Introduction

Overview

Park Nicollet Health Services (PNHS) must meet various regulatory agency guidelines for mandatory education. On an annual basis, managers and supervisors are responsible for ensuring employees are provided training applicable to their job function. You will fulfill theRight to Know portion of the mandatory education series, including OSHA bloodborne pathogen training, by completing this course.

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Topics

I. Course overview

II. Hazardous Substances

III. Healthcare-acquired infections

IV. Bloodborne Pathogens

V. Tuberculosis

VI. Antibiotic-resistant organisms

VII. Infection exposure prevention

VIII.Your work environment

IX. Your role and resources

Approximate length50 minutes

PrerequisitesThere are no prerequisites to this course.

Questions about the content in this course?• Employee Safety questions: call 952-993-5080• Infection Control questions: call 952-993-5456

OSHA requires you to complete this course on paid work time. Please work with your supervisor to coordinate this.

For Contact Hours, click Attachments in the upper right-hand corner and select the relevant PDF.

Head + Heart, Together Behaviors: Employee Safety

Course Objectives: Employee Safety Aligned HHT Behaviors

Understand how Right to Know relates to your job. Head: Thinks Critically; Develops Self

Describe the purpose of safety data sheets and how to obtain them.

Head: Thinks Critically

Describe the purpose of signal words, hazard statements and precautionary statements on container labels.

Head: Thinks Critically

Describe where to find PPE and when to use it for the job you do.

Head: Thinks Critically

Describe your resources for ergonomic issues. Head: Thinks Critically; Develop Self

Head + Heart, Together Behaviors: Infection Prevention

Course Objectives: Infection Prevention Aligned HHT Behaviors

Name two things you can do to prevent healthcare-associated infections.

Head: Thinks Critically; Develops Self

Identify diseases that can be spread through blood and body fluid

Head: Thinks Critically

List how you can prevent being exposed to infections on the job Head: Thinks Critically

Describe symptoms of active tuberculosis (TB) Head: Thinks Critically

Describe when you should perform hand hygiene Head: Thinks Critically; Develops Self

Identify patient care activities that require personal protective equipment (PPE).

Head: Thinks CriticallyHeart: Focuses on Those We Serve

Identify where to access infection prevention information at PNHS.

Head: Thinks Critically; Develops Self

What is 'Right to Know'?

Introduction

The primary objective of Employee Right to Know/Hazard Communication training is for you to know how and where to find specific hazard information

Team member: Right to understand

You have a right to understand; this course covers a variety of training topics covered under PN's Right to Know Program.

PN's "Employee Right to Know and Personal Protective Equipment" policy

The purpose of the Safety Management Plan is to establish, maintain, and promote safety at Park Nicollet. PNHS recognizes that an effective Safety Management Plan can reduce the number of job-related injuries, illnesses, and fatalities by managing workplace safety and health as well as ensuring compliance with regulatory standards.

For more information, please refer to Park Nicollet's "Employee Right-To-Know and Personal Protective Equipment" policy.

What is 'Right to Know'?

Minnesota Employee Right to Know Act

In 1983, the Minnesota legislature expanded OSHA’s standard and named it the Minnesota Right to Know Act (ERTK). To comply, employers must identify hazardous substances (chemicals), harmful physical agents, and infectious agents in the workplace and provide training to employees who are exposed to them.

OSHA: Hazard Communication Standard (29 CFR 1910.1200)

The Occupational Safety and Health Administration’s (OSHA) Hazard Communication Standard (29 CFR 1910.1200) is based on the concept that employees have a ‘right to know’ the hazards they are exposed to.

Changes to OSHA’s Hazard Communication Standard

OSHA’s Hazard Communication Standard (29 CFR 1910.1200) was revised in 2012 to include the Globally Harmonized System (GHS) worldwide framework for standardizing and harmonizing the classification and labeling of chemicals.

• This means that manufacturers now classify substances the same way throughout the world in terms of physical, health, and environmental hazards.

• It also now requires manufacturers use a standardized labeling and safety data sheet format worldwide.

The goal of this enhancement is to improve protection of human health and the environment by providing an internationally understood system for classification and labeling of chemicals.Not only do you have a “Right to Know” about chemical hazards, you have a “Right to Understand” what the hazards mean to you.

Hazardous substances

Topics covered in this section include:

• Hazard classification

• Cytotoxic drugs

• Safety data sheet (SDS)

• Container labeling

• Personal protective equipment (PPE)

• Emergency procedures

If you have questions on topics covered in this section of the course, contact PN's Safety Manager at 952-993-3957.

Disposal of hazardous substancesIn the event that you need to dispose of a hazardous substance, such as a chemical or a pharmaceutical, follow the manufacturer's recommendation for disposal. Also you may refer to the Hazardous Waste for Healthcare Workers mandatory education course on tLP.

Hazard classification - Physical

Introduction:Manufacturers assign a hazard/danger classification to a chemical based on tests, literature and practical experience. The Globally Harmonized System (GHS) further breaks hazards down into physical hazards and health hazards.

Physical hazards

Chemicals that may catch fire, explode, or react in some way.

TypesExplosivesFlammables and combustibles compressed gases Oxidizers Reactives (with self, water, or air)CorrosivesOrganic peroxides

Note: In this presentation, we’ll focus on the hazards you may encounter at Park Nicollet.

Hazard classification - Physical

Flammables and combustibles:

Safe handling and storage

Keep container closed when not in use

Do not use near open flame or ignition source

Store flammable liquids in flammable storage cabinets

Ground and bond containers containing flammable liquids over 5 gallons

Oxidizers are substances that increase the burning of fuels by increasing the oxygen. Examples include:

Benzoyl peroxide

Concentrated nitric acid

Sodium hypocholorite (bleach)

Safe handling and storage

Do not mix with fuels

Store separately from flammables and combustibles

Note: Oxidizers are generally very reactive. In many cases, contact with combustible material will result in fire.

Hazard classification - Physical

A compressed gas is a gas or mixture of gasses in a container that is under pressure. Examples include:

Nitrogen

Oxygen

Compressed air

Safe handling and storage

Ventilate areas where gases are used

Identify cylinders by name, not color

Firmly close valve when not in use

Keep safety cap on cylinder when not in use

Firmly secure cylinders during storage and use

Hazard classification - Physical

Corrosives can be acidic or caustic (base). They are capable of destroying human tissue. Acids can also destroy metal.

