Billings Clinic

JOB SAFETY ANALYSIS

Affected Personnel: Care Providers (RNs, LPNs, CNAs, Clerks, PT/OT) /

Date:

Hazard Assessment Performed By:

Hazard Categories/Types

Struck by (SB) / A = Moving/flying object
B = Falling material
C = Patient/Patient / Contact with (CW) / A = Electricity E = Gases/fumes/dust/noise
B = Chemical F = Water/steam
C = Heat/cold G = Poor or no air
D = Radiation H = Blood/body fluids / Caught Between (CBT) / A = Pinch point
B = Protruding object
C = Moving / stationary object / Overexertion – patient/patient handling (OEP) / L = Lifting
P – Pushing/pulling
S/A = Static/Awkward Posture
R = Repetition
Struck against (SA) / A = Stationary/moving object
B = Protruding object
C = Sharp/jagged object / Caught on (CO) / A = Pinch point
B = Protruding object
C = Moving/stationary object / Fall – Same level (FS) / S = Slip
T = Trip
B = Balance / Overexertion – Other (OEO) / L = Lifting
P – Pushing/pulling
S/A = Static/Awkward Posture
O = Overtime/long shifts
R = Repetition
Contact by (CB) / P = Patient
O = Moving/stationary object / Caught in (CI) / A = Pinch point
B = Protruding object
C = Moving/stationary object / Fall to below (FB) / S = Slip
T = Trip
B = Balance

Risk Class Codes

/ A = / Imperative actions must be taken to suppress risk to lower level
B = / Action should be taken to minimize risk
C = / Operation permissible (may include controls that reduce risk but if they fail, risk will return to higher level)
Task Steps, Materials, Equipment
(Injury Rate)
[Residual Risk Class] / Hazard(s), (category-type) / Controls (Engineering or Administrative) / Warning System(s) or Device(s) / PPE / Handling/Work Practices / Env. Controls
Patient Transfers
Residual Risk Class = C
Includes the following transfers:
·  Bed to chair, stand, wheelchair, or walker
·  Wheelchair to toilet, chair, or tub
·  Chair to stand or walker
·  Bed positioning / Strains and Sprains
(OEP-L, P, S, A, O) / ·  Lift and transfer equipment – Slides boards, mechanical lifts, electric lifts, gait belts
·  Policies on fall assessment and Patient/Patient handling / ·  Signage on equipment / ·  None / ·  Always first refer to patient file to determine transfer requirements. These procedures MUST BE FOLLOWED! Updates to the patient file are required as new information becomes available, and at least weekly note: report any out of date patient file to your supervisor immediately –
1)  “Self-care”: patient needs NO assistance
2)  “One person”: patient needs one person to assist with gait belt
3)  “Two Person”: patient needs two people to transfer
4)  “Equipment Assist”: patient is to be moved via lift assist equipment
·  All employees, including new employees, are to be trained and their skills reviewed prior to doing transfers, AND prior to use of equipment.
·  All patient files are to be kept current to assure proper transfer assistance is provided.
·  Do pre-use check of equipment (Slings, hooks, cables, etc.) to assure it
·  MAKE SURE YOUR PATH OF TRAVEL AND SET-POINT ARE PREPARED BEFORE YOU START TO MOVE PATIENT
·  Always stay clear of suspended person
·  Know weight limits of gear and do not exceed them / ·  N/A
Patient interaction
Residual Risk Class = C / Patient ambulation falls
(OEP-L, A) / ·  Gait belt / ·  None / ·  None / ·  Do not wear chains, loose ear-rings, ties, nametags, etc. that patients could grab
·  Always use gait belt for assistance
·  DO NOT “CATCH” patient if he/she falls. Assist / support patient to the floor.
·  Ensure that patient is not injured before attempting to move them from floor.
·  Seek assistance from co-workers to move patient from the floor using appropriate lift techniques or device. / ·  None
Patient interaction
Residual Risk Class = C / Potentially combative patients
(SB-C), (CB-P) / ·  Restraints / ·  None / ·  None / ·  Always first refer to patient file to determine their behavior issues, needs, and “Handling Requirements”. These MUST BE FOLLOWED!
·  Updates to the patient file are required as new information becomes available, and at least weekly note: report any out of date patient file to your supervisor immediately
·  Assure staffing levels are adequate and report inadequate staffing immediately
·  DO NOT BE ALONE WITH POTENTIAL COMBATIVE INDIVIDUALS
·  Do not wear chains, loose ear-rings, ties, nametags, etc. that patients could grab
·  Approach patients with caution
·  Always use a paired (two person) approach
·  Use calm and non-confronting approach
·  If there is any indication with any patient that they may become combative, step out, and get assistance from other trained individuals; wait for patient to calm down before re-entering / ·  N/A
Patient interaction
Residual Risk Class = C / Needle Sticks, Exposure to blood and other potentially contaminated materials
(CW-H)] / ·  Safety sharps
·  Sharps containers
·  Admin. Policy on Universal Precautions / ·  Warning signage on devices / ·  Gloves
·  Face masks or shields
·  Gowns
·  Respirator / ·  Always first refer to patient file to determine patient’s background. Assure all immunizations are current for patients and staff
·  DO NOT RECAP NEEDLES. DISPOSE OF THEM IMMEDIATELY IN SHARPS CONTAINERS
·  Do not recycle needles
·  Updates to the patient file are required as new information becomes available, and at least weekly note: report out of date patient files to your supervisor immediately
·  Always use sharps container and assure container is located in area where sharps are used
·  Assure that ALL POTENTIALLY EXPOSED STAFF ARE current on universal precautions and procedures training (attendance at training is mandatory!)
·  Use standard precautions and procedures for any potential exposure to blood or other bodily fluids; and when exposure to other communicable diseases is possible (e.g., scabies or pediculosis)
·  Always use gloves and wash hands thoroughly with antibacterial soap for at least 2 minutes pre-shift, and 30 seconds minimum between patients / ·  All sharps must be disposed of in approved sharps containers and then removed from the facility by an approved hazardous materials waste hauler to an authorized disposal site.
General lifting, and Material handling
Residual Risk Class = C / Strains and Sprains
(OEO-L, P, A, R) / ·  None / ·  None / ·  None / ·  Use legs, not back – keep back vertical during lift
·  Do Not twist when lifting; move your whole body instead
·  Set work area up such that weights are at waist level
·  Pre-shift and post-break stretching exercises are encouraged
·  Limit weights lifted as much as possible and report any difficult lifts for re-design
·  Use two-person lift for heavier and awkward loads; and assist equipment (scissor lifts, dollies, forklifts etc.) to eliminate lifts
·  Rotate to other tasks throughout the shift / ·  N/A

