OSHA Inspection: BEVERLY MANOR OF MONROEVILLE

Issued

Mar 20, 1992

Abate by

Jul 20, 1992

Penalty

Initial $2,625 · Current $1,362 Reduced

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 caused, aggravated, or precipitated employee injuries
to the trunk and upper extremities.  The exposure occured at the
following operation:
a)  Nursing Department:  Nursing personnel including nursing
assistants (NA), licensed practical nurses (LPN) and registered
nurses (RN) while performing routine patient transfer
activities.  the injury records for 1988, 1989, 1990, 1991
document a pattern of such injuries.
The following conditions contributed to the existence of this hazard:
1.  Administrative procedures did not provide for effective
communication to employees of information relating to
resident transfer methods.  This information is necessary
to reduce the risk of employee injury.  This condition was
evidenced by inadequate transfer information on resident
care plans and by the practice of employees performing solo
transfer of residents.
2. Management involvement in addressing ergonomic hazards was
inadequate as evidenced by the absence of an effectively
implemented written program outlining ergonomic program
goals, policies, procedures, and workplace evaluation
techniques.
3.  Assist devices were inadequate as to variety, quantity and
policy of use.
4.  An injury prevention program had not been developed and
implemented that would allow for expert review of work place
conditions, work practices, and work routines that contribute
to employee injuries.
5.  Training did not include an adequate opportunity for
employees to practice transfer methods or discuss the
information presented during training sessions.
Among other methods, a feasible and acceptable abatement method to
correct this hazard would be implementation of an affective program
for dealing with resident transfer.  At a minimum include the
following elements in the program:
I   Management Commitment
Implement an ergonomics program.  Ensure that the
program includes a clear statement of managements
commitment to effectively deal with the problem of
employee injuries related to resident transfers and
other strenuous activities.  Ensure that the program
is written; addresses the area of employee involvement;
and provides a mandatory mechanism for regular program
review and evaluation.
II   Worksite Analysis
1.  Analyze medical, safety, and insurance records
including the OSHA-200 log and information
compiled through the medical management program;
2.  Identfy those employee jobs that are the most
physically stressful and may be related to
employee injuries;
3.  Develop and implement ergonomic solutions to
resident transfer and handling problems;
4.  Conduct periodic workplace surveys to evaluate
the implementation and effectiveness of resident
transfer methods.
III  Hazard Prevention and Control
1.  Ensure that patient chairs and other furniture are
designed to facilitate safe transfer.  For example
select chairs that allow for proper positioning
of employee's feet during a resident transfer.
Use of wheelchairs with removable arms whenever
possible.  Give consideration to location of
controls and the range of height adjustments
for beds.
2.  Assure that assist devices such as hoist are
available in sufficient quantity to ensure resident
transfers are performed according to care plans.
When selecting a particular type of assist device
include consideration of resident comfort and
employee preference.  Use Gait Belts in a manner
consistant with correct resident handling
procedures.
3.  Develop and implement a maintenance program for
lift assist devices.  Ensure that sufficient
back up equipment is available during periods
when primary equipment is out of service.
4.  Reduce the number of resident transfer to the
maximum extent feasible by use of equipment such
as a chair scales that require no resident
transfers and use of shower chairs that are
compatible with toileting facilities.
5.   Assure that two person lifts occur when the
situation dictates their need and that the
employees are trained to recognize the need for
additional assistance and make appropriate
requests.
IV   Training
1.  Supervisory nurses will be trained to properly
evaluate the resident transfer techniques
practiced by the nursing staff.
2.  Training on resident transfer techniques will
be presented by instructors who have been
certified in the existing "Lift with Care Program"
or equivalent.
3.  Orientation training for new employees will
include practice and discussion of proper resident
transfer techniques as indicated in the existing
"Lift with Care Program".  On the job
orientation will include the opportunity for the
training officer to observe the trainee during
resident transfer procedures.
4.   Refresher training will be provided that includes
practice and discussion of proper resident
transfer techniques.  Employees who miss training
sessions will be provided with equivalent training
sessions.  Employees returning to work after time
off from a work related injury will be reevaluated
in resident transfer techniques and retrained
as necessary.
5.   All employees expected to use lift assist devices
will be trained in the proper use and limitations
of the equipment.
V   Medical Management Program
1.  Insure that the medical management program includes
a worksite review to verify that restricted duty
workers are not exposed to stresses which may
complicate or delay recovery.
ABATEMENT SCHEDULE
Step 1 - Submit to the Area Director a detailed plan of abatement
outlining a schedule for the implementation of engineering
and/or administrative measures to control employee injury
due to resident transfer tasks.  All proposed control
measures shall be approved by a person knowlegable in the
evaluation of workplace conditions which cause lifting
disorders and injuries.  Sixty day progress reports are
required during the abatement period.
Step 2 - Abatement shall have been completed by the implementation
of feasible engineering and/or administrative controls.

Issued

Mar 20, 1992

Abate by

Feb 19, 2007

Penalty

Initial $1,875 · Current $679 Reduced

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 including nurses; nursing assistants; housekeeping employees;
laundry workers; and others, whose work may involve direct contact
with blood or other body fluids were exposed to the hazard of
infection from Hepatitis B Virus (HBV) and/or Human Immunodeficiency
Virus (HIV).  The following conditions contributed to this hazard:
1.  The employer had not developed and implemented a
comprehensive training and information program relating
to blood borne diseases hazards for exposed employees.
Feasible and useful methods for reducing this hazard, among others,
are:
1.  Implement a training program for all exposed workers at the
time of initial employment and at least annually thereafter.
2.  Ensure that the training program contains the following
elements:
A.  A general explanation of the epidemiology and symptoms
of blood borne diseases;
B.   An explanation of the modes of transmission of blood
borne pathogens;
C.   An explanation of the use and limitations of practices
that will prevent or reduce exposure including
appropriate engineering controls, work practices, and
personal protective equipment;
D.   Information on the types, proper use, location,
removal, handling, discontamination and/or disposal
of personal protective equipment;
E.  Information on the hepatitis B vaccine, including
information on its efficacy, safety and benefits;
F.   Information on the appropriate actions to take and
persons to contact in an emergency;
G.   An explanation of the procedure to follow if an exposure
incident occurs;
H.  An explanation of signs, labels, and/or color coding
requirements; and
I.  Information on universal precautions as established
the Centers of Disease Control (CDC).

Issued

Mar 20, 1992

Abate by

Feb 19, 2007

Penalty

Initial $1,125

Issued

Mar 20, 1992

Abate by

Feb 19, 2007

Penalty

Initial $750 · Current $679 Reduced