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CHAPTER 12

CHAPTER 12. THE WORKPLACE. Introduction. Over 50% of time is spent in the workplace Occupational hazards exist in work areas It is important to improve the “quality of life” in the workplace. Workplace Safety. Environmental hazards Physical safety Emotional safety. Reducing Risk.

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CHAPTER 12

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  1. CHAPTER 12 THE WORKPLACE

  2. Introduction • Over 50% of time is spent in the workplace • Occupational hazards exist in work areas • It is important to improve the “quality of life” in the workplace

  3. Workplace Safety • Environmental hazards • Physical safety • Emotional safety

  4. Reducing Risk • Occupational Safety and Health Administration (OSHA) • Centers for Disease Control and Prevention (CDC)

  5. Reducing Risk • Workplace programs • Safety plan • Consult federal, state, and local governments • Distinguish between real and imagined risk • Seek administrative support • Calculate costs of program

  6. OSHA Focus • Biological • Chemical • Psychological • Physical • Environmental

  7. CDC Focus • Lead federal agency for protecting health and safety of citizens at home and abroad • Publishes updates on a variety of health issues and concerns • Partners with other agencies in investigating health threats and research

  8. NIOSH • Part of the CDC • Conducts research and makes recommendations for preventing work-related injuries and disease

  9. American Nurses Association • Quality indicators for acute care setting • Commission on Workplace Advocacy • Core initiatives

  10. Core Initiatives • Nursing shortage • Patient safety/advocacy • Workplace rights • Appropriate staffing • Workplace health and safety

  11. JCAHO • National patient safety goals • Change each year • Based on type of facility • Ambulatory • Assisted living • Behavioral health • Critical access • Home care

  12. Workplace Programs • Identify potential hazard • Assess degree of risk • Develop a plan • Implement the program

  13. Violence • Violence is a social issue • The rate of assaults on hospital workers is much higher than that of private industry • Threats • Physical assaults • Muggings

  14. Violence • Situations that increase workers’ susceptibility to homicide and assault are • Having routine contact with the public • Working alone or in small numbers • Working late • Poor security

  15. Violence • Situations that increase workers’ susceptibility to homicide and assault are • Patients and families who carry weapons • Lack of experienced staff members • Units and patients that need seclusion or restraint activities

  16. What Nurses Should Know • Does violence in the surrounding community affect my workplace? • Does the layout of the facility invite violence? • Is there a prompt response by administration to violence?

  17. What Nurses Should Know • Are incidents being reported and addressed by management? • Would training that deals with workplace violence be adequate for employees and management? • Which types of patients are more prone to violence?

  18. Behaviors • History of violent behavior • Delusional, paranoid, or suspicious speech • Aggressive and threatening statements • Rapid speech and angry tone of voice

  19. Behaviors • Stiff posture, clenched fists, tight jaw • Alcohol/drug use • Male gender or a youth • Unrealistic policies

  20. When Assault Occurs: Placing Blame on Victims Victim Gender Women receive more blame than men Subject Gender Female victims receive a greater amount of blame from women than from men Severity The more severe the assault, the more often the victim is blamed

  21. When Assault Occurs Beliefs The world is a just place; therefore, the person deserves the misfortune Age of Victim The older the victim, the more he or she is held responsible for the assault

  22. Keep an Eye Out • Look for clues indicating potential violence • Call patients, family members, and visitors by their names • Encourage the patient or the patient’s family to vent anger

  23. Keep an Eye Out • If you feel uncomfortable, trust your intuition • Know your institution’s policies and procedures

  24. Preventing Workplace Violence • Have management commit to an ongoing prevention program that addresses different scenarios on workplace violence • Require that all violent incidents be reported and reviewed • Hold all patients, visitors, staff members, and management accountable for their behavior; adopt a zero-tolerance policy related to workplace violence

