Medical Office Safety Manual

What Should a Medical Office Safety Manual Include?

The contents of a Medical Office Safety Manual should reflect the practice’s actual operations.

A primary-care physician’s office may need a different combination of programs than an urgent-care clinic, dermatology practice, oncology office, orthopedic practice, diagnostic clinic, or specialty practice performing minor surgical or laboratory procedures.

Depending on operations, the manual may address:

• Medical office safety responsibilities.
• Hazard assessments.
• Safety inspections.
• Bloodborne Pathogens.
• Exposure Control Plan.
• Universal Precautions.
• Needlestick and sharps prevention.
• Safer medical devices.
• Exposure incident response.
• Hepatitis B vaccination.
• Specimen collection and handling.
• Infectious disease exposure.
• Respiratory hazards.
• Respiratory Protection.
• Hazard Communication.
• Medical office chemical safety.
• Personal Protective Equipment.
• Medical waste.
• Hazardous drugs.
• Oxygen and compressed gases.
• Radiation safety.
• Laboratory safety.
• Workplace violence.
• Emergency procedures.

Programs should be selected according to the work actually performed, hazards present, equipment used, and applicable safety requirements.

Medical Office Safety Program

An effective Medical Office Safety Program establishes responsibilities and procedures for identifying workplace hazards, preventing occupational exposures, safely handling sharps and specimens, controlling chemical and respiratory hazards, providing appropriate PPE, and correcting unsafe conditions.

Management should provide employees with the equipment, safeguards, training, PPE, and resources necessary to perform their assigned work safely.

Physicians, managers, supervisors, and other designated personnel should:

• Identify workplace hazards.
• Maintain applicable written safety programs.
• Evaluate occupational exposure to blood and other potentially infectious materials.
• Maintain the Exposure Control Plan.
• Evaluate safer medical devices.
• Maintain sharps-safety procedures.
• Evaluate respiratory hazards.
• Evaluate chemical exposures.
• Maintain engineering controls.
• Provide appropriate PPE.
• Maintain equipment and safeguards.
• Conduct workplace inspections.
• Provide required employee training.
• Correct unsafe conditions.
• Investigate exposure incidents and workplace injuries.
• Maintain required records.

Employees should follow established procedures, use required engineering controls and PPE, report unsafe conditions, and immediately report occupational exposure incidents.

Medical Office Hazard Assessments

Medical-office operations should be evaluated to identify biological, chemical, ergonomic, physical, and other workplace hazards.

Hazard assessments may consider:

• Blood and other potentially infectious materials.
• Needles and sharps.
• Patient specimens.
• Infectious diseases.
• Respiratory hazards.
• Cleaning and disinfecting chemicals.
• Sterilants.
• Hazardous drugs.
• Oxygen and compressed gases.
• Radiation.
• Laboratory materials.
• Electrical equipment.
• Ergonomic stress.
• Slips and falls.
• Workplace violence.

Assessments should be reviewed when procedures, equipment, chemicals, medications, technology, or workplace conditions change significantly.

Medical Office Safety Inspections

Periodic safety inspections can help identify unsafe conditions and verify that established procedures are being followed.

Inspections may include:

• Examination rooms.
• Procedure rooms.
• Laboratories.
• Specimen-processing areas.
• Medication-storage areas.
• Chemical-storage areas.
• Sharps containers.
• Medical-waste areas.
• Oxygen and compressed gas cylinders.
• Electrical equipment.
• X-ray areas.
• PPE supplies.
• Emergency equipment.
• Exit routes.
• Fire-protection equipment.

Identified deficiencies should be documented and corrected in a timely manner.

Job Safety Analysis (JSA/JHA)

A Job Safety Analysis (JSA/JHA) may be useful for selected medical-office tasks where a step-by-step hazard analysis can improve employee protection.

Potential JSAs/JHAs may address:

• Specimen handling.
• Chemical handling.
• Medical-waste handling.
• Sterilizer operation.
• Compressed gas cylinder handling.
• Chemical spill cleanup.
• Equipment maintenance.
• Selected laboratory activities.

Routine clinical procedures may be more appropriately addressed through clinical protocols, exposure-control procedures, and established work practices rather than creating a JSA for every medical procedure.

