injury prevention in long-term care - cove risk · the united states occupational safety and health...

Injury Prevention in Long-Term Care

Chris Clark, ARM, COEESenior Health & Safety Consultant

Cove Risk Services, LLC

Massachusetts Care Self-Insurance Group, Inc.Safety Awareness For Everyone from Cove Risk Services

• Statistical Support• OSHA Requirements• Commitment to Safety – Management & Employees• Safety & Health Programs • All Departmental Hazards• Nursing • Housekeeping• Kitchen/Dietary• Maintenance• Laundry• Accountability

MenuToday’s Specials

• Why is safety so important?

• Who is responsible?

• What is the goal?

• How do we get there?

Employee Safety in Long-Term Care

• Nursing homes are ranked fifth among all industries for lower back injuries.

• 17 injuries for every 100 full-time workers – it’s unnecessary.• Nursing home workers have the most injuries related to

overexertion of any industry (not construction or manufacturing).

• Injuries are up 55% in the last decade.• DART rates are concerning.

Injuries in Nursing Homes

Facts and Statistics

• BLS data shows that nursing aides, orderlies, and attendants account for 70% of nursing home injuries that resulted in days away from work.

• Female employees had more injuries that resulted in lost workdays than did male employees.

Nursing Home Jobs with the Most Injuries

Number of Injuries/Illnesses* by Type of Event, Nursing and Personal Care Facilities

Source

Other - 2,351

Exposure to Harmful Substances - 2,937

Assaults & Violent Acts by Person(s) - 4,923

Contact with Objects & Equipment - 10,275

Falls - 12,748

Bodily Reaction & Exertion - 50,216

*with days away from work.Total Injuries/Illnesses – 83,450

Source of Injury or Illness Event*, Nursing and Personal Care Facilities

This is where the high DART rate comes from…

Source

Patient or Resident - 42,142 Hand/Powered Tools - 781 Co-workers or Other Non-residents - 1,139 Chemical - 1,298 Vehicles, Wheelchairs & Carts - 3, 087 Containers - 3,489 Furniture & Fixtures - 3,583 Floors & Walkways - 11,966 Other - 15,965

*with days away from workTotal Injuries/Illnesses – 83,450

• Caregivers are working faster – cutting corners• America is becoming overweight – residents and

patients are getting heavier (bariatric)• More acutely ill residents and patients means more

dependent patients – requiring more handling • Healthcare workers – their own heath is a factor• Traditional safety training is missing the mark

Why Injuries Are Increasing

• Nursing (in general) has the highest rate of Falls to the Floor on the Same Level of any group of workers

• 96 cases per 10,000 workers• Housekeeping plays major role in preventing

slipping/falling problem• Kitchen slips and falls, cuts and lacerations, burns…• Policies and training must be strong• Accountability must be stronger

Other Injury Risks

The United States Occupational Safety and Health Administration (OSHA) is an agency of the United States Department of Labor. Congress established the agency under the Occupational Safety and Health Act, which President Richard M. Nixon signed into law on December 29, 1970.

OSHA’s mission is to ‘‘assure safe and healthful working conditions for working men and women by setting and enforcing standards and by providing training, outreach, education and assistance.”

OSHAOccupational Safety & Health Administration

• OSHA has been using outreach and enforcement programs aimed at reducing injuries and illnesses among nursing home workers.

• This initiative emphasizes taking a comprehensive safety and health program approach to address all causes of injuries and illnesses in the industry.

• Long-term care is 1 of 3 industries receiving specified attention from OSHA.

OSHA’s Role in the Nursing Home Industry

• Requirements

• Guidelines

• Nursing home e-tool

• Etc.

OSHA vs. Nursing Homes

• Management leadership

• Employee participation

• Implementation tools

Management Leadership and Employee Participation

Your management team:

• Morally devoted to keeping employees safe

• Open door policy

• Implements policies and establishes accountability

• Allows and provides training on important topics

• Focuses on financial impact to keep the operation successful

Management’s Role

Employee participation provides the means through which workers identify hazards, recommend and monitor abatement, and otherwise participate in their own protection.

