General safety Module 2008 2 - Synergy Medical Staffingsynergymedicalstaffing.com/career/templates/synergy/forms/General...General Safety Self-Study Learning Module ... Failure to

Synergy Medical Staffing 2008

GENERAL SAFETY

SELF-STUDY LEARNING MODULE No. 2

Includes: Learning Objectives Electrical Safety Guidelines Fire Safety Guidelines General Hazardous Communication: Your Right to Know General Body Mechanics: Guidelines for Lifting and Moving

Safety Guidelines for Preventing Workplace Violence Post-Test (must be turned in to receive credit for completing the

module)

Always review the Emergency Preparedness plan of each facility in which you accept assignment for specific information in case of emergency.


General Safety Self-Study Learning Module Objectives • Understand basic electrical safety guidelines

• Understand how electricity may harm the body

• Understand basic electrical emergency procedures

• Recognize basic fire extinguisher types and their use

• Understand basic fire safety guidelines

• Understand general guidelines for fire emergency

• Understand what is a hazardous chemical

• Understand routes of exposure for hazardous chemicals and protective measures

• Understand how to obtain information about hazardous chemicals at work -sites

• Recognize basic principles about hazardous material labeling

• Understand general procedure for exposure to hazardous chemical(s) and reporting

• Understand basic ergonomic injuries and their cause

• Understand general principles of good body mechanics for bending, moving, lifting and

patient transfer

• Understand general guidelines about workplace safety, violence, causes, prevention,

and reporting


GENERAL SAFETY RULES

SYNERGY has developed these safety rules patterned after the Federal OSHA requirements. Read and become familiar with these rules and other safety rules that apply to your job.

Failure to follow these safety rules may be grounds for termination and may disqualify your workers’ compensation benefits.

1. Report any injury to SYNERGY and your work site supervisor immediately. 2. Report any observed unsafe condition to your employer/supervisor. 3. Horseplay is prohibited while on duty at all times. 4. The drinking of alcoholic beverages is not permitted on the job. Any employee discovered

under the influence of alcohol or drugs will not be permitted to work. SYNERGY has the right to ask employees to submit to a drug screen.

5. If you do not have current First Aid Training, do not move or treat an injured person unless there is an immediate peril, such as profuse bleeding or stoppage of breathing. Use gloves as necessary. 6. Appropriate clothing and footwear must be worn on the job at all times. 7. Where there exists the hazard of falling objects, an approved hard hat must be worn. 8. You should not perform any task unless you are trained to do so and are aware of the hazards associated with that task. 9. Wear personal protective equipment. This equipment should be available to use on the job, maintained in good condition, and worn when required. 10. Learn safety work practices. When in doubt about performing a task safely, contact your supervisor for instruction and training. 11. The riding of a hoist hook, or on other equipment not designed for such purposes, is prohibited at all times. 12. Never remove or bypass safety devices. 13. Do not approach operating machinery from the blind side; let the operator see you. 14. Learn where fire extinguishers and first aid kits and other safety equipment are located at your work site. 15. Maintain a general condition of good housekeeping in all work areas at all times. 16. Obey all traffic requirements when operating vehicles on public highways. 17. When operating or riding in client owned or using your personal vehicle for business purposes, the vehicle seat belt shall be worn. 18. Be alert to hazards that could affect your, your fellow employees and others at the worksite. 19. Obey safety signs and tags. 20. Always perform your assigned task in a safe and proper manner; do not take shortcuts. The taking of shortcuts and the ignoring of established safety rules is a leading cause of employee injury. Ask your work site supervisor questions when you are unsure of any aspect of job duties.


ELECTRICAL SAFETY GUIDELINES

The following are general electrical safety guidelines. Always follow facility specific policies and procedures!

Basic Circuit: The basic circuit begins with a power source. Voltage is the driving force supplied by the power source and is measured in volts. Current is the number of charges flowing per second. This flow of charges is produced by voltage and measured in amperes (amps). Conductors carry the energy and can be metal, like the wires that carry electricity from the power source to the user and back. Water is also a conductor. Insulators, or non-conductors, can't carry an electrical charge. Insulators include the casings around wires and the porcelain or glass devices sometimes seen on power lines. The resistor is the device that uses electricity, such as a light bulb or any piece of electrical equipment. A resistor can also be a conductor. Basic Information About Electrical Current:

Electrical current will not flow unless it has a complete path, also known as a circuit, which returns to its source, such as a battery or transformer. Current flows, just like water.

Current can flow through you and other conductors, such as metals.

Earth and concrete will also conduct current.

Electric current can harm you when it flows through your body, an "electric shock".

Grounding: Electrical outlets in health care facilities have grounded systems with 3 receptacles. An electrical charge always moves toward the ground through the shortest conductive route. With a faulty piece of equipment, the charge may have no alternative but to pass through the patient, caregiver, or both.

Two-pronged plugs: If you must use a two-pronged polarized plug, check for an important safety feature: one prong that is wider than the other, to match the wider receptacle. To ground the system and prevent shock, such plugs fit into the wall outlet in only one way. Never try to force the plug in the wrong way.

