Physical Injuries

Photo © Stuart Miles

Preventing physical injuries requires a thorough analysis of the medical office. Although, you may not reach 100% prevention, the rate of physical injury can be substantially reduced by asking the following questions.

  • What are potential hazards?
  • How might someone be at risk for injury?
  • What injuries might result from the hazard?
  • How likely could the hazard lead to injury?
  • What can be done to prevent or correct hazards?
  • Are there certain behaviors that can contribute to the hazard?
Determining the root causes of physical injuries can also aid in the analysis.
  • Lack of or inadequate training
  • Lack of safety policy/procedures
  • Lack of regular inspections
  • Lack of disciplinary actions/process
  • Lack of staff input or recommendations

Security Threats

Photo © tungphoto

No one should be subjected to unsafe work conditions. Security threats can be scary for staff, patients and visitors. Depending on the type of incident, direct medical office staff to dial 911 for any or all of the following:

  • Disorderly conduct
  • Suspicious activity
  • Theft to personal or business property
  • Verbal threats
  • Weapons possession
  • Assault
  • Any crime committed against person or property

Fire Safety

Photo © Creativedoxfoto

Remember to include these simple procedures in your fire safety policy.

The R.A.C.E. Procedure

Remove patients from danger

Activate the alarm and dial 911

Close doors and window

Extinguish fire

To extinguish the fire, use The P.A.S.S. Procedure

Pull the pin

Aim the nozzle

Squeeze the trigger

Sweep from side to side

Staff should be encouraged to report any information when safety concerns are suspected no matter how insignificant they think it may be. Creating and maintaining a safe work environment should be done on a regular basis. The medical office must proactively manage and support the safety policy in order to protect their staff from occupational and environmental hazards.

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