CHSP Hazard Identification and Control Questions and Answers — Questions and Answers
Question 1: A hospital is designing a new pharmacy cleanroom for compounding sterile preparations. To minimize the risk of airborne contamination, which of the following hazard control strategies should be prioritized during the design phase?
- Mandating the use of N95 respirators for all staff inside the cleanroom.
- Developing a comprehensive training program on aseptic techniques for all pharmacy staff.
- Installing a high-efficiency particulate air (HEPA) filtration system. (Correct answer)
- Implementing a strict surface cleaning and disinfection protocol.
Correct answer: Installing a high-efficiency particulate air (HEPA) filtration system.
According to the hierarchy of controls, engineering controls are more effective than administrative controls or personal protective equipment (PPE) because they are designed to remove the hazard at the source. A HEPA filtration system is an engineering control that physically removes airborne contaminants, providing a more reliable and consistent level of protection than relying on PPE, training, or cleaning protocols alone.
Question 2: A healthcare safety professional is conducting a prospective risk assessment for a new robotic surgery program. Which of the following methods is most appropriate for proactively identifying potential failures and their effects before the program is implemented?
- Root Cause Analysis (RCA)
- Job Hazard Analysis (JHA)
- Failure Mode and Effects Analysis (FMEA) (Correct answer)
- Incident investigation report review
Correct answer: Failure Mode and Effects Analysis (FMEA)
Failure Mode and Effects Analysis (FMEA) is a proactive, systematic method used to identify and address potential problems and their resulting effects within a process before an adverse event occurs. In contrast, Root Cause Analysis (RCA) is a retrospective method used to analyze serious adverse events after they have happened. A Job Hazard Analysis (JHA) focuses on the relationship between a worker, a task, and the environment but is less comprehensive for a complex system like robotic surgery. Reviewing incident reports is also a retrospective approach.
Question 3: A medical unit has experienced an increase in musculoskeletal injuries among nursing staff, primarily related to repositioning bariatric patients. Which of the following administrative controls would be an appropriate component of a comprehensive Safe Patient Handling and Mobility (SPHM) program?
- Installing ceiling-mounted patient lifts in all bariatric patient rooms.
- Providing all staff with back support belts.
- Implementing a policy that requires a team of at least two staff members and the use of a friction-reducing device for all bariatric patient repositioning tasks. (Correct answer)
- Replacing all manual hospital beds with fully electric models.
Correct answer: Implementing a policy that requires a team of at least two staff members and the use of a friction-reducing device for all bariatric patient repositioning tasks.
Administrative controls involve changing the way people work. Implementing a specific work practice policy, such as requiring a team lift and the use of an assistive device, is a classic example of an administrative control. Installing ceiling lifts and replacing beds are engineering controls. Providing back belts is a form of personal protective equipment (PPE), which is the least effective control measure.
Question 4: A Job Hazard Analysis (JHA) is being performed for the task of changing a medical gas cylinder. What is the primary purpose of the first step in the JHA process?
- To recommend appropriate personal protective equipment.
- To identify the potential hazards associated with the task.
- To break down the job into a sequence of basic steps. (Correct answer)
- To calculate the risk score for the overall task.
Correct answer: To break down the job into a sequence of basic steps.
The first fundamental step in conducting a Job Hazard Analysis (JHA) is to break the job down into a sequence of distinct steps or tasks. Only after the job steps are clearly defined can the associated hazards for each step be identified, and appropriate controls be recommended. Calculating a risk score may be part of a broader risk assessment but is not the initial step of a JHA.
Question 5: An ambulatory surgery center is conducting its annual workplace violence (WPV) hazard assessment. Which of the following factors should be considered a key environmental risk factor for potential violence?
- The number of staff who have completed de-escalation training.
- The presence of a written 'zero-tolerance' policy towards violence.
- Unrestricted public access to patient care areas and poor lighting in the parking lot. (Correct answer)
- The average wait time for patients in the reception area.
Correct answer: Unrestricted public access to patient care areas and poor lighting in the parking lot.
Environmental risk factors for workplace violence include physical aspects of the building and its surroundings. Unrestricted access allows potential aggressors to enter sensitive areas, and poor lighting can increase risk by concealing threats. While de-escalation training, policies, and wait times are important components of a WPV prevention program, they are considered administrative or procedural factors, not environmental ones.
Question 6: Following a serious medication error, a hospital's patient safety officer convenes a team to conduct a Root Cause Analysis (RCA). The primary goal of this RCA is to:
- Determine the appropriate disciplinary action for the individuals involved.
- Identify and correct the underlying system vulnerabilities that led to the error. (Correct answer)
- Complete the required regulatory reporting within the mandated timeframe.
- Calculate the financial impact of the adverse event on the organization.
Correct answer: Identify and correct the underlying system vulnerabilities that led to the error.
The central tenet of a Root Cause Analysis (RCA) in healthcare is to move beyond individual blame and identify the underlying systemic problems or process failures that contributed to an adverse event. The focus is on prevention by fixing the system, not on punishing individuals. While reporting and financial assessment are consequences of an event, they are not the primary goal of the RCA process itself.
CHSP Hazard Identification and Control Questions and Answers
A hospital is designing a new pharmacy cleanroom for compounding sterile preparations.
To minimize the risk of airborne contamination, which of the following hazard control strategies should be prioritized during the design phase?