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OSHA’s Renewed Emphasis on Healthcare

May 27, 2016 11:00AM ● By MED Magazine

By Vince Weber 



In April 2015, the Occupational Safety and Health Administration (OSHA) renewed indefinitely its “National Emphasis Program (NEP) on Nursing and Residential Care Facilities.” This renewed focus has not only resulted in the addition of new OSHA offices and staffing here in the Midwest, but is also expected to result in additional activity, including OSHA inspections, for local employers.


The focus of the NEP will be on the five hazard areas reportedly causing the majority of workplace illnesses and injuries for healthcare workers. The five areas specifically targeted during inspections are detailed below.


Ergonomic and Musculoskeletal Disorders (MSDs)

OSHA asserts that MSDs related to patient handling account for about 44% of all reportable injuries in the healthcare industry. Compliance Safety and Health Officers (COSHOs) will spend considerable time reviewing the number of ergonomic injuries at a worksite. They will determine whether the employer's ergonomic program adequately addresses issues related to program management, program implementation, employee training, and occupational health management. This will ensure that employees are not only protected from ergonomic injuries and illnesses, but also that they are properly treated in the event that they experience such an injury or illness.


Slips, Trips, and Falls

Slips, trips, and falls are the second leading cause of work related injuries. The NEP will focus on a number of areas within the facility, including kitchens, dining rooms, hallways, laundries, bathing areas and access/egress points. Inspectors will be looking for conditions such as floors and walking surfaces that are slippery, wet, uneven, cluttered, or lacking adequate lighting. Guarding of floor holes and openings, stairways and elevated surfaces, as well as spill cleanup, and appropriate footwear will also be evaluated.


Blood-borne Pathogens

With the advent of several new high profile disease concerns such as the Zika and Ebola viruses, along with existing diseases such as HIV and Hepatitis, OSHA will increase their focus on blood-borne pathogens and infection control. COSHOs have been instructed to evaluate employers' Exposure Control Plans (ECPs), engineering and work practice controls, blood-borne pathogen training, personal protective equipment (PPE), and post-exposure treatment. Employers should be prepared to monitor and evaluate the adequacy of their blood-borne pathogen programs on a regular basis.


Tuberculosis/Contagious Diseases

With some areas of the United States experiencing an increase in active tuberculosis cases, inspectors will evaluate whether a facility has had a suspected or confirmed tuberculosis case among patients within the prior six months. They will evaluate the employer’s procedures to promptly isolate and manage the care of suspected or confirmed cases, and whether testing is offered to employees exposed to infected individuals. Employers should be prepared to demonstrate that they have effective protocols in place to safely control active and suspected tuberculosis cases.


Workplace Violence

Recent OSHA press releases and publications have stated that workplace violence is a "recognized hazard in nursing and residential care facilities," accounting for 13% of all recorded injuries. COSHOs will conduct reviews of injuries related to workplace violence and determine if appropriate controls and policies are in place to address aggressive or violent persons. Employers can be cited under the General Duty clause (OSHA Act of 1970 sec. 5(a)(1)) if incidents have occurred and adequate policies or procedures are not in place.


Employer Preparation

Although most healthcare facilities receive a number of inspections, it is important to remember that the focus of an OSHA inspection is on the health and safety of the employee. In order to be prepared for an OSHA inspection, employers should take the following steps:

1.      Establish policies and procedures related to the five NEP focus areas.

2.      Ensure that all employees have been trained on the facility's health and safety programs.

3.      Conduct an internal audit to determine if the existing policies, procedures, and employee training adequately addresses the focus areas.

4.      Establish guidelines for handling an OSHA inspection, including who is informed, who manages the flow of information, and who will escort the inspector during travels through the facility.


Employee safety is an essential consideration for all workplaces. Healthcare employers should use OSHA's recent emphasis as an opportunity to verify the accuracy of their existing programs and abate potential hazards. Failing to do so could subject employers to OSHA citations and penalties, increased injury and illness rates, and increased workers’ compensation costs.



Vince Weber is a Loss Control Specialist with RAS.