TRAUMATISMES CARTILAGE CROISSANCE A. BENAMIROUCHE EHS BENAKNOUN EHS BENAKNOUN.
Environmental Health & Safety 4-6783 stonybrook/ehs/healthcare
description
Transcript of Environmental Health & Safety 4-6783 stonybrook/ehs/healthcare
Environmental Health & Safety 4-6783
www.stonybrook.edu/ehs/healthcare
Hazard Communication/Right-to-Know
for MSO, Medical Students and Nursing Students
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Training Outline
1. Hospital Safety Information Environment of Care Respiratory Protection Injury/Illness Reporting Reducing SB Medicine Staff Exposures
Contaminated Sharps Injuries Formaldehyde (Formalin) Safety Glutaraldehyde/OPA Safety Hazardous Drugs (HD) Safety - New Ethylene Oxide (EtO) Safety - New Waste Anesthetic Gases (WAG) Safety - New
Ergonomics Policy Environmental Awareness Transporting Infectious and Diagnostic Specimens
2. Hazard Communication/Right to Know 2
Management Plans:• Each reference card has
critical information• Posted in all patient care
areas• Please review; you are
responsible for knowing information on cards
Environment of Care (EOC)
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Top 12 Ways to Insure EOC
Compliance1. Always wear your Stony Brook ID badge.2. Know proper procedure for Major Chemical
Spill response. – Call University Police at 911 or 631-632-3333
from cell phone. (Off sites call 911)3. Know the location of your department’s
Emergency Management Manual and Plan.4. Know location of your unit’s disaster kit for
power outages (flashlights, batteries, extension cord, duct tape, glow sticks).
5. Know how to shut off the oxygen supply valve.
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Top 12 Ways to Insure EOC
Compliance6. Report building issues to Plant Operations at
4-2400.7. Know proper fire response procedures (RACE).8. Know locations of nearest fire alarm pull
stations and how to use a fire extinguisher (PASS).
9. Secure your personal belongings.10. Know how to access Safety Data Sheets, SDS,
on-line (formerly referred to as MSDS).11. Adhere to no smoking policy.12. Report building related issues. (Tech Park:
Contact Facilities Manager, 4-4380)
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Respiratory Protection
• SBUH requires all hospital employees, who come in contact with patients with known or suspect TB or another airborne pathogens, be annually fitted with a hospital approved N95 respirator.
• If you experience significant weight gain or loss, dental or facial surgery, or other condition that may affect respirator fit, you must be re-fitted, even if it is within a year of your last fit test.
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N95 Respirator- User Instructions
1. Prior to wearing a respirator you must be medically cleared by Employee Health, and trained/fit tested by EH&S.
2. Only wear the Type, Make, Model and Size respirator you were fitted with (e.g., N95, 3M 1860S). Keep fit test card with respirator information in your ID badge.
3. Read user instructions.4. Inspect your respirator and conduct the User Seal Check
prior to each use.5. Before you enter an isolation room that requires a
respirator, put on your respirator in the corridor (not in the ante-room or patient room).
6. For TB exposure, discard the N95 respirator when soiled or damaged. For SARS or smallpox exposure, discard after each use, unless directed otherwise.
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N95 - No Interfering Facial Hair
• Anyone with interfering facial hair cannot be fit tested or wear a N95 respirator because it prevents a good seal around the face.
• A small goatee or mustache that fits inside the respirator may be OK, but a full beard or substantial “stubble” is not.
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Do I need to Wear a Surgical Mask over the N95 Respirator?
Typically no. The hospital approved N95 respirators (3M 1860
and the Moldex/Inovel 1500 series) are both rated as surgical masks.
N95 Respirators
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N95 Annual Respirator
Fit Testing For Residents: Fit testing will take place the day of Orientation. (If you are not able to get fit tested at Orientation, you can be fit tested at one of the open monthly sessions).
==================================Open monthly fit testing schedule is provided in the Hospital weekly announcements and on the
Hospital’s intranet under “Hot Topics”.
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Injury/Illness Reporting
Report any work related injury/illness to your supervisor.
If necessary, seek medical attention at Employee Health and Wellness. If life threatening or off hours, go to the ED.
Complete an Employee Injury/Illness Report and fax to 2-2687.
