Complete guide to laboratory safety terry jo gile

Annotated Bio

L A B M A N A G E M E N T

Laboratory training: Safety at any age By Terry Jo Giie, MT(ASCP), MA Ed

I t has often been said there are three kinds of people in thisworld: those who make things happen, those who watchthings happen, and those who say, "Wiiat happened?" All too often when it comes to laboratory safety, "W'Tiat hap- pened?" is tbe coiTinion scenario. To avoid this situation, on- going safety training is ;i must. No successful safet}' program is complete without it.

Safet\' training comes in different versions: orientation, which is done within the first 10 days of employment or wben a new safety issue is introduced into the workplace, and man- dator\' training, which is done to meetaecreditation and regu- latory requirements. The Lah Safety Officer should review accident and injury reports and the OSI IA 300 log at least quarterly to determine how effective training has been, and to identif}' areas where additional training may he needed. Table I outlines safety training and who needs to attend.

Tbe most obvious criterion for effectiveness is on-tbe- job results. If a safety-training program is effective, labora- tory employees have few or no injuries due to unsafe acts. It is also helpful to verify all employees' knowledge of required safet}' procedures at least annually, using a form like the one shown in Form A.

After stafF members have eompleted a knowledge eheck- list, ask the supervisors of each lab section to provide feed- hack on any areas where staff members appeared to have tnjuble in answering questions or indicated they did not al-

Table 1.

Topic All laboratory safety policies and procedures

[ Fire extinguisher practice

I Spill cleanup

* Fire prevention and preparedness

' Fire drill evacuation

' Chemical safety

1 Biological hazards '• Infection control

i Radiation safety

I Ergonomics symptom survey

1 Specimen packaging i and shipping procedures

Who needs to be trained Ail lab staff

All lab staff

All technical staff

All lab staff

All lab staff

All staff who handle or transport chemicals

All lab staff

All lab staff

Only employees that use or transport radioactive materials

All tab staff

Staff that packages specimens for shipping by ground or air

How often Upon employment J Upon 1 employment

Upon employment

Annually

Annually

Annually

Annually

Annually

Annually

As needed

Every 24 months

A d a p t e d f rom t h e Cumph-re Guide lo l.ahiiriiUiry Safety hy T e r r y J o ( l i l c ,

IlCPm, iiiL-. Marbkhcaii, MA; 2004'

ways comply. This input may suggest the need to schedule training in certain areas.

Safety training also occurs when updating staff as regula- tory requirements change. A good place to find out about changes that may require additional training are on regula- tory websites, sueh as OSHA (f); in professional journals; and at meetings of professional associations serving lab profes- sionals, such as the Clinical Laboratory Management Asso- ciation or the Aineriean Society for Clinical Laboratory Sci- ence. New or amended regulations sometimes speeify a deadline by whieh training on the changes must be conducted to bring labs into compliance. Therefore, watch for chang- ing content in the rules, and he sure to check for any training deadlines tbat may be imposed.

Establish an annual schedule

Beeause safet}' training is so important, and beeause there is so much ground to cover, it is helpful to lay out a full sched- ule for the year. Bloek out an annual schedule that ineludes detailed sessions where special needs have been identified and awareness/reminder sessions to keep key aspeets of lab safety in the front of all staff members' minds.

Public healtb associations, such as the Nati(jnal Safety C^ouncil, often run national safety awareness camjiaigns that ean be leveraged to make training more effective. Tbe following arc some suggestions:

January - Specimen transport February - Personal protective equipment (PPF.) March - Hoods/F.nvironincntal April - C-hemical hygiene May - Bloodhorne pathogens June - General safety- July - C^ompressed gases August - Safe work ]>ractices September - Ergonomics October - Fire safety Novetnber - Electrical safety December - Waste managL'iiient Inspection or audit deadlines from accrediting agen-

cies, such as the College of American Pathologists or the Joint Commission on Accreditation of Health Organiza- tions, nuiy iilso influence the training schedule.

