1. Wilburn, Susan MPH, RN


How to assess and improve safety in your workplace.


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SYMBOLIn the last three months, the number of back and needlestick injuries has increased in my facility. How can we evaluate our occupational health and safety program and make the changes necessary to minimize injuries?

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An increase in the number of workplace injuries is both cause for concern and occasion to evaluate the overall health and safety program in your setting. First, quantify the problem by using work-related illness and injury information taken from worker's compensation data or Occupational Safety and Health Administration reporting forms.


Next, determine if the following programs are in effect in your workplace: a back injury prevention program that includes no-lift policies; a latex safety program that includes the elimination of latex and vinyl examination gloves and of all powdered, high-protein latex gloves; and a needlestick injury prevention committee (which includes frontline health care workers) to evaluate, select, and implement the use of safer needle devices.


These recommendations were agreed upon by more than 100 health care leaders who met last autumn at an ANA-sponsored conference on health care's environmental agenda. The group also recommended incorporating the following principles into workplace health and safety programs. They may also be used to evaluate programs currently in operation at your facility.


* Adopt the principles from the World Health Organization's Safe Injection Global Network: "a safe injection does no harm to the recipient, does not expose the health care worker to any risk, and does not result in waste that is dangerous for the community." Extend these standards to other health care practices.


* Include visible leadership from top management in the health and safety program. Management should demonstrate its commitment to health and safety by assigning responsibility and allocating appropriate resources to the program. For example, adequate staffing (including a designated occupational health program staff) and hazard-control materials are essential to safety.


* Involve frontline workers and use an interdisciplinary process to evaluate hazards and to select and implement control measures. Joint labor-management health and safety committees can be effective if they have the authority and support to implement decisions. Frontline workers can help select the most appropriate safety devices and work practice controls; this may encourage staff members to accept any changes.


* Encourage the reporting and recording of work-related symptoms, injuries, and near accidents. Eliminate factors that contribute to under-reporting, such as assigning blame and awarding prizes for reduced numbers of reported injuries. Ensure prompt if not immediate response to reported injuries.


* Focus on prevention by using the industrial hygiene hierarchy of controls, a method of applying control measures for prevention of occupational injury and disease. When possible, eliminate hazards and implement engineering and work practice controls to prevent exposure to hazards.


* Advocate research on prevention and enforceable standards.


* Analyze the projected effect on worker health and safety before restructuring the workforce and implementing new technology, procedures, products, chemicals, and medications. When introducing new products or initiating new procedures, request a health hazard evaluation from the National Institute of Occupational Safety and Health. Be vigilant-illness and injury to health care workers may put all employees, patients, and the community at risk.


Purchasing Safer, More Healthful Products

CleanMed 2001, an international conference on environmentally preferable medical products, is scheduled to take place on May 4 and 5 in Boston. The purchase of health care products that are safer and more healthful in the workplace and the environment will be addressed. For more information, call Peter Diamond or (617) 524-6018 or go to