Hazards and Solutions

The information below provides a list of the most prevalent hazards in this industry and possible solutions for hazards associated with working in nursing homes and personal care facilities.

• Musculoskeletal Disorders: Safe Patient Handling
• Bloodborne Pathogens/Needlesticks
• Tuberculosis
• Workplace Violence
• Slips, Trips, and Falls
• Methicillin-Resistant Staphylococcus aureus (MRSA)
• Chemicals/Hazardous Drugs

Where can I find help evaluating my workplace to identify hazards?

• Compliance Assistance Quick Start. OSHA. By following this step-by-step guide, you can identify many of the major OSHA requirements and guidance materials that may apply to your workplace. Small and new businesses may find Quick Start helpful as an introduction to the compliance assistance resources on OSHA's website.
• Health Care Industry. This module applies to employers and employees in the health care field.
  
  
• Anatomy of a Nursing Home with Potential Hazards. OSHA. Shows a typical nursing home floor plan with potential hazards identified.
  
  
• Nursing Home. OSHA eTool. Offers a graphical menu to identify hazards and controls in the nursing home industry.
  
  
• Beyond Getting Started: A resource guide for Implementing a Safe Patient Handling Program in the Acute Care Setting [641 KB PDF^*, 34 pages]. OSHA and the Association of Occupational Health Professionals in Healthcare (AOHP) Alliance, (Revised 2011).

Musculoskeletal Disorders The following provide guidelines to help you identify areas in your workplaces where musculoskeletal disorders (MSDs) may be a concern. It also offers recommendations for developing procedures to reduce the risks.

• Ergonomics: Guidelines for Nursing Homes. OSHA Safety and Health Topics Page.
• Guidelines for Nursing Homes: Ergonomics for the Prevention of Musculoskeletal Disorders. OSHA 3182-3R, (2003, Revised March 2009). Also available as a 2 MB PDF, 44 pages. Provides guidelines that identify and provide recommendations for nursing home employers to help reduce the number and severity of work-related MSDs in their facilities.
• Nursing Home Guidelines Frequently Asked Questions (FAQs). OSHA.
• Ergonomics Guidelines for Nursing Homes Webcast. OSHA.
  
  
• Hospital. OSHA eTool. Provides modules that assist healthcare workers to recognize hazards associated with musculoskeletal disorders (MSDs).
• Whirlpool/Shower Module
• Healthcare Wide Hazards Module - Ergonomics
  
  
• A Back Injury Prevention Guide for Health Care Providers [2 MB PDF, 47 pages]. Cal/OSHA. Provides general guidelines designed to help prevent staff injury from lifting or moving patients.
  
  
• Caring for Caregivers [7 MB PDF^*, 52 pages]. Job Safety & Health Quarterly (JSHQ), (2002). Outlines ways to teach workers how to protect themselves on the job.
  
  
• For additional information, see OSHA's Ergonomics Safety and Health Topics Page.

Bloodborne Pathogens/Needlesticks The following provide information to help you identify areas in your workplace where needlesticks and Bloodborne pathogens hazards may be a concern. Also, links to tools you can use to come into compliance with the OSHA requirements are included below.

• Hospital. OSHA eTool.
  • Healthcare Wide Hazards Module. Assists healthcare workers to recognize hazards associated with bloodborne pathogens.
    • Needlesticks/Sharps Injuries
    • (Lack of) Universal Precautions
    • Bloodborne Pathogens
      
• Revision to OSHA's Bloodborne Pathogens Standard - Technical Background and Summary. OSHA, (2001, April). Includes revised information regarding the identification, evaluation, and selection of effective engineering controls, including safer medical devices.
  
  
• OSHA's Revised Bloodborne Pathogens Standard. OSHA Slide Presentation, (2001), 34 slides. Provides a PowerPoint presentation on the revised Bloodborne Pathogens Standard.
  


• Frequently Asked Questions. OSHA. Provides some commonly asked questions and answers regarding needlestick hazards and prevention.
  