Acid examples: sulfuric acid (battery acid), hydrochloric acidBase examples: sodium hydroxide (Draino), ammonium hydroxide

Safe handling and storageStore acids and bases separatelyDo not use metal containers to store or dispose of acidsWork near an eyewash, shower or hose

A reactive is a compound that is capable of catching fire or exploding if subjected to certain conditions. Examples include:

Water reactives: Sodium metalShock sensitive: Dry picric acidExplosive: Nitroglycerin

Safe handling and storageSubstitute with less hazardous materials whenever possibleStore in isolation from other chemicals

Health Hazards

Hazard Classification - Health

Substances that are carcinogenic, corrosive, irritant, toxic, or can damage eyes, lungs, mucous membranes, skin, or which produce acute or chronic health effects.

Types

• Acute toxic

• Skin corrosion or irritant

• Eye effects

• Sensitizer

• Cancer causing or cell mutagenicity

• Toxicity to reproductively, target organ, or upon breathing it

Health Hazards

How do hazardous chemical affect the body?

The effect a certain chemical has on the body depends on several factors:

• The physical form of the chemical

• How the chemical enters the body

• The amount of chemical that actually enters the body -the dose

• How toxic (poisonous) the chemical is

How hazardous chemicals enter the body?

• Ingestion: The chemical is swallowed

• Inhalation: The chemical is breathed in

• Absorption: The chemical soaks through the skin

• Injection

Health Hazards

Toxicity (how poisonous hazardous chemicals are) depends on:

Dose: The effects of any toxic chemical depends on the amount of a chemical that actually enters the body

Acute toxicity: The measure of how toxic a chemical is in a single dose over a short period of time

• Some chemicals will only make you sick if you get an ‘acute” or high dose all at once. An example is ammonia.

Chronic toxicity: The measure of the toxicity of exposure to a chemical over a long period of time

• Some chemicals are mainly known for their chronic or long-term effects. Examples include formaldehyde and cytotoxic drugs.

Both Acute and Chronic toxicity: Most chemicals have both acute and chronic effects. An example is carbon monoxide

Cytotoxic drugs

What are cytotoxic drugs?

If you have direct patient contact, you may be caring for patients who receive cytotoxic drugs (also know was antineoplastic drugs). Cytotoxic drugs are used in chemotherapy to kill cancer cells and are therefore labeled with orange chemotherapy labels. These drugs are also used for non-cancer treatments, including Crohn's disease, multiple sclerosis, and rheumatoid arthritis.

Healthcare professionals with frequent exposure to cytotoxic drugs may be at risk of developing cancer or showing DNA changes. To minimize these risks, training regarding safe handling is required for employees who dispense or administer cytotoxic drugs.

Cytotoxic drugs

Safe handling of cytotoxic drugs

Up to 72 hours after cytotoxic drug administration, a patient may still be excreting some of the drug in their body fluids and is considered to be under Chemo Precautions.

When caring for these patients, the following should be done:

• Follow Standard Precautions to protect yourself.

• Wash contaminated surfaces three times with soap and water.

• Place glassware or other contaminated reusable items in a plastic bag, transport them to the dirty utility room, and wash them three times using soap and water.

• Place any linen contaminated with cytotoxic drugs in a linen bag labeled "chemotherapy," then place the bag in a second linen bag.

Cytotoxic drugs

Cytotoxic Drug Spills

In the event of a cytotoxic chemical spill, Park Nicollet team members respond safely as per the Park Nicollet cytotoxic drug safe handling policy. Spills will be cleaned up by a qualified team member who has been trained to handle cytotoxic drugs.

1. Locate the cytotoxic chemical spill kit, personal protective equipment and other cleanup materials

2. For spills greater than 5ml or for spills on carpeting, contact Security

3. Dispose of cleanup materials in black hazardous waste disposal bins.

4. Send a completed cytotoxic spill form to EOHS.

Safety data sheet (SDS)

What is an SDS?

A safety data sheet (SDS) contains detailed information for a specific product written by the manufacturer. They are intended to provide workers with information they need in order to safely work with chemical products.

Revisions to the OSHA Hazard Communication standard in 2012 have resulted in a new standard format for all SDSs. You will begin to see all SDSs have 16 sections that are in a specified sequence.

Products determined to be hazardous by the manufacturer must be included in the Damarco SDS database where they can be assigned to your location/department inventory list. A paper copy of a chemical inventory in your department is not required, but may be appropriate in some cases (i.e., Environmental Services, Nutrition and Food Services, etc.).

Safety data sheet (SDS)

Accessing SDSs

In order to ensure staff has access to current SDSs, our SDS inventory is maintained electronically by an external vendor, Damarco Solutions. Damarco Solutions provides access 24 hours a day, 365 days a year to SDSs. This service can be accessed most efficiently online via Facets.

Access SDSs online by following these steps:

1. Go to Facets.

2. Point to Medical Clicks in the left menu.

3. Click Safety Data Sheets.

To access SDS information over the phone, call the 24-hour toll-free hotline at 1-877-451-6919.

Safety data sheet (SDS)

More information on SDSs

When working with SDSs, contact the Safety Manager at 952-993-3957 or the Safety Assistant at 952-993-6663 for assistance in the following situations:

• You are unable to locate an SDS

• You are no longer using a chemical listed in your department's hazardous chemical inventory

• Your department obtained a new chemical

If you receive a copy of an SDS with a shipment from a vendor, please send it to the Safety Manager at Employee Occupational Health and Safety, Meadowbrook Building, W515.

Manufacturer’s labels

The manufacturer's label on incoming containers of hazardous chemicals is PNHS's primary labeling system. Labels on incoming containers must not be removed or defaced.

Manufacturer’s labels follow the Globally Harmonized System (GHS) of chemicals labeling.

Components of a manufacturer’s label• Pictogram• Signal word• Hazard and precautionary statements• The product identifier• Supplier information

Click Here for Video on Understanding the Globally Harmonized System (GHS)

Label components: Hazard pictograms

IntroductionHazard pictograms on manufacturer's labels alert users of the chemical hazards to which they may be exposed. The pictogram on the label is determined by the chemical hazard classification.

Health Hazards• Carcinogen• Mutagenicity• Reproductive toxicity• Respiratory sensitizer• Target organ toxicity• Aspiration toxicity

Flammable Hazards• Flammables• Pyrophorics• Self-heating• Emits flammable gas• Self-reactives• Organic peroxides

Label components: Hazard pictograms

Exclamation mark

Hazards

• Irritant (skin and eye)

• Skin sensitizer

• Acute toxicity (harmful)

• Narcotic effects

• Respiratory tract Irritant

• Hazardous to ozone layer (non-mandatory)

Gas cylinder

Hazards

Gases under pressure

Corrosive

Hazards

• Skin corrosion/burns

• Eye Damage

• Corrosive to metals

Label components: Hazard pictograms

Explosive

Hazards

• Explosives

• Self-reactives

• Organic peroxides

Oxidizer

Hazards

• Oxidizer (reacts with and oxidizes other substances)

Fatal or Toxic

Hazards

• Acute toxicity.