General Duties

Residual Risk Class = C / Slip/Trip/Falls
(FS-S, T, B), (FB-S, T, B) / ·  Admin. Policy titled “Waste Stream Management Plan” / ·  None / ·  None / ·  Housekeeping is CRITICAL to our safety! Keep work areas organized and free from debris and trip hazards (extension cords, files, papers, debris);
·  Report any areas that are continual problems
·  Keep file drawers closed when not in use
·  Clean-up work area(s) prior to all breaks and at the end of each shift
·  IMMEDIATELY place “Wet Floor” signs liberally in area of spills/hazards
·  Assure IMMEDIATE clean-up/mop-up of spill or wet area
·  DO NOT WALK BY A HAZARD, take responsibility to correct it / ·  Recycle materials as possible

General Duties

Residual Risk Class = C / Falling Material
(SB-A, B) / ·  Admin. Policy titled “Personal Protective Equipment” / ·  Labels on hard hats or bump caps / ·  Hard-toed shoes
·  Hard hat
·  Bump cap / ·  Keep file drawers closed when not in use
·  Do not wear open-toed shoes
·  Wear hard-toed shoes as appropriate.
·  Ensure that all unstable and top heavy items (e.g., files cabinets, etc.) are secured (e.g. attached to wall) to prevent them from tipping over
·  Wear appropriate head protection wear objects may fall from above / ·  None