Designing a training program

When tiesigning any training session or program, what will be covered anil who will he trained needs to be deter- mined. 'Fhis information will guide decisions about what delivery formats may work best and what level of detail sessions should provide.

Create an outline of what will be covered. Factual infor-

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L A B S A F E T Y

niation may include: • An overview ofthe regulation. W^o is covered? What

arc the main requirements? Is the regulation effective now {or when will it take effect): What are the penalties or otber risks from noncompliance?

• Potential bealtb bazards. Summarize tbe dangerous prop- erties of chemicals or equipment, t\'pes of potential inju- ries, routes of entry or infection, and so on.

• Engineering controls. W'bat safet\' equipment or physi- cal safeguards does tbe lab have in placer What must em- ployees do to take full advantage ofthe safeguards?

• Safe work practices. What are the lab's standard operat- ing procedures to minimize risk?

• Persotiiil protective equipment. In addition to the stan- dard lab coat, what other PPE items, sucb as eye protec- tion, respirators, and special gloves, must be used for tbe specific task(s) covered in the training?

• Handling accidents and recovery. Who cleans up the spill? U-Tiat emergency medical treatment is available?

The role of age in learning

Labs may have employees ranging in age fi-om 18 to 70 or more. All employee's age can play an important role in what metliod

of training is successful. For example: Employees over the age of 70 have a wealth of knowledge but are slow to change and prefer to have a live speaker give the infonnation in a small group, as opposed to working with a computer or otber technolog)': • Tbe Swing Generation, ages 56-69, works well under

deadlines but needs additional time to adjust to any changes required. Training for tbis group is best done with an in- person speaker or using a video.

• Baby Boomers, ages 36-55, are usually computer literate and prefer tbeir training via video or online. They like hands-on learning as well. They value continuing educa- tion and like to attend seminars and conventions.

• Gen Xers, ages 24-35, are very computer savv'y and ex- pect training to be fun. Online training at an interesting site will keep them engaged. Understanding the content is an important Hrst step, but

staff members need to take that content seriously and apply it fully in their day-to-day efforts. All employees, regardless of age, listen to radio station "WlIFxM" ("What's In It For Me?"), so make sure presentations include reasons wby the training will benefit them.

Specific learning objectives spell out wbat employees should be able to do after completing the training, and define what

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constitutes acceptahle performance or competence. Benjamin Bloom's classic text, Taxonoirty of Educational Objectives: The Cliimfication nf Editcutional Goah;^ provides an excellent frame- work tor developing learning olijectives for training. Each of the cognitive levels Bloom descrihes huilds on previous levels, to ensure that the employee understands the content. Bloom's cognitive levels, from lowest to highest, are: • Knowledge: Terminology; specific facts; ways and means of

dealing with specific criteria or methods. Kjiowledge en- ables the employee to remcmlter the safety requirements ot each tiisk and relate them to previously learned infonnation.

• Comprehension: Understanding the meaning of infor- mation so that the learner is able to perform a task that depends on it, such as using PPE or ergonomic equip- ment as instructed.

• Application: The use of previously learned information in new concrete situations to solve problems that have single or best ;mswers.

• Analysis: Breaking down information into its component parts, trying to develop new conclusions by finding evi- dence to support them.

• Synthesis: Creatively or divergently applying prior kjiowiedge and skills to produce something new. Most iearning objectives that involve synthesis are prepared for management-level personnel.

• Evaluation: }uL\ii;cs the value of material based on per- sonal values/opinions, resulting in an end product witb a defined purpose, but which might not have a "right" or "wrong" answer. Evaluative learning objectives are used mostly for management-level personnel. Bloom mentions two other cognitive domains tbat are also

important in designing training: • Psychomotor: Deals witb motor skills. Laboratory work

is ver\' tactile; successtijl lab workers have higbly devel- oped motor skills and usually do well with tbe psycbo- motor requirements. Use "bands-on" teaching and prac- tice metbods for tbe psychomotor domain.

• Affective: Deals with attitudes, feelings, and emotions. It is more difficult to write clear and meaningful ;iffec- tive learning objectives tban any otber type of objective. Affective objectives are motivational ratber than knowl- edge- or analysis-based. Build these objectives on clear reasons why the bebavior is good for other employees or the organization as a whole.

