Research Paper on "Occupational Safety and Health in Healthcare"

Research Paper 5 pages (1605 words) Sources: 3

[EXCERPT] . . . .

Healthcare

Occupational Safety and Health in Healthcare

Healthcare is the quickest growing segment of the U.S. economy, employing over eighteen million workers. Women make up almost 80% of the healthcare workforce. Health care workers face a wide assortment of dangers while on the job, comprising needle stick wounds, back injuries, latex allergy, aggression, and anxiety. Even though it is likely to avert or decrease healthcare worker contact to these risks, healthcare workers persist to experience injuries and illnesses in the workplace. "Cases of nonfatal occupational injury and illness among to healthcare workers are among the highest of any industry sector" (Healthcare workers, 2012).

In 2011, the U.S. Labor Department's Occupational Safety and Health Administration (OSHA) proclaimed a new National Emphasis Program (NEP) designed to help avert ergonomic harms and workplace aggression for nursing and residential care facilities. OSHA will be looking at this industry for three years by way of the NEP, offering guidance to OSHA compliance officers on identifying and conducting inspections in facilities for dangers that include:

Blood or other infectious substances

Communicable disease contact

Ergonomic stressor associated with lifting patients

Workplace aggression

Slips, trips, and falls (Morgan, 2012).

According to the Bureau of Labor Statistics (BLS), the occurrence rate for cases involving days away from work in the nursing and residential care sector was over two times higher than that of all private industry as a whole, in spite of the availability of practical controls to address harms. "What's more, data shows that 48% of all reported injuries in nursing care facilities for 2010 were due to overexertion. Injuries from slips, trips, and falls were also very commonly reported among the nonfatal occupational injury and illness cases reported in nursing and residential care facilities. Combined, overexertion and slips, trips, and falls accounted for 51.4% of all reported cases with days away from work within this industry for 2010" (Morgan, 2012).

If one operates a nursing home or residential care facility, they should be prepared for OSHA to be more active in their facility. There is expected to be increased inspections targeting back injuries, blood borne pathogens exposures, workplace violence and slips, trips and falls. If an organization is not aggressively addressing these exposures, now is the time for them to start. All organizations within the healthcare industry should take notice and watch this special emphasis program. The thought is that when this program has proved to be a success in nursing and residential care facilities, OSHA will begin to target others, since these same types of exposures exist in other healthcare environments such as hospitals and clinics (New OSHA inspection initiative focuses on healthcare, 2011). "More than 380,000 sharps-related injuries occur annually in hospital settings, and an estimated 600,000 to 800,000 such injuries occur annually across the health care sector" (Harris, 2012). It is these high rates of injuries and non-compliance that have driven OSHA into action.

OSHA's goal is to considerably reduce the rates of injury and illnesses within these facilities, by the use of accessible and practicable controls to address dangers. The recognition of such hazards will be the main focus throughout inspections. Nursing and residential care facilities should anticipate increased inspections, both announced and unannounced, to further the goals of the Program. It is believed that OSHA will target facilities with a day away from work rate of ten or greater per one hundred full-time workers. It has been suggested that nursing and residential care facilities take immediate steps to make sure their compliance with OSHA requirements. It is likely that inspections where hazards are found will consequence in the imposition of considerable penalties in order to make sure the success of the Program (Occupational Safety and Health Administration ("OSHA") Targets Nursing and Residential Care Facilities, 2012).

Lack of compliance, continually high incidence rates, and years of disregard have finally gotten OSHA's attention. The NEP will focus on ergonomic hazards related to patient handling, as well as contacts with blood borne pathogens and TB and slips, trips, and falls. Under the NEP about 1,000 nursing homes with the highest incidence rates will be inspected by specifically trained teams. Enforcement for ergonomic hazards will be under the general duty clause. The second part of OSHA's program is a Data Initiative. Injury and illness data collected from roughly 80,000 establishments will discover those with the highest rates. "Hospitals are certain to make that list because their rates, though well below those of nursing homes, are consistently double the national average for general industry. Considering that incidence rates in health care are commonly thought to be under-reported, expect the already high rates to climb following this enforcement effort" (Harris, 2012).

It remains to be seen how many citations will be given or how much the penalties might be related to these or other emphasis programs aimed at health care. Frankly, it most likely depends on what it takes to make organizations to straighten up. "Looking at FY2011, the cost per citation works out to only $838, not exactly enough to scare a facility into compliance. Before anyone starts thinking that's cheap enough to just be the cost of doing business, consider the options OSHA has to ramp up the pain" (Harris, 2012).

Serious violations that are likely to harm or kill and the employer knew or should have known, can go up to $7,000 per violation. Willful violations, knowingly committed, have a minimum of $5,000 and can go up to $70,000. Repeat violations also go up to $70,000. Failure to correct a violation on time is worth up to $7,000. It is possible that an organization can be hit with a combination of these penalties. In addition, willful or repeat violators may also be subject you to criminal or civil actions. OSHA has some judgment in assessing and settling penalties, but if it becomes obvious that low penalties are fueling disregard for the program, the easy fix is to just start adding zeros to the penalties (Harris, 2012).

This should be a wake-up call for health care. OSHA is using blunt language in characterizing health care as very poor safety performers. With over sixteen million employees across thousands of sites, incident rates far higher than general industry norms, low inspection rates, complaints driving half of hospital inspections, and millions of infections and 99,000 fatalities per year, health care makes an attractive target. The new emphasis programs for nursing homes and residential care facilities are more than likely just the beginning. "An industry view of TJC accreditation as the only program that matters, combined with the relative lack of OSHA inspections and low penalties, has marginalized occupational health and safety programs within health care, created high incidence rates, and nurtured the myths discussed in this paper. Health care may see OSHA as an abstract concept, but OSHA has marked health care as a high-hazard industry" (Harris, 2012).

Over the years the poor response rate that has been shown by health care facilities only strengthens OSHA's perception that health care is not serious about infection control. This setting begs for regulatory intervention, which is exactly what OSHA is doing. There are no health care exemptions to the OSHA requirements, and years of operating under the honor system haven't worked. Health care must put the same emphasis on OSHA programs as they currently give the Joint Commission. To do otherwise is just plain negligent (Harris, 2012).

It appears that healthcare facilities are taking the NEP seriously and are re-evaluating the way they do things in order to make sure that they are in compliance with OSHA's standards. Nursing and residential care employers are taking steps to ensure they are in conformity with applicable OSHA standards and that their facilities are equipped for an OSHA inspection. These steps include:

Reviewing the NEP thoroughly in order to understand all of the areas… READ MORE

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