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Completed by: Click here to enter text. Signature: Click here to enter text. Date: Click here to enter text. IDENTIFY RISK ANALYZE RISK ASSESS RISK MANAGE RISK Critical Activity / Tasks Similar Exposure Groups (SEGs) Mode of Transmission Potential Risks of Exposure Existin g Control s Risk Factor s Likelihoo d (1-5) Severit y (1-5) Total (1- 10) Priorit y (L/M/H) Uncertaint y (L/M/H) Standards Proposed Controls Person Assigned Target Date Status (NS/IP/C) 1. Personal Protective Equipment (PPE) 1.1. Wearing and Removing PPE All Contact Direct contact (with infectious blood or body fluids) to unprotected skin Click here to enter text. Click here to enter text. Click here to enter text. Click here to enter text. Clic k here to ente r text . Click here to enter text. Click here to enter text. Click here to enter text. Click here to enter text. Click here to enter text. Click here to enter text. Click here to enter text. Contact Indirect contact (with objects that have been contaminated with infectious blood or body fluids) to unprotected skin Click here to enter text. Click here to enter text. Click here to enter text. Click here to enter text. Clic k here to ente r text . Click here to enter text. Click here to enter text. Click here to enter text. Click here to enter text. Click here to enter text. Click here to enter text. Click here to enter text. Contact Inadvertant touching of face and mucus membranes of eyes, noise, Click here to enter text. Click here to enter text. Click here to enter text. Click here to enter text. Clic k here to ente r Click here to enter text. Click here to enter text. Click here to enter text. Click here to enter text. Click here to enter text. Click here to enter text. Click here to enter text. Infectious Disease Threat Organizationa Risk Assessment (IDT ORA) Tool 1 © Public Services Health and Safety Association
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Page 1: terraform-20180423174453746800000001.s3.amazonaws.com…  · Web view2020-01-23 · Cross contamination through waiting area furniture. Click here to enter text. Click here to enter

Completed by: Click here to enter text.Signature: Click here to enter text.Date: Click here to enter text.

IDENTIFY RISK ANALYZE RISK ASSESS RISK  MANAGE RISK

Critical Activity / TasksSimilar

Exposure Groups (SEGs)

Mode of Transmissio

nPotential Risks of

ExposureExisting Controls

Risk Factor

sLikelihood

(1-5)Severit

y(1-5)

Total (1-10)

Priority(L/M/H)

Uncertainty (L/M/H)

Standards

Proposed Controls

Person Assigne

dTarget Date

Status (NS/IP/C)

1. Personal Protective Equipment (PPE)  1.1. Wearing and

Removing PPEAll Contact Direct contact

(with infectious blood or body fluids) to unprotected skin

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Contact Indirect contact (with objects that have been contaminated with infectious blood or body fluids) to unprotected skin

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Contact Inadvertant touching of face and mucus membranes of eyes, noise, and/or mouth

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Contact Exposure during removal of PPE (e.g., incorrect sequence, self and cross contamination)

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Contact Percutaneous Click Click Click here Click Click Click Click here Click here Click Click Click Click

Infectious Disease Threat Organizationa Risk Assessment (IDT ORA) Tool 1© Public Services Health and Safety Association

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Completed by: Click here to enter text.Signature: Click here to enter text.Date: Click here to enter text.

IDENTIFY RISK ANALYZE RISK ASSESS RISK  MANAGE RISK

Critical Activity / TasksSimilar

Exposure Groups (SEGs)

Mode of Transmissio

nPotential Risks of

ExposureExisting Controls

Risk Factor

sLikelihood

(1-5)Severit

y(1-5)

Total (1-10)

Priority(L/M/H)

Uncertainty (L/M/H)

Standards

Proposed Controls

Person Assigne

dTarget Date

Status (NS/IP/C)

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Droplet Infectious agent comes in contact with unprotected skin or mucus membranes

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Droplet / Airborne

Infectious agent enters person's breathing zone

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All Breach of PPE (e.g., tears, incompatibilities, equipment failure, glove separates from the sleeve) and exposure to intact and non intact skin

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2. Transport Patients

Infectious Disease Threat Organizationa Risk Assessment (IDT ORA) Tool 2© Public Services Health and Safety Association

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Completed by: Click here to enter text.Signature: Click here to enter text.Date: Click here to enter text.

