Trained first aiders in “low risk” microbusinesses

WorkSafe contacted me today concerning some issues raised in a previous post concerning their first aid information. Some small tweaks have been made to that post but one point required elaboration.  There is some dispute over whether low risk micro businesses require a trained first aider.   Below is my position.

FIRST AID NEEDS ASSESSMENT

The First Aid Compliance Code discusses a first aid needs assessment.   In our experience of assessing scores of workplaces, large and small, for first aid needs (including over 28 McDonald’s restaurants but that’s another story), we are convinced that a workplace that relies on others to provide an acceptable level of emergency first aid response would expose the employer to avoidable legal issues.   Unless, of course, one relies on “as far as is reasonably practicable” after someone may have been seriously injured or died on your premises.  It is doubtful that the relatives of the deceased would be so forgiving.  (Consider the actions of concerned relatives following the Kerang court case decision.)

Ask yourself, is it better to have a trained first aider on site just in case, or rely on an ambulance being readily available and render no assistance?

Time is crucial in an emergency, with the risk of a person’s condition becoming more serious the longer treatment is delayed.  Emergency ambulances, even in metropolitan areas, can be delayed and, in an emergency, waiting with an unconscious and/or non-breathing person will seem an eternity.  Any delay in rendering appropriate first aid treatment will complicate proving that an appropriate duty of care was applied in the circumstance.

The Australian Resuscitation Council has made its guidelines available online. For those interested in establishing an appropriate level of first aid response for their workplaces, the guidelines are recommended to read.  But more importantly is the need to have suitably trained first aiders on site, particularly after an assessment of the workplace’s  first aid needs has been conducted.  A first aid kit is next to useless if CPR is required.

Of course, the need for first aid is minimised if all the other OHS matters are dealt with first in an orderly safety management system.

Kevin Jones

Flawed first aid information

First Aid Complaince CodeSome time ago WorkSafe Victoria issued Compliance Codes on a number of workplace safety issues.  One was concerning First Aid.  The Compliance Codes were intended to replace Codes of Practice which had been around for decades.

The previous major change to workplace first aid was in 1995 when the First Aid Code of Practice was reviewed in Victoria.  Other Australian States vary between prescriptive and non-prescriptive first aid guidelines.

On 31 May 2009, WorkSafe released a factsheet on first aid for low risk micro businesses.  A low risk micro business is explained in the factsheet as those that

  • employ fewer than 10 people
  • are located where medical assistance or ambulance services are readily available
  • are businesses that don’t expose employees to hazards that could result in serious injuries (eg serious head injury, de-gloving, scalping, electric shock, spinal injury) or illnesses that may require immediate medical treatment.

First Aid for Low Risk Micro BusinessesSome examples of low risk micro businesses were included in the factsheet –  “retail shops and outlets, offices, libraries and art galleries” Why a one page information sheet for this sector was deemed to be needed is a mystery?  I asked WorkSafe several questions about this factsheet

  • What was the rationale for the production of this guidance for this sector? Given that the Compliance Code is specifically referenced.
  • Is retail really a low-risk micro-business?
    • What about the use of ladders?
    • Young workers?
    • Working alone or unsupervised?
    • Occupational (customer) violence?
    • Petrol stations?
    • Convenience stores?
    • Night shift security needs?
    • Knife cuts from removing stock from boxes?
    • Manual handling?
  • First aid kits are required but not first aid training. In the case of respiratory failure a first aid kit is next to useless for CPR.
  • Why is only St John Ambulance referenced on the guidance?

The factsheet misunderstands first aid by placing low risk microbusineses into the “paper-cut” sector.  This is doing micro-businesses a dreadful disservice.

TRAINED FIRST AIDER

Shortly after the First Aid Compliance Code was released St John Ambulance broadcast an email about workplace first aid compliance.  In that email St John wrote:

Low risk organisations (office, libraries, retail etc) should have at least one qualified First Aider for 10 to 50 employees…

The May 2009 fact sheet makes no mention of the need for a trained first aider but WorkSafe’s own Compliance Code states this as a compliance element.