General Duties

Residual Risk Class = C / Emergency Preparedness
(All categories-All types) / ·  Admin. Policy titled “Emergency Management Plan” / ·  None / ·  None / ·  Emergent conditions can result in unpredictable hazards. Alertness is a key. Seek assistance regarding hazards during emergency situations.
·  Participate in emergency drills and be aware of evacuation routes; and eye wash, first aid station and staff locations
·  Keep all emergency exit routes unobstructed and accessible. Know the evacuation routes for your area. Know the location and contents of the Safety and Emergency Procedures Kardex.
·  Assure fully charged, inspected, and proper extinguishers are in your work area
·  Ensure that there are supplies on-site that are adequate for chemical and physical hazards present; and that MSDS’s are available
·  Make sure that medical emergency numbers are posted / ·  Collect hazardous waste for off-site disposal
Chemical (soaps, cleaners, disinfectants) Use
Residual Risk Class = C / Irritation of eyes and skin
(CW-B) / ·  Admin. Policy titled “Hazardous Materials Management Plan” / ·  Some areas may have an air monitoring system to warn of poor air quality.
·  Confined spaces must be checked for air quality using a calibrated gas monitor
·  Container label
·  Warning signs / ·  Gloves
·  Eyewear
·  Face mask / shield
·  Gowns
·  Respirator
·  Review MSDS for each chemical involved to determine appropriate PPE.
·  Contact supervisor or Safety Office for assistance / ·  Know the contents of MSDS’s for all hazardous materials you are assigned to use.
·  Review the hazard assessment for the tasks to determine protective equipment needs. Check date of assessment for currency.
·  Always wash prior to leaving the work area
·  Never eat, drink, or smoke in a chemical use or storage area
·  Inspect equipment daily for wear or deterioration and replace as needed. Clean and maintain in a sanitary condition and ready for use
·  Personal protective equipment is a last resort for protecting your health and safety. All feasible engineering controls and work practices must be used before relying upon personal protective equipment to reduce exposure / ·  Collect hazardous waste for off-site disposal
·  Collect all regulated waste for appropriate storage and off-site disposal
Chemical Use
(Corrosives, Toxics)
Residual Risk Class = C / Irritation of eyes and skin, burns, asphyxiation, death
(CW-B, G) / ·  Admin. Policy titled “Hazardous Communica-tions Plan – Chemical Safety” / ·  Some areas may have an air monitoring system to warn of poor air quality.
·  Confined spaces must be checked for air quality using a calibrated gas monitor
·  Container label
·  Warning signs / ·  Gloves
·  Eyewear
·  Face mask / shield
·  Gowns
·  Respirator
·  Review MSDS for each chemical involved to determine appropriate PPE.
·  Contact supervisor or Safety Office for assistance / ·  Assure that all primary and secondary containers are labeled indicating the contents and hazards
·  Know the contents of MSDS’s for all hazardous materials you are assigned to use.
·  Review the hazard assessment for the tasks to determine protective equipment needs. Check date of assessment for currency.
·  Always wash prior to leaving the work area
·  Never eat, drink, or smoke in a chemical use or storage area
·  Inspect equipment daily for wear or deterioration and replace as needed. Clean and maintain in a sanitary condition and ready for use
·  Assure that eyewash facilities and a quick drench shower are functional where corrosive materials are used. Assure that all primary and secondary containers are labeled indicating the contents and hazards
·  Personal protective equipment is a last resort for protecting your health and safety. All feasible engineering controls and work practices must be used before relying upon personal protective equipment to reduce exposure / ·  Collect hazardous waste for off-site disposal
·  Collect all regulated waste for appropriate storage and off-site disposal

Chemical Use

Compressed gasses-Oxygen
Residual Risk Class = C / Fire, burns, smoke inhalation, cryoburns, cuts, contusions, fractures, death
(SB-A), (CW-C) / ·  Admin. Policy titled “Compressed Gases – Handling and Storage”
·  Vertical cylinder stands
·  Cylinder transports / ·  Signage on cylinders / ·  None / ·  Perform an assessment of the area and assure that ignition hazards are eliminated
·  Assure that equipment (including connectors, hoses, fittings, valves, regulators, gauges, etc.) is routinely inspected and in good condition and free from leaks, rust, wear, deteriorated parts
·  Assure that oxygen cylinders are stored with cylinder caps in place and cylinders kept in an upright position, and secured
·  Keep “no smoking/ignition sources” signs posted in cylinder storage area
·  Keep proper and fully charged fire extinguisher in storage area
·  Assure fire extinguisher is in cylinder storage area and fully charged
·  Assure all ignition sources are removed from area of flammables storage and use
·  Assure that fittings/connections are tight
·  Store flammables separate from oxidizers including oxygen cylinders
·  Know by memory, procedures for response to oxygen enhanced fires or environments / ·  N/A

Certification: This document has been completed in conjunction with representatives of the department(s) or workgroup(s) listed above and serves as a comprehensive assessment of the hazards present in the covered task, activity, or work area.

Applicable Billings Clinic or department specific standards:
Applicable outside agency regulations or accrediting standards

Supervisor/Employee Review:

My Supervisor has reviewed this JSA with me, I have read the material, and I agree to follow the protective measures outlined above.

Employee (Print Name): ______
Employee: ______Date: ______
(Signature)
Supervisor (Print Name): ______
Supervisor: ______Date: ______
(Signature)