Employee Participation

Working safely:

• Helps protect employees

• Increases “employee morale”

• Affects the “bottom line”

• Decreases potential injuries to residents

Safety Pays Off in Nursing Homes

Implementation tools, provided by management, include:

Implementation Tools

• Budget• Information• Personnel• Assigned responsibility• Adequate expertise and authority• Means to hold responsible persons accountable

(line accountability)• Program review procedures

• Healthcare ergonomics• Slips, trips, falls• Material handling• Combative residents• Cuts/lacerations• Burns• Machine safety (Lockout/Tagout)• Needlesticks• Bloodborne pathogens• Infectious disease

Safety Programs = Injury Risks

Root causes almost always lead to cutting corners,

going too fast, and not following the facilities’ safety

expectations…ALL BEHAVIORAL

Workforce exposure to all current and potential

hazards should be prevented or controlled by using

engineering controls, wherever feasible and

appropriate; work practices and administrative

controls; and personal protective equipment.

Hazard Control

Back Injury PreventionALL DEPARTMENTS

correct

Your Spine

• The spine includes vertebrae (bones), discs (cartilaginous pads or shock absorbers), the spinal cord and nerve roots (neurological wiring system), and blood vessels (nourishment). Ligaments link bones together, and tendons connect muscles to bones and discs. The ligaments, muscles, and tendons work together to handle the external forces the spine encounters during movement, such as bending forward and lifting.

ALL DEPARTMENTS

Your Spine

• This is a normal spine.• The normal anatomy of the spine is usually

described by dividing up the spine into 3 major sections: • The cervical, • The thoracic, and • The lumbar spine. (Below the lumbar

spine is a bone called the sacrum, which is part of the pelvis).

• Each section is made up of individual bones called vertebrae. There are 7 cervical vertebrae, 12 thoracic vertebrae, and 5 lumbar vertebrae.

ALL DEPARTMENTS

The spine is composed of:

• Vertebra• Discs• Spinal cord and nerves

ALL DEPARTMENTS

Your Spine

Nerve Root

Spinal Cord

Vertebra

Disc

Your Spine

The spine is composed of:

• Vertebra• Discs• Spinal cord and nerves

ALL DEPARTMENTS

Herniated Disc

Disc Herniation Factors

Many factors increase the risk for disc herniation: • Lifestyle choices such as tobacco use, lack of regular

exercise, and inadequate nutrition substantially contribute to poor disc health.

• As the body ages, natural biochemical changes cause discs to gradually dry out, affecting disc strength and resiliency.

• Poor posture, combined with the habitual use of incorrect body mechanics, stresses the lumbar spine and affects its normal ability to carry the bulk of the body’s weight.

ALL DEPARTMENTS

How to Lift Properly

RULES TO LIFT BY• Never bend, lift, and twist at

the same time!• Use mechanical aids or

assistance when possible.• Bend your knees and use

your legs to lift!Plan the Lift • Before attempting to lift, determine its weight and know where it’s going.• Is it a two-person job? • Is there anything in the way that needs to be moved prior to lifting? • Stand directly in front of the load, with feet about shoulder-width apart. • One foot should be in front of the other for balance.

ALL DEPARTMENTS

How to Lift ProperlyCorrect Positioning

• Get help if needed• Bend the knees and tighten the stomach

muscles. Using both hands, grasp the object firmly and pull it as close as possible to your body (BREATHE NICE AND EASY).

• Lift with the legs - NOT THE BACKLeg muscles are stronger than back muscles. Lift with the legs, until they are straightened. Avoid jerky movements. Keep the natural curve in the spine; don’t bend at the waist. To turn, move the feet around by pivoting on the toes, not by twisting at the stomach.