Label components: Signal words

DANGER

• Indicates a hazardous situation which, if not avoided, will result in death or serious injury.

• This signal word is to be limited to the most extreme situations.

WARNING

• Indicates a hazardous situation which, if not avoided, could result in death or serious injury.

CAUTION

• Indicates a hazardous situation which, if not avoided, could result in minor or moderate injury.

Label components: Hazard and precautionary statements

Signal words on product labels are paired with hazard and precautionary statements.

Hazard statementsHazard statements are intended to form a set of standardized phrases about the physical, health, and environmental hazards of chemical substances and mixtures.

Examples of hazard statements• Flammable material• Combustible liquid• Harmful if swallowed• Causes serious eye damage

Precautionary statementsPrecautionary statements are intended to form a set of standardized phrases giving advice about the correct handling of chemical substances and mixtures.

Examples of precautionary statements• Keep out of reach of children• Rinse mouth• Do not induce vomiting• Do not eat, drink or smoke when using this product

Secondary container labels

If chemicals are transferred into other containers for storage or use throughout the day (i.e. soaking bins, sinks, bottles, liquid nitrogen dewers, etc.), these containers must be labeled using the secondary labeling requirements at right.

Do you need common product labels?To obtain common product labels, visit the Obtaining common product labels area on the Health and Safety page on facets.

Secondary label requirements

Labels for secondary containers must be:• legible• prominently displayed on, above, or

adjacent to the container• in a format that is as comprehensive

as the GHS label from manufacturers

The label must include:1. the name of the chemical2. the appropriate hazard warning, such

as the NFPA diamond or words that convey the same (flammable, causes lung damage, etc).

Labels frequently contain other information, such as precautionary measures and PPE required, but this information is provided voluntarily.

Personal protective equipment (PPE)

Personal protective equipment (PPE) includes any specialized clothing or equipment worn for protection against health and safety hazards. Personal protective equipment is designed to protect many parts of the body, e.g., eyes, head, face, hands, feet, and ears.

• Store PPE where it is easily accessible or used; it should not be locked up.

• A red or white personal protective equipment sign (shown at right) should be used on the outside of cabinet and drawers containing PPE.

• REMOVE your PPE before leaving patient care or other work areas.

We'll be discussing PPE more on the following page and in the Infection exposure prevention section later in this course.

Selecting personal protective equipment

OSHA's Personal Protective Equipment standard requires that employers must provide personal protective equipment (PPE) for their team members based on an assessment of the hazards in their job.

• This assessment must be documented and employees must be informed on what, how, and when PPE is to be used based on their job tasks. For more information, visit OSHA's PPE standard site.

• To meet this requirement a Hazard Assessment for Personal Protective Equipment (HAPPE) Form is available by contacting your HRBP.

• Supervisors are responsible for ensuring the completion of this form upon reviewing job descriptions for their staff annually.

Chemicals are one of the potential hazards team members may have contact with in the healthcare environment. Managers of each department are responsible for making sure team members are trained to handle chemicals used in the department. Team members are required to participate in required training and to follow these procedures.

PPE used for blood and body fluid exposure may not protect you while handling chemicals.

A Park Nicollet employee is shown handling liquid nitrogen. She is wearing recommended personal protective equipment including a full face shield, glasses, and loose-fitting thermal insulated gloves.

What to do if splashed with a chemical

If a chemical is splashed into the eyes or on the skin, team members should:

• rinse the skin or eye out with generous amounts of water

• report to EOHS for evaluation

For more information on how to test and maintain your departmental eyewash and shower, review section H in the ERTK policy.

Departments using corrosive chemicals must maintain a shower and/or eyewash station to be used in case someone is exposed.

Click though the animation below to view a scenario on splashes.

Healthcare-acquired infections

Topics covered in thissection include:

• Healthcare-acquired infections

• How do patients get healthcare-acquired infections?

• Infections that can cause big problems in healthcare

What are healthcare-acquired infections?

Healthcare-acquired infections are infections that patients get during the course of treatment within a healthcare facility.

Common types of healthcare-acquired infections

Catheter-associated urinary tract infections

Central line-associated blood stream infections

Surgical site infections

Ventilator-associated pneumonia

Healthcare-acquired infections kill more people than AIDS, breast cancer, and auto accidents combined.

We know that simple practices like hand hygiene, environmental cleaning, and removing invasive devices are effective ways to prevent healthcare acquired infections.

In this course, you will learn about ways to keep yourself and your patients free of healthcare-acquired infections.

What puts patients at risk for healthcare-acquired infections?

• Surgical procedures

• Invasive devices like urinary catheters

• Healthcare worker’s lack of attention to infection control practices like hand hygiene safe injection practices

• Contaminated environmental surfaces and patient care equipment

• Ill healthcare workers

Antibiotic resistant infections complicate this issue. They are a growing problem in hospitals and they are linked to longer hospitalizations, costs, and risk of death.

In the upcoming pages, you'll review current information on the following infectious agents that are causing problems in healthcare setting (including home care).

• Bloodborne pathogens

• Tuberculosis (TB)

• MRSA

• Clostridium diffcile

• Other multi-drug-resistant organisms (MDROs)

Bloodborne pathogens

Topics covered in this section include:

• What are bloodborne pathogens and how are they spread?

• Examples of bloodborne pathogens

• Bloodborne pathogen exposures at Park Nicollet

• Reporting exposures–time is of the essence

• Infection prevention resources

• Preventing BBP exposure

What are bloodborne pathogens and how are they spread?

Bloodborne pathogens (BBPs) are microorganisms in blood that can cause disease.

Examples of bloodborne pathogens:

Hepatitis B virus (HBV)

Hepatitis C virus (HCV)

Human Immunodeficiency virus (HIV)

Exposure

HCWs have become infected with BBPs after exposure on the job. In addition, patients have become infected with BBPs during procedures performed in healthcare facilities.

Healthcare workers who know they are infected with a bloodborne pathogen are responsible for reporting the infection to EOHS by calling 952-993-5080.

What are bloodborne pathogens and how are they spread?

Spread of bloodborne pathogens

BBPs are spread from person to person when an infected person's blood or body fluids (BBF) have contact with someone else's blood, mucous membranes, or open skin. BBPs are not spread by casual contact like touching.

