Stephen is on loan to us from George Mason University's MPH program. We're pleased to have his perspective on health sciences news.
Job safety inspections reduce workplace injuries and subsequent worker’s compensation claims, saving millions of dollars in profits for companies, according to a study recently published in Science. California’s Division of Occupational Safety and Health inspected 409 companies included in the study from 1996-2006. It found that inspected firms saved an average of about $355,000 in injury claims and compensation for paid lost work (AP, 2012). The same companies saved an average of 26 percent on workers’ compensation costs (AP, 2012). (Image Credit)
OSHA policies are not consistent throughout all 50 states. OSHA inspections are often considered “disruptive,” “costly,” and often lead to layoffs, financial instability, or business closure (HealthDay, 2012). Marc Freedman, executive director of labor law policy for the U.S. Chamber of Commerce, said the idea of having inspections is not a problem for most business owners. “It’s more a question of how those inspections are conducted and what the relationship between the inspector and employer is,” Freedman told The Associated Press.
The current political and economic climates have prompted debate about the balance between government regulation and the bottom line. This study could possibly ease the combative discourse with the collective goal of achieving high profits and securing workplace safety.
Dual use research has become a hot topic recently in government-funded research. This post, Part 1 of a two-part series on Understanding Dual Use Research, will provide you with the foundation for interpreting and understanding the policies and discussions going on this Spring about dual use research.
Dual Use Research of Concern (DURC): "DURC is life sciences research that, based on current understanding, can be reasonably anticipated to provide knowledge, information, products, or technologies that could be directly misapplied to pose a significant threat with broad potential consequences to public health and safety, agricultural crops and other plants, animals, the environment, materiel, or national security" (NIH, 2012).
Life sciences: This term "pertains to living organisms (e.g., microbes, human beings, animals, and plants) and their products, including all disciplines and methodologies of biology such as aerobiology, agricultural science, plant science, animal science, bioinformatics, genomics, proteomics, synthetic biology, environmental science, public health, modeling, engineering of living systems, and all applications of the biological sciences. The term is meant to encompass the diverse approaches for understanding life at the level of ecosystems, organisms, organs, tissues, cells, and molecules" (NIH, 2012).
Extramural research: Research "which is funded by a department or agency under a grant, contract, cooperative agreement, or other agreement and not conducted directly by the department or agency" (NIH, 2012).
Intramural research: Research "which is directly conducted by a department or agency" (NIH, 2012).
Dual Use Tracking
In our PI-Dashboard research registration product, we track dual use with the following questions:
Filling out this part of the research registration provides all information necessary for research approval and oversight in one place. Our PI-Dashboard was designed to promote biosafety and researcher well-being by collecting and connecting any information that may affect the research itself or the implications of the research.
Part 2 of our Understanding Dual Use series will explain recent concerns and policies developing around dual use research of concern.
When developing a health campaign, critically analyzing what is important to those you are trying to reach is imperative for a program to be successful. The yearly, often high-profile, nature of seasonal influenza vaccination along with the enormous target population makes campaign planning and advocacy for vaccination difficult and exhausting.
Each year, we work closely with the NIH's Occupational Medical Clinic, Clinical Center Director's Office, and communications team to put on a flu vaccination clinic for all of the health care workers, as well as employees and contractors at the facility. Health care workers, along with others who have frequent contact with patients, are required to be vaccinated through the NIH's program or by another facility. With health care worker's hectic schedules and their desensitization to flu vaccine advocacy messages, it was a challenge for the communications team to develop a campaign that would (1) bring the health care workers into the clinic for vaccination quickly and (2) encourage them to receive the vaccine instead of finding a reason to decline.