A low-risk micro-business may not generate the potential hazards that WorkSafe lists in its definition above but employees in these businesses do have to respond to the injury needs of their customers.  In these times of public liability and the expansion of OHS obligations to include customers, neighbours, and others who are affected by work processes.

WorkSafe itself describes an employee’s duty of care:

“All workers have a duty of care to ensure that they work in a manner that is not harmful to their own health and safety and the health and safety of others.”

The omission of a trained first aider is unforgivable.  What would an employee do if a client collapses in the foyer of a convenience store with a heart attack or chokes on the food that they have just purchased?  What would one do if a stab victim stumbles into the only open retail outlet, perhaps a petrol station, at 2.00am? How would that petrol station attendant  treat someone who has had petrol accidentally splashed in their face?

These matters cannot be treated by a person who is untrained in basic first aid who only has a first aid kit available.  Training for all workers who work alone or in isolation in micro-businesses is a basic element of compliance, one that WorkSafe fails to list in its latest workplace first aid factsheet.

EMERGENCY NUMBER

Almost as unforgivable is that the factsheet makes no reference to the Australian emergency number of 000.  One of the first actions to be performed in a workplace where someone is seriously injured is to call for an emergency ambulance.  While waiting for the medical authorities, and if safe to do so, first aid should be rendered. WorkSafe needs to remember that CPR requires training and that a first aid kit is next to useless in this type of situation.

ST JOHN AMBULANCE

It is curious that only St John Ambulance is listed on the factsheet for further information.  There are many first aid equipment and training providers in Victoria.  It would have been fairer to either recommend all providers or none at all.

[UPDATE: WorkSafe has advised SafetyAtWorkBlog that they will be addressing the St John Ambulance and 000 issues raised.]

COMPLIANCE CODES

On 18 September 2008, the WorkSafe website described the First Aid Compliance Code as covering

“…first aid arrangements including first aid needs assessment, first aid training, first aid kits and first aid facilities.”

In a media statement at the time on compliance codes generally WorkSafe Executive Director, John Merritt was quoted:

“The codes were developed after extensive consultation with industry, employers, employees, governmental agencies and the community to provide greater certainty about what constitutes compliance under the OHS Act.”

“The codes include practical guidance, tools and checklists to make it easier for duty-holders to fulfil their legal obligations.”

Mr Merritt added that: “These codes will provide Victorian employers, workers and Health and Safety Representatives with certainty and assistance in meeting their responsibilities.”

The Compliance Codes are aimed at the many dutyholders yet one of the rationales for the new single sheet guidance is that dutyholders (employers) do not read Compliance Codes.  It seems that the Codes are now principally read by OHS professionals and advisers.

(This position may be one of the reasons WorkSafe is pushing so hard for a truly professional OHS structure through its HaSPA program – the establishment of an OHS middleman between the rules and their application in the real world.)

It is a considerable change to the readership the Compliance Codes were aimed at and is a substantial change from the Codes of Practice which, in the case of First Aid, were handed out to all first aid trainees, included in information kits for health & safety reps, and were read by dutyholders and integrated into their OHS management practices.

The significance of Compliance Codes and Codes of Practice at the moment is that these documents are to be part of the Federal Government’s move to harmonisation of OHS laws.  (Some eastern States have already begun joint publication of guidances). Variations in these documents, often the most referred-to OHS documents in workplaces across the country, will undercut the aim of harmonisation – the reduction of business compliance costs through harmonised OHS requirements.  If the practical application of laws are not harmonised, the aims will never be met and the process could be seen as seriously flawed.

Kevin Jones

Working alone – a poorly understood work hazard

Working alone is an established workplace hazard in many industries.  The control measure most applied is “don’t work alone” that is, undertake as many work tasks in isolated location with someone supervising or in close contact.

Modern technology has often been applied as a possible control measure – “deadman switch”, GPS tracking, mobile phone use.  Many of these control measures are second nature to workers in this century and are so commonplace that their safety role is ignored.

