Claire House

Significant Hazard Register and Safe Operating Procedures (SOP’s)Staff Induction ToolIssued 13 March 2009

Significant Hazard Register & Safe Work ProceduresINDEX

INDEX

Page 1 Fire Danger / Smoking rules & danger / Emergency evacuation

Pages 2 - 4 Moving & Handling & up off the floor ! Danger to staff & residents

Pages 5 - 7 Preventing & containing spread of infection ! Danger to everyone

Page 8 Managing Blood Spill Safely ! Danger to staff

Page 9 Preventing Needle Stick Injury

Pages 10 & 11 Critical Points in Food Preparation ! Danger to residents

Page 12 Hazards in the Kitchen / Preventing Fires & burns

Page 13 No Chemicals / Hazards for Cleaners / Environmental Cleaning

Page 14 Hazardous Waste management / Rubbish Collections

Page 15 Danger medication Error ! Danger to residents

Page 16 Managing Challenging Behaviour & Intruder Danger

Page 17 Electrical Danger

Page 18 Sunshine & Ergonomic Danger

Page 19 Avoiding Hazards transporting Residents in Vehicles

Page 20 Signing Sheet

Introducing Claire House

Taking all practical steps to keep everyone safe

FIRE HAZARD:- Smoke inhalation- Heat & burns

Training: Fire Warden - At induction -- refresher training [6 monthly]

FIRE PLAN:Warning Systems:

Alarms Located throughout the Home Tested monthlyEmergency numbers on wall - 111The muster point is ________________________Highly visible notices Floor Plan showing

- exits- muster point- location of Fire Fighting Equipment

Equipment:Fire extinguishers – checked annually

Staff participation:Fire Wardens know their responsibilities

1. Help people to safety2. Call for help3. Roll call people at work4. Look for missing people [only if it is safe]5. Help the injured6. Report to the Fire Service7. Control people until given the all clear

Run exit drills

SMOKING IN THE BUILDINGBEWARE FAT FIRES IN KITCHENBEWARE DRIERS IN LAUNDRY

Significant Register and Safe Work Procedures

Page 1

FIRE PLAN

Extinguishers suit fires caused by:

- appliances- switches- power tools- fat or oil- petrol - kerosene

Approved Fire PlanDated: __________

HAZARDS

Staff with muscles strainStaff in painResidents with skin tearsResidents with pulled shouldersResidents fallingResidents with injuriesResidents with bruises or broken bones

RISK INCREASES WHEN:Too heavyAwkward / bulky / resistantLifting & twisting Lifting repetitivelyReaching outAbove your head No hand gripsSlippery or uneven surfacesNeeding help Poor posture

References:NZ Patient Handling Guidelines: - pictures of Lifting Techniques- Pictures of unsafe liftingACC’s Lighten UP & Reduce the RiskCode of Practice Manual Handling

SAFE OPERATING PROCEDURE

TAKE GOOD CARE OF YOUR OWN BACK

1. Assess the Risk2. Avoid the lift if possible [use vehicle /

equipment]3. Divide the lift4. Plan the lift5. Back straight6. Bend knees7. Load close to body8. Good posture9. Be fitNEVER LIFT ANYTHING TOO HEAVY OR AWKWARD

REPORT ANY PROBLEMS

If residents are hard to move – TELL A TEAM LEADER

Report BACK PAIN or strain AT ONCE

FILL IN AN INCIDENT FORM

Please no not lift residentsDo not try and manage difficult people aloneDo not rushDo not hook residents under the arms to lift them upDo not lift people up from the floor

Significant Register and Safe Work ProceduresWORKSHOPMOVING & HANDLING HAZARDS

Page 2

Resource Equipment Available if Required

HAZARD:Resident falling out of hoist

Residents falling outNot secured wellHitting head on floor

Rules:Monitor residents closely

Assist only as necessary

Encourage regular toileting

Beware slippery floors

Do not leave frail people unattended

If required to move & handle, work in pairs.

Equipment:

Sliding BoardsPadded Waste Belts [with handles] for residents

Hoists: NOT used in the Home at this time. NB: Should the need for them arise, staff will be trained PRIOR to their use.

