Don’t Ignore the Little Things: Safety is More than Just COVID Prevention

As we look back at how we overcame some of the challenges of the pandemic—focusing on masks and social distancing and enhanced wiping of counters and doorknobs—it is easy to forget about all the other things that could hurt us on the job.

by Philip J. Seibert, Jr., CVT

HT1.pngThe effects of COVID-19 have changed our lives and the way we work. Aside from the medical implications, the pandemic has drastically changed our personal and work habits. Some of those changes have been good, but some of them have resulted in unintended consequences. At work, the biggest change is in the way we interact with our clients and patients. Curbside service and limited contact have changed our focus and placed stresses on the team and the facility that we never anticipated.

As we look back at how we overcame some of those challenges—focusing on masks and social distancing and enhanced wiping of counters and doorknobs—it is easy to forget about all the other things that could hurt us on the job. So, as we make yet more adjustments to operations with a reopening plan, we should resurrect the behaviors and activities that are necessary to keep us safe from all the other hazards we face in our duties.

Animal Handling

Some animals behave better when the owner isn’t in the exam room. But when the client is not present, some staff members may let their guard down a little and perhaps be less attentive during restraint, which can become problematic.

In 2020, when most practices went to curbside service only, the profession experienced an increase in animal bites while attempting to get patients out of vehicles with minimal owner contact. It’s usually better to let the client get the animal out of the vehicle to avoid potential problems with territorial behaviors.

Another effect of curbside service was the increased time and labor it takes to accomplish even simple tasks. Extremely busy staff members often take shortcuts that lead to injuries such as back strains. Back injuries can happen quickly but are easily preventable. Everyone is different and there are no specific “safe” lifting limits that fit every situation. The best prevention is to use the correct posture when lifting anything, including patients (See sidebar “Lift with Your Legs”).

Exposure to Chemicals and Drugs, Especially from Ingestion of Food or Beverages

We all know that chemicals and pharmaceuticals cause changes in our bodies, and we wouldn’t intentionally ingest those things unless it were medically necessary. But one of the behaviors we’ve seen in the socially distanced workplace is folks taking meals or snack breaks in “their area” instead of a communal break room or cafeteria. While such behavior may be good to prevent the spread of a virus, the staff member may then be at more risk of ingesting contaminants such as drugs or medicines.HT2.png

Treatment rooms, exam rooms, labs, and animal housing areas are inappropriate places for lunch breaks because of the presence of harmful biological and chemical contaminants. It’s extremely diffcult and generally impractical to remove all those hazards just to have a snack or drink. Meals, snacks, or beverages must be stored, prepared, and consumed in a sanitary location, even during a pandemic.

Security and Violence Prevention

It’s easy to think that one is safe if the front door is locked. And in the last year, our front doors have been locked a lot! But the reality is that workplace violence is an ever-present problem.

Of course, we are all familiar with the well-publicized episodes of workplace violence where a disgruntled former employee returns to the business seeking revenge or retribution, but for the veterinary practice there are three more likely sources: random robberies, personal relationships gone bad, and disgruntled clients.

People who commit robbery will usually try to be stealthy about it. They try to gain the element of surprise by waiting until there are few people in the business. Folks with relationship problems likewise usually seek to catch their ex-partner alone to limit witnesses to the event. Both of those folks rarely just walk in the front door—unlocked or not. They tend to use the sta€ entrance or an unlocked back door to gain entry undetected because they know that most places are not as diligent about security in those areas as they are at the customer entry.

HT3.pngUntil recently, violence against veterinary workers by customers was a pretty rare event, but in recent years that trend has been changing. We’re starting to see an increase in episodes where a customer who feels they have been cheated or disrespected are taking physical actions. In a recent event, a distraught client used physical intimidation to make a veterinarian and technician examine and treat his cat. The client called the clinic with an “urgent” need for his cat to be examined but was told there were no appointments available for the next two days. After the phone call, the client came to the clinic, gained entry via the side entrance door, and forced the veterinarian and a technician to examine and treat his cat immediately. The client was later arrested for the equivalent of false imprisonment. Although the sta€ was not physically injured, the situation could have gotten much worse.

All exterior doors to the facility should be locked at all times unless they are monitored (such as a client entrance) or in immediate use.

To balance the need for practical access with the need for security, a keyless, push-button, or finger pad lock is the best answer for non-client entry doors.

