• Safety and Health Program

• Regulatory/Organizational Agencies

• Trade Organizations

• Employee/Employer Rights
  

• Admissions and Records

• Carbonless Paper

• Computer Workstations

• Recordkeeping

• OSHA has concluded that effective management of worker safety and health is a decisive factor in reducing the extent and the severity of work-related injuries and illnesses. Effective management addresses all work-related hazards, including those potential hazards that could result from a change in worksite conditions or practices. It addresses hazards whether or not they are regulated by government standards.
  
  OSHA's experience in the Voluntary Protection Program has also indicated that effectively managing safety and health protection programs improve employee morale and productivity, as well as significantly reduce workers' compensation costs and other less obvious costs of work-related injuries and illnesses. 

Additional Information

• OSHA Safety and Health Program, Technical Links Page.

• Framework for a Comprehensive Health and Safety Program in Nursing Homes. OSHA OOHN, (1996). Provides detailed discussion and application of a safety and health program for nursing homes.

• Guidelines for Protecting the Safety and Health of Health Care Workers -Developing Hospital Safety and Health Programs. NIOSH.

• Health Care Financing Administration (HCFA)
  
  

  • The Health Care Financing Administration (HCFA) is a federal agency within the U.S. Department of Health and Human Services. HCFA runs the Medicare and Medicaid programs — two national health care programs that benefit about 75 million Americans. The HCFA and the Health Resources and Services Administration, run the Children’s Health Insurance Program, a program that is expected to cover many of the approximately 10 million uninsured children in the United States.
    
    

  • HCFA also regulates all laboratory testing (except research) performed on humans in the United States. Approximately 158,000 laboratory entities fall within HCFA’s regulatory responsibility. HCFA, with the Departments of Labor and Treasury, help millions of Americans and small companies get and keep health insurance coverage and help eliminate discrimination based on health status for people buying health insurance.
    
    

• Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
  
  

  • The mission of JCAHO is to continuously improve the safety and quality of care provided to the public through the provision of health care accreditation and related services that support performance improvement in health care organizations.
    
    

  • The Joint Commission evaluates and accredits more than 19,500 health care organizations in the United States, including hospitals, health care networks, managed care organizations, and health care organizations that provide home care, long term care, behavioral health care, laboratory, and ambulatory care services. The Joint Commission is an independent, not-for-profit organization, and the world's leading health care standards-setting and accrediting body.
    
    

• The Centers for Disease Control and Prevention (CDC) 
  
  

  • The CDC is recognized as the lead federal agency for protecting the health and safety of people - at home and abroad, providing credible information to enhance health decisions, and promoting health through strong partnerships. The CDC serves as the national focus for developing and applying disease prevention and control, environmental health, and health promotion and education activities designed to improve the health of the people of the United States.
    
    

• The National Institute for Occupational Safety and Health (NIOSH) 
  
  

  • NIOSH is the Federal agency responsible for conducting research and making recommendations for the prevention of work-related disease and injury. The Institute is part of the (CDC).
    
    

  • NIOSH is responsible for conducting research on the full scope of occupational disease and injury ranging from lung disease in miners to carpal tunnel syndrome in computer users. In addition to conducting research, NIOSH: investigates potentially hazardous working conditions when requested by employers or employees; makes recommendations and disseminates information on preventing workplace disease, injury, and disability; and provides training to occupational safety and health professionals.
    
    

• The College of American Pathologists (CAP)
  
  

  • The mission of CAP, the principal organization of board-certified pathologists, is to represent the interests of patients, the public, and pathologists by fostering excellence in the practice of pathology and laboratory medicine worldwide.
    
    

  • The College of American Pathologists is a medical society serving more than 15,000 physician members and the laboratory community throughout the world. It is the world's largest association composed exclusively of pathologists and is widely considered the leader in providing laboratory quality improvement programs.
    
    

• The American College of Radiology (ACR)
  
  

  • The ACR is the principal organization of radiologists, radiation oncologists, and clinical medical physicists in the United States. The college is a nonprofit professional society whose primary purposes are to improve service to the patient, advance the science of radiology, study the socioeconomic aspects of the practice of radiology, and encourage continuing education for radiologists, radiation oncologists, medical physicists, and persons practicing in allied professional fields.
    
    

• National Fire Protection Association (NFPA)
  
  

  • NFPA is a worldwide leader in providing fire, electrical, and life safety to the public. Established in 1896, this nonprofit, member organization's mission is to reduce the worldwide burden of fire and other hazards on the quality of life by developing and advocating scientifically based consensus codes and standards, research, training, and education. NFPA is currently developing the first consensus-based building code. Membership in NFPA totals more than 67,000 individuals from around the world and more than 80 national trade and professional organizations.

