OSHA Inspection: BEVERLY HEALTHCARE

Issued

Dec 5, 1991

Abate by

Feb 19, 2007

Penalty

Initial $2,625 · Current $521 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
hazards of repetitive lifting and other strenous operations.  This exposure
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 effective implemented
written program outlining ergonomic program goals, policies,
procedures, and workplace evaluation techniques.
3.    Assist devices were inadequate 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.
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.  Identify 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 hoists 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 consistent 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 chair scales that
require no resident transfers and use of shower chairs
that are compatible with toileting facilities.
IV  Training
1.  Supervisary 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.
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

Dec 5, 1991

Abate by

Jan 10, 1992

Penalty

Initial $1,875 · Current $521 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 (nurses; nurses aids; housekeeping workers, 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).
The following conditions contributed to this hazard:
1.  Hepatitis B vaccinations were not provided to health care
workers who may be exposed to blood or other body fluids.
Feasible abatement methods for reducing this hazard would include:
1.  Make available a Hepatitis B Vaccination to all employees
whose work may involve direct contact with body fluids or
blood-borne pathogens free of charge.
2.   Assure all medical evaluations and procedures are performed
by or under the supervision of a licensed physician and
that all laboratory tests are conducted by an accredited
laboratory.
3.  Assure that all evaluations, procedures, vaccinations and
booster dose(s) are provided to the employees at a
reasonable time and place, and according to standard
recommendaitons for medical practice.

Issued

Dec 5, 1991

Abate by

Jan 10, 1992

Penalty

Initial $1,875 · Current $518 Reduced

Issued

Dec 5, 1991

Abate by

Jan 10, 1992

Penalty

Initial $900 · Current $521 Reduced