Below are questions to help you understand Occupational Health and Safety (OHS) in your organization. The four elements of the tool, the Organization, Infection Control, Training and Record Keeping sections comprise a "Dashboard", or overview of your OHS program. Please have a responsible person working in each described area answer the questions. Please answer by placing an X in the "Yes/No/Don't Know" box OR write the number/percentage answer in the appropriate box. If the question is unclear or not applicable, please note this and any additional information in the Comments box. Boxes that are grayed out indicate answer options not applicable for that question.
Organization
Organization questions examine the structure and processes used to evaluate and address Occupational Health & Safety (OSH) in your organization. These should be answered by senior management or designee.
Item/description / Yes / No / Don't
Know / # or % / Comments
Is there an OHS policy for the organization?
Is this OHS Policy in written form?
Is there a trained person in charge of OHS?
Is there a dedicated budget for health and safety?
Does the Health & Safety Committee (HSC)
meet quarterly or more often?
record meeting minutes with action items?
What % of action items were implemented in the past year?
Are there procedures for conducting workplace hazard assessments?
How many hazard assessments were completed in past year?
What % resulted in written recommendations?
Is there a staff clinic for work-related injury/illness?
Is there a Return-to-Work Safely program?
Is there a Patient safety program?
Infection Control
The Infection Control program uses practices which, when used appropriately, restrict the spread of infection. This section should be filled out by the Infection Control staff.
Item/description / Yes / No / Don't
Know / # or % / Comments
Vaccination information
Is there a policy in place requiring vaccination of employees-free of charge- to protect against potentially occupationally-acquired diseases?
Are the following vaccinations offered to employees:
HBV vaccination series?
Influenza vaccine ?
MMR vaccine ?
Varicella vaccine ?
Tdap vaccine ?
Is staff vaccination status recorded and evaluated annually?
Prevention (hand-washing)
Is there a policy requiring workers to wash hands before caring for patients?
Do patient care areas have sinks readily available?
Are antiseptic soap, water and towels available?
Is hand sanitizer available?
Are signs posted to remind staff and visitors to wash their hands with soap?
Are cleaning solutions replaced according to policies and procedures?
Treatment
Is INH available for post-TB exposure free of charge?
Is HBV,HCV,HIV post-exposure assessment and, where indicated, prophylaxis available free of charge (note any exceptions in Comments section)?
Infection Control- cont
Item/description / Yes / No / Don't
Know / # or % / Comments
Bloodborne Pathogens
Is there a bloodborne pathogen policy in place requiring workers to use standard/universal precautions when caring for patients?
Is biohazardous medical waste segregated & clearly labelled?
Airborne Pathogens
Is there a policy in place to protect workers from exposure to airborne/droplet pathogens (e.g. TB)?
Does this policy require the use of respirators, protective eye wear and gowns?
Are respirators available & accessible ?
Do staff know when/ how to use a respirator?
Are staff fit-tested for respirators on a regular basis?
Is TB symptom surveillance testing conducted on regular basis?
Personal Protective Equipment (PPE)
Are the following items of personal protective equipment (PPE) available to workers:
Medical gloves?
Face shields, masks and/or eye protection?
Impermeable gowns?
Do staff know when/how to use these PPE?
Infection Control- cont.
Item/description / Yes / No / Don't
Know / # or % / Comments
Isolation Measures
Is there a policy of early identification and isolation of patients potentially infected with airborne pathogens (e.g. TB)?
Is there sputum collection available when TB is suspected?
Are there designated isolation rooms for TB patients?
Is signage clearly posted outside isolation rooms and does it indicate the type of isolation?
Are symbols and pictures used on isolation signs?
Are isolation signs geared towards both staff and visitors?
In the isolation areas are there enough:
Face masks?
Gowns?
Booties?
Hats?
Are the gowns, booties and hats properly cleaned/disposed of?
Safety Devices: In order to protect health care workers from bloodborne pathogens, the use of safety-engineered devices (including needless and safety needles) are recomended. These devices have safety features to protect the health care worker from being accidently injured by a stick with a needle or other sharp device for the following practices.
Safety Devices
Is there a policy in place requiring use of sharp devices that have safety features ?
Do the following sharp devices have safety features:
Phlebotomy devices?
IV devices?
Syringes?
Surgical devices?
Are there sufficient supplies of these devices?
Are these safety devices used consistently?
Are syringes recapped?
Are sharps disposal containers available in all patient care areas?
Training
Training includes all formal and informal methods of educating staff on health and safety measures and infection control. This section should be filled out by the Human Resources or Training/Education department.
