Lack of Oversight Promotes Dangerous Conditions for Health-Care Workers

Roofers, firefighters and athletes all have risky, injury-prone jobs. So do health-care workers.

According to a recent report by Public Citizen, a consumer advocacy organization, nurses, nurses’ aides, orderlies and hospital/continuing care attendants suffer more musculoskeletal injuries than people working in any other profession. The reason, the report suggests, isn’t just because much of what these workers do is physical, but because of insufficient safety inspections at their work sites.

The report, as interpreted by MedPageToday.com, examined 2010 data from the Occupational Safety and Health Administration (OSHA), the federal agency responsible for establishing safety standards at the workplace and ensuring that they are followed.

OSHA reports from physical, labor-intensive industries were compared for rates of inspection, injury and employment. With 9.1 million workers in 2010, the construction sector, for example, tallied 74,950 injuries. OSHA inspected 52,179 construction sites that year.

The health-care/social assistance sector, by comparison, employed more than twice as many people-18.9 million-and reported 176,380 injuries that year, or more than twice as many as construction. But OSHA conducted only 2,504 inspections of health-care and social assistance facilities in that same year … or less than 5% of the number conducted for construction.

One explanation for the disparity in the number of inspections, according to the report, probably relates to the severity of the injuries their employees tend to suffer, noting that in 2010, 774 construction workers died; 141 health-care and social assistance workers died that year from on-the-job injuries.

Still, the report said, although the proportion of deaths might explain the different number of inspections, “healthcare inspections would need to be increased by about a factor of four to bring them into parity with construction sector inspections.”

The age-old problem of budgetary restrictions also contributes to lack of oversight of health-care worker safety. OSHA had $535.2 million for fiscal 2013, and was responsible for monitoring 7 million work sites.

Also, there were regulatory complications. A standard established in 2000, according to the report, “required employers to implement ergonomics programs in response to employee complaints about work-related musculoskeletal disorders …,” but it never took effect. It was repealed by Congress in 2001.

Public Citizen noted that implementation of OSHA standards has been successful in the past in protecting health-care workers, and has resulted in unexpected innovation and financial benefits for workers. One example, notes MedPage Today, is the Bloodborne Pathogens Standard, which requires controlling exposure to sharp devices and needles, and storing and disposing of them properly.

The Needlestick Safety and Prevention Act requires employers to “implement new developments in safety technology” and to “solicit employees’ input in the selection of sharp devices.” Sometimes, as we’ve blogged, measures such as the safe injection practices defined by the Centers for Disease Control and Prevention (CDC) fall by the wayside, sometimes with serious consequences, such as outbreaks of hepatitis, that affect patients even more than workers.

Injuries to health-care workers are expensive: They cost about $7 billion a year, according to the report.

Here’s what Public Citizen recommends that OSHA do to protect health-care workers and the patients who depend on them:

  • Require lifting and transfer aids or similar devices while caring for residents and patients during all shifts and units.
  • Implement a zero-tolerance policy regarding workplace violence and threats, oral or otherwise. Require employees to report instances of workplace violence and offer suggestions how to minimize risk, as well as protection for people who report workplace violence.
  • Amend the current blood-borne pathogen regulations to require a comprehensive log of sharp device injuries reviewed by management and use of the best-available technologies for sharp devices, and consult with employees before purchasing them.
  • Increase funding to dramatically increase OHSA’s number of inspections and enforce new legislation.

If a hospital or assisted-care facility visit is in your foreseeable future, inquire of the institutions you’re considering what the practices are for protecting workers. Safer workers are happier workers, and that has a direct effect on the patient’s experience and outcome.

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