OSHA RFI, to address biohazards for healthcare workers

  1. 0 I participated in a conference call with OSHA 2 weeks ago. I will work with them as a member of the Consumers Union to discuss and come up with recommendations for HCWs exposure to boihazards, including Hospital acquired infections.

    My focus has been MRSA, but HCWs are exposed on a regular basis to a number of infections. Delayed diagnosis of these infections can create a problem with exposure while inadequately protected to these illnesses. I will offer my opinion by answering the Request for Information that OSHA is seeking. Repeated exposures to these sometimes deadly and horrible infecitons should not be accepted as part of your daily routine. It could jeopardize your life or that of your family members if you carry it home.

    This RFI ends on August 4, 2010. Please submit your own opinions, for your own protection. http://www.dol.gov/federalregister/P...px?DocId=23847

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  2. Visit  Mammy1111 profile page

    About Mammy1111

    From 'Bangor, Maine'; Joined Jan '09; Posts: 100; Likes: 54.

    12 Comments so far...

  3. Visit  nursemarion profile page
    0
    Other than protecting ourselves as best we can I am not sure what else we can do. This is the risk we live with just as people who walk high on metal beams to do construction for a living or people who put out fires for a living. You go into a job knowing that there are certain risks. Sick people are full of germs. Personally I worry more about the people out in the public who don't know they are sick.
  4. Visit  Mammy1111 profile page
    0
    If OSHA finally recognizes boihazard exposures, such as MRSA, which HCWs encounter regularly, it will force facilities not to take it so lightly. There are ways to stop MRSA from spreading and/or having HCWs get exposed so often, that most hopsitals have not adopted. Infection control is consistantly underfunded by hospital administrations. Exposure to deadly MDROs is not something that HCWs should take lightly or in stride. If you become infected because of unknown infection in a patient or because your hospital is consistantly late in diagnosing these infections and therefore inadequate precautions are prescribed.....you will pay the price with your own health, your career and your own money. You will have the fight of your life if you want to get workmans comp for such an infection.
    OSHA has a sincere desire to do something contstructive about this. If you have ideas about how to better protect yourself and your coworkers, this is your chance to send your ideas to OSHA. It is the job of OSHA to make your workplace safe and that is their desire with this new RFI and work toward decreased biohazard exposure.
  5. Visit  nursemarion profile page
    0
    In my experience it is sloppy, lazy people who do not follow even standard precautions, not the hospital's lack of effort or funding that cause the problems. Not too long ago I went to the ER with a grossly swollen, red infected cat bite on my hand. The doc and the nurse who started my IV did not wear gloves. This is the ER for goodness sake and my hand was wrapped and draining. I told them it was infected going in. No excuse for this, no excuse at all. Infection control departments need to be more aggressive with policing these things. I see it all the time, people still don't wear gloves for injections and IVs even though there is possible blood exposure. Then they cry about getting MRSA. If you take all possible precautions and still catch something it is a shame but if you don't bother to protect yourself it is your own doing or undoing. I am sick of sloppy health care workers, we have known about standard precautions for many years. Get with the program already. OSHA regs need to be enforced by the hospital. I know there are circumstances beyond our control- unexpected bleeding, surprise TB exposure, etc. But universal precautions will take you a long way in protectiong yourself and others.
  6. Visit  Mammy1111 profile page
    0
    Surprise MRSA pneumonia, surprise C diff, surprise many other infections. Screening and proper follow up can help control these infections thus decreasing exposures. It's a win win for patients and HCWs.
    I agree that compliance with precautions are not always followed, but even if they were, there are problems with late detection of infections when HCWs were unaware and unexpectedly exposed.

    I am with the program. I am working with both OSHA and the CDC to help both patients and Healthcare workers. If you think things are fine where you are, so be it. But, I doubt very much that they are.....
  7. Visit  ♪♫ in my ♥ profile page
    0
    One thing that I would like to see is implementation of something like a current bill in California: Infections among HCW presumed to work-related, just as they are with public-safety workers.