IDENTIFY RISK ANALYZE RISK ASSESS RISK  MANAGE RISK

Critical Activity / TasksSimilar

Exposure Groups (SEGs)

Mode of Transmissio

nPotential Risks of

ExposureExisting Controls

Risk Factor

sLikelihood

(1-5)Severit

y(1-5)

Total (1-10)

Priority(L/M/H)

Uncertainty (L/M/H)

Standards

Proposed Controls

Person Assigne

dTarget Date

Status (NS/IP/C)

2.1 Transporting and Receiving Patients - Intrafacility

Health Care Workers / Security

Contact Direct patient contact while transporting or assisting

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Droplet Infectious agent comes in contact with unprotected skin or mucus membranes

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Droplet / Airborne

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Contact / Droplet

Cross contamination through staff, equipment (e.g., stretcher, wheel chair) and/or materials (e.g., patient belongings)

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2.2 Transporting and Receiving

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Infectious Disease Threat Organizationa Risk Assessment (IDT ORA) Tool 3© Public Services Health and Safety Association

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Completed by: Click here to enter text.Signature: Click here to enter text.Date: Click here to enter text.

IDENTIFY RISK ANALYZE RISK ASSESS RISK  MANAGE RISK

Critical Activity / TasksSimilar

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Mode of Transmissio

nPotential Risks of

ExposureExisting Controls

Risk Factor

sLikelihood

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Total (1-10)

Priority(L/M/H)

Uncertainty (L/M/H)

Standards

Proposed Controls

Person Assigne

dTarget Date

Status (NS/IP/C)

Patients - Interfacility Transport

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Droplet Infectious agent comes in contact with unprotected skin or mucus membranes

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Droplet / Airborne

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Contact / Droplet

Cross contamination through staff (including EMS), equipment (stretcher) and/or materials (patient records, personal belongings)

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Infectious Disease Threat Organizationa Risk Assessment (IDT ORA) Tool 4© Public Services Health and Safety Association

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Completed by: Click here to enter text.Signature: Click here to enter text.Date: Click here to enter text.

IDENTIFY RISK ANALYZE RISK ASSESS RISK  MANAGE RISK

Critical Activity / TasksSimilar

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nPotential Risks of

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Risk Factor

sLikelihood

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Priority(L/M/H)

Uncertainty (L/M/H)

Standards

Proposed Controls

Person Assigne

dTarget Date

Status (NS/IP/C)

close proximity of seating during transportation (i.e., ambulance)

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3. Points of Entry and Common Areas

3.1 Providing Information and Direction

Volunteers Contact Direct patient contact while transporting or assisting

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Droplet Infectious agent comes in contact with unprotected skin or mucus membranes

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Droplet / Airborne

Infectious agent enters person's breathing zone

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3.2 Waiting in Common Area

Patients Contact Cross contamination through waiting

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Infectious Disease Threat Organizationa Risk Assessment (IDT ORA) Tool 5© Public Services Health and Safety Association

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Completed by: Click here to enter text.Signature: Click here to enter text.Date: Click here to enter text.

IDENTIFY RISK ANALYZE RISK ASSESS RISK  MANAGE RISK

Critical Activity / TasksSimilar

Exposure Groups (SEGs)

Mode of Transmissio

nPotential Risks of

ExposureExisting Controls

Risk Factor

sLikelihood

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Priority(L/M/H)

Uncertainty (L/M/H)

Standards

Proposed Controls

Person Assigne

dTarget Date

Status (NS/IP/C)

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All Exposure due to crowded or close proximity in seating

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4. Emergency Department (ED)

4.1 Registering Patients

Registration Staff Contact Direct and

indirect patient contact while registering hospital visit

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Droplet Infectious agent comes in contact with unprotected skin or mucus membranes

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Infectious Disease Threat Organizationa Risk Assessment (IDT ORA) Tool 6© Public Services Health and Safety Association

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Completed by: Click here to enter text.Signature: Click here to enter text.Date: Click here to enter text.

