OSHA Inspection: LEHIGH VALLEY HOSPITAL

Issued

Apr 27, 1990

Abate by

Nov 30, 1990

Penalty

Initial $490 · Current $490

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
serious injury/illness from blood-borne diseases:
a) Health care workers exposed to body fluids and thus at risk of
developing blood borne infections including but not limited to:
nurses, lab technicians and technologists (phlebotomy, histology,
cytology, x-ray, immunology, respiratory, stat, toxicology, blood
bank) and other employees at risk depending on their work assignment
(transport unit, linen service) were exposed to the hazard of being
infected with HBV and/or HIV through possible direct contact with
blood or other body fluids, observed on January 17, 1990.
Based on a comparison of the 1989 inservice training records to the
1990 employee listing to include an in-house physician's list, it
was determined that 49 percent of the employees at risk of HIV/HBV
infection had not received training on universal precautions.
One feasible and acceptable abatement method to correct this hazard is
to ensure mandatory participation of employees in the inservice program
or universal precautions. Information provided should include at a
minimum:
1) Education on precautionary measures, epidemiology, modes of
transmission, and prevention or HIV/HBV.
2) Counseling regarding possible risks to the fetus from HIV/HBV and
other associated infectious agents.
3) The location and proper use of personal protective equipment, proper
work practices, and the concept of universal precautions as it
applies to their work practices.
4) The meaning of color coding or other methods used to designate
contaminated articles or infectious waste.
5) Procedures to be taken if exposed to needlesticks or body fluids.
6) The hospital's policy regarding the availability of hepatitis B
vaccine.

Issued

Apr 27, 1990

Abate by

Aug 1, 1991

Penalty

Initial $490 · Current $490

Hazardous substances 8300

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
serious injury from lifting and transferring of patients:
a) Nursing department employees engaged in the manual lifting and
transferring of patients were exposed to an increased risk of
musculoskeletal injuries. The hospital's injury and illness records
(OSHA 200 logs) for 1988 and 1989 documented that there was a pattern
of back injuries among this group of employees that were caused or
aggravated by the exertions involved in the performance of these
tasks on or about January 18, 1990.
One feasible and acceptable abatement method to correct this hazard is
the implementation of a comprehensive back injury prevention program.
This program should include at a minimin:
1) A formal written policy endorsed by the Hospital Administrator
or President which outlines the authority and specific responsibility
of the staff in the implementation, compliance and enforcement of the
various provisions of the hospital's back injury prevention program.
2) Investigation and analysis of back injury cases as a means of
identifying specific, activities and patient care areas where
greatest number of incidents are occurring.
3) Detailed ergonomic evaluations of those tasks which are associated
with the highest frequencies of employee back injuries, including
the identification of specific elements in those tasks which are
capable of being modified through the use of mechanical lifting
devices and aids or changes in lifting methods, including where
necessary, the use of multiple personnel during specified lifting
tasks.
4) Assuring that lifting devices or aides are readily available and
easily accessible on each floor.
5) Official procedures and guidelines describing specific step-by-step
techniques for the various routine lifting and patient transfer tasks
performed by nursing department personnel.
6) Baseline assessments of the lifting skills and abilities of all new
hires prior to assignment to specific patient care areas.
7) Mandatory inservice back injury prevention training for all nursing
department employees who may be involved in lifting and patient
transfer tasks. Training sessions should include, at a minimum:
a) A review of the hospital's back injury prevention policy.
b) A discussion of the general rules of body mechanics, along with
those musculosketal disorders which may result from overexertions
encountered during lifting and patient transfer tasks.
c) Hands-on demonstrations of the specific lifting and patient
transfer techniques described in the hospital's procedures and
guidelines with specific emphasis on the use of mechanical lifting
devices and aids.
d) A discussion of the benefits of exercise in reducing the incidence
of work induced back injuries, including the identification of
sources of information on specific exercises and available
exercise programs.
e) A review of the procedures to be followed by employees subsequent
to the occurrence of a back injury, along with a description of
the medical and rehabilitation services and return-to-work program
which are available to these employees.
8) Internal monitoring of staff compliance with the policy and procedure
of the back injury prevention program.
ABATEMENT NOTE:
Step 1 - Effective administrative protection including the establishment
of a formal back injury prevention policy, mandatory in-service
training and baseline assessments of new hires, shall be
provided as an interim protection measure until feasible
engineering and permanent administrative controls can be
implemented which will reduce employees exposure to nominal
risk.
Step 2 - Submit to the Area Director a written, detailed plan of
abatement outlining a schedule for the implementation of
engineering and administrative measures to control employee
injury due to manual lifting and employee transfer tasks.
Engineering controls to reduce musculoskeletal stress include,
but are not limited to, task redesign, reduction of lifting
frequencies or weight and use of mechanical lifting devices
and aids. The plan shall include at a minimum, target dates for
the following actions which must be consistent with the dates
required by this citation:
1) Investigation and analysis of back injury cases to identify
where the greatest number of incidents are occurring.
2) Ergonomic evaluations of those tasks which are associated
with the highest frequencies of back injuries.
3) Development of procedures and guidelines for routing,
lifting and patient transfer tasks.
4) Evaluation of mechanical lifting devices and aids.
5) Procurement, installation and implementation of selected
procedures and lifting devices.
6) Monitoring to assure effective utilization of the control
measure(s).
Ninety (90) day progress reports are required during the
abatement period.
STEP 3 - Abatement shall have been completed by the implementation
of the back injury prevention program and upon verification
of the program's effectiveness in reducing the occurrence
of musculoskeletal injuries among nursing department personnel.

Issued

Apr 27, 1990

Abate by

May 23, 1990

Penalty

Initial $350 · Current $350

Issued

Apr 27, 1990

Abate by

May 14, 1990

Issued

Apr 27, 1990

Abate by

May 14, 1990

Issued

Apr 27, 1990

Abate by

Aug 1, 1991

Issued

Apr 27, 1990

Abate by

May 2, 1990