OSHA Inspection: RICHLAND MANOR

Issued

Nov 12, 1991

Abate by

Feb 19, 2007

Penalty

Initial $2,625 · Current $848 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 1989, 1990, 1991 document a pattern of
such injuries.
The following conditions contributed to the existence of this hazard:
1.  Administarative 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.  The training program did not include an opportunity for
employees to practice transfer methods or to discuss the
information presented during training sessions.  The
training did not include proper use and application of lift
assist devices.
4.  Assist devices were inadequate to variety, quantity and policy
of use.
5.  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 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 transfers 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 abate-
ment outlining a schedule for the implementation of engineer-
ing 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

Nov 12, 1991

Abate by

Feb 19, 2007

Penalty

Initial $1,875 · Current $849 Reduced

General-duty citation text

Section 5(a)(1) of the Occupational Safety and Health Act of 1970:  The
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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) 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 disease 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

Nov 12, 1991

Abate by

Feb 19, 2007

Penalty

Initial $1,875 · Current $848 Reduced

Issued

Nov 12, 1991

Abate by

Feb 19, 2007

Penalty

Initial $900 · Current $850 Reduced