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Risk Management in NHS Laboratories (Part 1) – Practice Flashcards

Terminology

  • Hazard = anything with the potential to cause harm.

  • Risk = likelihood and severity of harm occurring.

  • Risk Assessment (RA) = structured process to identify hazards, evaluate risk, and implement controls (legally required and mandated by ISO 15189).

Typical Laboratory Hazards

  • Biological samples / pathogens

  • Chemicals & reagents

  • Sharps

  • Electrical equipment & moving parts

  • Manual handling, DSE, slips/trips/falls

  • Fire, compressed gases, waste

  • Operational hazards: staff shortage, instrument failure, expired reagents, procedure deviation

5-Step Risk Assessment

  1. Identify hazards (observe task, non-routine steps, consult staff & incident records).

  2. Assess risks (who could be harmed & how, existing controls, additional controls, assign responsibility & timescale).

  3. Control using hierarchy (Eliminate → Substitute → Engineering → Administrative → PPE).

  4. Record findings on approved template & Q-Pulse; quantify with 5\times5 matrix (Likelihood \times Consequence).

  5. Review every 2 years, after change, or post-incident.

Hierarchy of Control (most → least effective)

  • Elimination

  • Substitution

  • Engineering controls (isolate people)

  • Administrative controls (SOPs, training)

  • PPE (last line of defence)

Reasonably Practicable Principle

  • Balance risk reduction against time, cost, effort; must withstand legal scrutiny (e.g. dichloromethane assay outsourced to eliminate chemical hazard).

Key Legislation & Standards

  • HSW Order (NI) 1978 / HSW Act (GB) 1974

  • Management of H&S at Work Regs 1999 – duty to risk assess & provide info

  • COSHH Regs 2002 – control hazardous substances (chemical & biological)

  • Manual Handling Regs 1992, DSE Regs 1992, PUWER 1998, PPE Regs 1992

  • ISO 15189:2022, HCPC proficiency, IBMS good practice

Training & Documentation

  • Mandatory: Induction, COSHH, H&S awareness, Manual Handling, DSE, Infection Control, Risk Awareness, Fire Safety

  • Documents: Trust & Lab H&S policies, SOPs, RAs/COSHH, training records, inspection/audit reports, incident records, emergency plans

Chemical Safety (COSHH)

  • Safety Data Sheet (SDS) supplied under UK REACH; headings include identification, hazards, first aid, handling/storage, disposal, etc.

  • COSHH Assessment covers: use & quantity, hazards (H-statements), controls, health monitoring, storage, disposal, emergency actions.

  • Storage: minimal stock, correct concentration, labelled, inventory maintained.

Biological Safety

  • ACDP classifies pathogens; lab containment level indicates what can be processed (most labs Level 2, some Level 3 zones).

  • Biohazards assessed within COSHH; routes of entry: inhalation, absorption, ingestion, injection.

Waste Disposal Streams

  • Clinical / offensive, sharps, cytotoxic & pharmaceutical, high-risk (HG4/CJD), anatomical – follow colour-coded bins & labels.

PPE Essentials

  • Lab coat, nitrile gloves, eye protection, insulated gloves, masks (CL3) – PPE only protects wearer; does not replace other controls.

Fire Safety

  • Hazards: flammable liquids, gases, electrical equipment.

  • Controls: Fire RA, storage checks, equipment inspection, drills, appropriate extinguishers (water, foam, dry powder, CO_2).

Incident Reporting & RIDDOR

  • Report accidents/near-misses immediately; record facts (who/where/when) on Q-Pulse (lab) and Datix (Trust).

  • RIDDOR 1997: legal duty to notify HSENI of deaths, major/>3-day injuries, diseases, dangerous occurrences.

Roles & Responsibilities

  • Trust Chief Executive → General Manager → Service Managers → Lab H&S Officer → Departmental H&S Officers → All staff.

  • Staff must follow SOPs, use PPE, maintain housekeeping, report incidents/defects.

Review Snapshot

  • RAs: living documents; update after 2 years, change, or incident.

  • Ultimate aim: eliminate hazard; if not feasible, apply layered controls down to PPE.

  • Effective H&S integrates with Quality Management System to safeguard staff, service continuity, and patient care.