IDENTIFY RISK ANALYZE RISK ASSESS RISK  MANAGE RISK

Critical Activity / TasksSimilar

Exposure Groups (SEGs)

Mode of Transmissio

nPotential Risks of

ExposureExisting Controls

Risk Factor

sLikelihood

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Priority(L/M/H)

Uncertainty (L/M/H)

Standards

Proposed Controls

Person Assigne

dTarget Date

Status (NS/IP/C)

Droplet / Airborne

Infectious agent enters person's breathing zone

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4.2 Waiting for Registration, Care and Treatment

Patients and Other Visitors Contact Cross

contamination through waiting area furniture

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All Exposure due to crowded or close proximity in seating and line ups

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4.3 Conducting Triage and / or Isolating Patient

Triage Nurse Contact Direct and indirect patient contact during triage and / or transporting to private isolation room

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Droplet Infectious agent comes in contact with unprotected skin or mucus

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Infectious Disease Threat Organizationa Risk Assessment (IDT ORA) Tool 7© Public Services Health and Safety Association

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Completed by: Click here to enter text.Signature: Click here to enter text.Date: Click here to enter text.

IDENTIFY RISK ANALYZE RISK ASSESS RISK  MANAGE RISK

Critical Activity / TasksSimilar

Exposure Groups (SEGs)

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nPotential Risks of

ExposureExisting Controls

Risk Factor

sLikelihood

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Standards

Proposed Controls

Person Assigne

dTarget Date

Status (NS/IP/C)

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Contact / Droplet

Cross contamination and spread through EMS transport staff and equipment (e.g., stretchers)

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5. Clinical Diagnostic and Treatment

5.1 Evaluating and Diagnosing PUI

Clinical Staff (Physicians,

Nurses, Specialists,

etc.)

Contact Direct and indirect patient contact during clinical diagnosis and treatment

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Droplet Infectious agent comes in contact with unprotected skin or mucus membranes

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Infectious Disease Threat Organizationa Risk Assessment (IDT ORA) Tool 8© Public Services Health and Safety Association

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Completed by: Click here to enter text.Signature: Click here to enter text.Date: Click here to enter text.

IDENTIFY RISK ANALYZE RISK ASSESS RISK  MANAGE RISK

Critical Activity / TasksSimilar

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Standards

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Status (NS/IP/C)

Droplet / Airborne

Infectious agent enters staff 's breathing zone while evaluating and providing care

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5.2 Treating and Caring for Patient with an Infectious Disease of High Consequence

Clinical Staff Contact Direct and indirect patient contact during treatment and care of patient

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Droplet Infectious agent comes in contact with unprotected skin or mucus membranes

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Droplet / Airborne

Infectious agent enters worker's breathing zone while interacting and providing care

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Contact Cross contamination and spread through staff and equipment (e.g.,

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Infectious Disease Threat Organizationa Risk Assessment (IDT ORA) Tool 9© Public Services Health and Safety Association

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Completed by: Click here to enter text.Signature: Click here to enter text.Date: Click here to enter text.

IDENTIFY RISK ANALYZE RISK ASSESS RISK  MANAGE RISK

Critical Activity / TasksSimilar

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Risk Factor

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6. Ambulatory Care

6.1 Checking in Patients for Appointments

Reception Contact Direct contact and spread of blood or other body substance

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Droplet Infectious agent comes in contact with unprotected skin or mucus membranes

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Droplet / Airborne

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Contact Cross contamination through environmental surfaces and materials

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Infectious Disease Threat Organizationa Risk Assessment (IDT ORA) Tool 10© Public Services Health and Safety Association

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Completed by: Click here to enter text.Signature: Click here to enter text.Date: Click here to enter text.

