Search

The connection between nursing injury rates and patient outcomes has not been totally grasped in the health care occupational health setting. This article concludes that nursing injury rates are linked to the nursing shortage and less nursing time at the bedside, both of which have been scientifically linked to negative patient outcomes. Because nurses' working conditions affect patients' outcomes, more funding and changes are needed to improve these conditions.

In Washington State, health care workers have the highest rate of compensable back injuries. Washington Hospital Services, a self-insured workers' compensation program, implemented a zero lift program in 31 of its 38 hospitals. Zero lift was defined as replacing manual lifting, transferring, and re-positioning of patients with mechanical lifting or use of other patient assist devices. This program included two trusts, two pools of hospitals that self-insure workers' compensation. The pools are governed by elected boards of trustees from the pool memberships and regulated by the State Department of Labor and Industries. This pretest–posttest descriptive study compared patient-handling injury data prior to program implementation with those after program implementation. Patient-handling injury claims decreased by 43% in the participating hospitals from 2000 to 2004 (i.e., from 3.51 to 2.23). The time lost frequency rate decreased by 50% (i.e., from 1.91 to 1.03).

Overview of Health and Safety in the Health Care Environment, D. A. Sterling Epidemiology, J. M. Boiano, J. P. Sestito, S. E. Luckhaupt, C. F. Robinson, and J. T. Walker Back Injury Prevention in Health Care, W. Charney, A. Hudson, S. Gallagher, J. D. Lloyd, A. Baptiste, A. Nelson, J. A. Haley, M. Matz, B. D. Owen, A. Garg, J. Villeneuve, J. Gilmore, and W. Martin Emerging Infectious Diseases, W. Charney, J. H. Lange, G. Mastrangelo, J. Lavoie, Y. Cloutier, J. Lara, G. Marchand, and Office of Emergency Preparedness Disinfection and Infection Control, E. J. Stewart, R. N. Olmsted, P.-G. Zanoni, L. Lee, J. Millogo, and K. M. Duesman Progress in Preventing Sharps Injures in the United States, J. Doe, J. Perry, A. E. Gomaa, J. Jagger, and Emergency Care Research Institute Violence in the Health Care Industry, J. Lipscomb, J. Rosen, M. London, K. McPhaul, J. A. Simonowitz, California Occupational Safety and Health Administration, and Service Employees International Union Prevention of Slip, Trip, and Fall Hazards for Workers in Hospital Settings, J. W. Collins and J. L. Bell Ergonomics, M. Wan, Kaiser Permanente, J. Villeneuve, and G. Fragala Chemodrugs, T. P. Fuller Tuberculosis Engineering Controls, L. M. Conroy, J. E. Franke, B. S. Tepper, J. Mehring, D. Hodge, D. Kass, W. Charney, J. Fisher, C. Ishida, P. M. Sutton, M. Nicas, and R. J. Harrison Electrocautery Smoke: Reasons for Scavenging, J. D. Paz, Stackhouse, Inc., National Institute for Occupational Safety and Health, L. V. Kayman, Association of Operating Room Nurses, W. Charney, S. Miller, S. Campbell, and B. Reynolds Safe Use of Ethylene Oxide in the Hospital Environment, A. R. Reich Monitoring Aldehydes, E. W. Finucane and W. Charney Pentamidine, W. Charney, L. Rose, and P. Quinlan Ribavirin, J. Bellows, R. J. Harrison, W. Charney, K. J. Corkery, R. Kraemer, and L. Wugofski Trace Anesthetic Gas, E. W. Finucane, A. Schapera, W. Charney, P. A. Heinsohn, and D.L. Jewett Cost-Benefit, W. Charney and D. Maynes Clinical Approach to Glove Dermatitis and Latex Allergy, D. Shusterman Latex Glove Use: Essentials in Modern Hospital Safety, W. M. Truscott Health and Safety Hazards of Shiftwork: Implications for Health Care Workers and Strategies for Prevention, J. Schirmer Radiation Protection in Hospitals, J.-P. Gauvin Reproductive Hazards in Hospitals, L. V. Kayman Medical Waste, M. L. Garvin, H. B. Kuhn and E. Peters The Occupational Hazards of Home Health Care, E. Askari and B. DeBaun Caring Until It Hurts: How Nursing Work Is Becoming the Most Dangerous Job in America, Service Employees International Union Laboratory Safety, W. Wood Biological Exposure Index Testing: Two Case Studies, W. Charney, M. Lipnowski, and L. Wugofski Functions and Staffing of a Hospital Safety Office, L. V. Kayman and J. F. Clemons Education for Action: An Innovative Approach to Training Hospital Employees, M. Weinger and N. Wallerstein Stress Factors, L. A. Job, W. E. Shearn, K. Kahler, J. Pearl, and M. McDonald Case Studies of Health Care Workers in the Compensation System, L. S. Colbert Index

Lifting is an art, not a random task. If risk is concentrated where it can be controlled, incident rates can be reduced dramatically. It is much easier to control the variables that lead to injury in a team of two lifting members than in a population of nurses. The lifting team study shows that a 95% reduction in lost time injuries can be obtained if a professional lifting team, rather than nurses, lift clients. Secondary benefits to the lifting team approach are: greater nursing morale, recruiting tasks become easier if nurses do not have to lift, and additional time for bedside nursing care.