Regardless of the many zookeeper attacks that have gained media headlines over recent years, many workers are assaulted and killed while working alone.  Industries that do not have a strong history of safety management most often get caught out by having a staff member injured or killed.  Bosses or industry associations often express wonder at how such an incident could occur.  Safety professionals would have seen the hazard instantly.

The risk of violence from working alone has been a hot topic in Australia since a Victorian female real estate agent was murdered while showing a prospective “client” an isolated property.

HSS0075-Real      -3.477447e+266state-Property            51804944nspection                    afety[1]WorkSafe Victoria has just released a further publication concerning this matter.  The alert is okay in its context but is doing a disservice by being restricted to real estate agents.  Worksafe has more generic guidance but focus on real estate agents? Why not produce similarly detailed guidance guidance that is more broadly applicable to workers in isolation – pizza deliverers, night shift workers, street cleaners, office cleaners a whole raft of occupations that operate alone?

WorkSafe has said previously that real estate agents gain priority because such guidances are developed in conjunction with industry associations.  A legitimate question can be asked, why is a government authority producing guidance for a sector that already has an industry body who can do this?  Shouldn’t an OHS regulator be focusing on those areas that don’t have industry support?

Below are some of the recommended control measures in the latest publication.  SafetyAtWorkBlog’s more generic control measures are in red.

  • having a new client stop by the office and complete a personal identification form before viewing a property to verify details

Have a detailed list of staff work locations and a contact name and (after hours) number for a supervisor at each location

  • inspecting properties during the day. If night inspections are necessary, ensure the agent is accompanied. Identify exit points in case a quick escape is needed

Work with a colleague wherever possible

  • inspecting the property before showing clients,to assess any existing risks or hazards

Consider the security measures of each work area – lighting, access/egress, phone coverage, camera surveillance, etc

  • making an excuse and leaving the site immediately if the client becomes aggressive or makes the agent feel uncomfortable

Cancel the work task at the first sign of hazard

  • calling the office with a pre-assigned emergency code phrase if the agent senses a dangerous situation

The “safe word” control measure is well established in the escort business.  It can work but will only notify of a dangerous situation not eliminate it

  • regularly training staff on safety procedures, including instructions on dealing with potential offenders and incident reporting.

Develop safe work procedures in consultation with staff 

When considering control measures in these situations it may be very useful to understand that prosecutions are likely to consider that employers have undertaken control measures “as far is reasonably practicable” – a movable feast of judgements.  Ask yourself or your client the question, would they prefer to know that an employee is in danger, injured or killed, or would they prefer to have the employee safe and loose a potential client?  The court may consider camera or other technical surveillance to be reasonably practicable but what would your employee who has lost an eye, limb and quality of life think?

Consider other control measures ONLY AFTER elimination has been seriously considered.

Kevin Jones

Other OHS guides concerning working alone are available below

WorkSafe WA

WA Dept of Commerce

Trade Union site

WorkSafe Victoria

Workplace Health & Safety Queensland

New Youth@Work website

The South Australian government has launched a website focusing on young people at work, not surprisingly called Youth@Work.  

South Australia has a habit of marching to a slightly different beat to the dominant Australian States on OHS.  They did not follow WorkSafe Victoria’s “Homecomings” ads and they have been well ahead of anyone in researching and explaining the relevance of wellness as an OHS issue.

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“Homecomings” safety ads reach the US

As mentioned last month in SafetyAtWorkBlog, the Victoria-designed “Homecomings” advertisements are to be launched on United States television.  The Department of Labor & Industries for Washington State announced the ads on 19 May 2009.  According to the DL&I media release

“These ads are particularly effective at bringing home the importance of safety in the workplace and the effects it can have on so many people,” said Don Brunell, president of the Association of Washington Business. “When an accident happens at work, it affects everyone – family, friends and co-workers.”

