OSHA Inspection: ST. LUKE'S HOSPITAL

Issued

Oct 3, 1991

Abate by

Dec 4, 1991

Penalty

Initial $2,500 · Current $2,500

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 HBV through direct contact
with blood or other body fluids and HBV vaccinations were not offered
to health care workers working in SPD Department.
Feasible and useful abatement methods for reducing the hazard, among
others are:  offer HBV vaccinations to all employees where potential
exposure to blood and body fluids is a substantial risk.

Issued

Oct 3, 1991

Abate by

Dec 4, 1991

Penalty

Initial $2,500 · Current $2,500

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, SPD, housekeeping and laundry
located throughout the facility.
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 a health care worker has a percutaneous (needlestick or cut)
or a mucosa membrane (splash to eye, nasal mucusa, or mouth)
exposure to body fluids, or has a cutanueous 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 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).
Follow up procedures shall be taken for health care workers,
exposed or potentially exposed to HBV.  The type of procedure
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 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.
(a)  Employees throughout the facility were not receiving
HIV testing following an unknown source needlestick or
puncture.
(b)  Employees throughout the facility were not receiving
training following an unknown source needlestick or
puncture, on the need to report any febrile illness.

Issued

Oct 3, 1991

Abate by

Nov 4, 1991

Penalty

Initial $2,500 · Current $2,500

Issued

Oct 3, 1991

Abate by

Nov 4, 1991

Penalty

Initial $2,500 · Current $2,500

Issued

Oct 3, 1991

Abate by

Nov 4, 1991

Penalty

Initial $2,000 · Current $2,000

Issued

Oct 3, 1991

Abate by

Nov 4, 1991

Penalty

Initial $1,000 · Current $1,000

Issued

Oct 3, 1991

Abate by

Nov 4, 1991

Issued

Oct 3, 1991

Abate by

Nov 4, 1991

Issued

Oct 3, 1991

Abate by

Nov 4, 1991