Electricity can damage the nerve cells, the heart, and the skin: Nerve cells: nerve cells transmit messages via electricity. If electric current enters the body, it

can be mistaken for normal electrical signals and stimulate nerves, causing pain, paralysis and muscle contractions. Heart: The heart is a muscular pump and is powered by electrical signals that regulate heartbeat.

For this reason, the heart is extremely vulnerable to electric current that may accidentally pass through the body. Skin: The skin is a natural insulator and protects the body against small shocks. However, a

patient's skin may be less resistant due to many factors, such as wetness from dressings and loss of bladder control; surface cuts; IVs; probes and catheters. Burns to the skin may also occur.

General Safety Guidelines:

Only QUALIFIED ELECTRICAL PERSONNEL should modify, test and repair electrical equipment

Check electrical outlets before use. Report cracks, chips, or breaks in the outlet.

Unplug, tag and report any plugs or sockets that form a connection that is warm to the touch.

Never bend prongs of a plug when trying to insert the plug into an outlet.

Disconnect cords by grasping the plug (DON'T PULL THEM OUT BY THE CORD).

Don't use equipment that has a frayed or cracked electrical cord or plug with a missing prong.


Keep electrical devices and their cords away from heat sources.

Keep cords out of the way of traffic so they don't become tripping hazards. Don't place an electrical cord where it can be accidentally cut or become wet. Never use electrical

equipment with wet hands.

Always turn the appliance/equipment OFF before unplugging. Plug electrical equipment into the outlet with the power switch in the OFF position.

Inspect all electrical equipment before use. If you find any cracks, broken switches, or other apparent flaws, remove it from service and write up a work order or repair request. Don't use equipment that malfunctions in any way (e.g., equipment that sparks, smokes, etc.).

Don't cover or block openings in an electrical device.

If the equipment has been dropped, have it inspected before it is used again. Keep electrical appliances away from oxygen equipment. Any electric -powered motor capable of

creating a spark can ignite an oxygen explosion under certain conditions. Don't run oxygen tubing under clothing, bed covers, furniture, or carpets. Keep the oxygen

system upright. Make sure it is turned off when not in use.

Post facility-authorized signs, such as "Warning: Oxygen in Use". Enforce "no smoking" rules.

Be Aware of Special Dangers:

Oxygen increases the flammability of other materials. Extra precautions must be taken in oxygen therapy areas to prevent electrical sparks.

Operating rooms have floors that are grounded to help prevent sparks that could trigger an explosion of flammable gases. When flammable anesthetics are used, equipment must be grounded, and personnel must wear special gowns and booties so that any static charges are conducted to the ground. Electro-surgery units are potentially hazardous because very high currents are delivered to

patients.

Guidelines for Handling Electrical Emergency

Summon help. If a fire develops, stay calm; follow all facility policies and procedures. Remember that water is an electrical conductor. If you use water or another conductor on live

wires, you can become part of the circuit, causing electrical shock to yourself. In case of electrical shock:

Summon help.

Don't touch the person. If you touch the victim with your hands, you can become part of the circuit.

Turn off the power or pull the plug to the machine, tool or appliance, if it is safe to do so. If this isn't possible, call the electric company, police, EMS, etc., as appropriate per facility specific protocol.

Remember that shock can cause paralysis, respiratory failure, heart failure, and burns that can destroy skin, nerves and muscles.

Restore breathing/circulation if you are trained and authorized to do so until help arrives.

Treat the victim for shock as appropriate.


FIRE SAFETY GUIDELINES

The information contained in this section of the module is general and meant to serve only as a guideline. Follow all client facility policies and procedures about reporting fires, handling fires, and evacuating patients.

Every health care facility should have a written fire and evacuation plan available for training and for use as a reference in case of fire and/or evacuation emergency. Make sure you are familiar with your facility's plan so that if a fire emergency arises, you can react appropriately.

Note and follow the proper method for the following in each facility in which you accept assignment: (Participate in drills and training programs when they are offered.)

Location of the written fire plan, fire alarm pulls, fire extinguishers, and emergency exits. Find out what your responsibilities will be! Taking just a few minutes to locate these items can save lives! Who reports the fire to the fire department (some fire plans designate that only certain people may

do this, such as the fire marshal); procedure for transmitting the alarm to the fire department, if not automatically transmitted; and how to report details of the fire's location.

How to report the fire intra-facility, for example "Code Red" or "Dr. Red" The assembly point to use if evacuation is ordered. Managing special-needs patients during evacuation and how to deal with oxygen equipment for

patients on ventilators.

This information should be part of your orientation at the facility. If for some reason this information is not provided to you, take responsibility and become informed.

Examples of Causes of Fires in Healthcare Facilities:

Careless smoking by patients, visitors and staff. Pressurized oxygen. Flammable liquids and gases. Electrical equipment.

Preventing Fire:

Keep heat away from things that can burn. Check fire doors. Be sure they're unobstructed, that they can open easily and close tightly to

prevent fire from spreading. Keep passages clear . Furniture and equipment should not block doorways, stairways, etc.

Dispose of waste carefully. Always stay alert for fire hazards. Report dangerous or suspicious conditions to your

supervisor immediately.

