A US Department of Labor Occupational Safety and Health Administration (OSHA) investigation has found that in early 2021, a New Jersey medical facility and temporary staffing agency failed to ensure the safety and health of nurses giving flu shots and testing potentially infectious patients for the coronavirus.
OSHA’s investigation, which was initiated in January in response to a complaint, found that the medical facility did not provide medical evaluations to determine each employee’s ability to use a respirator before they required workers to use them, and failed to fit-test employees required to wear respirators. OSHA proposed $273,064 in citations for two willful violations. In 2020, OSHA cited the medical facility for similar hazards after the company failed to protect staff providing medical and dental care from the coronavirus.
Additionally, investigators also found the temporary staffing agency contracted by the medical facility failed to ensure medical evaluations were done and did not provide fit-tests for workers required to use respirators. OSHA cited the staffing agency for two serious citations, with $13,653 in proposed penalties.
In October 2020, the medical facility contracted with the temporary staffing agency to provide nurses to assist staff with the administration of flu vaccines initially. After the assignment began, the medical facility required nurses to administer 200 to 300 coronavirus tests each day for patients and the public.
The employers have 15 business days from receipt of their citations and penalties to comply, request an informal conference with OSHA’s area director, or contest the findings before the independent Occupational Safety and Health Review Commission.
On March 12, 2021, OSHA launched a national emphasis program, focusing enforcement efforts on companies that put the largest number of workers at serious risk of contracting the coronavirus. The program also prioritizes employers who retaliate against workers for complaints about unsafe or unhealthy conditions, or for exercising other rights protected by federal law. That national emphasis program page can be accessed here.
On June 10, 2021, OSHA issued an Emergency Temporary Standard (ETS) to protect healthcare workers from contracting coronavirus. The ETS information page can be accessed here.
OSHA’s additional guidance can be accessed here.
Compliance Perspective
Issue
Employers are obligated to comply with OSHA guidelines and standards, and to ensure that all healthcare staff work in a safe environment. Failure by a facility to follow OSHA guidelines and regulations may result in citations and financial and other penalties. Every employee that is required to wear a respirator while providing care or services must have a medical evaluation completed and a fit-test to ensure proper fit of the respirator for the employee. Leaders of the facility must be knowledgeable of the requirements for medical evaluation and fit-testing for respirators prior to assigning their use.
Discussion Points
- Review your policy and procedures for the use of medical respirators in your facility. Ensure that a medical evaluation and fit testing for medical respirators are incorporated into your policies.
- Train staff, including staff who will be responsible for fit-testing and ensuring medical evaluation is completed before the use of medical respirators, on your policy and procedures for the use of medical respirators and other PPE. Document that these trainings occurred and file each signed document in the employee’s individual education file.
- Periodically audit employee files for those who have been assigned to use medical respirators to ensure that a medical evaluation was completed, and that fit testing was performed prior to the use of a medical respirator.