Bloodborne Pathogens

Medical office employees with occupational exposure to blood or other potentially infectious materials should be protected according to applicable Bloodborne Pathogens requirements.

Potential exposure may occur during:

• Injections.
• Vaccinations.
• Blood draws.
• IV procedures.
• Fingersticks.
• Specimen collection.
• Wound care.
• Minor surgical procedures.
• Biopsies.
• Suturing.
• Sharps disposal.
• Cleanup of blood or OPIM.

The Bloodborne Pathogens Program should address applicable exposure determination, engineering controls, work-practice controls, PPE, housekeeping, Hepatitis B vaccination, post-exposure evaluation, employee training, and recordkeeping.

Exposure Control Plan

Medical practices with employees who have occupational exposure should maintain an Exposure Control Plan.

The plan should address applicable:

• Exposure determination.
• Job classifications.
• Tasks involving occupational exposure.
• Engineering controls.
• Work-practice controls.
• Personal Protective Equipment.
• Housekeeping.
• Hepatitis B vaccination.
• Exposure incident procedures.
• Post-exposure evaluation and follow-up.
• Communication of hazards.
• Training.
• Recordkeeping.

The Exposure Control Plan should be reviewed and updated as required.

Exposure Determination

The employer should identify employees who have reasonably anticipated occupational exposure to blood or OPIM while performing their assigned duties.

Potentially exposed employees may include:

• Physicians.
• Physician assistants.
• Nurses.
• Nurse practitioners.
• Medical assistants.
• Phlebotomy personnel.
• Laboratory personnel.
• Employees performing wound care or procedures.
• Employees assigned to handle regulated waste or contaminated materials.

Employees should be evaluated according to their actual duties rather than simply their job title.

Administrative employees without occupational exposure should not automatically be included solely because they work in a medical office.

Universal Precautions

Universal Precautions should be observed to prevent contact with blood and other potentially infectious materials.

Applicable blood and OPIM should be treated as potentially infectious regardless of a patient’s known or perceived infection status.

Employees should use required engineering controls, work-practice controls, and PPE.

Engineering Controls

Engineering controls should be used to eliminate or minimize occupational exposure where feasible.

Depending on the procedures performed, controls may include:

• Needleless systems.
• Sharps with engineered sharps-injury protections.
• Self-sheathing needles.
• Safety lancets.
• Sharps disposal containers.
• Other safer medical devices.

Engineering controls should be examined and maintained or replaced as necessary to ensure their effectiveness.

Safer Medical Devices

Medical offices should identify, evaluate, and implement appropriate safer medical devices when required.

The evaluation should reflect the procedures performed and devices used by the practice.

Employees responsible for direct patient care should be involved in identifying, evaluating, and selecting effective engineering controls where required.

Needlestick and Sharps Prevention

Needles, lancets, scalpels, suture needles, and other contaminated sharps can expose employees to bloodborne pathogens.

Employees should:

• Use approved safety devices.
• Activate safety features as intended.
• Minimize unnecessary handling.
• Dispose of contaminated sharps promptly.
• Use appropriate sharps containers.
• Avoid reaching into sharps containers.
• Report needlesticks and other exposure incidents immediately.

Sharps-safety procedures should be incorporated into employee training.

Needle Recapping

Contaminated needles should not be bent, recapped, or removed except when permitted by applicable requirements.

When recapping or removal is necessary for a specific procedure and no feasible alternative exists, an appropriate mechanical device or one-handed technique should be used.

Employees should receive instruction on the approved method.

Sharps Containers

Sharps containers should be appropriate for the materials being discarded and positioned for convenient employee use.

Containers should be:

• Closable.
• Puncture resistant.
• Leak resistant as applicable.
• Appropriately labeled or color coded.
• Accessible.
• Located as close as feasible to where sharps are used.

Containers should be replaced before overfilling creates an additional hazard.

Hepatitis B Vaccination

Employees with occupational exposure should be offered Hepatitis B vaccination according to applicable requirements.

The vaccination should be made available within the required timeframe following initial assignment unless an applicable exception exists.

Employees who decline vaccination should complete required declination documentation.

Employees who initially decline may later request vaccination while remaining occupationally exposed.