General Guidelines for Handling Discovery of Fire:

Stay calm. Act in an organized, responsible manner to avoid frightening patients. Remove patients as appropriate from danger areas by following facility evacuation

protocols. Report the fire by facility-approved means. Close all doors. Fire, heat and smoke should be confined and isolated to prevent their

spread and to cut off drafts that can fan the flames. Close all doors and windows leading to fire area. Sound the alarm. Follow the instructions in the facility's fire plan for giving the fire alarm.

Instructions may include: who calls the fire department; activating the fire alarm; using a special code over the public address system; notifying the supervisor, the institution's fire marshal, other staff members and calling the switchboard.


Learn your assignment. Study the fire safety plan for each facility that you work in. Be sure

you know exactly what you have to do, step-by-step. Discuss questions with your work-site supervisor. R.A.C.E. is an acronym commonly used to stand for the major steps of fire response.

Here's what each letter stands for: Relocate people away from immediate danger, primarily by exiting the room where

the fire is located. Activate the alarm system at the fire pull station. Follow procedures for alerting

others. Contain the fire or smoke by closing doors and windows. Extinguish the fire, if time and personal safety permits and if allowed by the facility

fire plan.

Understanding Fire: Four things must be present at the same time in order to produce fire: Enough oxygen to sustain combustion, Enough heat to raise the material to its ignition

temperature, Some sort of fuel or combustible material, and

The chemical reaction that is fire.

Oxygen, heat, and fuel are frequently referred to as the "fire triangle." The chemical reaction of "fire" is usually included as the fourth element.

Take any of these four things away, and you will not have a fire or the fire will be extinguished. Fire extinguishers put out fire by taking away one or more elements of the fire triangle.

Fire safety is based upon the principle of keeping fuel sources and ignition sources separate.

It is very important to understand the four different classifications of fuel. Class C: Electrical and energized

Class A: Wood, paper, cloth, trash, and plastics. Solid combustible materials that are not metals.

Class B: Flammable liquids such as gasoline, oil, grease, and acetone. Any non-metal in a liquid state and on fire.

electrical equipment. As long as it's "plugged in," it would be considered a class C fire.

Class D: Metals such as potassium, sodium and aluminum. Found in some laboratories or in industrial settings that use these materials. It takes special extinguishing agents (e.g., Metal-X, foam) to fight such a fire.


Types of Fire Extinguishers: Most fire extinguishers will have a pictograph (picture -symbol) label telling you which fuels the extinguisher is designed to fight.

Portable fire extinguishers are intended only for small fires or as a temporary means of suppressing a larger fire until the automatic system is activated or professional firefighters arrive, consequently, they empty rapidly, sometimes in 20-30 seconds. The best way to use them is to completely discharge the extinguisher and then leave it on the floor and exit the area as quickly as possible. Please Note: Before amateur fire-fighting efforts begin or as others carry out these efforts, the fire department should be notified. Delaying notification only gives the fire a chance to grow beyond control and threaten other occupants of the facility. APW: Air -Pressurized Water: APW stands for "air-pressurized

water." APWs are large, silver extinguishers which are filled about two-thirds of the way with water, then pressurized with normal air.

Water (APW) Extinguishers are designed for Class A (wood, paper, cloth) fires only.

Do not use water to extinguish flammable liquid fires.

Do not use water to extinguish an electrical fire .

Carbon Dioxide (CO2) Extinguisher: Carbon Dioxide extinguishers are filled with non-flammable carbon dioxide gas under extreme pressure. You can recognize a CO2 extinguisher by its hard horn and lack of pressure gauge. The pressure in the cylinder is so great that when you use one of these extinguishers, bits of dry ice may shoot out the horn. CO2

extinguishers are red and available in many sizes. In the larger sizes, the hard horn will be located on the end of a long, flexible hose.

CO2 Extinguishers are designed for Class B and C (flammable liquid and electrical) fires only. CO2s may be ineffective at extinguishing Class A fires because they may not be able to displace enough oxygen to successfully put the fire out.

Dry Chemical Extinguisher (ABC): Dry Chemical

Extinguishers come in a variety of types.

Pay close attention to the type of fire the dry chemical extinguisher is meant to put out. Read the labels!

• "ABC" indicates that the extinguisher is designed to extinguish class A, B, and C fires. • "BC" indicates that the extinguisher is designed to extinguish class B and C fires. • "DC" is short for "dry chemical"

It is extremely important to identify which types of dry chemical extinguishers are located in your area. Read the labels and know their locations! You don't want to mistakenly use a "BC" extinguisher on a Class A fire, thinking that it was an "ABC" extinguisher.

Not all fuels are the same. If you use the wrong type of fire extinguisher on the wrong type of fuel, you can make matters worse. Read the labels!


Using a Fire Extinguisher

It's easy to remember how to use a fire extinguisher if you can remember the acronym PASS, which stands for Pull, Aim, Squeeze, and Sweep. Some fire extinguishers use a picture-symbol (pictograph) marking system to help determine proper use. Whether you are able to use fire extinguishers or hoses depend on facility internal policy.

Remember “PASS”: Pull, Aim, Squeeze, Sweep 1. Pull the pin. 2. Aim at the base of the fire. This will allow you to If you aim at the flames (which is discharge the frequently the temptation), the extinguisher. extinguishing agent will fly right

through and do no good. You want to hit the fuel.

