Aim: This Hospital Safety Manual contains  information, policy statements, guides, and safety preventions procedures. It includes Industrial Hygiene,Examples of Job Hazards,Responsibility of management in safety program,Hazard Communication ,Disaster Planing, Risk Management, Special Safety measures for patients.

Rationale: The Hospital Safety Manual addresses ways to meet safety standards.

Personnel responsible :Director, Risk/Operations manager, HR executive,Biomedical Engineer, Security incharge.

Industrial Hygiene – Industrial hygiene is the science of anticipating, recognizing, evaluating, and controlling workplace conditions that may cause workers’ injury or illness. Industrial hygienists use environmental monitoring and analytical methods to detect the extent of worker exposure and employ engineering, work practice controls, and other methods to control potential health hazards.

Recognize and control hazards
Industrial hygienists recognize that engineering, work practice, and administrative controls are the primary means of reducing employee exposure to occupational hazards. Engineering controls minimize employee exposure by either reducing or removing the hazard at the source or isolating the worker from the hazards.

1.Biomedical engineering control
Enclosing work processes or confining work operations,  installing general and local ventilation systems and periodic maintenance of equipments.

2.Work practice control

  1.  following proper procedures that minimize exposures while operating production and control equipment;
  2. inspecting and maintaining process and control equipment on a regular basis;
  3. implementing good house-keeping procedures;
  4. providing good supervision and
  5. mandating that eating, drinking, smoking, chewing tobacco or gum, and applying cosmetics in regulated areas be prohibited.

3. Administrative control

When effective work practices and/or engineering controls are not feasible to achieve the permissible exposure limit, or while such controls are being instituted, and in emergencies, appropriate respiratory equipment must be used. In addition, personal protective equipment such as gloves, safety goggles, helmets, safety shoes, and protective clothing may also be required. To be effective, personal protective equipment must be individually selected, properly fitted and periodically refitted; conscientiously and properly worn; regularly maintained; and replaced as necessary.

Examples of Job Hazards
 1. Chemical Hazards-Substances used in laboratory
Harmful chemical compounds in the form of solids, liquids, gases, mists, dusts, fumes, and vapors exert toxic effects by inhalation (breathing), absorption (through direct contact with the skin), or ingestion (eating or drinking). Airborne chemical hazards exist as concentrations of mists, vapors, gases, fumes, or solids. Some are toxic through inhalation and some of them irritate the skin on contact.

2.  Biological Hazards
hese include bacteria, viruses, fungi, and other living organisms that can cause acute and chronic infections by entering the body either directly or through breaks in the skin. Laboratory and medical personnel also can be exposed to biological hazards. Any occupations that result in contact with bodily fluids pose a risk to workers from biological hazards.
Prevention–

  1. effective personal hygiene, particularly proper attention to minor cuts and scratches, especially those on the hands and forearms, helps keep worker risks to a minimum.
  2. Staff should practice proper personal hygiene, particularly hand washing. Hospitals should provide proper ventilation, proper personal protective equipment such as gloves and respirators, adequate infectious waste disposal systems, and appropriate controls including isolation in instances of particularly contagious diseases such as tuberculosis.

3. Physical Hazards

It includes radiation, noise, vibration, illumination, and temperature.
In occupations where there is exposure to ionizing radiation, time, distance, and shielding are important tools in ensuring worker safety. Danger from radiation increases with the amount of time one is exposed to it; hence, the shorter the time of exposure the smaller the radiation danger.
Prevention—
Distance also is a valuable tool in controlling exposure to both ionizing and non-ionizing radiation. Radiation levels from some sources can be estimated by comparing the squares of the distances between the worker and the source. For example, at a reference point of 10 feet from a source, the radiation is 1/100 of the intensity at 1 foot from the source.

Shielding also is a way to protect against radiation. The greater the protective mass between a radioactive source and the worker, the lower the radiation exposure.Lead aprons are provided to the X ray technicians for safety.

Badges for technician-Radiation safety badges are provided to our xray technicians for monitoring of radiation.

Ergonomic Hazards
lifting, holding, pushing, walking, and reaching.Any of those conditions can cause ergonomic hazards such as excessive vibration and noise, eye strain, repetitive motion, and heavy lifting problems. Improperly designed tools or work areas also can be ergonomic hazards.

Prevention— (e.g., designing or re-designing work stations, lighting, tools, and equipment); teaching correct work practices (e.g., proper lifting methods); employing proper administrative controls (e.g., shifting workers among several different tasks, reducing production demand, and increasing rest breaks); and, if neces- sary, providing and mandating personal protective equipment. Evaluating working conditions from an ergonomics standpoint involves looking at the total physiological and psychological demands of the job on the worker.
Responsibility of management in safety program

  • management commitment and employee involvement,
  • worksite analysis,
  • hazard prevention and control,
  • safety and health training.

Hazard Communication – The purpose of this section is to ensure that the hazards of all chemicals produced or imported are evaluated, and that information concerning their hazards is transmitted to employers and employees. This transmittal of information is accomplished by means of comprehensive hazard communication programs, which  includes container labeling and other forms of warning, material safety data sheets and employee training.

  1. List of hazardous Materials-
    Alcohol (Spirit, Ether )
    Acid-Hypo-chloride solution
    Disinfectants
    Cleaning agents
  2. Container labeling-All the drugs, spirit, solutions, cleaning agents, are labelled and kept at appropriate place.
  3. warning-Warning labels/symbols are put to warn about hazardious material.

Material safety data sheets-it is intended to provide workers and emergency personnel with procedures for handling or working with that substance in a safe manner, and includes information such as physical data storage, disposal, protective equipment, and spill-handling procedures,

Employee training-The induction program which is organized for the new employees , consists of all the hazard communication procedures.

Hazardous Waste – Hazardous waste is generated at hospital is blood spill, human infected parts, infected waste generated from ward, OT etc.

Prevention—Biomedical waste management rules are followed to prevent hazards from biomedical waste.

Disaster Planing  – Disaster and fire exit plan

Risk Management – Risk management as it applies to medical equipment and its safe use. Risk management committee is formed to address the risks in the hospital. The committee analyse the risks,incidences in the hospital and implement safe practices.
Ref—Incidence reporting form

Special Safety measures for patients- For the safety of patients and their relatives hospital follows the following safety measures.

  • Safety belts and Railings for beds and wheelchairs.
  • Special attention  to disables and elderly patients.
  • Call bells in private rooms.
  • Universal precautions in HIV positive and communicable disease patient.
  • Safe transportation of patient by following safe techniques.
  • Caution signs/boards at various places.
  • Patient education for their safety.

Policies and procedure

  • Laboratory safety program
  • Disaster planning
  • Policy for risk management
  • Employee safety