Long Term Care
Long term care covers a variety of services to meet the health and personal needs of people who cannot fully care for themselves for a short or long period of time.
What are the hazards associated with long term care?
The major hazards to which employees in long term care facilities are potentially exposed are: bloodborne pathogens; tuberculosis; slips, trips and falls; ergonomic stressors (especially back injury); and workplace violence.
Exposure to bloodborne pathogens can occur when providing medical assistance, including first aid, or during housekeeping activities when blood is or may be present, such as disposing of contaminated needles.
Occupational exposure to tuberculosis can occur when a resident with active tuberculosis is not properly assessed before being admitted to the facility.
Slips, trips and falls can occur when staff traverse corridors with wet or slippery floors.
Finally, workplace violence is a constant risk for staff when dealing with residents who may have some level of mental impairment (e.g., due to dementia) or when dealing with family members of residents.
Is there a special emphasis program associated with this topic?
Occupational exposure to bloodborne pathogens, tuberculosis, slips, trips and falls, and workplace violence in long term care facilities falls with the OSH Division long term care special emphasis program.
What can I do to protect myself?
Gloves and other necessary personal protective equipment must be provided by the employer and worn when providing medical assistance where the presence of blood and other potentially infectious materials (OPIM) are present or can reasonably be expected to be present. Accordingly, universal precautions should always be followed when providing first aid.
Slip-resistant shoes should be worn when working in areas having slippery or wet floors. Be sure to use proper patient handling techniques, especially the use of patient lifting devices, when moving residents from their beds or when assisting them into and out of bed.
In addition, using safety data sheets to become familiar with the hazards of chemicals you may be required to use along with wearing the appropriate personal protective equipment.
What resources are available to assist employers?
Safety and Health Programs
Example programs for hazard communication, respiratory protection, hazardous chemical program, bloodborne pathogens exposure control plan and PPE and hazard analysis are available and should be adapted to the conditions of each particular workplace. Federal OSHA also has workplace violence prevention programs that can be used as a resource.
Training and Outreach Services
Presentations on a variety of topics associated with laboratory work are available to assist employers in training their employees. These include: bloodborne pathogens; hazard communication, respiratory protection, ergonomics and personal protective equipment. These pre-recorded webinars on hazard communication, respiratory protection, bloodborne pathogens and toxic and hazardous substances can also be accessed at any time.
In addition, the education, training and technical assistance bureau provides free online safety and health training and outreach services (i.e., speaker's bureau requests, safety booths) upon request. Oregon OSHA has a free on-line course for workplace violence prevention.
Lastly, the NCDOL Library offers free safety and health videos (including streaming video services) and related research assistance on consensus standards (i.e., ANSI, NFPA, NEC).
Safety and Health Topics
Safety and health topic pages on bloodborne pathogens, personal protective equipment, respiratory protection, hazard communication, tuberculosis, ergonomics, medical services and first aid, walking and working surfaces, recording and reporting and workplace violence can provide more resource information.
Consultation Services
The consultative services bureau provides free and confidential onsite consultation regarding worksite safety and health hazards.
Which standards apply?
OSH has adopted the following standards applicable to long term care facilities in North Carolina. Note: Please also check the standards information and activity webpage to see if there has been any recent or upcoming regulatory activity on this topic.
General Industry
- 29 CFR 1910.22 - walking-working surfaces, general requirements
- 29 CFR 1910.132 - personal protective equipment, general requirements
- 29 CFR 1910.1020 - access to employee exposure and medical records
- 29 CFR 1910.1030 - bloodborne pathogens
- 29 CFR 1910.1200 - hazard communication
Recordkeeping
- 29 CFR Part 1904 - recordkeeping
General Duty Clause
NCGS 95-129(1) - general duty clause
Other Applicable Standards
The Which OSHA Standards Apply webpage can also help identify other standards that may be applicable to your worksite.
Where can I learn more?
Industry Guides
- Industry Guide 49 - OSHA General Industry Standards Requiring Programs, Inspections, Procedures, Records and/or Training, provides requirements for standards related to long term care.
Compliance Documents
- Operational Procedure Notice 132, Special Emphasis Program for Long Term Care Facilities, establishes the enforcement policy and provides an explanation of the applicable standards to ensure uniform enforcement when conducting inspections of long term care facilities.
Technical Assistance
Inquiries about workplace safety and health requirements can be submitted to Ask OSH through the online form, by email to ask.osh@labor.nc.gov, or by phone at 919-707-7876.