Abstract
Predictors of Depression in Registered Nurses
Arica Brandford, MSN, RN, JD
Women comprise 80% of the health care workforce and 90% of the nursing workforce. Women experience stress at a rate twice that of males. Often, the demands and stressors of the nursing profession are emotionally and psychologically detrimental for registered nurses, resulting in depressive symptoms or clinical depression. Despite the relevance of stress and depression for nurses, there is a paucity of research in the United States examining depression incidence and prevalence in registered nurses. The purpose of this review of the literature was threefold. The first aim was to evaluate the prevalence and incidence of depression in registered nurses. The second aim was to determine risk factors for and predictors of depression in registered nurses. The final aim was to identify gaps in understanding of and research about depression in registered nurses that may guide future research.
Diabetes at Work: Facing the Unknown
Dominique Bulgin, AD; Elizabeth Anne Thomas, PhD, RN, ANP-BC, COHN-S, CNL, FAAOHN
The experience of older working adults managing type 2 diabetes in the workplace is affected by many factors. “Diabetes at Work: A Grounded-Theory Pilot Study” explores how these factors affect older adults as they balance managing diabetes with maintaining gainful employment. In-depth qualitative interviews were conducted with six working older adults using grounded-theory methodology. This secondary analysis of the study explored how the unpredictable nature of diabetes influences participants’ attitudes toward changing their lifestyle and work life to better manage their disease. Open coding and line-by-line coding were used initially, focusing on action and process. Memos were kept throughout the process both to track conceptual ideas and to establish researcher reflexivity. Constant comparison methods were conducted across and between interviews. A common category emerged from the participants’ experiences: acknowledging, fearing, accepting, and ultimately facing the unknown. The unpredictable nature of diabetes was found to be a mental burden to the participants; however, they were able to relieve some of the burden using proactive methods to manage diabetes in and outside of the workplace. This pilot study illuminates the lived experience of older working adults with type 2 diabetes. By understanding this phenomena, future interventions can be developed that will allow these individuals to better control their diabetes, which can lead to the preservation of their productivity in the workplace.
Community-Based Employer and Sunshine ERC Partnership: Integrating TWH and Experimental Interdisciplinary Training for Occupational Health and Safety Trainees
Candace Burns, PhD, ARNP
This poster presented the process and outcomes of integrating a Total Worker Health program via a health fair and an OH&S student interdisciplinary training experience. A community-based employer used the knowledge and expertise of a variety of OH&S professional students and their supervising faculty (i.e., I.H., O.H.N., O.M., O.H.P., O.S.) to provide selected health promotion screenings, health education, and traditional occupational safety education to employees in a lead-acid battery manufacturing plant. Both worker and trainee outcomes were presented. Barriers, challenges, and lessons learned were also discussed.
Sleep Quality and Obesity Among Female Hospital-Based Registration Nurses
Julia Buss, MS, RN
Shift-working nurses are vulnerable to poor sleep quality. Previous research findings show that short sleep increases preference for high fat/high sugar foods and is associated with obesity. This study described the prevalence of obesity and its association with sleep duration and sleep quality among hospital nurses. A cross-sectional web-based survey was used to collect data from members of the Academy of Medical/Surgical Nurses. Participants self-reported caffeine and alcohol intake, waist circumference, and height and weight used to calculate body mass index (BMI). Obesity is defined as BMI > 30 kg/m2; abdominal obesity is waist circumference >88 cm. Sleep quality and duration were measured with the Pittsburg Sleep Quality Index (PSQI); scores range from 0 to 21, and >5 indicates poor sleep quality. Pearson correlations were used to test associations between BMI, waist circumference, and sleep variables. A total of 256 nurses completed the survey; 35% were obese, 50% had abdominal obesity, and 78% reported poor sleep quality, with mean sleep duration 7.4 ± 1.5 hours. Worse sleep quality was correlated with higher BMI (n = 220, r = .23, p < .001), higher waist circumference (n = 198, r = .23, p = .001), use of alcohol to sleep (n = 219, r = .14, p = .03), and use of caffeine to stay awake (n = 220, r = .26, p < .001). Sleep duration was negatively correlated with BMI (n = 226, r = −.15, p = .02) such that the shorter the sleep duration, the higher the BMI. Sleep quality and short sleep may be risk factors for obesity in female hospital nurses. Interventions to improve sleep among shift-workers should be included in worksite wellness programs.
