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Checklist of Highlighted Hazards in the Emergency Department 

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Checklist
1-Blood, Other Potentially Infectious Materials (OPIM) and bloodborne pathogens
a. If there is occupational exposure to Blood, or OPIM is there a written Exposure Control Plan that is evaluated annually? [1910.1030(c)(1)(i) - Bloodborne Pathogens]
b. Does the exposure control plan reflect changes in technology that eliminate or reduce exposure to bloodborne pathogens, and document annually consideration and implementation of appropriate commercially available and effective safer medical devices designed to eliminate or minimize occupational exposure? 
 [1910.1030(c)(1)(iv)(A) - Bloodborne Pathogens]
c. Are engineering and work practice controls used to eliminate or minimize exposure to bloodborne pathogens? [1910.1030(c)(1)(iv)(B) , and (d)(2)(i) - Bloodborne Pathogens]
d. Is a sharps injury log established and maintained for the recording of percutaneous injuries from contaminated sharps? Including type and brand of device involved, and how and where the incident occurred? [1910.1030(h)(5)(i) - Bloodborne Pathogens]
e. Does the employer provide and ensure employees wear appropriate PPE when exposure to Blood or OPIM is anticipated? [1910.1030(d)(3)(ii) - Bloodborne Pathogens]
f.  Do employees discard contaminated needles and other sharp instruments immediately or as soon as feasible after use into appropriate containers? 
[1910.1030(d)(4)(iii)(A)(1) - Bloodborne Pathogens]
g. Are 'universal precautions' observed under circumstances in which differentiation between body fluid types is difficult or impossible? [1910.1030(d)(1) - Bloodborne Pathogens]



2- Hazardous Chemicals Checklist
a. Is there a written program which meets the requirements of the Hazard Communication Standard to provide for worker training, warning label, and access to material safety data sheets? [1910.1200 - Hazard Communication]
b. Are eye wash fountains provided for immediate emergency use, if there is a possibility that an employee's eyes may be splashed with a corrosive chemical? [1910.151(c) - Medical Services and First Aid]
c. Have all personnel involved in any aspect of handling covered hazardous drugs (physicians, nurses, pharmacists, housekeepers, employees involved in receiving, transport or storage) received information and training to apprise them of the hazards presented by hazardous drugs in their work area? [OSHA Technical Manual 5.A.2 and 1910.1200 - Hazard Communication]
d. Is appropriate Personal Protective Equipment provided (e.g., gloves, goggles, splash aprons) when handling hazardous or toxic drugs? [1910.132 - Personal Protective Equipment]
e. Are hazardous medications prepared in the pharmacy (and not in the emergency department) using appropriate safety equipment such as biological safety cabinets? [OSHA Technical Manual]



3-Slips/Trips/Falls Checklist
a. Are floors kept clean and dry? [1910.22(a)(2) - Walking Working Services], and 1910.141(a)(3)(ii) - General Environmental Controls, Sanitation]
b. Are aisles and passageways clear and in good repair with no obstruction across or in aisles that could create a trip hazard? [1910.22(b)(1) - Walking Working Services]
c. Are exits kept free and unobstructed? [1910.37(a)(3) - Exit Routes, Emergency Action Plans, and Fire Prevention Plans]



4- Latex Allergy Checklist
a. Are appropriate gloves provided when exposure to blood or Other Potentially Infectious Materials (OPIM) exists? [1901.1030(d)(3)(i) - Bloodborne Pathogens]
b. Are employers providing alternative gloves to employees who have exposure to blood or other potentially infectious materials and may be allergic to the gloves normally provided? [1910.1030(d)(3)(iii) - Bloodborne Pathogens]



5- Equipment Hazards Checklist
a. Is electrical equipment free from recognized hazards? [1910.303(b)(1) - Electrical, General]
b. Is electrical equipment free from recognized hazards? [1910.304(b)(1) - Electrical, General]
c. Are employees trained not to plug or unplug energized equipment when their hands are wet? [1910.334(a)(5)(i) - Electrical, Equipment]
d. Are all damaged receptacles and portable electrical equipment tagged out and removed from service? [1910.334(a)(2)(ii) - Electrical, Equipment]



6-Workplace Violence Checklist
a. Is a workplace violence prevention program in place to help protect employees from violence and to train staff to recognize and diffuse violent situations? [OSHA Publication 3148 - Guidelines for Preventing Workplace Violence for Health Care and Social Service Workers]
b. Do emergency department doors exit out only, so people off the streets can't access the emergency department unless they enter through the waiting room area? [DHHS (NIOSH) Publication No. 2002-101 - Violence Occupational Hazards in Hospitals]
c. Is access to the emergency department area controlled? Are patients buzzed in by a receptionist through a secure door? [OSHA Publication 3148 - Guidelines for Preventing Violence for Health Care and Social Service Workers]



7-Tuberculosis Checklist
a. Are employees protected from exposure to the exhaled air of individuals with suspected or confirmed Tuberculosis? [1910.134]
b. Are isolation rooms provided, or is an area provided that exhausts room air directly outside or through a HEPA filter to safely isolate potentially infectious patients? [OSHA Directive CPL 2.106 (1996, February)]
c. Are patients isolated who have suspected or confirmed tuberculosis? [OSHA Directive CPL 2.106 (1996, February)]
d. Are warning signs posted outside emergency department respiratory isolation rooms in accordance with [1910.145(a)(1)] to prevent accidental entry?
e. Are suitable respirators provided when such equipment is necessary to protect the health of employees? [1910.134]
f. Are respiratory protective programs including the requirements outlined in [1910.134] established and maintained?
g. Are workers educated and trained to ensure their knowledge of tuberculosis including signs, symptoms, transmission, controls, and post-exposure protocols? [OSHA Directive CPL 2.106 L.e.4 (1996, February)]



8.Workplace Stress Checklist
a. Are programs established to address workplace stress, such as: Employee Assistance Programs (EAP) or Organizational Change Programs? [Stress at Work - DHHS (NIOSH) Publication No. 99-101]



9. Methicillin Resistant Staph Aureus (MRSA) Checklist
a. Are universal precautions practiced to help protect employees from infection? [Guideline for Isolation Precautions in Hospitals, CDC, 1996]
b. Are hospitals establishing their own local MRSA data and providing treatment information to clinicians? [Guideline for Isolation Precautions in Hospitals, CDC, 1996]



10-Homeland Security - Terrorism Checklist
a. Is there a plan in place to protect healthcare employees and emergency responders from patients that have been exposed to chemical, biological, and radiological hazards? [Hospitals and Community Emergency Response, OSHA Publication 3152 (1997) and OSHA's Emergency Preparedness and Response Safety and Health Topic Page]




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