4 common nursing hazards demanding hospitals' attention

Nursing comes at a cost, as these workers face a number of hazards each day while just doing their everyday jobs.

Targeting some of the most common causes of workplace injury and illness in the healthcare industry, the U.S. Department of Labor's Occupational Safety and Health Administration last month announced the agency is expanding its use of enforcement resources in hospitals and nursing homes to focus on musculoskeletal disorders related to patient or resident handling, bloodborne pathogens, workplace violence, tuberculosis and slips, trips and falls.

U.S. hospitals recorded nearly 58,000 work-related injuries and illnesses in 2013, amounting to 6.4 work-related injuries and illnesses for every 100 full-time employees: almost twice as high as the overall rate in the private industry, according to the Bureau of Labor Statistics.

"Workers who take care of us when we are sick or hurt should not be at such high risk for injuries — that simply is not right," said David Michaels, PhD, MPH, assistant secretary of labor for occupational safety and health. "Workers in hospitals, nursing homes and long-term care facilities have work injury and illness rates that are among the highest in the country, and virtually all of these injuries and illnesses are preventable."

Here, Medline CNO Martie Moore, RN, MAOM, CPHQ, talked to Becker's Hospital Review about what organizations should know to prevent these hazards. Ms. Moore is the former CNO of Portland, Ore.-based Providence St. Vincent Medical Center. She currently serves as a CNO consultant, working with hospitals, clinics and physician offices nationwide on nursing services and patient care. 

Exposure to bloodborne pathogens

Ms. Moore believes greater stricter guidelines for use of exam gloves and proper hand washing techniques have helped protect clinicians from exposure to bloodborne pathogens. However, needle sticks and splashes still occur. OSHA estimates 5.6 million out of roughly 12.2 million workers in the healthcare industry and related occupations are at risk of occupational exposure to bloodborne pathogens.

Therefore, Ms. Moore believes more work needs to be done to protect caregivers at the bedside. "Clinicians need to wear their eye gear and be very cautious about the care they deliver," she says.

Injuries

Exposure to bloodborne pathogens isn’t the only hazard nurses face: Rates of workplace injury are higher in healthcare than other industries. Nurses experience more than 35,000 injuries involving the back, hands, shoulders and feet each year, according to the BLS.

Many things influence the likelihood of injury, including age of the nurse and environment. The first step hospitals can take to prevent injury is establishing a safe patient handling program, rooted in education and equipped with tools available to assist nurses so they aren't using physical exertion to lift, move or manage a patient. These tools might include mobile full-body floor lifts, sit-to-stand lifts, standing assistance aids, overhead ceiling track systems or slings and accessories.

But it's not enough for organizations to have the tools available. They also have to consider how the tools fit into the workflow, according to Ms. Moore. For instance, if the worker has to go to multiple locations to find assist equipment, put the equipment together and return to a patient's room, they're less likely to take the time to use the resource. "So you have to look at how [to] incorporate those tools into the normal process of care to assure that the tools there — they utilize it and you prevent injury," she says.

She added, "Clinicians don't have time for an injury. Certain injuries can be career-limiting, or even career-ending. You've got to be thinking about how to help people consciously learn how to move and lift correctly with the right tools so it comes naturally."

Ms. Moore recommends organizations offer simulations for nurses to practice correct lifts. Hospitals should also offer training on how to properly put on and take off personal protective equipment so nurses are protected against injuries or illnesses from contact with chemical, radiological, physical, electrical, mechanical or other hazards. 

Hand washing-related dermatitis

Nurses also need the right tools when it comes to protecting their hands. A recent study from the University of Manchester revealed healthcare workers following hand hygiene protocols are 4.5 times more likely to suffer moderate to severe skin damage. In the same study, researchers found healthcare workers made up 1,796 out of 7,138 cases of irritant contact dermatitis reported. 

Ms. Moore has had friends walk away from their nursing career due to hands that are overly irritated as a result of hand hygiene practices. She urges hospitals and health systems to think about how they can help preserve the hands of caregivers. "Leadership needs to think about gloves and hand care differently. This is a proactive cost to preserve their healthcare workforce," she says.

Cold and flu germs

Protecting nurses goes beyond their hands. As cold and flu season nears, hospitals and health systems must prepare to protect their workforce, including extra measures for those who do not receive the vaccinations for personal or religious reasons.

One option is having the nurses wear an antiviral face mask, which has been show to kill or inactivate 99.99 percent of laboratory-tested flu viruses. "Organizations shouldn’t wait until they see an influx of influenza to react," says Ms. Moore. "Being proactive about the types of tools to use, planning head and having it available will help you and your organization be prepared, educated and safe."

Overall, in today's environment, hospitals and health systems must make it a goal to improve the work environment for nurses, according to Ms. Moore. She says organizations must have a safety officer looking not only at patient safety issues, but workplace safety issues. "There is so much coming at leaders that it's easy to take your eye off of this and move your eye onto something else, and you can't do that. This is your most important asset. Your greatest resource is your workforce," she says.

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