The Hazards Manifest in RHP Hospital - Case Study Example

Occupational health and safety Assignment 2 Report     Name: Zhang Jing Student ID: 110101058 Username: zhajy103       Due date: 20/10/14   Words: 2550words. Executive Summary This paper assesses the hazards manifest in RHP hospital. The methods used in the evaluation are survey questions and secondary sources such as books, journals and articles. However, some limitations that affect the methods are that surveys may be limited by errors that may well arise due to poor measurements and omissions and secondary sources may contain outdated information. RPH was the first hospital to be set up in Western Australia. The hospital has with time invested heavily in far-reaching research laboratory conveniences and infrastructure. The hospital handles a lot of activities related to surgery. If not well managed, these surgical activities contain fire or explosion hazards. Surgical fires typically emerge a lot form ignitable tools such as gowns, adhesive tape, or gauze, just the once they are lie unprotected in an oxygen-rich area. Other hazard causes are surgery tools such as lasers and electrosurgical, poor waste anaesthetic gas disposal structures, antibacterial, sterilising and disinfection materials in the operating theatre. A combination of these things make available a source of energy for ignition, fuel and oxidizer offering a breeding ground for fire eruption and transmission. To deal with the hazards, it is recommended that there should be proper management of the surgical room suite, supplies, systems and tools, identification of critical safety tasks/jobs and set standards and competencies, and conducting sufficient HazOp analysis. The key legislation relation to fire and explosion hazards in Australia are the Workplace Health and Safety (WHS) regulation 2011 and the Australian Standard (AS) 4083 - 2010 Planning for emergencies – Health care facilities. Methodology Various approaches may be taken to hazard identification and different methods may be used. Ideally a variety of methods should be used for hazard identification. As Holmes, Triggs, Gifford and Dawkins (1997) emphasise, different people and different methods are likely to identify different problems. A more comprehensive picture is therefore gained by using a range of methods. In this paper, survey questions are the primary method. The survey is used to collect information from a few selected individuals through a set of questions. Survey research is preferred because it is efficient, versatile and allows for easy generalizability. However, the method is limited by errors that may well arise due to poor measurements and omissions. Omission errors are likely to be caused by a poor sampling frame that will lead to inadequate coverage of the population, sampling errors due to differences in characteristics in the sample members and the population as well as respondent’s non-response, which may well alter the sample due to let-down by respondents making it hard to generalise. Additional information is obtained from evaluations of findings of the works by other authors such as books, journals and articles (see references). Emergency Hazards, factors and Impact Health is very important for each and every one individual. The Australian government has invested heavily in promoting the health status of its citizens. The country has many hospitals. One such hospital is RPH. RPH RPH was the first hospital to be set up in Western Australia. It is a leading teaching and referral hospital in the country. The hospital has attracted international recognition in patient care, training and research; it houses Nobel Prize-winning research and world-leading experts in areas such as stroke, burns care and HIV research. The hospital provides work for close to 7,000 individuals, of which around 4,700 are employed on a full-time basis. Also, there are over 500 volunteers in the ‘Friends of RPH’ service. RPH has just about 530 medical, operating day and multi-day beds plus other 49 intensive-care beds, an additional 190 beds can be found at the Shenton Park Campus. RPH attends to approximately 77,000 in-patients and 298,000 casualties every year. Its emergency departments is among the busiest in Australia, with over 58,000 expositions per year (RPH, 2014). Potential Hazards RPH houses both a General Surgery Unit and an academic unit. The General Surgery Unit has for a long time established a robust assurance to offer outstanding teaching, research and service in RPH. The unit also offers leadership in the extensive medical community at both the state and national levels. The academic unit hosts academic appointees with distinctive interests in vascular surgery, gastrointestinal surgery, breast surgery, urological surgery, dietary studies, translational cancer studies, medical prosecutions, clinical learning, research and methodology (RPH, 2014). The hospital has with time invested heavily in far-reaching research laboratory conveniences and infrastructure. It has produced wide-ranging publications on various topics, especially on surgical management of particular disorders and the prospects of the surgical line of work. UWA sixth year students in Bachelor of Medicine and Bachelor of Surgery degree take on surgical cycles of seven weeks on surgical units within RPH, which goes together with lessons in Anaesthesia for one week (RPH, 2014). Therefore, it can be concluded that RPH handles a lot of activities related to surgery. If not well managed, these surgical activities contain fire or explosion hazards in the hospital. A hazard is a potential for harm to arise