In the community, people are at risk for bloodborne pathogen infection if they:

• have vaginal or anal intercourse without the use of a condom

• share IV needles or "works"

• take part in unsafe body piercing and tattooing practices

In a healthcare setting, workers are at risk for bloodborne pathogen infections if they:

• are stuck with a needle or sharp object (referred to as a "sharp") that was used on an infected person

• are splashed with infected blood or body fluids on broken skin, or in the eyes, nose or mouth

Examples of bloodborne pathogens

Hepatitis B Virus (HBV)

What is HBV?A virus that affects the liver

SymptomsAbdominal pain, nausea, vomitingFatigue, loss of appetite, joint painYellowing of skin or whites of eyes (jaundice)Up to 30% of people have no symptoms

Time from exposure to positive testUsually a few weeks

Incubation period (time from exposure to symptoms) Average 2-3 months

Potential long-term effectsLife-long chronic infection, liver cirrhosis (scarring), liver cancer, liver failure, death.

Risk of infection after needlestick exposure Up to 1 in 3 if not immune

Examples of bloodborne pathogens

Hepatitis C Virus (HCV)

What is HCV?A virus that affects the liver

SymptomsAbdominal pain, nausea, vomitingFatigue, loss of appetite, joint painYellowing of skin or whites of eyes (jaundice)Up to 80% of people have no symptoms

Time from exposure to positive testUsually a few weeks

Incubation period (time from exposure to symptoms) Variable. Early symptoms can occur 2-3 months after exposure, late symptoms can occur up to 20 years after exposure.

Potential long-term effects85% of infected persons develop chronic infection, putting them at risk for liver cirrhosis and death.

Risk of infection after needle stick exposure Approximately 1 in 50

Special concernsMost common bloodborne infection; number one reason for liver transplants in the US.

Examples of bloodborne pathogens

Human Immunodeficiency Syndrome (HIV)

What is HIV?A virus that destroys the immune system

SymptomsFlu-like illness can occur shortly after exposure. People may live symptom-free for years before developing cancers or infections known as opportunistic diseases.

Time from exposure to positive test About 6 weeks

Risk of infection after needlestick exposure Approximately 1 in 300

HIV in Minnesota·There were 301 new HIV diagnoses reported in Minnesota in 2013, a decrease of 4% from 2012·Great disparities in HIV diagnoses persist among populations of color and American Indians living in Minnesota ·Male-to-male sex remains the leading risk factor for acquiring HIV/AIDS in Minnesota ·New HIV diagnoses remain concentrated in the Twin Cities seven-county metro area (82% of new diagnoses in 2013) ·Foreign-born (non-US born) persons made up nearly 1 in 5 of new HIV infections in 2013, and progress from HIV to AIDS more quickly than U.S. born persons living with HIV in Minnesota

Source: MN Dept of Health <http://www.health.state.mn.us/divs/idepc/diseases/hiv/stats/2013/hivsurvrpts2013.html>

Bloodborne pathogen exposures at Park Nicollet

In 2012, a total of 194 employee exposures to bloodborne pathogens occurred at PNHS. To date, no Park Nicollet employees have become infected with a bloodborne pathogen due to a workplace exposure.

Exposure type Number of exposures

Percent of exposures

Splash 58 31%

Injection needle 37 20%

Suture needle 20 11%

Cutting device 18 10%

SpecimenCollection (blood, other)

17 9%

Surgical instrument

19 10%

IV device 7 5%

Other 11 6%

Total 187 100%

Reporting exposures: Time is of the essence

If you are EVER exposed to blood or body fluids through a needle stick or a splash to the eyes, nose, mouth or broken skin, you must do the following IMMEDIATELY.

1. Wash the exposed area.

2. Call the BBF pager (952-231-5223).

3. Ask a department supervisor or charge nurse to help you with the exposure reporting process (which includes completing some paperwork). Your shift supervisor can also arrange coverage of your responsibilities so you can take care of yourself.

The reason you need to report exposures immediately is because preventative treatments, which greatly reduce the chance of becoming infected with HBV or HIV, may be necessary. The preventative treatment for HIV works best when given within a few hours of the exposure.

Infection prevention resources

For more information , review the OSHA Bloodborne Pathogen Standard.

• Standard Precautions and Communicable Disease Guidelines outline routine precautions used with all patients and additional precautions needed for certain diseases and conditions. For more information, review the procedure.

• Other Park Nicollet Infection Prevention Policies found on the Infection Control web page (Facets > Policies > Infection Control). These policies include:

o Cleaning, Disinfection & Sterilization of Patient Care Items

o Tuberculosis Control Plan

o Safe Practices for Injections, Infusions and Multi-dose containers

o Hand Hygiene

• Park Nicollet's Exposure Control Plan lists ways to eliminate or reduce worker and patient risk for exposure to bloodborne pathogens. This plan is based on OSHA Bloodborne Pathogen Standard requirements. For more information, review the policy.

• Hazard Assessment for Personal Protective Equipment (HAPPE) form is an assessment which is filled out by your leader. This form designates the types of personal protective equipment (PPE) that will be provided based on an assessment of the hazards in your job. This PPE list is found in your job description.

Preventing BBP exposure

Get the hepatitis B vaccineThis vaccine is available from Employee Occupational Health and Safety and it is free to PNHS employees.

Dispose of sharps in sharps box immediately after useRemember, improper needle disposal and failure to safely activate safety devices was an important factor in a number of PNHS employee needle-sticks in 2012.

62 incidents (32%) of bloodborne pathogen exposure at PNHS in 2012 occurred after the sharp was used due to failure to properly activate safety device, device left laying, sharps protruding from sharps container, etc.

Use sharps with built-in safety featuresAlways engage the safety feature. If you do not know how the safety feature works, ask your manger or shift supervisor.

Practice standard precautions with ALL patients at ALL timesStandard Precautions is a set of practices including hand hygiene, and use of barriers like gloves, gowns and facial protection. Standard Precautions would have prevented up to 27% of the exposures that occurred at Park Nicollet in 2012.

You will learn more about Standard Precautions later in this course.

Preventing BBP exposure

Do not recap needlesIn the few cases where it is necessary to recap, use a safety recapping device or one-handed technique.

Be aware of biohazard labels Containers that hold infectious waste must have a biohazard label. This includes specimen containers, sharps boxes, red infectious waste disposal bags, and infectious waste containers.

Clean up spills of blood and body fluids!Use biohazard spill kit if available1. Put on gloves (double glove or heavy duty household cleaning gloves)2. Wear barrier gown/face shield if anticipate splashing3. Contain the spill with an adequate number of paper towels, or use the absorbent material in the spill kit4. Pick up broken glass with forceps, tongs, or tools in spill kit. Transfer glass into sharps box5. Place soiled paper towels or absorbent material in biohazard bag6. Use PN-approved disinfectant to first clean the visible soilage, then disinfect the spill surface with a new disinfectant wipe/cleaning cloth 7. Decontaminate reusable equipment used in spill clean-up.8. Remove gloves9. Perform hand hygiene

Preventing BBP exposure

Use biohazard bags

Dispose of materials contaminated with blood and body fluids in a red biohazard-labeled plastic bag. This includes canisters of bloody fluid and dressings saturated with blood or body fluids.

