Health & Safety

Staff bill introduced in Sacramento!

BREAKING NEWS: Our safe staffing bill is introduced in Sacramento!

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Nurse Training Update – Infectious Disease

For SEIU Nurse Alliance of California: Infectious Disease Update from Mark Catlin

“Fever is a major symptom in the WHO Ebola case definition, and thermometers have been used widely by healthcare workers and government officials to screen for EVD cases among persons in hospitals, shops, and airports and at road check points. However, as many as a third of the patients at the Moyamba ETC had no fever at admission. Several other reports have also noted the lack of fever among EVD patients, and there are indications that fever has been present in fewer EVD patients during the 2013–2016 West Africa outbreak compared with previous outbreaks. Most patients (61%) referred to the Moyamba ETC had negative Ebola PCR results, indicating that the WHO case definition is not sufficiently specific in identifying EVD.” – M. Catlin

BOTTOM LINE: While the article abstract describes some facts, figures, and links, the important take away for nurses is a call for vigilance when reviewing charts, handling patients upon intake, especially those who have traveled outside the US to known at-risk regions of the world.

A Source Article Abstract: “The 2013–2016 outbreak of Ebola virus disease (EVD) in West Africa infected >28,000 people, including >11,000 who died, and disrupted social life in the region. We retrospectively studied clinical signs and symptoms and risk factors for fatal outcome among 31 Ebola virus–positive patients admitted to the Ebola Treatment Center in Moyamba District, Sierra Leone. We found a higher rate of bleeding manifestations than reported elsewhere during the outbreak. Significant predictors for death were shorter time from symptom onset to admission, male sex, high viral load on initial laboratory testing, severe pain, diarrhea, bloody feces, and development of other bleeding manifestations during hospitalization. These risk factors for death could be used to identify patients in need of more intensive medical support. The lack of fever in as many as one third of EVD cases may have implications for temperature-screening practices and case definitions.” (SOURCE: http://wwwnc.cdc.gov/eid/article/22/9/15-1621_article#suggestedcitation )

Figure1_Infectious Disease

Figure 1. Survival analysis for patients with confirmed Ebola virus disease admitted to the treatment center in Moyamba District, Sierra Leone, December 19, 2014–February 17, 2015. Survival among A) all patients; B) male and female patients; C) patients with and without bleeding manifestations at admission; and D) patients with initial PCR results showing high- and low-level viremia, as defined by cycle thresholds of <22 and >22, respectively.
(SOURCE: http://dx.doi.org/10.3201/eid2209.151621 )

Figure2_Infectious Disease

Figure 2. Ebola viral load for patients with confirmed Ebola virus disease admitted to the treatment center in Moyamba District, Sierra Leone, December 19, 2014–February 17, 2015. Viral loads were determined by semiquantitative PCR and are expressed as cycle thresholds for patients with fatal (n = 18) and nonfatal (n = 13) disease. (SOURCE: http://dx.doi.org/10.3201/eid2209.151621 )

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SEIU, Flint Michigan, and YOU: Nurses in action to protect ourselves and our communities

It’s not an “over there” or “effecting them” issue; in fact, many communities are suffering at the hands of negligent leadership with respect to their drinking water.  The people of Flint are fighting for their health and for their communities, but most importantly, they are setting the stage for a national discussion on holding those we have elected to protect our infrastructure accountable, locally and nationally. Click here for a short presentation with helpful links to signs and symptoms you can look for in your day to day work (and home) environment.

The following summarizes some of the key points:

  • The timeline link shows the Flint drama unfolding from April 2014, when the water source was switched up through January of this year when the state of emergency was declared and the media coverage expanded from local, to regional and eventually to national coverage.
  • With the additional pressure by a vocal public, demanding awareness and scrutiny, a suspiciously corresponding outbreak of Legionaire’s Disease in the same region has been brought to light.
  • Mayo clinic has provided a guideline for signs and symptoms which you may leverage to say informed and vigilant.

FlintLivesMatterSo, what can we do about it as Nurses?

