Transcript BASIC HEALTH AND SAFETY TOPICS FOR PHYSICIANS Information for Tulane University physicians who serve as residents, house officers, or medical staff May 2007 Tulane University -

BASIC HEALTH AND SAFETY
TOPICS FOR PHYSICIANS
Information for Tulane University
physicians who serve as residents,
house officers, or medical staff
May 2007
Tulane University - Office of Environmental Health & Safety (OEHS)
OBJECTIVES
– Know the purpose of program
– Know how to respond if injured on the job
– Know how to report an emergency security
situation
– Know how to respond if confronted by an
individual with a weapon
– Know the types of external and internal
disasters
Tulane University - Office of Environmental Health & Safety (OEHS)
OBJECTIVES
– Know how to respond to a Bomb Threat
– Know the communication methods for emergency
incident notification at Tulane University
– Know how to evacuate and respond to a fire
– Know locations and types of fire extinguishers and how
to use them
– Know identification, handling, and disposal of
hazardous materials
– Know how to respond to a hazardous material incident
Tulane University - Office of Environmental Health & Safety (OEHS)
OBJECTIVES
– Know how to identify and report faulty,
damaged, or in need of repair equipment
– Know the types of utility systems and how to
report problems
– Know the location of the medical gas shutoff
valves and how they can be shutoff in the case
of an emergency
– Know radiation safety for patient care
Tulane University - Office of Environmental Health & Safety (OEHS)
SCOPE
• This module applies to residents, house officers,
and medical staff who are employed by the Tulane
University Health Sciences Center (TUHSC).
• Please complete the quiz at the end of the training
module.
• By successfully completing the quiz, a certificate
will be issued and data indicating participation in
this program will be electronically sent to OEHS
for recordkeeping.
Tulane University - Office of Environmental Health & Safety (OEHS)
SAFETY
• This program has been developed to describe how
Tulane University will provide a physical environment
free of recognized hazards and manage staff activities
to reduce the risk of injuries.
• The Office of Environmental Health & Safety (OEHS)
has been established to implement this program for
Tulane University.
• The OEHS is not responsible for the Environment of
Care Program at the Tulane University Hospital and
Clinic (TUHC) except for Radiation Safety.
Tulane University - Office of Environmental Health & Safety (OEHS)
POLICIES AND PROCEDURES
• The Tulane University Environmental Health & Safety Policies and
Procedures Manual contains the safety policies and procedures for
Tulane University. You should also become familiar with the health
and safety policies and procedures for the facility at which you
practice.
• If you are injured on the job, then complete the following checklist:
– Notify your supervisor, Complete a First Report of Injury Form (FROI),
Notify the Worker's Compensation (W/C) Specialist at 988-2869. If
necessary, seek medical treatment at nearest hospital or clinic. Provide
copy of FROI to healthcare provider. Provide all medical documentation
to supervisor and W/C Specialist. Keep copies of documentations.
• For a copy of the FROI Form, go to the following website:
http://www2.som.tulane.edu/oehs/safety/18F-oehss04.pdf
Tulane University - Office of Environmental Health & Safety (OEHS)
SECURITY
• At TUHSC, to report an emergency security situation or if
you observe a suspicious individual or circumstance, tell
the nearest TUHSC Police Officer or dial 988-5555 or if
on campus, dial 55555.
• The following locations are staffed by TUHSC Police staff
at all hours: TUHC Emergency Room and the TUHSC
Police Dispatchers Station in the Medical School Lobby.
• Know the emergency telephone number for your facility.
• To respond in the case of any or all suspected thefts or
non-emergency events, call TUHSC Police at 988-5531, or
contact the designated private security service at your
healthcare location.
Tulane University - Office of Environmental Health & Safety (OEHS)
SECURITY
• Always wear your identification badge on
the outer clothing except when working in a
sterile environment.
• Never unlock or leave security-sensitive
areas unlocked.
