How to know when it’s time to call OSHA

July 31, 2018

Did you spot an OSHA violation at your practice? Here’s what to do.

As a hygienist, you’re no doubt aware of the various OSHA standards for dental practices. Because of this, it’s easy for you to spot a violation that may be taking place at your office.

Despite clinicians’ best efforts, OSHA violations can still happen. Often, these are simply mistakes made by a team member who may not be fully aware of the correct protocols and policies in place. But other times, these may happen when clinicians or team members are taking shortcuts and hoping no one will notice.

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“Being negligent of OSHA guidelines violates veracity, in that we are ethically responsible to be truthful in our care,” says Katrina M. Sanders, RDH, BSDH, M.Ed, RF. “It also violates beneficence (‘do good’) and nonmaleficence (‘do no harm’) as they guide our decision-making when it comes to seeking the best interest of our patients. Finally, it violates the principle of societal trust, which directly affects the ways in which the public views dental providers. Every time a patient asks us ‘Is that sterile?’ our integrity is being questioned.”

So, what should you do if you recognize an OSHA violation taking place at your practice? Read on to find out.

Give the benefit of the doubt

Unless a dentist or team member is blatantly breaking the rules on purpose, many times OSHA violations happen due to misinformation or a lack of training. Often, the “violator” doesn’t even know that he or she is doing something wrong.

If this is the case at your practice, then Kim Miller, RDH, BSDH, recommends making the violation known only to those involved in the “broken” process.

“Not all team members are involved with all operations, so this first step should include only those involved,” she says. “A suggested approach is to say, ‘You may not be aware of the OSHA guidelines for sterilization. I am concerned. I have observed what I perceive to be a violation, may I share my concerns with you? Can we work together and come up with a solution?’”

Go to management

Speaking directly with the violator is a good way to bring the violation to the person’s attention, but what if no changes take place?

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“If the issue is endangering the health and well-being of your patients, team or self, act immediately and go to your direct supervisor,” Miller says. “Many times this is an office manager or the doctor themselves. Either way, schedule a time to discuss this - don’t take them by surprise. Set up an appointment to discuss an OSHA concern. You have already put your concern out there to at least one other team member, so freely tell your office manager or dentist why you are asking for a meeting.”

Miller advises putting the concern in writing and documenting the steps you’ve taken thus far to correct the issue.

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Contact OSHA

“In the event that the OSHA violation is discussed at length and the leadership of the office still supports the continued violation, it is the professional and ethical responsibility of the dental hygienist to reporting this violation,” Sanders says.

To submit a report to OSHA, Sanders recommends submitting one to a local or regional OSHA office. These offices have committees that can conduct randomized investigations of the violation to ensure compliance, she says.

Complaints can be made to OSHA by filling out an online form, faxing and/or mailing a written form, or calling a local or area office. If the violation is potentially life-threatening, then OSHA recommends calling a local or regional office immediately to report it.

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“The mission of OSHA is essentially to support the safety of the worker, and it is important that the worker understand their role in ensuring their own safety,” Sanders says. “This could be something as simple completing a Hepatitis B series/titer, ensuring personal protective equipment meets standards, and that protocols are in place to address issues such as needlesticks or the need for an eyewash station. With every unaddressed OSHA violation, the worker increases their risk for harm within the workplace.”

While it’s illegal for an employer to fire, demote or retaliate against a worker for filing a complaint with OSHA, many hygienists may still be hesitant to report a violation.

“A fear of repercussions by an employer is a very real and understandable concern,” Sanders says. “While this is something I coach young grads through quite often, my first and ultimate question to them is this: ‘Is this an office you want to continue to work for?’ As with anything, it is important for the dental provider to weight the risks and benefits of remaining employed with an unethical practice where violations of this nature are of no concern to leadership.”

Sanders says hygienists should also consider the consequences of not reporting the OSHA violation in terms of patient care.

“A dental provider who is not following protocol with regards to personal protective equipment and/or proper handling of a needlestick can put the patient at risk for developing a contracted disease. This has been seen in countless violations, particularly with the contraction of Hepatitis C, the contraction of HIV, and the spread of easily transmissible diseases such as pneumonia, herpes, valley fever, influenza and the common cold, to name a few,” she says.

Final advice

There are numerous resources available to hygienists, including the OSHA website, the American Dental Association and OSAP. Staying up to date on infection control policies and procedures is also helpful.

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Miller recommends encouraging the dentist at the practice to hire an OSHA specialist or infection prevention coordinator if one isn’t already on staff. She also suggest notifying the office manager and/or dentist that you intend to contact OSHA to report a violation before you do so.

“Don’t keep it a secret. If there is truly a violation, it needs to be corrected. This will give them one last chance to correct the issue before you make that call,” she says.

To Sanders, whether or not to report a violation to OSHA comes down to ethics.

“My advice is always to remind my colleague that he or she needs to feel ethical and sound in his or her judgement and decision-making,” she says. “If they have voiced their concerns and these concerns are not being addressed, it is important to remember why these governing bodies exist: to support the health and safety of the worker.

“If you are working in an unsafe environment, it violates the first law of Maslow’s Hierarchy of Needs, and it impedes your ability to provide sound and ethical care to your patients. Is this what you spent years of education, countless tears, stress during school and continuing education coursework to build? A career with an office that does not value or protect your safety?”