• When it is time to set the load down, reverse the procedures for lifting to minimize the strain on the back.

ALL DEPARTMENTS

Slips, Trips, and Falls

Prevention efforts• Know your path of travel. Do not allow objects to remain in

your way.• Icy conditions – Proper footwear is essential to prevention.• Clean spillages quickly. Use signage until area is clean and dry.• Communicate hazards to others.• Keep storage areas safe. Don’t store items on the floor in

walking paths.• Report near misses (incidents that almost result in an

accident) to management.

Preventing Slips, Trips, and FallsALL DEPARTMENTS

• Winter walking surfaces are unpredictable. Footwear is vital.

• Weather conditions may cause the floors to be wet or the ground to be icy.

• Always look where you are stepping and use caution on wet floors and ice to avoid slipping. Never assume the walking surface is dry.


STAIRS• Footwear – high heels don’t belong• Distraction on stairs• Take one step at a time• Do not overload your arms – keep what you carry

controllable by one arm• Use the handrails• Never stop to talk on the stairs or landings• Make sure lighting is good. Report dead bulbs.


Awareness of Surroundings

Store all items safely in their designated spot. Be aware of their location and yours…

Awareness of SurroundingsALL DEPARTMENTS

• Overhead structures (cabinets)

• Desks• Med carts• Lift equipment• Tables

• Beds• Wheelchairs• Furniture• Linen carts• Scales

Nursing Department

• Frequent manual repositioning and lifting of residents and patients is the primary risk.

• Two-person Manual Lift is the most common patient transfer method.

• Care Plans are lacking clear definition of “totally dependent,” “partially dependent,” and “independent.”

• Caregivers taking unnecessary risks due to limited time (legit or not).

• How much are caregivers lifting per day? Some estimates suggest 10,000 human pounds per day.

Healthcare ErgonomicsRisks for Injury: Patient Handling Tasks

NURSING DEPARTMENT

• SPH Policy – What does it include?• Equipment – What does your facility have?

Does the equipment meet the lifting demands?• Types of Movements – transfers, repositioning, toileting,

weighing, feeding, changing, bathing, showering, walking with residents (gait training)

• Training – Orientation? What does it cover? How is it performed?

• Accountability – How is competency checked? Is there a disciplinary policy?

Healthcare ErgonomicsSafe Patient Handling Program

NURSING DEPARTMENT

• Housekeeping – NOT just the responsibility of the housekeeping department

• “Clean as you go” policy• Urine, food, beverages• Mopping strategy – signage• Footwear – slip-resistant treads• Cords (bed, phone, TV, medical equipment)• Thresholds• Equipment and furniture• Lighting• Be a champion for your unit

Preventing Slips, Trips, and FallsNURSING DEPARTMENT

• Be part of the solution.• Anticipate – Be aware of the common daily reactions.

Be ready for all behaviors.• Tolerate – Be calm during challenging behaviors.• Look for clues as to why and adjust your approach.• Do not expect residents with dementia and Alzheimer’s to understand.• Avoid agitation – Try to understand what the resident is perceiving that they are

experiencing.• Demonstrate patience.• Help maintain the routines of the resident.• Keep the right mood. Avoid arguments. Try not to startle the resident. • Be agreeable and cooperate as much as possible.• Defuse with redirection.• Understand medical history and risk factors.

Combative ResidentsNURSING DEPARTMENT

Pathogenic organisms that are present in human blood and can cause disease in humans. These include, but are not limited to, hepatitis B virus (HBV) and human immunodeficiency virus (HIV).

Bloodborne PathogensNURSING DEPARTMENT, HOUSEKEEPING, LAUNDRY

Bloodborne Pathogens Standard

• Scope and Application• Definitions• Exposure Control Plan• Methods of Compliance• HIV and HBV Research

Laboratories and Production Facilities

• Hepatitis B Vaccination and Post-Exposure Follow-up

• Communication of Hazards to Employees

• Recordkeeping• Effective Dates

NURSING DEPARTMENT, HOUSEKEEPING, LAUNDRY

The standard applies to all employees with

occupational exposure to blood and other

potentially infectious materials.