We all assumed that there had to be research done on what would increase the likelihood of health care workers' compliance with the flu vaccination mandate. Thankfully, someone has done the research! According to a study published this week in Occupational and Environmental Medicine, health care workers who believe that the seasonal influenza vaccine is effective are more likely to get their flu shots. Other characteristics that contribute to a health care worker's willingness to receive the vaccine each year are:
- "knowing the vaccine is effective;
- a willingness to prevent the spread of the flu virus;
- a belief that the virus is highly contagious and that prevention is important;
- having a family that is usually vaccinated; and
- convenient access to vaccination" (HealthDay News, 2012).
The study also include the factors that had little influence on health care workers' motivation to get vaccinated:
- "willingness to protect either themselves or patients at risk of complications if they caught the flu;
- previous experience with having the flu;
- being in contact with children; or
- having direct patient contact" (HealthDay News, 2012).
As was assumed by the NIH flu team, the study also found that "influenza vaccination will only be successful in [health care workers] if they are properly educated and if the vaccine is easily accessible" (HealthDay News, 2012). Reducing barriers to getting the vaccination and motivating people to get it will be a yearly battle, but luckily this research will help us and our NIH colleagues increase flu vaccination compliance even more in the 2012-2013 season.
Federal Government officials, private practices, and health IT advocates alike have one thing on their minds these days: EMRs. Electronic medical records (EMRs) are computerized records "composed of the clinical data repository, clinical decision support, controlled medical vocabulary, order entry, computerized provider order entry, pharmacy, and clinical documentation applications...used by healthcare practitioners to document, monitor, and manage healthcare delivery within" a healthcare organization (HIMSS, 2006). In much simpler terms, an EMR is an electronic version of one's paper patient record that can range in technical complexity from scanned paper documents to a robust data entry system. EMRs are discussed less frequently in biomedical research support and occupational medicine, yet they carry great importance for promoting biosafety within the organization.
Biomedical research institutions tend to have needs that are different from patient health organizations. Biomedical researchers are not only at risk for traditional health issues, such as asthma and influenza, they are also at risk for nontraditional and potentially lethal work-related injuries and illnesses. These risks require medical surveillance, used "for the early identification of conditions, if any, that could present an increased risk of adverse health effects related to the task being performed...including the duration of the task, the materials being used, and the potential for exposure" (NCSU, 2011).
By combining an EMR with a traditional medical surveillance program, biomedical research institutions can help protect employees from nontraditional risks, such as HIV needle sticks and tuberculosis. An electronic medical surveillance system allows clinics to proactively recall patients based on workplace risks and enrollment in surveillance programs that match the type of risks they are exposed to in their work.
Having both a patient's medical record and his or her workplace risks in one place allows occupational healthcare providers to have a full view of a patient's current and past health, as well as an understanding of beneficial preventive measures (such as vaccines) that can be tailored to the individual's health and workplace needs. This use of an enhanced EMR technology helps occupational medical providers keep a watchful eye on multiple workers with a wide variety of risks.
Health information technology (Health IT or sometimes HIT) has been the topic of much discussion from the Federal Government down to the small medical practice. When it comes to biomedical, clinical, and other types of health science research, there are complex needs that health IT is ideal for solving.
In biomedical research specifically, there are major concerns about promoting and ensuring biosafety in labs, as well as around the institution itself. These institutions often have multiple stakeholders in health and safety, occupational medicine, animal care, environmental and industrial health, and even in administrative roles who have to be aware of potential hazards, materials being worked with, and researcher compliance with biosafety measures.
Many times, when people think of health IT, they think only of EMRs and EHRs. The world of possibilities for health IT is far grander than medical record management. The following list will show you some ways that health IT can ensure biosafety - a primary concern at biomedical research institutions.
1. Health IT can easily connect research, health, and safety stakeholders to make sure that everyone is informed and aware of all potential hazards for each researcher.
2. Clinical, laboratory, and research management can be simpler and more accurate through automation and analytics in many health IT packages. This takes the burden off of health and safety workers who are overseeing many individuals.
3. Online biosafety, research, and safety training and training compliance tracking helps supervisors to be sure that all staff have the training they need to be safe.
