We go to the hospital for treatment and feel the hospital is a very safe place but did you know that a hospital is one of the most hazardous places to work?
The Healthcare industry is one of the most hazardous environments to work in. Employees (health care workers) in this industry either directly as doctors and nurses or indirectly as aides, helpers, laboratory technicians, or even medical waste handlers are constantly exposed to a complex variety of health and safety hazards in the course of their work.
Now the whole world is suffering from the COvid-19 pandemic, health care workers (HCW) as front-line workers are fighting to protect the life of people by keeping their own life at high risk of being exposed to covid-19. More than 570,000 HCW are infected and 3000 HCW lost their life because of covid-19 worldwide in first series of Covid-pandemic. Nepal is no exception and especially in the second series of covid-19, Nepal is greatly suffering and health care workers are serving the day-night for saving the life of people. In this situation, HCW in Nepal is suffering from not only Ill-health and death but also fear of exposure, stress, fatigue from overwork, prolonged use of PPE, discrimination, violence, social isolation, etc.
Not only to this covid situation, but there will also be always a great challenge to the health care worker to executing their roles of protecting the lives of people by protecting themselves being exposed to the various health and safety hazards including physical, biological, chemical, musculoskeletal injury, radiation that has been used for treatment, stress, and violence from the patient, patient family, and visitor.
Health and safety effect by a biological hazard such as Influenza, rubella,measles, SARS, hepatitis A, b virus, HIV, tuberculosis, etc, and exposure to the various chemical like antineoplastic drugs, hydroxychloroquine, aerosolized medications, anesthetic gases, phenolics, ammonium compounds, bleach, ethylene oxide, glutaraldehyde is a most serious one for HCW worker during treating, handling patients, Taking specimens of blood, body fluids or other clinical specimens, cleaning disinfecting and sterilizing the work surface
In a report published by the WHO, the disease burden caused by percutaneous sharps injuries among healthcare workers was found to be three million per year. Moreover, 40% of hepatitis B, 40% of hepatitis C, and 4.4% of HIV among healthcare workers were due to needle stick injuries. It is very unfortunate that approximately 1000 healthcare workers die annually from occupational HIV. In the 2013–2016 Ebola virus disease outbreaks, over 890 healthcare workers were infected, with a case fatality rate of 57%.
In other hand fire, earthquake, flooding, explosion are common emergency situation in Nepal, Single 2015 earthquake take the hundred of HCW life and damaged the 446 public health facilities 16 private hospitals were completely destroyed, and 765 health facilities were partially damaged
In a health care facility, it’s not only the health and safety matter of health care workers but also to the other management staff, patients, visitors the public. Now there is a question? Have all the hospital/health care facilities in Nepal have the plan, procedure, and enough resources to tackle such health and safety emergency situation in their facility? Do the entire staff is well aware of biological, chemical, and other potential hazards and well trained and equipped to protect themself and others? Does management give support for managing health and safety in their facility and show visible leadership? Can the hospital have the resource to safely evacuate the entire staff, patient, a visitor in the case of emergency like fire, earthquake, etc? Does the government have a mechanism to monitor and support the health care facility to implement and maintain the health and safety standard?
The concept of occupational safety and health in Nepal is in the initial stage, no one is giving health and safety as the first priority including health care facilities such as hospitals. Thousand of HCW are getting injury, ill-health, and death during their work and millions of dolor financial lost being caused by accident incident in hospital In Nepal. It is unfortunate to know that many of these tragedies are preventable through the implementation of sound health and safety management practices in their operation. Not only hospital worker, but and patient, and visitor are needed to be protected from these workplace hazards and also a hospital from huge financial loss caused by accident and incident. A small incident can ruin the hard-earned reputation of a hospital. So that government, hospitals, staff, and all the related parties must work together to manage the health and safety standards at the hospital
The government of Nepal has to formulate the health and safety act, Guidelines, standards, procedures for the health and safety of health care facilities and HCW and establish a strong mechanism to implement and monitor. Government and related health and safety institutions need to establish the data center of occupational safety and health incident. Occupational health and safety factors related to their job should be included in the study curriculum of HCW and practice them accordingly to make health & safety and attitude.
On another side, the Management of health care facilities most integrated OSH into their business by developing health and safety policy, manual, risk assessment and establishes the mechanism for monitoring, audit, and review of health and safety performances. Health care facility should be considered to both structural safety such as design, construction and, the layout of facility as per safety standards, and non-structural safety such as developing a safe system of work, focusing training and awareness to the entire staff, etc and make a sufficient arrangement to protect the people and property.
Health care facilities in developed and developing countries are far advanced in adopting the health and safety standards, but in countries like Nepal, only the collective effort of entire parties can able to manage health and safety standards at a health care facility, which is really needed.
Finally, safety is the integrated part of the business, not an additional cost, so safety a small investment of a rich future
Author: Deepak Lamichhane
(MSC, NEBOSH IDIP)
Himalayan safety solution Pvt ltd