medical risk register

RISK REGISTER GROUP RISK ASSESSMENT

Medical Department

Department: Medical Unit/ Section: OPD

SN

Process Activities Process Owner

D/ ID

R/NR/E

Failure Mode

Hazard Existing Control

Risk Evaluation

Additional Control

Risk Communicatio

n

SR

Residual Risk

L S R

1 Out- Patient Medical Care

1. Reception, handling and transport of patients

Hospital Attendants

D R Improper body posture & technique

Ergonomic:musculoskeletal injuries and cumulative trauma disorders

Employee education & Training,Good House keeping,Personal Hygiene,Proper Job procedures,PPE,PME

1 3 LR Personal & Group communication,Seminars &Clinical meetings,

Failure to wear PPE

Biological:Exposure to infections

Employee education & Training,Good House keeping,Personal Hygiene,Proper Job procedures,


PPE,PME

Defective equipment

Physical: Accidents & Injury



2. Clinical Examination

Medical Officer

D R Failure to wear PPE




3. Administration of medicines by injections

Nurse D R Needle- Stick Injury

Biological:Exposure to Blood- borne pathogens HIV, Hepatitis B & C


1 4 HR

Personal & Group communication,Seminars &Clinical meetings,

4. Dressing & stitching of wounds

Dresser/ Nurse/ MO



Employee education & Training,Good House keeping,Personal Hygiene,


Proper Job procedures,PPE,PME

Needle stick Injury



1 4 HR


5. Dispensing medicines

Pharmacist D R Contact with medicines due to breakage of bottles

Chemical:Exposure to chemicals

Employee education & Training,Good House keeping,Personal Hygiene,Proper Job procedures,PPE,


6. Computer work

Office Staff/ Medical officer/ Pharmacist/Nurse

D R Long working hours & bad body posture

Ergonomic: musculoskeletal injuries and cumulative trauma disorders

Employee education & Training,Good House keeping,Personal Hygiene,Proper Job procedures,PPE,


D - DirectID - Indirect

R - RoutineNR - Non-RoutineE - Emergency

L - LikelihoodS - SeverityR - Risk

SR - Statutory Requirements LR - Low RiskMR - Moderate RiskHR - High RiskER - Extreme Risk

RISK REGISTERGROUP RISK ASSESSMENT

MATHURA REFINERY HOSPITAL

Department: Medical Unit/ Section: IPD

SN


D/ ID

R/NR/E

Failure Mode


Risk Evaluation

Addl Contro

l

Risk Communicatio

n

SR

Residual Risk

L S R

II In- Patient Medical care

1. Handling, Shifting and transport of patients

Hospital Attendants

D R Improper body posture & technique




Failure to wear PPE




Defective equipment e.g. trolleys, wheel chairs




2. Clinical Examination

Medical Officer





Use of Gloves

Chemical:Latex allergy caused by exposure to natural latex gloves




Nurse/Medical officers

D R Needle- Stick Injury


Employee education & Training,Good House keeping,Personal Hygiene,Proper Job procedures

2 4 HR


,PPE,PME


Dresser/ Nurse/ MO





Needle stick Injury



1 4 HR


5. Nursing Care Nurses D R Substandard conditions: wet floors

Physical:Slips & trips



Substandard conditions: Faulty

Physical:Electric Shock

Employee education & Training,Good

1 3 LR Personal & Group communication,

electrical equipment

House keeping,Personal Hygiene,Proper Job procedures,PPE,PME

Seminars &Clinical meetings,

Exposure to chemicals

Chemical:Skin defatting, irritation, and dermatoses because of frequent use of soaps, spirits, detergents &Disinfectants.



Use of Gloves

Chemical:Latex allergy caused by exposure to natural latex gloves.



Failure of PPE and faulty technique

Biological:Risk of contracting a communicable disease from the patients.


2 4 HR


Substandar Biological:Infections due to

Employee education

2 4 H Personal &

d practiceNeedle stick injury

the exposure to blood, body fluids or tissue specimens possibly leading toblood-borne diseases such as HIV, Hepatitis B and Hepatitis C.

& Training,Good House keeping,Personal Hygiene,Proper Job procedures,PPE,PME

R Group communication,Seminars &Clinical meetings,

Awkward body position or overexertion

Ergonomic:Fatigue and lower back pain due to the handling of heavy patients and to long periods of work in a standing posture.



Shift Work Stress, strained family relations, and burnout due to shift and night work, overtime work, and contact with sick patients, especially accident victims and their relatives.