3. Squeeze the top 4. Sweep from side to side until handle or lever. the fire is completely out. Start This depresses a button using the extinguisher from a that releases the safe distance away, then move pressurized forward. Once the fire is out, extinguishing agent in keep an eye on the area in case the extinguisher. it re -ignites.

Follow instructions: When officials responsible for fire fighting and evacuation arrive (fire marshall, firefighters, police, etc.), obey their orders. They are trained in handling emergencies and need everyone's cooperation.

General Guidelines for Fighting Fires: Fires can be very dangerous and you should always be certain that you will not endanger yourself or others when attempting to put out a fire. Consider the following before attempting to fight a fire: Do you know what is burning? If you don't know what is burning, you don't know what type of

extinguisher to use. Is the fire spreading rapidly beyond the spot where it started? The time to use an

extinguisher is in the beginning stages of a fire. If the fire is already spreading quickly, it may be best to evacuate according to facility protocol.

Do you have adequate or appropriate equipment? If you don't have the correct type or large enough extinguisher, it is best not to try to fight the fire. Could you inhale toxic smoke? If the fire is producing large amounts of smoke that you would

have to breathe in order to fight it, it is best not to try. The final guideline is to always position yourself with an exit or means of escape at your

back before you attempt to use an extinguisher to put out a fire. In case the extinguisher malfunctions, or something unexpected happens, you need to be able to get out quickly.

Guidelines for Removing/Evacuating Patients: The primary goal during a fire emergency is to protect patients in place while keeping smoke and flame from reaching them. However, patients may need to be moved to a safe area if fire poses an immediate danger to them or if the fire department orders evacuation.

Each facility's fire plan should indicate the authorized methods of patient evacuation, when such evacuation takes place and who makes these decisions. You must follow these facility specific rules. Please review these at each facility to which you accept assignment so that you will be prepared if a fire emergency arises.

Take advantage of any training classes at the facility. Healthcare workers should learn and practice emergency patient carries. The one you choose will depend on facility protocol, patient condition, your strength, time and training.


GENERAL HAZARDOUS COMMUNICATION: Your Right to Know

In this section of the module, you will receive general information about hazardous chemicals. You will learn:

What is a hazardous chemical, Routes of exposure,

How a hazardous chemical may affect your health,

Where to get information about hazardous chemicals you work with at client facilities, Labeling,

General information on handling chemicals safely, and

The general procedure to follow for exposure and who to contact in case of an emergency or if you have questions.

Hazard communication is a worker safety program required for all workers who use chemicals or other hazardous substances in their workplace. SYNERGY is a temporary staffing business with multi-geographic sites nationally and does not control the worksite at client facilities. However, SYNERGY does provide general training as required by OSHA in hazard communication. SYNERGY's Hazard Communication Plan may be found in the Quality Improvement Manual located in your local SYNERGY office. Site specific training must necessarily be done by SYNERGY's client facilities.

Chemical Hazards: Four basic characteristics make chemicals hazardous. • Toxic: Poisonous in the long or short term. May cause cancer, birth defects, or other disease. Examples include pesticides and a variety of other chemicals. Anything can be toxic in a large enough quantity, even water. • Corrosive: Burns human tissue, corrodes metals and other materials. Examples include pool acids and a variety of cleaning products. • Flammable : Catches fire easily or burns intensely. High vapor pressure and low flashpoint

materials. Examples include gasoline, solvents, phosphorous and magnesium. • Reactive : Spontaneously produce violent/hazardous reactions when they come into contact with common materials such as air or water. They can explode, produce heat, or release toxic gases. Examples include peroxides, aluminum compounds, cyanide compounds and chloride compounds.

Routes of Exposure: In order for a chemical to affect a person's health, it must somehow get into the body. Entry into the body may happen through one of four basic routes of exposure: • Eye/Skin Contact: Damage is done to the skin/eyes at the point of contact (such as burns and dermatitis). Generally, this is an obvious route of exposure that is easily noticed. • Skin Absorption: The chemical penetrates through the skin and into your blood stream where it is distributed throughout the body. This generally occurs without obvious sensation-- it can happen without you knowing it. • Ingestion: The chemical is eaten and gets into your bloodstream. Many chemicals

are hazardous when eaten. Unintentional ingestion can happen when your mouth is open, when you are smoking cigarettes, when hands are not washed before eating, or when you eat in a contaminated environment.

Inhalation: The lungs are designed to take oxygen out of the air and put it into your blood, so they are also excellent at doing the same with hazardous chemicals. Contact damage can also occur by inhaling acid vapors/mists or asbestos fibers. You can inhale chemicals in the form of dusts, fumes, mists, vapors, or gases.

Once introduced into your bloodstream, chemicals are distributed throughout the body. Each chemical has its own set of target organs to which it may cause damage. For example, solvents tend to hurt the liver, mercury the central nervous system, and methanol the eyes.