TWO REPORTS FROM THE FRONT LINE: TWO NURSES UNION OFFICIALS REPORT ON SAFETY ISSUES DURING THE SARS CRISIS IN CANADA Presentation to the Commission to Investigate the Introduction and Spread of Severe Acute Respiratory Syndrome (SARS) E. Bujna and L. McCaskell Presentation to the Commission to Investigate the Introduction and Spread of Severe Acute Respiratory Syndrome (SARS) B. Wahl PERSONAL PROTECTIVE EQUIPMENT Respirators and Other Personal Protective Equipment for Health Care Workers J.H. Lange and G. Mastrangelo Airborne Pathogens: Selection of Respiratory Protection M. Nicas THE MULTIFACETED SYSTEMS INVOLVED IN PROTECTING AGAINST OCCUPATIONALLY ACQUIRED RESPIRATORY INFECTIOUS DISEASES: PUBLIC HEALTH AND OCCUPATIONAL SAFETY, A SHARED RESPONSIBILITY Knowledge Gaps and Research Priorities for Effective Protection against Occupationally Acquired Respiratory Infectious Diseases: A Canadian Perspective A. Yassi and E. Bryce Ventilation Systems for Handling Infectious Diseases in a Healthcare Environment S.J. Derman DETERIORATION OF THE PUBLIC HEALTH SYSTEM AND THE SQUANDERING OF LIMITED RESOURCES Infectious Diseases, A Resurgent Problem: Developing Effective Public Health Responses G. Avery The Fallacy of Bioterrorism Programs: A Catastrophe for U.S. Public Health H.W. Cohen, R. Gould, and V. Sidel INFLUENZA: THE OLD AND PRESENT THREAT A Killer Flu? Planning for the Devastating Effects of the Inevitable Pandemic M.A. Hamburg, S.A. Hearne, J. Levi, K. Elliott, L.M. Segal and M.J. Earls Influenza: Biology, Transmission, Course, Complications, Prevention, and Treatment H.W. Cohen and C.M. Coyle INFECTIOUS DISEASES AND THE BUREAUCRACIES THAT ARE ACCOUNTABLE FOR PUBLIC SAFETY Hospital Cleaners and Housekeepers: The Frontline Workers in Emerging Diseases B. Stringer Establishing Cooperative Synergy: Which Agencies, Which Departments? N. Maher A Rural Hospital's Preparedness for an Emerging Infectious Disease Epidemic J. Harris Endnotes Epilogue APPENDICES American Federation of Labor and Congress of Industrial Organizations Interim Guidance for Protecting Health Care Workers Caring for Patients Potentially Exposed to Aerosolized Yersinia pestis from a Bioterrorism Event Index

There is an epidemic of health-care worker back injury in the State of Washington. Voluntary programs are not keeping pace with the increasing back injury rates to health-care workers. Adding all the health-care industry SIC codes, hospitals, nursing homes, home health and residential care puts health-care as the leading industry in the State of Washington for back injury. Licensed practical nurses, nurses aides, and registered nurses account for the majority of all claims in the health-care industry. Self-insured hospitals led the state for lost time compensable back injuries between 1993 and 2001, and combined Washington State Fund and self-insured health-care hospitals and nursing homes led all other industries for compensable soft-tissue disorders of the neck, back, and upper extremities. Legislation is needed to protect this group of workers in this type of industry. A bill will be re-introduced in the 2006 session that calls for hospitals to implement back injury prevention programs through either the Zero-Lift model, with nursing staff use of lift equipment, or the Lift-Team model, with a specially trained team using lift equipment, or a combination of the two, for all shifts. The State of Washington should provide funding, through savings created by back injury prevention programs, for small rural health-care institutions to assist them in compliance with the legislation.

A newly organized employee safety program, with an 11–step design, has been introduced at Valley General Hospital in Monroe, Washington, with the intention of changing the “culture of safety.” A 1–year report of the results indicates that the overall incidence of injury claims, lost-time injuries, and needlestick injuries were reduced after the program was implemented and timely reporting of claims within 24 hours was increased. The hypothesis, that by creating more visibility for the employee safety program a decrease in injury rates would occur, was confirmed.