OSHA Inspection: ADAMS HOUSE HEALTHCARE

Issued

Jul 9, 1991

Abate by

Aug 14, 1991

Penalty

Initial $5,000 · Current $2,500 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 who had direct contact with blood or body fluids were not
adequately protected from potential infections due to a possible
immune deficiency from a sero conversion.
IN THE FOLLOWING INSTANCES, THE EMPLOYER DID NOT ENSURE THAT THE
EMPLOYEES WERE ADEQUATELY PROTECTED FROM POTENTIAL INFECTIONS IN
THAT:
1. THE EMPLOYER DID NOT PROVIDE THE HBV VACCINE TO THE NURSES AND
CERTIFIED NURSE AIDES WHO WERE EXPOSED TO BODY FLUIDS.
2. THE EMPLOYER'S PROGRAM DID NOT ENSURE THAT EMPLOYEES EXPOSED TO
BLOOD AND/OR BODY FLUIDS SHALL BE EVALUATED CLINICALLY AND WITH
HIV TESTING AS SOON AS POSSIBLE AFTER THE EXPOSURE, FURTHER
EVALUATIONS AT  6 WEEKS, 16 WEEKS, AND 6 MONTHS AFTER THE INCIDENT.
AMONG OTHER METHODS, ONE FEASIBLE AND ACCEPTABLE ABATEMENT METHOD
WOULD BE THE IMPLEMENTATION OF AN EMPLOYEE TRAINING PROGRAM
EMPHASIZING THE FOLLOWING:
1. EMPLOYEES WHO POTENTIALLY ARE EXPOSED TO BODY FLUIDS SHALL BE
OFFERED  THE HEPATITUS VACCINATION FREE OF CHARGE IN AMOUNTS AND
AT TIMES PRESCRIBED BY STANDARD MEDICAL PRACTICE.
2. AFTER AN EXPOSURE, THE HEALTH CARE WORKERS SHALL BE EVALUATED
CLINICALLY AND BY HIV ANTIBODY TESTING AS SOON AS POSSIBLE, AND
ADVISED TO REPORT AND SEEK MEDICAL EVALUATION OF ANY ACUTE
FEASIBLE ILLNESS THAT OCCURS WITHIN TWELVE WEEKS AFTER EXPOSURE.
HIV SERONEGATIVE WORKERS SHALL BE RETESTED 6 WEEKS PAST EXPOSURE,
AND ON A PERIODIC BASIS THEREAFTER (12 WEEKS AND 6 MONTHS AFTER
EXPOSURE.  12 MONTHS IS RECOMMENDED).

Issued

Jul 9, 1991

Abate by

Aug 14, 1991

Penalty

Initial $5,000 · Current $1,660 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
excessive, repetative lifting and other strenuous operations while
performing normal required operations as nurses and certified nurse
aides:
IN THE FOLLOWING INSTANCES, THE EMPLOYER DID NOT ENSURE THAT THE
EMPLOYEES WERE ADEQUATELY PROTECTED FROM EXCESSIVE LIFTING AND OTHER
STRENUOUS ACTIVITIES:
1) FOR A PERIOD OF APPROXIMATELY TWO MONTHS, WATER MATTRESSES WERE
PLACED ON RESIDENT'S BEDS AS PRESSURE RELIEF DEVICES. THE ADDED
WEIGHT OF THE MATTRESSES SUBJECTED EMPLOYEES TO EXCESSIVE LIFTING
AND PULLING OPERATIONS WHILE "ROLLING UP" PATIENTS.
2) TWO-THIRDS OF THE PATIENT BEDS IN THE FACILITY HAVE THE BED CRANK
POSITIONED IN A MANNER WHICH REQUIRES A STOPPED POSITION WHILE
CRANKING THE BED UP. THE POSITION, COMBINED WITH A WORN,
INADEQUATELY LUBRICATED SHAFT AND AXLE, SUBJECTS EMPLOYEES TO
STRAIN INJURIES.
3) SOME NEW AND TEMPORARY EMPLOYEES ARE OVERLY CAUTIONS AND MAY NOT
CONTRIBUTE EQUALLY TO LIFTING, TRANSFERRING AND/OR ASSISTING
OPERATIONS. REGULAR, MORE EXPERIENCED EMPLOYEES WOULD THEN BE
REQUIRED TO PERFORM THE MAJORITY OF THE OPERATION WHICH COULD
EXCEED THE MAXIMUM PERMISSIBLE LIMIT.
AMONG OTHER METHODS, FEASIBLE ADMINISTRATIVE AND ENGINEERING CONTROLS
COULD INCLUDE THE FOLLOWING:
1) DEVELOP A COMPANY POLICY TO ENSURE THAT WHEN A NEW PRODUCT IS
CONSIDERED FOR USE, THAT IT IS THOROUGHLY TESTED TO DETERMINE
IF IT WILL COMPROMISE THE HEALTH AND SAFETY OF WORKERS REQUIRED
TO WORK WITH IT BEFORE IT IS IMPLEMENTED.
2) PHASE IN RESIDENT BEDS THAT ARE MORE ERGONOMICALLY CORRECT AS NEW
FURNITURE IS PURCHASED. ALSO, AS AN INTERIM MEASURE, CONSIDER
ASSIGNING RESIDENTS THAT ARE LIGHTER OR MORE CAPABLE OF HELPING
THEMSELVES TO BOTTOM CRANK BEDS TO REDUCE THE OVERALL STRAIN ON
EMPLOYEES.
3) DEVELOP A COMPANY POLICY TO SCREEN TEMPORARY EMPLOYEES TO VERIFY
CERTIFICATION AND KNOWLEDGE OF LIFTING TECHNIQUES. ALSO, DEVELOP
POLICY TO HANDLE OVERLY CAUTIOUS OR INEXPERIENCED EMPLOYEES WHO
CAN NOT CONTRIBUTE EQUALLY TO LIFTING OPERATIONS.
4) UTILIZE THE HOYER LIFT ON A REGULAR BASIS AND CONDUCT A SURVEY
TO DETERMINE WHICH RESIDENTS SHOULD BE INITIALLY SET UP WITH HOYER
PADS TO AID EMPLOYEES WHO MUST ASSIST HIM/HER LATER IN THE DAY.
5) RESEARCH AVAILABLE OPTIONS TO PROVIDE NON-SLIP SHOES TO RESIDENTS
OR HOW TO CONVERT SOLES TO NON-SLIPS.
6) DEVELOP AN ERGONOMICS TASK FORCE CONSISTING OF MANAGEMENT, NURSES
AND NURSE AIDES TO PERIODICALLY DISCUSS ERGONOMIC PROBLEMS AND
WORK TOGETHER TO IMPLEMENT FEASIBLE, EFFECTIVE CONTROLS TO REDUCE
OR ELIMINATE EXPOSURES TO EMPLOYEES.

Issued

Jul 9, 1991

Abate by

Aug 14, 1991

Penalty

Initial $2,500

Issued

Jul 9, 1991

Abate by

Aug 14, 1991

Penalty

Initial $1,000 · Current $340 Reduced

Issued

Jul 9, 1991

Abate by

Aug 14, 1991