One ad is available for viewing at http://www.lni.wa.gov/main/worksafe/ 

[It looks like parts needed to be re-filmed to show left-hand drive vehicles and obviously the music rights for Dido’s song couldn’t apply in the US]

Kevin Jones

WorkHealth concerns increase

Victoria’s WorkHealth program is due to roll-out its next stage of worker health assessments.  However, the program has been seriously curtailed by the failure of its funding model.  According to The Age  newspaper on 18 may 2009, employer associations have begun to withdraw their support compounding the embarrassment to the Premier, John Brumby, who lauded the program in March 2008.

The Master Builders Association will not be supporting the program due to WorkHealth’s connection with WorkSafe.  The Victorian Automobile Chamber of Commerce (VACC) thinks likewise.  There are concerns over the privacy of worker health records and that data from health checks may affect worker’s compensation arrangements or future claims.

The VACC is also concerned that employers will be blamed for issues over which they have little control – the health of their workers.

Many of these concerns could have been addressed by locating WorkHealth in the Department of Health, where health promotion already has a strong role and presence.  It is understood that the funding of WorkHealth from workers compensation premium returns on investment caused the program to reside within the Victorian WorkCover Authority.  There has also been the suggestion that WorkHealth was a pet program of the WorkCover board.

The program aims of free health checks for all Victorian workers was admirable and still achievable but the program was poorly introduced, poorly explained, based on a flawed funding model and now seems to be, if not dead, coughing up blood.

Kevin Jones

A vision for the OHS profession

WorkSafe Victoria is very involved with moves to improve the professionalism of OHS practitioners in Australia.  There is no doubt that improvements are required but the role of a state-based regulator in a non-regulatory system is curious. Surely such changes should be run from a national perspective

Safety professionals often look at the prominence, influence and market share of professional organisations for the doctors or the accountants.  In Australia, at the moment, the health care profession’s accreditation/registration process is having a new structure introduced.  After a long review process the Australian Health Workforce Ministerial Council identified these areas for change

  • Accreditation standards will be developed by the independent accrediting body or the accreditation committee of the board where an external body has not been assigned the function.
  • The accrediting body or committee will recommend to the board, in a transparent manner, the courses and training programs it has accredited and that it considers to have met the requirements for registration.
  • Ministers today agreed there will be both general and specialist registers available for the professions, including medicine and dentistry, where ministers agree that there is to be specialist registration. Practitioners can be on one or both of these registers, depending on whether their specialist qualification has been recognised under the national scheme.

This third point is an excellent one and so easily applied to the safety profession and the practitioners. “Specialist” and “generalist” seems to reflect the composition of the safety industry in Australia.  There are those on the shopfloor or offices who deal with hazards on a daily basis.  There are those who research and write about safety.  And there are those who are a bit of both.  The two category system of accreditation seems simple and practical and readily understood by those outside of the profession.

  • Both categories will attract experts in various fields but the categories themselves don’t relate to specific areas of expertise. The Ministerial Council has agreed that there will be a requirement that, for annual renewal of registration, a registrant must demonstrate that they have participated in a continuing professional development program as approved by their national board.
  • Assistance will be provided to members of the public who need help to make a complaint.
  • The Ministerial Council agreed that national boards will be required to register students in the health profession
  • …boards will be appointed by the Ministerial Council with vacancies to be advertised. At least half, but not more than two thirds, of the members must be practitioners and at least two must be persons appointed as community members.
  • There will be a new “Australian Health Practitioner Regulation Agency”

 These points deal with matters sorely lacking from many areas of the safety profession – independence, transparency, skills maintenance, a clear and independent complaints procedure, diverse representation and a formal regulatory agency.

To this SafetyAtWorkBlog would add the concept of a Safety Industry Ombudsman for it is always necessary to have someone watching the “watchmen”.

Currently the Australian safety profession is part way through a mish-mash of a process of professionalisation.  Surely it would be better to follow the most contemporary of processes being implemented by health care and others.  Such a process would take some time and require support from the various disciplines of safety and the government.  More importantly, it may require “vision” but during this time of substantial change in OHS legislation and regulatory structure, it is surely the right time to bring in long-term structural change to a profession that would benefit business and the public very well indeed.

Kevin Jones

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