Environmental Safety

Environmental Safety .......................................................ES: 1

1. Introduction ............................................................................ ES: 1
2. Purpose/Overall Goals ............................................................. ES: 1
3. Course Objective..................................................................... ES: 1
4. Accident Prevention ................................................................ ES: 2
5. Compressed Gas ..................................................................... ES: 3
6. Electrical Safety ..................................................................... ES: 4
7. Radiation Safety ..................................................................... ES: 5
8. Safe Medical Devices Act ....................................................... ES: 6
9. Bomb Threats ......................................................................... ES: 7
10. Workplace Violence .............................................................. ES: 8
11. Personal Safety ..................................................................... ES: 9
12. Conclusion ............................................................................ ES: 10

© Copyright Clinical Assessments by Prophecy, a Division of Advanced Practice Strategies

 ES: 1

Environmental Safety

INTRODUCTION
Healthcare settings involve the use of medical equipment such as compressed gases, radiation
technology, and electrical devices. If operated correctly, they can be lifesaving – but incorrect use can be
life-threatening. Healthcare workers also are at increased risk for slips and falls, aggressive patient
behavior, threats, and more.

Environmental safety is everyone’s responsibility. Accidents can be prevented as long as healthcare

workers know how to use equipment properly and can recognize hazards and respond to them. Learning
important safety facts can go a long way toward keeping patients and staff as protected as possible.

PURPOSE/OVERALL GOAL
This module outlines areas within the healthcare environment that could pose safety risks, and what
healthcare workers need to know in order to work safely and efficiently.

The goal of this module is to make you aware of common hazards so you can reduce the risk of injury to
yourself, your coworkers, and patients.

COURSE OBJECTIVES
After completing this module, the learner should be able to:
1. Describe how to avoid slips, trips, and falls
2. Explain safety precautions when working with compressed gas, electricity, and radiation
3. Demonstrate appropriate actions required by the Safe Medical Devices Act
4. Describe what to do in the event of a bomb threat
5. Describe how to avoid and manage workplace violence
6. Demonstrate appropriate personal safety measures
 ES: 2

ACCIDENT PREVENTION
According to the Centers for Disease Control, the knees, ankles, and feet are the body parts most
commonly injured after a slip, trip, or fall – and such an injury is significantly more likely to result in
fractures and multiple injuries.

Slips, trips, and falls can happen for a number of reasons, such as:
 Contaminants on the floor
 Indoor/outdoor walking surface irregularities
 Inadequate lighting
 Clutter
 Loose cords on the floor
 Long hoses, wires, and medical tubing

If an accident occurs:
 Remain calm.
 Inform your supervisor.
 Remove/report the problem to the proper department (Environmental Services, Engineering,
etc.)

If you are injured and need treatment, see your Employee Health Nurse or go to the Emergency
Department. If you are seriously injured or think you might have broken bones, do not move, since that
could make an injury worse. Instead, call for help and/or wait for others to help you. Be sure to tell them
what caused your accident so they can remove or report the problem.

If another person is injured, wait for someone to assist you. You can hurt yourself if you try to lift or
move an injured person by yourself. Use a wheelchair or a stretcher to take the person to the
Emergency Department for treatment.

If the person is seriously hurt or unconscious, wait with the injured person while someone calls for help.
If there is any possibility of a back, neck, or head injury, the injured person should not be moved .

Once you have taken care of the injured person, report the accident. If you know the cause of the
accident, report it so the problem can be removed. All accidents need to be reported.

Things to remember:
 Accident prevention in the workplace is everyone’s responsibility.
 Accidents can be prevented if workers recognize hazards and respond to them.
 Use warning signs to alert others of possible hazards, and take extra care when you see a
warning sign.
 Almost all accidents can be prevented if you REMOVE the problem or REPORT the problem.
 All accidents must be reported.
 ES: 3

COMPRESSED GAS SAFETY

Compressed gas cylinders need to be treated with utmost care and respect. Hazards associated with
compressed gases include:
 Oxygen displacement
 Fires
 Explosions
 Toxic gas exposures
 Physical hazards associated with high-pressure systems

Keep these facts in mind:

 If the contents of a compressed gas cylinder are released too quickly, the cylinder can become
an uncontrollable projectile.
 If the cylinder tips over, it may explode.
 Compressed gases should be handled only by experienced and properly trained workers.
 Special storage, use, and handling precautions are necessary in order to control the hazards
associated with compressed gas.

These are signs you may see at your facility to indicate compressed gas is in use:
 ES: 4

ELECTRICAL SAFETY
Electrical hazards can cause burns, shocks, and electrocution (death). Always use caution when working
with or near electricity.