Exposure Incidents

Needlesticks, cuts from contaminated sharps, splashes to mucous membranes, and other qualifying occupational exposures should be immediately reported.

Procedures should address:

• Immediate first aid.
• Incident reporting.
• Documentation of the exposure.
• Identification of the source individual when applicable.
• Medical evaluation.
• Required testing.
• Post-exposure prophylaxis when medically indicated.
• Counseling.
• Follow-up.

Employees should understand the importance of prompt reporting.

Post-Exposure Evaluation and Follow-Up

Following a qualifying exposure incident, the employer should provide confidential medical evaluation and follow-up according to applicable requirements.

Required information should be provided to the evaluating healthcare professional.

The employee should receive required information concerning the results of the evaluation.

Medical information should be maintained confidentially.

Specimen Collection and Handling

Employees collecting or handling blood and other patient specimens may be exposed through sharps, leaking containers, splashes, broken containers, or contaminated surfaces.

Procedures should address:

• Specimen collection.
• Container closure.
• Labeling.
• Transport within the workplace.
• Leaking containers.
• PPE.
• Spill cleanup.
• Disposal.

Employees should minimize unnecessary handling of specimens.

Specimen Transport

Specimens should be placed in appropriate containers that prevent leakage during collection, handling, processing, storage, transport, or shipping as applicable.

Employees should follow established procedures when primary containers are contaminated externally or become damaged.

Laboratory Safety — When Applicable

Medical practices performing laboratory testing should evaluate the hazards associated with their specific laboratory activities.

Potential hazards may include:

• Blood and OPIM.
• Chemicals.
• Reagents.
• Preservatives.
• Centrifuges.
• Sharps.
• Electrical equipment.
• Biological materials.

Laboratory safety procedures should reflect the tests and processes actually performed.

Centrifuge Safety — When Applicable

Employees operating centrifuges should follow manufacturer instructions and established procedures.

Procedures may address:

• Tube inspection.
• Balancing.
• Rotor condition.
• Lid operation.
• Specimen containment.
• Equipment cleaning.
• Response to broken tubes or spills.

Employees should not open or service equipment in a manner that exposes them to moving components or contaminated materials.

Infectious Disease Exposure

Medical office employees may encounter patients with communicable diseases.

The practice should evaluate foreseeable employee exposures and establish appropriate infection-prevention and occupational safety procedures.

Controls may include:

• Patient screening.
• Hand hygiene.
• Appropriate PPE.
• Respiratory hygiene.
• Isolation or separation procedures when appropriate.
• Engineering controls.
• Work-practice controls.
• Employee exposure procedures.

The measures used should reflect the diseases, services, and exposures reasonably anticipated in the practice.

Respiratory Hazards

Medical office employees may encounter infectious aerosols, airborne contaminants, hazardous chemicals, or other respiratory hazards depending on the services provided.

The employer should evaluate respiratory hazards and determine appropriate controls.

Controls may include:

• Ventilation.
• Engineering controls.
• Administrative controls.
• Work-practice controls.
• Appropriate PPE.
• Respiratory protection when required.

Respiratory Protection — When Required

When respirators are necessary to protect employees from occupational respiratory hazards, an appropriate Respiratory Protection Program should be established.

Applicable requirements may include:

• Hazard evaluation.
• Respirator selection.
• Medical evaluation.
• Fit testing.
• Training.
• Inspection.
• Maintenance.
• Program evaluation.

Employees required to use tight-fitting respirators should complete applicable medical evaluation and fit-testing requirements before required use.

Masks and Respirators

Employees should understand the difference between a face mask used for source control or splash protection and a respirator used to protect the wearer from applicable inhalation hazards.

A surgical or procedure mask should not automatically be treated as equivalent to an appropriate respirator.

Respiratory protection should be selected according to the identified occupational hazard.

Personal Protective Equipment

PPE should be selected based on the employee’s assigned tasks and anticipated exposures.

Depending on the work performed, PPE may include:

• Gloves.
• Protective clothing.
• Safety glasses.
• Goggles.
• Face shields.
• Masks.
• Respirators.
• Other task-specific protection.

PPE should be appropriately selected, maintained, used, removed, and disposed of or decontaminated.

