Occupational Health &

SAFETY / Reporting

Sahel General Hospital

Staff Development Department
Mohammad F. Deek SDC
RN,MHS
OBJECTIVES
At the end of this lecture you’ll be able to:
• Define OH&S
• Detect the causes of failure.
• Identify the safety program and its
components.
• Categorize hospital’s Hazards
Define: Incident, Accident and Near Miss
Recognize the chain of communication as per
SGH policy
Introduction
The hospital environment presents
particular and, in some cases, unique
safety problems when compared with
other industrial settings. These
problems affect the patient, staff,
and visitor.
Causes
The causes of such hazards fall into
two broad categories

a) Failure of a device to correctly perform

the desired function. -
b) Failure of hospital personnel to
correctly use medical equipment.
Safety Program
every hospital needs a safety
program and a safety committee to
oversee these aspects of the
hospital's daily function.
THE SAFETY PROGRAM:

A safety program has three major

components. These are:
a) The identification of hazards and risk.
b) The prevention of hazards and risk.
c) Documentation
The identification
component requires constant vigilance with
respect to in- hospital activities and
information from outside sources on the
hazards and risks associated with procedures
or equipment. It is particularly important that
the identification phase be an ongoing one
that can respond to new information. One
particularly important part of identification is
incident analysis.
Protection to personnel and
patients
Elimination or direct control of the hazard
and Supervision and education of the
worker.
Inspection and preventive maintenance,
The replacement or change in types of
equipment, changes in procedures, the
addition of safety and protective devices,
and improved worker qualifications.
Documentation
serves as a record of the program
provide visual and concrete documentation
to accrediting or licensing bodies such as
the Joint Commission for Accreditation of
Hospital Organization (JCAHO), which
requires a documented program
review the prevention efforts and the
"causes of incidents and also serve as a
permanent record of what was done and
why
 HOSPITAL EMPLOYEE HEALTH
AND SAFETY
Hospital environmental exposures are
categorized in the same way as in other
workplaces;
there are chemical, physical, biological, and
psychological conditions.
The hospital has many of the same exposures
in these categories, as do other workplaces;
electrical equipment deficiencies, toxic gases,
weights to lift or move, job motivation and
responsibility, and poor housekeeping.
OH& S
The National Institute for Occupational Safety and
Health completed a survey of 3687 hospitals to
identify the types and frequencies of injuries and
illnesses among hospital employees.

This study found that among all the exposures

typified, the most common types of injury were
strains and sprains.
These injuries are usually caused by improperly
lifting objects, including patients, and slipping and
falling on slippery floors, stairs, or ladders.
Hospital Occupational Health and
Safety
1. Pre- employement medical
examinations should be given to all
new employees. These examinations should
include a medical history, a thorough physical
examination, laboratory tests (blood, urine, chest
X-ray, etc.), and special consultations as indicated
by the history , physical findings, or special job
requirements.
2. Periodic health maintenance
procedures should be instituted that
include a general examination,
as in item 1 above, an assessment of continued
job compatibility, and special appraisals
necessitated by extensive illness or job
changes
3. Health and safety education
programs should be developed to
include job orientation safe working
habits
relevant health information and the use of the hospital
occupational health unit for reporting injury or illness.
4. Employee immunizations should be given
that include smallpox, diphtheria, tetanus, polio, and
other diseases as indicated by epidemics or unusual
laboratory conditions. Updating should also be a part
of this program.
5. Provisions for care of illness and injury at work should
include
arrangements for medical, surgical, psychological, and
rehabilitative services; specific location availability of
competent medical personnel, and a formalized procedure should
be maintained. Treatment and reports of occupational injuries
and illnesses should conform to state compensation laws and
OSHA requirements.
7. Environmental control and surveillance services
should be provided to detect, avoid, or limit
harmful occupational exposures.
Special attention should be given to hazardous
occupational exposures for women of childbearing age, to
employees exposed to ionizing or non-ionizing radiation,
and to operating room personnel exposed to anaesthetic
gases.
8. Employee health and safety records should be
maintained in the health unit.
These must include examinations, injury or illness reports,
radiation records, and other environmental exposure
reports or records.
9. Coordinated planning is
recommended between the health
unit and other hospital departments
and services including the safety
committee, infection control
committee, labour union, and similar
groups.
Hospital Acquired Infection
Nosocomial infection
Infection occurring during
hospitalization is considered the
major problem.
‘cross infection’
REPORTING
 Policy
All incidents in each department are
reported to the quality department
and Occupational Health & Safety
(OH&S) following the channel of
reporting mentioned in the procedure

