The OSHA/NIOSH toolkit contains an appendix that is an editable document any hospital can use to draw up its respiratory protection program.

OSHA Steps Up Enforcement at Hospitals, Nursing Homes, Long-Term Care Facilities

Inspectors will be on the lookout for five hazards: musculoskeletal disorders caused by patient handling, bloodborne pathogens, workplace violence, tuberculosis, and slips, trips and falls.

Targeting some of the most common causes of workplace injury and illness in the health care industry,OSHA announced June 25 that it is expanding its use of enforcement resources at hospitals, nursing homes, and long-term care facilities to focus on these five hazards: musculoskeletal disorders related to patient or resident handling; bloodborne pathogens; workplace violence; tuberculosis; and slips, trips and falls.

A June 25 memorandum from Deputy Assistant Secretary Dorothy Dougherty to regional administrators and state designees includes BLS, OSHA, CDC, and NIOSH data on those hazards, information about past OSHA emphasis programs and inspections, and instructions on how OSHA and state plan inspectors should focus on them during programmed and unprogrammed inspections at these work sites. They are in the North American Industry Classification System Major Groups 622 (hospitals) and 623 (nursing and residential care facilities).

Her memorandum said "the goal of this policy is to significantly reduce overexposures to these hazards through a combination of enforcement, compliance assistance, and outreach."

OSHA's announcement said U.S. hospitals recorded nearly 58,000 work-related injuries and illnesses in 2013, representing 6.4 work-related injuries and illnesses for every 100 full-time employees, which is almost twice as high as the overall rate for private industry. "Workers who take care of us when we are sick or hurt should not be at such high risk for injuries – that simply is not right. Workers in hospitals, nursing homes, and long-term care facilities have work injury and illness rates that are among the highest in the country, and virtually all of these injuries and illnesses are preventable," said Assistant Secretary Dr. David Michaels. "OSHA has provided employers with education, training, and resource materials, and it's time for hospitals and the health care industry to make the changes necessary to protect their workers," he added.

"The most recent statistics tell us that almost half of all reported injuries in the health care industry were attributed to overexertion and related tasks. Nurses and nursing assistants each accounted for a substantial share of this total. There are feasible solutions for preventing these hazards and now is the time for employers to implement them," he said.

American Nurses Association Executive Director Debbie Dawson Hatmaker, Ph.D., RN, FAAN, issued a statement thanking OSHA and the Obama administration for expanding the focus of OSHA inspections to include MSDs related to manual patient handling. "Labor statistics have consistently shown that nurses, nursing assistants and other health care workers are at high risk of MSDs from manually lifting, transferring, and repositioning patients. Manual patient handling is unsafe for patients and often results in painful, career-ending health care worker injuries. ANA is hopeful that OSHA's enforcement memo will encourage hospitals to proactively address safe patient handling and mobility and create comprehensive programs to protect patients, nurses and other health care workers. While OSHA's action is a step in the right direction, ANA believes a federal ergonomic standard is necessary to protect health care workers and is working with Congress to introduce legislation that would establish such a standard," she said.

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