If There Was an Occupational Health Nurse at the North Pole
Nancy Clover, RN, COHN-S, FAAOHN
To attract future nurses to occupational health and safety, high school students should be educated about the value of occupational health nursing. As teens enter the workforce, they must be able to identify hazardous situations and feel empowered to take corrective action. A PowerPoint presentation was developed to give a brief overview of occupational and environmental health nursing. The second half of the presentation focused on the hazards Santa faces in his job and asked the teens to identify solutions to minimize these hazards.
Metabolic Syndrome and Diabetes: How the Occupational Health Nurse Can Impact Early Detection and Disease Progression
Kellie Collins, ARNP-C, MSN, MPH
Metabolic syndrome and diabetes affect an overwhelming number of individuals, with an extremely high prevalence in the working population. Early detection and treatment can prevent progression of the disease and resulting complications. Occupational health nurses have the unique opportunity to affect the daily lives of American workers by screening, education, and implementation of interventions to assist workers with disease management.
Hand and Wrist Tendonitis in the Occupational Health Setting
Bryan Combs, MSN, CRNP, FNP-BC, CNL, ATC
The purpose of this presentation was to educate the audience on common hand and wrist tendonitis in the occupational health setting. Musculoskeletal disorders are one of the most prevalent occupational problems in America today. Occupational health nurses must be able to properly evaluate, diagnose, and treat chronic conditions in the hand and wrist. Tendonitis can affect activities of daily living and work productivity and result in lost work time. Advanced practice nurses often evaluate chronic work-related conditions; they must know the key signs and symptoms of tendonitis and effective ways to treat it. Common forms of tendonitis in the hand and wrist are stenosing tenosynovitis, Extensor Carpi Radialis, and DeQuervain’s tendonitis. By understanding these conditions, advanced practice nurses can decrease worker pain, increase function, and prevent unnecessary health care and worker costs. Workers must be treated effectively and educated about proper care and prevention in workplaces. This presentation will include modalities, procedures, and therapies to increase function and decrease health care and work-related costs. Advanced practice nurses can use the evaluation and treatment skills discussed in the presentation to eliminate unnecessary diagnostic tests and referrals leading to more cost-effective and timely care.
Stress Evaluation in a Brazilian Nursing Team: Salivary Cortisol Levels, the Job Stress Scale, and the Perceived Stress Scale
Angelica Consiglio, PhD, MSC, RN; Ann Paula Scherer de Brum, RN; Jassica Porto Faira de Paula; Ana Maria Muller Magalhes, PhD, RN
Fifty-six women who worked on nursing teams in emergency department (ED) and pre- and postsurgery units were evaluated for salivary cortisol levels and completed the Perceived Stress Scale and the Job Stress Scale. Salivary cortisol levels were determined at three time points: at awakening, 30 minutes after waking, and before sleeping at night. Data were analyzed using a t test; p < .05 was considered statistically significant. The study was approved by the local ethics committee. The average Perceived Stress score was 25.03 ± 7.71, and the average Job Stress Scale score was 38.13 ± 4.22. The cortisol levels taken 30 minutes after awakening were higher for the ED team (32.64 ± 16.08 nmol/L) compared with the pre- and postsurgery units team (23.56 ± 12.56 nmol/L, p = .04). Stress, as a risk factor for many diseases, is indeed higher in the ED nursing team than the pre- and postsurgery units team perhaps because the ED team has intense workload demands. Cortisol, as a biological marker, was not only above the normal range within this group but also higher than the other team. (This study was supported by the Research and Events Support Fund at Hospital de Clinicas de Porto Alegre and Coordination for the Improvement of Higher Education Personnel Scholarship to A.P.S.B.)
