Staff Health and Safety

Introduction and General Safety Guidelines

We value the health and safety of our staff and the people we serve and strive to maintain a healthy and safe work environment by:

1. effectively identifying and reducing or eliminating occupational hazards wherever possible;
2. establishing basic safety rules and guidelines for the Accend Services work environment;
3. providing training to all staff members in work safety;
4. fully documenting, reviewing and analyzing workplace injuries or accidents when they occur to prevent future occurrences; and
5. maintaining an atmosphere of open and honest communication with all staff members to facilitate problem-solving regarding workplace safety issues.

Injuries to staff have been historically very rare at Accend. The top causes of injuries to employees or persons served that have required medical attention or caused lost work time are 1) slips, trips and falls; and 2) traffic accidents. You can best ensure safety for you, your coworkers and the people you serve by remaining self and situationally-aware at all times, identifying potentially unsafe situations or activities.

Follow these general guidelines for safety:

General

• Make safety a number one priority at all times, remain alert and aware of potentially dangerous conditions;.
• Report hazardous conditions immediately to your supervisor;.
• Report injuries, regardless of how minor, and all dangerous conditions immediately to your supervisor.

Travel

• Plan routes ahead of time to unfamiliar locations.
• While driving, follow all traffic laws, drive only, do not read or write.
• Mobile phone use while driving is illegal unless you have a bluetooth-enabled audio system in your car. Keep in mind that even hands-free calls while driving is associated with a higher accident risk. Limit the duration of bluetooth calls to a few minutes or let voicemail answer and call back after you have stopped the vehicle.

Environmental

• Do not enter neighborhoods or environments alone where you do not feel safe;.
• Take note of the condition of walkways, steps, stairs and other environmental conditions that could present hazards, and take appropriate measures;.
• Wear proper protective equipment when helping individuals with household chores involving the use of chemicals, use all chemicals according to the instructions on the label, and do not use household chemicals that are not properly labeled.

Exposure to Infectious Agents

• Use universal precautions at all times;
• Wear gloves or other proper protective equipment when handling materials or assisting with personal care when contact with bodily fluids is possible.
• Wash hands before and after providing personal care;.
• For more information, see the Infection Control Procedures below.

Behavior

• Completely familiarize yourself with individual service plans and assessments of behavior prior to providing services.
• Remain aware of the precipitating events and precursors that could indicate potentially dangerous behavior is imminent;.
• When problem behavior occurs, assure your own safety first by removing yourself from harm's way or assuring a safe exit from the area;.
• Avoid physically intervening with behavior directed towards others unless you can do so without becoming a victim;.
• Familiarize yourself with and follow the individual's crisis plan;.
• Call 911 when presented with severely dangerous behavior by a individual that you cannot successfully redirect;.
• Document and report all behavioral observations.

Body Mechanics

• Do not lift heavy objects unless you know that you can do so safely.
• When lifting with another person, communicate and count to three to coordinate your efforts.
• lift using your legs by bending at the knees, while keeping your back as straight as possible.

Stress

• Take breaks during long work days.
• Eat a healthy diet, and get plenty of rest and exercise.
• See your doctor for routine health exams.
• Use PTO (vacation and sick time) to rest, relax, and recover from illness.
• Report and openly discuss problems that affect your work satisfaction.

Health and Safety Incident Reporting

A Health and Safety Incident report is required whenever any of the following occurs:

• any staff member or persons served is injured at work requiring even basic first aid.
• an accident or incident occurs or condition exists that might have resulted in serious injury.
• incidents involving exposure to blood or body fluids.

If you are injured at work, regardless of the severity of the injury or whether or not you think you will miss work or seek medical treatment, do the following:

1. Seek medical attention immediately if necessary.
2. Call your Program Manager or the on-call supervisor.
3. Complete an Injury Report form.
4. Meet with your supervisor as soon as possible to: complete an Employee Accident or Incident Report in Tabs^TM, and if you may seek medical attention or miss work, complete a 1st Report of Injury form online. This page provides information about the claims process and tools. You will be advised to complete a First Report if there is even a slight chance you will seek medical treatment or miss work becaue of the injury. The supervisor should upload a copy of the completed report to your file.
5. If seeking medical attention, inform your hospital or clinic that it is for a work-related injury.
6. Provide your supervisor with a copy of all physician's orders.
7. You may be asked to bring additional forms to your physician.
8. If placed on work restrictions, follow these restrictions and all other physician's orders in the workplace and at home.

When Seeking Medical Attention

If you need to seek medical attention, document your travel to the clinic as Non-Billable Travel. Use Other Prior-Authorized Time for the time you spend at the clinic.

Do not drive yourself to a clinic unless you are completely safe to do so, considering the nature of your injury. A coworker or supervisor can give you a ride and document their time in the same way. If none is available, you may request reimbursement for a taxi. Of course, call 911 for emergency transport if necessary.