Tulane University - Office of Environmental Health & Safety (OEHS)
SECURITY
• If you are confronted by an individual with a weapon,
cooperate and follow their specific instructions. Give them
what they ask.
• Avoid eye contact and discreetly obtain description of the
individual.
• After you are certain that the person has left, call TUHSC
Police at 55555.
• If you are at a non-TUHSC facility, contact their security
department or dial 911 if appropriate.
Tulane University - Office of Environmental Health & Safety (OEHS)
Security
• At TUHSC, to report security incidents involving
patients, visitors, personnel and property, call
TUHSC Police at 988-5555. If you are at a nonTUHSC healthcare facility, contact the designated
security department or service.
• Advise your supervisor of the occurrence.
• For additional crime prevention and safety tips, go
to the following website:
http://www.tuhscpd.tulane.edu
Tulane University - Office of Environmental Health & Safety (OEHS)
SECURITY
• If you have trouble starting your vehicular at the
TUHSC campus, then contact TUHSC Police to
attempt a jump start. They can not provide other
roadside assistance.
• Upon request at all hours, TUHSC Police will
provide foot and/or vehicle personal safety escorts
within the TUHSC areas for anyone associated
with Tulane University.
• Off campus escorts can not be provided.
Tulane University - Office of Environmental Health & Safety (OEHS)
EMERGENCY PREPAREDNESS
• Mass Casualty
– In the case of an internal or external disaster involving
injuries, an emergency situation will be announced by
Administration or Nursing Supervisor.
– An internal disaster can involve a hazardous material
incident, fire, explosion, etc. in which rapid emergency
response is needed to provide care and treatment for
victims.
– An external disaster can involve an explosion, building
collapse, severe weather emergency, etc. in which mass
casualties are generally transported to a healthcare
facility.
Tulane University - Office of Environmental Health & Safety (OEHS)
EMERGENCY PREPAREDNESS
• Bomb Threat
– If you receive a telephone call indicating a bomb threat,
keep the caller on the phone. Pay attention to the caller,
voice, mannerisms, background noises, etc. Have
someone immediately call TUHSC Police at 988-5555.
If you are at a non-TUHSC healthcare facility, contact
the designated security department or service.
– For response, complete the checklist found at the
following website:
http://www2.som.tulane.edu/oehs/safety/03Foehss01.pdf
Tulane University - Office of Environmental Health & Safety (OEHS)
EMERGENCY PREPAREDNESS
• Severe Weather
– Employees will be advised of an emergency
situation via website, email, public address, or
supervisors. For official information regarding
Tulane University, staff must call the Alertline:
862-8080 or 1-877-862-8080 or
http://emergency.tulane.edu.
– Stay in contact with your supervisor directly.
Do not call the operators for information.
Tulane University - Office of Environmental Health & Safety (OEHS)
EMERGENCY PREPAREDNESS
• In order to continue patient services in the
case of a severe weather emergency,
physicians will be designated as essential by
their departments or managers and may be
asked to return to the facility to assist
beyond their normal work schedule.
• However, if it is a major hurricane, then
staff may be asked to evacuate.
Tulane University - Office of Environmental Health & Safety (OEHS)
EMERGENCY PREPAREDNESS
• Total Facility Evacuation
– This is the movement of patients and occupants from an
area or the entire hospital and clinic to outside grounds
or an adjacent area which is safe.
– Assist with patient care or other duties as requested by
the Charge Nurse, Clinic Manager, or Supervisor.
– Patients may be transported to designated facilities.
Tulane University - Office of Environmental Health & Safety (OEHS)
LIFE SAFETY (FIRE)
• Evacuate an area if a fire is discovered and occupants must
be moved.
• For healthcare and ambulatory healthcare facilities, remain
on the same floor. Relocate occupants to the next smoke
compartment which is a designated safe area of refuge on
the floors. For information as to their exact locations,
contact your supervisor or the Hospital Safety Officer.
• If there is a fire inside a unit or area, then move all
occupants through the designated smoke barrier doors to
the next compartment and proceed to administer medical
care and life support using available equipment.