Health Effects: The health effects caused by chemicals can be broadly classified as acute (shortterm, immediate) and chronic (long term, cumulative). Chemicals can be generally classified according to the health effects they cause, including:

• Teratogens: Chemicals which cause birth defects and reproductive harm in males or females. For males, examples include lead and ethylene glycol ethers. For females, examples include organic solvents (glycol ethers, toluene) and ethylene oxide.

• Carcinogens: Chemicals which cause cancer. Examples include benzene, chromium , coal tars and soot, DBCP pesticide, formaldehyde, some mineral oils , and PCBs . • Sensitizers: Chemicals which cause the body to develop an allergic reaction, typically pulmonary or dermatologic (skin) in nature, similar to what happens upon exposure to poison oak or poison ivy. Chemical examples include latex protein (found in latex surgical gloves), turpentine, formaldehyde, chromic acid, epoxy resin components , nickel and cadmium. • Many other health affects can also occur, such as dermatitis from the repeated drying effect of solvents and scarring of lung tissue from particles of asbestos fibers and silica dust.

It is important to remember that many of the health effects of chemicals, especially combinations of chemicals, are unknown. The health effects we know about were for the most part discovered in hindsight, such as asbestos, cigarette smoke, formaldehyde, lead, and saccharin. Therefore, the best practice is to minimize exposure to all chemicals.

Getting Information About Hazardous Chemicals: Material Safety Data Sheets (MSDS)

Most of the health hazard information mentioned above can be found in Material Safety Data Sheets (MSDS), which are essentially detailed product labels. Manufacturers must provide an MSDS for any product they make that contains hazardous components or parts. Also, state and federal regulations require chemical inventory and MSDSs for all such products used in a work-area. These must be readily accessible for reference by employees during routine work hours and in emergencies. Just about everything has an MSDS, from exotic laboratory chemicals, to common paints, to liquid paper.

If you do not know where MSDSs for your work-site/work-area are located, ask your supervisor.

All MSDSs are required by law to provide specific information about the subject product, although the quality of the information and how it is presented varies greatly. In general, MSDSs provide the following information: • The chemical name, synonyms, manufacturer, and an emergency contact number. • Hazardous ingredients.

• Physical description (e.g., boiling point, vapor pressure, basic chemical parameters, appearance and odor). • Fire and explosion data, including flash point and how to extinguish. • Reactivity data (e.g., incompatible materials). • Health hazard information similar to that discussed previously and including symptoms of over- exposure. • Other information relating to clean-up, disposal, special precautions, control measures and protective equipment.

Your Rights: The worksite is required to have MSDSs available for every hazardous chemical or substance you use or encounter as a part or your job. These must be readily accessible for review at all times you are in the work place. Depending on state law, you may also have additional rights.

Check each worksite's written hazardous communication plan for site -specific information.


Chemical Labeling: State and federal regulations require that all chemical containers be labeled with ingredient and hazard information. Most over the counter products have this information printed on them (e.g., bug spray, spray paint, solvents). Always read the labels provided on the products you use!

The chemical labeling systems most commonly used are the Hazardous Materials Identification System (HMIS) and the National Fire Protection Association (NFPA) diamonds. (See illustration below. ) These systems rely on color-coding and a numerical rating system to identify the hazard and its severity.

Color-coding: • BLUE = Health Hazard • RED = Flammability Hazard • YELLOW = Reactivity Hazard

Numbers indicate the degree of hazard: 0 = Minimal 1 = Slight 2 = Moderate 3 = Serious 4 = Extreme

Information indicating what numbers to assign to each category can be obtained from the MSDS or the individual in charge of the hazardous communication program at the facility in question. Often times HMIS or NFPA numbers will be given directly in the MSDS.

Employee Training: Employee training should be conducted prior to the first assignment in which hazardous substances will be encountered and annually thereafter.

Protection from Chemicals :

Engineering Controls: Many safety devices are built into worksites. Using these safety devices is your first and most important defense against chemical injuries. Examples of safety devices include ventilation systems, emergency shutoffs, baffles and hand guards.

Personal Protective Equipment: If engineering controls can’t eliminate all the hazards in the workplace, then personal protective equipment (PPE) should be supplied and used. It is your responsibility to wear PPE once you have received it and been trained on its use.PPE may include gloves, goggles, gowns, steel boots, etc. Check with your facility supervisor to make sure you have the appropriate protective equipment if you have any doubts whatsoever. If the MSDS says to use a respirator or protective gloves, find out from your facility supervisor about the specific type you should use.

Avoid Inhalation • Use proper ventilation • Use respiratory protection

Prevent Ingestion • No eating, drinking, or smoking around chemicals • Wash hands frequently • Read labels

Prevent Skin or Eye Contact • Wear protective equipment • Minimize the area of exposed skin

Examples of Protective Measures

• Follow all procedures and policies relating to

chemicals or other hazardous substances. • Avoid operations without proper instruction and/or

authorization. • Ask questions/request information. • Wear appropriate protective equipment. Report

accidents immediately to your facility supervisor and to your local SYNERGY office, even minor injuries or exposures. Fill out incident or accident


General Emergency Guidelines:

Recognizing Hazardous Conditions: A key element in working safely with chemicals is to be able to identify hazardous conditions. The methods indicated below should be used as general warning signs of hazardous conditions. Always follow all facility policies and procedures for evacuation and emergency procedures.

