Transcript OSHA and Veterinary Medicine

OSHA AND VETERINARY
MEDICINE
Office Management
INTRODUCTION
OSHA stands for Occupational Safety and
Health Administration and was founded
in 1970 to ensure employee safety.
 www.osha.gov
 Employer is responsible for providing a
safe working environment for all team
members and will be penalized if they do
not.
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Up to $70,000 per violation
OSHA oversees workplace hazards,
including safe use and disposal of
chemicals.
 Must have MSDS (Material Safety Data
Sheets) sheets on hand for quick
reference.
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WHY DO WE NEED OSHA IN VETERINARY
MEDICINE?
Essential to prevent transmission of zoonotic
disease.
 Safety plans are needed in case of fire or natural
disaster.
 Normal day to day potential hazards should be
addressed.
 Proper protection should be utilized when
handling chemicals, or other dangerous
situations.
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ZOONOTIC DISEASES
Zoonoses- diseases that may be directly or
indirectly transmitted to humans from wild or
domesticated animals.
 More than 1400 diseases are currently known to
be zoonotic.
 60% are caused by pathogens known to cross
species lines.
 Veterinary team members may be held liable if
not properly educating the public and are vital in
the public health role of control of zoonotic
diseases.
 All employees should sign statement that they
have received prevention training.
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DISEASE TRANSMISSION
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Mode of disease transmission is important to
understand when trying to prevent the spread of
a disease.
Reservoir- place where infectious organism survives
and replicates (within animal or soil)
 Host- living organism that offers an environment for
maintenance for the organism but that may not be
required for the organism’s survival.
Depending on disease, organism may be transmitted to
more than one host or reservoir.
Control methods are generally aimed at reservoirs and
hosts.
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TYPE OF TRANSMISSION
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Direct
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Requires close contact between the
reservoir of the disease and the
susceptible host
Indirect
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Intermediaries carry the agent of
disease from one source to another
Vector- living organism that transports
infectious agents
 Ex: fleas, ticks, mosquitos
 Vehicle- mode of transmission of an
infectious agent from the reservoir to the
host.
 Ex: food, water
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CONTROL OF ZOONOTIC DISEASES
Is important as a technician to recognize early
symptoms of zoonotic diseases and know how to
treat.
 Those at risk are immune compromised, the old,
and the young.
 Prevention may be aided by good hygiene,
vaccination, and water filtration.
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ANIMAL HANDLING AND HUSBANDRY
 Animal
related injury
number one injury in a
vet clinics
 Potential of zoonotic
diseases
 Training is a must
with new employees!!
 When bitten, employee
should wash area for
at least 5 minutes and
seek medical attention.
PERSONAL HYGIENE
 Regular
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Hand washing is strongly encouraged
Before eating, drinking
Before smoking
Before leaving
Before and after using restroom
After handling specimens
After handling animals
HOW TO PERFORM A THOROUGH
HAND WASHING
 Wet
both forearms with warm water
 Apply a generous amount of disinfecting soap
in the palm of one hand
 Using a vigorous motion, scrub each side of
the hand, between the fingers and at least
halfway up the arm
 If there is debris under the fingernails, use a
hard pick or stiff brush to remove matierial
while soap is still on the hands
 Rinse both hands thoroughly with warm or
tepid water
 Dry both hands and arms with a towel or air
dryer
SAFETY HAZARDS IN THE VETERINARY
PRACTICE
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Moving Equipment/Lifting
Multiple employees should be involved if over 40 lbs.
 Lift with legs. NOT BACK!
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Wet Floors
Signs should be posted to
indicate a wet floor hazard.
 May need to dry the floor
sometimes
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Running
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Team members should not be
allowed to run through the
practice.