Fire Prevention: Clutter and Electrical Gizmos

It’s a fact of life that when folks are busy, general cleanliness and organization tend to take a back seat to the task at hand. That tendency is sometimes exaggerated when the disorganization happens in a place where the general public can’t see it. In reality, “I’ll put it away later” hardly ever works out. With the increased workload and curbside service trend of the last year, a lot of practices are suffering from a “clutter” problem. Clutter can be a problem because:

  • Improper storage increases the likelihood of articles falling from stacks or piles
  • Material stacked in a hallway or walkway or on stairs is likely to trip a person
  • Work becomes more diœcult if materials are not in their normal place, and the clutter “grows” as one searches for things
  • Housekeeping and sanitation are more diffcult when things are in the way
  • Clutter has a way of spreading to the point where it may become a fire hazard or block emergency exits

Remember this phrase: “Don’t put it down, put it away.” It is important to store supplies promptly and put items away after use. And make sure those emergency exits are free and clear in case you need them.

Technology is revolutionizing medicine in a lot of ways, but it has a price. From a physical safety perspective, the cost of that revolution is access to power— specifically having enough outlets to plug in all the stuff we use.

As more and more things require electricity, buildings designed just a few years ago are already suffering from a lack of available outlets. So sometimes the answer is to use a power strip. Although using a surge protector for sensitive electronic devices is smart, using a power strip just to gain more outlet space is a terrible idea. It’s so easy to overload those devices that the National Fire Prevention Association has released numerous safety bulletins warning of the serious fire danger from surge and power strips when they overheat. Except for sensitive electronic devices, appliances, tools, equipment, and personal convenience devices (space heaters, aromatherapy devices, etc.) should always be plugged directly into a wall outlet and never into outlet-multiplying devices.

Medical Procedure Issues: WAGs, Radiation, Zoonotic Diseases

One thing is for sure, the work didn’t stop during the pandemic, and the risks associated with the medical procedures didn’t go away either. Waste anesthetic gas (WAG) exposure can be a significant health problem for veterinary staff members.

Fortunately, preventing that exposure is relatively easy:

  • Fill the vaporizer in a well-ventilated area and maintain the anesthetic machine according to the manufacturer’s directions
  • Always use the scavenging device for all gas anesthesia procedures
  • Check the anesthetic circuit for leaks for each and every patient
  • Maintain the scavenger properly and change adsorption scavengers before they become saturated
  • Avoid tank or mask gas induction procedures
  • Maintain good general ventilation in the patient area to prevent the accumulation of gas from recovering patients

Although it’s virtually impossible to avoid all exposures to radiation, it is easy to keep exposure safely below the permissible limits. The ALARA principle—As Low As Reasonably Achievable—is the doctrine that is endorsed by most veterinary and medical safety organizations. Some of the principles of ALARA are:

  • Share radiographic duties among sta€ members to avoid one person receiving excess exposure. Every staff member must have and use a personal dosimetry badge to track their exposure.
  • Everyone should leave the room during exposure when possible. Staff who remain in the room must wear a protective apron during the exposure, even for dental radiograph procedures.
  • StaFF members who manually restrain a patient during an exposure must wear protective gloves. Placing the gloves over the top of the hand and single-sided hand shields are not acceptable substitutes.
  • Strive to position the patient properly to reduce retakes. Although it’s widely accepted that our animal patients can’t transmit COVID-19 to us, there are many zoonotic diseases that we can get from contact with animals. Simple bacterial or fungal infections are rarely deadly but do cause discomfort and sometimes exacerbate other medical conditions.
  • Since we can’t avoid contact with sick animals, we must protect ourselves. Barrier protection such as disposable exam gloves and gowns go a long way, but proper personal hygiene is the best defense. Regular handwashing and safe eating and drinking practices (only in sanitary environments) are the most important personal hygiene actions one can perform (See sidebar “Handwashing 101”).

We certainly should never forget that the overriding purpose of a veterinary practice is the care and treatment of patients, but that doesn’t mean we have to endure injury to accomplish the mission. It’s certainly wise to heed the dangers of the moment, but it’s foolish to ignore all the other risks to focus solely on one issue.

Phil Seibert
Philip J. Seibert Jr., CVT, is owner of SafetyVet in Calhoun, Tennessee.

 

Photo credits: andresr/E+ via Getty Images, appleuzr/DigitalVision Vectors via Getty Images, mediaphotos/iStock via Getty Images Plus, nattrass/E+ via Getty Images

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