Contact the Accident Reporting System (ARS) at 888-800-0029.
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How can we prevent future injuries?
Contaminated Sharps Injuries
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Reducing Contaminated
Sharps InjuriesUse a device with a safety, if available. If you are unsure how to use a device, seek
guidance.Actively participate in trials of new safety devices.Limit distractions and conversations -- Don't
disturb a colleague while they are using a sharp.Avoid multiple attempts during phlebotomy, ABGs,
IV catheter insertions, CV catheter placement, and lumbar punctures.
Use blunt tip needles in OR.Use extreme care when suturing.
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Reducing Contaminated Sharps
InjuriesTake your time, don't rush. "Cool off" after interpersonal conflict.Avoid passing. Immediately discard used sharp in sharps
container.When a sharps containers is ¾ full, have
someone contact Hospital Custodial Services at 4-1455. (Off-sites: call Bob Weniger at 4-4066).
Report all injuries and complete an Employee Injury/Illness Report and Sharps Injury Log.
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Formaldehyde/Formalin Safety
-human carcinogen-
When using specimen containers with formalin:
• Minimize length of time containers are open
• Avoid spillage• Clean up any spillage
immediately• Wear PPE – nitrile gloves
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Glutaraldehyde and Cidex OPA –
eye, skin, respiratory tract irritant
How to minimize exposure:• Use appropriate ventilation: GUS• Wear PPE (gloves, gown and eye
protection).• Pour carefully. • Keep containers closed when not in
use.• Use Glute-out neutralizer prior to drain
disposal and for spills.
Glutaraldehyde and Cidex OPA Safety
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Glutaraldehyde and Cidex OPA –
eye, skin, respiratory tract irritant
• Look for “HD Precautions” sign on in-patient room doors
• Wear appropriate PPE Anticipation of hand exposure – wear double nitrile
gloves, change out after 30 minutes For chemo and for anticipation of body splash –
wear chemo gown
• Avoid crushing or cutting HD tablets• Review HD Management policy, EC:0048
Hazardous Drugs (HD) Safety
Hazardous Drug - as defined by NIOSH (National Institute of Occupational Health & Safety), any drug identified by at least 1 of the following 6 criteria: carcinogenicity, teratogenicity or other developmental toxicity, reproductive toxicity in humans, organ toxicity at low doses in humans or animals, genotoxicity, or new drugs that mimic existing HDs in structure or toxicity. Include drugs for cancer chemotherapy, antiviral drugs, hormones, some bioengineered drugs and other miscellaneous drugs and are identified on NIOSH’s List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings.
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Ethylene Oxide (EtO) Safety
• EtO is a flammable, colorless gas used to sterilize surgical equipment
• Central Sterile Supply (CSS) uses EtO in closed system sterilizers/ aerators
• 2 EtO abators works automatically and interface with sterilizer/aerators
• CSS has gas alarm system with master alarm panel outside EtO room with visual and audible alarms– 3 separate EtO monitors, in EtO Room
and by each abator
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• WAG = nitrous oxide and halogenated anesthetics (e.g., halothane, enflurane, isoflurane, desflurane). – exposure from leakage of patient's anesthetic breathing
circuit during delivery of anesthetic and exhalations of patients recovering from anesthesia
• Use anesthesia delivery units with gas scavenging as per manufacturer’s instructions.
• Face masks used for administrating inhaled anesthetics should be available in variety of sizes, pliable, provide effective seal to prevent leakage, and positioned on the patient’s face properly.
• Wear PPE during spills of liquid anesthetic agents (gloves, goggles, face shields)
Waste Anesthetic Gases (WAG) Safety
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Ergonomics Policy
EH&S is responsible for managing the
Ergonomics Program, in consultation with
Employee Health & Wellness
Ergonomics: science of human work focusing on designing work stations, tools & tasks for safety, efficiency & comfort.
Musculoskeletal Disorders: (SDS) result from bodily reactions due to bending, climbing, crawling, reaching, twisting, overexertion, or repetitive motion. Injuries can occur to muscles, nerves, tendons, ligaments, joints, cartilage, and spinal discs in back, neck shoulder, elbow, wrist or hand.
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Ergonomics Policy
Reporting: Employees need to report work related injuries to their supervisor.