1/ Stay informed – Did you know that the National Patient Safety Foundation declared the week of March 13 – 19th as “National Patient Safety Week”, their website at http://www.unitedforpatientsafety.org/ has an informative blog containing news, and discussion pertaining to patient and community safety.

2/ Join the fight – This isn’t just about Flint. The Nurse Alliance of California wants you to know and be prepared for additional discoveries about local issues arising from leaders who are deliberately or ignorantly “asleep at the wheel”. Remember the Exide incident? The Natural Resources Defense Council (NDRC) has posted advice on preventing lead poisoning in children.

 

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Updates to OSHA’s Recordkeeping Rule

From Federal OSHA:

“OSHA will now receive crucial reports of fatalities and severe work-related injuries and illnesses that will significantly enhance the agency’s ability to target our resources to save lives and prevent further injury and illness. This new data will enable the agency to identify the workplaces where workers are at the greatest risk and target our compliance assistance and enforcement resources accordingly.”

— Assistant Secretary of Labor for Occupational Safety and Health, Dr. David Michaels

The Occupational Safety and Health Administration’s revised recordkeeping rule includes two key changes:

First, the rule updates the list of industries that are exempt from the requirement to routinely keep OSHA injury and illness records, due to relatively low occupational injury and illness rates. The previous list of industries was based on the old Standard Industrial Classification (SIC) system and injury and illness data from the Bureau of Labor Statistics (BLS) from 1996, 1997, and 1998. The new list of industries that are exempt from routinely keeping OSHA injury and illness records is based on the North American Industry Classification System (NAICS) and injury and illness data from the Bureau of Labor Statistics (BLS) from 2007, 2008, and 2009. Note: The new rule retains the exemption for any employer with ten or fewer employees, regardless of their industry classification, from the requirement to routinely keep records.

Second, the rule expands the list of severe work-related injuries that all covered employers must report to OSHA. The revised rule retains the current requirement to report all work-related fatalities within 8 hours and adds the requirement to report all work-related in-patient hospitalizations, amputations and loss of an eye within 24 hours to OSHA.

Establishments located in States under Federal OSHA jurisdiction must begin to comply with the new requirements on January 1, 2015. Establishments located in states that operate their own safety and health programs (State Plan States) should check with their state plan for the implementation date of the new requirements. OSHA encourages the states to implement the new coverage provisions on 1/1/2015, but some may not be able to meet this tight deadline.

The final rule will allow OSHA to focus its efforts more effectively to prevent fatalities and serious work-related injuries and illnesses. The final rule will also improve access by employers, employees, researchers and the public to information about workplace safety and health and increase their ability to identify and abate serious hazards.

Changes to reporting requirements: What needs to be reported to OSHA?

OSHA’s updated recordkeeping rule expands the list of severe injuries that employers must report to OSHA.

As of January 1, 2015, all employers must report

1. All work-related fatalities within 8 hours.

2. All work-related inpatient hospitalizations, all amputations and all losses of an eye within 24 hours.

You can report to OSHA by

1. Calling OSHA’s free and confidential number at 1-800-321-OSHA (6742).

2. Calling your closest Area Office during normal business hours.

3. Using the new online form that will soon be available.

Only fatalities occurring within 30 days of the work-related incident must be reported to OSHA. Further, for an in-patient hospitalization, amputation or loss of an eye, these incidents must be reported to OSHA only if they occur within 24 hours of the work-related incident.

More information on new reporting requirements.

Changes to recordkeeping requirements: Who is required to keep records? Who is exempt from keeping records?

OSHA regulations require certain employers to routinely keep records of serious employee injuries and illnesses. However, there are two classes of employers that are partially exempt from routinely keeping records. First, employers with ten or fewer employees at all times during the previous calendar year are exempt from routinely keeping OSHA injury and illness records. OSHA’s revised recordkeeping regulation maintains this exemption.