Training:- Placing the canvas under the resident- Special care / needs of resident- SECURELY attaching the buckles- The controls-Manoeuvre- When to use- Hoist DANGERS

This equipment must only be used with the utmost care, by trained staff.Always seek help [ask] if you are unsure.

To minimise lifting hazards please encourage residents to use aids provided.

Encourage mobility rather than lifting to save time:

Walking frames

Hand grips

Walking sticks

Shower seats

Significant Register and Safe Work ProceduresMore about Moving & Handling Hazards

Page 3

PERSONAL PROTECTIVE EQUIPMENT REQUIRED:

Sensible clothing – ease of movement

Sufficiently protective of toes

Minimising Slips Trips & Falls / InjuryNo worn carpets / frayed rugs to trip onNon slip surfaces on stairs / Flat paved areasRamp for wheelchair access / Hand railsLift to avoid stairs

Walkways & exits clearAvoid clutterPut things away

Signage up when floors are wetVacuum cleaner cords must be put away immediately after useStore heaviest things at lowest level

Beware residents in long skirts - when getting up from chairs standing on hem- going up stairs standing on hemBeware long socks or ill fitting shoes or slippers

Significant Register and Safe Work ProceduresSlips Trips & Falls

Page 4

Safety: NO LIFTING PLEASE! Don’t cause more injuries! Don’t haul people up under the arms Don’t wrench their shoulder and your back! Assess: If not hurt then help resident up!

Roll over naturally, turning

the head in the direction of

the roll

Roll onto hands and knees.

Use chair to help up

Slowly

Bend knees carefully

Best without bystanders

usually

Helping up off the floor:

Cannot get up = hoist or call for help# Fractured Hip = Call an ambulance

Significant Register and Safe Work ProceduresPreventing & Containing Spread of Infection

Page 5

WASH YOUR HANDS WELL

Prevent & Contain Infection

→ WASH YOUR HANDS between resident contact

→ Sort finger nails

→ No rings with stones

→ Cover any cuts

→ Wear gloves to protect against bodily fluids / infections

STANDARD PRECAUTIONS

Also need long sleeved gown & gloves

Also need sufficiently protective mask.

To minimise the risk of Infection

CAREFUL

HAND

WASHING

short nails   

protective cream   

cover cuts

PROTECT

YOURSELF

CLEAN &

CONTAIN

SAFE

HANDLING -blood -chemicals -animals

Personal Protective Equipment - gloves - goggles - gowns - NO dirty linen touching uniforms

Blood spills Chemicals Animal excretion

NEVER INTO CUT OR OPEN WOUND! Avoid contact with skin Avoid contact with nose Avoid splashes in eyes

CONTACT PRECAUTIONS [e.g. scabies, chicken pox, ESBL]

AIRBORNE PRECAUTIONS [e.g. Norovirus, active tuberculosis]

Significant Register and Safe Work ProceduresPreventing & Containing Spread of Infection

WASH YOUR HANDS WELL

Prevent & Contain Infection

→ WASH YOUR HANDS between resident contact

→ Sort finger nails

→ No rings with stones

→ Cover any cuts

→ Wear gloves to protect against bodily fluids / infections

Decide treatmentDetermine site of infection

Antibiotics

Antibacterial washes

Can the area be covered?

No Take standard precautions

Use antimicrobial wash

Help client with basic hygiene

Treat rubbish and linen as hazardous

Wear gloves

Wash hands

Clearance

YES NO

STOP

MRSA Infection Identified

MRSA

Occlusive dressing

YES

Decontaminate(clean room)

Sandra leeHealth & Safety Consultant

021 726 397

A single room may not be required

Resident movement should not be restrictedproviding infection can be covered

Consult infection control policies

Page 6

Significant Hazard Register & Safe Work ProceduresPreventing & Containing Spread of Infection

PERSONAL PROTECTIVE EQUIPMENT REQUIREDGloves, gowns

WHO ARE WE PROTECTING?

