OSHA Inspection: ST. MARY HOSPITAL

Issued

Jul 25, 1996

Abate by

Aug 27, 1996

Penalty

Initial $3,500 · Current $2,625 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 hazard of being infected with Mycobacterium
tuberculosis
through patient
contact and special procedures such as aerosolized pentamidine treatment,
bronchoscopy, suction
procedures, sputum induction and autopsies:
a) Nurses, nurse's aides, respiratory therapists, transporters, social
workers, phlebotomists,
doctors, and housekeeping personnel were exposed to the hazard of being
infected with
Mycobacterium tuberculosis through repeated and prolonged contact with
active or suspect
tuberculosis patients that occupied rooms not provided with negative
pressure. Including, but
limited to:
On or about 4/4/96 Sixth and Fifth Floor;
Rooms 627,628,527,528 and Family Practice Center
b) Employees who were exposed to the hazard of being infected with
Mycobacterium
Tuberculosis through contact with active TB patients, were not provided
PPD skin test every
three months as recommended by the Centers for Disease Control (CDC).
Including
but not limit
to:
Emergency Room, Family Practice Center, Respiratory Therapy, Nursing
units- ICU, SCU,
5NO, 6NO,2NO, Endoscopy and Operating Room.
Among other methods, some feasible and acceptable abatement methods to
correct this hazard
as recommended by the CDC guidelines are:
1. Rooms occupied by TB or suspected TB patients must be under negative
pressure exhausted
to the outside and away from intake vents.
2. Perform Mantoux tuberculin skin tests on PPD negative health care
workers to identify
persons whose skin tests convert to positive.  The frequency of the tests
must be in accordance
current CDC guidelines.
3. Screen patients suspected of having TB so that active TB patients may
be quickly placed in
AFB isolation.  Provide a rapid diagnostic service.
4. Provide training to employees on the hazard and control of
tuberculosis.  The training must
include the epidemiology, transmission and pathogenesis of tuberculosis.
Abatement Note:  Once rooms have been certified as being under negative
pressure, the
following steps should be taken to ensure that condition:
1. Periodic checks are required to ensure that the desired negative
pressure is present and that
the continuous monitoring devices, if used, are properly.
2. If smoke tubes or other visual checks are used, TB isolation rooms and
treatment rooms
should be checked frequently for negative pressure.
3. TB isolation rooms should be checked daily for negative pressure while
being used for TB
isolation.
Reference:  CDC MMWR October 28, 1994/Vol 43
Guidelines for preventing the Transmission of Tuberculosis in Health Care
Settings
Special Focus on HIV related issues.
Violation observed on or about 2/27/96 and 4/4/96.

Issued

Jul 25, 1996

Abate by

Aug 6, 1996

Penalty

Initial $5,000 · Current $3,750 Reduced

Issued

Jul 22, 1996

Abate by

Jul 30, 1996

Issued

Jul 22, 1996

Abate by

Aug 1, 1996

Penalty

Initial $5,000 · Current $3,750 Reduced

Issued

Jul 22, 1996

Abate by

Jul 26, 1996