By: Kelly D. Ogle, BSDH, MIOP, CMPM, CHOP®
Director of OSHA and HIPAA Services
When Donald Trump was elected President of the United States in 2016, the general expectation was a reduction in OSHA rule- making, inspections, and enforcement.
The number of workplace OSHA inspections from January 20—July 20, 2017, was roughly the same as the same time frame in 2016, while Barack Obama was President.
The Severe Violator Enforcement Program, introduced in 2010 under President Obama, is still in effect. As of July 21 of this year, OSHA named twenty-one employers as severe violators, allowing OSHA to conduct follow-up inspections and to inspect other sites owned by the employer. The good news? None were in healthcare!
As expected, rulemaking has slowed. Sixteen regulations have been completely withdrawn, including the Injury and Illness Prevention Program, or I2P2, fulfilling the goal of “reducing the unnecessary regulatory burden on the American people.”
Thirteen proposals are still under consideration, including Lockout/Tagout Update and Tracking of Workplace Injuries and Illnesses. The other regulations on OSHA’s chopping block do not apply to healthcare.
What about the broader infectious disease protection rule that has been under consideration for several years? This would have a significant impact on healthcare workers (HCWs) and their employers, protecting HCWs from droplet, airborne, and contact infections in addition to bloodborne pathogens (of course, there is already a BBP standard).
Worker Infection Control Plan
Should this proposed rule become law, employers will be required to develop and implement a Worker Infection Control Plan specific for the facility. Unlike the Bloodborne Pathogen Standard, which applies to any worksite where exposure to blood and other infectious diseases is possible, this rule would apply only to healthcare. Also unlike the Bloodborne Pathogen Standard, this rule would take into consideration the type of healthcare delivered and the likelihood and frequency of potential exposures. One size does not fit all!
As with most (if not all) of OSHA’s regulations, the development of the control plan begins with an assessment of the workplace, then using the findings to develop standard operating procedures.
- Worksite Assessment
The employer or designated administrator would have to evaluate the likelihood of exposure based on the demographics of the patients served, the type of care provided, the location of the facility, and the responsibilities of the healthcare workers.
- Assignment of Responsibilities
The employer would have to delegate the responsibilities of creating the SOP and updating it annually to a responsible administrator. This could be the employer, the practice manager, or a clinician. Someone would be as-
signed daily management of the SOP. This could be the same individual, but should be someone with a good working relationship with those involved in direct patient care activities—those who are at the greatest risk of exposure.