OSHA Inspection: FRANKLIN PLAZA NURSING HOME

Issued

Feb 22, 1990

Abate by

May 9, 1990

Penalty

Initial $810 · Current $810

General-duty citation text

Section 5(a)(1) of the Occupational Safety and Health Act of 1970: The
employer did not furnish employment and a place of employment which were
free from recognized hazards that were causing or likely to cause death
or serious physical harm to employees in that:
Health care workers (such as nurses, nurses' aides, lpn's and
maintenance personnel working in patient care areas) were exposed to
the hazard of being infected by HBV and/or HIV through possible
direct contact with blood or other body fluids.
Feasible and useful abatement methods for reducing this hazard, among
others, are:
1) Modify the facility's IC (Infection Control) policy to address all
circumstances warranting Hepatitis B vaccinations and to identify
employees at substantial risk of directly contacting body fluids.
Offer all such employees hepatitis B vaccinations in amounts and at
times prescribed by standard medical practice, in accordance with
CDC guidelines for protection against viral Hepatitis.
On 2/8/90, it was observed that high risk employees had not been
offered the Hepatits B vaccination.
2) Provide testing and care as follows:
a) If a health care worker has a percutaneous (needlestick or cut) or
mucous membrance (splash to eye, nasal mucosa, or mouth) exposure to
body fluids or has a cutaneous exposure to blood when the worker's
skin is chapped, abraded, or otherwise nonintact, the source patient
shall be informed of the incident and tested for HIV and HBV
infections, after consent is obtained.
b) If patient consent is refused or if the source patient tests positive
the health care worker shall be evaluated clinically and by HIV
antibody testing as soon as possible and advised to report and seek
medical evaluation of any acute febrile illness that occurs within
12 weeks after exposure.
HIV seronegative workers shall be retested 6 weeks post-exposure and
on a periodic basis thereafter (12 weeks and 6 months after exposure)
c) Follow up procedures shall be taken for health care workers exposed
or potentially exposed to HBV. The types of procedures depends on the
immunization status of the worker (i.e., whether HBV vaccination has
been received and antibody response is adequate) and the HBV
serologic status of the source patient. The CDC immunization practice
Advisory Committe has published its recommendations regarding HBV
post-exposure prophylaxis in table format in the June 7, 1985,
Mordidity and Mortality Weekly Report.
d) If an employee refuses to submit to the procedures in (b) or (c)
above when such procedures are medically indicated, no adverse action
can be taken on that ground alone since the procedures are designed
for the benefit of the exposed employee.
On 1/8/90, a registered nurse was stuck with a contaminated needle.
Other than first aid, the proper follow-up procedures were not
administered as stipulated by the Center for Disease Control Acquired
Immunodeficiency Syndrome, Aids - Recommendations and Guidelines.
3) All high risk health care workers (including employees in any
occupation where they are directly exposed to body fluids) shall
receive education on precautionary measures, epidemiology, modes of
transmission and prevention of HIV/HBV. Health care workers shall be
counseled regarding possible risks to the fetus from HIV/HBV and
others associated infectious agents.
On 2/8/90, it was observed that a registered nurse and a licensed
practical nurse did not receive the training as required on blood-borne
disease. The licensed practical nurse stated that is routine and
automatic to recap needles after being used. Both this individual and
the RN who was stuck with a contaminated needle are direct examples of
the necessity of the training requirements.

Issued

Feb 22, 1990

Abate by

Mar 26, 1990

Penalty

Initial $810 · Current $810

Issued

Feb 22, 1990

Abate by

Mar 5, 1990

Penalty

Initial $810 · Current $810

Issued

Feb 22, 1990

Abate by

Mar 16, 1990

Issued

Feb 22, 1990

Abate by

Mar 16, 1990