Incident Trending: when a trend of MSD injuries is identified in an area, a hazard assessment will be conducted.
Response: Controls may be used to reduce hazards
Training: General ergonomics awareness will be provided by EH&S during Orientation, recertification classes and online.
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Environmental Awareness
What happens to waste that is poured down the
drain?
It goes to the Sewage Treatment Plant at the University and then into the Long Island Sound.
Sewage Treatment Plant at the University
Long Island SoundPort Jefferson, NY
Remember: Do not put any hazardous waste down the drain.
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What is Chemical
Hazardous Waste?
• Chemical hazardous waste can include medications, cleaning products, paints, solvents, acids/bases.
• Most hazardous wastes have been identified throughout the Hospital and are being collected.
• If you are unsure whether you are generating a hazardous waste or are disposing of a new chemical product, complete a Waste Determination (Admin P&P EC:0045).
• If you have any questions, contact EH&S at 4-6783.
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You might see the following 4 waste disposal containers on the units:
• Pharmacy Return Box – all unused or expired drugs
• Black 2-gallon container – Partially Used Drugs with a label.
• Locked Box (Critical Care areas) – Epinephrine, Propofol (Diprivan), Eptifibatide (Integrilin) and Nitroglycerin
• Chemo container (Oncology areas) – Chemotherapy waste.
HW
HW
Common Chemical
Waste Containers
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Regulated Medical Waste
(Red Bag Waste)• Place the following in Red
Bags:• All waste generated in
diagnosis, treatment or immunization of humans:
• Cultures and stocks• Human pathological
waste excluding teeth• Human blood and
blood products• Waste products must be
“saturated” with blood or bodily fluids so that when squeezed produces free flowing fluid or flecks
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Sharps Waste
• Needles• All Syringes with needles• Syringes without needles that
have come in contact with blood or body fluids
• Pipettes• Slides and cover slips• Scalpel blades• Glass test tubes• Disposable staples• Explanted orthopedic
hardware
Place in Sharps Containers:
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• All Infectious substances must be packed and shipped by specially trained employees.
• Hazardous materials MUST be properly labeled and packed for shipment.
• Training for shipping infectious substances and other hazardous materials is required and available from EH&S (4-6783).
Transporting Infectious Substances
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OSHAOccupational Safety & Health Administration
Oversees Hazard Communication Standard in the private sector
PESHPublic Employees
Safety & Health BureauOversees Hazard Communication (RTK) Standard for public employees at the state and local level
Hazard Communication/RTK - OSHA & PESH
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Required Departmental
Postings
Employers must post a sign in every workplace to inform employees that they have a right to hazard information.
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Employer Responsibilities
• Notify you about your right to request information
• Provide information within 72 hours
• Maintain information• Provide education and
training
• Maintain records on exposures
• Maintain labeling system
• Provide hazard information to non-employees
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Employee Rights
• Submit written requests for information
• Refuse to work with a toxic substance if no reply received within 72 hours
• Obtain access to University’s written Hazard Communication, Right to Know program
• Can not be forced to waive any rights under the Law as a condition of employment
• Can file complaints with Department of Labor or NYS Attorney General
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The Hazard Communication Standard has aligned with the UN Globally Harmonized System of Classification and Labeling of Chemicals (GHS):
• Provides common and coherent approach to classifying chemicals and communicating hazard information on labels and safety data sheets (SDS)
• Improves quality and consistency of hazard information, making it safer for workers by providing easily understandable information on handling and safe use of hazardous chemicals
Revised Haz Comm Standard
Changes• New Hazard classifications• New Labeling requirements
– Signal words (Danger or Caution), pictograms, hazard statements, precautionary statements
• Standardized Safety Data Sheets (SDS)
Major changes to Haz Comm Standard
NEW
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Previous Labeling - NFPA
Safety Diamond
Assign a number to reflect the degree of hazard to the worker
RATING SYSTEM: 0-4The higher the number, the higher the hazard!
Label all secondary containers with product and hazard information!
