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Here are just a few examples of ways GDI Insurance Agency, Inc. helps keep your employees safe; Here is the cover and contents page of a Dental Office Safety Manual. I have also pulled some of the contents of this manual and added it below these pictures. If you fill out a contact us form on our website, just ask for your free copy of either a medical or dental office safety manual, or a free copy of an employee manual. I will have a GDI broker email your copy in word so you can edit it. No cost or obligation.
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Bloodborne Pathogens Program
Reference Standard
Occupational Safety and Health Administration; Bloodborne Pathogens, Subpart Z, 29 CFR 1910.1030
Purpose
This procedure establishes minimum procedures to be followed to prevent exposure to Bloodborne Pathogens during potential exposure incidents. Our only exposure incidents are: responding to illness and injury or while performing sanitation or cleaning duties following a spill of blood or other potentially infected fluid.
Scope
This procedure applies to all of our company employees, all contractors and vendors performing work on company property, and all other individuals who are visiting or have business with our company.
Responsibilities
Management is responsible for development and review of this program. Management is also responsible for appropriate employee training.
Management and supervisors are responsible for enforcement of this program.
Employees shall comply with all procedures outlined in this policy.
Contractors and vendors shall comply with all procedures outlined in this policy.
Definitions
Bloodborne Pathogens: (BBP) Pathogenic microorganisms that are present in human blood and can cause disease to humans. Examples are: HIV, Hepatitis B and AIDS.
Contractor : A non-company employee being paid to perform work in our facility.
Exposure incident : Any specific eye, mouth, other mucus membrane, non-intact skin, or other contact with blood or potentially infected material.
Other Potentially Infected Material : (OPIM) Any bodily fluid that is visibly contaminated with blood or any fluids in which it is difficult or impossible to tell what the fluid is and/or if it is contaminated with blood.
Personal Protective Equipment : (PPE) Gloves, safety glasses, suits, face shields, etc. worn to prevent contact with blood or other bodily fluids.
Regulated Waste : Liquid or semi-liquid blood or OPIM in a liquid or semi-liquid state if compressed; items that are caked with dried blood or OPIM and are capable of releasing these materials during handling; contaminated sharps; wastes containing pathogens or microbiological waste.
Sharps : Medical devices with a point and/or a blade capable of penetrating human skin (e.g. hypodermic needles, scalpers, etc.).
Universal Precautions : Our approach to infection control. All bodily fluid will be treated as if it was contaminated with a bloodborne pathogen and appropriate protection and sanitation steps will be taken.
Vendor : A non-company employee being paid to perform a service in our facility.
Procedure
Exposure Control Plan
There are only two possibilities for BBP exposure in our facility:
- While responding to an illness or injury to provide first aid care
- When cleaning and sanitizing a bodily fluid spill
Additionally, an employee could experience unintended exposure from contact with blood or OPIM. Accordingly, there are no engineering controls available. Our exposure control plan is:
1. Only designated personnel who are trained, authorized and equipped to respond to medical emergencies and or bodily fluid spills will do so. All other personnel will avoid contact and notify their supervisor if a spill or exposure incident is encountered.
2. While responding to bodily fluid spills, an appropriate level of personal protective equipment will be worn including:
- Safety glasses-Incidents with minimal exposure potential (e.g. a laceration with minimal bleeding)
- Face Shield-Incidents with a potential of bodily fluid becoming airborne (e.g. a laceration with spurting, arterial bleeding)
- Disposable liquid proof gloves-All incidents
- Apron/disposable suit and shoe covers-Incidents with a potential of bodily fluid becoming airborne or incidents in which response personnel could walk through a spill or move against material contaminated with a spill
- Barrier mask and/or Bag Valve Mask-Incidents requiring mouth to mouth or mouth to nose breathing
Adequate supplies of personal protective equipment are kept in the following locations:
(List locations of BBP PPE) ________________________________________________.
3. Regulated Waste such as: contaminated dressings, bandages and other materials will be double bagged in red biohazard bags and disposed of as regulated waste using an approved disposal contractor. We do not use any medical sharps.
4. All potentially contaminated surfaces will be cleaned and sanitized with an approved sanitizing solution or will be disposed of as contaminated medical waste. Personnel performing this duty will be trained in all aspects of this plan and will be required to wear appropriate PPE as outlined above.
5. After performing necessary duties personnel will clean and sanitize any contaminated PPE, remove and discard it.
6. All personnel are required to wash their hands with soap and warm water (waterless skin sanitizer is available to use when potable water is remote from the scene) immediately after removing PPE.