Here are some safety tips to keep in mind:

1. Check plugs for loose or broken pins or for any melted areas.
2. Unplug equipment by handling the plug itself and not the cord.
3. Do not use cheaters (adaptors that convert three-pin plugs into two-pin plugs).
4. Never use electrical equipment that has frayed cords or exposed wires.
5. Do not roll equipment over electrical cords, because it can damage the cord.
6. If you receive a shock when using electrical equipment, immediately turn it off and take it out of
service so it can be repaired.
7. Never operate electrical equipment with wet hands or while you are standing in water.
8. Never try to repair electrical cords or equipment unless you are qualified and authorized to do
so.

Take electrical equipment out of service and report it if the equipment:

 Smells “hot”
 Has smoke coming out of it
 Is not working properly
 Has had a liquid fall into it

When outdoors, be aware that overhead wires also can pose electrical hazards, so observe these safety
steps:
 Assume that all overhead wires are energized at lethal voltages. Never assume that a wire is safe
to touch, even if it is down or appears to be insulated.
 Never touch a fallen overhead power line; instead, call the electric utility company to report it.
 If an overhead wire falls across your vehicle while you are driving, stay inside the vehicle and
continue to drive away from the wire. If the engine stalls, do not leave your vehicle. Warn
people not to touch the vehicle or the wire. Call or ask someone to notify the local electric utility
company and emergency services.

This is a sign you may see at your facility to indicate electrical equipment is in use:
 ES: 5

RADIATION SAFETY
Protection is imperative when you are working with or near radiation. Medical imaging equipment such
as X-ray machines, CT scanners, mammography machines, and other devices produce various levels of
radiation.

You can protect yourself by always following your facility’s policies and procedures. Here are some
practical tips:
1. Minimize Time – If you reduce your time around radiation, you reduce your exposure. Put
forethought into how you will accomplish a procedure, before you attempt it.
2. Maximize Distance – Doubling the distance between a person and the radiation source reduces
the radiation exposure by a factor of 4. This means every step back makes a significant exposure
difference.
3. Maximize Shielding – If a lead wall is provided, use it. Wear lead aprons, double-sided
preferred, with a thyroid shield. Use lead gloves if provided. A 0.5-mm thick lead apron reduces
scattered radiation by approximately 10 times.
 Use a Badge Monitor – Wear your badge monitor on the outside of your lead apron and have it
read at the prescribed times. Only wear your own badge, never another person’s badge. Never
wear the badge at home and/or when you are undergoing a radiological procedure yourself.

This is a sign you may see at your facility to indicate radioactive equipment is in use:
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SAFE MEDICAL DEVICES ACT

The Safe Medical Devices Act of 1990 requires a medical device user facility (DUF) to report – to the U.S.
Secretary of Health and Human Services, the manufacturer, or both – whenever they believe there is a
probability that a medical device has caused or contributed to a death, illness, or injury.

Medical devices include:

 Hospital beds and wheelchairs
 Oxygen tanks
 Walkers and canes
 Catheters
 Air mattresses
 Hoyer lifts
 Suction equipment
 Wound vacs
 Blood glucose monitoring devices
 Electronic blood pressure monitor/machine
 And more

As a healthcare worker, your responsibility is to do the following:

 Remove the suspected device from service and tag as “Defective, Do Not Use.”
 Do not change any control settings on the device unless necessary to minimize injury at the time
of the occurrence.
 Retain all disposable and reusable equipment, accessories, and packaging related to the
incident.
 Do not clean the device; instead, place contaminated materials in an appropriate container and
label with a biohazard tag.
 Report the incident to your manager.
 Complete the appropriate documentation.
 Do not give the device to the company vendor.
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BOMB THREATS
Most bomb threats are received by phone. All bomb threats should be considered serious until proven
otherwise.

According to federal guidelines, should a bomb threat be received by phone, the nurse or other
healthcare professional taking the call should immediately institute the following procedures and
complete a “Record of Bomb Threat”:
1. Remain calm. Don’t panic.
2. Keep the caller on the line as long as possible. Do not hang up, even if the caller does.
3. Write down, as best you can, every word spoken by the person calling.
4. Listen for any strange or unusual background noises such as music playing, motors running,
traffic sounds, etc., which might be helpful in providing clues to determine where the call was
made from.
5. Determine whether the voice is male or female, familiar or unfamiliar, and listen for any
accents, speech impairments, nervousness, etc.
6. Record as much information as you can. You may not be able to get everything, but gather as
much as possible.

Questions to ask include:

 Where is the bomb located (building, floor, room, etc.)?
 When will it go off?
 What does it look like?
 What kind of bomb is it?
 What will make it explode?
 Did you place the bomb? If yes, why?
 What is your name?

If a bomb threat is received by handwritten note, handle the note as little as possible. If it is received by
email, do not delete the message.