• Strong Odors: Often times when a large chemical spill has occurred, you can smell the vapors. However, great caution should be exercised when relying upon your nose since some chemicals will not have an odor, some will immediately fatigue your sense of smell at dangerous levels, and others already present a significant hazard by the time you smell them. The key is to read the MSDSs for the chemicals you work with (especially the ones you work with in bulk) and know their characteristics.

• Burning/Itching Eyes or Skin: Some chemical vapors (e.g., acids) start to burn on contact. • Restrictive Breathing: Some chemicals may irritate your respiratory tract and cause your chest or throat to tighten. • Visible Clouds or Mists • Large Surface Area Spills

When identifying hazardous conditions extreme care and caution should be used. Recognize that PPE used in everyday operations may not provide adequate protection. If you see any of the warning signs indicated above or have any concerns, contact your facility supervisor or safety administrator immediately and follow instructions.

Exposure: In the event that you are exposed to chemicals, the following general emergency guidelines may need to be enacted (client facilities may have additional emergency procedures which you should follow):

• Shower: Flush exposed areas for at least 15 minutes. Remove contaminated clothing or PPE while under the water stream. Seek medical attention. • Eyewash: Flush your eyes for at least 15 minutes. Do not rub your eyes. Hold them open and roll them around in the water stream. Know where eyewashes and eyewash stations are located in your work area. Report eyewash stations that malfunction when tested. Seek medical attention. • Fresh Air: If you have inhaled hazardous vapors, immediately get to a source of fresh air

(i.e., outside if possible). • Ingestion: If you swallow chemicals, seek medical attention immediately and do not induce vomiting without medical advice (the MSDS should be consulted as well). Some chemicals are hazardous when vomited.

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In any type of chemical exposure , follow facility emergency procedures for decontamination (shower, eye wash). Seek immediate medical attention. MSDS should be consulted to determine what type of actions to take. Inform your facility supervisor and your local SYNERGY office as soon as possible. Fill out reports as requested. If you have additional concerns over the hazards of a specific chemical (acute or chronic effects), contact the work-site supervisor, safety committee representative or designee.


GENERAL BODY MECHANICS : Guidelines for Lifting and Moving Safety

It is the policy of SYNERGY to offer training to employees in the general principles of good body mechanics and the application of these in order to prevent fatigue, strain, or injury to the patient and/or employee.

Healthcare Associates must always follow facility-specific policies and procedures, including use of facility-approved safety equipment. Patients are to be moved/transferred only according to physician's orders and/or by facility approved methods appropriate to the specific patient and in which you have training. Always consult supervisor if you are unsure of transfer technique for a specific patient. Seek the assistance of co-workers if you feel help is needed to safely move any patient.

∗ REPORT ALL PATIENT and EMPLOYEE INJURIES to the FACILTY and to SYNERGY.

The most common injury reported by health care workers is back injury! Education is the key to preventing this from happening to you. General principles of good body mechanics are illustrated below.

Common Ergonomic Injuries and Their Causes

Strains and sprains: most often to the back, fingers, ankles and knees due to improper lifting or carrying techniques.

Repetitive motion injuries: most often to fingers, hands, wrists, neck and back from repeating one motion over and over or from poor posture or positioning.

Eyestrain, headaches and fatigue: due to poor lighting, posture or positioning, or to noise. Adjust

Your Equipment and/or Workstation to Prevent Ergonomic Injuries Adjust your chair height and backrest (feet should be flat on the floor, knees level with hips,

and lower back supported). Use a footrest and cushion or pillow as needed.

Sit at least an arm's length away from the computer screen. Keep wrists straight and elbows at right angles. Reduce glare by changing screen position or lighting.

Adjust your position, stretch, and change your pace of work throughout the day.

Tips for Keeping in Shape

Strive for your ideal weight goals.

Get plenty of rest.

Maintain proper posture. Avoid slouching when walking and sitting.

Exercise regularly after getting approval from your doctor. Many patient care activities require the health care worker to push, pull, lift, and carry. By using proper body mechanics, you can avoid injury and fatigue.


Good Body Mechanics Can Be Summarized by Three Principles

Keep a low center of gravity by flexing your hips and knees instead of bending at the waist. This position distributes your weight evenly between the upper and lower body and helps you maintain your balance. Create a wide base of support by spreading your feet apart. This stance provides lateral

stability and lowers your center of gravity. Maintain proper body alignment and keep your center of gravity directly over the base of

support by moving your feet rather than twisting and bending at the waist.

Pull or Push When Possible Pushing and Pulling: Pushing or pulling requires less energy. Stand close to the object and

place one foot slightly ahead of the other, as in a walking position. Tighten your leg muscles and set your pelvis by contracting the abdominal and gluteal muscles at the same time.

To Push: Place your hands on the object and flex your elbows. Lean into the object by shifting your weight from the back leg to the front leg, and apply smooth, continuous pressure. To Pull: Grasp the object and flex your elbows. Lean away from the object by shifting weight

from the front leg to the back leg. Pull smoothly, avoiding sudden, jerky movements. Stooping: Stand with your feet 10" to 12" apart, with one foot slightly ahead of the other to widen

your base of support. Then lower yourself by flexing your knees, and place more weight on the front foot than on the back foot. Keep your upper body straight by not bending at the waist. To stand up again. Straighten your knees and keep your back straight.