Second, establishments in certain low-hazard industries are also exempt from routinely keeping OSHA injury and illness records. Since 1982, this list has been comprised of establishments in the divisions of retail trade; finance, insurance and real estate; and the service industry if the three year average lost workday case rate for their major industry group was 75 percent or less of the overall three year average of the lost workday case rate for private industry. OSHA’s revised recordkeeping regulation provides an updated list of low-hazard industries that are exempt from routinely keeping OSHA injury and illness records. The new list of exempt industries is now classified by North American Industry Classification System (NAICS), which is the standard used by Federal statistical agencies in classifying business establishments for the purpose of collecting, analyzing and publishing statistical data related to the U.S. business economy. The injury and illness rate threshold is based on more recent BLS data.

More information on updated recordkeeping requirements.

Status of Changes in the State Plan States

Effective Dates for New Reporting Requirements in OSHA State Plans

This table is current as of December 11, 2014. The table will be updated as we receive further response from the States.

State

Anticipated/Actual Adoption Date

Effective Date: Reporting**

Effective Date: Industry Conversion**

Significant Differences from OSHA Standard

Alaska

Pending

Pending

Pending

Arizona

3/1/2015

3/15/2015

3/15/2015

California

Pending

Pending

Pending

OSHA Injury and Illness Recordkeeping and Reporting Requirements

Under the OSHA Recordkeeping regulation (29 CFR 1904), covered employers are required to prepare and maintain records of serious occupational injuries and illnesses, using the OSHA 300 Log. This information is important for employers, workers and OSHA in evaluating the safety of a workplace, understanding industry hazards, and implementing worker protections to reduce and eliminate hazards.

 

On September 11, 2014, OSHA announced changes to the list of industries that are exempt from the requirement to routinely keep OSHA injury and illness records, and to the list of severe work-related injuries and illnesses that all covered employers must report to OSHA. These new requirements will go into effect on January 1, 2015 for workplaces under Federal OSHA jurisdiction. The guidance materials found on this page have been updated to reflect the new requirements.

For complete information on these changes, please visit:
Updates to OSHA’s Recordkeeping Rule

The OSHA law prohibits employers from retaliating or discriminating against a worker for reporting an injury or illness.

§  29 CFR 1904.39

Am I required to prepare and maintain records?

Employers with more than ten employees and whose establishments are not classified as a partially exempt industry must record work-related injuries and illnesses using OSHA Forms 300, 300A and 301, available here. Partially exempt industries include establishments in specific low hazard retail, service, finance, insurance or real estate industries and are listed in Appendix A to Subpart B and here.

Employers who are required to keep Form 300, the Injury and Illness log, must post Form 300A, the Summary of Work-Related Injuries and Illnesses, in a workplace every year from February 1 to April 30. Current and former employees, or their representatives, have the right to access injury and illness records. Employers must give the requester a copy of the relevant record(s) by the end of the next business day.

What forms should I use?

Recordkeeping Forms

What is recordable under OSHA’s Recordkeeping Regulation?

§  Covered employers must record all work-related fatalities.

§  Covered employers must record all work-related injuries and illnesses that result in days away from work, restricted work or transfer to another job, loss of consciousness or medical treatment beyond first aid (see OSHA’s definition of first aid below).

§  In addition, employers must record significant work-related injuries or illnesses diagnoses by a physician or other licensed health care professional, even if it does not result in death, days away from work, restricted work or job transfer, medical treatment beyond first aid, or loss of consciousness.

§  Injuries include cases such as, but not limited to, a cut, fracture, sprain, or amputation.

§  Illnesses include both acute and chronic illnesses, such as, but not limited to, a skin disease (i.e. contact dermatitis), respiratory disorder (i.e. occupational asthma, pneumoconiosis), or poisoning (i.e. lead poisoning, solvent intoxication).

§  OSHA’s definition of work-related injuries, illnesses and fatalities are those in which an event or exposure in the work environment either caused or contributed to the condition. In addition, if an event or exposure in the work environment significantly aggravated a pre-existing injury or illness, this is also considered work-related.

§  For further questions or clarifications, take advantage of the additional resources on this page (under “In Focus”) or call 1-800-321-OSHA (6742).

What is first-aid for purposes of OSHA recordkeeping?