Item/description / Yes / No / Don't
Know / # or % / Comments
Is safety training required for employees:
At time of hire?
Once a year?
When a need arises?
Are training materials readily available to employees who want to review them?
Where are they located? (describe under comments)
Does training for employees include the following topics:
Policies/procedures related to health & safety?
Recognition of hazards?
Control of hazards?
Reporting hazards or exposures?
Blood-borne pathogens?
Use of PPE?
Safety devices?
Respiratory hazards?
Violence prevention?
Handwashing?
Is training conducted:
In-person?
On-line?
In another fashion?
Are safety and health educational messages (such as flyers or posters) posted:
Throughout the facility?
In specific locations? If so, where?
Are training records kept for employees?
Is compliance with training reviewed and enforced?
Is the training conducted by:
Employee Health Nurse or Physician?
Staff Nurse or Physician?
Safety supervisor?
Human resources or hiring personnel?
Other (please describe)
Record Keeping and Statistics
The Record Keeping and Statistics section addresses the recording and evaluation of safety statistics over time. Health and Safety or Human Resources should consult their logs and other records to fill out this section.
Item/description / Yes / No / Don't
Know / # or % / Comments
Are there policies/procedures for reporting injuries/illnesses?
What was the total number of staff within the organization at beginning of the year?
Within the past year, what are the total number of:
Injuries?
Needlestick injuries?
Violent incidents against staff?
Occupational disease cases including HepB, HIV, TB, other?
Workers who had to be quarantined?
New cases of TB among health workers?
Deaths in organization?
Within the past year, what percentage of staff:
Accepted HIV Counselling & Testing when offered?
Were screened for TB?
Were immunized for Hep B?
Were immunized for MMR?
Do you track employee turnover?
Citations
Infection control section adapted from the WHO "Rapid Assessment Tool: Bloodborne Pathogen Exposure Prevention" ; "Workplace Assessment Field Guide for Healthcare";HealthWISE - Work Improvement in Health Services - Action Manual, ILO; and personal communications with Susan Wilburn / http://innovation.ghrp.ubc.ca/johsc/WPAFieldGuide.pdf
http://www.ilo.org/wcmsp5/groups/public/---ed_dialogue/---sector/documents/instructionalmaterial/wcms_237276.pdf
Organization and Record Keeping sections adapted from Spiegel et al. 2012. Tool,weapon or white elephant. BMC Medical Informatics and Decision Making.12:84 / http://www.biomedcentral.com/1472-6947/12/84
EMPLOYEE WORKPLACE SAFETY CLIMATE SURVEY
Below are questions designed to help you understand Occupational Health and Safety (OHS) in your organization. The four areas focus on facility chracteristics, personal perception about safety, perception of the approach to safety by management, and general safety practices at your facility. Please answer each question with an X in the appropriate box. If the question is unclear, not applicable, or you wish to elaborate please include this additional information in the comments box.Facility characteristics
Yes / No / Don't Know
1. Does your facility have an occupational health and safety committee?
2. Does your facility provide education and training for healthcare workers on... bloodborne pathogens?
3. ...infection control practices?
4. ...use of personal protective equipment(gloves, safety glasses, scrubs, etc.)?
5. ...handling of hazardous drugs?
6. ...use of safety devices (example: needles)?
7. ...latex allergies?
8. ...violence prevention?
9. Does your facility have procedures/protocols for assessing...workplace hazards?
10. ...work-related injuries?
11. ...reporting exposure to blood or other body fluids?
12. ...early identification and isolation of patients with tuberculosis? Or other infectious communicable disease:______(please describe)
13. Does your facility...offer Hepatitis B vaccine to workers free of charge?
14. ...document injuries and needlesticks?
15. ...document the immunization status of employees?
16. ...use N-95 respirators/ properly fit tested for their use?
17. ...enforce proper hand washing universal precautions for all patient encounters?
COMMENTS:
Safety culture - safety, managers & practices
Please answer with an X whether you 1=Strongly Disagree, 2= Disagree, 3=Neutral, 4=Agree or 5=Strongly Agree with the following statements / 1. Strongly Disagree / 2. Disagree / 3. Neutral / 4. Agree / 5. Strongly Agree
In the following section please describe how YOU PERCEIVE workplace safety :
18. I care about my personal safety at work
19. I care about the safety of my coworkers
20. I consider minor accidents to be a normal part of our daily work
21. I accept minor accidents to be a normal part of our daily work
22. I have great trust in my coworkers’ abilities to ensure safety
23. I feel that safety rounds/evaluations have no effect on safety
24. I consider safety training to be meaningless or nonexistent
25. I rarely talk about safety at work
26. I generally feel safe when working with others at work
27. I have witnessed others break safety rules in order to complete work on time
COMMENTS:
In the following section please describe how you perceive that the MANAGERS/SUPERVISORS at this workplace approach safety:
