Hazard Reduction

Edition: July 2012 - Vol 20 Number 07
Article#: 4027
Author: Repertoire

It may not be news to distributor sales reps that their long-term-care customers are stressed out. Indeed, this overworked, underpaid sector experienced one of the highest rates of lost work days due to injuries and illness of all major American industries in 2010, according to the U.S. Department of Laborís Occupational Safety and Health Administration (OSHA). In fact, the incidence rate for cases involving days away from work in the nursing and residential care sector was 2.3 times higher than that of all private industry as a whole, according to a recent OSHA report. No matter that the long-term-care industry has controls in place to address hazards. The report indicates that the overwhelming number of injuries that year was attributed to overexertion, slips, falls and trips.

But, work-related risks in nursing homes and extended care facilities go further than that. From unsafe cleaners and disinfectants to exposure to tuberculosis (TB), bloodborne pathogens and methicillin-resistant Staphylococcus aureus (MRSA), nurses and nursing assistants face on-the job risks every day.

In response to such high numbers of risks to workers who dedicate their lives caring for unwell individuals, OSHA has established its National Emphasis Program for Nursing and Residential Care Facilities (NEP) to protect workers from serious safety and health hazards common in medical industries. Over the next three years, the group will focus outreach efforts and inspections on specific hazards in nursing homes and residential care facilities.


Once OSHA has determined which facilities are among the highest-risk nursing homes and extended care facilities, the National Emphasis Program will assess employer efforts to address resident handling efforts as they impact its staff. Specifically, NEP inspectors will assess long-term-care facilities for the following:

Program management. Does the facility have a system for hazard identification and analysis? Who at the facility is responsible for compliance with this system? Do employees have input in developing lifting, transferring and repositioning guidelines? Is there a system for monitoring compliance and following up on deficiencies? Have there been recent changes to lifting/transferring/repositioning procedures and, if so, how have these changes impacted related injuries and illnesses of staff?

Program implementation. How are resident mobility guidelines determined at the facility? What is the decision logic for using lift, repositioning or transfer devices? Who at the facility decides how staff should lift, transfer or reposition residents? Are the procedures in place appropriate to help reduce lifting/transferring/repositioning hazards?

Employee training. Have nursing and therapy workers been properly trained to recognize hazards associated with lifting, transferring and repositioning residents, as well as to report injuries early?

Once OSHA determines whether there is a process in place to help ensure that work-related disorders are identified and treated early, it will determine the need to follow up with further assistance in an Ergonomic Hazard Alert Letter Follow-up Policy. When necessary, it will conduct a follow-up inspection and/or citations.

In addition, through its National Emphasis Program, OSHA will work with long-term-care facilities to evaluate work environments for hazards likely to cause employee slips, trips and falls; employer exposure control plans to determine if they address bloodborne pathogen risks; and determine whether facilities are taking appropriate measure to prevent worker exposure to TB. Workplace violence, exposure to MRSA and exposure to hazardous chemicals, including hazardous sanitizers, disinfectants and drugs, also will be evaluated.

For more information about the National Emphasis Program for Nursing and Residential Care Facilities, visit www.osha.gov/OshDoc/Directive_pdf/CPL_03-00-016.pdf. Information about workplace violence and ergonomics is available to long-term-care employers and staff at www.osha.gov/SLTC/nursinghome/index.html.