Tune up your clinic security and safety for spring
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March 1, 2019
As March gets into full swing, spring will be on everyone’s minds. In some of the southern climes, some of you will be feeling the first effects of the warm season and (rightfully so) will want to enjoy it. In the clinic and the laboratory, however, it’s still important to remember that safety is paramount. Unless you take a good inventory of the safety issues around your facility, the medical clinic or laboratory can actually be a pretty dangerous place when the weather warms up. Here are the things safety experts say you should keep in mind to ensure your facility is safe this spring.
Keep your employees cool—and your chemicals. As the temperature outside rises, it’s important to make sure the temperature inside stays constant, both for personal comfort and for safety.
“You need to make it comfortable for your staff so they will wear PPE,” says Dan Scungio, MT (ASCP), SLS, laboratory safety officer for Sentara Healthcare, a multihospital system in Virginia, and otherwise known as “Dan, the Lab Safety Man.” If you don’t already have a stash in storage, now is the time to buy lightweight lab coats for your staff that are made with materials designed to be cooler, but with the same protective and spill-proof qualities.
Another thing to consider, especially in the healthcare environment, is that many reagents and chemicals need to be kept at a constant temperature and humidity level to maintain their stability and quality, Scungio says. By changing the temperature of the air inside, you risk compromising the safety of those chemicals. Consult manufacturer’s recommendations to determine the proper atmospheric conditions for each chemical.
Work with facility maintenance to maintain temperature. One of the problems in warmer weather is that people try to take temperature control into their own hands. Employees will often bring in fans and dehumidifiers/humidifiers to keep things cool. This is a big problem. Fans can spread airborne bacteria and contaminants throughout the facility. Fans are rarely cleaned on a regular schedule, and the same goes for humidifiers, which are filled with water that is often left standing and can breed bacteria. When it comes to temperature control, most facilities already have industrial air conditioning and humidifiers that work better than anything people can bring in from home.
Watch out for slips and falls. The problem with transitional seasons like spring and fall is their inconsistency. Temperatures might be warm and toasty during the day, melting any snow and ice that may have accumulated during an earlier snowfall. At night, however, temperatures can dip back down into freezing territory, making your entrances and parking lots hazardous.
“When things start melting, we think [we] have everything under control, but in the morning, surfaces will be slippery,” says Marge McFarlane, PhD, CHSP, CHFM, HEM, MEP, CHEP, principal of Superior Performance, LLC, in Eau Claire, Wisconsin.
Remember that in many areas of the country, it’s possible to get snowstorms even in May. For that reason, you should always have a supply of sand and salt nearby, as well as snow shovels so you can keep common areas clear of snow and ice.
Scungio says that in Virginia where he works, there were four snowstorms in only a few weeks that left piles of snow. One day it was 50ºF, the next it was 70ºF, and then at night the temperature dipped below freezing.
“All that snow is refreezing at night, and it definitely needs to be dealt with,” he says. “Pay attention to your surroundings.”
Keep the numbers of your plowing contractors handy in case you need your parking lots cleared overnight. Also, rubber mats in your entranceways are a must for keeping floors slip-free.
Encourage proper footwear. Since this is the season of slippery floors, which can lead to slips, trips, and falls, it’s probably a good idea to talk to your staff about wearing proper footwear. Warmer weather brings with it the temptation to break out the flip-flops, sandals, and open-toed shoes, which have no place in the healthcare workplace.
In addition to opening up toes to hazards from falling equipment and spilled chemicals and body fluids, sandals and flip-flops can make people more likely to trip, and exposed toes can be a sanitary issue. A better choice is a shoe with good traction, such as sneakers that offer comfort while protecting the feet (check out the new Skechers line of shoes with grippy soles, designed just for healthcare workers).
It’s also a good idea to remind your staff and visitors to be careful outside when it’s slippery and on wet floors. Some experts suggest teaching workers to walk “like a penguin,” shifting their body weight from side to side and taking small steps to help prevent falls.
Don’t prop open doors. It’s a nice day and the sun is shining, and the temptation to open the door is understandable. But don’t allow your employees to do it, experts say. In addition to potentially throwing off the facility’s internal temperature and humidity (see above), it’s a security issue.