Flammability
Health Reactivity
Special Hazard
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New GHS Labeling
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New Pictograms and Hazard Classes on Labels and Safety Data Sheets
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Safety Data Sheets (SDS)
– Your Guide to Workplace Safety
• Material Safety Data Sheets are now called Safety Data Sheets (SDS)
• SDS will be uniform, with the same 16 sections in the same order
• SDS will have:– Signal word (Danger or
Warning)– Hazard Pictograms – Hazard Statements– Precautionary Statements
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Accessing SDS &
Chemical Inventories• SDS and departmental
inventories are available on-line at Hospital intranet, “Inside SBUMC”, under “RESOURCES” or go to: http://asa-msds.campus.stonybrook.edu/
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Accessing Pharmaceutical SDS
• On the Hospital Intranet page, scroll down to Resources.
• Select drop down for Drug References and Select MicroMedex.
• Type in the name of the drug in the search field and click “Search”.
• Scroll down and click on the "Toxicology and Exposure Information" section.
• Click on MSDS.
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Why are SDS important to me?Provides details on:1.Hazards2.How to be protected from injury or illness
– What PPE to wear– Safe work practices– Exposure controls
3. What to do if a spill occurs
4. What to do if a co-worker or I get exposed– First aid
Look for the red arrows throughout the MSDS sections.
Safety Data Sheets (SDS)
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Review of a Sample SDS• Formalin Solution, neutral buffered, 10%– Sigma Aldrich
SDS Review
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16 sections:1. Identification2. Hazards Identification3. Composition/Ingredients4. First Aid Measures5. Fire Fighting Measures6. Accidental Release
Measures7. Handling & Storage8. Exposure Controls &
Personal Protection
9. Physical & Chemical Properties10. Stability & Reactivity11. Toxicological Info.12. Ecological Info.13. Disposal Info.14. Transport Info.15. Regulatory Info.16. Other Info.
SDS Review
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Section 1 - Identification
In case of an emergency.
SDS – Section 1
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Section 2 - Hazards Identification
How can this product harm me if improperly handled?
SDS – Section 2
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2. Hazards ID – Pictograms, Hazard Statement,
Precautionary statement
You need to know how this chemical could harm you, if not handled properly
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SDS – Section 3
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Section 4 – First Aid MeasuresWhat do I do if this chemical get on my skin, in my eyes, or if I breathe it in?
SDS – Section 4
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Section 5 – Firefighting Measures
SDS – Section 5
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What do I do for a release or spill ?
SDS – Section 6
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Spill Kits for Minor
Chemical SpillsGlutaraldehyde Spill Kits Located near GUS stations and areas where glutaraldehyde/Cidex OPA used
Chemotherapy Spill KitsLocated in areas where chemotherapy are prepared and administered
Formalin Spill Kits Located in labs and areas using formalin
Battery Acid Spill KitsLocated in powered industrial truck charging areas and other non-alkaline battery areas.
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Chemical Spill Response
• Minor spills of less than a gallon can be cleaned up by trained staff using a spill kit (chemo spills: < 50 ml).
• Major spills over 1 gallon, call University Police at 911 (cell: 631-632-3333). – Offsites: call 911
If at any time during clean up of a minor spill, you need assistance, call 911 (631-632-3333).
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Section 7 – Handling & StorageHow should I handle and store this product safely?
SDS – Section 7
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Section 8-Exposure Controls & Personal
Protection
How much can I be exposed to without experiencing problems?
SDS – Section 8
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Section 8 – Personal ProtectionWhat must I wear to protect myself… gloves, goggles, respirator?
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Section 9 – Physical & Chemical Properties
SDS – Section 9
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Section 10 – Stability & Reactivity
SDS – Section 10
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Section 11 – Toxicological InformationHow can this product harm me?
SDS – Section 11
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Section 12 – Ecological Information
SDS – Section 12
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Section 13 – Disposal Considerations
How should I dispose of this product safely?
SDS – Section 13
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Section 14 – Transport Information
What must I do if I need to ship this product?
SDS – Section 14
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Section 15 – Regulatory Information
SDS – Section 15
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Section 16 – Other InformationCodes used in Section 3
SDS – Section 16
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• Contact EH&S at 4-6783– Ask to speak to a staff member in
the Healthcare Safety team!• Email us at
[email protected]• Review Admin and EH&S P&Ps at Inside
SBUMC under “Policies & Procedures”
• For additional reference material go to: www.stonybrook.edu/ehs/healthcare
Questions or Comments?
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