Terry Jo Gile, MT (ASCP), MA Ed.

MADE SIMPLETraining

Lab Safety

Lab Safety Training Made Simple ©2006 HCPro, Inc. iii

ACKNOWLEDGMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .v

ABOUT THE AUTHOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ix

PREFACE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xi

CHAPTER 1—LAYING THE FOUNDATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1

CHAPTER 2—BASIC TRAINING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5

CHAPTER 3—JANUARY: SPECIMEN TRANSPORT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19

CHAPTER 4—FEBRUARY: HOODS AND ENVIRONMENTAL CONCERNS . . . . . . . . . . . . . . . . . . . . .33

CHAPTER 5—MARCH: PERSONAL PROTECTIVE EQUIPMENT . . . . . . . . . . . . . . . . . . . . . . . . . . .39

CHAPTER 6—APRIL: ERGONOMICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51

CHAPTER 7—MAY: BLOODBORNE PATHOGENS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .61

CHAPTER 8—JUNE: GENERAL SAFETY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .71

CHAPTER 9—JULY: COMPRESSED GASES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .79

CHAPTER 10—AUGUST: SAFE WORK PRACTICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .87

CHAPTER 11—SEPTEMBER: CHEMICAL HYGIENE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .95

CHAPTER 12—OCTOBER: FIRE SAFETY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .105

CHAPTER 13—NOVEMBER: ELECTRICAL SAFETY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .115

CHAPTER 14—DECEMBER: WASTE MANAGEMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .121

CHAPTER 15—TOOLS AND FORMS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .131

CONTENTS

1Lab Safety Training Made Simple ©2006 HCPro, Inc.

The key to a successful safety program is training your employees properly—and right from the very beginning. This

book is designed to serve as the foundation for your lab safety training program. It will help you lay out a plan for

maintaining health and safety as mandated by such organizations as the Occupational Safety and Health Admin-

istration (OSHA), the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), and the College of

American Pathologists (CAP), as well as the policies and procedures of your facility. If you follow the training outlined

in this book, you should be ready to handle everything from an unannounced CAP inspection to a debate over

whether techs should be able to wear sandals in the lab (a no-no, says the Safety Lady!).

If you’re like me, you did not enter the lab with visions of training others. Likely as not, you’d rather concentrate on

science. I understand completely. With more than 42 years spent in the lab, and 23 of them as a lab safety officer, I

know that there are many of you who would rather concentrate on your primary task of analyzing specimens. How-

ever, the environment of the lab is changing rapidly. For example, lab tests have become more sophisticated, and lab

equipment more automated. New employees who enter the lab arrive with varying education and skills. There is a

shortage of lab technologists that did not exist when I entered the field. Funding for training is complex, to say the

least. Finally, there are many factors affecting employee health. Today, laboratorians are at a greater risk than ever

before of contracting communicable diseases from specimens and, in some cases, from those in the facility.

With these changes, lab operations must change. This, in turn, means that training of laboratorians must change. It

must improve. Over the years I found that it was easier to manage such changes by learning how to teach others. After

receiving my undergraduate degree in biology I went on to earn a master’s degree in education.

However, you do not have to get a master’s in education to put together a program—to start, you only need the infor-

mation presented here. In this book I offer my experience and background to help you craft training programs that

will cut down on the confusion and allow you to concentrate more on science. I’ll help you determine

• who must be trained;

• what type of training to use, e.g., face-to-face classroom interaction, self-study, video, web-based training;

• when to apply that training, and in what situations, e.g., to employ internal staff or outside resources;

• where the training fits into your lab’s needs and within the needs of your facility; and

• how to apply that training to meet the dicta of current regulations and mandates.

Chapter

1LAYING THE FOUNDATION

C H A P T E R 1

2 Lab Safety Training Made Simple©2006 HCPro, Inc.

TRAINING NEEDS AND IMPERATIVES

People make the mistake of thinking that training is the process of laying out the plan from Point A to Point B for the

purpose of achieving fixed results. That’s part of training, but it’s not enough. You need to create a training outline

that fulfills a need but is also flexible enough to accommodate any change in regulation, or situation, that arises in

your laboratory. Without this, the training will lose meaning and focus. Creating such a driving force can make things

difficult, because in the laboratory training is mandated both by regulations and by the situations that arise in the

day-to-day operations of the lab. You cannot use a regulation as the basis for training any more than you can tell an

inspector, “I’m doing it this way because the Safety Lady said so.” I’d love to have that much power, but I also have to

follow the rules.

The first step toward creating a good training program is reviewing the needs behind it. What you will need is a pro-

gram that is flexible enough to both accommodate and to absorb changes. You don’t have to know every little detail

that comes along. However, as a lab manager or safety officer, you well know the kinds of things that happen, and you

can structure your training along those lines. Helping you set parameters are the regulations that I spoke of, but also

the lab incidents (case studies), and feedback from surveyors and employees.

Below I have listed a few conditions that will always crop up in your training program. They are inspection, safety

training, and the establishment of a training calendar. Keeping them in mind will help you shape the training program

that will best serve your needs when policies, plans, or regulations change, so you won’t have to start from scratch.