Gloves

Appropriate gloves should be used when hand contact with blood, OPIM, hazardous chemicals, or other identified hazards is reasonably anticipated.

Disposable gloves should be replaced when torn, punctured, contaminated, or when their ability to function as a barrier is compromised.

Disposable gloves should not be washed or decontaminated for reuse.

Alternative glove materials should be available where necessary.

Eye and Face Protection

Employees should use appropriate eye and face protection when procedures may generate splashes, sprays, droplets, or flying particles.

Protection may include:

• Safety glasses.
• Goggles.
• Face shields used with appropriate primary eye protection when necessary.

Protection should be selected according to the anticipated hazard.

Protective Clothing

Protective clothing should be appropriate for the task and anticipated exposure.

Depending on procedures, this may include gowns, laboratory coats, clinic jackets, or other protective garments.

Contaminated protective clothing should be removed and handled according to established procedures.

Hazard Communication

Medical offices using hazardous chemicals should maintain an appropriate Hazard Communication Program.

The program should address applicable:

• Chemical inventories.
• Safety Data Sheets.
• Container labeling.
• Employee information and training.
• Non-routine tasks.
• Contractor communication.

Employees should understand how to obtain and use Safety Data Sheets.

Medical Office Chemical Safety

Medical offices may use disinfectants, cleaners, laboratory reagents, specimen preservatives, sterilants, and other hazardous substances.

Employees should:

• Follow label and Safety Data Sheet precautions.
• Use required PPE.
• Maintain container labels.
• Follow established handling procedures.
• Store chemicals appropriately.
• Avoid unauthorized chemical mixing.
• Report spills and damaged containers.

Disinfectants and Cleaning Chemicals

Disinfectants and cleaning chemicals should be used according to manufacturer instructions and established procedures.

Employees should understand applicable:

• Dilution procedures.
• PPE requirements.
• Ventilation precautions.
• Contact hazards.
• Storage requirements.
• Spill procedures.

Employees should not mix chemical products unless specifically instructed and authorized to do so.

Sterilants — When Applicable

Medical offices using chemical sterilants or high-level disinfectants should evaluate potential employee exposures.

Procedures should address:

• Chemical handling.
• Ventilation.
• PPE.
• Storage.
• Spill response.
• Exposure procedures.
• Disposal.

The safety program should reflect the specific products actually used.

Formaldehyde — When Applicable

Practices using formaldehyde or formaldehyde-containing solutions for specimen preservation or other purposes should evaluate employee exposure and applicable regulatory requirements.

Controls may include:

• Appropriate containers.
• Ventilation.
• Handling procedures.
• PPE.
• Spill response.
• Employee training.

Formaldehyde requirements should not be included in practices where the chemical is not present.

Hazardous Drugs — When Applicable

Medical practices that receive, prepare, administer, or dispose of hazardous drugs should evaluate occupational exposure.

Potentially affected practices may include oncology, specialty infusion, and other medical settings.

Controls may address:

• Receipt and storage.
• Preparation.
• Administration.
• PPE.
• Spill response.
• Waste.
• Employee training.

Hazardous-drug procedures should reflect the drugs and tasks actually present in the practice.

Chemical Spill Response

Employees should know how to respond to foreseeable chemical spills.

Procedures should identify:

• How to report the spill.
• Appropriate PPE.
• Cleanup materials.
• Ventilation considerations.
• When evacuation is necessary.
• When specialized assistance is required.
• Disposal procedures.

Employees should not attempt to clean a spill beyond their training or available protective equipment.

Medical Waste Handling

Medical office employees may handle ordinary trash, regulated waste, contaminated materials, sharps, pharmaceuticals, and other wastes.

Procedures should distinguish among the different waste streams and identify appropriate handling methods.

Employees should:

• Use designated containers.
• Avoid reaching into waste containers.
• Avoid manually compressing bags containing potential sharps.
• Use appropriate PPE.
• Report damaged or leaking containers.

Regulated Waste

Regulated waste associated with blood or OPIM should be handled and contained according to applicable requirements.

Containers should be appropriate for the materials being discarded.

Employees should receive training on which materials are considered regulated waste and how they should be handled.

