Billings Clinic
JOB SAFETY ANALYSIS
Affected Personnel: Care Providers (RNs, LPNs, CNAs, Clerks, PT/OT)
Hazard Assessment Performed By:
Date:
Hazard Categories/Types
Caught
Between (CBT)
A = Pinch point
B = Protruding object
C = Moving / stationary
object
Overexertion –
patient/patient
handling (OEP)
L = Lifting
P – Pushing/pulling
S/A = Static/Awkward
Posture
R = Repetition
A = Pinch point
B = Protruding object
C = Moving/stationary object
Fall – Same
level (FS)
S = Slip
T = Trip
B = Balance
Overexertion –
Other (OEO)
A = Pinch point
B = Protruding object
C = Moving/stationary object
Fall to below
(FB)
S = Slip
T = Trip
B = Balance
L = Lifting
P – Pushing/pulling
S/A = Static/Awkward
Posture
O = Overtime/long shifts
R = Repetition
Struck by (SB)
A = Moving/flying object
B = Falling material
C = Patient/Patient
Contact with
(CW)
A = Electricity
B = Chemical
C = Heat/cold
D = Radiation
Struck against (SA)
A = Stationary/moving object
B = Protruding object
C = Sharp/jagged object
Caught on
(CO)
Contact by (CB)
P = Patient
O = Moving/stationary object
Caught in
(CI)
Risk Class Codes
Task Steps,
Materials,
Equipment
(Injury Rate)
[Residual Risk
Class]
Patient
Transfers
Residual Risk
Class = C
Includes the
following
transfers:
 Bed to chair,
stand,
wheelchair, or
E = Gases/fumes/dust/noise
F = Water/steam
G = Poor or no air
H = Blood/body fluids
A=
Imperative actions must be taken to suppress risk to lower level
B=
C=
Action should be taken to minimize risk
Operation permissible (may include controls that reduce risk but if they fail, risk will return to higher level)
Hazard(s),
(categorytype)
Controls
(Engineering or
Administrative)
Warning
System(s) or
Device(s)
PPE
Handling/Work Practices
Env.
Controls
Strains and
Sprains
(OEP-L, P, S,
A, O)
 Lift and
transfer
equipment –
Slides boards,
mechanical
lifts, electric
lifts, gait belts
 Policies on fall
assessment and
Patient/Patient
handling
 Signage on
equipment
 None
 Always first refer to patient file to
 N/A
determine transfer requirements. These
procedures MUST BE FOLLOWED!
Updates to the patient file are required as
new information becomes available, and at
least weekly note: report any out of date
patient file to your supervisor immediately
–
1) “Self-care”: patient needs NO
assistance
2) “One person”: patient needs one
person to assist with gait belt
3) “Two Person”: patient needs two
people to transfer
4) “Equipment Assist”: patient is to be
moved via lift assist equipment
 All employees, including new employees,
are to be trained and their skills reviewed
prior to doing transfers, AND prior to use
of equipment.
 All patient files are to be kept current to
assure proper transfer assistance is
provided.
 Do pre-use check of equipment (Slings,
hooks, cables, etc.) to assure it
 MAKE SURE YOUR PATH OF
TRAVEL AND SET-POINT ARE
PREPARED BEFORE YOU START TO
MOVE PATIENT
 Always stay clear of suspended person
 Know weight limits of gear and do not
exceed them
walker
 Wheelchair to
toilet, chair,
or tub
 Chair to stand
or walker
 Bed
positioning
Patient
interaction
Residual Risk
Class = C
Patient
ambulation
falls
(OEP-L, A)
 Gait belt
 None
 None
 Do not wear chains, loose ear-rings, ties,
 None
nametags, etc. that patients could grab
 Always use gait belt for assistance
 DO NOT “CATCH” patient if he/she falls.
Assist / support patient to the floor.
 Ensure that patient is not injured before
attempting to move them from floor.
 Seek assistance from co-workers to move
patient from the floor using appropriate
lift techniques or device.
Patient
interaction
Residual Risk
Class = C
Patient
interaction
Residual Risk
Class = C
Potentially
combative
patients
(SB-C), (CB-P)
 Restraints
 None
 None
 Always first refer to patient file to
 N/A
determine their behavior issues, needs,
and “Handling Requirements”. These
MUST BE FOLLOWED!