  25. Preventing Workplace Violence • Follow current information and guidelines from agencies such as your state nurses’ association and OSHA • Insist on an ongoing education program for all staff members that includes comprehensive treatment for victimized employees

  26. Participate in Workplace Safety • Assess the workplace regularly • Be alert for suspicious behavior • Maintain behavior that helps to defuse anger • If situation escalates, remove self and call security • Know your clients

  27. Participate in Workplace Safety • Report situation to supervisor • Call the police • Get medical attention • Contact collective bargaining or state nurses association • Participate in policy-making

  28. Sexual Harassment

  29. Behaviors Defining Sexual Harassment • Pressuring another to participate in sexual activities • Asking another person about his or her sexual activities, fantasies, or preferences • Making sexual innuendos, jokes, comments, or suggestive facial expressions to another person

  30. Behaviors Defining Sexual Harassment • Continuing to ask for a date after the other person has expressed disinterest • Making sexual gestures with hands or body movements or showing sexual graffiti or visuals • Making remarks about a person’s gender or body

  31. Sexual Harassment • Two forms of sexual harassment are • Quid pro quo • A hostile environment

  32. Sexual Harassment • Fight sexual harassment per American Nurses Association (ANA) • Confront • Report • Document • Support

  33. Latex Allergy • First identified in the 1970s • Has become a major problem in the workplace • Estimated that 8%-12% of health-care workers are sensitive to latex

  34. Symptoms • Contact dermatitis (most common) • Generalized hives • Urticaria • Rhinitis • Wheezing • Anaphylaxis

  35. Decreasing the Potential for Latex Allergy • Reducing unnecessary exposure • Using alternative gloves (nitrile) • Employee education programs • Identifying workers at risk

  36. Needlestick Injuries

  37. “Needlestick Act” • Passed in 2001 • Revised blood-borne pathogens standards • Obligates employers to consider safer needle devices

  38. OSHA Blood-Borne Pathogens: Recommendations 1991 • Free hepatitis B vaccine • Protective equipment that fits • Immediate and confidential medical evaluation

  39. OSHA Blood-Borne Pathogens: Recommendations 1991 • Implement universal precautions • Provide adequate sharps disposal • Remove hazards in workplace • Provide annual training for employees

  40. The Nurse’s Responsibilities • Always use universal precautions • Use and dispose of sharps properly • Get immunized against hepatitis B • Report all exposures • Know the human immunodeficiency virus/hepatitis B virus (HIV/HBV) status of your patient

  41. The Nurse’s Responsibilities • Comply with postexposure follow-up • Support others who have been exposed • Become active in safety committees • Educate others

  42. Ergonomics

  43. Preventing Back Injuries • Participate in safety committees • Work in teams; do not be afraid to ask for help • Use transfer and lifting equipment • Do back exercises

  44. Repetitive Stress Injury (RSI) • Usually affects individuals who spend long hours at computers • Most common injury is carpal tunnel syndrome • Mouse elbow • Badly designed computer stations present the highest risk

  45. Preventing RSI • Monitor placement • Keyboard alignment • Mouse position • Body alignment • Vary tasks • Use fingertips when typing • Keep fingernails short

  46. Impaired Workers

  47. Common Signs of Impairment • Witnessing an employee consuming alcohol or other substances on the job • Apparent in employee’s dress, appearance, posture, and gestures • Employee’s use of slurred speech and abusive/incoherent language

  48. Common Signs of Impairment • Reports from patients/coworkers • Witnessing unprofessional employee conduct • Employee has significant lack of attention to detail • Witnessing an employee stealing controlled substances

  49. Impaired Nurse Programs (INPs) • Most employers and 37 boards of nursing have strict guidelines • INPs conducted by boards of nursing work with employers to assist impaired nurses • Compassion from coworkers is of utmost importance

  50. Professional Responsibilities • Nurses need to uphold the standards of their profession • Ignoring substance abuse places clients and other nurses in danger • It is important to “help a colleague obtain help”

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