• Occupants may move in any direction from one smoke
barrier zone to another.
Tulane University - Office of Environmental Health & Safety (OEHS)
LIFE SAFETY (FIRE)
• If you discover a fire, follow the acronym: E S C A P E
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E - Evaluate the situation.
S - Secure the area by removing occupants in the area of the fire.
C - Close the doors to the room where the fire is located.
A - Activate the building fire alarm system.
P - Phone 55555 for TUHSC or the appropriate emergency number
for your healthcare facility. DO NOT CALL 911 unless it is the
designated number to be used by your facility for emergencies.
– E - Extinguish the fire as appropriate
Tulane University - Office of Environmental Health & Safety (OEHS)
LIFE SAFETY (FIRE)
• Remember – it is not required that you extinguish the fire.
• To enter the room to extinguish the fire, first feel the
closed door with the back of your hand. If it is warm or
hot to the touch, then do not open the door. Assist with
evacuation and/or other functions.
• Do not enter the room or any area if it is filled with smoke.
• If the door is not warm or hot, then slowly open the door.
• Before entering make sure you keep your back to a safe
and unobstructed exit to which the fire will not spread.
• Extinguish the fire using an available portable fire
extinguisher.
Tulane University - Office of Environmental Health & Safety (OEHS)
LIFE SAFETY (FIRE)
• To use a portable fire extinguisher, follow the
acronym: P A S S
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P - Pull the pin on the handle
A - Aim the nozzle at the base of the fire
S - Squeeze the handle
S - Sweep the fire from side to side.
• Be sure that the fire is confined to a small area.
Tulane University - Office of Environmental Health & Safety (OEHS)
LIFE SAFETY (FIRE)
• Know the location of the nearest fire extinguisher
and on what types of fires it can be used.
• Hallway fire extinguishers inside cabinets are
generally dry chemical extinguishers which can be
used on all common types of fires (Class ABC).
• Carbon dioxide fire extinguishers (Class BC) can
not be used on fires involving combustibles (Class
A) but can be used on all other types of common
fires.
Tulane University - Office of Environmental Health & Safety (OEHS)
HAZARDOUS MATERIALS AND
WASTE
• For spills at TUHSC excluding TUHC, call OEHS
at 988-5486 or go to
http://www.som.tulane.edu/oehs/hazspill.htm.
• Hazardous materials include but are not limited to
chemical, biological, explosive, flammable,
radioactive and toxic materials.
• They may be solid, liquid, or gaseous in nature.
• Hazardous materials become hazardous waste
when they are no longer usable or recyclable.
Tulane University - Office of Environmental Health & Safety (OEHS)
HAZARDOUS MATERIALS AND
WASTE
• When handling all hazardous materials or wastes, precautions must be
taken to preclude accidental contact with the material/waste to include
Personal Protective Equipment (PPE), work practice controls, and
engineering controls, i.e. special exhaust ventilation.
• Staff must be familiar with the hazardous materials with which they
come in contact.
• For information, refer to the label and to the Material Safety Data
Sheets (MSDSs) which are usually located at the Nurse's Station, in
departments, or designated areas.
• All hazardous materials and waste containers must be appropriately
labeled.
• Hazardous gases i.e. ethylene oxide and nitrous oxide must be properly
exhausted from work areas.
Tulane University - Office of Environmental Health & Safety (OEHS)
HAZARDOUS MATERIALS AND
WASTE
• Biohazardous waste, also referred to as Potentially Infectious
Biomedical Waste (PIBW) includes diseased human and animal parts,
contaminated dressings, pathological specimens and contaminated
laboratory waste, hypodermic needles and other sharps, disposable
contaminated clothing, contaminated bandages and gloves.
• Chemical waste includes those that may be toxic, corrosive, explosive,
ignitable, or reactive and includes some chemotherapeutic agents.
• Physically hazardous waste includes non-infectious sharps and broken
glass items.
