Occupational Safety and Health Course for Healthcare Professionals

Occupational Safety and Health Course for Healthcare Professionals

Define key terms in Subpart E & L. Identify the key elements of the regulations. Discuss the implications of these regulations for

healthcare settings.

1.45 million fires in the United States. Over 3300 civilian deaths; 16,705 injuries. 15.4 Billion in property loss. 34% of these fires were in structures.

* NFPA, Fire Loss in the United States, 2008; revised September 2009.

Exit Routes, Emergency Action Plans, and Fire Prevention Plans

1910.33 – 1910.39

1910.35: An employer who demonstrates compliance with the exit route provisions of NFPA 101-2000, the Life Safety Code, will be deemed to be in compliance with the corresponding requirements in 29 CFR 1910.34, 1910.36, and 1910.37.

For automatic sprinkler systems, may follow NFPA and National Board of Fire Underwriters standard in place at the time of installation.

A resource for many organizations.

Exit Route: a continuous and unobstructed path of exit travel from any point within a workplace to a place of safety.

Exit access: that part of an exit route that leads to an exit (a corridor that leads to a stairway(Exit).

Exit: that part of an exit route that provides a protected way of travel to the exit discharge.

Exit Discharge: the part of the exit route that leads directly outside or to a street, walkway, refuge area, or open area with access to the outside.

Exit routes must be permanent. An exit must be separated by fire resistant

materials. Openings into an exit must be limited. The number of exit routes must be adequate. Exit discharge must lead directly outside. Exit doors must be unlocked from the inside. A side-hinged exit door must be used. Exit route: ceiling at least 7’6” high, 28” wide.

The danger to employees and patients must be minimized.

Must be free and unobstructed. Safeguards (sprinklers, alarms, exit lighting) must

be in working order at all times. Lighting and marking of exits must be clearly

visible. Signs must say EXIT, at least 6” high, by ¾”.

Key aspects: Clear and unobstructed!

(b)(1) At least two exit routes must be available in a workplace to permit prompt evacuation during an emergency:

The exit routes must be located as far away as practical from each other so that if one exit route is blocked by fire or smoke, employees can evacuate using the second exit route

Procedures for: * reporting a fire * emergency evacuations * employees who remain to operate critical plant operations before they evacuate * accounting for all employees and patients after evacuation

(b) An emergency action plan must be in writing, kept in the workplace, and available to employees for review.

However, an employer with 10 or fewer employees may communicate the plan orally to employees

EAP

Emergency care procedures. Alarm system for employees. Employer must designate and train employees to

assist in a safe and orderly evacuation of other employees.

Review the action plan with employees when they start their job, when their responsibilities in the plan change, or when the plan changes.

An employer must designate and train employees to assist in a safe and orderly evacuation of other employees.

Plans should address emergencies that the organization can reasonably expect in the workplace:

* Fire * Toxic chemical release * Hurricanes * Tornadoes * Floods * ?others

A fire prevention plan must include:◦ list of all major fire hazards, ◦ proper handling and storage procedures for hazardous

materials, ◦ potential ignition sources and their control, and ◦ the type of fire protection equipment necessary to control

each major hazard.

Procedures to control accumulations of flammable and combustible waste materials

Need to assure that an adequate number of employees are available at all times during working hours to act as “evacuation wardens” so that employees can be swiftly moved from the danger location to safe areas.

They must know the correct place to direct employees, trained in workplace layout and alternative escape routes, aware of handicapped employees who may need extra assistance, check all rooms and enclosed spaces for employees, an account for or verify that all employees are in the safe areas.

This subpart contains requirements for: ◦ Fire brigades

◦All portable and fixed fire suppression equipment

◦ Fire detection systems

◦ Fire or employee alarm systems

1. Oxygen source

2. Fuel source

3. Ignition mechanism

"Class A fire" - involves ordinary combustible materials such as paper, wood, cloth, and some rubber and plastic materials.

"Class B fire" - involves flammable or combustible liquids, flammable gases, greases and similar materials, and some rubber and plastic materials.

"Class C fire" – involves energized electrical equipment where safety to the employee requires the use of electrically nonconductive extinguishing media.

“Class D fire” – fire involving combustible metals such as magnesium, titanium, zirconium, sodium, lithium, and potassium.

Noted in CAMH (Jan 2009) LS.O2.01.35 Kitchen grease and oil fires. Significant risk area. Avoid splashing.

Never pick up a burning pan of grease!

(a)Scope:◦ The placement

◦Use

◦Maintenance

◦ Testing of portable fire extinguishers provided for the use

of employees.

◦ Training and education

Employee Education * General principles of fire extinguisher use * Upon employment, if role or equipment changes, and annually

Inspection, maintenance and testing * Portable extinguishers: inspected every 30 days * Annual maintenance

If required: The employer shall provide portable fire extinguishers

and shall mount, locate and identify them so that they are readily accessible to employees without subjecting the employees to possible injury.

Visually inspected annually and tagged with date of the inspection.

* Are selected and distributed based on the classes of anticipated workplace fires and on the size and degree of hazards affecting their use.

Travel distance to extinguisher: 75 ft

For Class K (grease fire areas): 30 ft

Fires in hospitals are never good. Devastating results. Need to protect patients and employees from the

serious hazard of a fire.

What we have learned…..

What we can do…..

April 13th, 1918: Oklahoma City, State Hospital – 38 May 15th, 1929: Cleveland Clinic – 125 April 5th, 1949: St. Anthony’s Hospital, Illinois – 74 Jan 7th, 1950: Mercy Hospital, Davenport, Iowa - 41 July 14th, 1960: Guatemala City, Mental Hospital - 235 December 8, 1961: Hartford Hospital, CT - 15 May 20th, 1980: Kingston, Jamaica, Nursing Home.

Many others with similar outcomes.

Serious issue with serious outcomes Much has been done in the last few years through

education and preparation to prevent these fires. Consider the risk factors: * Oxygen rich environment * Lots of fuel sources – paper and cloth drapes,

antiseptic agents, endotracheal tubes, plastic masks, etc.

* Ignition sources: electrocautery, lasers, light sources.

Kitchen fires

Electrical fires

OR fires

Waste material fires

Fires due to smoking

Recognize the importance of employee education. Special focus in OR’s/special procedure areas. Reminders. Debriefing after drills/events.

What can happen with simple appliances?

How can we prevent this?

Keys to success: * a clear plan * employee education and practice * clarity & ease of fire exits * awareness/abatement of potential fire hazards.

Think Safety, Not Just Compliance!