Safety is more than meeting OSHA standards and accreditation agencies’ requirements. It is also about employee

safety. It concerns many of the intangibles involved in maintaining a strong work ethic and a dedication to producing

timely and accurate results.

Inspection preparation

How many of you are currently preparing for inspections from regulatory or accreditation agencies? Regardless of who

is doing the inspection, there are three “givens” to any on-site inspection. The inspection team will

1. Conduct a safety walk-through.

2. Observe your staff in action and ask them questions about safety as they work.

3. Scrutinize your paperwork to make sure you have the required training documentation and to see that

people on all shifts have been fully trained.

L A Y I N G T H E F O U N D A T I O N

If the compressed gas tanks aren’t connected properly, they’ll note it; if you haven’t disinfected the cryostat machine

properly, they’ll note it; if you can’t prove that your eyewash station is checked weekly, they’ll note it. Fines and fees

will follow. (In Chapter 4, I mention an incident in which a hospital that was fined more than $100,000 for expos-

ing workers to formaldehyde.)

Let the regulators set your calendar

In compiling information employing my materials, consult also the charts and logs from agencies and industry. They

are very useful in spotting gaps in training or giving you a cue to issues you’ll want to address. Consult OSHA form

300, a log for recording work-related illness and injury, for this purpose (www.osha.gov). This is a great tool for spot-

ting gaps in training. Review it with your accident and injury reports at least quarterly to determine whether training

was effective and to what extent training was helpful. Identify areas that need improvement.

Mandatory safety training

OSHA, CAP, and JCAHO all require mandatory safety training in their regulations. There are many ways you can

ensure that you meet the requirements set out by each. If you use my mandatory safety training chart in Chapter 2 as

the foundation of your training, you can then augment it with material from your own facility’s training programs or

create something based upon materials and guidelines from the agencies themselves—for example, a reminder in

Microsoft Outlook. Use the chart with other tools to remind yourself of upcoming training sessions; to schedule the

speaker; and to gather your props, tools, and training printouts. Among them should be the CD-ROM that comes

with this book. On that disk, I have the games to which I refer in the chapters. I also have a PowerPoint presentation

for chemical hygiene that you can use in your own lab, or adapt to other areas of the lab. Refer to my Web site,

www.safetylady.com, for more on how to incorporate multimedia into your presentation. Please note that this book

corresponds with the safety calendar I set out in the presentation materials I use in my lectures, so wherever you go,

you are on the same track.

Hazards, needs assessments, and training activities

Training cannot begin until you verify all employees’ levels of knowledge of required safety procedures. You will need

to do this annually, at the least, and record it formally. For this task I recommend using a form such as the Safety

Knowledge Checklist, which you will find on the CD-ROM and in Chapter 15, the tools and forms chapter.

Using a checklist helps you to discover any weak links in the chain. It is better to do this sooner rather than later.

Assessing employee skills is a way for you to assess any risk; these risks you may address in your training plan. If you

cannot assess employee skills, how can you assess risk?

3Lab Safety Training Made Simple ©2006 HCPro, Inc.

C H A P T E R 1

4 Lab Safety Training Made Simple©2006 HCPro, Inc.

Once employees’ skill levels are assessed, you will need to institute refresher training. Schedule motivational reminder

sessions or in-depth reviews. Document all training activities—what was done, who participated, and what the results

were. Being able to prove that proper and timely training was provided can be an important defense against legal lia-

bility after an adverse incident.

Update and quiz staff on new regulations

The final area of mandatory training is updating staff when regulatory requirements change. You can find out about

changes that may require additional training not only at the OSHA Web site mentioned earlier, but in professional

journals and at meetings of professional associations serving lab professionals, such as the Clinical Laboratory Man-

agement Association (CLMA), the American Society for Clinical Laboratory Science (ASCLS), the Commission on

Office Laboratory Accreditation (COLA), and the American Association for Clinical Chemistry (AACC). Earlier we

mentioned JCAHO, which I did not mark as a lab-specific organization. However, because JCAHO may be increasing

its scrutiny of lab operations, I recommend lab managers take special note of any of JCAHO’s lab-related mandates.

New or amended regulations sometimes specify a deadline by which training on the changes must be conducted to

bring the laboratory into compliance. Therefore, as you watch for changing content in the rules, be sure to check for

any training deadlines that may be imposed.

Again, use my chart as a guide. Just as you establish weekly, monthly, and yearly process reviews, do the same thing

with information. Go to the Web site for each organization and set up alerts, so that information about certain topics

is readily available to you. For a variation on training, you might review the compliance recommendations set out by

my colleagues Dawn Runge, PhD, and Michele Smith MT(ASCP), SCT, in Chapter 9 of their book, Lab Billing and

Coding: Effective Strategies for Compliance (HCPro, 2006).

Issues overview

One of the things I hear from my colleagues at trade shows and conventions is the difficulty they face when trying to

implement safety programs. Now it is your turn to take the baton. Go to your computer and make a list of all the

problems you see in your lab’s safety training program. Create your own “issues overview.” Maybe in your case, chemi-

cal hygiene is the topic that comes up most often. Perhaps it is sharps injuries. You know your lab better than I! This

is the foundation of your plan.

In the next chapter I will lay the foundation that is essential to establishing any good training program. From there,

we will move on to address specific subjects and situations.

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