§  Using a non-prescription medication at nonprescription strength (for medications available in both prescription and non-prescription form, a recommendation by a physician or other licensed health care professional to use a non-prescription medication at prescription strength is considered medical treatment for recordkeeping purposes)

§  Administering tetanus immunizations (other immunizations, such as Hepatitis B vaccine or rabies vaccine, are considered medical treatment)

§  Cleaning, flushing or soaking wounds on the surface of the skin

§  Using wound coverings such as bandages, Band-AidsTM, gauze pads, etc.; or using butterfly bandages or Steri-StripsTM (other wound closing devices such as sutures, staples, etc., are considered medical treatment)

§  Using hot or cold therapy

§  Using any non-rigid means of support, such as elastic bandages, wraps, non-rigid back belts, etc. (devices with rigid stays or other systems designed to immobilize parts of the body are considered medical treatment for recordkeeping purposes)

§  Using temporary immobilization devices while transporting an accident victim (e.g., splints, slings, neck collars, back boards, etc.)

§  Drilling of a fingernail or toenail to relieve pressure, or draining fluid from a blister

§  Using eye patches

§  Removing foreign bodies from the eye using only irrigation or a cotton swab

§  Removing splinters or foreign material from areas other than the eye by irrigation, tweezers, cotton swabs or other simple means

§  Using finger guards

§  Using massages (physical therapy or chiropractic treatment are considered medical treatment for recordkeeping purposes)

§  Drinking fluids for relief of heat stress

Where can I learn more about recordkeeping requirements?

§  Regulatory Text

§  Training Module

§  Training Presentations

Does OSHA provide training for the general public on recordkeeping requirements?

Yes. Through its national network of OSHA Training Institute (OTI) Education Centers, OSHA offers the OSHA #7845Recordkeeping Rule Seminar course. This half-day course covers the OSHA requirements for maintaining and posting records of occupational injuries and illnesses, and reporting specific cases to OSHA. Included in the course are hands-on activities associated with completing the OSHA Form 300 Log of Work-Related Injuries and Illnesses,OSHA Form 300A Summary of Work-Related Injuries and Illnesses, and the OSHA Form 301 Injury and Illness Incident Report. To search for specific course locations and dates, please visit the OTI Education Centers searchable schedule.

What if I still have questions?

§  FAQs

§  Q&A Search

§  Hearing Loss Chart*

§  Letters of Interpretation

§  OSHA contacts

§  Recordkeeping Advisor

Are there other resources related to OSHA recordkeeping requirements?

§  Compliance Directive (CPL 2-00-135)

§  NAM settlement agreement

§  SIC Manual

§  BLS injury and illness statistics

What is the OSHA Data Initiative (ODI)?

 

OSHA issues a proposed rule to improve workplace safety and health through improved tracking of workplace injuries and illnesses.

“With the information acquired through this proposed rule, employers, employees, the government and researchers will have better access to data, resulting in improved programs to reduce workplace hazards and prevent injuries, illnesses and fatalities. The proposal does not add any new requirement to keep records; it only modifies an employer’s obligation to transmit these records to OSHA. We encourage the public to review this proposed rule and look forward to their comments.”

— Dr. David Michaels Assistant Secretary of Labor for Occupational Safety and Health

The purpose of this rulemaking is to improve workplace safety and health through the collection of useful, accessible, establishment-specific injury and illness data to which OSHA currently does not have direct, timely, and systematic access. With the information acquired through this proposed rule, employers, employees, employee representatives, the government, and researchers will be better able to identify and abate workplace hazards. OSHA is proposing to amend its recordkeeping regulations to add requirements for the electronic submission of injury and illness information employers are already required to keep under Part 1904. The proposed rule amends 29 CFR 1904.41 to add three new electronic reporting requirements.

For information on OSHA’s current recordkeeping requirements, please visit the OSHA Recordkeeping Webpage.

The Occupational Safety and Health Administration announced that it will extend the comment period to October 14, 2014 on the proposed rule to improve workplace safety and health through improved tracking of workplace injuries and illnesses. The docket on the proposed rule can be accessed here. For more information on the extension, see the news release.

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