If you receive a suspicious package, inform authorities immediately. Do not move the package. Signs of a
suspicious package include:
 No return address
 Poorly handwritten
 Excessive postage
 Misspelled words
 Strange odor
 Foreign postage
 Strange sounds
 ES: 8

WORKPLACE VIOLENCE
The National Institute for Occupational Safety and Health (NIOSH) defines workplace violence as “violent
acts (including physical assaults and threats of assaults) directed toward persons at work or on duty.”
Unfortunately, healthcare workers are at higher risk for job-related violence.

But preparation and training can help avoid or mitigate violence. Healthcare workers should understand
the importance of a culture of respect and dignity in preventing workplace violence.

A written program for workplace violence prevention, incorporated into an organization’s overall safety
and health program, offers an effective approach in reducing or eliminating the risk of violence in the
workplace.

Topics that you should be aware of include:

1. Risk factors that cause or contribute to assaults
2. Policies and procedures for documenting changes in behavior in patients
3. The location and operation of safety devices such as alarm systems
4. Early recognition of escalating behavior, or recognition of warning signs or situations that may
lead to assaults
5. Ways to recognize, prevent, or diffuse volatile situations or aggressive behavior, manage anger,
and appropriately use medications
6. Ways to manage aggressive, violent or hostile behavior in people other than patients and
clients, such as relatives and visitors
7. Proper use of safe rooms – areas where staff can find shelter from a violent incident
8. A standard response action plan for violent situations, including the availability of assistance,
response to alarm systems, and communication procedures
9. Techniques for caring for a violent patient, such as remaining aware of surroundings, minimizing
items that could be used as weapons, and keeping your body positioned between the patient
and the door
10. Progressive behavior-control methods and when and how to apply restraints properly and
safety when necessary
11. Ways to protect yourself and your coworkers, including use of the “buddy system“
 ES: 9

PERSONAL SAFETY
To help protect your personal safety as a healthcare worker, follow these steps:
1. Wear your facility-issued badge at all times, and expect to see other employees wearing their
badges also.
2. Avoid carrying large sums of money. Keep car keys, credit cards, wallet, etc., separate from
purses while going to and from your car.
3. Plan your route of travel using well-lit routes. Walk with others if possible.
4. Lock your car and keep packages or other items out of sight.

To make your work area safer, here are some reminders about personal security:
1. Keep valuable items, including purse and coats, secured.
2. Lock your work area whenever it is unoccupied.
3. Report any unusual activity, unknown persons, or any incident to Security immediately, such as:
o Persons wandering or looking around
o Theft or missing property
o Nuisance phone calls
o Unauthorized “sales” visits
4. When leaving the department, let the last remaining person know.
 ES: 10

CONCLUSION
As with other professions, healthcare workers face certain safety and health hazards. However,
healthcare workers have not only themselves to protect, but also the patients who are depending on
them for care. A culture of safety, therefore, is of paramount importance and a shared responsibility.

In the busy healthcare setting, it is essential that you understand common safety risks and issues, and
how to prevent or manage them. Environmental safety includes accident prevention, the proper use of
compressed gases, electrical and radiation safety, what to do in a crisis such as a bomb threat, and how
to prevent and manage workplace violence.

By following simple safety practices, you can help ensure a more secure environment for all.

REFERENCES:
 Bomb Threat Call Procedures. United States Department of Homeland Security. Available at:
https://emilms.fema.gov/is906/assets/ocso-bomb_threat_samepage-brochure.pdf. Accessed
October 10, 2016.
 Compressed Gas and Equipment. United States Department of Labor, Occupational Safety and
Health Administration. Available at: https://www.osha.gov/SLTC/compressedgasequipment.
Accessed October 6, 2016.
 Compressed Gases Self-Inspection Checklist. The National Institute for Occupational Safety and
Health (NIOSH) Available at: http://www.cdc.gov/niosh/docs/2004-101/chklists/r1n29c~1.htm.
Accessed October 6, 2016.
 Electrical Safety. United States Department of Labor, Occupational Safety and Health
Administration. Available at: https://www.osha.gov/Publications/electrical_safety.html.
Accessed October 10, 2016.
 Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers. United
States Department of Labor, Occupational Safety and Health Administration. Available at:
https://www.osha.gov/Publications/osha3148.pdf. Accessed October 10, 2016.
 H.R.3095 – Safe Medical Devices Act of 1990. Available at: https://www.congress.gov/bill/101st-
congress/house-bill/3095. Accessed October 10, 2016.
 Slip, Trip, and Fall Prevention for Healthcare Workers. Department Of Health And Human
Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety
and Health. Available at: https://www.cdc.gov/niosh/docs/2011-123/pdfs/2011-123.pdf.
Accessed October 6, 2016.
 Solutions: X-Ray Radiation. United States Department of Labor, Occupational Safety and Health
Administration. Available at: https://www.osha.gov/SLTC/semiconductors/solutions/x-ray.html.
Accessed October 10, 2016.

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