A Systematic Review of Control Measures to Reduce Hazardous Drug Exposure
Rachael Crickman, MN, BSN, RN, OCN, AOCNS, BA
The researchers asked, “What evidence-based control measures exist to reduce or eliminate the risks of occupational hazardous drug exposure for health care workers?” To answer this question, databases were searched, including PubMed, the Cumulative Index to Nursing and Allied Health (CINAHL), the Cochrane Library, and Embase. The search included publications from 1979 to March, 2014. The initial search yielded 499 publications, 29 of which met final review criteria. Selected articles and guidelines were graded according to the strength and quality of the evidence, using the Johns Hopkins Nursing Evidence Rating Scale (2012). Strategies to reduce the risk of occupational exposure to hazardous drugs included hazard identification, engineering controls, personal protective equipment, and environmental monitoring. Few studies examined the effectiveness of a comprehensive hazardous drug control program using multiple interventions for reducing or eliminating risk for all health care workers. Additional research is needed to evaluate this finding, as well as explore the level of precautions required for noncytotoxic hazardous drugs, and the reproductive risk posed to males who are exposed to these drugs.
Development, Implementation, and Evaluation of an Evidence-Based Safety Guideline to Reduce the Risk of Musculoskeletal Injuries for Older Workers
Nancy Delloiacono, DNP, RN, ANP-BC
A paucity of evidence-based nursing guidelines is available for occupational health nurses to assess, educate, and evaluate musculoskeletal changes that occur with age. These changes increase the risk of workplace injuries, many times resulting in extended lost work time, disability, or even death. The number of older workers will increase dramatically in the coming years and therefore, occupational health nurses will be challenged when caring for the “new” workforce. The purpose of this project was to provide occupational health nurses with the knowledge needed to provide quality care for older workers. New Jersey occupational health nurses were surveyed to identify the top three work-related injuries seen in their practices. Overexertion injury was the most prevalent. Because no nursing guidelines addressing musculoskeletal safety for older workers exist, an evidence-based guideline was developed to fill this gap. To disseminate this guideline, an online educational program was developed. To evaluate this program, occupational health nurses completed a pretest and posttest. One month following the program, the nurses were assessed for their knowledge retention. To determine whether the knowledge gained resulted in a change in practice, nursing documentation in older worker health records at three New Jersey workplaces were reviewed. Chart review demonstrated a change in practice. For occupational health nurses to care for these individuals using “best practices,” they need evidence-based safety guidelines. These guidelines could reduce injuries, guide practice, and affect policy for older workers.
An Analysis of Violence in the Workplace Focusing on the Health Care Setting
Michael Dolliver, RN
An analysis of violence in the workplace focusing on the health care setting included a discussion of the effect on nurses in particular and strategies for process improvement to aid in better overall outcomes for practitioner–patient interactions, quality of care, and cost to institutions as well as the strategies that have been implemented to make these outcomes a reality.
Service Animals in the Workplace
Peggy Doty, BSN, RN, COHN
Service animals are an option to assist individuals with disabilities gain greater independence in the workplace. However, this phenomenon creates many questions for supervisors and occupational health nurses. Service animals can be instrumental in assisting with complex return to work situations as employees develop independence and transition from home to work. Service animals can guide individuals with vision impairment and alert individuals with hearing impairment. Today, service animals provide a wide array of services, including assisting with mobility impairments, seizure disorders, diabetes, psychiatric and mental health disorders, and posttraumatic stress syndrome. This presentation focused on the following: (a) What is a service animal? (b) Do service animals differ from pets? (c) How do service animals affect employees and their job performance? (d) How do coworkers interact with an employee who uses a service animal in the workplace? (e) Who is responsible for the service animal in the workplace? (f) Does a coworker have the right to know why a person has a service animal? (g) What if workers are allergic to the service animal in the department? (h) What legislation or statute governs service animals in the workplace? (i) How does the occupational health nurse respond to these questions? and (j) Do service animals affect a preplacement examination?