Highlights of 29 CFR 1910.1030NURSING DEPARTMENT, HOUSEKEEPING, LAUNDRY

Exposure Control Plan includes:

• The written exposure determination;• The procedures for evaluating the circumstances surrounding an exposure incident; and

• The schedule and method of implementing other sections of the standard.

Highlights of 29 CFR 1910.1030 (cont’d)


Methods of Compliance• Universal precautions• Engineering and work practice controls• Personal protective equipment• Housekeeping



Hepatitis B Vaccination• HBV vaccination must be made available within 10 working days of initial assignment to all employees who have occupational exposure.

• HBV vaccination must be made available without cost to the employee, at a reasonable time and place, and by a licensed health care professional.



Work practice controls: • Use only approved needles.• Do not re-cap needles.• Never dispose of a needle in anything but an approved container.• Ensure that sharps containers remain in a safe position/placement. • Check for and ensure that sharps containers are emptied before they become full.• Responsible Person – An effective exposure control program should have a

responsible person to oversee the program. Know who this person is and communicate concerns.

• Needlestick Prevention Committee – There should also be a committee to meet and evaluate the hazards, collect injury data, and make recommendations for program improvement (with an objective of prevention). Communicate concerns to this committee.

• Expect to be investigated if an exposure occurs.

NeedlesNURSING DEPARTMENT, HOUSEKEEPING, LAUNDRY

Cleaning Supplies/Chemicals

Hazard Communication and GHS• Ask questions whenever you’re not sure about a hazard or

protective measure.• Read the chemical label and SDS to learn about:

- Health problems that can result from exposure, and- Routes of exposure.

Use Assigned Personal Protective Equipment (PPE)• Read the SDS to find out which type of PPE will protect you from exposure.• Select and wear PPE that’s in good condition and fits properly.• Remove and dispose of PPE carefully to prevent the spread of

contamination, if the risk exists.

HOUSEKEEPING, MAINTENANCE, LAUNDRY


Handle Materials Safety• Inspect containers regularly, and report leaks and missing or unreadable labels.• Keep containers closed when not in use.• Remove from a container only the amount you need for a job.• Use required ventilation to remove vapors.• Store/use chemicals so as to prevent hazardous reactions with other chemicals.

Practice Good Hygiene• Keep food, drink, cigarettes, cosmetics, and street clothes out of

hazardous areas.• Wash thoroughly after working with hazardous chemicals.• Launder work clothes that may be contaminated separately.

(cont’d)



Potential Hazard Exposure to hazardous cleaning chemicals found and used in the laundry or housekeeping process.• Soaps and detergents may cause allergic reactions and dermatitis.• Broken skin from soap or detergent irritation may provide an avenue for infection or

injury if exposed to chemical or biological hazards.• Mixing cleaning solutions that contain ammonia and chlorine will form a deadly gas.• The Hazard Communication Standard ensures employee awareness of the

hazardous chemicals they are exposed to in the workplace.• Medical Services and First Aid: Where the eyes or body of any person may be

exposed to injurious corrosive materials, suitable facilities for quick drenching or flushing of the eyes and body shall be provided within the work area for immediate emergency use [OSHA standard 29 CFR 1910.151(c)].

(cont’d)


• Keeps knives sharp. Sharp knives make clear, safe cuts. A person is less likely to cut themselves with a sharp knife. (Use the correct cutting board or surface.)

• Use a stabilizing tool and not your fingers to steady the food, or use proper hand hold method (claw method – fingers curled in).

• Use the correct knife for the job. For example, use carving knives for large jobs, boning knives to remove meat from the bone and paring knives for slicing small jobs.

