OSHA Inspection: VIRTUA MEMORIAL HOSPITAL

Issued

Nov 14, 2016

Abate by

Mar 23, 2018

Penalty

Initial $12,471 · Current $12,471

General-duty citation text

OSH ACT of 1970 Section (5)(a)(1): The employer did not furnish the employees employment and a place of employment which were free from hazards that were causing or likely to cause death or serious physical harm to employees, in that employees were required to perform patient handling tasks resulting in physical stressors that have caused or are likely to cause serious musculoskeletal injuries and disorders (MSDs):     Virtua Memorial Hospital located at 175 Madison Avenue, Mount Holly NJ 08060 ? Employees including, but not limited to, Registered Nurses (RNs) and Patient Care Technicians (PCTs), are required to manually lift and ambulate patients without the use of safe patient handling equipment, including mechanical patient handling equipment and patient handling aids, in areas such as, but not limited to: Orthopedic/Stroke Unit and the Renal Unit.      a)    Orthopedic / Stroke Unit:  A RN  and two PCTs were observed manually lifting a patient, without the use of safe patient handling equipment or devices, while ambulating a patient from the bed to a chair, observed on or about October 5, 2016.     b)    Renal Unit:  A RN and a PCT were observed manually lifting a patient without the use of safe patient lifting devices or equipment, while ambulating a patient from a bed to a chair, observed on or about October 5, 2016.            Feasible and useful method to correct the hazard - Fully implementing a Safe Patient Handling Program that includes a lifting and transferring policy, related procedures with guidance on the reduction and/or the elimination of manual patient handling tasks by use of appropriate equipment and mechanical devices; and determining the safest method to lift, transfer, ambulate or reposition each patient.      A Safe Patient Handling Program will include:      1. Patient Assessment:      The facility needs to continue to assess the following: a) Lifting, transferring, and repositioning needs of each resident and b) Safety consideration for direct care employees by selecting the most appropriate assistive devices based on the residents ability to bear weight, follow directions, assist with bed mobility, ability to ambulate, and the rehabilitation goals.        The patient assessment will eliminate all manual physical assists by RNs and PCTs and will minimize in all cases and eliminate when feasible the manual physical assist by one or two persons to lift, transfer and reposition the patient.      Use an assessment criteria to determine a patient?s movement needs and identify the most appropriate methods to move and ambulate the patient while minimizing in all cases and eliminating when feasible the manual physical assistance required by the staff.  The assessment needs to take into consideration the recommended weight limit of 35 pounds for patient handlers.        The facility needs to continue to convey to all staff responsible for the patient care through formal shift change meetings, care plan documentation, and training with the mind set of keeping the patients as independent as possible but at the same time addressing the actions that may cause patient handler injury.       2.  Equipment:      A sufficient amount of appropriate assistive devices must be provided with the variety of appropriate slings and sizes of slings for the tasks to enable mechanical lift, transfer, ambulation and repositioning for the patients and to protect the staff.       In order to eliminate manual lifting more than 35 pounds of the patient?s body weight the following needs to be considered: a) One full dependency lift is needed for every 8 to 10 non-weight bearing patients; b) One sit/stand lift needs to be provided for every 8 to 10 partial weight bearing patients and c) Ambulation aids are needed for every patients with balance, strength or endurance limitations.  The equipment footprint will be considered for the bedroom and bathroom configurations.      3.  Workplace Assessment:      The infectious disease unit and the renal unit rooms, bathrooms, bathing areas and floor transitions must be assessed to identify factors that might contribute to patient handling incidents. This includes space constraints, furniture that might interfere with transfers or repositioning, the bathroom configuration, bed height adjustability the equipment storage locations and other physical barriers that might restrict movement of lifting equipment.      4.  Training:      Training must be provided to all staff on all shifts responsible for implementing the comprehensive system-wide approach to safe patient handling.  The training should include the concept that manual patient handling should be minimized in all cases and when feasible.  The staff will be trained in the use and should demonstrate competence in the use of patient handling and the procedures to follow for patient lifting, transferring, and ambulating equipment.       5.  Staff Responsibilities:      The Administrator will ensure the following: a) Continuing support and understanding of  the implementation of the new Ergonomics Program policies and procedures; b) All staff affected by the policy are trained by providing appropriate and sufficient assistive devices for all the patient handling tasks in the facility; c) Identifying acceptable storage locations for the patient handling equipment; d) Providing the resources necessary for the medical management program and patient handling program; e) Assign safety and health responsibilities to hold subordinates accountable; and f) The safety and health program remains effective and open to improvements      Supervisory Personnel/Program Coordinators will ensure the following: a) Increase additional training in hazard detection and accident/incident investigation; b) Ensure maintenance controls and availability of assistive devices; and c) Reinforce employee training through continual performance feedback and through enforcement of safe work practices      There will be an appropriate assessment of each patient to determine lifting and transferring methods that are consistent with the patients? needs and rehabilitation goals.  The assessment should minimize in all cases (eliminate when feasible) the manual assist by one or two persons to lift, transfer and reposition the patient.  All patients will be quickly reassessed if their condition changes.          RNs and PCTs will be provided with the following: a) Training to become competent in the procedures when transferring or moving the patients; b) Training to use appropriate assistive devices when performing high-risk patient handling tasks; c) Ability to report any patient handling injury to management without any barriers or reprisal; and d) The ability to continue to notify management without any barriers or reprisal of the following: change in patients condition, the need for retraining on devices or equipment, and immediately notify maintenance or a designated member of management for immediate response to repair or replace mechanical devices, slings, or missing components.      6.  Medical Management Program       The program will include the following elements such as, but limited to:  a) All injuries need to be reported promptly to the unit manager without any barriers or reprisal; b) Employees need to receive appropriate care based on a protocol that is approved by an occupational physician c) Each injury needs to be promptly investigated to determine the root cause, address the findings, develop and implement preventive measures; d) Ensure that musculoskeletal disorder injuries which have occurred are tracked and trended on a regular basis using data from the past three years in order to improve upon the Ergonomics Program through education, training, and monitoring the needs for additional assistive devices; and e) each injurie needs to be evaluated for further treatment if necessary.