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Toxicities
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Chemicals
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Cleaning supplies
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Should not mix certain chemicals together
Chemotherapy agents
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Radiology chemicals
Sometimes are expelled in urine and feces of pets
Medications
Excess drug powder and residue can collect on the hands
 Repeated ingestion may not be safe
 Washing hands is essential after handling medication
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Radiation
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Must be taken seriously
Excess can cause birth defects, sterility and
even cancer
Must wear proper PPE
OSHA states that employees must provide
and demonstrate proper use of PPE in
veterinary clinics
Collimation also important when it comes to
radiation as well
A dosimeter badge is worn on collar to
measure radiation exposure
Allowed .05 Sv/year as occupationally
exposed (5 rem/year)
Appropriate signs must be posted to
indicate radiology sites
ANESTHETIC GASES
 Practices
are expected to properly store,
label and use chemicals safely.
 Should help to keep employee exposure
under allowed limits.
 Should:
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Have periodic monitoring of equipment and
exposure levels.
Have proper ventilation.
Have proper scavenging systems.
Train staff appropriately.
MASKING AND TANK INDUCTION
 Make
sure masks and tanks have tight-fitting
seals and are connected to scavenging
systems.
 Use proper fitting masks for patients
 Only use masking procedures when medically
indicated
 Remember to turn on oxygen, place mask,
then turn on gas, reverse order to remove
mask.
SIMPLE ANESTHETIC EXPOSURE
BADGES
 Used
to help test
exposure to anesthetic
gases.
 Can be obtained from
several labs.
 Should be worn by a
typical employee on
typical workload day.
 OSHA recommends
testing every 6-12
months.
WASTE ANESTHETIC GAS SCAVENGERS
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Active Scavengers
Fan in a box that creates
vacuum
 Cost from $400-$1000
 Will need maintenance and
replacement
 Manual activation, must be
turned on
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Passive Exhaust
Channels gases through a
tube from patients
diaphragm
 Limited distance
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Adsorption
Charcoal absorption
canisters
 Should be monitored and
changed
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BIOHAZARDS
Sharps containers
 Biological bags
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FORMALIN/FORMALDEHYDE
 Make
sure properly identified and stored.
 Keep least amount on hand as possible.
 Wear Appropriate PPE.
ETHYLENE OXIDE
Form of sterilization procedure.
 Not used as commonly today.
 MUST be used with a ventilation system.
 Link with cancer.
 Fines associated with trying to shortcut the process.
 OSHA requires monitoring to take place. Will use
bade devices to detect exposure levels.
 Detailed written plan also required.
 Make sure to follow manufacturer instructions.
 Make sure to follow proper storage and training
recommendations.
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ETHYLENE OXIDE CONTINUED
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Emergency Plans
If exposed, adequate fresh air is the treatment of
choice.
 If irritation persists, consult physician.
 If in contact with liquid form, removal all
contaminated clothing and wash skin surfaces for 15
minutes.
 If in contact with eyes, use eyewash for at least 15
minutes and consult an ophthalmologist.
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CHEMICALS
 Five
Specific requirements that veterinary
clinic must follow:
1. Practice must have a written chemical plan.
 2. A complete list of all hazardous chemicals
must be maintained.
 3. The practice must maintain a library of
material safety data sheets.
 4. All containers of hazardous chemicals must
be properly labeled.
 5. The practice must train all staff members
on the dangers and safety aspects of the
chemicals.
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BULK CHEMICALS
 If
more than 20
gallons, should consult
with fire department
about storage.
 Should make sure
areas with large
amount of chemicals
are properly identified.
 Should have plans in
place if emergency
occurs for avoiding
areas with bulk
chemicals.
CHEMICAL SAFETY TRAINING
Conduct training as soon after the person is hired
as possible.
 Prepare workbook or handout for training.
 Include worker’s rights.
 Provide hospital policy copies.
 Stress importance of PPE.
 All chemicals must be stored in tightly sealed
containers and be placed below eye level in case
they are spilled.
 If have to store on higher shelves, use step stool
to retrieve.
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DETERMINING CHEMICAL’S HAZARD
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Health Hazard: chemical for which there is evidence that acute
or chronic health effects may occur in exposed employees. Falls
into following categories:
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Carcinogen
Toxic
Irritant
Sensitizer
Any agent which damages the lungs, skin, eyes or mucous
membranes.