    I agree with cxg174 insofar as there being a lackadaisical attitude among many HCW regarding infection control and poor compliance with full contact isolation protocols.
  8. Visit  Mammy1111 profile page
    0
    I am suggesting exacty what you say in my RFI. I have also participated in a telephone conference with OSHA and these are the types of things that they want to address with employee exposures.
  9. Visit  nursemarion profile page
    0
    Everyone is swabbed for MRSA on admission to the hospital. They give probiotics to help prevent C-Dif. They have hand sanitizers by the entrance doors for all staff and visitors to use. Gloves are everywhere. I really think that the hospital is doing its part. Doctors are STILL overprescribing antibiotics for people who do not need them, and they are the worst offenders for gloves. Is anyone looking at them? Besides, most infections are not a surprise, we normally assume everyone is infected these days.
  10. Visit  Streamline2010 profile page
    2
    I agree with the comment that facilities need to take MRSA and the rest of it seriously. There is a very long thread here someplace on this forum about worst experiences or messiest jobs or whatever. Coming from the chemical industry, I am truly appalled at how often nurses, aides, and other medical professionals are apparently sprayed with excrement and bodily fluids. I read numerous stories in that thread, and all of them had the same thing in common: Total lack of personnel protective equipment for the caregivers doing the job. Yes, I know it might be insulting to a patient to have a caregiver go in there in a disposable suit, shoe covers, and a full face shield. But, come on, biohazards are biohazards, and how much (preventable) exposure do these hospitals and nursing homes expect their employees to put up with. Again, I think a lot this goes back to "Be a nice little girl and do your job, honey." In the chemical plants and labs, I was issued Tyvek suits, shoe covers, respirators, face shields, maybe even a supplied air mask and a pressure suit, and my exposure was monitored, and OSAH was really interested in what all we were getting exposed to, and OSHA was levying some hefty fines for incidents and violations. Just sayin'... The chemical industry has been required to do that for well over 35 years.
    3rdcareerRN and ♪♫ in my ♥ like this.
  11. Visit  nursemarion profile page
    1
    Quote from Streamline2010
    I agree with the comment that facilities need to take MRSA and the rest of it seriously. There is a very long thread here someplace on this forum about worst experiences or messiest jobs or whatever. Coming from the chemical industry, I am truly appalled at how often nurses, aides, and other medical professionals are apparently sprayed with excrement and bodily fluids. I read numerous stories in that thread, and all of them had the same thing in common: Total lack of personnel protective equipment for the caregivers doing the job. Yes, I know it might be insulting to a patient to have a caregiver go in there in a disposable suit, shoe covers, and a full face shield. But, come on, biohazards are biohazards, and how much (preventable) exposure do these hospitals and nursing homes expect their employees to put up with. Again, I think a lot this goes back to "Be a nice little girl and do your job, honey." In the chemical plants and labs, I was issued Tyvek suits, shoe covers, respirators, face shields, maybe even a supplied air mask and a pressure suit, and my exposure was monitored, and OSAH was really interested in what all we were getting exposed to, and OSHA was levying some hefty fines for incidents and violations. Just sayin'... The chemical industry has been required to do that for well over 35 years.
    The PPE is there- the nurse only needs to go and get it. Nothing is stopping a nurse from covering his or herself up but their own actions. Every year nurses go to the annual inservices where they tell us where and when to wear PPE. We ALL know what to do, the hospitals stock the stuff, everything is in place. The gap is between what we should be doing and what we actually do. The reasons for this are:

    1. Laziness
    2. Peer pressure (why are you gowning up for that???)
    3. Time pressure
    4. Apathy and desensitization after being around sick people for so long
    5. No enforcement of proper procedure
    6. Fear of waste- hospitals are all hurting and we hate to waste supplies when we know in the end it comes out of our own paychecks in the long run- less money to spread around= lower pay.

    Nurses are not alone in that we are constantly reminded about costs, how the hospital is losing money, might close, jobs may be lost, no raise again, no more benefits or retirement, do more with less, yada yada yada.

    If the cost of infection is instead emphasized, so that people could see what poor practice results in, maybe they could see it as a win-win situation to follow precautions.

    I will shut up now. I am sorry for posting again on this topic I just have strong feelings about it.
    3rdcareerRN likes this.
  12. Visit  Streamline2010 profile page
    0
    That's very reassuring. I start nursing school soon, and this was one issue that bothered me. Along with no-jobs, of course. I kept reading through that entire thread, thinking it was rather insane, lol.
  13. Visit  ♪♫ in my ♥ profile page
    2
    We just had a patient infected with a somewhat unique organism and resistance pattern. Our infection-control dept. just cultured our med-prep area and *gasp* it grew out her bug. The explanation? Poor compliance by some nurses, and the doc, with isolation protocol.

    The doc actually 'faced' me in front of the pt. saying, "Why are you wearing that gown?" and then said, "that's not necessary" and examined the patient without even wearing gloves... let alone the gown and booties (this pt. was incontinent of urine and had pyelo with the resistant bug).

    I reported him to the infection-control dept.
    nursemarion and 3rdcareerRN like this.
  14. Visit  Fribblet profile page
    0
    I know this technically isn't a biohazard, but I feel we aren't monitored as closely as we should be regarding radiation exposure. In the ER I work at, x-rays a constantly being shot and no one is issued any sort of monitoring device.


    On a more biohazardy note: The ER is a particularly interesting place as far as biohazards go. We take care of lots of patients, and are in close contact with patients, that turn out to have TB, bacterial meningitis, MRSA, etc. Often times we are not even aware that these infections were present until days later. Sometimes, if I took care of a patient with a communicable disease at the end of my week, I only happen to hear about it a week later after I've potentially spread it to everyone in my household.

    We also take care of patient's that spit on us, hit us, throw bodily fluids, and behave violently when starting an IV/drawing blood. Drug seekers can be some of the worst offenders, and if they're homeless IV drug users, they have all sorts of nasty infections.

    It's impossible to gown up in the ER for every pt at might possibly have an infection or might throw their urinal at you or spit on you. So I'm not sure that there's anything we can do about it short of making management put their money where their mouths are and let us take care of abusive patient's by putting them out on their ass in the street.


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