- Susceptible people

- Old and frail people

- People already sick or failing

- Fit & healthy staff [much less likely to be affected]

RULES ABOUT WEARING GLOVES

Wear gloves when handling blood or bodily fluids

Wear gloves when cleaning dirty places

Wear gloves when you are told someone is “infectious”

Wearing gloves from one place to another ONLY protects YOU!

Wearing gloves from one place to another CONTAMINATES the Home

Gloves are NOT needed when you prepare food

NEVER wear gloves from ROOM to ROOM

Page 7

Vancomycin Resistant Enterococci [VRE] Contain the Spread From the bowel of the infected person ON THEIR HANDS

ONTO ANYTHING THEY TOUCH

Health care worker Infected person

Equipment

Care giver Their bed

Doctor Urine

RN

Break the Cycle! WASH YOUR HANDS

Don’t contaminate your uniform – wear gown or apron

Dispose of wound dressings & urine soaked items in double plastic bags

Clean everything thoroughly with hot soapy water & detergent

Use ajax & bleach in water on frequently touched surfaces

Help Clients with personal cares

By touching By touching

By touching

By touching

Significant Register and Safe Work ProceduresWaste & Hazardous Substances

Page 8

SPIT

occlusive dressing

Check skin integrity

WASH Soap Water MAKE BLEED

WASH Soap Water

WASH Soap Water

REPORT NOW

BLOOD Contamination

NeedlestickSplash Open Wound

Incident form

RINSE in eyes?

BLOW

in mouth?

in nose?

BLOOD SPILL1. ASSESS THE RISK

RISK- amount- source- spread

2. PROTECT YOURSELF

Choose PPE Personal ProtectiveEquipment:- gloves- goggles- gown- apron- gumboots

3. MOP UP Use paper towelDispose into plastic bag

4. WASH Use detergent and warm water

5. DRY Use paper towelEnsure area is completely dry

6. DISPOSE Place all paper towels & gloves in plastic bag

Spills on carpet Mop with paper towelsClean with detergentShampoo with industrial cleaner ASAP

Hazard Blood Contamination [Hep B & C / HIV]

→ Only if it gets in your body

→ Cover cuts

→ Wear gloves for blood spills & wound care & infectious people

→ Report Needle Stick Injury at once [Tests will be needed within 24 hours to keep you safe]

Significant Hazard Register & Safe Work ProceduresPreventing Needle Stick Injury

Page 9

Rules about Sharps Containers:- Have small ones available

- Take the container to the user

- Visiting health professionals do this too

- Replace when 3 / 4 full

- Write the collection agency phone on the container

- Check containers on monthly Haz ID

HAZARDS:

BLOOD- HIV- Hepatitis B- Other blood borne diseases

Guideline to Minimise the Risk:

Take container to where the needle is used

DO NOT transport needle from where you used it to the sharps container.

Dispose needle / sharp DIRECTLY into sharps container

Do not push hands down into containers

Do NOT carry containers against the body

Only use containers supplied NOT other interim containers

Container is replaced when ¾ full

Contractor removes old container and replaces with empty one.

PERSONAL PROTECTIVE EQUIPMENT GUIDE:

Gloves are worn for taking BM’s

Gloves are worn when giving insulin injections

Hazard Significant Registers and Safe Operating ProceduresCritical Points in Food Preparation

FOOD HAZARDS

NOROVIRUS

→ Vomiting

→ Lots of diarrhea

→ VERY sick residents

→ Highly contagious

→ STARTS IN KITCHEN

Other less tummy upsets START IN THE KITCHEN

Minimising the Risk

Critical Point Number 1 – Personal Hygiene

Washes hands wellHair tied upHands clean and nails shortNo rings with stonesCuts covered [use a glove if necessary]Nice clean clothesAprons on: washed dailyNo smoking in food areas.