Issued

Nov 14, 2016

Abate by

Feb 28, 2017

Penalty

Initial $1,000 · Current $0 Reduced

General-duty citation text

29 CFR 1904.29(b)(1): 29 CFR 1904.29(b)(1): A log of all recordable work-related injuries and illnesses (OSHA Form 300 or equivalent), was not completed in the detail as required by the regulation:     a) Virtua Memorial Hospital located at 175 Madison Avenue, Mount Holly NJ 08060:  On or about May 16, 2016 the employer did not have the OSHA 300 log Column E (Where the event occurred) completed in the detail as required by the regulation for the calendar year 2016.    b) Virtua Memorial Hospital located at 175 Madison Avenue, Mount Holly NJ 08060:  On or about May 16, 2016 the employer did not have the OSHA 300 log column F (Description of the injury or illness and object/substance that directly injured or made person ill and part of the body affected) completed in the detail as required by the regulation for the calendar year 2016.

Issued

Nov 14, 2016

Abate by

Feb 28, 2017

Penalty

Initial $1,000 · Current $0 Reduced

General-duty citation text

29 CFR 1904.30(a): 29 CFR 1904.30(a):  The employer did not keep a separate OSHA 300 Log for each establishment that was expected to be in operation for one year or longer:           a)  Virtua Memorial Hospital:  On or about May 16, 2016, the employer did  not keep a separate OSHA 300 log for Virtua Memorial Hospital located at 175 Madison Avenue, Mount Holly NJ 08060.    b)  Early intervention program:   On or about May 24, 2016 and July 5, 2016 the employer did not keep a separate OSHA 300 log for the Virtua Early intervention program located at 101 Burrs Road, Building 2A, Mount Holly, NJ 08060.

Issued

Nov 14, 2016

Abate by

Feb 28, 2017

Penalty

Initial $1,000 · Current $0 Reduced

General-duty citation text

29 CFR 1904.40(a): The employer did not provide an authorized government representative the records within the four business hours.    a) Virtua Memorial Hospital located at 175 Madison Avenue, Mount Holly NJ 08060:  On or about August 3, 2016 the employer the employer failed to provide the CSHO with copies of the OSHA 301 forms (Employee incident report) within four business hours.