IDENTIFY RISK ANALYZE RISK ASSESS RISK  MANAGE RISK

Critical Activity / TasksSimilar

Exposure Groups (SEGs)

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nPotential Risks of

ExposureExisting Controls

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dTarget Date

Status (NS/IP/C)

6.2 Waiting in Common Area

Patients All Exposure due to crowded or close proximity in seating

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Contact Cross contamination through furniture, equipment, and environmental surfaces

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7. Laboratory

7.1 Specimen Collection, Transport, and Submission

Phlebotomist / Health Care

Workers

Contact Collection of clinical specimens

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Droplet Sprays or splashes generated during specimen collection tasks

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Contact / Droplet

Direct handling of contaminated,

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Infectious Disease Threat Organizationa Risk Assessment (IDT ORA) Tool 11© Public Services Health and Safety Association

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Completed by: Click here to enter text.Signature: Click here to enter text.Date: Click here to enter text.

IDENTIFY RISK ANALYZE RISK ASSESS RISK  MANAGE RISK

Critical Activity / TasksSimilar

Exposure Groups (SEGs)

Mode of Transmissio

nPotential Risks of

ExposureExisting Controls

Risk Factor

sLikelihood

(1-5)Severit

y(1-5)

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Standards

Proposed Controls

Person Assigne

dTarget Date

Status (NS/IP/C)

punctured, and/or unsealed clinical specimens

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Contact Skin puncture from contaminated glass during spill clean up

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Contact Cross contamination of surfaces in clinical collection and spill clean up areas

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7.2 Managing and Testing Routine Clinical Specimens

Laboratory Workers

Contact / Droplet

Direct handling of contaminated, punctured, and/or unsealed clinical specimens

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Infectious Disease Threat Organizationa Risk Assessment (IDT ORA) Tool 12© Public Services Health and Safety Association

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Completed by: Click here to enter text.Signature: Click here to enter text.Date: Click here to enter text.

IDENTIFY RISK ANALYZE RISK ASSESS RISK  MANAGE RISK

Critical Activity / TasksSimilar

Exposure Groups (SEGs)

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nPotential Risks of

ExposureExisting Controls

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sLikelihood

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Standards

Proposed Controls

Person Assigne

dTarget Date

Status (NS/IP/C)

All Sprays, splashes, or aerosols generated during laboratory processes, procedures, activities, and tasks

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All Splash, splatter, or aerosols with blood or body substances created during spills

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Contact Skin puncture from contaminated glass during spill clean up

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8. Environmental Cleaning & Disinfecting8.1 Cleaning and

Disinfecting of Public and General Areas

Housekeeping Workers /

Environmental Services Workers

Contact Direct contact and spread of blood or other body substance

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Infectious Disease Threat Organizationa Risk Assessment (IDT ORA) Tool 13© Public Services Health and Safety Association

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Completed by: Click here to enter text.Signature: Click here to enter text.Date: Click here to enter text.

IDENTIFY RISK ANALYZE RISK ASSESS RISK  MANAGE RISK

Critical Activity / TasksSimilar

Exposure Groups (SEGs)

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nPotential Risks of

ExposureExisting Controls

Risk Factor

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Standards

Proposed Controls

Person Assigne

dTarget Date

Status (NS/IP/C)

Droplet Infectious agent comes in contact with unprotected skin or mucus membranes

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8.2 Cleaning and Disinfecting In Patient - Care Areas

Health Care Workers /

Housekeeping Workers /

Environmental Services Workers

Contact Direct contact and spread of blood or other body substance

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Droplet Infectious agent comes in contact with unprotected skin or mucus membranes

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Contact Cross comamination of cleaning equipment and supplies outside the hot zone

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8.3 Containing, Cleaning and Disinfecting Spills of Blood or Other Body

Health Care Workers /

Housekeeping Workers /

Environmenta

Contact Direct contact and spread of blood or other body substance

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Infectious Disease Threat Organizationa Risk Assessment (IDT ORA) Tool 14© Public Services Health and Safety Association

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Completed by: Click here to enter text.Signature: Click here to enter text.Date: Click here to enter text.