• Biohazard bags MUST go into a red leak proof infectious waste bin.

• NEVER dispose of biohazard bags in regular trash.

Be sure to understand the process for disposing of infectious waste in your department.

Tuberculosis

Topics covered in this section include:

• What is tuberculosis (TB)?

• The two types of TB

• Epidemiology of TB in Minnesota

Mycobacterium tuberculosis

What is tuberculosis (TB)?

TB is an infection caused by Mycobacterium tuberculosis bacteria. TB bacteria are airborne-transmitted. If someone inhales TB bacteria, they can become infected with TB. TB bacteria usually affect the lungs, but they can infect any body site.

TB disease occurring outside the lungs is called extra-pulmonary TB. Extra-pulmonary TB is usually not contagious.

People who work in healthcare facilities can be at risk for being exposed to patients with active TB.

Click on the picture of the globe (to the right) to learn more about TB in the world today.

For more information on caring for patients with TB, review the Tuberculosis Control Plan.

The two types of TB

Active TB

What is active TB?Active TB occurs when TB bacteria attack body tissues and cause a person to have symptoms of TB.

What are the symptoms of active TB?Symptoms of active TB in the lungs (pulmonary TB) include cough, fever, bloody sputum, weight loss and night sweats. Symptoms in other body sites (extra-pulmonary) depend on the body site affected by TB.

How is active TB spread? People with pulmonary TB can release TB bacteria into the air when they cough or sneeze. TB bacteria are then airborne. If someone else inhales airborne TB bacteria, they can get infected with TB. People who share a household with someone with active TB are at highest risk of contracting TB.

How is active TB diagnosed? Diagnosing active TB includes patient history and physical, Mantoux Tuberculin skin test (MTST) or blood test such as T-spot, chest X-ray, and appropriate laboratory testing, including microbiological testing.

What precautions should be used when caring for a patient with active TB? Airborne and Standard Precautions must be used when caring for a patient with active TB.

The two types of TB

Latent TB

What is latent TB?Latent TB occurs when a person has TB bacteria in their body, but it causes no signs of symptoms because the immune system is keeping the bacteria under control.

What are the symptoms of latent TB? There are no symptoms of latent TB.

Can Latent TB be spread from person to person? No, latent TB is NOT contagious.

How is latent TB diagnosed? The Mantoux Tuberculin skin test (MTST) or a blood test such as T-spot are used to diagnose latent TB.Most healthcare workers with direct patient contact are required to have an annual testing for latent TB. If you have questions, please contact your supervisor or Employee Occupational Health and Safety.

What precautions should be used when caring for a patient with latent TB?Since Latent TB is not contagious, only Standard Precautions are needed for patients with Latent TB.

Who should get a TB skin test? Persons who are at high risk and could benefit from preventative therapy should be screened. For more information on screening your patients for latent TB, see the Minnesota Department of Health link listed in Resources tab.

For more information on screening your patients for latent TB, visit the Minnesota Department of Health Web site.

Epidemiology of TB in Minnesota

In Minnesota, the number one risk factor for TB is being foreign-born.

Country of origin for 2014 TB cases at PN

USA

Somalia

Kenya

Liberia

Iraq

For more information on screening, diagnosis, and treatment of latent and active TB, visit the Minnesota Department of Health Web site.

Number of TB Cases in 2014

Minnesota 151

Park Nicollet 11 (5 pulmonary, 6 extrapulmonary)

Scenario: Tuberculosis

Agnes is a 25 year old immigrant from Somalia. Over the past two months she has noticed fatigue and night sweats and an occasional cough. Over the past few weeks, she has more coughing and sometimes her sputum is bloody. She’s also noticed a few low grade fevers and weight loss. When she is seen by her physician, TB is suspected and the diagnosis is later confirmed.

Antibiotic-resistant organisms

Topics covered in this section include:

• Methicillin-resistant Staphylococcus aureus (MRSA)

• Clostridium difficile (C. diff)

• Other Multi-Drug-Resistant Organisms (MDROs)

Methicillin-resistant Staphylococcus aureus (MRSA)

What is MRSA?

Methicillin-resistant Staphylococcus aureus (MRSA) is

a type of Staphylococcus aureus bacteria that is

resistant to multiple antibiotics. MRSA is concerning

because it is hard to treat and it has been

transmitted to patients in healthcare settings.

How is MRSA transmitted?

• through contact with infected body substances

• through contact with contaminated items,

environmental surfaces and hands

Who gets MRSA?

• MRSA has been spread from patient to patient

in hospitals.

• People who have invasive device are at higher

risk for MRSA.

• Community-associated MRSA can be

diagnosed in young, healthy people who have

not had contact with healthcare facilities.

For additional information on MRSA, visit the Minnesota Department of Health Web site.

Scanning electron micrograph (SEM) depicted numerous clumps of methicillin-resistant Staphylococcus aureus bacteria. Image courtesy of Centers for Disease Control and Prevention.

Optional: To learn about how MRSA can affect patients, watch the Partnering to Heal video.

Clostridium difficile (C. diff)

What is C. diff?

C. diff is a toxin-producing bacteria that causes

severe diarrhea and intestinal inflammation.

How do people get C. diff?

People in good health usually don't get C. diff. People

who are elderly, have underlying illnesses or who

have been treated with antibiotics are at greater risk

of acquiring C. diff. Antibiotics put people at risk for

C. diff because they kill competing intestinal bacteria

and allow C. diff to grow and multiply. C. diff bacteria

are found in the feces. People can become infected if

they touch items or surfaces that are contaminated

with feces and then touch their mouth or mucous

membranes. Healthcare workers can spread the

bacteria to other patients or contaminate surfaces

through hand contact. Infection prevention practices

like hand hygiene, Standard Precautions, and

environmental cleaning reduce risk of C. diff.

transmission. Additional precautions for preventing

C. diff. will be reviewed later in this course.

For additional information on C. diff , visit the CDC Web site.

Scanning electron micrograph (SEM) Clostridium difficile bacteria from a stool sample. Image courtesy of Centers for Disease Control and Prevention.

Other multi-drug-resistant organisms (MDROs)

In recent years, new antibiotic resistant organisms and new mechanisms of antibiotic resistance have been identified.

Examples of these organisms are:

• Carbapenem-resistant Enterobacteriaceae (CRE)

• Extended Spectrum Beta-Lactamase-Producing bacteria (ESBLs)

Antibiotic-overuse is major factor that is contributing to the growing number of MDROs. Despite an increase in MDROs, there is no increase in the antibiotic options for treatment of MRDOs. Controlling the spread and emergence of MRDOs depends on research and development for effective treatment options, antibiotic stewardship, and healthcare worker attention to infection prevention practices like hand hygiene, Standard Precautions and isolation practices.

