Pinnacle Enterprises Canada
Healthcare Safety Info-eLink™

"Dedicated to Promoting Healthcare Occupational Health and Safety Management Excellence and Safe Patient Care"

MISSION

To achieve high quality safe patient care, improving the quality of occupational health and safety in healthcare must be a priority. My goal in this effort is to provide a high quality comprehensive user-friendly website with well-organized Internet links to credible sources of health and safety information primarily related to healthcare. Healthcare Safety Info-eLink™ is a not-for-profit service offered by Christopher Lipowski for occupational health and safety professionals who are committed and dedicated to advancing safe working conditions in healthcare as well as in all other occupational sectors.

GUIDING PRINCIPLE - "First Do No Harm"

Maximize Efforts to Improve Safe Patient Care in Hospitals through improving Healthcare Workplace Health and Safety Conditions and Practices. To close the gap between best practice and common practice by encouraging hospitals to reach levels of quality and safety that are comparable to those of the best high-reliability organizations.

PURPOSE

Data on the Canadian workforce has consistently indicated that healthcare workers are at greater risk of workplace injuries and more mental health problems than any other occupational group Health Canada. In the U.S. for example:

Health Care is the second-fastest-growing sector of the U.S. economy, employing over 12 million workers. Women represent nearly 80% of the health care work force. Health care workers face a wide range of hazards on the job, including needlestick injuries, back injuries, latex allergy, violence, and stress. Although it is possible to prevent or reduce health care worker exposure to these hazards, health care workers actually are experiencing increasing numbers of occupational injuries and illnesses. Rates of occupational injury to health care workers have risen over the past decade. By contrast, two of the most hazardous industries, agriculture and construction, are safer today than they were a decade ago, NIOSH.

In addition to this unacceptable situation, many patients suffer preventable care-related adverse events (AEs) during hospitalization. AEs among hospital patients are unintended injuries or complications resulting in death, disability or prolonged hospital stay that arise from health care management. A study in 2004 funded by CIHI and the Canadian Institutes of Health Research found that 7.5% of adult medical or surgical patients suffered adverse events in hospital, about one third of which were deemed preventable. Although most patients recover within six months, each year between 9,250 and 23,750 Canadian adults experience a “preventable” adverse event in hospital and later die, according to the study, Baker et al. 2004. The Institute of Medicine's "To Err is Human: Building a Safer Health System" reported: "The human cost of medical errors is high. Based on the findings of one major study, medical errors kill some 44,000 people in U.S. hospitals each year. Another study puts the number much higher, at 98,000." IOM. In Canada, healthcare acquired infections or nosocomial infections, affect more than 220,000 people annually resulting in excess of 8,000 deaths in Canadian hospitals each year. Therefore, patient safety in Canadian healthcare organizations has become an increasingly important topic and led to the creation of the Canadian Patient Safety Institute (CPSI). A study by the CPSI estimated the economic burden of adverse events in Canada in 2009-2010 was 1.1 billion dollars. This estimate did not include the direct costs of care after hospital discharge, or societal costs of illness, such as loss of functional status or occupational productivity. To address the issue of identifying strategies for improving patient care, much valuable effort has been focused on application of new technologies, developing better communication and coordination among clinicians, and creation of a patient adverse (sentinel) event information database to be shared by hospitals for learning purposes, Canadian College of Health Service Executives - ppt. However, a growing body of research indicate that healthcare worker health and safety conditions are not just an important but an essential factor associated with the quality of patient care, Yassi, A. For example, OSHA (U.S.) reports that workplace safety also affects patient care. OSHA recommends hospitals develop a health and safety management system with a holistic approach that integrates patient safety and employee safety programs, Safety and Health Management Systems: A Road Map for Hospitals. Dr. Lucian Leape endorses OSHA Programs on Health Care Worker Safety: "Many of us in medicine have long recognized that hospitals can be dangerous places not only for patients who are at risk of experiencing a medical error or an adverse event, but also for nurses, physicians, and other health care workers", National Patient Safety Foundation. The 2004 Canadian Adverse Events Study suggested, "The greatest gains in improving patient safety will come from modifying the work environment of healthcare professionals, creating better defenses for averting adverse events and mitigating their effects", The Role of Healthcare Environments in Shaping a Safety Culture - Lowe, G.S. The Joint Commission published a monograph recently stating that greater awareness of the potential synergies between patient and worker health and safety activities is required, Improving Patient and Worker Safety. One major step that healthcare institutions can take toward championing patient and healthcare worker safety, according to the monograph, is becoming a high-reliability healthcare organization (HRO) -- described as "systems operating in hazardous conditions that have fewer than their fair share of adverse events". The monograph also identifies functional management systems and processes, strategies and tools that have been used to successfully integrate health and safety activities. A report by The Lucian Leape Institute presents details on healthcare safety challenges. Therefore, efforts to increase the quality of hospital occupational health and safety conditions and practices can be expected to have a direct positive impact on patient safety outcomes and an overall reduction in healthcare costs, Nichol, K.
One strategy to achieve sustainable healthcare safety performance excellence is to implement an "Integrated Healthcare Safety Management System", a holistic approach that manages patient and staff safety programs together. Since the first step toward solving a problem is to understand it and knowledge is essential for advancing meaningful safety improvement initiatives to their maturity, this web service was founded to provide a simplified and efficient means of accessing credible, useful healthcare occupational, environmental and patient safety information.
Christopher Lipowski, CRSP