Are You at Risk?
Karen Dougherty, BSN, RN, CEN
Using a coordinated approach, a registered nurse health coach and a dietician health coach created a well-planned, organized, and comprehensive program for a worksite health promotion program that focused on meeting the health needs of all employees.
Implementing Hospital Respiratory Protection Programs: New Educational Resources
Hasina Hafiz, MPH; Debra Nova, PhD, RN; Barbara Braun, PhD; Brette Tschurtz, BA
Protecting workers from exposure to all types of respiratory hazards is a significant issue for all hospital staff, particularly occupational health nurses. To address this often overlooked danger, The Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH), and National Personal Protective Technology Laboratory (NPPTL) has spearheaded a cluster of research activities around respiratory protection programs (RPP). CDC/NIOSH/NPPTL developed a soon-to-be released resource, Hospital Respiratory Protection Program Toolkit: Resources for Respirator Program Administrators, to assist hospital respirator program administrators in the development and implementation of a comprehensive respiratory protection program that will meet the requirements set forth in OSHA (Occupational Safety and Health Administration) standard (29 CFR 1910.134). In addition, The Joint Commission collaborated with CDC/NIOSH/NPPTL to develop an educational monograph designed to assist hospitals in addressing common challenges and barriers in the implementation of their RPP. The monograph, Implementing Hospital Respiratory Protection Programs: Strategies From the Field, features examples, strategies, new resources, and a variety of implementation approaches that were solicited from practitioners and vetted through an eight-member Technical Expert Panel (TEP). This document is designed to be a companion to the CDC/NIOSH/NPPTL Toolkit. This poster illustrated the processes by which these resources were developed and highlighted the key points.
Designing Cost-Effective Occupational Health Nurse Educational Offerings “On a Shoestring”
Tena Hall, RN
Because the Department of the Army faced harsh economic times for the past 2 fiscal years, the need to develop cost-effective approaches to continuing nursing education became critical. It was especially important to identify more cost-effective ways to determine both the need for continuing education development and offerings required for certifications related specifically to occupational health nursing. Occupational medicine collaborated with sister programs in the Occupational and Environmental Medicine Portfolio: the Army Hearing Program (AHP), Tri-Service Vision Conservation and Readiness Program (TSVRC program), Environmental Medicine Program (EMP), and Surety Medicine Program (SMP) to develop specific American Nurses Credentialing Center (ANCC) accredited courses. These efforts to combine resources and limit the financial responsibilities of the Army and its employees were challenging and met several obstacles initially. The Army Nurse Corps Continuing Nursing Education director provided assistance and guidance in eliminating the accreditation associated-costs. Support from the program director and informing collaborators solidified the new alliance and proved beneficial. Instead of the feared negativity that corporate organizations or other industries typically encounter, the internal nursing planning committee received encouraging support in their pursuit of cost-effective applications for continuing nursing course accreditation. This collaborative method may not always be effective outside of the military and government umbrella but was favorable in streamlining processes and identifying innovative ways to reduce costs and continue the organization’s everyday mission. This experience could be replicated at other companies and facilities.
Mentoring-Sharing Experience to Promote Excellence
Jane Rene Hamilton, ARNP-FNP
The Mentoring Program for Nurses was developed as an outcome of the ExxonMobil Nursing Professional Development Network. This program was a significant initiative that was well received by the ExxonMobil nursing community. It was well implemented and appeared to have a positive impact on this nursing community. One of the unique aspects of the program was its implementation in a global nursing community. A description of the Nursing Professional Development Network itself was presented at the American Association of Occupational Health Nurses poster session in 2013. The current presentation was designed to describe one of the initiatives of the network and its success in promoting excellence in global occupational health nursing by sharing knowledge and experiences among nursing colleagues through a mentoring program.