28. Management seems to care about my safety
29. Worker’s safety practices are very important to management.
30. Workers are regularly made aware of dangerous work practices or conditions
31. Workers are regularly praised for safe conduct.
32. Workers receive instructions on safety when hired.
33. Management looks for causes, not guilty persons, when an accident occurs
34. Fear of sanctions (negative consequences) from management discourages employees here from reporting near-miss accidents
35. Management strives for everybody at the worksite to have high competence concerning safety and risks
36. Management never considers employees' suggestions regarding safety
37. Management encourages employees here to work in accordance with safety rules - even when the work schedule is tight
COMMENTS:
In the following section please describe the occupational health and SAFETY PRACTICES for healthcare workers within YOUR FACILITY:
Please answer with an X whether you 1=Strongly Disagree, 2= Disagree, 3=Neutral, 4=Agree or 5=Strongly Agree with the following statements / 1. Strongly Disagree / 2. Disagree / 3. Neutral / 4. Agree / 5. Strongly Agree
38. I have been instructed to use personal protective equipment
39. I have been trained on the proper use of personal protective equipment
40. I have a clear understanding of what to do if I am exposed to blood or bodily fluids
41. I have a clear understanding of the infection control practices of my facility
42. My facility tracks injuries at work to include needle sticks
43. Personal protective equipment is easily accessible and well stocked
44. I am aware of a safety reporting system for accidents at work
45. My facility promotes universal precautions as an expected practice at all times
46. I have been trained on disaster preparedness or emergency response
47. I was required to have certain vaccines when I was hired
COMMENTS:
Open Response Questions
48. Which of the following are challenges or barriers for implementing occupational health and safety or employee health activities in your facility? (Mark an X to all that apply)
a. Lack of Funding
b. Limited access to supplies /
c. Lack of training materials /
d. Lack of awareness among healthcare employees /
e. Limited staff
f. Other, please describe:______/
49. What are your 3 biggest safety concerns at work?
1)
2)
3)
Survey adapted from the following references:
Eisenberger, R. & Huntington, R. Perceived organizational Support. Journal of Applied Psychology, 1986,Vol.71,No.3,500-507
Gillen, M., Baltz, D., Gassel, M., Kirsch, L., & Vaccaro, D. (2002). Perceived safety climate, job demands, and coworker support among union and nonunion injured construction workers. Journal of Safety Research, 33, 33-51.
Kines, P., et al., Nordic Safety Climate Questionnaire (NOSACQ-50): A new tool for diagnosing occupational safety climate, International Journal of Industrial Ergonomics (2011), doi:10.1016/j.ergon.2011.08.004
Occupational Health Services Asset Dashboard
Directions: To assess availability and location of existing resources which may assist in providing some aspect of occupational health services, please complete the grid below. Mark any asset location that may provide a specific task or occupational health service program element.
Asset Location
Clinic/ Hospital Resource / Offsite Resource
TASKS / Employee Health Unit / Infection Control Unit / HIV Service / Hospital Leadership / Patient Safety Team / Hospital/ Clinic Network / Regional Partners (Public/ Private) / City Clinics / Nat’l Ministries of Health / Min of Labor / Private Agencies - (UN AIDS, PEPFAR, Gates) / Other:
1. Organization of Safety Program
Policy
Trained person
Committee
% Staff Trained in Safe Practice
· Safe Sharps
· Airborne
· BBP
Workplace Assessment Conducted
· Immunization Hx
· Worker Assessment
· Avail of PPE?
2. Infection Control
· Vaccine Program
· Training
· Hand Washing
· INH
· PEP available
· BBP and Airborne
Availability of Safe Sharps & PPE
Asset Location
Clinic/ Hospital Resource / Offsite Resource
TASKS / Employee Health Unit / Infection Control Unit / HIV Service / Hospital Leadership / Patient Safety Team / Hospital/ Clinic Network / Regional Partners (Public/ Private) / City Clinics / Nat’l Ministries of Health / Min of Labor / Private Agencies - (UN AIDS, PEPFAR, Gates) / Other:
3. Training
· New Hire safety training
· BBP
· Airborne –Policies
· Infectious control/ Work Practices
Who teaches/ competent persons
4. Recordkeeping/ Statistics
· Reports of Illness & Injury
· Needle stx
· Quarantine workers
· New TB
· % screened for TB
· % staff counseling & testing
· Deaths of HCW
· Disability
· Retention