Health and Safety Guide to Working in
Isolation in the Health and Disability Sector
A guide for employers
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Purpose
This document has been developed by the Health and Disability Sector Safer Industry
Forum group with the assistance of ACC. Its purpose is to provide guidance for
employers and managers in identifying, assessing and controlling the hazards that are
associated with working in isolation.
This guide will also assist with the development of appropriate policies and procedures
to enable organisations to meet their legal obligations.
Scope
This document is relevant for all healthcare employers and their employees who are
required to work in isolation as part of their duties.
Supporting this document is a one-page checklist for employees. A copy has been
included at the end of this booklet for you to photocopy. If you want to download a copy
for your staff, go to www.acc.co.nz and search ACC5260.
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What is Working in Isolation?
Working in isolation can be defined as:
Working alone or remote from normal services and support, limiting capacity to
summon assistance readily in the event of injury, illness, violence, emergency or other
event, and therefore increasing the risk of harm.
A lone worker is:
A worker whose activities involve a large percentage of their working time operating in
situations without the benefit of interaction with other workers or without supervision
or collegial interaction.
Employees may work in isolation if they:
•
Physically work alone, for example at night in a laboratory
•
Work separately from others, for example community nurses
•
Work at home, for example researchers
•
Work outside normal hours, for example on-call maintenance staff
•
Work shift work or night work, for example security staff
•
Travel as part of work, for example social workers
•
Provide home-based care, for example home-based support workers
•
Work unsupervised, for example night staff
•
Work in geographical isolation, for example in a remote part of the countryside
•
Work on a reduced staff roster, for example on public holidays
•
Work in a situation of emotional isolation, for example a new, young or
inexperienced worker in a new position. It might also include cultural and
gender isolation, such as someone from a minority culture/ethnicity working in
a ‘mainstream’ organisation, or working in a profession with a gender majority,
for example male caregivers.
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Health and Safety Responsibilities
The Health and Safety in Employment Act, 1992 (HSE Act) sets down responsibilities
and obligations to ensure safety, and health and wellbeing, while at work.
Employer responsibilities
Employers must take all practicable steps to ensure the safety of employees at work,
and in the case of lone workers they should:
•
Establish if lone working is necessary, and identify the hazards and appropriate
management options
•
Use hazard identification and risk assessment processes to help determine the
level of supervision required
•
Engage with their employees and work together to decide what level of support
and assistance is required. This might include:
–
Consulting staff groups and their unions about health and safety
management systems
–
Providing employee support systems, including appropriate training
–
Ensuring that employees understand the risks associated with their work
and that the necessary safety precautions are taken
–
Supervisors providing guidance in situations where the risks of working in
isolation are unclear
–
Supervisors making periodic site visits and addressing health and safety
issues that arise. If recommendations for improvements or corrective
actions are made, these should be carried out within a reasonable
timeframe.
Employee responsibilities
Employees must take all practicable steps to ensure their own safety, and that no action
or inaction causes harm to others. This means that if they are lone workers they should
be trained so that they know they should:
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•
Take reasonable care to look after their health and safety while at work, which
could include reporting unexpected fatigue, feeling compromised, or requiring
additional support
•
Report and, if reasonably practicable and they are sufficiently skilled to do
so, rectify identified hazards. Reporting hazards should be done as soon as is
practicable, for example by contacting someone directly, through a handover
book or during the handover time at work
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•
Comply with any workplace safety and health procedures, for example use
materials and equipment safely as per instructions. If in doubt, they should ask
•
Ensure that safety processes remain operational
•
Report all accidents and incidents, including any problems with procedures that
are in place and are not practicable for the lone workers to rectify.
Role of the elected and trained health and safety representative
Health and safety representatives have a very important role in representing lone
workers and issues surrounding working in isolation. Their role may entail:
•
Helping to facilitate regular evaluations of the necessity of lone working, in the
first instance
•
Contributing to the development of safe systems of work
•
Advising on safe work practices
•
Representing any suggestions from the lone workers to the employer
•
If required, issuing hazard notices as per the HSE Act.
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Hazard Identification, Risk Assessment
and Hazard Control
Hazards should be identified, risks assessed and controls put in place. In the case of
working in isolation, hazards, assessments and controls may differ from what ‘normally’
occurs.
Remember, working in isolation isn’t necessarily working alone!