and cause an accident. Causes of Fire and Explosion Hazards at RPH Surgical fires typically emerge a lot form ignitable tools such as gowns, adhesive tape, or gauze, just the once they are lie unprotected in an oxygen-rich area. The survey findings indicate that resultant fires can lead to serious economic losses through hospital property damage, and patient injury. Such fires are destructive to the surgical room suite and call for specialised clean-up and restoration, hence, will have an effect on hospital operations. Moreover, surgery tools such as lasers and electrosurgical used to cut, seal, or evaporate tissues in a lot of operative procedures pose numerous exceptional challenges. Usually, ignition temperatures of usual inflammable supplies is meaningfully lowered where there are medicinal oxygen sources. The respondents state that such surgical gadgets are likely to generate hotness and sparks in or near the oxygen sources. Fire or explosion hazard is likely to occur if waste anaesthetic gas disposal structures are not connected and adjusted as they should be. The head of the surgery unit suggested that another cause of the fire or explosion hazards are the ever-present antibacterial, sterilising and disinfection materials in the operating theatre. Such explosive supplies characteristically burn wilder in ignited through oxygen sources. More often than not, these classifications are used constantly by patients with compromised lung capacity. It is very much challenging to provide the good oxygenation that possibly presents a discriminating hazard if patients use the devices while smoking or cooking. In addition, surgical apparatus characteristically contain items with frothed insulation and/or structural plastics. A combination of these things make available a source of energy for ignition, fuel and oxidizer offering a breeding ground for fire eruption and transmission. The above can diagrammatically be represented by a fire triangle as indicated below Other Causes Besides the surgical supplies and tools, Collins and Keeley (2003) state that the immediate causes of hazardous occurrences more often than not encompass operators or maintenance personnel human error. These errors arise from poor accountability of the senior management in an organisation. They conducted a study on 718 loss of control incidents selected randomly from close to 2500 investigations. An extract from their study indicate that 110 incidents occurred due to poor maintenance, 17 cropped from failure to follow scheduled maintenance procedures, and 93 were due to a failure by the organisation to provide adequate maintenance procedures. Collins and Keeley (2003) indicate that just 5.6 per cent of the incidents resulted from a personal deliberate violation. They also state that the causes of any accident, normally can be drawn back to failures in safety management. Bellamy et al (1989) reported similar findings in their initial examination of the causes of loss of control occurrences. One key instance of fire and explosion in Australia is that of Esso Longford facility on 25th September 1998. Two people were killed and there was an acute interruption of gas supply to industries and retail customers in Victoria. The company was found guilty of breaches of the Occupational Health and Safety Act 1985 (Vic.) and was penalised up to $2 million. An investigation by the Royal Commission (1999) revealed that among the causes of the fire and explosion were; absence of operating measures; insufficient personnel training; and reduced supervision; among others. It was concluded that: ‘a combination of ineffective management procedures, staffing oversights, communication problems, inadequate hazard assessment and training shortfalls combined to result in a major plant upset with consequential tragic loss of life’ (Nicol 2001). Nicol (2001) also states that these concerns are applicable to all hazardous services; they are not exclusive to the oil and gas undertakings. He also indicates that there are additional factors that boost the likelihoods of accidents and incidents, such as the growing age of hazard facilities and a growing age status of the labour force. Risk Assessment Risk could be exist in numerous areas of mental health practice. It usually transfers through some behaviour. For example, instance, violence, aggression, self-harm, suicide, mental health, (Woods, 2013). Risk assessment entails a vigilant analysis of what might cause injury to human life or the environment. The assessment takes account of the likelihood of injury and the severity of the impacts, this allows for an estimation of the risks. It assists in the identification of the necessary measures to make sure that risks from the hazards are sufficiently controlled, managed or totally eliminated. The table below presents a qualitative risk assessment of the fire and explosion hazards at RPH using a risk matrix. As you can see, the use of the matrix comprises deciding on event likelihoods of occurrence (in five categories covering from very likely/almost certain to very likely/rare) and event impact/consequences (in five categories covering from 1 or more fatalities/catastrophic to no injury/insignificant (Marsden, 2004). Table 1: RPH fire and explosion hazards risk assessment matrix Impact/Consequence Likelihood of Occurrence Very likely / Almost certain Likely / Has occurred Not common / Has occurred Unlikely / Not common Very unlikely / Rare 1 or more fatalities Catastrophic Extreme Extreme High Intermediate Low Permanent disability Major Extreme High Intermediate Low Low Medical treatment Serious High High Intermediate Low