• Do not dispose of broken glass or anything else sharp in a trash receptacle, as it could puncture the trash bag, possibly cutting the handler. Dispose into a separate container.

Cuts and LacerationsKITCHEN / DIETARY

• Never cut toward yourself. Use safe cutting techniques. • Mandatory PPE - Wear cut-resistant gloves. (NOTE: They

are cut-resistant, not cut-proof. Injuries can still occur.)• Provide food-safe rubber gloves to go over cut-resistant

gloves to protect against food cross-contamination.• If the knife falls, step back and let it drop.• Never use a knife to open cans or pry lids.• Wash knives separately.• Never put knives under things or in sinks where they

cannot be seen.

Cuts and Lacerations (cont’d)

KITCHEN / DIETARY

Meat Slicer Safety

Make sure your employees understand and follow the following safety procedures when handling meat slicers:

• Always use the push guard for pushing food toward the blade.• Make sure blocks of meat or cheese are not too large for the

push guard to hold. • If necessary, cut the meat or cheese into smaller pieces so they can be

safely used on the slicer.• Return the blade setting to “zero” when finished using the slicer.• If anyone interrupts you when using the slicer, stop slicing and respond

to the person. Return to slicing only when your full attention is focused on the task at hand.

KITCHEN / DIETARY

Practice Safe Slicer Cleaning Procedures• Prepare your cleaning and sanitizing solution bucket.• Turn the blade to zero.• Turn off and unplug the slicer. Use Lock Out/Tag Out procedures, if necessary, to ensure no one

will plug in the unit while you are sanitizing it.• Wear cut-resistant gloves.• Wipe away larger pieces of meat and cheese from the top and bottom of the slicer.• Unscrew the blade cover and wipe the plate down all the way to the blade.• Move the rag in a circular motion to completely clean the blade.• Wipe down the grips and handles.• When you clean and break down the slicer for the night, remove the slide and blade cover while

wearing cut-resistant gloves. Wash the blade, slide, and blade cover in the sink or dishwasher.• Do not leave the cutting blade soaking in the sink where another employee

might inadvertently strike an arm or hand against the blade.

Meat Slicer (cont’d)

KITCHEN / DIETARY

Result primarily from:

• Spilling and splashing of hot fats, oils, and food products

• Hot beverages• Contact with hot surfaces such as stove tops,

ovens, grills, pots, pans, and trays• Steam

Burns & FiresKITCHEN / DIETARY

• Turn off stoves when not in use.• Assume all pots and metal handles are hot. Touch only when you

are sure they are not hot or when wearing proper gloves/mitts.• Organize your work area to prevent contact with hot objects

and flames.• Keep pot handles away from hot burners.• Make sure handles of pots and pans do not stick out from counter

or stove.• Use oven mitts that are provided and long gloves for deep ovens.• Use only recommended temperature settings for each

type of cooking.

Burns & Fires - ControlsKITCHEN / DIETARY

• Open hot water and hot liquid faucet slowly to avoid splashes.• Open lids away from you to allow steam to escape.• Wear long-sleeved cotton shirts and cotton pants.• Report any faulty equipment to your supervisor.• Do not overfill pots, pans, or fryers.• Do not leave metal spoons in pots while cooking.• Do not overstretch to reach an uncomfortable distance.• Do not open cookers and steamers while they are under pressure.• Do not lean over pots of boiling liquids.• Remember that foods removed from the microwave

continue to cook.

Burns & Fires – Controls (cont’d)

KITCHEN / DIETARY

First Aid for Burns and Fires

• If clothing catches fire, smother the flames.

Stop, Drop, and Roll• Place area under cold running water.• Do not apply ointment.• Do not break blisters.

KITCHEN / DIETARY

Other Important Information

Mixers must be guarded when in use. Do not operate a mixer without a guard in place.

• Follow all tool manufacturer’s safety guidelines.• Disconnect power when servicing or changing out parts or accessories to powered equipment.