• Hazardous materials are identified through the following: Chemical
Inventory information provided to the purchaser at the time of
purchase, Material Safety Data Sheets (MSDS), and labels on
containers.
Tulane University - Office of Environmental Health & Safety (OEHS)
HAZARDOUS MATERIALS AND
WASTE
• All contaminated sharps must be properly
disposed of by placing them in specifically
labeled puncture-resistant, disposable
containers with covers. Do not reuse them.
Sharps must never be discarded into trash
receptacles or linen receptacles.
• Sharp containers when 2/3’s full should be
sealed and properly disposed.
Tulane University - Office of Environmental Health & Safety (OEHS)
HAZARDOUS MATERIALS AND
WASTE
• Prior to wearing PPE, first obtain information on
the types of items needed, such as gloves,
protective clothing, respirator, eye wear, etc.
• These items are available in your department and
must be worn, as applicable. Review the Material
Safety Data Sheets (MSDS) for information on the
types of PPE needed.
• Be sure that the PPE is suitable for the hazardous
material and that you know the limitations of the
PPE and how to properly wear and use them.
Tulane University - Office of Environmental Health & Safety (OEHS)
HAZARDOUS MATERIALS AND
WASTE
• If you discover a hazardous material or waste incident,
proceed as follows:
– Alert persons in the immediate area; confine the spill safely to
prevent further contamination, i.e. close doors, pull down sash of
hood; evacuate spill area; notify immediate supervisor or
Departmental Safety Representative; if personal contact occurs,
use an eye wash fountain and/or safety shower for flushing of the
eyes and body for at least 15 minutes. Contact OEHS at 988-5486.
Document the occurrence.
• If the incident occurs at a non-TUHSC healthcare facility,
then immediately contact your supervisor and the
department responsible for spill clean up. Do not contact
OEHS.
Tulane University - Office of Environmental Health & Safety (OEHS)
HAZARDOUS MATERIALS AND
WASTE
• Become familiar with the physical and
health hazards associated with each
hazardous material that you use. Refer to
the MSDS for this information.
Tulane University - Office of Environmental Health & Safety (OEHS)
HAZARDOUS MATERIALS AND
WASTE
• Under the OSHA Hazard Communication - Right
To Know Standard, employees have a right to
know about the hazardous materials on the job and
how to protect themselves, both under normal
operating conditions and in foreseeable
emergencies.
• You must know of operations in your work area
where hazardous chemicals are present.
• This standard generally deals with labeling of
containers, MSDSs, chemical inventories, and
training of employees.
Tulane University - Office of Environmental Health & Safety (OEHS)
HAZARDOUS MATERIALS AND
WASTE
•
•
•
To detect the presence or release of a hazardous chemical in your area, refer to
the MSDS for visual appearance or odor information.
MSDS Contents include the following: Identity, Manufacturer,
Characteristics, Physical and Health Hazards, Routes of Entry, Exposure
Limits, Control Measures, First Aid, Precautions for Safe Handling and Use.
Terms/Definitions
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Carcinogen - causes cancer in humans
Corrosive - causes irreversible alteration in living tissue
Flammable – can easily fuel a fire
Toxic - capable of causing health effects
Irritant - can have reversible inflammatory effect
Oxidizer - chemical that promotes combustion in other materials
Routes of entry - points in which chemicals can enter the body
Sensitizer - can cause an allergic reaction in some people
TLV - Threshold Limit Value - exposure over 8 hour day
Water Reactive - reacts with water.
Tulane University - Office of Environmental Health & Safety (OEHS)
EQUIPMENT
• Equipment that is faulty, damaged, or in need of repair must be
immediately reported to the charge nurse, clinic coordinator, or
supervisor who will then contact the responsible department or
contract service.
• If the device presents a safety hazard, then respond immediately by
phoning the appropriate service department. Equipment in need of
repair must be properly tagged and not used. Devices that are
damaged, overheating, noisy, have frayed power cords or damaged
plugs, must be reported using the above procedure. This also includes
any loose controls, switches, burned out lamps or any suggestion of
device malfunction.