Incidents That Include Damage to Personal Property

When and incident results in damage to personal property, see the Personnel Policy for guidelines on potential reimbursement and reporting procedures.

Infection Control

At work at Accend Services, as in life, we do not always know who may carry infectious illness. Some infections have long latency periods before they cause disease. Control of exposure at work requires good hygiene and use of universal precautions. What follows are information and guidelines for reducing risk of contracting or spreading infectious illess.

Definitions

Bloodborne Pathogens

A bloodborne pathogen (BBP) is a microorganism in human blood that can cause disease. They are transmitted by contact with blood or contaminated body fluids. Affected persons often have chronic infections and can transmit the BBP years after the initial infection.

Infectious Bodily Fluids

Not all body fluids are considered potentially infectious. Body fluids containing visible blood, semen, and vaginal secretions are considered potentially infectious fluids, as are fluids from around the lungs, heart, and abdominal wall. Concentrated virus in a research lab is also considered potentially infectious. However, sweat, tears, nasal secretions, saliva, sputum, vomit, urine, and feces are not considered infectious unless blood is present in these fluids

Infectious Conditions

Infection needs four simultaneous conditions to exist. If you take any condition away, the danger from infection will be reduced or eliminated. The conditions which must exist simultaneously are:

1. A sufficiently-large dose of contaminated body fluid to constitute an infectious risk;
2. A portal of entry into a host; and
3. A diminished resistance level in the host, for instance, if a medical worker is tired, has the flu or a cold, the host is more susceptible to infection.

Occupational Exposure

An occupational exposure occurs when a worker experiences a percutaneous injury, mucous membrane contact, or skin contact with potentially infected blood or body fluid. The percutaneous injury may be from a needle or other sharp object. Mucous membrane contact may occur after a splash to the eyes, nose, mouth, or throat. Skin that is abraded or otherwise compromised due to a cut, rash, or break can assist transmission by providing a portal of entry.

Portal of Entry

A portal of entry is an opening in human body into which pathogens may enter, such as the eyes, nose, mouth, or open cuts or sores.

Universal Precautions

Universal precautions is short-hand for an approach to infection control that requires people to treat all human blood and certain human body fluids as if they were potentially infectious. Some common and effective universal precautions are:

• Hand washing with soap and water or use waterless sanitizing cleansers before and after providing personal care, and immediately following body fluid contact, and glove removal
• Use of Personal Protective Equipment (PPE): gloves, masks and protective eye wear
• Placement of barriers such as tissues or a towel between a caregiver and a bleeding person or ask them, if they're able, to do it themselves, i.e. wipe own nose or apply pressure to wounds

Hand-washing

Hand-washing is the single most important Universal Precaution procedure for preventing the spread of biological contamination. Despite this fact many health care personnel don't wash their hands properly. The following are hand washing tips and procedures.

1. Consider the sink, including the faucet controls, contaminated.
2. Avoid touching the sink.
3. Turn water on using a paper towel and then wet your hands and wrists.
4. Work soap into a lather.
5. Vigorously rub together all surfaces of the lathered hands for 15 seconds. Friction helps remove dirt and microorganisms. Wash around and under rings, around cuticles, and under fingernails
6. Rinse hands thoroughly under a stream of water. Running water carries away dirt and debris. Point fingers down so water and contamination won't drip toward elbows.
7. Dry hands completely with a clean dry paper towel.
8. Use a dry paper towel to turn faucet off.
9. To keep soap from becoming a breeding place for microorganisms, thoroughly clean soap dispensers before refilling with fresh soap.
10. When hand washing facilities are not available at a remote work site, use an appropriate antiseptic hand cleaner. As soon as possible, rewash hands with soap and running water.

Exposure Incident Response Procedures

At any time when you believe you may have experienced an Occupational Exposure (defined above), do the following:

1. Report this immediately to your supervisor or the on-call supervisor.
2. Go immediately to your physician, walk-in clinic or Emergency Room and report the exposure
3. Meet with your supervisor as soon as possible to complete a Accident or Incident Report, and if advised to do so, a 1st Report of Injury form online, or on the Minnesot 1st Report of Injury form here.
4. Follow all physician orders for follow-up

Methicillin-resistant Staphylococcus Areus (MRSA) Infections

MRSA is a type of staph bacteria that is resistant to certain antibiotics. Most MRSA infections are skin infections that may appear as pustules or boils that are red, swollen, and painful. Some vulnerable people can get MRSA infections in the bloodstream, at surgical sites, or as pneumonia. People, including healthcare workers, can be colonized with MRSA, but not show any symptoms of being ill. These people can spread MRSA to others even though they don’t have symptoms.