All incident reports should be

analyzed and presented to the
administration
Procedure
 All employees have to inform their
superior about the incident/accident at
the time it happened:
• Ancillary services: Head of department/
Nursing supervisor during evening and
night shift
• Nurses: Head nurse/ Nursing supervisor.
(Nursing supervisor will report incident to nursing director)
• Support services : Head of department/
Nursing supervisor during evening and
night.
 Incident report should be filled by
head of department.

(details of incident should be recorded. Record date,

time, place of injury)
 If the accident is a needle prick or
involves a contamination from a
patient, record the name of patient
from which needle/other was
contaminated if applicable.
Record if pricked person has history of
Hepatitis B Vaccine evaluation.
If the incident needs immediate
intervention (cut, injury, fall,..) send
the employee to ER to get the needed
treatment when necessary and inform
OH&S officer/ Quality department.
The employee will take the incident
report with a copy of ER sheet when
applicable and consult employee’s
physician.
Employee’s physician will investigate that all necessary
is done in ER when applicable, order needed tests or
vaccination as needed and documents feedback plus
sick leave if required on the incident report
Employee reports to:
HR department for ordering the needed
tests/ vaccines, record sick leaves in
employees file and signs the form
Laboratory for blood sample
Pharmacy to get vaccinated
The employee takes all the documents
to the quality department and a copy
is sent to HR for filling.
Analysis and corrective actions are
documented on the form and action
followed up with concerned.
HR enters the sick leave on system
and in case of further complications
HR follows with department head and
employee’s physician and informs the
quality department.

In case of claim of disability or extended sick

leaves, the HR department informs the employee’s
physician who in turn investigate the issue with
concerned physician and sends her findings back
to HR
HR informs the quality department to
update the copy of incident report in
the quality department.
The quality department prepares a
report about incidents/accidents and
send to department heads and CEO
During evening, nights and
holidays/vacations days, the incidents
are reported as described, documented
in the 24 hours report of supervisors,
medical treatment received in the ER
since employee physician is not available,
and official incident form is then
completed directly on the consecutive
working day.
When an incident involves a patient, an
incident report will be filled by staffing
witnessing the incident/accident in the
involved department.
Details of incident should be reported .
Record date, time, place of injury.
Incident also documented on the 24
hours report (nursing).
The patient’s doctor is informed and
involved residents and immediate
medical attention given.
Report is sent to quality department
for final reporting and analysis.
When an incident involves a visitor or
any other customer, the same report
is filled by the witness from the
hospital staff in coordination with
the OH&S or the quality department,
appropriate corrective actions taken
and then the final report is
forwarded to the quality for
reporting and analysis.
Class work /Case scenario
Its 3a.m., I am working in a medical units and caring of 10
patients.
My IV Round started, the hallway was poorly lightened .I
slipped and fallen down accidently due to my inadequate
shoes and a broken tile in the floor.
At 4:30 am I felt a localized pain in my right ankle with
edema; I continue my nurses notes. At 05:15 am the
pain intensity increased rapidly and I can’t walk.
An X ray performed upon ER Physician request and an
orthopedic consultation was required to confirm my
Right Ankle Trauma.
15 days of sick leave were necessary !!!
 Questions

1. Identify risk factor (s) of slip and fall.

2. How could we prevent slip in this case?
3. Who are the concerned person(s) to be
notify?
4. What is the necessary document to be
filled? Reporting chain of communication