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OSHAOSHA INFORMATION
The number for TOSHA consultation: 1-800-325-9901
The five questions:
1. What is universal precautions?
2. What do you do when there is a blood spill?
Personal protective equipment
Cleanup and disposal procedures
Disinfection (hazard communication applies)
3. What do you do with contaminated sharps and laundry?
4. Have you been offered the hepatitis B vaccination free of charge?
5. Where is the Exposure Control Plan?
Link to article and exposure control plan for dentists on Tn Dental Assoc. website:
Link to OSHA/TOSHA requirements for dentists:
BELOW ARE:
1. SHARPS INJURY TARGETING PROGRAM CHECKLIST
2. SHARPS INJURY AND PREVENTION INFORMATION
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SHARPS INJURY TARGETING PROGRAM CHECKLIST PRE INSPECTION:
OPENING CONFERENCE:
WALK AROUND:
CLOSING CONFERENCE:
TYPES OF SHARPS AND ENGINEERING CONTROLS : See “Fact Sheet” CITATION GUIDELINES: (c)(1)(ii)(c)- Failure to include procedures for the evaluation of exposure incidents in the exposure control plan (c)(1)(iv)- No review and update of the Exposure Control Plan, as necessary, to reflect changes in technology, such as the use of effective engineering controls, that can eliminate or minimize exposures (c)(1)(iv)(B) – Did not document annual consideration and implementation of safer medical devices (c)(1)(v) – Exposure Control Plan did not solicit and document front line employee input in the selection of sharps with engineered sharps injury protection. (d)(2)(i) – Engineering and work practice controls were not used to eliminate or minimize employee exposure. (d)(2)(ii) – The employer did not have a system for regular checking of the engineering controls to ensure that safer devices function effectively (d)(2)(vii) – Removing, bending, shearing, or recapping needles (d)(2)(vii)(A)-Bending, recapping or removal of contaminated sharp without demonstrating and documenting that no alternative is feasible or that it is required by a specific medical procedure (d)(2)(vii)(B)-Removing a needle or sharp (such as a scalpel blade) without using a one-handed technique (d)(2)(viii)(A)-(D)-Inappropriate containers for contaminated reusable sharps (d)(2)(x)-Food or drinks being kept in refrigerators, freezers, shelves, cabinets or on countertops or benchtops with blood or OPIM are present (d)(4)(i)-Worksite not maintained in a clean and sanitary condition or did not determine and implement a written schedule for cleaning and disinfection (d)(4)(ii)(E) –Reaching by hand into containers of contaminated reusable sharps (d)(4)(iii)(A)(1)-Contaminated sharps not discarded immediately (d)(4)(iii)(A)(2)(i)-Sharps containers not located as close as feasible to the immediate area where sharps are used (d)(4)(iii)(A)(2)(ii)-Sharps containers not maintained upright throughout use (d)(4)(iii)(A)(2)(iii) – Sharps containers overfilled (d)(4)(iii)(A)(3)(i)-Sharps containers not closed when moving (d)(4)(iii)(A)(4)-Sharps containers opened or emptied (f)(1)(i)-Hepatitis B vaccination not made available to employees with occupational exposure (f)(2)(iv)-Employees who declined the Hepatitis vaccination did not sign a declination form (f)(3)(v)-Post-exposure evaluation did not include counseling (f)(3)(I)-Failure to conduct an evaluation of exposure incidents following procedures established in Exposure Control Plan (f)(4)(ii)-Healthcare professional evaluating an employee after an exposure incident was not provided the required information (f)(5)-Healthcare professional’s written opinion not obtained and provided to the employee within 15 days of post-exposure evaluation (g)(2)(i)-Training for employees with occupational was not at no cost to the employee and/or during working hours (g)(2)(ii)(A)-Initial training was not conducted at the time of assignment (g)(2)(iv)-Annual training not provided within one year of the previous training (g)(2)(vii)(F) –Training did not include the use and limitations of engineering controls.
0800-1-10-.04(1)-Type and brand of device in use not documented within 6 days for every exposure incident 0800-1-10-.04(2)-Sharps with engineered protection evaluated and in use not documented 0800-1-3-.27(b) All violations of the Bloodborne Pathogens Standard will normally be classified as serious (except for recordkeeping violations).
2.
