Occupational Safety for the Nursing Profession

1
Occupational Safety for the Nursing Profession
2
Presentation by
Risk Management Division
Centers for Long Term Care, Inc.
Steve Spainhouer, OSHT, ASSE
3
The US Department of Labor states that working in
a nursing environment is the second most
dangerous job, outside of the construction trades.
Typical Injuries
Muscular-Skeletal Disorders (MSD)
Exposures to Blood-borne Pathogens
Injuries as a result of Workplace Violence
(Patient related)
4
Facts
Back pain affects up to 38 per cent of nurses
Work injuries cost employers an estimated 1
billion dollars a year
Nursing Homes are an OSHA-targeted industry
for Training and Inspections
5
Ergonomic Training Goals
(1) teach employees to recognize the signs and
symptoms of MSDs so that they can report them
early and respond to them appropriately
(2) identify those jobs or tasks that have
ergonomic stressors capable of causing MSDs and
(3) know how to control ergonomic stressors.
Success of the ergonomics program depends to a
great extent on the effectiveness of ergonomics
training.
6
Keys to Points for Educating Employees

• Back Pain and Possible Causes

• Safe Patient Handling Techniques

• Alternate Methods for Patient Handling

• Work Practice and Engineering Controls

7
NON-WORK RELATED CAUSES OF MSD and BACK PAIN

• Genetic causes
• Age
• Physical capabilities
• General Health
• Other factors such as psychosocial
• factors like as job dissatisfaction,
• monotonous work, and limited job
• control.

8
LIFTING HAZARDS

• Unsafe lifting practices account for a
• majority of back injuries
• Most back injuries occur as a result of
• twisting and turning while bearing a
• load
• Unassisted lifts account for over half of
• all neck, back and shoulder injuries

9
Preventing Muscular-Skeletal Disorders
Guiding and Slowing FallsActivityResident
HandlingDescriptionMethod for guiding and
slowing fallsWhen to Use When resident is
falling.Points to Remember The use of transfer
or gait belts may assist the caregiver in guiding
the fall. Hold onto the belt/handles and slowly
lower the resident to the floor using correct
body mechanics. Reviewing resident assessments
and watching for signs of weakness are effective
ways of preventing falls. Keep back straight,
tighten abdominal muscles, bend legs, and stay
close to resident if safe to do so. Do not
attempt to stop the fall abruptly as this may
contribute to caregiver injury.
10
Preventing Muscular-Skeletal Disorders
Bathtub, Shower, and Toileting ActivitiesActivit
yResident HandlingDescriptionToilet seat
risersWhen to Use For toileting partially
weight-bearing residents who can sit up unaided,
use upper extremities (have upper body strength),
are able to bend hips, knees, and ankles, and are
cooperative. Independent residents can also use
these devices.Points to Remember Risers
decrease the distance and amount of effort
required to lower and raise residents. Grab bars
and height-adjustable legs add safety and
versatility to the device. Ensure device is
stable and can accommodate residents weight and
size.
11
Preventing Muscular-Skeletal Disorders
Patient Transfers ActivityResident
HandlingDescriptionMechanical assist method
for moving patients from a bed to a chair When
to Use When resident is not ambulatory Points
to Remember The use of transfer requires the
employee to be trained on the specific lift
device to be used and the use of an assistant.
Lift devices must be kept in good working order
and checked thoroughly before each use. Make sure
the patient understands their roll and what to do
BEFORE the lift device is utilized.
12
Blood-borne Pathogen Exposures
800,000 needle-stick injuries occur each year in
the United States
Source US Dept of Labor, BLS
16,000 (est) healthcare workers a year contract
HIV as a result of exposure incidents
Source American Hospital Assn, 1992
HBV and HCV pose greater risk than HIV
Source US Centers for Disease Control
13
Needlestick Injuries Among Health Care Workers
Source EPINet.Data University of Virginia
14
The majority of needle-sticks occur when health
care workers Dispose of needles Administer
injections Draw blood Recap needles Handle trash
and dirty linens
15
When Do Needlesticks Happen?
16
Patient Aggression and Workplace Violence Issues
Common Causes may include

• Drugs and Substance Abuse

• Psychological Reasons

• Stress of Aging

• Breakdown in Communication Systems

• Criminal Intent

17
Patient Aggression and Workplace Violence Issues
Types of Aggressive Behavior
!
Immediate Confrontations
Hitting, Pushing, Grabbing, Pinching, Kicking,
Biting, Verbal Abuse
Distance Attacks
Striking or stabbing at someone with an object,
use of a firearm or other weapon
18
Patient Aggression and Workplace Violence Issues
Tools to PREVENT Incidents

• Workplace Violence Policies

• Employee Awareness

• Employee Training in Crisis
• Intervention Techniques

• Physical Barriers / Security Presence

19
Patient Aggression and Workplace Violence Issues
Potential Sources for Conflict
Client, patient or customer
Family member or significant other
Current or Former Employee, Manager or Supervisor
Stranger on Stranger
20
Summary
The nursing industry has many hidden
occupational hazards.
The leading causes of employee injury claims in
the nursing profession include

• Muscular-skeletal disorders (back or shoulder
  pain)

• Exposures to blood-borne pathogens

• Injuries that are the result of workplace
  violence
• or patient aggression.

21
Centers for Long Term Care, Inc.