Pharmaceutical Waste — When Applicable

Medical practices generating pharmaceutical waste should establish appropriate procedures for segregation, storage, handling, and disposal according to applicable requirements.

Employees should not dispose of medications or hazardous pharmaceutical waste through ordinary waste streams when prohibited.

Instrument Processing — When Applicable

Medical offices that reuse instruments should establish procedures for safe transport, cleaning, disinfection, sterilization, and storage.

Employees may be exposed to:

• Contaminated sharps.
• Blood and OPIM.
• Chemicals.
• Heat.
• Steam.
• Equipment hazards.

Appropriate engineering controls, work practices, and PPE should be used.

Sterilizers and Autoclaves — When Applicable

Sterilizers and autoclaves can expose employees to heat, steam, hot surfaces, and pressurized equipment.

Employees should:

• Follow manufacturer instructions.
• Use appropriate loading and unloading procedures.
• Allow materials to cool when necessary.
• Use appropriate PPE.
• Report leaks or equipment defects.
• Avoid opening equipment in an unsafe manner.

Only appropriately instructed employees should operate sterilization equipment.

Oxygen Safety — When Applicable

Medical offices using oxygen should establish procedures for safe storage, handling, and use.

Oxygen can accelerate combustion.

Employees should:

• Keep oxygen equipment away from inappropriate ignition sources.
• Secure cylinders appropriately.
• Protect cylinders and valves from damage.
• Use compatible equipment.
• Follow established storage procedures.
• Report leaks or damaged equipment.

Compressed Gas Cylinders — When Applicable

Compressed gas cylinders should be appropriately secured, stored, handled, and protected from damage.

Employees should use appropriate regulators and connections.

Cylinder valves should be protected from impact or other conditions that could cause uncontrolled release.

Only appropriately trained or authorized employees should change regulators or perform other specialized tasks.

Waste Anesthetic Gases — When Applicable

Medical practices using anesthetic gases should evaluate potential employee exposure.

Applicable controls may include:

• Scavenging.
• Ventilation.
• Equipment inspection.
• Leak prevention.
• Maintenance.
• Work practices.
• Employee training.

These procedures should be included only when anesthetic gases are actually used.

Radiation Safety — When Applicable

Medical practices using X-ray or other radiation-producing equipment should establish appropriate employee-safety procedures.

Procedures may address:

• Safe positioning.
• Restricted access.
• Shielding.
• Equipment condition.
• Employee training.
• Exposure monitoring when required.
• Applicable state radiation-control requirements.

Employees should follow established radiographic safety procedures.

Laser Safety — When Applicable

Specialty practices using medical lasers should evaluate potential eye, skin, fire, plume, and electrical hazards.

Controls may include:

• Restricted access.
• Warning signs.
• Eye protection.
• Equipment procedures.
• Smoke or plume control.
• Fire prevention.
• Employee training.

The safety program should reflect the type and class of laser equipment used.

Electrical Safety

Electrical equipment, cords, plugs, receptacles, and panels should be maintained in safe condition.

Employees should not use damaged electrical equipment.

Electrical panels should remain appropriately accessible.

Employees should report equipment that shocks, sparks, overheats, or otherwise operates abnormally.

Only qualified or otherwise authorized personnel should perform electrical work requiring specialized knowledge or training.

Slips, Trips and Falls

Medical offices should maintain examination rooms, corridors, laboratories, waiting areas, procedure rooms, and other walking-working surfaces in safe condition.

Potential hazards include:

• Water.
• Body fluids.
• Chemical spills.
• Cords.
• Equipment.
• Supplies.
• Damaged flooring.
• Clutter.

Temporary hazards should be promptly corrected or appropriately protected.

Walking-Working Surfaces

Floors, stairs, ramps, walkways, and other walking-working surfaces should be maintained in safe condition.

Equipment, supplies, waste, carts, and other materials should not unnecessarily obstruct employee travel or required exit routes.

Employees should promptly report damaged flooring or other unsafe conditions.

Housekeeping and Decontamination

Work areas should be maintained in an orderly and sanitary condition.

The practice should establish appropriate procedures for cleaning and decontaminating surfaces and equipment.