“Vermin can come in,” says McFarlane. “Do you want four-legged or furry creatures to enter and hide out and startle your patients?”
But animals and bugs aren’t the only things that can come inside. An open door is a breach in your security wall and invites human intruders as well. At night, intruders can hide more easily, so the open door becomes even more of a safety concern.
Even if intruders from the outdoors aren’t a problem, a propped-open door is a break in the barriers designed to keep your facility clean and safe inside, such as in areas of negative pressure. Also, many doors in healthcare facilities are rated as fire doors, and keeping them open can break fire codes.
Lock the doors and protect the front lines. If this isn’t enough reason to keep doors closed, consider your frontline workers: the people in your reception and triage areas. In many ways they are the faces of your organization, the voices on the phone, and the ones who collect money from patients. As a result, they also are the most vulnerable in your office, as any violent incident is likely to manifest itself there and escalate if not promptly addressed. Front desk workers should never be on their own. Not only will they be overwhelmed with work, but also an incident can quickly escalate out of control. If they need to defend themselves, having more than one person puts them in a position of power, and at the very least, someone can run for help.
There should be a way for everyone in the office to know when danger lurks. A panic button, a code word, or a PA announcement system can let people in the back know when things are getting ugly and give them a chance to help or escape.
The front door shouldn’t be the only way out, especially if an armed person is blocking it. Your office should have at least two exits, and most rooms should have two exit routes as well. Workers should be aware of them, and they should be easily identified and clear of obstructions. As well, consider giving front desk workers a barrier. Having an open desk merely gives an intruder an open invitation to jump over it and overwhelm desk staff. A better solution is to install bulletproof glass, deep counters, and a receptionist area with lockable doors.
Cover the perimeters. Many safety experts say that violence against clinics in nicer weather usually starts outside. Someone looking to cause trouble will first stake out the perimeter. Take a good look around the outside and see how inviting it is to a would-be intruder. There should be no dark areas outside your facility where people can lurk in the shadows. Walkways, parking areas, bus stops, and areas near doorways should have plenty of lighting, as should the actual building itself, where shadows of hiding persons can be projected.
Next, invest in some cameras. Closed-circuit video systems have become so affordable that it makes sense to spend some money on a system that can not only record activity around your perimeter, but also broadcast the signals to front desk staff. Lastly, trim your hedges and trees, and remove snow banks.
Overgrown shrubbery in warmer weather and piles of snow in winter make ideal places for someone to hide. Instruct your maintenance department to keep vegetation to a minimum and to remove snow appropriately.
Make sure everyone is drinking water regularly. Those working in the healthcare environment face unique challenges when it comes to water. Unlike other jobs, healthcare employees are discouraged from bringing water bottles into the medical environment because they can pose a sanitation and infection control hazard. And in the busy world of healthcare, finding time to run to water coolers or common areas to drink can be difficult or deprioritized.
The issue is that most people don’t realize they’re dehydrated until they get symptoms, even in cooler, drier weather. Symptoms of mild dehydration include sleepiness, dizziness, and headaches, none of which are ideal in a job that requires a lot of multitasking and high focus.
The Institute of Medicine (IOM) says an adequate daily intake for men is about 13 cups (3 liters) and 9 cups (2.2 liters) for women. Encourage employees to find the time to drink regularly and make sure that there’s an adequate source of water throughout the facility.
Enforce the dress code. The most obvious change seen among workers during the summer months is the clothes they want to wear. While wearing shorter, lighter clothes is understandable on a hot day, these clothes can pose a serious infection control risk.
“You still need the same kind of protective shoes that you always wear at any other time of the year in the lab,” Scungio says. “Capri pants don’t cover your legs, nor do shorts, so that should not be allowed as part of the laboratory dress code. But you can tend to see that in the summertime as well. And [the solution] is strictly management enforcement of the dress code.”
Scungio suggests sending out a reminder to employees that the dress code doesn’t change with the season. He also recommends purchasing lightweight lab coats for the summer months to encourage PPE compliance on hot days.