General Guidelines for Moving, Lifting and Carrying Objects Wear shoes with low heels, flexible non-slip soles, and closed backs.

Assume correct position before initiating moving or lifting.

Face the object you are going to lift. Size up the load!

Place feet wide enough apart to have good balance and place one foot well in front of the other.

Carry balanced loads. Keep your back straight.

Bend the knees to lower your body to the level where you are working. Bend with your knees only, don't bend from your waist or bend with straight knees.

Bend elbows and keep them close to your body.

Push, pull, glide or roll an object which is to be lifted or moved. Work as close as possible to an object which is to be lifted or moved (hug the load).

Use the weight of the body as a force for pulling or pushing by rocking on the feet.

Lift objects by straightening your legs .

Don't arch your back and neck to reach or lift an object. Knowing how to lift and move patients the right way is the key to protecting your patient's safety and your own personal safety.

Patient Transfers: Some patients cannot or should not move themselves. For example, patients who are immobilized due to injury; those having medical conditions that make it difficult to move about, such as victims of stroke, arthritis or certain types of cancer; and those recovering from surgery that leaves them temporarily weak or unable to move themselves.


Injuries that happen while transferring patients are among the most common seen in health care workers. Most accidents and injuries can be prevented if you know the basics of body mechanics as indicated above for lifting and moving and take care to use proper technique and caution whenever you lift or move a patient.

Possible consequences of trying to lift without using caution, common sense and proper technique could include strains, sprains, hernias, and muscle spasms.

Advances in patient transfer equipment offer improved performance, increased weight capacity, and greater user-friendliness. Such equipment is also safer and more comfortable for the patient. Equipment options include gait belts for the patient, slider boards, slider sheets, mechanical lifts, and overhead hoists. Always follow physician's orders and facility-specific policies and procedures for use of these devices on any patient. You should only use assistive devices in which you have been trained, otherwise, get assistance from co-workers or supervisor.

Before beginning any transfer, explain the procedure to the patient and demonstrate his or herrole. After all transfers, position the patient comfortably and re-apply safety straps, raise the side rails, etc., as appropriate for the particular patient. Make sure the patient can reach the nurse call button.

Applying Body Mechanics to Lifting and Moving Patients and Other Loads Think ahead and evaluate the situation (size up the load). Consider each patient's medical

condition, strength, mobility, etc., before attempting any lift or carry. Let the patient know exactly what you'll be doing to calm any fears and encourage cooperation. Read doctor's orders, patient care plans, check with a supervisor/charge nurse, etc. before moving a patient if you are unsure about how to move or lift the patient. Wear gloves if necessary.

Use your strongest muscles. Since leg muscles support the bulk of the body's weight whenever you stand, walk, run, etc., these muscles are much stronger than lower back muscles. By squatting, bending your knees, keeping your back straight and lifting with your legs, you can avoid strain on back muscles (and lift more weight). Position the equipment. Place the wheelchair, stretcher, gurney, etc., as close to the patient as

possible and in proper alignment for the shortest, easiest transfer. Make the necessary adjustments. Adjust the chair, stretcher, etc., to bed level (or vice versa),

and lower any handrail or side rail. This will minimize the amount of lifting or lowering required. Be sure to lock the wheels on the chair and/or bed. Keep your feet apart, straighten your spine . This will provide a stable base, help you maintain

your balance and leave you more energy for the lift. Your feet should be at least shoulder width apart in preparation for lifting. Straighten your spine. Use your arms and legs. Remember the importance of lifting with your legs and not your back.

Center your body weight evenly between your feet. Tuck your elbows into your body. Your upper arms should touch your ribs. Slide the patient. By pulling or pushing the patient as far as possible, you can help minimize the

move. Use a turn sheet if possible. Hold the patient close . This will help your balance and reduce strain on your arms and back. Lift in unison. When working with others, make sure everyone knows what to do in advance and

moves at the same time. Avoid sudden, jerky movements. When setting patients or items down, bend at the knees, not the back. Don't take chances and get help if you need it. Use only those procedures with which you are

familiar and have had training in. Don't hesitate to ask questions or seek help if you're unsure of which procedure to use, or if you don't think you can handle the lift or carry without strain. It's better to be safe than sorry.


GUIDELINES FOR PREVENTING WORKPLACE VIOLENCE

Purpose: SYNERGY has the following policy in compliance with OSHA guidelines (Safety and Health Program Management 1989) regarding provision of safe and healthful work environment.

Policy: The contents of this policy are merely general guidelines as SYNERGY is a temporary staffing business with multi-geographical locations and clients and does not control the work environment at client facilities. SYNERGY does, however, provide general training on OSHA's workplace violence guidelines. Specific workplace violence training should be provided by client facilities as applicable and appropriate.

