The current NIOSH funded Targeted Research Training Program is focused on occupational exposures, health, and safety of Home Healthcare Workers. In an effort to keep a focus on healthcare workers, our recent interdisciplinary trip was to The University of Cincinnati Medical Center and UC Health Occupational and Environmental Medicine. Students from the UC ERC Training Programs of Occupational Nursing and Medicine, Environmental and Industrial Hygiene, and Occupational Safety and Health Engineering were able to attend. The students were engaged, applied academic learnings from the classroom to the acute care setting, and demonstrated their interest and excitement for protecting healthcare workers.

We are extremely grateful to Tamara Rash, Occupational Health and Safety Manager at UC Health for spending the day with us to provide an overview of her role at UC Health. She provides health and safety program leadership in the organization. We saw many areas and had rich discussions focused on health and safety in many areas including, but not limited to, microbiology lab, emergency room, emergency room decontamination area outside for chemical/biohazard exposures, acute care patient areas, and more. In addition, we are extremely grateful to Drs. Wulsin and Dayna Kiydal and the clinical leadership staff for welcoming us into the Occupational Medicine clinic to provide an overview of the comprehensive occupational health services offered to healthcare staff. Below, the students share about their experience.

Students and faculty touring UCMC

A Memorable Day at UCMC: Exploring Occupational Medicine

By Supreet Khare

On December 8, 2023, I had the pleasure of embarking on a tour of the renowned University Medical Center (UCMC) as an Occupational Medicine Resident at UC. Joined by my colleagues from MPH classes and a handful of friends, the experience left an indelible mark on me.

Our guide for the day was the charismatic Ms. Tamara Rash, whose passion for UCMC was contagious. She not only made the tour informative, but also infused it with a sense of excitement that resonated with everyone present.

The highlight of the day was undoubtedly the laboratory tour. As an Occupational Medicine Resident, witnessing cutting-edge technology and state-of-the-art facilities was awe-inspiring. The meticulous precision and dedication of the staff in the laboratory left me in awe, emphasizing the commitment to excellence that defines UCMC.

What stood out for me was the seamless integration of theory and practical application in the Occupational Medicine department. We met with Dr. Victoria Wulsin, who has always been a source of inspiration for many at UC. The tour not only enhanced my understanding of occupational health but also provided valuable insights into the innovative approaches employed at UCMC.

The camaraderie among my fellow MPH classmates and friends further enriched the experience. Sharing this adventure with like-minded individuals added an extra layer of enjoyment and made the day even more memorable.

In conclusion, my time at UCMC was nothing short of fantastic. From the engaging Ms. Tamara Rash to the captivating laboratory tour, every aspect of the experience contributed to my appreciation for occupational medicine. This tour not only broadened my knowledge but also fueled my enthusiasm for the field, leaving me eager for more opportunities to explore the dynamic world of healthcare at UCMC.

Field Trip to the University of Cincinnati Medical Center

By Judith Arthur

On the 8^th of December 2023, we embarked on a field trip to the University of Cincinnati Medical Center (UCMC). On that day, we were met by the health and safety personnel of the center and Dr. Elizabeth Bien at 9:00 am. We had our visitors' name tags made in the lobby and we began touring by visiting the ED unit, micro lab, two-tower inpatient unit, and the UC employee health and wellbeing center. Due to the increase in COVID-19 cases, we were required to wear masks for the tour.

At the time of the visit, a new decontamination unit was being constructed at the center and this process was isolated from patients and the staff to prevent exposure to noise, dust, and other toxic contaminants. From the tour, we observed that workplace violence is a major concern at any healthcare center, and the ED was a predominant high-risk area. Several controls, which included setting up a violence committee, training staff, and implementation of metal detectors and security were currently in place to manage issues concerning workplace violence. At UCMC, the risk of chemical and biological exposure, particularly in the labs, was significantly reduced through the installation of eye wash stations at vantage points, training of staff on the safe handling and storage of chemicals, appropriate use of PPEs and biosafety cabinets, signage for hazard communication and annual health surveillance.

During the tour, it was observed that workers in charge of processing and decontamination of instruments were at risk of developing workplace musculoskeletal disorders. This was due to the long hours of standing (static posture) while performing their task. Introducing a sit-to-stand workstation together with frequent rest periods was key in reducing musculoskeletal disorders. Although compressed air was employed to dry the instruments in this unit, we learned workers were not at risk of noise exposure based on a recent noise survey that was completed and ensured the noise produced was within recommended allowable limits.

As a soon-to-be industrial hygienist, I have benefited immensely from this tour as I have acquired new skills and knowledge needed to improve patient safety in the health sector.

Chemical and Biological Exposure Safety

By Hannah Frame

Chemical and biological exposures are common in healthcare settings and something that the University of Cincinnati Medical Center (UCMC), Cincinnati’s Level I trauma center, has carefully considered through their decontamination, or “decon” room and outside area. The purpose of this room and outside area is to rid incoming patients of any chemical or biological hazards present on their exteriors before entering the facility and interacting with the healthcare staff. As an example, if a large-scale chemical explosion occurred and resulted in an influx of patients, each patient would have to shower before entering the UCMC to rid themselves of any chemicals. The current decontamination room is just outside of the emergency department and consists of an enclosed tent under a sprinkler system. The tent can only hold a few patients, but in the case of a large-scale decontamination event, a large curtain can be released from the wall and used to enclose a much larger area. The sprinkler system, which is stored at the top of the ambulance entrance, can be lowered down to the height of the patients so that they can more easily clean off. This process ensures that healthcare staff are less likely to be exposed to the contaminants that patients are bringing into the hospital.