Housekeeping procedures should distinguish between:

• Ordinary cleaning.
• Blood or OPIM cleanup.
• Chemical spills.
• Hazardous-drug contamination.
• Regulated waste.

Employees should receive appropriate training for the cleanup activities assigned to them.

Emergency Eyewash — When Applicable

Where employees may be exposed to corrosive materials requiring immediate flushing, suitable emergency washing facilities should be available as required.

Access should remain unobstructed.

Employees should understand the location and proper use of emergency washing equipment.

Ergonomics

Medical office employees may perform repetitive computer work, prolonged standing, patient positioning, material handling, and other tasks that create ergonomic stress.

Potential controls may include:

• Appropriate workstation arrangement.
• Adjustable seating.
• Equipment positioning.
• Task variation.
• Safe lifting practices.
• Mechanical assistance when appropriate.

Employees should report persistent musculoskeletal symptoms.

Patient Handling — When Applicable

Some medical offices may require employees to assist patients with transfers, positioning, mobility, or examinations.

The practice should evaluate tasks involving significant patient-handling demands.

Employees should use available assistance, equipment, and appropriate techniques rather than attempting patient-handling tasks that exceed their capabilities.

Workplace Violence Prevention

Medical office employees may interact with distressed, angry, intoxicated, cognitively impaired, or otherwise unpredictable patients and visitors.

Workplace violence procedures should reflect the practice’s actual risk factors.

Controls may address:

• Recognizing concerning behavior.
• Reporting threats.
• Emergency communication.
• De-escalation where appropriate.
• Access control.
• Obtaining assistance.
• Contacting law enforcement.
• Incident investigation.

Employees should prioritize personal safety when confronted by threatening behavior.

Patient and Visitor Behavior

Employees should understand how to respond when a patient, family member, or visitor becomes verbally abusive, threatening, or physically aggressive.

Employees should:

• Maintain appropriate distance.
• Avoid unnecessary escalation.
• Obtain assistance.
• Follow established security procedures.
• Leave the immediate area when necessary for personal safety.
• Contact emergency services when appropriate.

Working Alone — When Applicable

Employees working alone during opening, closing, after-hours procedures, laboratory work, or other activities may face increased risk during medical, security, or workplace-violence emergencies.

Where employees work alone, procedures should address communication and access to emergency assistance.

Higher-risk tasks should be evaluated to determine whether working alone is appropriate.

Workplace Security

Security procedures should reflect the practice’s location, patient population, hours, staffing, and previous incidents.

Measures may include:

• Controlled access.
• Appropriate lighting.
• Emergency communication.
• Alarm or duress systems.
• Visitor procedures.
• Security cameras.
• Incident reporting.

Security controls should support employee safety without unnecessarily interfering with emergency egress.

Fire Prevention

Fire-prevention procedures should address the hazards present within the medical practice.

Potential considerations include:

• Oxygen.
• Compressed gases.
• Electrical equipment.
• Flammable materials.
• Laboratory operations.
• Medical equipment.
• Storage.

Fire extinguishers and other fire-protection equipment should remain accessible.

Emergency Action Plan

Employees should understand procedures to follow during foreseeable medical-office emergencies.

The Emergency Action Plan may address:

• Fire.
• Medical emergencies.
• Chemical releases.
• Gas leaks.
• Severe weather.
• Power failure.
• Workplace violence.
• Security threats.
• Evacuation.
• Shelter-in-place.

Employees should understand alarm methods, exit routes, assembly locations, emergency communication procedures, and assigned responsibilities.

Medical Emergencies

Medical offices should establish procedures for foreseeable patient and employee medical emergencies.

Employees should understand:

• How to summon emergency medical assistance.
• Their assigned responsibilities.
• Locations of emergency equipment.
• Communication procedures.
• Incident-reporting procedures.

Employees should perform only those emergency-response activities for which they are appropriately trained and authorized.

First Aid

The practice should maintain appropriate procedures for obtaining prompt medical assistance for employee injuries.

Employees should understand how to report workplace injuries and obtain necessary care.

Occupational exposure incidents involving blood or OPIM should be handled according to Bloodborne Pathogens procedures rather than solely as ordinary first-aid events.