It is important to know that healthy people are at low risk for getting infected with MRSA. Some steps to follow to protect yourself from MRSA if you have a individual who has tested positive, or has an active infection, are as follows:

• Wash your hands with soap and water after any physical contact with the infected (or colonized) person.
• Staff should keep any breaks in skin covered with bandage
• If the person has an uncontrollable cough, the biggest risk is contaminated droplets on your skin or other objects.
• Make a general assessment of the cleanliness of the home environment and the person's hygiene. You may want to make the decision that it is not a safe place to meet.
• Always use paper towel, or other disposable towels, to dry your hands within the infected (or colonized) person’s home.
• Wash your hands immediately after leaving the home of an infected (or colonized) person. If hand washing is not an option, you may use alcohol-based hand sanitizer.
• Disposable gloves should be worn if there is a chance of coming into contact with body fluids.
• Disposable gloves should be worn if you have any open wounds on your hands.
• If the person you are meeting is coughing and/or sneezing uncontrollably you should wear a surgical mask during the visit.
• If you are meeting with an infected (or colonized) person in his/her home you should make that your last stop. You should shower and wash your clothing on hot water and dry it in a hot dryer immediately upon returning home.
• If you are meeting at the Accend Office, ask for disinfectant solution. After the infected (or colonized) person leaves the office, you should clean the room using the provided solution. Spray down the chairs, desk, and other items that were touched (door knobs, phones, etc) and let it sit for 10 minutes. After the 10 minutes you should wipe the items dry with disposable paper towels.
• If you are transporting an infected (or colonized) individual in your car, you should disinfect the seats (and anything else the individual touched) using either the provided solution, or an antibacterial disinfecting wipe that is known to kill MRSA. Transporting an individual with MRSA is not recommended.

COVID-19 and Other Repiratory Illnesses

As of May 1, 2023, we have expired and stopped updating our stand-alone Coronavirus Response Plan. What follows are general guidelines for COVID-19. Our policy is that you follow the CDC guidelines for each of the situations found below, whenever you experience any of them. Check back here and tap the links provided, as this guidance changes from time to time.

• Full vaccination is still highly recommneded as a strategy for preventing infection, or reducing the impact of infection from exposure.
• If you have symptoms, test positive, or were exposed to COVID-19 follow the guidelines on the CDC website here.

Symptoms and Isolation

Symptoms of COVID-19 and Other Respiratory Illnesses include:

• Fever or chills
• Cough
• Shortness of breath or difficulty breathing
• Fatigue
• Muscle or body aches
• Headache
• New loss of taste or smell
• Sore throat
• Congestion or runny nose
• Nausea or vomiting
• Diarrhea

As for any communicable illness, please return to work only once you have been symptom-free for 24 hours

Emergency and Disaster Response

Fire

Immediately identify by name who will:

• Where available, use the intercom to announce that there is a fire in the building and everyone should evacuate. If the building does not have an intercom, move into the common area and announce, “Fire! Evacuate!” in a loud voice.
• Call 911
• If it is safe to do so, attempt to suppress small fires with a fire extinguisher.
• If you can safely, go from room to room to check that everyone has heard the warning and evacuated.
• Gather everyone who has evacuated in the area designated for each building.

Severe Weather

High Winds/Tornado

In the case of dangerous straight line winds or tornado warnings, immediately take shelter in the following designated locations until the danger is passed.

Flash Flood

During a flash flood warning affecting your location, shelter in place in an above-ground location. Flash floods can create dangerous driving conditions, risk of being swept away by currents, sinkholes and other hazards. Do not attempt to travel in the affected area until authorities announce that it is safe to do so.

Blizzard or Ice Storm

During a blizzard or dangerous ice storm, shelter in place. Do not attempt to travel in the affected area until it is safe to do so.

Chemical Spill

Listen to the instructions on the emergency system and follow them. If ordered to evacuate the area, do so. If ordered to shelter in place, do so in an interior room with windows closed. Continue to monitor the emergency announcements until the danger is passed.

Terrorism

If able to do so safely, evacuate and move quickly clear of the building. If unable to evacuate, shelter in place in your suite or office. Lock the office/suite door and move to a location within the suite or office farthest from the door.

Call 911 as soon as you can safely do so and follow the instructions of the dispatcher.

Medical Emergencies

Offer assistance or first aid that you know how to safely perform. Do not attempt to move a person who may have a spinal injury. Check breathing and pulse.

Identify someone by name to call 911. Report the problem and answer all of the dispatcher's questions as clearly and calmly as possible. Stay on the line until instructed by the dispatcher to hang up.

Feedback or Questions about this Chapter

This guide is a living document. We want to improve it with your help. Do you have questions? Found a typo? Find yourself wanting more information? Please send us your thoughts about anything in this chapter by tapping on the link below.

Updates to this Chapter

April 28, 2023: COVID-19 guidance posted and the Coronavirus Response Plan archived.

May 7, 2024: COVID-19 guidance updated. Heading modified to "COVID-19 and Other Respiratory Illnesses"