7. Any employee (including both personnel trained and authorized to respond to incidents and those that are not) should immediately do the following if an exposure is suspected:
- Wash exposed skin surfaces with large amounts of soap and warm water. Exposed mucus membranes should be rinsed with large quantities of warm water
- Report any actual or suspected exposure incident to their supervisor or the plan administrator. The employee will immediately be referred to a physician or other licensed health care provider for confidential follow-up care to be provided at no cost to the employee.
Plan Review
This plan will be review and revised as needed annually by the program administrator.
Training
All employees who are authorized to respond to potential exposure incidents will be trained annually regarding this exposure control plan and their duties.
Employees who have no occupational contact with potentially contaminated materials will receive awareness training upon hire.
Hepatitis B Vaccination
All personnel who are assigned job duties where they are required to respond to potential exposure incidents will be offered the Hepatitis B vaccination series at no cost. The initial offer of the Hepatitis B vaccination will be within 10 days of assignment. If the employee initially declines the vaccination s/he can rescind the declination at any time. Any employee who declines the Hepatitis B vaccination is required to sign the declination form. (See Appendix A for copies of the Acceptance and Declination statements)
Reducing Workers’ Compensation Claims for Health Care Workers
Health care workers, especially those employed by nursing homes, perform a variety of lifting tasks that put extreme strain on their bodies. Often, an employee must physically support and move residents who are larger and heavier than he/she can bear. As a result, these workers are at high risk for developing job-related injuries. In 2007 (the most recent data available), nursing aides, orderlies and attendants alone sustained 24,340 musculoskeletal disorders, the second highest of any occupation.
You can take measures to reduce the physical strain on your employees by practicing ergonomics, the science of designing tasks to the physical make-up of the workers. Proper lifting equipment, training, and modification of tasks will prevent injuries and reduce workers’ compensation claims.
The Benefits of Portable Mechanical Lifts
According to the National Institute for Occupational Safety and Health (NIOSH), a 100-bed nursing home facility can expect to spend $25,000 to $30,000 just on portable (not ceiling mounted) mechanical lifts. As a general rule, one full-body lift should be provided for approximately eight to 10 non-weight bearing residents. The facility should also have one stand-up lift for approximately every eight to 10 partially weight bearing residents.
Both types of machines cost around $3,000 to $6,000, totaling approximately $50,000 per facility. This may appear to be a costly investment; however, cost-benefit analysis reveals that the initial investment in lifting equipment and employee training on the machines is recovered in two to three years through reductions in workers’ compensation expenses.
In fact, NIOSH has found safe lifting programs to be so important and effective that officials introduced a bill to the U.S. House of Representatives in May 2009 that, if passed, could mandate use of these machines in all healthcare facilities.
In the proposed bill, Congress stressed the value of portable mechanical lifts not just for keeping employees healthy, but also for increasing patient safety and retaining valuable staff in a time where many healthcare facilities face extreme nursing shortages.
Safety Program
To reduce the risk of employee injuries as a result of patient handling, a nursing home facility should design a safe handling program to include the following:
- Continual training on injury prevention
- Covering risks, causes and symptoms of musculoskeletal disorders
- Practicing transfer and lifting resident methods
- Procedures for detecting and reporting early signs of back pain
Facility Analysis
In addition to establishing a safety program, the employer should conduct an analysis of the facility to identify any potential hazards. By observing employees as they tend to residents, administering surveys and discussing the issue with employees, the facility can easily detect which tasks pose potential dangers. The facility should also analyze the recorded injuries to uncover any reoccurring problems.
Expert Guidance
Beyond these administrative controls, the facility should also consider hiring an expert in musculoskeletal disorders to care for injured employees. This person should be responsible for:
- – Recording injuries and illnesses
- – Identifying injuries and providing treatment early on
- – Establishing no-lifting tasks for the injured employees until they recover
- – Monitoring injured employees and determining when they can return to their normal duties
Guidelines for Lifting
As part of its educational programs, the facility should provide employees with specific guidelines for lifting residents to ensure that it is done correctly and safely. Some guidelines include:
- – Maintain good balance while transferring residents
- – Lift the person close to your own body
- – Lift residents with another employee present, especially residents who have fallen
- – Do not exceed the recommended lifts per worker per day
- – Do not use equipment that is unfamiliar until properly trained
- – Avoid manually lifting when possible-use the provided lifting equipment
Rely on the Experts
Our Property-Casualty team is experienced in delivering health care solutions that help you keep your workers and patients safe while protecting your bottom line. Contact GDI Insurance Agency, Inc. at 209-634-2929 to learn more about our health care safety and ergonomics programs.
The ABCs of Medical Malpractice Insurance
It is a requirement in most states that physicians obtain medical malpractice insurance. In those states where this requirement does not exist, physicians will almost always purchase this coverage before seeing patients at a hospital or other health care facility. It is not necessary for federally employed physicians to purchase this coverage, as medical malpractice suits would be filed against the federal government. In general, this same logic applies to physicians employed by a state. Physicians usually buy their insurance from a commercial company or a physician-owned mutual company; they can buy this coverage either individually or through a group practice. Hospitals and health care facilities instead purchase their own insurance. For hospitals that directly employ their medical staff, they usually buy a policy that covers both the employees and the entire hospital.
