Laboratorians are resourceful, and if you follow them through their work day, you would be amazed at some of the processes they have put into place in order to perform the tasks they’ve been assigned to do. Not all of these processes follow the written lab procedures, though. Not all of them are acceptable by lab accrediting agencies, and many are simply unsafe. Lab quality auditors will often tell you that when there is an error, look to the system (the procedures, the equipment, the layout, etc.) before you look to the person(s) who committed the error. The problem most likely lies with the system, and if you’re having safety issues in your lab, that system may be the source of the problems there as well.
If you look at the total number of blood and body fluid splash exposures you’ve had in the past year, you may see a pattern. For example, it is a common practice to uncap chemistry specimen tubes behind a counter-mounted splash shield and then place them into a rack. What typically occurs next, though, is that the rack is carried- usually by someone wearing no face protection- over to the analyzers for testing. I often see lab techs pipetting quality control material while using no face protection. What is the system issue here? In some cases, it may be that goggles or face shields are not available. It may also be that there is no education about when splashing can occur (anytime there is an open specimen or chemical) or about the dangers of splashes of specimens and QC material. If PPE or education is not provided, staff will create an unsafe “workaround” to get the job done.
If staff in the lab throw away paper and other items that don’t belong into a sharps container, this can be expensive for the lab and ultimately bad for the environment. Sharps waste removal is charged to the department by weight, and often the waste is incinerated. Throwing away trash incorrectly is another workaround process. The system issue may be education, but it usually is that there are not enough of the necessary types of waste receptacles in the area for staff to use. If we set up the lab to make it easy for people to do the right things (for safety or for quality), there will be better overall compliance.
There are many other examples of staff workarounds that affect personal safety. Does your staff wear lab coats into clean areas? Having some coat hooks by the exits and signs to remind people about the proper process would help. Do employees get injured when changing cryostat or microtome blades? Provide implements such as forceps to use when handling the dangerous sharps. Investigate the causes of your lab employee incidents, and you may discover other unsafe workarounds as well.
Laboratorians are smart, and they are driven to get their work done. Unfortunately, there are barriers that exist within our lab systems that may seem to hinder them from their goals. Human nature and ingenuity will take over, and workarounds will arise. Sometimes the workarounds function well, and they may be legitimate and safe. When the workarounds become dangerous, it’s time to analyze them and look for repairs to the broken system in order to prevent injuries or exposures. Making it easy for staff to follow the regulations in the laboratory is another step toward an improved overall safety culture.