INSPIRING QUOTES FOR YOU TO THINK ABOUT

“Why do we chose to work in healthcare? Because it gives us a chance to make a difference in the lives of others during our short time on earth. If enough of us do that, we will make this world a better place for our children and grandchildren.”
~ Quint Studer

The Quality Worklife-Quality Healthcare Collaborative defines a healthy healthcare workplace as: A work setting that takes a strategic and comprehensive approach to providing the physical, cultural, psychosocial and work/job design conditions that maximize health and well-being of healthcare providers, quality of patient outcomes and organizational performance. “A fundamental way to better healthcare is through healthier healthcare workplaces. “It is unacceptable to work in, receive care in, govern, manage and fund unhealthy healthcare workplaces.

“Many healthcare leaders are reluctant to commit to the goal of “High-Reliability“ because they regard it as unrealistic, unachievable or a distraction from their current serious fiscal and regulatory pressures. One of the important roles for policymakers and stakeholders is to encourage, persuade and demand that healthcare organizations embark on this journey. The Joint Commission also encourages and invites them to join us on the journey to High-Reliability, because all patients deserve safe care.”
~ Mark R. Chassin, M.D., FACP, M.P.P., M.P.H. President and Chief Executive Officer, The Joint Commission

“Workplace safety is inextricably linked to patient safety. Unless caregivers are given the protection, respect, and support they need, they are more likely to make errors, fail to follow safe practices, and not work well in teams.”
~ National Patient Safety Foundation, Lucian Leape Institute.

"Culture clearly announces every day to every worker whether safety is a key value...it determines the extent of casualties, trauma disorders, stress claims and compensation paid...and it dictates whether elements of a safety system succeed or fail. The goal is to change your companyís culture until safety becomes an internal value that is incorporated in every plan, decision, and work activity. In the new safety culture, every employee will know that the only way to do anything is safely."
~ Dr. Dan Petersen

“Unsafe acts are like mosquitoes. You can try to swat them one at a time, but there will always be others to take their place. The only effective remedy is to drain the swamps in which they breed. In the case of errors and violations, the "swamps" are equipment designs that promote operator error, bad communications, high workloads, budgetary and commercial pressures, procedures that necessitate their violation in order to get the job done, inadequate organization, missing barriers, and safeguards . . . the list is potentially long but all of these latent factors are, in theory, detectable and correctable before a mishap occurs.”
~ Dr. James T. Reason.


ABOUT THE WEBSITE FOUNDER

Healthcare Safety Info-eLink™ Founded and managed by Christopher J. Lipowski, CRSP,
Principal / Senior Occupational Health and Safety Specialist / Healthcare & Academic Safety Management Advisor
first and former McGill University Health and Safety Officer - is dedicated to the memory of Z.J. Lipowski, M.D. author of The Theory of Attractive Stimulus Overload and Affluence, Information Inputs and Health.


LinkedIn - Christopher Lipowski, CRSP


Occupational Health and Safety Services


HEALTH AND SAFETY ETHICS

International Code of Ethics for Occupational Health Professionals (pdf)

National Association for Healthcare Quality - Code of Ethics and Standards of Practice

Professional Ethics For the OHS Professional
Dr. Peter Strahlendorf (ppt)

Code of Ethical Conduct - Mount Sinai Hospital Ontario


NEWS AND AND CURRENT TOPICS OF INTEREST FOR
OCCUPATIONAL AND PUBLIC HEALTH PROFESSIONALS

Federal government revises occupational exposure limit for asbestos - Employers must have asbestos exposure management program - 07/13/2017 (Canadian Occupational Safety - Thomson Reuters)