Step One: Identify the hazards
Work-related injuries and diseases can arise from hazards at work. Hazard identification
and risk assessment should be carried out and appropriate controls implemented to
eliminate, isolate or minimise hazards. Determine if the hazards are significant (as
outlined in the HSE Act). Hazards may include:
•
The design of the work processes
•
The materials, substances and equipment being used
•
Physical hazards such as noise and exposure to infection
•
The organisation of the work
•
Factors such as stress, emotional isolation, workload or lack of instruction
or training.
Working in isolation is a hazard that may increase or alter the risks associated with
other hazards.
Below are examples of hazards that might be further compounded by working in
isolation.
•
Accidents and emergencies arising out of the work, and the provision (or lack of
it) of first aid treatment
•
Sudden illness or incapacity
•
Inadequacy of rest, hygiene and welfare facilities
•
Physical violence from members of the public and/or intruders
•
Physical demands of the work, for example lifting or carrying
•
Mental demands of the work, for example is the work monotonous, repetitive or
is there a need for high vigilance and concentration, which means the risks may
be increased by working in isolation?
•
The hours of work, for example night shifts, length of shifts, breaks
•
Physical or professional limitations specific to employees and/or the work
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• Personal needs and work experiences of the employee, such as:
Contributory
factors
•
–
Pregnant employees
–
Migrant workers with issues with language, cultural barriers and training
–
Pre-existing medical, physical or mental health problems
–
The emotional state of employees
–
People who rely on public transport to get to and from work
Special circumstances on the site, for example geographical location.
Step Two: Assess the risks
Risk assessment
To address hazards identified with lone working, a risk assessment must be carried out.
Risk assessment is a process of identifying what hazards exist in the workplace and how
likely it is that they will cause harm or serious harm to employees and others. It is the
first step in deciding what prevention or control measures employers need to take to
protect their employees from harm.
Good risk assessment is the key to maximising safety wherever work in isolation is
occurring. It should address two main features (in addition to the risk the hazard poses):
•
Whether the work can be done safely in isolation
•
Whether there are adequate arrangements to ensure the lone worker is safe.
Risk assessments should use all available information, including details from accident
records and consultation with the health and safety representatives and safety
managers.
The risk assessment should include arrangements for systematic monitoring of the
hazards associated with working in isolation, and should be updated regularly, as and
when processes, staff and work methods change. It should identify the preventative and
protective measures needed (as far as is reasonably practicable).
Managers should identify situations where people may work in isolation and ask
questions such as:
•
Is there safe access and egress?
•
Can all equipment, substances and loads involved in the work be safely handled
by one person?
•
Is there a risk of violence?
•
Are women especially at risk if they work alone?
•
Are young workers especially at risk if they work alone?
•
Medical suitability?
•
Does working in isolation impose any extra demands on the lone worker’s
physical or mental abilities or professional responsibilities?
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•
Does the lone worker suffer from any illness or injury that might increase the
risks associated with working in isolation? Has there been a discussion between
the employer and the employee about their capability?
•
If home working, have a hazard identification and risk assessment of the job and
the workplace been carried out?
•
Staffing levels: Can the job be done safely by a single person? The manager
should ensure that any additional hazards or risks to which the lone worker is
exposed are managed and controlled adequately.
Step Three: Control the hazards
Controlling the hazards associated with working in isolation may require extra hazard
control measures. Precautions should take account of normal work and foreseeable
emergencies, for example fire, equipment failure, illness and accidents. Procedures will
need to be put in place to monitor isolated workers to see they remain safe.
Hazard controls may include:
Emergency procedures
Emergency procedures, including in the event of serious and imminent danger, should
be established and employees trained in their use. Information about emergency
procedures and danger areas should be provided to isolated workers.
Supervision
Supervisors should periodically visit and observe people working in isolation and
appoint competent people to assist the isolated workers.
Personal protective equipment
Where a hazard cannot be eliminated or isolated, provision of and training in the use of
personal protective equipment (PPE) may be appropriate.
First aid
Isolated workers should have ready access to first aid equipment and facilities at all
times. Risk assessment may indicate that the employee needs training in first aid, for
example where there is no access to a qualified first aider. If the employee is not trained
in first aid, adequate procedures need to be put in place in case of an accident.