Other training considerations

VVTiile age and knowledge level ot" the audience are impor- tant considerations in cboosing tbe best format for deliver- ing a particuhu- type of training, cost is anotber concern. Con- fer witb management on budget questions, particularly wben considering engaging an outside trainer or purchasing safety training products. Options include live presentations to small or large groups, audiotapes, videotapes, print- or computer- based self-study, or online courses. We 11-designed games can also be effective in teacbing some skills or in reminding staff to remain compliant witb procedures tbey already know.

Day-to-day observation by management and tbe Labora- tory Safety Ofiicer can find breaches of safety before they be-

Purpose: Sjfcij in our hhonlTHm is uf prime impnmncc. A reiie" trfafcty policies uid ynxc- ilures SB i>ur siaff helps ensure that safe pnctices are il»i>-i ftJIiwcd.

InMnKtioos: Keiiev m h appbcabk iieni cm the bllouin^ Ibt »ith a>ch empknte « the rime of inltiil hire, and innually thereafter. ITie supeniswr ami ihe emplo^-ee musi sign "nil JiK the iVinn when OHnpleteil. lo tlociuntnt the safcw reiie* fric the cinplcn-ce's fik,

Piinnnl this liinn ni I j b .-yminuandan when compkod.

G m c n l Safely; LJ State the kjiam and descrihe the US'? ofthe safetj U Uianf.nstrate the cipciad'in of the e\T!«ash Q Deinunstrate the iiperatHin »f the itiedunical |Hpcttcs Q State the lucatmn ni the circuit lirealiers • Destnlie the |iniceilure useii in the cstnt iif

dectricil shiicL in|iin • State the location of crunprr.sed gas nlinilers and desaihe pracedures for ttwlT UM • State the Icication far stiirajie nf wheeled cans U Wheie is your own hnhh reciinl kitated. and do ynu have a right tii review it at any tune?

Rn: Safety: O State tht li>ratii)n of fire eitinBuishcrs and iteiiKHisirjte or descrihe theit use d Sute the lotatHin ol the fire liinket and demonstrate or deacnlie its use [J State the localion of the lire alartn timeN • lilentih posted tianuliim rtMiti.-. from the labiirattwi' G Srate the Uionon of the tria^ area where staff is to repon bllowin); an n-jcuatiiin

l>escril)f pnncdures to follow in the event of a fire \y\ai doe^ the acnmym RACE stand for- What doer, the aoimyni PASS slaml liir- Uave >i)u participateil in a fire dnil in this ficilily?

U

S- Terry Jo Gile. HCPro, Inc. Marblehead, ^\.\, 2004, pp. 243-245.

Cbcmical Safet)-: • Locate the MSDS (""jL and ImA up a hmnVms chemical Hith w+iich you wott a State the primari- rouie of entn fat this chemical a EHscuis the ^-niptoms of riveicipiBure a lilcntih- the pii)tecti« equipment and lentilatiiMi that is required Q I^K-ate the iinitecnve equipment in vour work area • IJescrihf the special pn-cauiicms needed if the chcmital is a carcinogen CJ State the emcntiniy first aid jiriitedutes fiH the. chemical Q Describe llie appropriaie S|H1I ilejiiup f(ir this chemical • Slate the liK-ation of the Chemical Hypene Plan (J Uest-ribe the iinUix.-ol liir environmental miinminnf!, if any Q State the location of the chemiral spill Lit and ILS jHTipcr use Q Descnhehow to clean up a chemical spill lan;er thaniiiK (1) ^llon [J Describe hoa- to dean up a chemical spill of otie (I) pint or lesi.