4. Electronic medical records and electronic medical surveillance programs allow healthcare providers to see all of a researcher's medical history, potential work hazards, and important information in one place, helping providers make immediate, critical connections in otherwise disparate data.
5. In the unfortunate case that an injury or illness happens on the job, healthcare providers, health and safety, and administration can collaborate on an investigation and begin to take action against future similar biosafety and safety incidents.
There are certainly many more ways that health IT can pave the way for biosafety in a research institution. To find out more, visit our product page to see how we go about connecting institutions and promoting biosafety.
This was our second year exhibiting at the American Biological Safety Association (ABSA) conference, and it was another success! We brought our new display in its many-pound entirety to Anaheim, CA and it looked great, if I do say so myself.
From the moment the exhibit hall opened, we were flooded with biosafety professionals from all over the country - from California to Georgia, up to Massachusetts and beyond. In between meeting new people, we were fortunate to be able to hang out a bit with our customers/friends from the NIH DOHS, in between their crazy conference schedules, that is.
As with the SRA International Annual Meeting, we learned a lot about our current and potential customers:
- They have complex needs that keep them from being able to manage health and safety matters efficiently
- Lag time between research submission, review, and approval is only as fast as the system allows - and paper-based systems lag way behind paperless ones
- There is a great need for software systems that work with the user rather than against them
- They really know how to party, especially when moon bounces are involved
Biosafety professionals, thank you for your tireless efforts to keep research safe and productive!
Yuck - according to this study, healthcare workers in English and Welsh hospitals who wear gloves are less likely to follow hand washing compliance measures. Fuller et al. (2011) found that "the rate of hand hygiene compliance was 41.1% with glove use, versus 50% without glove use" (Pal, 2011). In other words, glove use was strongly associated with lower occurances of hand washing. (Image Credit)
Fuller et al. posit that "healthcare workers may feel that wearing gloves not only protects them from the pathogens on patients but also protects patients from the pathogens on healthcare workers' hands and that this obviates the need for hand disinfection." Pal (2011) notes that "putting gloves on 'dirty hands' will lead to workers picking up, and possibly transferring, more pathogens, especially during high-risk contact."
Not complying with hand hygeine policies in a healthcare setting can lead to a dangerous work environment and a possible biosafety issue. Health and safety in the workplace - espeically workplaces that include patient care - can be a life or death situation.
"Wearing gloves can reduce transmission of organisms between workers and patients, but gloves are not a substitute for hand hygiene...Hands should be cleaned before the gloves are put on and then immediately after they are removed, according to World Health Organization (WHO) guidelines" (Pal, 2011).
The Mayo Clinic provides detailed instructions on proper handwashing:
"It's generally best to wash your hands with soap and water. Follow these simple steps:
- Wet your hands with running water.
- Apply liquid, bar or powder soap.
- Lather well.
- Rub your hands vigorously for at least 20 seconds. Remember to scrub all surfaces, including the backs of your hands, wrists, between your fingers and under your fingernails.
- Rinse well.
- Dry your hands with a clean or disposable towel or air dryer.
- If possible, use your towel to turn off the faucet."
Medical surveillance is an occupational health and safety practice used in biomedical and clinical research facilities to track employee compliance for receiving the necessary medical attention (e.g., vaccines, tests, serum samples) for the materials they are working with. Electronic medical surveillance programs are automated systems that could be thought of as specialized EMRs that contain the necessary information for protecting the researcher while he or she is at work.
An individual's medical surveillance record would include research materials, animals, and equipment he is working with at a minimum. For example, if Principal Investigator Dr. Morgan is working with HIV, monkeys, and needles, it would be important to have a system that can automate regular HIV testing and can be able to handle recording Dr. Morgan's treatment when she is bitten by a monkey, gets the monkey's HIV-positive blood in her eye, or gets stuck with an infected needle. Bottom line, electronic medical surveillance allows occupational health care providers to enforce researcher compliance with preventative measures and to be prepared for worst case scenarios, like monkey bites.