General Information:

1. Violence can happen in any department or area of a healthcare work-site such as emergency departments, admissions, intensive care units and pharmacies. Violence can also occur in parking lots, elevators, stairways and at any time of the day or night. Examples of workplace violence may include:

Physical altercations Attempts to cause physical harm

Rapes Bringing weapons into the workplace Verbal threats to inflict bodily harm

2. Workplace violence may be committed by strangers; customers, clients, patients or their families and friends; co-workers; and by personal relations of employees and co-workers.

3. Economic impact of workplace violence could include: lost work days, lost wages, lost productivity, property damage, and diminished public image.

4. Factors that can increase the likelihood of violence:

A history of violence or aggression Head injuries

Alcohol or other substance abuse Certain brain disorders

5. Examples of behavior that could precede violence:

Making threats, talking about carrying weapons

Screaming, cursing, challenging authority

Restlessness, pacing

Violent gestures (e.g., like pounding on the wall or desk)

6. Examples of risk factors for workplace violence in healthcare environments: Prevalence of handguns and other weapons among the public in general

Healthcare workers may work in small groups or alone (as in home health or private duty)

Healthcare workers may have to work late night or early morning

Availability of drugs and money at hospitals, clinics, pharmacies, making them robbery targets Unrestricted movement of the public in clinics and hospitals (i.e. there may be extensive

contact with the public)

Presence of gang members, drug/alcohol abusers, trauma patients, and distraught family members in certain work areas

Work site may be in a high crime area or location Isolated work with clients during exams or treatment Lack of training in recognizing and managing escalating hostile and aggressive behavior

Poorly lighted parking areas


7. Employees should promptly report incidents of workplace violence to their work-site supervisor and to their local SYNERGY office.

8. Healthcare Associates should understand and comply with the workplace violence prevention programs in facilities in which they accept assignment. Employees are not to engage in violent conduct at any time while on assignment.

9. Healthcare Associates should follow general safety guidelines:

Treat everyone with respect.

Check patient charts ahead of time (if applicable and possible). Watch for any warning signs of violence and call for assistance when uncomfortable with any

situation. Follow facility-specific procedures for how to handle/report the situation.

Remain alert for potential for violence, especially in unfamiliar surroundings; request that facility security accompany to car (if applicable in the facility); have car keys ready for use; avoid carrying purses or other valuables (if possible); lock valuables up in locker if available at work-site; do not leave medications and medication keys unattended.

Take advantage of violence prevention classes at client facilities or community. Report any security hazards, such as unlocked doors, broken lights, etc. to supervisor.

Please take the Quiz that follows


POST-TEST GENERAL SAFETY SELF-STUDY LEARNING MODULE No. 2

1. Which of the following statements is

FALSE with respect to general electrical safety?

a. Electricity can damage the nerve cells, heart and skin

b. Only qualified electrical personnel should repair electrical equipment

c. Electrical cords should be disconnected by pulling them out by the cord

d. Extra precaution is needed when oxygen is being used in healthcare.

2. The Emergency Preparedness plan of each facility (hospital, nursing home,

doctor's office, etc.) should be reviewed for specific information on how to handle emergencies at the particular facility.

a. True b. False

3. Regarding fire extinguisher use, the acronym P.A.S.S. stands for "Protect, Alert, Suppress and Summon"

a. True b. False

4. Which of the following are part of the "fire triangle"?

a. Oxygen b. Heat c. Fuel d. All of the above e. None of the above

5. Which of the following are included in an MSDS:

a. Chemical name b. Health hazard c. What to do in case of exposure d. All of the above e. None of the above

6. Hazardous chemicals can enter the body by which of the following routes?

a. Eye and skin contact b. Skin absorption c. Ingestion (eaten) d. Inhaled (breathed) e. All of the above

7. Which of the following statements are TRUE about moving and lifting:

a. Bend your knees c. Hold the object/person close, "hug the

load" c. Avoid twisting d. All of the above e. None of the above

8. Only serious patient falls and injuries need to be reported.

a. True b. False

9. Back injury is the least common type of work-related injury among healthcare workers.

a. True b. False

10. Which of the following statements is TRUE about workplace violence:

a. Workplace violence is very rare in healthcare settings.

b. Nothing can be done to decrease workplace violence.

c. Incidents of workplace violence should be reported to your work-site supervisor and to your local SYNERGY office.

d. Patients, families and co-workers are never a violence threat in healthcare settings.


ANSWER KEY

GENERAL SAFETY SELF-STUDY LEARNING MODULE No. 2 SYNERGY Office Instruction: A score of 100% is required. If this score is not achieved, please have Applicant or Healthcare Associate review the material on the missed question(s) before retaking that question. The retake answers may be written in next to the missed answer on the answer sheet. 1. C 6. E 2. A 7. D 3. B 8. B 4. D 9. B 5. D 10. C


Name:___________________________________________________ Date:___________ APPLICANT/HEALTHCARE ASSOCIATE ANSWER SHEET

GENERAL SAFETY SELF-STUDY LEARNING MODULE No. 2 1. ______ 6. ______ 2. ______ 7. ______ 3. ______ 8. ______ 4. ______ 9. ______ 5. ______ 10.______

General safety Module 2008 2 - Synergy Medical Staffingsynergymedicalstaffing.com/career/templates/synergy/forms/General...General Safety Self-Study Learning Module ... Failure to

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