OSHA Inspection: ERIE CO HOME

Issued

2012-09-07 00:00:00

Abate by

2013-09-11 00:00:00

General-duty citation text

NYSLL Article 2, Section 27-a.3.a(1): The employer did not furnish
employment and a place
of employment which were free from recognized hazards that were causing or
likely to cause
serious physical harm to employees, in that employees were required to
perform lifting tasks
resulting in stressors that have caused or were likely to cause
musculoskeletal disorders (MSDs):
a).Location - Erie County Home, Walden Ave, Alden NY.  On or about
3/27-4/10/12
employees were exposed to the hazards of manually lifting, repositioning
and transferring
residents which were causing or likely to cause back, shoulder and neck
injuries.
Employees were required to transfer non-weight bearing and partial weight
bearing
residents manually by lifting or partially lifting them, exposing
employees to lifting-
related hazards resulting in injuries and disorders such as lumbar or back
strain/sprain/pain, herniated/ruptured disk, injury to the L5/S1 disc, and
various shoulder
injuries. Employees use a 2 person stand pivot in situations where the
resident
is not able
to bear weight and assist in the transfer.
Employees are required to reposition residents who have been determined to
be fully
dependent upon the caregiver or require extensive assistance from the
caregiver as
defined by NYSDOH MDS in bed mobility.  This was done without to
assistance of a
friction reducing device.  Repositioning in bed is done by a draw sheet.
Employees were required to provide toileting assistance to residents who
are fully
dependent, extensive assist or limited assist without the aid of
equipment.
Institutional Aides (IA's) at this facility are the primary employees to
do transferring,
lifting and repositioning tasks.  The DART rates for this facility for
2009, 2010 and 2011
are 15.8, 16.9 and 18.4, respectively.  Of all injuries occurring to
employees in 2009,
2010 and 2011, 85, 76and 74respectively, occurred to IA's.  Injuries
to
IA's in
2009, 2010 and 2011 resulted in 4556, 3495 and 3097 days away from work,
respectively.  Resident Handling was the contributing factor in 54, 64
and 52of
all injuries in 2009, 2010 and 2011, respectively.
Reasonable means of abatement include but are not limited to implementing a
comprehensive Safe Resident Handling and Movement Program for
transferring, lifting
and repositioning of non-weight bearing and partial weight bearing
residents.  Effective
Safe Resident Handling programs involve a systematic approach with both
management
and employee involvement.  Effective programs include engineering controls,
administrative controls and training.  Elements of effective programs
include but are not
limited to clear written policies and procedures which are understood by
all involved
departments; include a preventive maintenance program which monitors
inventory and
identifies equipment problems immediately, include an after action review
to help identify
and eliminate risk factors, provide training of Physical Therapy,
Occupational
Therapy
and In-Service staff on State of the Art safe resident handling
procedures, provide
training of front line healthcare workers to ensure they can identify
ergonomic risk
factors, properly use equipment and identify when a resident should be
reassessed, and
provide necessary mechanical lifting, transferring and repositioning
devices to minimize
to the greatest degree possible, the amount of manual lifting tasks
performed by theirstaff.  Effective Resident Handling Programs typically
have a point person responsible
for the program who is supported by management.
Support of SPH Serious Hazard/General Duty Violation
1.Serious Hazard Exists:
a.Type of accident or health hazard the general duty clause was designed to
prevent:
i.Over-exertion, awkward postures, forceful exertion while lifting,
transferring and repositioning residents
b.The most serious injury which could reasonably be expected to result
from the
type of accident or health hazard identified in (a) above.
i.Musculoskeletal disorders of the back, neck, knees and shoulders
including but not limited to bulging disk, herniated disk and stenosis.
c.Results of injury (in (b) above) could cause death or serious physical
harm
i.Injuries caused by lifting, transferring or repositioning residents has
resulted in more than 2500 days away from work in 2011 at Erie County
Home.
ii.These types of injuries have been shown to end healthcare worker careers
due to chronic pain or injury as documented in NIOSH's  Safe Lifting and
Movement of Nursing Home Residents, DHHS Publication No. 2006-117.
d. Employer Knowledge
i.Erie County Home has purchased lifting equipment to reduce the amount
of lifting done by healthcare workers including full mechanical lifts and
sit/stand lifts.
ii.Interviews with management indicate they are knowledgeable about "Safe
Patient Handling" principles and are building a new facility which will
have state of the art ceiling lift technology in a bariatric wing.
iii.Erie County Home has tried friction reducing devices in the past