Premium Costs
Premium costs for malpractice insurance are among the highest in the insurance industry. Insurers set premiums based on four factors:
1. The expected payouts for providers in that particular risk group.
2. The uncertainty of the estimate.
3. The expected administrative expenses and future investment income.
4. The profit rate sought by the insurer.
In contrast with auto insurance, medical malpractice insurance is not experience-rated. If a physician has a claim, his/her insurance does not go up. Instead, physician malpractice premiums are determined by their specialty and geographic location. Typically, physicians practicing in urban settings have higher premiums than those in rural areas. And physicians in high-risk specialties such as obstetrics and gynecology, neurosurgery and orthopedics rank among those with the highest premiums. Regulating medical malpractice insurance on an experience-rated basis has proven unsuccessful due to physicians’ claims experience being too variable over short periods of time, making it very difficult to produce an actuarially stable estimate of their risk.
For entire hospitals, experience-rated premiums are much more realistic because hospitals’ claims experience is more stable over time than individual physicians. Despite this, less than half of hospitals’ total premium is based on experience. Similar to individual physicians, most of their premium cost is dependent on the hospital’s location and level of care offered.
State-Specific Malpractice Regulations
Malpractice insurance is regulated predominantly by the states, and malpractice insurers tend to serve only one or rarely a small number of states. Some states have undergone tort reform to put a cap on noneconomic damages that can be collected in a medical malpractice suit, and this information can be found at your state legislature Web site. Some states have also made the purchase of medical malpractice insurance of at least $1 million mandatory, while others still have no minimum requirement. This information can also be found on your state legislature Web site.
The Medical Malpractice Crisis
A medical malpractice crisis is a period of instability in the medical professional liability insurance market of which deterioration in carriers’ financial ratios is followed by a substantial increase in premiums or even a decreased supply of insurance. When evaluating whether or not a state is experiencing a medical malpractice crisis, it is important to look at both the absolute levels of premiums and the amount of change over time. It is also important to monitor how generously providers are reimbursed in that specific state, simply because reimbursement affects providers’ ability to meet the rising cost of insurance.
There are many reasons why a malpractice crisis, of which many states are experiencing today, is a state-specific issue. First off, socio-demographic variations across states make for very different tort environments in terms of average award size and litigation. Secondly, the rules governing malpractice litigation also vary across states.
Contact us today to learn more about medical malpractice insurance.◊
This Coverage Insights is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice. Readers should contact legal counsel or an insurance professional for appropriate advice.
Medical Malpractice Insurance
For the past decade, the health care profession has struggled with a medical malpractice insurance crisis. Namely, the number of insurers offering coverage has greatly diminished causing a substantial increase in cost of coverage. Not only that, the monetary amount of a medical malpractice claim is skyrocketing as well – resulting in a greater risk of going without coverage.
What is Medical Malpractice Insurance?
Medical malpractice itself is the failure of medical professionals to provide adequate treatment to a patient, resulting in a personal injury or substantial loss of income. And, unfortunately, this does happen in medical settings today.
A medical malpractice suit could result when a medical professional fails to exercise the degree of care and skill that a physician or surgeon of the same medical specialty would have used under similar circumstances. To protect against these claims, medical professionals need medical malpractice insurance. This specific insurance covers doctors and other professionals in the medical field for liability claims surrounding the treatment of their patients.
History of Costs
The cost of medical malpractice insurance has been continuing to rise throughout this decade. Rate increases can be at least partly attributed to the slowly growing number and substantial increase in the monetary size of claims – centralized mainly at medical facilities in urban settings.
Other factors driving up prices include the decrease of coverage available due to several major insurers exiting the malpractice insurance business because of a lack of profit. Recent research indicates that premium increases may be moderating, but industry experts beg to differ since insurers are continually paying out significantly more in claims than they collect in premiums.
The medical malpractice insurance cost crisis has taken its toll on the profession as well as on patients in recent years. The lack of affordable malpractice insurance is threatening the ability of many physicians to practice medicine – with the most serious direct implication being that patients are left without access to medical care. Not only that, some medical professionals are financially forced to move to states with lower premiums, stop performing certain procedures or retire early from the field completely.
Even doctors who have already reduced their coverage to compensate for high premiums instead of leaving the field completely are not rushing to raise their coverage again. This has resulted in downsizing or even closing emergency rooms and trauma centers across the country, leaving patients with a further travel distance to receive care.