• Train all affected staff.• Document lockout/tagout procedures.

Power Tool SafetyMAINTENANCE

General Hazards• High-voltage overhead power lines• Damaged insulation on wires• Wires pulled at the plug• Missing grounding prong• Working near water/moisture with exposed wires and power• Digging or trenching near buried lines• Broken switches or plugs• Overloaded circuits• Overheated appliances or tools• Static electricity• Flammable materials

Electrical SafetyMAINTENANCE

• Type 1AA 375 lbs (max)• Type 1A 300 lbs (max)• Type 1 250 lbs (max)• Type II (2) 225 lbs (max)• Type III (3) 200 lbs (max)

Ladder Duty RatingsMAINTENANCE

• How much does the material you are hauling weigh?

• A 210 pound person + 20 pounds of gear exceeds the safe capacity of a Type III and a Type II ladder.

How much do you weigh?MAINTENANCE

Inspect the Condition of the LadderMAINTENANCE

Do not use!Ladders should be positioned safely. Ladders in need of repair must be taken out of service immediately or replaced.

Complete a Visual Inspection

• Are the side rails, cracked, broken or bent?• Are the steps or rungs in good condition?• Is the weight rating posted on the ladder?• Are you and your tools within the ratings?

MAINTENANCE

Ensure all of the necessary labels are in place and READ THEM!

Complete a Visual InspectionMAINTENANCE

Use Ladders as Intended…MAINTENANCE

Danger! The spreader isn’t fully open.

No standing on the top step!

Employee training on proper use of ladders will help prevent unsafe use.

Points of Contact

• We like four, but you can’t actually go up or down!

• We’ll accept three points of contact –this means either 2 feet + 1 hand OR 1 foot + 2 hands

MAINTENANCE

Other Important Items

• Rails should be even and well supported.• The rails should extend three rungs above the top

of an edge.• The feet should be level and well supported.• Boards or blocks should be used if needed to span

uneven ground.

MAINTENANCE

Simple Rules to Follow When on a Ladder

• NEVER lean over too far!• NEVER carry too much stuff!• NEVER bounce a ladder; move it!• NEVER stand on the top step of a ladder!• ALWAYS get the right size ladder for the job!

MAINTENANCE

Safe Use of a Ladder

• Get down off the ladder.• Move the ladder.• Make sure it is set properly.• Climb back up the ladder.• Use three points of contact.

MAINTENANCE

BBP

Contaminated Laundry• Contaminated laundry should be treated with all precautions as laid out

by the Bloodborne Pathogen Standard. • Soiled laundry could very well have blood or other potentially infectious material or

may contain sharps. NOTE: Contaminated laundry might also be improperly labeled.Follow the procedures outlined in the Bloodborne Pathogens Standard, such as:• Handle contaminated laundry as little as possible with minimal agitation.• Bag contaminated laundry at the location of use. Do not sort or

rinse laundry at the location where it was used.• Place wet contaminated laundry in leak-proof, and color-coded

or labeled, containers, at the location where it was used.

cont’d

LAUNDRY

BBP

Contaminated Laundry (cont’d)• Whenever contaminated laundry is wet and presents a

reasonable likelihood of soak-through of or leakage from the bag or container, the laundry shall be placed and transported in bags or containers which prevent soak-through and/or leakage of fluids to the exterior.

• Contaminated laundry must be placed and transported in bags or containers labeled with the biohazard symbol or put in red bags in accordance with:

• In a facility that utilizes universal precautions in the handling of all soiled laundry-alternative labeling or color-coding is sufficient, if it permits all employees to recognize the containers as requiring compliance with universal precautions.

• Use red bags or bags marked with the biohazard symbol, if the facility where items are laundered does not use universal precautions for all laundry.

• Contaminated laundry bags should not be held close to the body or squeezed when transporting to avoid punctures from improperly discarded syringes.