Contractor Safety

Medical offices may use outside contractors for equipment service, electrical work, HVAC maintenance, cleaning, construction, renovation, waste handling, and other specialized work.

Contractor activities should be coordinated to protect employees, patients, and visitors.

Relevant hazard information should be exchanged when required.

Medical Office Safety Training

Safety training should reflect each employee’s assigned duties and occupational exposures.

Depending on the practice, training may address:

• Bloodborne Pathogens.
• Exposure Control Plan.
• Needlestick prevention.
• Sharps handling.
• Exposure incident response.
• PPE.
• Specimen handling.
• Infectious diseases.
• Respiratory hazards.
• Respiratory Protection.
• Hazard Communication.
• Chemical safety.
• Medical waste.
• Hazardous drugs.
• Oxygen and compressed gases.
• Radiation.
• Laboratory hazards.
• Workplace violence.
• Emergency procedures.

Training should be provided at required intervals and whenever changes in tasks, procedures, equipment, or exposures make additional training necessary.

New Employee Safety Orientation

New employees should receive appropriate safety orientation before independently performing work that exposes them to workplace hazards.

Orientation may address:

• General office safety.
• Bloodborne Pathogens.
• Exposure Control Plan.
• Needlestick prevention.
• PPE.
• Chemical safety.
• Hazard Communication.
• Infectious disease procedures.
• Medical-waste handling.
• Emergency procedures.
• Workplace violence.
• Injury and exposure reporting.

Employees should receive task-specific training before performing specialized work.

Medical Office Safety Meetings

Periodic safety meetings can reinforce safe work practices and address current workplace concerns.

Potential topics include:

• Needlestick prevention.
• Sharps safety.
• Exposure incident response.
• PPE.
• Specimen handling.
• Respiratory hazards.
• Chemical safety.
• Medical waste.
• Workplace violence.
• Slips and falls.
• Emergency procedures.

Recordkeeping

Medical practices should maintain occupational safety and health records required for their operations.

Records may include:

• Exposure Control Plan reviews.
• Employee training.
• Hepatitis B vaccination documentation.
• Required medical records.
• Exposure incident documentation.
• Respirator records where applicable.
• Safety inspections.
• Equipment evaluations.
• Other required program records.

Confidential employee medical information should be maintained according to applicable requirements.

Additional Safety Programs

Depending on medical-office operations, additional safety programs may be necessary for:

• Respiratory Protection.
• Ionizing Radiation.
• Laser Safety.
• Compressed Gas Cylinders.
• Hazardous Drugs.
• Laboratory Safety.
• Formaldehyde.
• Ergonomics.
• Hazardous Waste.
• Spill Prevention and Response.
• Workplace Violence Prevention.
• Working Alone.

These programs should be included when employee activities or workplace hazards make them applicable rather than automatically adding programs unrelated to the practice’s operations.

Building a Medical Office Safety Manual

A useful Medical Office Safety Manual should reflect the actual practice rather than simply combining generic healthcare policies.

A primary-care office may require a different combination of programs than an urgent-care clinic, oncology practice, dermatology office, orthopedic practice, diagnostic clinic, or other specialty medical practice.

The manual should consider:

• Medical services provided.
• Employee job classifications.
• Occupational exposure to blood and OPIM.
• Needles and sharps.
• Specimen collection.
• Infectious disease exposures.
• Respiratory hazards.
• Chemicals.
• Medications.
• Medical waste.
• Oxygen and compressed gases.
• Laboratory activities.
• Radiation-producing equipment.
• Patient-handling activities.
• Workplace violence risks.

Selecting the appropriate programs creates a manual that is comprehensive without filling it with procedures unrelated to the medical practice.

Customized Medical Office Safety Manuals

A Medical Office Safety Manual can be developed around the specific procedures, employee exposures, equipment, chemicals, medications, diagnostic services, laboratory activities, and other hazards of the practice.

The finished manual may incorporate applicable programs for Bloodborne Pathogens, sharps safety, exposure incidents, infectious disease, Respiratory Protection, Hazard Communication, PPE, medical waste, compressed gases, radiation, workplace violence, emergency procedures, and other hazards present within the operation.

This provides medical employers with a practical safety manual organized around the work their employees actually perform.