Location and Specialty
The cost of medical malpractice insurance varies by specialty and location. Physician specialists practicing obstetrics and gynecology, orthopedics, neurosurgery and emergency medicine tend to have the highest premiums because they are performing procedures that have a higher risk of complication and their patients can have more serious illnesses and injuries. Premium costs continue to increase, especially in states that have not enacted tort reform. More specific information can be found at your specific State Legislature Web site.
Note: This Risk Insights is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice. Readers should contact legal counsel or an insurance professional for appropriate advice.
First Aid Responder Safety Checklist
As a trained first-aid responder, your primary responsibility is to provide immediate care to workers who become ill or injured. Your role in helping others also puts you at high risk due to exposure to potentially infectious materials, such as blood and other body fluids. When providing first aid, keep in mind the following safety considerations, including always wearing the appropriate personal protective equipment.
¨ When assisting an injured employee, always wear safety glasses, protective gloves and a barrier mask (available in the first-aid kit) to limit your exposure.
¨Conduct an assessment of the scene to determine if it is safe to enter and provide care. If the scene is safe, assess the injuries.
- If there are any immediate life-threatening injuries, administer the appropriate emergency life support, such as administering CPR and controlling hemorrhages.
- If there are no immediate life-threatening injuries, administer first aid such as bandaging wounds, stabilizing injured extremities, etc.
¨Request additional medical assistance as needed.
¨Relay information about the injuries to the oncoming ambulance.
¨ Remain with the patient and provide ongoing care as well as reassurance of his/her recovery.
¨ Hand patient over to emergency personnel as soon as they arrive and assist as necessary.
¨ If you have an exposure incident, wash/flush area with water or sanitizer and report it to your supervisor.
¨ Record emergency medical care given to the patient for diagnostic purposes.
¨ After each emergency call, restock and replace supplies used.
¨ Clean up by accident area by wiping all surfaces affected with a sanitizing cleaning agent and appropriately bagging soiled first-aid materials.
¨ Fill out a Report of Injury or Illness Form to log accident details.
¨ Attend all required first-aid training as required by GDI Insurance Agency, Inc.
Working Safely with Sharps:
Tips for Avoiding Needle Stick Injuries
The OSHA standard for bloodborne pathogens requires that any employee exposed to blood, or other potentially infectious materials (OPIM), follow proper safety precautions when working with needles and other possible contaminated sharps as part of their job duty.
A needle stick or cut from a contaminated sharp is one of the easiest ways workers expose themselves to potentially dangerous bloodborne illness, like hepatitis or HIV. Fortunately, most sharps accidents are preventable with the use of proper engineering controls, safe work practices, and personal protective clothing and equipment.
Handling, Storage and Disposal
The best way to prevent cuts and sticks from sharps is to minimize your contact with them. Follow these safety precautions when handling, storing or disposing of sharps:
Needle Safety
If you are stuck by a needle or other contaminated sharp, or get blood or OPIM in your eyes, nose, mouth, or on broken skin, immediately flood the exposed area with water and clean any wound with soap and water, or a skin disinfectant, if available. Report the incident to your supervisor and seek immediate medical attention.
Responding to Violent Residents
Sometimes residents can become violent with their caregivers. This is the leading cause of injury to employees in your industry. To minimize dangers to you and your co-workers:
- Remove furniture with sharp edges, and excess clutter that could potentially be used as a weapon in residents’ rooms.
- Identify another way to exit the room other than the door in the event that the resident becomes violent.
- Never enter a resident’s room alone if he/she has a history of violence; bring a co-worker with you as a precaution.
HANDLING PATIENTS IN THE SHOWER
Handling, lifting and maneuvering patients in the bathroom can be very straining on your body. They are relying on you to support their weight, as they cannot do so themselves. Try these handling assists to reduce your risk of injury:
- Shower Chairs: Place the patient in the chair and help him/her bathe. The chair is on wheels so it is easily transported in and out of the shower area.
- v Gait Belts: These belts have handles allowing for easier movement while helping patients walk and move.
- v Mechanical Lifting Equipment: These machines lift the patient from the bed and move him/her into the bathroom and other parts of the facility.
Take care of your own body! You cannot assist patients if you are injured yourself.
Effective Patient Handling
Lifting Comlications
- Size and weight of the resident exceeds the carrying capabilities of the employee
- Resident may be combative or unwilling to be moved
- Employee may lose his/her balance while trying to move a resident
- Small space such as bathrooms inhibit movement
- Objects such as beds get in the way of employees being able to get under the resident to lift them
What is Tuberculosis (TB)?
- Disease caused by Mycobacterium tuberculosis
- Affects nearly 1/3 of the world’s population – killing three million people per year
- Prevalent in health care facilities – specifically long-term care facilities for the elderly and drug treatment centers
Source: OSHA