 Updates to the patient file are required as
new information becomes available, and at
least weekly note: report any out of date
patient file to your supervisor immediately
 Assure staffing levels are adequate and
report inadequate staffing immediately
 DO NOT BE ALONE WITH
POTENTIAL COMBATIVE
INDIVIDUALS
 Do not wear chains, loose ear-rings, ties,
nametags, etc. that patients could grab
 Approach patients with caution
 Always use a paired (two person)
approach
 Use calm and non-confronting approach
 If there is any indication with any patient
that they may become combative, step out,
and get assistance from other trained
individuals; wait for patient to calm down
before re-entering
Needle Sticks,
Exposure to
blood and other
potentially
contaminated
materials
(CW-H)]
 Safety sharps
 Sharps
containers
 Admin. Policy
on Universal
Precautions
 Warning
signage on
devices
 Gloves
 Face masks
or shields
 Gowns
 Respirator
 Always first refer to patient file to
 All sharps
determine patient’s background. Assure
must be
all immunizations are current for patients
disposed
and staff
of in
approved
 DO NOT RECAP NEEDLES. DISPOSE
sharps
OF THEM IMMEDIATELY IN SHARPS
containers
CONTAINERS
and then
 Do not recycle needles
removed
 Updates to the patient file are required as
from the
new information becomes available, and at
facility by
least weekly note: report out of date
patient files to your supervisor
immediately
 Always use sharps container and assure
container is located in area where sharps
are used
 Assure that ALL POTENTIALLY
EXPOSED STAFF ARE current on
universal precautions and procedures
training (attendance at training is
mandatory!)
 Use standard precautions and procedures
for any potential exposure to blood or
other bodily fluids; and when exposure to
other communicable diseases is possible
(e.g., scabies or pediculosis)
 Always use gloves and wash hands
thoroughly with antibacterial soap for at
least 2 minutes pre-shift, and 30 seconds
minimum between patients
General
lifting, and
Material
handling
Strains and
Sprains
(OEO-L, P, A,
R)
 None
 None
 None
 Use legs, not back – keep back vertical
during lift
 Do Not twist when lifting; move your
whole body instead
 Set work area up such that weights are at
waist level
 Pre-shift and post-break stretching
exercises are encouraged
 Limit weights lifted as much as possible
and report any difficult lifts for re-design
 Use two-person lift for heavier and
awkward loads; and assist equipment
(scissor lifts, dollies, forklifts etc.) to
eliminate lifts
 Rotate to other tasks throughout the shift
 N/A
 Admin. Policy
 None
 None
 Housekeeping is CRITICAL to our safety!
 Recycle
Residual Risk
Class = C
General Duties Slip/Trip/Falls
an
approved
hazardous
materials
waste
hauler to
an
authorized
disposal
site.
Residual Risk
Class = C
(FS-S, T, B),
(FB-S, T, B)
titled “Waste
Stream
Management
Plan”
Keep work areas organized and free from
debris and trip hazards (extension cords,
files, papers, debris);
 Report any areas that are continual
problems
 Keep file drawers closed when not in use
 Clean-up work area(s) prior to all breaks
and at the end of each shift
 IMMEDIATELY place “Wet Floor” signs
liberally in area of spills/hazards
 Assure IMMEDIATE clean-up/mop-up of
spill or wet area
 DO NOT WALK BY A HAZARD, take
responsibility to correct it
materials
as possible
General Duties Falling
Material
Residual Risk
(SB-A, B)
Class = C
 Admin. Policy
titled “Personal
Protective
Equipment”
 Labels on
hard hats or
bump caps
 Hard-toed
shoes
 Hard hat
 Bump cap
 Keep file drawers closed when not in use
 Do not wear open-toed shoes
 Wear hard-toed shoes as appropriate.
 Ensure that all unstable and top heavy
items (e.g., files cabinets, etc.) are secured
(e.g. attached to wall) to prevent them
from tipping over
 Wear appropriate head protection wear
objects may fall from above
 None
General Duties Emergency
Preparedness
Residual Risk
(All categoriesClass = C
All types)
 Admin. Policy
titled
“Emergency
Management
Plan”
 None
 None
 Emergent conditions can result in
unpredictable hazards. Alertness is a key.
Seek assistance regarding hazards during
emergency situations.
 Participate in emergency drills and be
aware of evacuation routes; and eye wash,
first aid station and staff locations
 Keep all emergency exit routes
unobstructed and accessible. Know the
evacuation routes for your area. Know the
location and contents of the Safety and
Emergency Procedures Kardex.
 Collect
hazardous
waste for
off-site
disposal
 Assure fully charged, inspected, and
proper extinguishers are in your work area
 Ensure that there are supplies on-site that
are adequate for chemical and physical
hazards present; and that MSDS’s are
available
 Make sure that medical emergency
numbers are posted
Chemical
(soaps,
cleaners,
disinfectants)
Use
Irritation of
eyes and skin
(CW-B)
 Admin. Policy
titled
“Hazardous
Materials
Management
Plan”
 Some areas
may have an
air
monitoring
system to
warn of poor
air quality.