Cuts must be covered. Gloves may be used as well.If sick in any way & you’re OUT pleaseHands of nose and faceGet out rather than sneezing in kitchen

Critical Point Number 2 – Contamination during preparation

Good hand washing area with clean dry paper towel.Clean benches . Beware build up of fatty residues.Protective equipment is supplied and worn.Trained staff aware of dangers. Wash food handling equipment between raw and cooked

foods.Separate chopping boards for cooked and raw foodsEasy to tell apartStored separately

Page 10

Food trolley:-Transports food DIRECTLY- Not a food storage depot

Hazard Significant Registers and Safe Operating ProceduresCritical Points in Food Preparation

FOOD HAZARDSBacteria & virus’s grow

→ In warm food

→ Food left out

→ Poorly reheated

→ Food left too long

→ Blood drips in thawing

Minimising the Risk

Critical Point Number 2 – Contamination during preparation continuedBEWARE cross infection– i.e. keeping cooked food away from raw food, soiled

hands, soiled work surfaces, soiled equipment, clothing and utensils. Testing food with a clean spoon only.Pests, insects and vermin are controlled [eradicated from] the food preparation and

storage areas.Cleaning materials are provided and stored away from foodstuffs.No animals in the kitchen and storage areas.

Critical Point Number 3 – CookingThaw frozen meat well on BOTTOM SHELFNo drips on food belowPoultry and pork cooked at 70 degrees [minimum] at their centre

Critical Point Number 4 – Cool StorageRefrigerator:

Working well and keeping food cold.Cooked & raw food separated. Only cook as much as is neededLeft over food is covered and labelled in fridge.Thrown out after 24 hours.Liquids have lids.Food cooled as quickly as possible [smaller portions / into cooler place]Cooled within 90 minutesNo hot food directly into refrigerator [warms other food].

Storage Rules:Containerise as much as possible.Rotate stock Page 11

Freezer Rules:

- minus 18 degrees- working properly - good seal on lid-Once thawed food NEVER refrozen unless cooked first.- Stock rotated- Foods labelled and dated

Refrigerator Rules:

- __________ degrees- No drips or icing up- good seals around doors

Reheating Rules:

-Cold food must reach 70 degrees for 2 minutes- Through out uneaten reheated food.

Significant Register and Safe Operating Practice

HAZARDFlammable & Hot Hot FatUnattended CookingGas

GUIDELINE TO MINIMISERISK:

Do not leave hot surfaces unattended

Turn off power to appliances prior to cleaning.

Keep residents and visitorsout of kitchen

Know where fire safety equipment is located

Shut Kitchen door if no staff member in kitchen

Use oven cloths provided

Beware boiling water

Beware steamSet gas at minimum rate

needed

Turn off after use

Cool burns with water tor 10 minutes

Guideline to Minimise the Risk:

Hazards in the Kitchen

Page 12

Warn others prior to moving hot equipment from one area to another

Turn handles of pots and pans away from stove edge

Keep oven door closed when in use

Lift lids away from self allowing steam to escape

Allow appliances to cool prior to cleaning

Do not render fat in oven

Do not leave oil or fat unattended while cooking

Do not open dishwasher door until cycle is completed

Only use dishwasher according to procedure

Dishwasher door kept closed when not in use

Personal Protective Equipment:Staff must have hair tied back with none straggling out where it might fall into food

Hair should also be covered

Hazard Significant Register and Safe Work ProceduresHazardous Substances: Chemicals / Hazards for Cleaners

HOUSEKEEPINGMINIMISING HAZARDS

Dirty Toilets & bathrooms[Use gloves]

Infectious rooms[Use gloves]

Bodily Fluids[Use gloves]

Splash in eye!

Use tap wateror saline

NB: ONLY HOUSE HOLD CLEANERS ARE USED

√ Store out of reach of children [visitors children]

√ Use the LEAST corrosive cleaners possible PLUS bleach

√ A list of the cleaners we use is kept in the laundry- Each has a MSD sheet / information required on the label- Use only as directed on label or MSD sheet- Only apply at recommended labelled rates- When labelling consider strength / type / purpose- Labels must be clear & accessible and free from damage.- Wash off splashes as soon as they occur

Do not put any cleaners into unlabelled containersStaff are not to make up ‘special brews’