Communications and personal alarms
Appropriate communication and regular contact between the isolated worker and
supervision may be provided by using either a telephone or a radio. There are also
automatic warning devices available that operate if specific signals are not received
periodically from the lone worker, or devices that are activated automatically by the
absence of activity. Establish procedures to verify that a lone worker has returned to
their base or home on completion of a task.
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Preventing violence
Establish procedures to minimise the risk of violence from the public, for example:
•
The elimination of handling drugs/cash
•
Changes of route or timing when transporting valuables/medication, or when
doing routine and scheduled visits
•
Adequate building security for out-of-hours working
•
Give consideration to particular groups of employees such as women or young/
inexperienced staff
•
Provide training, for example in non-violent intervention, if appropriate
•
Liaise with community services, for example the Police.
Conditions of the workplace
Appropriate conditions include:
•
A safe, accessible means of entry to and exit from the workplace
•
Adequate lighting, heating and ventilation for the job to be carried out
•
All equipment able to be used safely and regularly inspected
•
Manual handling operations able to be performed safely by one person
•
For home visits, the premises should be assessed by qualified staff before visits
commence.
Information and training
Sufficient training and information must be provided to isolated workers to enable them
to identify hazards and take appropriate action to avoid harm. They must be able to
leave the workplace if there is serious and imminent danger.
Isolated workers need to be made aware of the risks, and controls should clearly define
the limits of work that can be carried out while working alone.
Permits to work
These are detailed, written instructions provided by the employer. They cover the
performance of hazardous activities, such as entry into confined spaces or electrical
testing. They should specify:
•
Check-in arrangements
•
Tests of communications equipment
•
Length of work periods
•
Suitable first aid equipment
•
Equipment, tools and electrical safety checks
•
Suitable PPE
•
Suitable manual handling information
•
Arrangements in bad weather
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•
Exit to safety after job completion
•
Emergency procedures and emergency teams.
Working in geographically remote or isolated areas
For an isolated worker at a remote location, consider:
•
The length of time the work should take and how frequently the worker should
report in
•
Travel to and from the location of work, especially out of normal hours
•
Access to adequate rest, hygiene, refreshment and first aid facilities
•
Access for emergency services to the location without hindrance
•
Procedures for responding to emergencies.
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A guide for your staff working by themselves
in the health industry
What should I do to help keep myself safe?
Here is a checklist you can use when you need to work in isolation. Ask yourself each of the questions,
and if you don’t know the answer, check with your supervisor.
An example of a checklist for people working by themselves
Do I know?
✓
What are hazards in my job? Note that these can be hazards that result
in immediate effects such as an injury, but can also be chronic, i.e., the
effects might be disease that may not be evident for some time.
How to report hazards to my supervisor? Some events may need to
be reported immediately (no matter what the time of day or night)
and others can be reported later.
How to escalate a safety concern that is not being addressed?
What to do in an emergency? For example, telephone numbers and
people to contact.
Do I know?
Enough about first aid? Is there a person available or have I been
trained to meet the minimum requirements that can be reasonably
predicted?
How to lift or carry safely? There are approved procedures available
using equipment and techniques.
How to deal with angry or violent people? Has this been part of
training so that I can avoid this situation?
How often to check in with someone at work?
Who to check in with at work?
What controls (if any) are in place to reduce the risk of injury from
chemicals/liquids?
Do I have?
A first aid kit equipped with enough supplies to meet any anticipated
or potential need that may arise?
The right personal protective equipment (PPE)? The type of PPE will
probably include RPE (respiratory protective equipment). Also have I
been fit tested to ensure that the RPE works as intended?
Access to current information and training?
ACC5260
A personal alarm or cell phone so I can keep in touch regularly? Have
the important contact people and numbers pre-programmed into the
machine.
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This checklist should be used in conjunction with the employers’ Health and Safety Guide to Working
in Isolation in the Health and Disability Sector (ACC5259). Also available is the resource Guidelines for the
provision of facilities and general safety and health in the healthcare industry available from the Department of
Labour website (www.dol.govt.nz).
Go to www.acc.co.nz to order additional copies of this form.
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Notes
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For further information
•
www.acc.co.nz/dpi
•
www.habitatwork.co.nz
•
www.dol.govt.nz
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www.acc.co.nz
0800 844 657
ACC5259 Printed February 2010 ISBN:978-0-478-31464-9
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