Negligible Minor injury Minor High Intermediate Low Negligible Negligible No injury Insignificant Intermediate Low Negligible Negligible Negligible Recommendations In order to steer clear of risks that could arise from the fire or explosion hazards, the following recommendations along with their action plans are proposed. Recommendation 1: Institute proper management of the surgical room suite, supplies, systems and tools Action Plan The surgical oxygen gas supply structures, ventilation, as well as waste disposal systems have got to be managed by the book and checked time and again to make sure that the risks are minimised. In normal circumstances, surgical devices contain several electro-mechanical and biochemical coordination and power sources. To reduce the risks the power can be delivered to an activating machine, or fluids and oxygenated gases be controlled through compressing them, diffusion or valving. Hospitals are subject to some of the most stringent life safety codes and inspections. However, a fire at a hospital can result in complications to delivery of care to patients. Hospital fire suppression and smoke control systems are complicated and rely on reliable power, consistent maintenance, and a series of interdependent systems operating together in order to function reliably. Emergency means of evacuation or area-of-refuge strategies also rely on the integrity of building systems for tenability. Recommendation 2: Conduct sufficient HazOp analysis Action Plan The hospital should also conduct a sufficient human Hazard and Operability Analysis (HazOp) analysis. HazOp is a well thought-out and organised method for scrutinising systems and assessing risks. Human faults should be scrutinised so as to identify and assess inconveniences that possibly will characterise risks to people or apparatus, or avert their efficient functioning. The method is founded on the assumption that risk events emanate from design variations or from operational intent (Andrews & Dunnett, 2000). Recommendation 3: Identify critical safety tasks/jobs and set standards and competencies Action Plan Particular jobs such as process operators, technicians, and supervisors should be thoroughly reviewed. The jobs or tasks should be decomposed in cross-reference to a risk assessment and/or the safety consideration to certify that each and every one safety critical activity is identified. In activities involving operations and management, RHP should conduct an analysis of errors and their consequences. The analysis should encompass activities such as; equipment design and configuration, normal process start-up and shut down operations, routine inspection and maintenance, among others. The identification of critical tasks/jobs will enable the management to set performance standards, particularly, for high risk tasks. Highly competent people in all aspects of a task are assigned the tasks/jobs. This can be facilitated through licensing and certification using written exams, checking prior experience and qualifications, and sample-based tests to assess knowledge. National standards and qualifications can as well be used. Legal Implications There are two pieces of legislation in Australia that touch on fire and explosion hazards. The one key legislation is the Queensland Workplace Health and Safety (WHS) regulation 2011. Section 335 of the WHS calls for particular controls to prevent fire and explosion hazards by requiring organisations to make sure that there is no ignition source in a hazardous area. Under section 52 of the WHS 2011, the organisation is required to manage risks to health and safety that may arise from a blast-off source in a hazardous atmosphere. This captures risks from inflammable and ignitable liquids (WHS, 2011). The second legislation is the Australian Standard (AS) 4083 - 2010 planning for emergencies – Health care facilities. The standard forms the basis from which national codes for preparing; planning, responding and recovering from internal as well as external emergencies are set out. According to the set of codes, fire falls under code red (Department of Health, Western Australia, 2013). References Archer, R, Borthwick, K & Tepe, S 2012, WHS - A Management Guide, 3rd Edition, Cengage Learning Australia, Victoria. Andrews, J. D. and Dunnett, S. J. 2000. Event Tree Analysis Using Binary Decision Diagrams. IEEE Trans. Reliability, 49(2): 230–238 Bellamy, L.J. et al., (1989). Evaluation of the human contribution to pipework and inline equipment failure frequencies. HSE Contract Research Report CRR15, HSE Books. Collins, A. and Keeley, D. (2003), Analysis of onshore dangerous occurrence and injury data leading to a loss of containment. HSL seminar paper, May 2003. Department of Health, Western Australia, (2013), Emergency Codes in Hospitals and Health Care Facilities, Viewed 10 October 2014, . Nicol, J. (2001), Have Australia’s major hazard facilities learnt from the Longford disaster?: An evaluation of the impact of the 1998 ESSO Longford explosion on the petrochemical industry in 2001. The Institution of Engineers, Australia. ISBN 085825 738 6. Marsden, S., Wright, M., Shaw J., and Beardwell, C. (2004), The development of a health and safety management index for use by business, investors, employees, the regulator and other stakeholders. Research Report RR217. HSE Books, ISBN 0 7176 2834 5. Queensland Legislation, (2014), Workplace Health and Safety (WHS) regulation 2011, viewed on 10 October 2014, . Woods, P, 2013. Risk assessment and management approaches on mental health units, Journal of Psychiatric and Mental Health Nursing, Vol.20 (9), pp.807-813 Read More