  
• Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis [334 KB PDF, 67 pages]. Centers for Disease Control and Prevention (CDC), Morbidity and Mortality Weekly Report (MMWR) 50(RR-11), (2001, June 29). Guidelines for management of occupational exposures to the hepatitis B virus (HBV), the hepatitis C virus (HCV), and the human immunodeficiency virus (HIV), and recommendations for post-exposure prophylaxis.
  
  
• What Every Worker Should Know: How to Protect Yourself From Needlestick Injuries. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 2000-135, (1997, July).
  
  
• For additional information, see OSHA's Bloodborne Pathogens and Needlestick Prevention Safety and Health Topic Page.

Tuberculosis (TB) The following provide guidelines to help you evaluate your workplace for exposure to tuberculosis and recommendations for developing procedures to reduce the risks.

• Prevention and Control of Tuberculosis in Facilities Providing Long-Term Care to the Elderly Recommendations of the Advisory Committee for Elimination of Tuberculosis. Centers for Disease Control and Prevention (CDC), Morbidity and Mortality Weekly Report (MMWR) 39(RR-10);7-20, (1990, July 13). Although this article is dated, it does provide some general information on tuberculosis and the elderly.
  
  
• Hospital. OSHA eTool.
• Healthcare Wide Hazards Module
• Tuberculosis. Assists healthcare workers to recognize hazards associated with tuberculosis.
  
  
• For additional information, see OSHA's Tuberculosis Safety and Health Topics Page.

Workplace Violence

• Guidelines for Preventing Workplace Violence for Health Care & Social Service Workers. OSHA Publication 3148-01R, (2004). Also available as a 624 KB PDF, 47 pages. Discusses OSHA's workplace violence policies and programs.
  
  
• Hospital. OSHA eTool.
• Healthcare Wide Hazards Module
• Workplace Violence. Assists healthcare workers to recognize hazards associated with workplace violence.
• For additional information, see OSHA's Workplace Violence Safety and Health Topics Page.

Slips, Trips and Falls The following provide tools to help in your evaluation of slip, trip and fall hazards in your workplace and guidance on preventing falls in nursing homes.

• Hospital. OSHA eTool.
• Healthcare Wide Hazards Module
• Slips/Trips/Falls. Assists healthcare workers to recognize hazards associated with musculoskeletal disorders.
  
  
• Falls in Nursing Homes. Centers for Disease Control and Prevention (CDC). Provides information to help prevent falls in nursing homes.

Methicillin-resistant Staphylococcus aureus (MRSA) MRSA infections occur most frequently among persons in hospitals and other healthcare facilities (such as nursing homes and dialysis centers) who have weakened immune systems.

• Hospital. OSHA eTool.
  • Multidrug Resistant Organisms Module
    • General Information. Question and answer tool to help employers and employees identify MRSA infections and assists in treatment options.

Chemicals/Hazardous Drugs The following provide tools to help in your evaluation of chemical hazards in your workplace and offer links to recommended solutions.

• Hospital. OSHA eTool.
• Dietary Module. Assists in identifying possible solutions for exposures to disinfectants and other chemicals found in the dietary department.
• Laundry Module. Assists in identifying possible solutions for exposures to disinfectants and other chemicals found in the laundry department.
• Engineering (Maintenance) Module. Assists in identifying possible solutions for exposures to disinfectants and other chemicals found in the maintenance department.
• Pharmacy Module. Assists in recognizing hazards associated with hazardous drugs.

• Hazard Communication. Implement a written program which meets the requirements of the Hazard Communication Standard to provide for worker training, warning labels, and access to Material Safety Data Sheets (MSDS).
  
  
• OSHA Technical Manual (OTM). TED 01-00-015 [TED 1-0.15A], (1999, January 20).
• Controlling Occupational Exposure to Hazardous Drugs
• Appendix VI:2-1. Some Common Drugs Considered Hazardous
• Appendix VI:2-2. Some Aerosolized Drugs.
  
  
• For additional information, see OSHA's Hazardous Drugs Safety and Health Topics Page.

Accessibility Assistance: Contact the OSHA Directorate of Technical Support and Emergency Management at (202) 693-2300 for assistance accessing PDF materials.

^*These files are provided for downloading.