√ We have a Dedicated cleaners cupboard / basket

√ Any garden chemicals are kept in a locked shed

√ Kept locked when not in use

Personal Protective Equipment Guide:Clean rooms without gloves Wash hands well in betweenOnly use gloves if it is DIRTYUse gloves to protect against bodily fluids

Page 13

Rules about Cleaner’s Trolleys:- House Hold Cleaners on top- Rubbish bag attached to the side- Contain gloves for dirty jobs- Out of reach of visitors children- Do not leave unattended- Do not leave in corridors for residents to trip over / get into-Store safely- Available to other staff easily

Chemicals swallowed:Hazardous Chemicals Centre Ph (03) 4747000

Significant Register and Safe Work Procedure

Waste & Hazardous Substances

Rules about Hazardous Waste:

Sharps & broken glass dedicated containers removed separatelyDressings & pads are placed in double plastic bags then in bins.Don’t push full bins down with hands [beware cuts / needle stick]

Do not over fill [as pictured above]

Wash hands thoroughly

Rubbish is collected regularly each week.Storage area away from general public areas. Page 14

Soiled Disposable Waste: This includes bloodstained waste and soiled

wound dressings, disposable pads, or human

waste. This should be:

Placed in two plastic bags – one

inside the other.

Secured at the top – tie in a knot.

Container used is strong wheelie bin

on wheels with lid.

This is collected no less than weekly

Soiled or blood stained linen: Place in a covered bucket / plastic lined

linen bag for transfer to the laundry.

Soak in strong ‘napisan’ or other bleach.

Bleach is effective against infectious micro-

organisms. Use correct amount as directed.

This linen is laundered separately from other

linen.

Drying the linen in a clothes drier for 10

minutes on high also achieves disinfection.

Wet linen: This i s collected in covered buckets, or plastic

lined linen bags for transfer to the laundry for

processing.

Sharps: [disposable syringes, needles, glass

ampoules and other sharp objects]. These are placed in special sharps

containers immediately after use. When

containers are three quarters full arrange for

collection by Medical Waste Disposal

Contractor or take to chemist for disposal

and replace containers at the same time.

Special Cultural Considerations for Biological Waste There is no particular different way of disposing of infectious waste or dressings from Maori or

other cultures. No waste is incinerated on site.

Personal Protective Equipment

Use gloves

Significant Register and Safe Operating PracticeHazard of Medication Error

Page 15

Serious Hazard Medication Error:

Incorrect dose including overdose [especially INSULIN OR MORPHINE]

Incorrect Drug [BEWARE OVERDOSE]

To wrong resident

Allergic reaction [SEEK HELP QUICKLY] Minimising the hazard:

Only trained staff give medications

Training INCLUDES EMERGENCY situations

- Emergency too much Morphine - Diabetic emergency

Follow policy & training / untrained don’t give out medications

Controlled Drugs-Stored safely- Given Carefully- Controlled [accounted for]- Staff aware of side effects

Insulin- Stored safely in fridge- Given carefully- Staff aware of OVERDOSE

Stored in locked medicine room.

Serious situation Call for Help- Cannot rouse- Floppy or flacid- Slow pulse / low BP- Very slow breathing

- Excited & nervous after insulin- BM under two & not well

← Controlled Drugs[secure]

← Returns [secure]

Significant Register and Safe Operating PracticeMinimising Harm from Challenging Behaviour: from resident / intruder or anyone else with STAFF TRAINING

Page 16

 Hazard or Risk:

Harm from hitting or throwing things  People falling or pushed over and hurting themselves  Cuts [with blood] & broken bones  Others upset & scared  Hurt feelings 

 

Prevention: ♥ Soft voice & ask first ♥ Help people FEEL GOOD ABOUT THEMSELVES 

♥ Understanding of needs & kindness ♥ Know early warning signs & ways to manage / prevent unhappiness 

♥ Something to look forward to for everyone ♥ Call on someone trained to help

 

Angry face

Rapid breathing & flared nostrils

Clenched fists and teeth / pointing

Yelling & swearing

Violent gestures  / hitting throwing

Call for helpMove 

people to safety

Do NOT argue

STEP AWAY

Telling someone what to do

Using a bossy voice

Forgetting dignity & respect

Refusal

Angry or stuborn person

Recognise signs of an angry person 

THE HARD WAY 

INTRUDER DANGER: 

Know how to lock up well

Significant Register and Safe Work Practice

HAZARDS ELECTRICAL

Danger electric shock!!