THE CRITICAL IMPORTANCE OF SAFETY LEADERSHIP video by Dr. Tom Krause - (Krause Bell Group)

Hazards of the Health Care Sector: Looking Beyond Infectious Disease - (Melissa A.McDiarmid MD, MPH)

Antibiotic-Resistant Gonorrhea - 2016 (CDC)

Antibiotic-resistant gonorrhoea on the rise, new drugs needed (WHO)

Overview of Enterovirus Infections (Merck Manual Professional)

Economic burden of healthcare-associated infections: an American perspective - Patricia W Stone, PhD, FAAN

Health-care organizations commit to improving mental health - HealthCareCAN - (Thomson Reuters, Occupational Safety)

Asbestos-Linked Cancer on the Rise (Carcinogens in the News - CAREX Canada)

Malignant Mesothelioma Mortality — United States, 1999–2015 - "Despite regulatory actions and decline in asbestos use, the annual number of malignant mesothelioma deaths remains substantial. Contrary to past projections, the number of malignant mesothelioma deaths has been increasing. The continuing occurrence of mesothelioma deaths, particularly among younger populations, underscores the need for maintaining efforts to prevent exposure and for ongoing surveillance to monitor temporal trends." - (CDC)

New cases of mesothelioma and asbestos-related lung cancer in one year cost $1.9B (Institute for Work & Health)

Impact of workplace cancers widely underestimated - "Occupational cancer is the number 1 cause of workplace death" (by Amanda Silliker, Canadian Occupational Safety)

Full Asbestos Ban, changed codes and regulations expected by 2018 - Candian Government to prohibit asbestos in new construction and renovations, ban it in imports such as brake pads (CBC News)

Cannabis legislation fails to protect Canada's youth - Diane Kelsall, MD MEd (CMAJ May 29, 2017 vol. 189 no. 21)

Mental Health Commission of Canada findings set a 'new normal' in the workplace (Maria Gergin - Borden Ladner Gervais LLP)

Depression is the leading cause of disability worldwide, and is a major contributor to the overall global burden of disease (WHO Factsheet)

Case Study Research Project Findings - The National Standard of Canada for Psychological Health and Safety in the Workplace - 2014-2017 (Mental Health Commission of Canada) (pdf)

Workplace Psychological Health and Safety in the Workplace - "Psychological health and safety (PHS) is embedded in the way people interact with one another on a daily basis, it is part of the way working conditions and management practices are structured. Bearing this in mind mental health is a significant challenge across workplaces. The Canadian Mental Health Commission has reported that, in any given year, one in five people in Canada will experience a mental health problem or illness, with a cost to the economy well in excess of 50 billion dollars. A Psychological Health and Safety Management System can help an organization identify hazards that can contribute to psychological harm to the worker. It is a preventive approach that assesses your workplaces practices and identifies those areas of concern." (CSA Group - SPE Z1003)

Burnout Among Health Professionals and Its Effect on Patient Safety - Audrey Lyndon, PhD (Agency for Healthcare Research and Quality)

Suicide Among Physicians Is A Public Health Crisis - Amitha Kalaichandran (TheHuffingtonPost.com)

Improving Work Functioning and Mental Health of Health Care Employees Using an E-Mental Health Approach to Workers' Health Surveillance: Pretest–Posttest Study - {"Working as a nurse involves dealing with a range of potential workplace stressors, such as psychological and emotional demands [1]. Unsurprisingly, mental health complaints including burnout, posttraumatic stress, anxiety, and depression are quite common in nurses [2]. Impaired mental health can have adverse effects endangering the health and safety of the nurses themselves but also of their patients [3,4]. Consequently, it seems worthwhile to pay preventive attention to the mental health and work functioning of nurses."} - Sarah M. Ketelaar et al (Saf Health Work. 2014 Dec; 5(4): 216–221)

National Academy of Medicine Launches 'Action Collaborative' to Promote Clinician Well-Being and Combat Burnout, Depression, and Suicide Among Health Care Workers (The National Academies of Sciences, Engineering, and Medicine)

CDC expands search for rats and people infected with Seoul virus (STAT - Boston Globe Media)

Statement from Dr. David Williams, Ontario's Chief Medical Officer of Health, on Seoul Virus Infection to rat exposure in Ontario (Ministry of Health and Long-Term Care)

Cryptosporidium parasite - Cryptosporidiosis - Information for Public Health & Medical Professionals (CDC)

Diseases directly transmitted by rodents - (CDC)

Occupational exposure to pesticides and other biocides and risk of thyroid cancer (Occup Environ Med. 2017 Feb 15. - PubMed)

