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 FallsActivity:Resident HandlingDescription:Method 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 ActivitiesActivity:Resident HandlingDescription:Toilet 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 resident’s weight and size.

11. Preventing Muscular-Skeletal Disorders Patient Transfers Activity:Resident HandlingDescription:Mechanical 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.