OSHA Inspection: CEDAR CREST MANOR

Issued

Apr 15, 1991

Abate by

May 14, 1991

Penalty

Initial $1,125 · Current $1,125

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 EMPLOYEES WERE EXPOSED TO
THE HAZARD OF BEING INFECTED BY HIV AND/OR HBV THROUGH DIRECT CONTACT
WITH BLOOD OR OTHER BODY FLUIDS AND APPROPRIATE MEDICAL FOLLOW-UP
PROCEDURES WERE NOT ESTABLISHED FOR HEALTH CARE WORKERS IN JOB
CATEGORIES OF NURSING SERVICE, HOUSEKEEPING AND LAUNDRY LOCATED
THROUGHOUT THE FACILITY:
A) AT THIS FACILITY, A NURSES'S ASSISTANT WAS BITTEN BY A PATIENT ON
3/06/90 AND THE ONLY FOLLOW-UP CONDUCTED WAS THE ADMINISTERING OF
A TETANUS SHOT.
B) AT THIS FACILITY A LPN RECEIVED A NEEDLE STICK ON 2/23/90. FOLLOW-UP
INCLUDED A BLOOD TEST 2/26/90 AND 5/24/90. NO 6-MONTH FOLLOW-UP WAS
CONDUCTED.
FEASIBLE AND USEFUL ABATEMENT METHODS FOR REDUCING THE HAZARD AMONG
OTHERS ARE:
1) IMPLEMENTATION OF FOLLOW-UP PROCEDURES AFTER POSSIBLE EXPOSURE TO
HIV AND/OR HBV.
IF THE HEALTH CARE WORKER HAS A PERCUTANEOUS (NEEDLE-STICK OR CUT)
OR A MUCOSA MEMBRANE (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 NON-INTACT, THE
SOURCE PATIENT SHALL BE INFORMED OF THE INCIDENT AND TESTED FOR HIV
AND HBV INFECTIONS, AFTER CONSENT IS OBTAINED.
IF PATIENT CONSENT IS REFUSED OR IF THE SOURCE PATIENT TESTS
POSITIVE, THE HEALTH CARE WORKER SHALL BE EVALUATED CLINCIALLY AND
BY HIV ANTIBODY TESTING AS SOON AS POSSIBLE AND ADVISED TO REPORT
AND SEEK MEDICAL EVALUATION OF ANY ACUTE 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).
FOLLOW-UP PROCEDURES SHALL BE TAKEN FOR HEALTH CARE WORKERS, EXPOSED
OR POTENTIALLY EXPOSED TO HBV. THE TYPE OF PROCEDURE DEPENDSON 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
PRACTICES ADVISORY COMMITTEE HAS PUBLISHED ITS RECOMMENDATIONS
REGARDING HBV POST EXPOSURE PROPHYLAXIS IN TABLE FORMAT IN THE
JUNE 17, 1985 MORBIDITY AND MORTALITY WEEKLY REPORT.

Issued

Apr 15, 1991

Abate by

May 14, 1991

Penalty

Initial $1,125 · Current $1,125

Issued

Apr 15, 1991

Abate by

Apr 26, 1991

Penalty

Initial $700

Issued

Apr 15, 1991

Abate by

Apr 26, 1991