Physical Hazard: chemical that is:
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Combustible liquid
Compressed gas
Explosive
Flammable
Organic peroxide
Oxidizer
Pyrophoric
Unstable
Water-reactive
HAZARDOUS CHEMICAL LABELS
All chemicals should be
properly labeled
 Should always label
secondary containers
 No special labels are
required, but should be
uniform throughout
practice.
 If can’t physically label,
use a color code system.
 If is a prescription, no
additional information is
needed than is what is
found on a customary
prescription label.
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DIAMOND LABELING SYSTEM
National Fire Protection Association uses colored
diamond labels to indicate the risks associated
with health, fire, reactivity, and special hazards
of specific chemicals.
 Diamond stickers are placed at entry point of the
practice, along with the room the hazard is
located in.
 Good for any emergency personnel that may be
responding to a situation.
 Also should be placed on chemicals that are
transferred from their original bottle.
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EXEMPTIONS
Hazardous waste- by EPA not OSHA
 Tobacco products
 Wood or wood products
 Articles (what is product of hazardous materials)
 Food, drugs, cosmetics or alcoholic beverages that
are packaged to be sold to consumers and that
are not opened in the hospital.
 Foods, drugs, cosmetics intended for personal
consumption by the employee while in the
workplace.
 Any common cleaner that is is used in way as is
used by average consumer.
 Any drug sold in final solid form to client for
immediate consumption by patient.
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WRITTEN CHEMICAL PLAN
Should be reviewed and revised often.
 Should include hazardous material and what
PPE is recommended for use while using this
chemical.
 Should describe training offered to employees on
a chemical.
 Should outline MSDS system.
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CHEMICAL SPILLS
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Spill kit should be developed and maintained in a
location that is easy to access.
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Should include
Cat litter
 Dustpan
 Broom
 Nitrate gloves
 Eye protection
 Copy of cleanup procedures
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CHEMICAL SPILL CLEANUP PROCEDURES
Remove all unnecessary people and pets from
area to prevent spreading and exposure to
chemical.
 Increase ventilation to area. Open windows and
turn on exhaust fans and vents.
 Put on protective gloves. Put on gown if needed.
 Cover spill with absorbable material, either cat
litter or paper towels.
 Clean up saturated absorbent material.
 Place chemicals in a trash bag and dispose of it
properly.
 Wash hands
 Replace materials used in spill kit.
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MATERIAL SAFETY DATA SHEETS
 Produced
by the
chemical
manufacturer.
 Should be kept
together in one
location.
 Should be indexed in a
systematic way.
 Call distributor or
manufacturer if need a
MSDS.
 Should be current
within 3 years
CONTENTS OF MSDS SHEETS
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Each MSDS sheet should contain:
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The identity of the chemical
Physical and chemical characteristics
Health hazards
Permissible exposure limits
Whether the product is a carcinogen
Emergency first aid procedures
Specific hazards
EYE WASH DEVICES
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Mounted and eyewash bottles.
Mounted stations should not
be on faucet used for bathing
animals because of exposure
to other chemicals.
Device should not be locked.
Hand held bottles are
designed for foreign bodies
and not chemicals.
Employees should be trained
as to location and operation.
Flushing is recommended for
5- 10 minutes, refer to MSDS
sheet.
FOOD AND BEVERAGES
 Consumption
of food
and beverages must be
limited to areas free of
toxic and biologically
harmful substances.
 Staff lunches, drinks,
condiments and snacks
must be stored in an
area free from
biological or chemical
hazards.
ELECTRICITY
Outlets should not be
overloaded with excessive
plugs and extension cords
 Symptoms of electrical
problems include frequent
tripping of circuits and lights
that dim when large pieces of
equipment are used.
 Extension cords should not be
used on a permanent basis
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If used, use with a 3 way
conductor for better protection
and should never be run
through doorways or windows.
EXITS
Should never be blocked
 Use caution where storing supplies
 Signs must indicate where the exit is located.