For additional information, PNHS Multi-drug resistant organism (MDRO policy)

Infection exposure prevention

Topics covered in this section include:

• Standard Precautions

• Hand hygiene

• It's OK to ask

• Personal Protective Equipment (PPE)

• Proper removal of PPE

• Transmission-based precautions

• Safe injection practices

Standard precautions: Protect your patients, protect yourself

What are Standard Precautions? Standard Precautions are practices that are used with all patients at all times and include:

• Hand hygiene: clean hands prevent the spread of infection

• Barriers like gloves and gowns prevent exposure to body fluid

What is the purpose of Standard Precautions?Earlier in this course, you learned that Standard Precautions can protect you from being exposed to bloodborne pathogens. Standard Precautions also protect your patients from being exposed to germs that cause healthcare-acquired infections by preventing healthcare workers from carrying germs from patient to patient.

For more information, view PN’s Communicable Disease Guidelines and Standard Precautions procedure.

When should I clean my hands?

To keep patients and yourself safe clean your hands before and after patient contact. This includes:

• After contact with the patient's environment

• After touching body substances, mucous membranes or open skin

• After removing gloves

• Before invasive procedures and touching invasive devices like IV or urinary catheters

• Before handling or preparing medications

• Between "dirty" (for example, assisting a patient in the bathroom) and "clean" tasks (for example, administering medication) to prevent cross contamination

• Before eating and after using the bathroom

Here are 2 strategies to help you perform hand hygiene before and after patient contact 100% of the time:

1. Clean hands as you enter and leave a “patient space.”

2. Foam in, foam out.

For more information, you may review the PNHS Policy onHand hygiene, fingernails and fingernail enhancements.

Patient space =Exam room, cubicle, and area around bed

What should I use for hand hygiene?

Use alcohol hand rub (AHR) for routine hand hygiene. • Apply enough foam to cover all

surfaces of skin• Rub all surfaces of your hands

including palms, between fingers, backs of fingers and thumbs

• Once your hands are dried, you are finished

Use soap and water • When hands are visibly soiled• when caring for a patient suspected

to have infectious diarrhea (such as patients in enteric contact isolation at Methodist Hospital).

How to use alcohol rub

1. Apply enough foam to cover all surfaces of skin

2. Rub all surfaces of your hands including palms, between fingers, backs of fingers and thumbs

3. Once your hands are dried, you are finished

For more information see How to HandrubPoster from the World Health Organization

Hand hygiene: soap and water

Introduction

Use soap and water when hands are visibly soiled or when caring for a patient suspected to have infectious diarrhea (such as patients in enteric contact isolation at Methodist Hospital).

Step 1: Wet hands under running water.

Step 2: Apply soap and thoroughly distribute over hands.

Step 3: Use friction to vigorously rub hands together for 15 seconds. Pay special attention to areas between fingers, under fingernails, and above wrists.

Step 4: Thoroughly rinse hands with water to remove residual soap.

Step 5: Dry hands with paper towel. If sink does not have an automatic faucet, use paper towel to turn off faucet.

It’s OK to ask

Patients and their families are encouraged to partner with healthcare workers to promote best hand hygiene practices by asking a simple but straightforward question: "Did you clean your hands?“

Things to keep in mind as you think about how to respond to this question:• respond honestly and graciously• Reassure patients that it's OK to ask with your

facial expressions, body language and words • what kind of response would you want to hear

if you were the patient asking "Did you clean your hands?"

An appropriate response would be, "Thank you for reminding me" and then, perform hand hygiene in front of the person asking the question. What kind of response would you want to hear if you were the patient asking "Did you clean your hands?"

Personal protective equipment (PPE)

It is important to wear appropriate PPE when in situations where your skin, face, or clothing could be exposed to blood and body fluids.

Transmission-based precautions

Introduction

Transmission-based precautions, also known as isolation precautions, are practices needed in addition to Standard Precautions to prevent transmission of certain infectious diseases.

The Communicable Disease Guidelines are your resource for determining when a patient needs Transmission-based precautions.

Transmission-based precautions

Contact Precautions

When used

When patients are known or suspected to have infections spread by direct contact.

Examples of infections requiring

MRSA, VRE, ESBL, CRE

What these precautions emphasize

Hand hygiene, use of PPE, and careful attention to environmental cleaning.

Signage

At Methodist Hospital, a Contact Isolation sign on the door of a patient’s room means that healthcare workers must use contact precautions during patient care. Follow all instructions for preventing infection transmission listed on isolation signs.

Transmission-based precautions

Enteric Precautions

When used

When patients are known or suspected to have infections spread by direct contact with stool.

Examples of infections requiring enteric precautions

Clostridium difficile (C. diff.) diarrhea

What these precautions emphasize

Hand hygiene with soap and water, use of PPE and careful attention to environmental cleaning.

Signage

At Methodist Hospital, an Enteric Isolation sign on the door of a patient’s room means that healthcare workers must use enteric precautions during patient care. Follow all instructions for preventing infection transmission listed on isolation signs.

Transmission-based precautions

Droplet Precautions

When used

When patients are known or suspected to have infections spread by large droplets released through coughing or sneezing and that travel short distances (about 3-6 feet) before settling on surfaces.

Examples of infections requiring droplet precautions

Influenza, Pertussis, and Neisseria meningitidis

What these precautions emphasize

Wearing a mask when in same room as with infected patients.

Signage

At Methodist Hospital, a Droplet Isolation sign on the door of a patient’s room means that healthcare workers must use droplet precautions during patient care. Follow all instructions for preventing infection transmission listed on isolation signs.

Transmission-based precautions

Airborne Precautions

When used When patients are known or suspected to have infections spread through tiny airborne particles.

Examples of infections requiring airborne precautionsTuberculosis

What these precautions emphasizeIn the clinic, these precautions emphasize limiting the time patient is around other patients, healthcare worker use of a mask or respirator when in the exam room with the patient, and leaving the room closed for 1 hour after the patient leaves. In the hospital, these precautions emphasize placing patients in airborne infection isolation rooms (negative pressure) and healthcare worker use of fit-tested respirators or PAPRs.

SignageAt Methodist Hospital, an Airborne Isolation sign on the door of a patient’s room means that healthcare workers must use airborne precautions during patient care. Follow all instructions for preventing infection transmission listed on isolation signs.

