OCCUPATIONAL HEALTH & SAFETY TRAINING :

“ FINDING HAZARD,
STRATIFY THE RISK,
AND
TAKING AN ACTION !

For Medical and Non-Medical Staff

AHMAD NUR AULIA, MD

Hazard Finding flowchart
Found
Hazard
Hazard
Finding
Training

Hazard Risk
Register

Controlling
Hazard by PIC
/ Dept.

OHS
Meeting
Purposes of Occupational Health & Safety
Training (OHS)
To be able to provide fast and efficient systems for all
individuals to response with the hazard surrounds and
making a better place to work
To set up a chain of “Hazard Finding” information
that allows effective and efficient respond from Person
or dept. In-charge at BIMC Nusa Dua
To maintain the safety and healthy workplace for its
worker to met the optimum health services
To protect property, facilities and equipment
To meet all laws and regulations applicable
Background
Disaster and accident know no place, time or person.
If it’s happened RIGHT NOW. Are you ready?
If it’s happened RIGHT NOW. Do our Hospital ready
face the worst scenario?
Physically ? Procedural? Facility? Manpower?
Find the
Hazard !
 HOSPITAL HAZARD IDENTIFICATION
Hazard : A source of Danger, A possibility of incurring loss
or misfortune
Identification : the process of objectively recognizing
something or someone by remembering
Factor that may causing hazard in hospital including :
Biological factor (virus, bacterial, and fungi)
Chemical factor (antiseptic, anesthetic gas, solvent gases,
cytotoxic)
Ergonomical factor (wrong procedure or awkward
movement and position)
Physical factor (temperature, light, noise, electrical, radiation)
Psychosocial factor (shift work, employee-employer
relationship)
Based on : KEPMENKES RI / No 432/MENKES/SK/IV/2007 ttg. Pedoman Manajemen K3 RS
Physical
Factor
Heat and
Noise in
CSSD
Dept.
Physical -
Ergonomic
Factor
Dust and
Ergonomic
in Medical
Record
Dept.
 Chemical
Factor
Disinfectant
and solvent
in All area
and
Pathology
Dept.
Biologic
Factor
AIDS,
Hepatitis
A, B in
ER , OR,
Pathology
Dept.
 Biologic
Factor
Tuberculosis in
Ward, Isolation,
Pathology Dept.
 Ergonomic
Factor
Repetitive work
with awkwarkd
posture in
Ward, Reception,
Dental Dept.
 Ergonomic
Factor
Wrong
Technique of
Manual
Handling in ER,
Ward, OR Dept.
Psychosocial
Factor
Unnecessary
Over time Shift
in All Dept.
BE AWARE ! It’s happened surround us!
HAZARD
FINDING
CARD
 Targeted to be

100 %
accomplished by
all staff to find the
HAZARD finding
every once
in
a 3-Month
Stratify
the Risk
Risk Assessment

Frequency x Likelihood x Severity =

SIGNIFICANT
FREQUENCY
LIKELIHOOD
SEVERITY
Example : By : dr. Hermes – Head of ER

1. 2.

By : tess –
Accrediation Consultant

F : 5 ( > 5 times daily ) F: 1 ( 1 to 10 times in a year)

L : 3 (Estimation 1 – 5 cases per year) L : 4 (Most likely one case within 6
month to 1 year)
S: 3 (Major injury [fell and broken S: 4 (Critical injury or fatality [died] )
limb] )

How important is the Hazard Finding System?

 Then what can we do about it?

1st Finding Hazard,

2nd Stratify the Risk,
3rd Take Action,
4th Evaluate the Changes
Risk Assessment
Frequency x Likelihood x Severity =

SIGNIFICANT
1st Case = 45 Moderate

2nd Case = 16 Acceptable

2nd

1st
Take action !
 Key Word on Action !
Trivial ( 1 - 9 ) No Action Required

Acceptable ( 10 - 25 )  No additional control 

Increase Monitoring to maintain Pre-Existing Control

Moderate ( 26 – 45 )  Need additional Control

(Engineering / Administrative / Availability of PPE /
APD(Personal Protective Equipment / Alat
perlindungan diri)  Continue monitoring pre-
existing and additional control were implemented
 Key Word on Action !
Significant ( 46 – 85 ) 1. To implement program
and/or operational controls (Engineering /
administrative control), and ensure availability of PPE.