• Normal laundry cycles should be used according to the washer and detergent manufacturer’s recommendations.

LAUNDRY

BBP

Personal Protective Equipment (PPE) Hazard - Contact with potential bloodborne pathogens due to not wearing appropriate PPE.

Possible Solutions• Employers must ensure that employees who have contact with contaminated laundry wear

appropriate PPE as discussed in the Bloodborne Pathogens Standard when handling and/or sorting contaminated laundry.

• Employers must ensure employees wear appropriate PPE such as gloves, gowns, face shields, masks, when sorting contaminated laundry.

• The use of thick utility gloves when sorting contaminated laundry may provide workers with additional protection.

• Utility gloves may be decontaminated for re-use if the integrity of the gloves is not compromised.• Gloves must be discarded if they are cracked, peeling, torn, punctured, exhibit other signs

of deterioration, or when their ability to function as a barrier is compromised.• Disposable (single-use) gloves shall not be washed or

decontaminated for re-use.

LAUNDRY

Heat Stress

Heat StressExposure to excessive heat can result in heat exhaustion and heat stroke. At high temperatures, the body circulates great amounts of blood to the skin in an effort to eliminate heat through perspiration. As a result, less blood is circulated to the body’s vital organs, including the brain. Heat exhaustion can lead to dizziness, blurred vision, nausea, and eventual collapse. If not treated promptly by lowering the person’s body temperature, a person suffering from heat exhaustion could suffer brain damage.

Even more serious than heat exhaustion is heat stroke. During heat stroke, the body stops sweating, making it impossible to dissipate heat. The body temperature may rise to a dangerously high level in a short time and cause death.

LAUNDRY

Heat Stress

Recognize the first signs of heat exhaustion(e.g., dizziness, lightheadedness, weakness, blurred vision, nausea) and take immediate action to lower the employee’s body temperature to prevent the progression of symptoms.

• Remove them from hot environment.• Provide cool water to drink.• Lay them on their back and raise their legs.• If they are sick to their stomach, lay them on their side.• If the person does not feel better in a few minutes,

call for emergency help.

LAUNDRY

Heat Stress

Recognize the signs of heat stroke (which can be fatal). The symptoms are severe headache, mental confusion, loss of consciousness, flushed face, and hot, dry skin, with no sweating. If someone has stopped sweating, seek medical attention immediately. If a worker shows signs of possible heat stroke, professional medical treatment should be obtained immediately.

The worker should be placed in a cooler, well-ventilated area, and the outer clothing should be removed. • The worker’s skin should be wet and air movement around the worker should be

increased to improve evaporative cooling until professional methods of cooling are initiated and the seriousness of the condition can be assessed.

• Fluids should be replaced as soon as possible. • The medical outcome will depend on the victim’s physical fitness and

the timing and effectiveness of first aid and medical treatment.

LAUNDRY

Accountability

Employees - Should an employee demonstrate unsafe behavior or lack of willingness to follow safety rules (resulting in injury or not), he/she will be accountable for ensuring that these procedures are properly followed.

An investigation will be completed and reported to the Human Resources Department and Safety Committee. A review of the accident findings will then be conducted. The disciplinary policy could then be utilized.

Supervisors - Accountability means, that upon final review of all factors associated with the accident, disciplinary action may be taken; up to and including discharge of supervisory duties or termination. The frequency of employee injuries while under the supervisor’s charge may also affect his or her performance evaluation and any subsequent increase(s) in salary.

SUMMARY

• Management• Policies• Training• Devices and tools• Equipment• Commitment • Accountability• You

Safety comes in all shapes and sizes

Thank you

Any Questions?Chris Clark, ARM, COEESenior Health & Safety ConsultantCove Risk Services, LLC

Massachusetts Care Self-Insurance Group, Inc.Safety Awareness For Everyone from Cove Risk Services

injury prevention in long-term care - cove risk · the united states occupational safety and health...

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