 If door looks like exit but is not must be marked
as “NOT an EXIT”
 Emergency lights are required and must be
tested on a yearly basis.
 Lights must be installed in locations that lead to
the exits
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AUTOCLAVES
Generate a high amount of heat and steam
 Should be properly ventilated before opening
door.
 Face and hands should be kept away from both
the vent and door when venting and opening the
autoclave.
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LARGE ANIMALS
Never be in chute with
large animal
 Make sure stalls are
locked
 Make sure approach
slowly and use common
sense.
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BATHING, GROOMING AND
INSECTICIDES
Wear appropriate PPE.
 Make sure that wet areas
or dangerous areas are
identified.
 All chemicals should be
stored and labeled
properly.
 Anything changed from
one container to another
should be properly labeled.
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 Compressed
cylinders
air
Should be stored in a dry,
cool place, away from
potential heat sources.
 Must be secured in an
upright position by holder,
bracket, chain or strap.
 Sign should identify
where these cylinders are
kept.
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http://www.youtube.com/watch?
v=ejEJGNLTo84
DRESS
Must dress
appropriately for job.
 No open toed shoes
 Jewelry should be kept
to a minimum
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NOISE HAZARDS
 Generally
the kennel
area.
 If prolonged
exposure, may be
harmful.
 Should be identified
by a sign and ear
protection should be
provided.
 Sound Panels may be
used to help reduce
noise.
ERGONOMICS
Repetitive movements.
 Have computers and office equipment
comfortable and able to prevent injury.
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OSHA REQUIRED TRAINING TOPICS
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Animal handling
Chemicals
Ethylene oxide
Emergency and fire prevention plan
Formaldehyde
Ionizing radiation
Medical services and first aid
Noise exposure
Medical waste and sharps
Personal safety, violence prevention
Portable fire exit
Personal Protective Equipment
Signs and tags
Worker’s Rights and Responsibilities
DEVELOPING SAFETY PROTOCOLS
Should be developed in each practice to ensure
employee safety.
 Must be instituted regarding how employees will
be notified in case of emergency. Where to meet
in case of emergency, and how safety plan will
take effect.
 Role playing may be needed
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IMPLEMENTING SAFETY PLANS AND
PROTOCOLS
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4 steps:
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1. Gather information
Designate a safety officer
 Make sure all registrations are current
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2. Delegation and Preparation
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3. Training
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Hazards can be placed in different sections
Training on the different sections
4. Implementation
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Following previous three sections
DEVELOPING A HOSPITAL SAFETY
MANUAL
Should include an overview of all materials
covered so far.
 Include hazards communication plan, MSDS
filing system, and explanation of secondary
labeling system.
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HAZARD COMMUNICATION: EMPLOYEES RIGHT
TO KNOW
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To establish compliance, a practice must have:
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A designated safety manager. This employee is responsible
for training all team members and ensuring the safety
program meets standard requirements.
A written plan
A summary of all hazardous chemicals available, including
injectable medications, pesticides, antiseptics. Disinfectants,
and laboratory agents.
MSDS’s available at all times. If any chemicals are
transmitted to another container, the new container must
be accurately labeled with descriptions that are transferred
to a spray a bottle to clean exam room tables.
An explanation of the labeling system.
A protocol for emergency evacuation.
A training program implementing the use of PPE and
monitoring devices as well as hazards of the practice.
Required for all practices with 11 or more employees.
STAFF RESPONSIBILITIES
Read the OSHA poster
 Comply with standards
 Follow rules and regulations
 Wear PPE while working
 Report hazardous conditions
 Report any job-related injury or illness to
employer and seek treatment
 Cooperate with OSHA compliance officers
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EMPLOYER’S RESPONSIBILITIES
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Responsibilities
Provide a hazard free workplace
 Set and enforce safety rules
 Provide Personal Protective Equipment (PPE) with
proper instructions
 Provide training on any potential workplace hazards
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EMPLOYER’S RIGHTS
 Rights:
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Enforce workplace rules
Be present during an inspection or
investigation.