Danger fire / explosion

Danger igniting from spark

REMEMBER:BEWARE frayed cordsBEWARE exposed wiringBEWARE poor contact

Take faulty appliances out of useLabel as faultyFill in on the Hazard ID FormReport to a Team LeaderCheck appliances brought in by residents carefully

SAFE WORK PROCEDURE:

No broken plugs & switches

Position electrical cables to avoid damage

Tag Testing 2 yearly for plug in appliances

Fire fighting equipment

Electrical Hazards

Page 17

RULES ABOUT ELECTRIC EQUIPMENT:Use according to manufacturers instructionsRegular maintenanceTake out of service if faultyDon’t use if appears wornDon’t use if electrical tag expiredHave electrical goods re-tested prior to expiry date.

Key Points to Minimise Risk:

Tagged safe with current electrical tag.Cords protected from traffic flowCords coiled neatly when not in use.Don’t run over cordsDon’t leave long cords in areas of traffic flowDon’t tie knots in leadsDon’t run over cordsCords coiled neatly when not in use.

Operate electrical equipment with dry handsEnsure correct dial settings before activatingwashing machineCheck lint filter prior to loading drier

Hazard Significant Registers and Safe Operating ProceduresENVIRONMENT

ERGONOMIC INJURYOffice BasedHAZARDSErgonomic - Muscular Injury

SAFE OPERATING PROCEDURE

SUNSHINE

HAZARDSBURNSBurns HURT!Deadly MELANOMASKIN CANCERS in later life

Beware: over exposure to ears, nose, backs hands

SAFE OPERATING PROCEDUREPlan on avoiding heat of the day if possibleEnjoy shade if possibleAlways wear a hatDON’T LET RESIDENTS OR YOUR CHILDREN BURNSUNSHINE EXPOSURE TIME IS A METERHEALTH MONITORING [regular checks]

PERSON PROTECTIVE EQUIPMENT REQUIREDHats, sunglasses, clothing bestSunscreen to a lesser degree

Page 18

Correctly set up work station

Good posture

Macro & mini breaks while working at the computer

Avoid repetition

Stretches

Beware glare

Significant Hazard Register & Safe Work ProceduresVEHICLE Usage

HAZARDSMotor Vehicle Accident

APPLY COMMON SENSEResponsibility

Driver skill

Vehicles

Carrying passengersDANGER SPEED! DANGER DISTRACTION!NEVER OVERLOAD

SAFE OPERATING PROCEDURETELL SOMEONE WHERE YOU ARE GOING & WHEN YOU WILL RETURN

Vehicles MUST have Current WOFVehicles MUST have current REGOOnly use mechanically sound vehiclesVehicles capable of taking passengers comfortablyALL PASSENGERS WEAR SAFETY BELTNumber of passengers limited to number of seat beltsKeys secure when not in use.Care when reversing / blind corners / around childrenNot to transport loads & passengers togetherOnly get on or off stationary vehicles

Only employees WITH CURRENT DRIVER LICENSEOnly employees approved by Manager [listed]Medically fit / not intoxicated

No cell phones to be answered or used while drivingDon’t overloadDon’t go too fast [keep to speed limits]Stop vehicles if passengers display challenging

behavioursStop vehicle if passengers unwell to assess & manage

PERSON PROTECTIVE EQUIPMENT REQUIREDSafety belt for each person in vehicle

Staff taking residents in their own vehicles

RULES:- Absolutely No Smoking in Vehicles-Tell the Home where you are going-Let us know expected returntimes-Residents must have consented to riding in our Vehicles in Care Planning

Page 19

Significant Hazard Register Signing Sheet for Staff / Volunteers & Contractors

I have read this Hazard Register & understand what could hurt me badly & how NOT TO GET HURTAnything I was not sure about I have asked and received good explanation. Please PRINT your name under signature

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