Induction must include health and safety

EDITOR - Dr Ward's article(1) on ‘Improving quality in hospital induction programmes' does not mention Health and Safety issues. This must be a grave omission. Junior doctors, and all doctors, need education and constant reminding on the hazards and risks of healthcare work. Clauses in work contracts, if present, are not always adhered to.

An induction programme should include clear advice on safe work practices and areas which deserve particular attention include:

1. management of needlestick injuries, including initial management of the source patient and what to do if, for example, a needlestick injury occurs out of hours;

2. hepatitis B serology with or without vaccination;

3. correct disposal of sharps (hospital laundry staff continue to suffer needlestick injuries), and disposal of other clinical waste;

4. use of gloves;

5. contact with chemicals for example, glutaraldehyde;

6. latex allergies.

   In the ideal world, an induction programme would also include advice on

7. stress management and relaxation methods;

8. alcohol and drug misuse (as highlighted in the recent World in Action TV programme).

The role of the occupational health department should be clarified, and guidance on where to obtain further information should be given.

The Health and Safety at Work Act 1974 places a duty on employers to ensure, so far as is reasonably practicable, the safety and health of all his/her employees. Employees also have general duties under the Act not to endanger themselves or others through their acts or omissions while at work. Aside from this, we carers need to acknowledge that despite familiarity with illness and hazards, we are not immune. By caring for ourselves, we can surely provide a better service for our patients.

Andree Rochfort, General Practitioner Bray Medical Centre, Herbert Road, Bray, County Wicklow, Ireland.

www.bmj.com/cgi/content/full/316/7131/S2-7131