Require a warrant for inspection.
Request postponement of inspection.
Expect that no trade secrets will be divulged
Consult an attorney
See any complaints
Have employees interviewed at a time that
does not interfere with staff member’s job
Right to appeal findings
ACCIDENT REPORTING AND
INVESTIGATION
Every accident must be reported to the safety
manager and/or practice manager and owner.
 If medical treatment is needed, appropriate
paperwork should be available for employee to
take to hospital or doctor.
 Paperwork may include First Notice of Accident
or Injury and Illness Accident Report as well as
Workers’ Compensation Insurance Claim form.
 Paperwork should be sent to appropriate
authorities upon employee’s return.
 Documentation of the safety program must exist.
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FIRE PREVENTION
Most common causes of fire
are overloaded electrical
circuits and items stored too
close to heat sources.
 Practices with 10 or more
employees must have a
written OSHA plan that
includes fire prevention and
response.
 Fire codes vary by location
and inspection is conducted
by the fire department.
 Before using fire
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FIRE EXTINGUISHERS
Must be located no more than 75 feet from any
distance within the clinic and placed 32 to48 inches
above the ground surface.
 Should be placed near the exit doors of the practice.
 All employees must be trained in the use of the fire
extinguisher
 PASS
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P= pull the pin
 A= Aim low. Point the extinguisher to the bottom of the
fire
 S= Squeeze the handle
 S= Sweep from side to side at the base of the fire until it
appears to be out.
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FIRE EXTINGUISHERS CONTINUED
Made of carbon dioxide, dry chemicals, halon or water.
Carbon dioxide is most effective on class B and C fires
(liquid and electrical) but is only effective for 3 to 8
feet because carbon dioxide disperses quickly.
Dry chemical fire extinguishers are used for a variety of
fires and contain and extinguishing agent and
compressed gas a propellant.
Halon extinguishers contain a gas that interrupts the
chemical reaction taking place when fuel burns
Water extinguishers are used for combustible (Class A)
fires only,
SMOKE DETECTORS/ FIRE SPRINKLERS
Batteries in smoke detectors should be replaced
on a yearly basis.
 Monthly testing is recommended.
 New buildings are required to have sprinklers
and should be evaluated to ensure they are
working order.
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ESCAPING ANIMALS
Windows should never be left open.
 Doors should never be left open.
 Should use slip leash when removing dogs from
kennels (double leash in opposite directions is
ideal).
 Feral animals should be handled with caution.
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VETERINARY PRACTICE AND THE LAW
Clients that are injured on the premises may be
tempted to sue. Prevention is the key.
 Team members must report any injury and be
aware of all potential hazards in the clinic.
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OSHA INSPECTIONS
Know who is allowed to admit inspectors.
 On-site inspection must be triggered by at least
one of the following:
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Written complaint and OSHA must believe that a safety
or health danger exists.
Complaint must allege that physical harm has occurred
and that hazards still exists.
Must allege imminent danger
Employer failed to provide adequate response to a
compliant
Business has history of failure-to-abate citations during
last 3 years.
Discrimination issues for filing complaints about OSHA
standards
HOW TO SURVIVE INSPECTION
 Be
polite and cooperative
 Verify credentials
 Request that inspection take place at a
more convenient time
 Make time for inspection
 Take notes and pay attention during
inspection
 Have employees “stand-by” during
inspection
 Show officer only what he or she asks to
see
 Have copies of hospital policies readily
available
 Correct any violations immediately
WHAT SHOULD YOU DO?
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Mr. Yazzi, a long term client, has
come into your practice with Taco, his
Pomeranian. Upon walking to the
counter to check out, Mr. Yazzi trips
on the scale, which was recently
moved into the hallway between the
exam rooms. He is able to catch
himself but twists his back, sending it
into muscle spasms. He states he is
fine and it was his fault for not
looking down. You offer him a chair
to sit down and rest and let his back
relax but he refuses and pays his bill
and leaves practice.