6. House- Keeping including cleaning of wards and bathrooms

Sanitary Workers

D/ ID

R Substandard conditions e.g.Wet floors

Slips, trips and falls



,PPE,PME

Substandard conditions e.g.Faulty electrical equipment

Electrical shock resulting from work with mechanized and electrical field equipment

Employee education Training,Good House keeping,Personal Hygiene,Proper Job procedures,PPE,PME


Substandard practice Failure to wear PPE

ChemicalBurns- Contact with strong oxidants, especially chlorine compounds used for disinfection




Chemical:Dermatitis and eczemas resulting from contact with various oils and solvents used for pest control




Biological:Exposure to various microorganisms while working with liquid or solid wastes

Employee education & Training,Good House keeping,Personal Hygiene,Proper Job

2 4 HR


procedures,PPE,PME


Biological:Risk of contracting infectious diseases while working in hospitals


1 4 HR


physical overexertion andawkward posture while carrying and otherwise handling containers and heavy pieces of equipment orby work in confined or awkward spaces

Ergonomic:Acute musculoskeletal injuries and cumulative trauma disorders






SR - Statutory Requirements

LR - Low RiskMR - Moderate RiskHR - High RiskER - Extreme Risk



Department: Medical Unit/ Section: Laboratory

SN


D/ ID

R/NR/E

Failure Mode


Risk Evaluation

Addl Contro

l

Risk Communicatio

n

SR

Residual Risk

L S R

III Laboratory Diagnostic Services

1. Collection of samples of blood, urine, & stool, biochemical and microscopic examination and

Laboratory Tecnicians

D R Substandard conditionse.g. faulty electrical equipment


Employee education & Training,Good House keeping,Personal Hygiene,Proper Job

1 3 LR


reporting of results

procedures,PPE,PME

Substandard conditionse.g. wet floors

Physical: slips and fall


1 3 LR


Substandard practice e.g. failure to wear PPE

Burns and scalds from flames, hot surfaces, hot gases and liquids




ChemicalExposure to an extremely wide variety of chemical substances



Substandard practice e.g. failure to wear PPE,Needle stick Injury

Biological:Exposure to an extremely wide variety of biological agents including viruses, bacteria, fungi,

Employee education & Training,Good House keeping,

2 4 HR Personal & Group communication,Seminars &

parasites, etc. Personal Hygiene,Proper Job procedures,PPE,PME

Clinical meetings,

Routine work in a fixed positionOverexertionrepetitive manual operations, e.g., in pipetting






Department: Medical Unit/ Section: Radiography

SN


D/ ID

R/NR/E

Failure Mode Hazard Existing Control

Risk Evaluation

Addl Contro

l

Risk Communicatio

n

SR

Residual Risk

L S R

IV Medical Radiography

1. Preparation for X-ray examinati

X-ray Technician

D R Poor Housekeeping

Physical:Slips and trips and falls in cluttered and



on , Exposure to Xrays, Washing and developing X-ray films and reporting results

slippery spaces especially in the poorly illuminated Dark Room

House keeping,Personal Hygiene,Proper Job procedures,PPE,PME


Substandard condition e.g. Faulty electrical equipment

PhysicalElectric Shock




Physical:Exposure to Ionizing Radiation (X- rays) may cause Radiation Sickness & leukemia


1 4 HR



Chemical:Exposure to a wide variety of photographic chemicals and their vapors and fumes maycause skin rashes, dermatitis, irritation of the eyes and mucous



membranes, acute orchronic irritation of the respiratory system





awkward body position or overexertion

Ergonomic:musculoskeletal injuries









Department: Medical Unit/ Section: Operation Theatre

SN


D/ ID

R/NR/E

Failure Mode


Risk Evaluation

Addl Contro

l

Risk Communicatio

n

SR

Residual Risk

L S R

V Operation Theatre Services

1. Handling, Shifting and

Hospital Attendants

D R/E Improper body posture &

Ergonomic:musculoskeletal injuries

Employee education & Training,

1 3 LR

Personal & Group communication

transport of patients

technique Good House keeping,Personal Hygiene,Proper Job procedures,PPE,PME

,Seminars &Clinical meetings,

Failure to wear PPE



1 3 LR


Defective equipment



1 3 LR


2. Operating on patients

Surgeon/ Nurses

D R/ E Substandard practices

PhysicalCuts and stabsFrom sharp objects


1 3 LR


Substandard conditionsFaulty equipmentWaste anesthetic gases

Chemical:Inhalation of waste anesthetic gases (ethyl-ether, ethyl-bromide, ethyl-chloride, halothane,Methoxy-fluorane, nitrous-oxide).


2 4 HR


Use of latex gloves

ChemicalLatex allergy caused by exposure to natural latex gloves and other medical devices



Failure of wearing PPENeedle stick injuries

Biological:Infections due to the exposure to blood, body fluids or tissue specimens possibly leading toblood-borne diseases such as HIV, Hepatitis B and Hepatitis C.