Transmission-based precautions

Contact and Airborne Precautions

Examples of infection requiring airborne and contact precautions:Chickenpox and measles

What these precautions emphasize:In the clinic, these precautions emphasize limiting the time the patient is around other patients and placement in a private or airborne isolation room ASAP. Rooms are closed for 1 hour after the patient leaves and before cleaning and preparing the room for the next patient (close airborne isolation rooms for 30 minutes). Hospitalized patients are placed in an airborne isolation room. These precautions also emphasize hand hygiene use of PPE, and careful attention to environmental cleaning. Team members not immune to chicken pox or measles should not enter rooms of patients with these infections.

Signage: At Methodist Hospital, an Airborne and Contact Isolation sign on the door of the patient’s room means team members must follow airborne and contact precautions. Follow all instruction listed on the isolation sign.

Transmission-based precautions

Other Precautions

Other precautions may be indicated when infections are spread by more than one mode of transmission.

When used

When patients have infections that are spread through multiple modes of transmission.

Examples of infections requiring Full Barrier Precautions

Ebola, Smallpox, Avian Influenza

What these precautions emphasize

Hand hygiene, careful use and removal of PPE, and environmental cleaning. Airborne isolation rooms may be required.

Signage

Signage will vary according to precautions.

Emerging Pathogens

The 2014-2015 Ebola epidemic is the largest in history, affecting multiple countries in West Africa. Imported cases, including death, and some locally acquired cases in healthcare workers have been reported in the United States CDC and partners are taking precautions to prevent the further spread of Ebola within the United States.

Ebola is spread through direct contact with blood or other body fluids of a person with symptoms of Ebola or who has died from Ebola.

At PNHS, you will find current Ebola resources are on the Facets Ebola website.

For more information see MDH Ebola website

CDC Ebola website

Know your immune status

Influenza

You need influenza vaccination every year.

Because influenza can be infectious for up to 24

hours before symptoms start, unvaccinated

healthcare personnel can spread influenza to

patients and are a key cause of influenza

outbreaks among patients. You cannot get

influenza from the vaccine.

Measles/Mumps/Rubella

If you are not already immune to these diseases,

you should be vaccinated. Team members who

are not immune to these diseases may not care

for patients with these diseases.

Varicella (chickenpox)

Varicella can be transmitted in hospitals by

patients, staff, and visitors. If you are not already

immune, you should be vaccinated. Team

members who are not immune to chickenpox

may not care for patients with chickenpox.

Tetanus/Diphtheria/Pertussis

To prevent tetanus, you need a booster every 10

years—sooner if you are injured. Healthcare

workers should receive one dose of Tdap

(tetanus, diphtheria, pertussis) vaccine if they

have not yet received it as an adult.

Are your vaccinations up-to-date? In addition to hepatitis B, you should be immune to:

Contact Employee Occupational Health and Safety (EOHS) if you have questions about your status. See EOHS Immunization web page for more informationPROTECT YOUR PATIENTS, PROTECT YOUR FAMILY, PROTECT YOURSELF...GET VACCINATED!

Safe injection practices

Since 2001, at least 49 outbreaks of hepatitis or bacterial infections have occurred in the US due to unsafe injection practices. In these outbreaks, an estimated 150,000 patients were notified that they may have been exposed to bloodborne pathogens due to lapses in injection safety and hundreds of patients were actually infected.

Many of these incidents involved healthcare providers reusing syringes, resulting in contamination of medication vials or containers which were used then on subsequent patients. These infections are 100% preventable.

The PNHS Policy:

Safe Practices for Injections, Infusions and Use of Multidose Containers is your resource for how to safely prepare, use and administer injections. This can be found on FACETS.

CDC Grand Rounds: Preventing Unsafe Injection Practices in US Healthcare Settings (2013)

Safe injection practices

This graphic displays how hepatitis C is transmitted in an outpatient setting.

Drug Diversion:When an employee steals a syringe containing narcotics intended for a patient, injects him/herself with the drug, and replaces the drug in the syringe with another liquid (such as saline), which is then injected into the patient.

In a multi-state case, an employee was charged with diverting drugs intended for patients and also caused at least 30 patients to be infected with Hepatitis C. (Source: http://www.justice.gov/usao/nh/press/2012/Kwiatkowski.html)

Your work environment

Topics covered in this section include:

• Harmful physical agents

• Workstation ergonomics

• Back safety

• Slips, trips, and falls

• Lockout/tagout awareness

Harmful physical agents

Four harmful physical agents

1. Occupation noise exposure Exposure to high levels of noise can cause permanent hearing loss. OSHA’s hearing conservation program requires employers to implement a hearing conservation program when workers are exposed to a time weighted average noise level of 85 dBA or higher over an 8 hour work shift.

2. Heat/coldTasks that require employees to work outside in the summer or winter can lead to heat or cold related illnesses. PNHS Maintenance workers at highest risk of this.

3. Ionization radiationIonizing radiation sources may be found in health care facilities. Team members in these areas receive special education and training on radiation hazards and are monitored for dosage.

4. Non-ionization radiation Lasers commonly operate in the UV, visible, and IR frequencies. Non-ionizing radiation can pose a considerable health risk to potentially exposed workers if not properly controlled. Team members who work with Lasers receive training on laser hazards.

Labeling of harmful physical hazardsIf a physical hazard is present in work environment above permissible exposure limit, PNHS must label equipment or work areas with name of physical agent and appropriate hazard warning.

Workstation ergonomics

Ergonomics is the study of fitting the work environment

or job task to the employee. Having a work environment

properly adjusted to fit you and performing job tasks in a

manner that does not cause you discomfort or pain is

very important.

Much of the discomfort associated with computer use

can be attributed to improperly adjusted workstations.

Studies have shown people who properly adjust their

workstations are more comfortable and experience fewer

health complaints.

What can you do to prevent

discomfort?

1. First, complete a work-station self-

assessment.

2. Next, discuss with your leader

about ordering ergonomic

resources.

3. If you still have discomfort, then

complete a request for an

ergonomics assessment.

For more information and ergonomic resources, you may visit the Health and Safety site on facets.

Preventing back pain

Most back pain is caused by muscle strain, trauma, or spinal deformity. Nearly 80% of all Americans will experience back pain in their lives.

What can you do to prevent back injury?

• Eliminate or reduce manual lifting and moving of patients

• Assess your patient before lifting or moving them

• Use assist (lift and transport) devices

• Exercise regularly

For more information, you may review the "Applying Principles of Safe Patient Handling (SPH)" e-learning course available on tLP. Search using the keywords "safe patient handling". This course is presented by the PNHS Safe Patient Handling Program and describes safe patient handling techniques which should be used in conjunction with safe patient handling equipment.

Click here for more information on Safe Patient Handling

Slips, trips, and falls

Introduction

The majority of falls happen from on the same level resulting from slips and trips. People fall when their body is in an unstable position.