The current decontamination room is under construction, and several signs are in place communicating what the final room will be, personal protective equipment (PPEs) that should be utilized before entering the room, and where the room can be safely entered. There was noise being produced from the construction, but it was explained that the construction is not near patient rooms- the construction workers wear hearing protection, but the noise does not impact patients or healthcare staff. There are also fire-retardant sheets over the doors that can act as fire suppressants in the case that the door (which also acts as a fire suppressant) is removed. This practice ensures that the construction does not interfere with safety measures that are already in place at UCMC.

Overall, the tour of UCMC had a high focus on safety and making sure that both patients and workers maintain a high level of safety at all times. Special precautions are in place to ensure that incoming patients are not introducing unnecessary chemical and biological hazards to the UCMC. 

Protecting Nurses - A Goal for UCMC

By Angela Theil

Walking through the bright new halls of the Emergency Department (ER) at the University of Cincinnati Medical Center (UCMC) as part of an Education Research Center (ERC) field trip, I saw new life and hope on the faces of the nurses. Many new initiatives declared that workplace safety is a priority for nurses and healthcare staff, especially surrounding workplace violence. All visitors and patients go through a metal detector upon entering the ER. Public safety personnel are stationed in the ER at all hours every day. The ER patient area is set up so that each room is visible from the nurse’s station. Each nurse wears a staff duress button, which can be easily pushed in case nurses find themselves in a vulnerable situation. Nurses are offered training from the Crisis Prevention Institute, which includes defensive strategies and de-escalation techniques. This training used to only be offered to nurses who worked in the Psychology and Mental Health areas. However, it is now offered to Emergency Room nurses and others who may find themselves in workplace violence situations. If an injury does occur on the job, employee health offers a 24/7 nurse injury line.

UCMC knows that safety needs to be continually monitored. A workplace violence committee meets to discuss ongoing safety concerns, and an interdisciplinary group makes rounds every day in different areas to identify workplace hazards and concerns. Employee health recognizes that health incorporates the wellness of the entire employee. Therefore, they offer mental health assistance to their employees as well as resiliency training. They recognize gaps in safety training and a lack of awareness about employee health offerings, so they are working to rectify this for new and current employees.

All of these initiatives gave me new hope in helping nurses and all healthcare workers feel safe on the job. I applaud UCMC for putting the time and resources toward tackling workplace violence and making sure each nurse feels safe taking care of others. I look forward to seeing what’s next in helping nurses be the best at their jobs.

Ergonomic Risk Factors

By Dickson Rungere

On December 8, 2023, we visited the University of Cincinnati Medical Center (UCMC) and toured different departments such as the emergency department, acute care tower, micro lab and neurology units, and employee health. We discussed workplace violence, bloodborne pathogens, and safe patient handling.

This field trip lifted the veil concerning workplace violence that is facing UC health medical employees and healthcare employees everywhere; some patients are violent to health workers during the provision of medical assistance that leads to serious injuries and damage of properties. I observed ergonomic risk factors and potential noise in decontamination rooms. Workers in decontamination room stand for a long period of time (static posture) when performing their activities, and repetition of certain activities may lead to musculoskeletal disorders. Sometimes, workers in the decontamination room use compressed gas to wash equipment, the release of this compressed air tends to produce potential noise. There are several chemicals used at the UC Medical Center, especially in laboratories; every laboratory uses different types of chemicals.

UC Medical Center with collaboration of the Crisis Protection Institute (CPI), Police department, and Public Safety work together to ensure medical workers’ safety, moreover, they even installed a badge on the clothes of medical workers to press whenever they are in danger. Several other safety details noted during the tour is an emergency preparedness plan is available in every department; each laboratory in UCMC has a list of chemicals used in the laboratory to communicate to workers the chemical hazards within the laboratory.

This site visit has impacted my knowledge concerning ergonomic risk factors in the decontamination room. Prior to this, I only understood the risks of ergonomic hazards faced through patient handling, but the tour helped me and others understand all workers throughout the hospital are also prone to musculoskeletal disorders

Workers’ Compensation

By John Singletary

On December 8th, Occupational Health Nursing, Occupational Medicine Residents, and Environmental and Industrial Hygiene students visited the University of Cincinnati Hospital with the safety experts. The entire tour was very engaging and exciting. When I took a tour of the labs, they had outstanding sanitary requirements. Work stations with overlapping activities was noted as the laboratory staff have multiple tasks to complete in the one space. I was impressed with how many hazardous waste bins were present; in each area, there were multiple for different purposes. We met with HR and learned about hospital policy. First, if you employ enough people and have enough money in Ohio, you do not need to outsource workers' compensation, so the hospital handles all of those claims. Injuries that may or may not be covered while on the job site and the potential for misinformation about occupational injuries was discussed. Site debriefing as a group is helpful to understand the application of workers compensation and the legal side of worker injury. I recognized the vital importance I will have as an Industrial Hygienist, to partner with and educate employers and employees about workers’ rights to healthy work places and services.

Thank you

Thank you to the University of Cincinnati Medical Center and UC Health for bringing UC Education and Research Center Students and Faculty on a tour of your facilities and demonstrating the safety practices in place to protect employees and patients.