IDENTIFY RISK ANALYZE RISK ASSESS RISK  MANAGE RISK

Critical Activity / TasksSimilar

Exposure Groups (SEGs)

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nPotential Risks of

ExposureExisting Controls

Risk Factor

sLikelihood

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Standards

Proposed Controls

Person Assigne

dTarget Date

Status (NS/IP/C)

Substances l Services Workers text.

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9. Equipment Reprocessing9.1 Transport,

Storage and Handling of Equipment

Housekeeping Workers /

Porters

Contact / Droplet

Direct handling of contaminated equipment

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Contact / Droplet

Leakage of bags or containers holding equipment contaminated with blood or body substances during transport, storage and handling

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Contact Cross comamination of dirty and

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Infectious Disease Threat Organizationa Risk Assessment (IDT ORA) Tool 15© Public Services Health and Safety Association

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Completed by: Click here to enter text.Signature: Click here to enter text.Date: Click here to enter text.

IDENTIFY RISK ANALYZE RISK ASSESS RISK  MANAGE RISK

Critical Activity / TasksSimilar

Exposure Groups (SEGs)

Mode of Transmissio

nPotential Risks of

ExposureExisting Controls

Risk Factor

sLikelihood

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Priority(L/M/H)

Uncertainty (L/M/H)

Standards

Proposed Controls

Person Assigne

dTarget Date

Status (NS/IP/C)

clean equipment and materials

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9.2 Pre-Rinse and Cleaning of Equipment

Medical Device

Reprocessing Workers

Droplet Splash or splatter of blood or other body fluids to unprotected skin and mucus membranes during pre-rinsing and cleaning tasks involving high pressure water

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Airborne Dispersion of aerosols from contaminated equipment being rinsed in basins and utility sinks

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Contact Percutaneous injury from sharps or equipment during handling and cleaning by hand

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Droplet / Airborne

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Infectious Disease Threat Organizationa Risk Assessment (IDT ORA) Tool 16© Public Services Health and Safety Association

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Completed by: Click here to enter text.Signature: Click here to enter text.Date: Click here to enter text.

IDENTIFY RISK ANALYZE RISK ASSESS RISK  MANAGE RISK

Critical Activity / TasksSimilar

Exposure Groups (SEGs)

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nPotential Risks of

ExposureExisting Controls

Risk Factor

sLikelihood

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Uncertainty (L/M/H)

Standards

Proposed Controls

Person Assigne

dTarget Date

Status (NS/IP/C)

from reprocessing equipment due to poor design, maintenance, and / or misuse

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10. Linen Management10. Handling and

Removing Soiled Linen

Health Care Workers

Contact / Droplet

Direct handling of contaminated linen

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All Splash or splatter of blood or other body fluids to unprotected skin and mucus membranes through excessive agitation of linen

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Contact Percutaneous injury from needles left or stuck into linen

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Infectious Disease Threat Organizationa Risk Assessment (IDT ORA) Tool 17© Public Services Health and Safety Association

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Completed by: Click here to enter text.Signature: Click here to enter text.Date: Click here to enter text.

IDENTIFY RISK ANALYZE RISK ASSESS RISK  MANAGE RISK

Critical Activity / TasksSimilar

Exposure Groups (SEGs)

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nPotential Risks of

ExposureExisting Controls

Risk Factor

sLikelihood

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Priority(L/M/H)

Uncertainty (L/M/H)

Standards

Proposed Controls

Person Assigne

dTarget Date

Status (NS/IP/C)

Contact / Droplet

Leakage of bags or containers holding textiles and fabrics contaminated with blood or body substances during storage and handling

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10. Transporting Linen

Housekeeping Workers /

Porters

Contact / Droplet

Direct handling of contaminated linen

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Contact / Droplet

Leakage of bags or containers holding textiles and fabrics contaminated with blood or body substances during storage, handling, transport, and / or shipping

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Airborne Dispersion of aerosols from contaminated laundry placed

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Infectious Disease Threat Organizationa Risk Assessment (IDT ORA) Tool 18© Public Services Health and Safety Association

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Completed by: Click here to enter text.Signature: Click here to enter text.Date: Click here to enter text.