Report warns of rise in drug-resistant tuberculosis (Center for Infectious Disease Research and Policy Academic Health Center, University of Minnesota)

The Risk of Tuberculosis Reinfection Soon after Cure of a First Disease Episode Is Extremely High in a Hyperendemic Community - Pieter Uys et al - PLOS December 9, 2015

Antibiotic-Resistant Neisseria gonorrhoeae Spread Faster with More Treatment, Not More Sexual Partners - Pieter Uys et al - PLOS May 19, 2016

Hospital Sinks May Be Awash in 'Superbugs' (MedlinePlus, 2017)

Drug-resistant 'nightmare bacteria' show worrisome ability to diversify and spread (Harvard T.H. Chan School of Public Health)

WHO publishes list of bacteria for which new antibiotics are urgently needed

Antibiotic / Antimicrobial Resistance (CDC)

NDM-1 Superbug - Dr. R V S N Sarma, MD., MSc (Canada) FIMSA, Senior Consultant physician

'Superbug' found in Pennsylvania patient highlights dangers of antibiotic resistance - Harvard Chan School of Public Health

13 Cases of 'Superbug' Fungal Infection in U.S. (CDC)

Candida auris - an emerging fungus that presents a serious global health threat. Healthcare facilities in several countries have reported that C. auris has caused severe illness in hospitalized patients. Some strains of Candida auris are resistant to all three major classes of antifungal drugs (CDC)

Candida auris Interim Recommendations for Healthcare Facilities and Laboratories (CDC)

Herpes Simplex Surveillance Protocol for Ontario Hospitals – Ontario Hospital Association and the Ontario Medical Association (2016)

Yellow Fever — Once Again on the Radar Screen in the Americas - Catharine I. Paules, M.D., and Anthony S. Fauci, M.D. (March 8, 2017DOI: 10.1056/NEJMp1702172)

Avian Influenza A (H7N9) Virus (CDC)

Three mutations switch H7N9 influenza to human-type receptor specificity - Robert P. de Vries et al (PLOSS Pathogens Jume 15, 2017)

Mitochondrial Genetics and Epigenetics; Novel paths linking air pollution and human disease - (Harvard School of Public Health)

Mitochondria as a Target of Environmental Toxicants - Joel N. Meyer, Nicholas School of the Environment, Duke University (pdf)

The role of epigenetics in genetic and environmental epidemiology - Christine Ladd-Acosta1 & M Daniele Fallin (Future Medicine - Epigenomics)

Epigenetic Effects of Cadmium in Cancer: Focus on Melanoma - Mario Venza et al (Curr Genomics. 2014 Dec; 15(6): 420–435)

The Systems Engineering Initiative for Patient Safety Center for Quality and Productivity Improvement (University of Wisconsin System)

Indoor Particulate Matter (U.S. EPA)

Ultrafine Particles : Efficacy of N95 Respirators in Conditions Representative of Human Breathing (IRSST)

Printer Emitted Particles: Are they safe? (Center for Nanotechnology and Nanotoxicology, T.H. Chan Harvard School of Public Health)

Printing, Photography and Reproduction Industry - Gordon C. Miller (Encyclopaedia of Occupational Health and Safety -ILO)

Future Care for Canadian Seniors: A Primer on Nursing Supply and Demand (The Conference Board of Canada - 2017)

ISO 45001, Occupational health and safety management systems - Requirements (ISO)

Ontario Bill Proposes to Create "Health and Safety Management System" under OHSA - Chelsea Rasmussen (Dentons)

Health and Safety Management Systems for Healthcare (Ontario Public Services Health & Safety Association)

Moving ahead with ISO 45001 for safety and health at work: 2017-04-24 - (Standards Council of Canada)

ISO 45001 Occupational Health and Safety Management Systems Information Guide - (NSF International Strategic Registrations USA)

Noise and neurotoxic chemical exposure relationship to workplace traumatic injuries: A review (Journal of Safety Research - Volume 60, February 2017, Pages 35–42)

National Safety Council survey finds workers in high-risk jobs are afraid to report safety issues. 41 percent of employees working in healthcare settings, said they were afraid to report safety issues.

Work Disability Prevention Management System Standard Development Project (CSA Group)

Aging and MSD: Strategies for older workers (University of Waterloo - The Centre of Research Expertise for the Prevention of Musculoskeletal Disorders)

CSA-Z412-00 (R2016) - Guideline on Office Ergonomics

Manual Material Lifting: a pain in the neck, back - "In Ontario, ergonomic interventions are legislated only for those in the health care sector and are especially limited in scope; They do not take into account injuries caused by repetitive, awkward or forceful work" - (Workers Health and Safety Centre of Ontario Federation)

Ergonomics for Healthcare Environments by T. Springer - (Knoll)

Participatory Ergonomics Programs – 9 keys to success - (Humantech Inc.)