Medical surveillance could certainly be done in a paper-based system, but it would be more difficult to confidently track surveillance programs and ensure biosafety. Electronic medical surveillance allows automation, quicker recall, and off-site access. Another benefit of an electronic system is that it can be connected to other systems in the institution, such as clinic scheduling and management, research protocol submission/approval, and accident reporting systems, which could be the institution's legacy systems, a collection of systems from multiple third parties, or from a third party's integrative product suite.
To illustrate, our Electronic Medical Surveillance Manager (EMSM) is installed in Occupational Medical Services (OMS) at the NIH. They have chosen to connect the EMSM to other HealthRx systems in use at the NIH. The NIH's workflow is rather impressive with the number of researchers and newly registered research that happens at the different facilities. Everything begins with a researcher being proposed on a new research registration or added to an existing registration in PI-Dashboard, our research protocol submission/approval system. Once the research is approved, OMS receives a notification and the researcher is added to the appropriate medical surveillance programs in the EMSM. The EMSM connects to the Clinical Access Manager, allowing OMS to view the researcher's medical and visit history and to schedule surveillance program-related appointments. Any unfortunate issues that may lead to occupational injury or illness are recorded in both our accident reporting system, the Workplace Injury & Illness Manager, and in the EMSM. This process would be similar in other institutions and with other products/systems.
As one can see, using electronic medical surveillance, as opposed to a paper-based system, allows for more flexibility, better biosafety practices, and much easier processes for occupational medical staff. With the industry's and the Federal Government's push to move to electronic systems, electronic medical surveillance isn't just for future consideration, it's important for research and occupational healthcare now.
The 2011-2012 flu season kicks off in late Fall, but now is the time to begin to plan your battle against the flu in your hospital or research facility. The best way for you and those in your institution to avoid getting the flu is to be vaccinated. You can further prevent getting sick by:
- Washing your hands often with soap and water;
- Avoiding touching your eyes, nose or mouth; and
- Trying to avoid close contact with those who have the flu (which may be unavoidable for some healthcare providers) (HHS, 2011).
Why get vaccinated? The seasonal flu vaccine also prevents H1N1, and getting the vaccine can reduce a healthy adult's chances of getting the flu by 70-90%! While the general public should be vaccinated, it is especially important for researchers and healthcare providers to get the vaccine. According to the NIH, "several studies have shown that vaccinating healthcare workers reduces influenza complications and influenza-associated mortality in patients" (NIH, 2011).
Symptoms of influenza include:
- Coughing and/or sore throat
- Runny or stuffy nose
- Headaches and/or body aches
- Vomiting and diarrhea (HHS, 2011)
Those with flu symptoms should see a doctor. If your doctor diagnoses you with the flu, should stay home and away from others, follow your doctor’s orders, and watch for signs that you need immediate medical attention. In addition,
- Regularly wash your hands with soap and water or an alcohol-based hand rub;
- Cover coughs and sneezes;
- Drink plenty of clear fluids; and
- Get lots of rest (HHS, 2011).
HHS provides a wealth of great resources
for getting the word out about flu prevention in your institution. This website includes posters, flyers, brochures, letters, videos, podcasts, public service announcements, blogs, widgets, and eCards free for your use.
An excellent example of a workplace influenza prevention program is the NIH's "Foil the Flu." This program targets health care providers, physicians, and all other NIH employees and contractors in an effort to keep the flu away from their facilities. We have partnered with the NIH for the past three years to automate their vaccination tracking with our online Vaccination Manager. Last year, we introduced an iPad version as well that not only made Occupational Medical Services staff look pretty cool, but also allowed them to be even faster with processing people through their "virtual turnstile."
Whether a research or health sciences institution is on the cutting edge of technology, like the NIH, or has a smaller-scale effort, flu vaccination is key to keeping employees and patients healthy, and research and caregiving moving forward.