IDENTIFY RISK ANALYZE RISK ASSESS RISK  MANAGE RISK

Critical Activity / TasksSimilar

Exposure Groups (SEGs)

Mode of Transmissio

nPotential Risks of

ExposureExisting Controls

Risk Factor

sLikelihood

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y(1-5)

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Priority(L/M/H)

Uncertainty (L/M/H)

Standards

Proposed Controls

Person Assigne

dTarget Date

Status (NS/IP/C)

into laundry chutes r

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10. Cleaning Soild Linen

Linen Services Workers

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Contact Cross comamination of soiled and clean laundry

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Contact Mattresses and pillows that cannot be adequately cleaned and disinfected

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11. Waste Management11.

1Placing Contaminated Material into

Health Care Workers

Contact Direct handling of waste materials

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Infectious Disease Threat Organizationa Risk Assessment (IDT ORA) Tool 19© Public Services Health and Safety Association

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Completed by: Click here to enter text.Signature: Click here to enter text.Date: Click here to enter text.

IDENTIFY RISK ANALYZE RISK ASSESS RISK  MANAGE RISK

Critical Activity / TasksSimilar

Exposure Groups (SEGs)

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nPotential Risks of

ExposureExisting Controls

Risk Factor

sLikelihood

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y(1-5)

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Priority(L/M/H)

Uncertainty (L/M/H)

Standards

Proposed Controls

Person Assigne

dTarget Date

Status (NS/IP/C)

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11. Closing and Decontaminating Waste Containers

Environmental Services Workers

Contact Direct handling of waste materials

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Droplet Splash or splatter of blood or other body fluids to unprotected skin and mucus membranes

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11. Interfacility Transport and Storage of Waste Containers

Material Handlers /

Porters

Contact Leakage of fluids during handling, storage, transport, or shipping of waste

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Infectious Disease Threat Organizationa Risk Assessment (IDT ORA) Tool 20© Public Services Health and Safety Association

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Completed by: Click here to enter text.Signature: Click here to enter text.Date: Click here to enter text.

IDENTIFY RISK ANALYZE RISK ASSESS RISK  MANAGE RISK

Critical Activity / TasksSimilar

Exposure Groups (SEGs)

Mode of Transmissio

nPotential Risks of

ExposureExisting Controls

Risk Factor

sLikelihood

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y(1-5)

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Priority(L/M/H)

Uncertainty (L/M/H)

Standards

Proposed Controls

Person Assigne

dTarget Date

Status (NS/IP/C)

containersContact Cross

contamination of waste containers and materials outside of the hot zone

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All Unsafe handling of waste (e.g., opening, leaks, spills, etc.)

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12. Handling Human Remains12. Post Mortem

PreparationsHealth Care

WorkersContact Direct handling

of human remains

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Contact Laceration and puncture with contaminated instruments

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IDENTIFY RISK ANALYZE RISK ASSESS RISK  MANAGE RISK

Critical Activity / TasksSimilar

Exposure Groups (SEGs)

Mode of Transmissio

nPotential Risks of

ExposureExisting Controls

Risk Factor

sLikelihood

(1-5)Severit

y(1-5)

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Priority(L/M/H)

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Standards

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dTarget Date

Status (NS/IP/C)

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12. Transportation of Human Remains

Health Care Workers

Contact Contact with contaminated equipment and materials outside of the hot zone

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Contact Leakage of fluids during handling, transport, or shipping from compromised body bag

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12. Mortuary Care and Disposition of Remains

Mortuary Workers

All Unsafe handling of remains (e.g. washing, cleaning, or embalming body, removing inserted medical equipment or implanted medical devices, opening body bag)

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Infectious Disease Threat Organizationa Risk Assessment (IDT ORA) Tool 22© Public Services Health and Safety Association

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Completed by: Click here to enter text.Signature: Click here to enter text.Date: Click here to enter text.

Infectious Disease Threat Organizationa Risk Assessment (IDT ORA) Tool 23© Public Services Health and Safety Association