Healthcare workers experience a number of risks in the workplace. One such risk is occupational exposure to chemical, biological, or radiological materials when hospitals receive patients contaminated with these hazardous substances. According to the Occupational Safety & Health Administration (OSHA), first responders or receivers in these situations at hospitals include healthcare workers “who have a role in receiving and treating contaminated victims (e.g., triage, decontamination, medical treatment, and security) and those whose roles support these functions (e.g., set up and patient tracking).
First receivers at hospitals should receive training even though they are removed from the site of the incident or emergency. OSHA letters of interpretation “provide that HAZWOPER First Responder Operations Level and First Responder Awareness Level training meet the requirements for first receivers in certain roles and positions. For other employees, a briefing at the time of the incident will be appropriate”. HAZWOPER First Responder Operations Level training must be provided to first receivers who are expected to decontaminate victims or handle victims before they are thoroughly decontaminated.
These requirements include a minimum 8-hour training duration covering topics found in 29 CFR 1910.120(q)(6)(ii), however these topics can be tailored to better meet the needs of these specific types of first receivers. Additionally, any training received for First Responder Awareness Level also counts towards an employee’s First Responder Operations Level 8-hour requirement. First Responder Awareness Level training is required for employees in the contaminant-free post-decontamination zone and could include ED clinicians, ED clerks, ED triage staff, decontamination system set-up crew members, patient tracking clerks, and hospital security guards. This training is less extensive and does not specify a minimum time requirement, but does outline topics to be covered in 29 CFR 1910.120(q)(6)(i).
Alternatively, employees can avoid the 8-hour training requirement if they demonstrate competence in specific areas, however this can be difficult to ensure. Hospitals must document how the training requirements are met as well as provide annual refresher training.
The core training elements for HAZWOPER First Responder Operations Level must include:
- Understanding the hospital emergency operations plan and their roles in the response.
- Site safety, including risks to receiving personnel.
- Appropriate selection and use of PPE.
- Decontamination procedures.