 Confined
spaces must
be checked
for air
quality
using a
calibrated
gas monitor
 Container
label
 Warning
signs
 Gloves
 Eyewear
 Face mask /
shield
 Gowns
 Respirator
 Review
MSDS for
each
chemical
involved to
determine
appropriate
PPE.
 Contact
supervisor
or Safety
Office for
assistance
Irritation of
eyes and skin,
burns,
asphyxiation,
death
(CW-B, G)
 Admin. Policy
titled
“Hazardous
Communications Plan –
Chemical
 Some areas
may have an
air
monitoring
system to
warn of poor
 Gloves
 Assure that all primary and secondary
containers are labeled indicating the
 Eyewear
contents and hazards
 Face mask /
 Know the contents of MSDS’s for all
shield
hazardous materials you are assigned to
 Gowns
use.
Residual Risk
Class = C
Chemical Use
(Corrosives,
Toxics)
Residual Risk
Class = C
 Know the contents of MSDS’s for all
hazardous materials you are assigned to
use.
 Review the hazard assessment for the
tasks to determine protective equipment
needs. Check date of assessment for
currency.
 Always wash prior to leaving the work
area
 Never eat, drink, or smoke in a chemical
use or storage area
 Inspect equipment daily for wear or
deterioration and replace as needed.
Clean and maintain in a sanitary condition
and ready for use
 Personal protective equipment is a last
resort for protecting your health and
safety. All feasible engineering controls
and work practices must be used before
relying upon personal protective
equipment to reduce exposure
 Collect
hazardous
waste for
off-site
disposal
 Collect all
regulated
waste for
appropriat
e storage
and offsite
disposal
 Collect
hazardous
waste for
off-site
disposal
 Collect all
Safety”
Chemical Use
Compressed
gasses-Oxygen
Residual Risk
Class = C
Fire, burns,
 Admin. Policy
smoke
titled
inhalation,
“Compressed
cryoburns, cuts,
Gases –
contusions,
Handling and
fractures, death
Storage”
(SB-A), (CW Vertical
C)
cylinder stands
 Cylinder
transports
air quality.
 Confined
spaces must
be checked
for air
quality
using a
calibrated
gas monitor
 Container
label
 Warning
signs
 Respirator
 Review
MSDS for
each
chemical
involved to
determine
appropriate
PPE.
 Contact
supervisor
or Safety
Office for
assistance
 Signage on
cylinders
 None
 Review the hazard assessment for the
tasks to determine protective equipment
needs. Check date of assessment for
currency.
 Always wash prior to leaving the work
area
 Never eat, drink, or smoke in a chemical
use or storage area
 Inspect equipment daily for wear or
deterioration and replace as needed.
Clean and maintain in a sanitary condition
and ready for use
 Assure that eyewash facilities and a quick
drench shower are functional where
corrosive materials are used. Assure that
all primary and secondary containers are
labeled indicating the contents and
hazards
 Personal protective equipment is a last
resort for protecting your health and
safety. All feasible engineering controls
and work practices must be used before
relying upon personal protective
equipment to reduce exposure
 Perform an assessment of the area and
assure that ignition hazards are
eliminated
 Assure that equipment (including
connectors, hoses, fittings, valves,
regulators, gauges, etc.) is routinely
inspected and in good condition and free
from leaks, rust, wear, deteriorated parts
 Assure that oxygen cylinders are stored
with cylinder caps in place and cylinders
kept in an upright position, and secured
 Keep “no smoking/ignition sources”
regulated
waste for
appropriat
e storage
and offsite
disposal
 N/A
signs posted in cylinder storage area
 Keep proper and fully charged fire
extinguisher in storage area
 Assure fire extinguisher is in cylinder
storage area and fully charged
 Assure all ignition sources are removed
from area of flammables storage and use
 Assure that fittings/connections are tight
 Store flammables separate from oxidizers
including oxygen cylinders
 Know by memory, procedures for
response to oxygen enhanced fires or
environments
Certification: This document has been completed in conjunction with representatives of the department(s) or workgroup(s) listed above and serves as a comprehensive
assessment of the hazards present in the covered task, activity, or work area.
Applicable Billings Clinic or department specific standards:
Applicable outside agency regulations or accrediting standards
Supervisor/Employee Review:
My Supervisor has reviewed this JSA with me, I have read the material, and I agree to follow the protective measures outlined above.
Employee (Print Name): _____________________________________________________
Employee: _______________________________________Date: ___________________
(Signature)
Supervisor (Print Name): ____________________________________________________
Supervisor: _______________________________________Date: ___________________
(Signature)