• The American Society for Healthcare Engineering (ASHE) is the professional society that represents individuals responsible for the environment of care used in healthcare delivery. The membership is served by providing leadership through education and advocacy.
  
  

• The American Hospital Association (AHA) is the national organization that represents and serves all types of hospitals, health care networks, and their patients and communities. Close to 5,000 institutional, 600 associate, and 40,000 personal members come together to form the AHA.
  
  

• The American Society for Healthcare Risk Management (ASHRM) is the preeminent society for healthcare risk management. This professional organization strives to advance risk management in the healthcare field through professional development, membership services, enhanced communications, risk management innovation, and effective governance.
  
  

• The Association for Professionals in Infection Control and Epidemiology, Inc. (APIC) is a multi-disciplinary voluntary international organization with over 10,000 members. Its purpose is to influence, support, and improve the quality of healthcare through practicing and managing infection control and applying epidemiology in all health settings. The organization, which is based in Washington, DC, is led by an elected board of members who volunteer their time and expertise.

Potential Hazard

• Exposure of staff to:
  
  

  • Work-Related Musculoskeletal Disorders (MSDs) - From file management (e.g., excessive reaching above shoulder height while filing).
    
    

  • Workplace violence during admissions. See the Hospital Emergency Department Module and/or HealthCare Wide Hazards - Workplace Violence.
    
    

  • Infectious diseases during admissions. See HealthCare Wide Hazards - Infectious Disease and Multi-resistant Organisms.

Possible Solutions

• Redesign or lower filing cabinets so they can be reached while maintaining the elbows in close to the body.
  
  

• Powered filing cabinets that move to any height.
  
  

• Use ladders or stools to access high files rather than reaching overhead. For additional information, see Computer Workstations Section.

Carbonless Paper

Potential Hazard

• Employee exposure to carbonless paper. Carbonless paper is used everyday for checks, credit-card receipts and medical forms. Tiny micro granules of dyes and resins are released when sheets are pressed together. The released chemicals can be absorbed through the skin or released into the air and inhaled resulting in mild to moderate symptoms of skin irritation and irritation of the mucosal membranes of the eyes and upper respiratory tract. Symptoms include: headaches, sinus infections, bronchitis, eye and skin irritations. Some rare cases of allergic contact dermatitis have also been reported. Symptoms include shortness of breath and hives.

Possible Solutions

• NIOSH suggests in most cases, good industrial hygiene and work practices should be adequate to reduce or eliminate symptoms including:
  
  

  • Adequate ventilation, humidity, and temperature controls
    
    

  • Proper housekeeping 
    
    

  • Minimal hand-to-mouth and hand-to-eye contact; and periodic cleansing of hands 
    
    

  • These recommendations are similar to ones that have been made by other researchers, programs, and agencies in the U.S. and abroad.

Additional Information

• Carbonless Copy Paper NIOSH Publication No. 2001-107 (2000, December), 155 pages, 1,042K PDF. This NIOSH report reviews current scientific information on health effects associated with occupational exposure to carbonless copy paper and recommends ways to reduce or eliminate symptoms.

Potential Hazard

• Employee's who use a computer (e.g., admittance area, data entry clerk, secretary) intensively  for 4 hours or more per day, can develop musculoskeletal disorders (MSD) of the hand/arm, shoulder, neck, and back.

Possible Solutions

• Look at the workstation layout and:

Additional Information

• Musculoskeletal Disorders (MSD) Checklist. Provided to help identify, analyze and control musculoskeletal disorders in computer workstation tasks.

• For more information, see OSHA's Computer Workstations eCAT.

Employee/Employer Rights and Responsibilities

Potential Hazard

• Employers and employees are not aware of their rights related to workplace safety.

Possible Solutions

• Employer and employee responsibilities and rights are addressed in Protecting Nursing Home Workers OSHA's Safety and Health Response. 
  
  

  • Employer Responsibilities and Rights.
    
    

  • Employee Responsibilities and Rights.
    
    

• Employee Rights: Position statement on confidentiality of health information.
  
  

• Employer Rights and Responsibilities following an OSHA Inspection. OSHA Publication 3000, revised (1999). Describes employer rights and responsibilities under the OSH Act of 1970. 
  
  

• New OSHA Workplace Poster - Publication 3165: Job Safety and Health Protection Poster,  required to be posted in the workplace, describes employee responsibilities and rights.
  
  

  • OSHA Poster, summarizes the major provisions of the OSHA Act of 1970 and tells employees how to file a complaint.
    
    

  • OSHA requires employers to display the OSHA Poster in a conspicuous place where notices to employees are customarily posted [1903.2].