Slips occur when there is too little traction between your footwear and the walking surface. Common causes include wet and oily surfaces, spills, ice, and change in flooring surface. The front foot slips forward and the body falls backward upon slipping.

Trips happen when your foot strikes an object and is suddenly stopped causing you to lose balance. Common causes include obstructed view, poor lighting, clutter, and uneven walking surfaces (steps, thresholds).

Step and fall occurs when the front foot lands on a surface lower than expected or when the front foot lands on an object higher than the other side causing the body to fall forward and/or sideways.

Slips, trips, and falls

What can you do?

• Ensure good housekeeping. Clean up spills immediately, remove obstacles from walkways, close file drawers and cabinets when done with them.

• Adjust your stride to the conditions and what you are doing. Shorten your stride in wet or slippery conditions.

• Take your time and pay attention to where you are going. Choose your path carefully. Don’t step over obstacles or snow banks.

• Select footwear that is appropriate for your work environment and the weather.

• In low light situations or when going from inside to outside, or vise versa, slow down. Pause to let your eyes adjust.

• Use handrails on steps going up or down.

• Learn how to fall. Roll, protect your head, turn your body to the side to spread the force of the fall over a wide surface.

• Report trouble spots to safety and security.

Lockout/Tagout awareness

PN maintenance staff attaches locks and tags to equipment while performing maintenance work. This ensures the equipment is not turned on or energized while they are performing that work.

In the event that you see a lock or tag on a piece of equipment in your work environment, DO NOT attempt to use that equipment or remove the lock or tag. Someone’s life may be on the line.

Your role and resources

Topics covered in this section include:

• Your role in safety and infection prevention

• Safety and infection prevention resources

Your role in safety and infection control

Follow all safety policies

Team members should be familiar with and follow policies related to their job functions. Look on the Policies page of Facets to learn more.

Participate in training

Team members receive safety and infection control training during new team members orientation and on an ongoing basis. Site-specific training from your supervisor supplements this training.

Keep work areas clean and organized

All team members are required to clean and organize their personal workspace and make sure work areas are free from items that could be potential safety hazards.

Use personal protective equipment (PPE)

When in situations where you could be exposed to blood and body fluids, airborne infectious contaminants, or hazardous chemicals, wear appropriate personal protective equipment (PPE). PPE includes gloves, gowns, face shields, N95 or PAPR respirators, and resuscitation masks.

Your role in safety and infection control

Follow infection control procedures

Healthcare workers have the responsibility of protecting patients, coworkers and themselves from infection.

Report concerns

Report concerns to your supervisor or use the event category ‘Employee Safety Concerns‘ in the BEST Reporting on Facets.

Report work-related injuries

Report all work-related injuries to Employee Occupational Health and Safety (EOHS) within 24 hours of the injury or upon onset of symptoms by going to the Health and Safety page on facets.

Report healthcare workers, patients, or visitor BBFs

Immediately report any blood and body fluid (BBF) exposures to the BBF pager at 952-231-5223 (952-231-5BBF).

Your role in safety and infection control

Don't come to work if you're sick

Diarrhea, fever, persistent cough, and rashes can be symptoms of a communicable disease.

Team Members must:

• use good judgment when determining if they are healthy enough to attend work and not place others at risk for acquiring an infection

• use EOHS as a resource for questions about communicable diseases (such as gastroenteritis) and work attendance

• the employee health clinic offers same-day appointments for a host of common treatments, ailments and conditions.

• self-report to EOHS communicable disease that could be transmitted to patients, coworkers and visitors (e.g., chickenpox, tuberculosis)

Your role in safety and infection control

Hand hygieneClean hands prevent the spread of infections. At Park Nicollet everyone who touches patients is expected to clean their hands before and after each patient contact. Park Nicollet's hand hygiene policy states that healthcare workers must perform hand hygiene before and after patient care contact.

Here are two strategies to help you perform hand hygiene before and after patient contact 100% of the time. 1. Clean hands as you enter and leave a patient's "space."2. Foam in, foam out. Make it a habit to clean your hands before and after touching patients. (See posters in your work areas.)

Know your immune statusAre your vaccinations up-to-date?

In addition to hepatitis B, you should be immune to: influenza measles, mumps, and rubella tetanus, diphtheria, and pertussis varicella (chicken pox).

Your resources

Employee Occupational Health and Safety The Employee Occupational Health and Safety department provides quality care and service to Park Nicollet employees by offering information and tools to manage their health and safety needs at work and home.

Employee Health ClinicAvailable for same-day appointments. To see clinic hours, visit the EOHS page on Facets.

EOHS Safety ManagerThe EOHS Safety Manager interprets safety rules and regulations, addresses manager and employee safety questions and concerns, develops safety policies and procedures, and promotes safety activities.The Safety Manager may be contacted at 952-993-3957The Safety Assistant may be contacted at 952-993-6663

Employee exposure and medical records EOHS maintains employee records containing information on an employee's Mantoux tests, vaccinations, blood and body fluid exposures, and work-related injuries. In accordance with OSHA regulations (OSHA 1910.1020), employees or their designated representatives may request a copy of their employee medical record. Requests must be made in writing to Employee Occupational Health and Safety.

Your resources

Infection Prevention and Control

Infection Prevention and Control is your resource for information on preventing infections in patients, visitors, and staff. This department uses current guidelines and research, and collaborates with microbiology, physicians, clinics, and hospital departments on strategies for reducing the risk of infection in the organization. This department is also a resource for information on immunizations.

See the Infection Prevention and Control website for policies, procedures, fact sheets, contact information etc.

Other

The following groups also support safety and infection control at Park Nicollet.

Clinical Resource Mentors: Infection Control (CRM:IC)

CRM:ICs are a direct link between your department and Infection Prevention. Some of the projects CRM:ICs are involved with include providing staff with infection control-related resources, and working to improve processes that reduce infection risk.

Environmental Safety Committee

The Environmental Safety Committee's mission is "to support and provide direction in maintaining a clean and safe environment for patients, staff, and visitors and to minimize risks to persons and property". The committee meets on a regular basis to set system-wide safety policies and discuss issues regarding safety.

Local Safety Committees

Local safety committees throughout Park Nicollet address departmental safety issues impacting team members, patients, and visitors. These committees meet quarterly to discuss safety and health issues, regularly perform safety inspections, and promote interest in safety. If you are interested in participating on your local safety committee, talk to your clinic or department manager.

Resources on Facets

Employee Occupational Health and Safety

• Locate additional safety information at Employee Occupational Health and Safety's department Web site.

Infection Prevention and Control Service

• Find infection control resources at Infection Prevention and Control Service'sdepartment Web site.

Access Right to Know policies

• The policies are located under the Facets homepage drop-down under Policies. They can also be found on the page of the department that owns the policy.