1 4 HR


shift and night work, overtime work

Mental stress and burnout



,PPE,PME

excessive standing during the operation

Ergonomic:musculoskeletal injuries Physical stress




R - Routine

NR - Non-Routine

E - Emergency

L - Likelyhood

S - Severity

R - Risk

SR - Statutory Requirements LR - Low Risk

MR - Moderate Risk

HR - High Risk

ER - Extreme Risk



Department: Medical Unit/ Section: Emergency Room

SN


D/ ID

R/NR/E

Failure Mode Hazard Existing Control

Risk Evaluation

Addl Contro

l

Risk Communicatio

n

SR

Residual Risk

L S R

VI Emergency Patient

1. Handling, Shifting and

Hospital Attendant

D E Improper body posture

Ergonomic:Musculoskeleta

Employee education &

2 3 LR Personal & Group

Care transport of patients

s & technique l injuries and cumulative trauma disorders

Training,Good House keeping,Personal Hygiene,Proper Job procedures,PPE,PME

communication,Seminars &Clinical meetings,

Failure to wear PPE




Defective equipment




2. Clinical Examination and management

Medical Officer

D E Failure to wear PPE




Use of Gloves Chemical:Latex allergy caused by exposure to natural latex gloves




Nurses,Medical officers

D E Needle- Stick Injury



2 4 HR



Dresser/ Nurse/ MO

D E Failure to wear PPE




Needle stick Injury



1 4 HR


,PPE,PME

5. Nursing Care Nurses D E Substandard conditions: wet floors

Physical:Slips & trips



Substandard conditions: Faulty electrical equipment




Exposure to chemicals

Chemical:Skin defatting, irritation, and dermatoses because of frequent use of soaps, detergents &Disinfectants.



Use of Gloves Chemical:Latex allergy caused by exposure to natural latex gloves.

Employee education & Training,Good House keeping,Personal

2 3 LR Personal & Group communication,Seminars &Clinical

Hygiene,Proper Job procedures,PPE,PME

meetings,

Failure of PPE and faulty technique

Biological:Risk of contracting a communicable disease from the patients.


1 4 HR


Substandard practiceNeedle stick injury

Biological:Infections due to the exposure to blood, body fluids or tissue specimens possibly leading toblood-borne diseases such as HIV, Hepatitis B and Hepatitis C.


2 4 HR


6. Communicating bad news

Medical officersNurses

D E Poor communication

Emotional upset and violence towards service provider



7. Shift work, night work and overtime work

Medical officers/ Nurses/ Attendant

D E Disturbed biological circadian rhythm

Stress,strained family relations and burnout



s House keeping,Personal Hygiene,Proper Job procedures,PPE,PME


Exposure to severely traumatized patients, multiple victims of a disaster or catastrophicevent or severely violent patients

Post-traumatic stress syndrome.









Department: Medical Unit/ Section: Occupational Health Centre

SN Process Activities Process Owner

D/ ID

R/NR/E

Failure Mode


Risk Evaluation

Addl Contro

l

Risk Communicatio

n

SR Residual Risk

L S R

VII

Occupational Health Services

1. Medical Examinations, Post checkup counseling and report preparation

Medical Officer





Factories Act 1948 for Periodic Medical Examinations

Use of Gloves

Chemical:Latex allergy caused by exposure to natural latex gloves



Long working hours on computers & awkward posture

Ergonomic:StressMusculoskeletal injuries

Employee education & Training,Good House keeping,Personal Hygiene,Proper Job procedures,


PPE,PME

2. Biomedical waste management including collection, segregation and storage of hospital waste

Sanitary workers

ID

R Substandard conditions: wet floors

Physical:Slips, trips & falls



Bio- medical Waste (management & handling) Rules 1998

Substandard conditions e.g.Faulty electrical equipment

Electrical shock resulting from work with mechanized and electrical field equipment




ChemicalBurns- Contact with strong oxidants, especially chlorine compounds used for disinfection




Chemical:Dermatitis and eczemas resulting from contact with various oils and solvents used for pest control

Employee education & Training,Good House keeping,Personal Hygiene,


Proper Job procedures,PPE,PME


Biological:Exposure to various microorganisms while working with liquid or solid wastes


1 4 HR Personal & Group communication,Seminars &Clinical meetings,


BiologicalRisk of contracting infectious diseases while working in hospital


1 4 HR Personal & Group communication,Seminars &Clinical meetings,

physical overexertion andawkward posture while carrying and otherwise handling containers and heavy pieces of equipment orby work in confined or awkward spaces

Ergonomic:Acute musculoskeletal injuries and cumulative trauma disorders






SR - Statutory Requirements

LR - Low RiskMR - Moderate RiskHR - High RiskER - Extreme Risk

medical risk register

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