2. If relevant, continuing monitoring to ensure

comply with the applicable legal / regulatory
requirement
 Key Word on Action !
Extensive ( >= 85)  1. To implement program
and/or operational controls (Engineering /
administrative control), and ensure availability of PPE.

2. If relevant, ensure the permit is maintain valid, or

application of permit is carried out & constantly
follow up.

3. If possible eliminate the hazard or substitute the

assets.
Take action! Start from You !
1. Eliminate the
Hazard Spills, Trips, Falls
 Potential Hazard :
 the emergency atmosphere, (i.e.,
high traffic and compact
treatment spaces)
slips/trips/falls may be a specific
concern. There is a potential slip
and fall hazard if water or
other fluid is spilled on the
floor, electrical cords run across
pathways, or if emergency
equipment or supplies block
passage and passageways.

 Solution :
 Provide safe clean-up of spills
and keep walkways free of
obstruction.
2. Substitute the
Hazard
Latex Allergy
 Potential Hazard :
 Gloves must be worn frequently
in the ICU, because of possible
occupational exposure to blood
and other potentially infectious
materials (OPIM) . This exposure
can potentially lead to latex
allergy.

 Solution :
 Employers must
provide appropriate gloves ( the
Latex free )
3. Isolate the
Hazard
Chemical Material
 Potential Hazard :
 Employee exposure to
hazardous chemicals (e.g.,
while decontaminating ED
patients after a chemical spill) or
exposure to hazardous drugs (e.g.,
during administration).

 Solution :
 Provide safe isolate place to
keep hazardous material in place
and the access only by the
permitted person in charge.
4. Use engineering
control
Machine Guarding
 Potential Hazard :
 Maintenance employees can be
exposed to possible
amputations, and strangulations
while performing maintenance
to machines, if no machine
guarding measures are utilized.

 Solution :
 According to OSHA Machine
Guarding Standard, machine
guarding must be provided to
protect employees from hazards
5. Use Administrative
control
Workplace Violance
 Potential Hazard :
 Workplace violence is an issue in
EDs because of the crowded and
emotional situations that can
occur with emergencies. In addition,
ED patients could be involved
with crimes, weapons, or
violence from other people that
could put the ED employee at an
increased risk of workplace
violence.

 Solution :
 Good work practice recommends a
security management program
that addresses workplace violence in
the ED
6. Use Personal
Protective Equipment
Tuberculosis
 Potential Hazard :
 Exposure to Tuberculosis and
other infectious agents from
patients in waiting room and
treatment areas. Staff may be
treating an emergency and be
unaware of other pre-existing
infectious conditions. 

 Solution :
 "Personal respiratory
protection should be used by
employee who has higher risk
of tuberculosis contamination
Management

Employee

FIND, STRATIFY & REPORT !

START FROM OUR SELF !
“HAZARD FINDING” ’S REPORTING FLOWCHART
1. All staff (medical & non medical) report the hazard finding using
“QUARTER-LY HAZARD FINDING REPORT CARD “

2. Pass the Card to Occupational

Health and Safety (OHS) Admin or OR
OHS Box in every dept.

3. OHS Admin collect all hazard finding and input

into single report of “QUARTER-LY SAFETY
REPORT MATRICULATION TABLE (HIRADC)”

4. The Report is updated daily and sent to Head of OHS to be

reassessed and determine whose person in-charge/dept in-charge
Background
Disaster and accident know no place, time or person.
If it’s happened RIGHT NOW. Are you ready?
If it’s happened RIGHT NOW. Do our Hospital ready
face the worst scenario?
Physically ? Procedural? Facility? Manpower?
DISASTER CODE EMERGENCY AND HAZARD
IDENTIFICATION

No easy slider that easy to

access
to evacuate
bedridden patient

Code Black Code Purple

THANK YOU
CALM AND BE SAFETY !