SHARPS INJURY PREVENTION
LIST and INFORMATION (September 2010) In all workplaces where employees are exposed to contaminated needles or other contaminated sharps, the employer shall comply with 29CFR 1910.1030, Tennessee Code Annotated 50-3-203(e)(1)-(e)(4) and Tennessee Rule 0800-1-10 as follows: v Evaluate available engineered sharps injury prevention devices for all sharps v Solicit input from employees directly involved in patient care in the evaluation and selection of devices and document this in the Exposure Control Plan v Select the devices most appropriate to your procedures v Train employees to use the devices, v Require use of the safer devices and use of safer work practices when handling and passing contaminated sharps v Update the Exposure Control Plan at least annually or when needed to document the devices evaluated and those placed into use v Justify the use of any sharps without sharps injury protection & document in the Exposure Control Plan v Maintain a Sharps Injury Log with: v Type and brand of device involved in the exposure incident v Department or work area of occurrence v Explanation of how it occurred The list below is to assist employers in complying with changes in Tennessee Code Annotated Section 50-3-203 (Senate Bill 1023/House Bill 634). Inclusion of types of devices does not represent or imply any evaluation, endorsement, or approval by The Tennessee Department of Labor and Workforce Development, the Tennessee Department of Health, or any other agency. This list is not all inclusive. Types of Devices and Engineering Controls Injection Equipment Hypodermic needles and syringes- sliding sheath/sleeve, needle guards Needleless jet injection Retractable needles Medication Vial Adaptors (used to access ports of medication vials) IV Medication Delivery Systems Needle guards for pre-filled medication cartridges Needleless IV access-blunted cannulas Needleless valve/access ports and connectors Prefilled medication cartridge with safety needles Recessed/protected needle Needle guards for pre-filled medication cartridges IV Insertion Devices Shielded or retracting peripheral IV catheters Shielded midline IV catheters IV Catheter Securement Devices Epidural/Spinal Needles Blood Collection Devices Arterial blood gas syringes Phlebotomy needles Butterfly blood collection needles Blood Donor Plebotomy Devices Other Catheter Equipment Guidewire Introducers-for venous and arterial access Central Venous Catheters Peripheral Inserted Central Catheters Radial Artery Catheters Umbilical cord sampling devices Lancets Laser lancet Retracting Lancet Strip Lancet Laboratory Devices Hemoglobin reader Mylar-wrapped glass capillary tubes Plastic capillary tubes Protected needles for blood culture vial access Vacuum tube stopper Plastic fingerstick sampling blood collection tube Slide preparation devices Surgical Devices Scalpels (disposable safety, retracting, shielded) Ultrasonic scalpel Blunted Suture Needles (for internal suturing- fascia/muscles) Surgical Glues & Adhesives Alternative Skin Closure Devices Surgical Sharps Protection and Other Surgical Sharps Protection Hands free transfer disposable magnetic drapes Sharps counting and disposal system Magnetic floor sweep Scalpel blade removal system Hemodialysis and Apheresis Devices Fluid Sampling Devices Sharps Disposal or Destruction Containers Irrigation Splash Shield (Eliminates use of needles in debridement procedures) Blood Bank Devices
Segment sampling devices Nuclear Medicine Devices
Cut or puncture-resistant barrier products (gloves, liners or pads) Huber Needle and related devices Smallpox Vaccination Needles Vaginal Retractors Surgical Prep Razors Bone Marrow Collection Systems Dental Safety Devices To access fact sheet online: www.state.tn.us/labor-wfd/sharpslist.pdf Page 2 The next list below contains web site resources that can be used for the purposes of information and research. The examples of effective engineering controls in this list do not include all those on the market, but are simply representative of the devices available. Neither the Tennessee Department of Labor and Workforce Development nor the Tennessee Department of Health approve, endorse, register or certify any medical devices. Inclusion on this list does not indicate approval, endorsement, registration or certification. International Health Care Worker Safety Center, University of Virginia: Available: Features a list of safety devices with manufacturers and specific product names:http://www.healthsystem.virginia.edu/internet/epinet/safetydevicenew.cfm and Safety in Surgery : http://healthsystem.virginia.edu/internet/safetycenter/internetsafetycenterwebpages/SafetyinSurgery/SafetyinSurgery.cfm International Sharps Injury Prevention Society: Available: http://www.isips.org/ ISIPS is an international group of medical device and pharmaceutical manufacturers, health organizations, healthcare professionals, medical waste disposal experts and others that are joining forces to provide education, information, and product knowledge that will help reduce the number of sharps injuries that occur each year. This website features a list of safety product categories with a description of the category and a list of safety products that fit under that category : http://www.isips.org/safetyproductlist.php Food and Drug Administration (FDA) Safety Alert: Needlestick and Other Risks from Hypodermic Needles on Secondary IV Administration Sets - Piggyback and Intermittent IV: Warns of the risk of needlestick injuries from the use of hypodermic needles as a connection between two pieces of intravenous (IV) equipment. Describes characteristics of devices which have the potential to decrease the risk. Occupational Safety and Health Administration (OSHA) Glass Capillary Tubes: Joint Safety Advisory About Potential Risks : Describes safer alternatives to conventional glass capillary tubes. Occupational Safety and Health Administration (OSHA) Needlestick Injuries Features recent news, recognition, evaluation, controls, compliance, and links to information on effective engineering controls. Selecting Evaluating and Using Sharps Disposal Containers: This document presents a comprehensive framework for selecting sharps disposal containers and evaluating their efficacy as part of an overall needlestick injury prevention plan: http://www.cdc.gov/niosh/sharps1.html Training for Development of Innovative Control Technologies (TDICT) Project TDICT "Safety Feature Evaluation Forms" in Appendix B of this directive.
Available: http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=DIRECTIVES&p_id=2570 Instruction that establishes policies and provides clarification to ensure uniform inspection procedures are followed when conducting inspections to enforce the Occupational Exposure to Bloodborne Pathogens Standard (29 CFR 1910.1030).
Available: http://www.seiu.org Page 3 |
(1)(i) thru (iv) –Deficient medical records maintained
–Failure to remove names from privacy cases on injury and illness logs| 2006 web hosting services by 2mHost.com |