Radon in the workplace (Ontario Ministry of Labour)

Mold remediation in a hospital - Toxicol Ind Health. 2009 Oct-Nov; 25(9-10):723-30 (NCBI)

Prevention and Remediation Strategies for the Control and Removal of Fungal Growth (CDC)

Mucormycosis - (CDC)

About Ebola Virus Disease (CDC)

Healthcare Exposure to Zika and Infection Control - (CDC)

Guillain-Barré syndrome (NIH)

Causes of Guillain-Barré syndrome (NHS - UK)

Role of Campylobacter jejuni Infection in the Pathogenesis of Guillain-Barré Syndrome, An Update - (BioMed Research International; Volume 2013 (2013), Article ID 852195)

The Development of Guillain-Barre Syndrome (Gbs) in Association with Confirmed Lyme Disease. A Potential Autoimmune Response in Gbs Secondary to Tick-Borne Diseases? - Seemal F Awan et al (Clin Microbiol 4:199. doi: 10.4172/2327-5073.1000199)

Lyme Disease (CDC)

Practices of Lyme disease diagnosis and treatment by general practitioners in Quebec, 2008–2015 - Salima Gasmi et al (BMC Fam Pract. 2017; 18: 65)

Mosquito-Borne Diseases (CDC)

West Nile Virus (CDC)

Zika Virus For Healthcare Providers (CDC)

Nurses' uniforms: How many bacteria do they carry after one shift? (J Public Health Epidemiol. 2012 Dec; 4(10): 311–315)

The Potential for Airborne Dispersal of Clostridium difficile from Symptomatic Patients (Oxford Journals Volume 50, Issue 11)

Indoor Air Quality - The role of HVAC Systems in Healthcare Facilities

Indoor Air Pollution: An Introduction for Health Professionals (EPA)

Microbiomes in the Built Environment - (EPA) - YouTube

Contaminated Devices Putting Open-Heart Surgery Patients at Risk (CDC - October 13, 2016)

Heater-Cooler Devices: Information for Health Care Providers and Staff at Health Care Facilities (U.S. FDA - March 28, 2017)

Robotic Surgical Tools Tough to Keep Clean - Findings suggest better cleaning procedures, more monitoring of instruments would help (MedlinePlus / NIH)

Global Guidelines for the Prevention of Surgical Site Infection (NCBI)

Are Hospital Floors an Underappreciated Reservoir for Transmission of Clostridium Difficile and Methicillin-resistant Staphylococcus aureus?

Understanding the Role of Contaminated Air in Healthcare Acquired Infections (Webinar) - Infection Control Today

Z316.5-15 Fume Hoods and Exhaust Systems Standard - (CSA)

Laboratory Ventilation Codes and Standards - (Siemens Industry, Inc.)

Effects of work practices and upper body movements on the performance of a laboratory fume hood - Ahn, K. et al.,J. Chem. Health Safety (2016)

NIOSH Study Finds Widespread Use of Scavenging Systems to Control Waste Anesthetic Gases During Medical Procedures, but Other Recommended Controls Lacking

NIOSH List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings, 2016 - (pdf)

Night Shift Work and Breast Cancer Incidence: Three Prospective Studies and Meta-analysis of Published Studies (R.C. Travis et al - JNCI J Natl Cancer Inst (2016) 108 (12)

A research university's rapid response to a fatal chemistry accident: Safety changes and outcomes (Journal of Chemical Health and Safety)

Latest Edition of NIOSH Manual of Analytical Methods
(5th edition) Now Available - (NIOSH)

Dust Sampling, Equipment Choice, Equipment Use, Interpreting Results - Bill Walsh, CIH, Galson Laboratories (pdf)

Formaldehyde Confirmed as Known Human Carcinogen -
The National Academies of Sciences, Engineering, and Medicine

Potential health hazards for students exposed to formaldehyde in the gross anatomy laboratory - Raja DS1, Sultana B. (J Environ Health. 2012 Jan-Feb;74(6):36-40)

Formaldehyde exposure of medical students and instructors and clinical symptoms during gross anatomy laboratory in Thammasat University - Lakchayapakorn K1, Watchalayarn P. (J Med Assoc Thai. 2010 Dec;93 Suppl 7:S92-8)


Health, Disease and Safety Information for the General Public

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Last updated July 2017

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