iv.Due diligence including reviewing SH900 logs would provide evidence
that employees are repeatedly being injured while lifting, transferring and
repositioning residents.
v.Employees of Erie County Medical Center Corporation have attended
NYSDOL sponsored Safe Patient Handling Conferences.
2.General Duty Support:
a.Employer failed to keep the workplace free from a hazard to which
employees
were exposed
i.Employees manually lift residents when transferring them from bed to
chair and from chair to bed.  This was witnessed by inspectors.
Employees used excessive force to reposition residents in bed and in
chairs which was witnessed by inspectors.  Employees manually lifting
deceased residents from gurney to morgue cart as reported by staff
members.
b.The hazard was recognized/foreseeable
i.The employer recognized the hazard and implemented the use of full
mechanical lifts and sit/stand lifts for the lifting, transferring of
someresidents in some situations.  Residents less than 140 pounds are often
lifted, handled or moved differently than those in excess of 140 pounds.
NIOSH recommends that no caregiver should manually lift more than 35
lbs of a person's body weight for a vertical lifting task. NIOSH further
recommends that when the weight to be lifted exceeds this limit, assistive
devices should be used. These recommendations have been adopted by the
Veterans Health Administration (VHA) and incorporated into its current
patient handling recommendations and patient handling algorithms.
Moreover, other major interest groups, such as the American Nurses
Association (ANA), National Association of Orthopedic Nurses (NAON),
and Association of Perioperative Registered Nurses (AORN) have all
adopted similar patient handling guidelines that recommend use of
technology-based solutions for patient handling and movement. The hazard
was foreseeable by evaluating the number and causes of injuries involving
resident handling.  The hazard is also foreseeable and recognizable by
OSHA and a focus of their Nursing Home NEP. In 2007 OSHA published
"OSHA Guidelines for Nursing Homes" (Publication # 3182) and revised
this document in 2009. In this document OSHA provides recommendations
based on a review of existing practices and programs, State OSHA
programs as well as available scientific information and reflect comments
from representatives of trade and professional organizations, labor
organizations, the medical community, individual firms, and other
interested parties.  In this document OSHA presents case studies where
SPH programs have been developed in nursing homes which have reduced
the number of employee injuries and the severity of injuries.  OSHA takes
the position "OSHA Recommends that manual lifting of residents be
minimized in all cases and eliminated when feasible".
c.The hazard was causing or likely to cause death or serious physical harm.
i.2008- 55of injuries due to resident handling (2468 days away from
work)
ii.2009- 54of injuries due to resident handling (3539 days away from
work)
iii.2010- 64of injuries due to resident handling (3175 days away from
work)
iv.2011- 52of injuries due to resident handling (2587 days away from
work)
These injuries resulted in an average of 63 days, 80 days, 75 days and 86
days away from work in 2008, 2009, 2010 and 2011 respectively. It has long
been recognized
in general industry that excessive exposure to ergonomic risk factors
including Force (the
amount of physical effort required to perform a task (such as heavy
lifting) or to maintain
control of equipment or tools; Repetition- performing the same motion
continually or frequently
and Awkward Postures- assuming positions that place stress on the body,
such as reaching above
shoulder height, kneeling, squatting, leaning over a bed or twisting the
torso while lifting can
result in a variety of disorders in affected workers.  These conditions
collectively are referred
to as Musculoskeletal Disorders and include conditions such as low back
pain, sciatica, rotatorcuff injuries, epicondylitis etc.  Nursing staff at
Erie County Home are exposed to all of these
same risk factors identified above.
d.There is a feasible and adequate abatement method to correct the hazard
i.An effective Safe Resident Handling program with management
commitment, employee involvement, proper equipment and training will
minimize or in some cases eliminate the amount of manual lifting,
transferring and repositioning done by employees and has been shown to
correct the hazard.  An effective program requires a systematic approach
where a combination of engineering and administrative controls along with
training is used.ing

Issued

2012-09-07 00:00:00

Abate by

2012-09-26 00:00:00

Issued

2012-09-07 00:00:00

Abate by

2012-11-14 00:00:00

Issued

2012-09-07 00:00:00

Abate by

2012-11-14 00:00:00

Issued

2012-09-07 00:00:00

Abate by

2012-11-14 00:00:00

Issued

2012-09-07 00:00:00

Abate by

2012-12-05 00:00:00

Issued

2012-09-07 00:00:00

Abate by

2012-10-24 00:00:00

Issued

2012-09-07 00:00:00

Abate by

2012-10-24 00:00:00

Issued

2012-09-07 00:00:00

Abate by

2012-10-24 00:00:00