Bbiodbonic Pathogen Safety: LJ State the iocatiĉ Hi cif the lahs ciipy of the Blondliorne fathoeen Standard • State the l.«,aticini.f the !ab^FjipiRure(Jaitnil Plan U State the IcKation of the labs Intection Cjintrol Wanual

Stale the percentage nsl of infectioti mth I lepatitis B from exposure to hlond and hod>* Ihiids IJescrihe how effective the Hepatitis B vaccine is Lin lour (4) nimles of transmission for l^l\' Point iHit a Iiii)ha7ard stmbol Sate ihe difference betu-ern infectious waste and regular trash Idcntili pniper containers for infectious waste and regular trash State the prosier method for reportinj; cipifture to IJood and boiK fluids Have vou done the ftilUming; Renewed the hloixlliome pathogen training material? 11 Ves 11 No Been vaccinated f.ir llepantis B'- | j Yes j | No Roienfd the risLassdoateil with Uep t i t i sO | j Yes | j No

vc Equipment: • Descrihe the location

o \Vear a long-sleeved lab coat. b i « length, buttoned or snapped dosed at all nmes;

o Not wear the lah Liiat in puhlic areas? o Change the lab coat when ™hh' soiled? o Place ihe yiiied lah ciut in the laundry container: o Wear i plastic apron if die lab coat cannoi lie buttotted

or snapped- o Use a ]dastic apron at m higb

splash/stain areas; o Wear gloies when periomiing lah tasks in the area? o \\ear gloves that are the mrrect sire? o Wear pcopei facial protection when necessar;-; o Wear shoes amt soda/hose at all times in ihe lab: o Wear shoes, not sandals, ihal adequately cover your feet.

hate no perforations and are not made of canvas?

For liirther explanation of any of rfie above items, please ciinsult ibe Ijhoratory Safet\- Manual or yiiur imiiieiliate supenisor.

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L A B S A F E T Y

come troublesome. Monitor adherence to recommended pro- tective measures regularly. When monitoring reveals a failure to follow recommended precautions, provide counseling and retraining, and consider appropriate disciplinary action, i? nec- essary. Make safety training a key part of any quality improve- ment (QI) initiative at the facility, and design future training to support QI initiatives.

Management should aiso measure training effectiveness by requesting employee feedback after each session. It is extremely shortsighted to say, "If they didn't fall asleep, it must have heen effective." Use an evaluation ques- tionnaire or an informal discussion. Ask whether learning objectives were stated clearly. Did the learning activity simulate the actual task? Did the employees par- ticipate in tbe program? Even if a pro- gram was well received in previous years, never assume — without asking — that it worked justaswell wben presented again.

Post-course assessments also measure training effectiveness by quantifying how well each employee retained and under- stood tbe information. Some states and accreditation organizations require post- training quizzes to document retention and comprebension. Tests can he oral, written, or ohserved. In all cases, retain the results in writing in the employee's personnel record or in a central location within tbe facility. Written learning ob- jectives determine tbe best format tor post-training assessment and tbe right questions to ask. For example, if after completing training the employee should he able to use a fire extinguisher, the as- sessment would require the employee to describe or demonstrate tbat task. If the employee needs to know five steps in the correct order for conducting a particular safety task, a written assessment could simply ask employees to number the steps. An observed, hands-on assessment would require the employee to perform the task with a supervisor watching.

Document, document, document. Regulator)' agencies all agree, if it is not documented in u riting, it did not occur. Document wbat was done, wbo partici- pated, and what the results were. Being ahle to prove that proper and timely training was provided may be an inipor- tLint defense against legal liability after an adverse incident and keep any labo- ratory professional from saying, "V\'bat bajipened?" LJ

w w w . m l o - o n l i n e . c o m

Terry Jo Gile, MTIASCPl, MA Ed, The Safety Lady, is a consultant, speaker, and author of the Complete Guide lo Laboratory Safety published in 2004 by HCPro Inc. Gile can be reached through her website www.safetyiady.com. For a free copy of the Lab Safety Advisor e-zine, go to: www.hcmarkBtplace.com /prod.cfm ?id=3506&s=EE36862A.

References

1, Bloom B. Taxonomy of Educational Objectives: The Classification of Educational Goals. United Kingdom: Longman GrQup;1969.

2. Gile TJ. Complete Guide to Laboratory Safety. Marblehead. MA: HCPro, Inc; 2004.

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