• The user should conduct a Performance Check on the equipment upon
its return from the service department.
Tulane University - Office of Environmental Health & Safety (OEHS)
EQUIPMENT
• Electrical extension cords/adapters must not be
used in lieu of permanent wiring.
• Electrical extension cords are permitted only for
temporary use.
• Should a department express a need for such a
cord/adapter, the following alternatives will be
proposed: Relocate the equipment, lengthen the
power cord, or install an additional outlet.
Tulane University - Office of Environmental Health & Safety (OEHS)
UTILITY
• This applies to systems, i.e. Fire Alarm System,
Elevators/Escalators, Electrical Distribution and
Emergency Electrical Power System, Pneumatic Tube
System, Plumbing System, Medical Gas System, Vacuum
System, and HVAC (Heating, Ventilation, Air
Conditioning), Telephones, Public Address System,
Information Systems, and electrical equipment that by
design, use or location may pose a possible electrical or
safety hazard.
• Problems, failures, and user errors with a utility must be
reported to the appropriate maintenance or facilities
services department.
Tulane University - Office of Environmental Health & Safety (OEHS)
UTILITY
• Hallway and stairwell lights, exit signs, Operating Rooms, Intensive
Care Units, Emergency Room, nurse’s station, patient rooms (at least
one duplex receptacle per bed), and designated systems, i.e. fire alarm,
telephone, public address, at least one elevator, etc. are supplied with
emergency power from the generators.
• Electrical receptacles and light switches with red covers indicate that
they are connected to the emergency generators.
• Also, there should be flashlights at the nurse's stations.
• In areas with medical gases, shut off valves are located in the hallways
and are labeled. During an emergency, these should be shut off with
the approval of nursing in patient care areas.
Tulane University - Office of Environmental Health & Safety (OEHS)
RADIATION SAFETY FOR
PATIENT CARE
• If a radiation therapy procedure involving sealed sources
or radiopharmaceuticals is being performed in a patient
room, the room door is labeled "Caution, Patient Contains
Radioactive Materials."
• Prior to entering a patient room, one must check with the
nursing station.
• The patient chart is also labeled "Caution, Radioactive
Materials."
• Note the time that can be spent in the immediate proximity
(i.e. within two feet) of the patient per day or per shift.
This limit applies to medical personnel and visitors so that
they do not exceed their Federal and State radiation
exposure limit.
Tulane University - Office of Environmental Health & Safety (OEHS)
RADIATION SAFETY FOR
PATIENT CARE
• Radiopharmaceutical therapy also results with radioactive
contamination from urine, perspiration, and saliva. Items
that come into direct contact with the patient, such as
gloves and eating utensils, are assumed to be
contaminated and must be left inside the room to be
surveyed after the patient has been discharged.
• In all cases, radiation exposure can be reduced by
minimizing TIME near radiation sources. Exposure can
also be reduced by increasing DISTANCE from radiation
sources. Standing behind portable lead
SHIELDING can also reduce radiation exposure.
Tulane University - Office of Environmental Health & Safety (OEHS)
RADIATION SAFETY FOR
PATIENT CARE
• For further information, refer to the Tulane
University Radiation Safety Manual or the
designated Radiation Safety Manual for
your healthcare facility.
• If there are any questions, then contact the
Tulane University Radiation Safety Officer,
Mr. Charles Reindl, at (504) 988-2867.
Tulane University - Office of Environmental Health & Safety (OEHS)
OFFICE OF ENVIRONMENTAL
HEALTH & SAFETY
WEBSITE
The following OEHS website is a great resource tool
for health and safety information:
www.som.tulane.edu/oehs
Tulane University - Office of Environmental Health & Safety (OEHS)
Tulane University
Office of Environmental Health & Safety (OEHS)
Louis Mayer, RS, CSP, MPH, CFI
Manager – Training, Education, and General Safety
(504) 988-2447
[email protected]
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