Identifying Obstructive Sleep Apnea in the Working Population
Stephanie Hammond, MSN, CRNP; Karen Heaton, PhD, CEN, FNP-BC
Obstructive sleep apnea (OSA) is a disorder that leads to increased risk of cardiovascular and cerebrovascular disease, diabetes mellitus, injury, and decreased quality of life when undiagnosed and untreated. The purpose of this study was to identify workers who may be at increased risk of OSA and determine the need for formal workplace screening and educational programs targeting OSA. This descriptive study reviewed data from 250 individual annual health screenings. The study used the methodological framework of Model for Improvement with a small test change of Plan, Do, Study, Act. The American Academy of Sleep Medicine OSA screening guidelines were used to review records of participants in a municipal health screening program. Among the data reviewed were diagnosis of hypertension, height, weight, and body mass index (BMI). An algorithm was developed for provider education and referrals based on screening results. This study was completed in fall 2014. The authors suspected that this worker population was at increased risk for OSA due to hypertension and obesity prevalence. A screening tool was developed to identify those workers at risk for OSA and provided education and referral for further evaluation of the disease.
Geisinger Health System—Culture of Health and Wellness
Diane Harlow, MEd; Kimberly Kiheeney, BSN, RN, COHN
This presentation introduced the culture of health and wellness approach at Geisinger Health System, identified current/future strategies to address the new economics of health care benefits design and rapid system growth, strategies and collaboration with occupational/employee health, and initial results of key pilot programs and return on investment. Included is the current/future 5-year strategic plan that includes the steps of development, implementation, and initial return on investment of an award-winning wellness program. The program included traditional and nontraditional programming to meet the needs of more than 20,000 employees, including spouses and domestic partners. The benefit-based population health strategy is now entering Year 3 with an overall participation rate of more than 70%. The director of Occupational Health coordinates the program with human resources (HR) oversight. The integration with the Occupational Health Program and employee health services has allowed for unique partnerships and pilot programs that include the prevention and management of health care worker low back pain and fatigue, telemedicine/telehealth, health and wellness coaching referrals based on new hire screening processes, and a robust analytics dashboard. Additional integration within HR provides data on employee satisfaction, recruitment, trends, and benefits design to meet regulatory guidelines.
A Clear View of Common Occupational Eye Injuries
Karen Heaton, PhD, FNP-BC
Eye injuries in the workplace are serious and can cause permanent disability. The purpose of this presentation was to introduce particular eye injuries that are common in the occupational health setting: corneal abrasion, foreign body, hyphema, chemical exposure, and welder’s flash. For each of these conditions, the mechanisms of injury, screening, and diagnostic studies were presented as well as appropriate and timely treatments and referrals. Finally, implications for return to work and work restrictions relative to the severity and nature of injury were included.
Physical Therapy and Occupational Low Back Pain: An Evidence Informed Approach
David Hoyle, DPT, MA, BS, OCS; Katie McBee, DPT, MS, OCS
Nonspecific occupational low back pain can have a profound effect on workers and their dependents and a potential financial burden to employers and society. Identifying the correct treatment in terms of amount, type, and timing is a challenge for health care workers. This poster used currently available evidence to outline a treatment-based algorithm using the STarT Back Tool and physical therapy-based clinical practice guidelines to achieve efficacious treatment of occupational low back pain.
A Little Valuim Doesn’t Matter
Glenda Sue Iha, DrPH; Heather Young, DNP
A study of U.S. workplace drug data by a large diagnostics laboratory, a provider of workplace drug tests, indicated that the rate of employees testing positive for prescription opiates had increased by more than 40% between 2005 and 2009, and by 18% last year. The data, culled from more than 500,000 drug tests, also indicated that workers tested for drugs after accidents were 4 times more likely to have opiates in their systems than those tested before being hired. Use of prescription medications during work hours and at home may impact the safety of the workforce. The poster presentation presented four key components necessary to address the medication risks in the workplace: (a) “why” medication reporting is important by comparing one large U.S. workforce current data set with national and international data; (b) share experiences with developing and implementing a medication reporting process including key elements; (c) discuss options for evaluating the risks of medications; and (d) discuss mitigating strategies to produce a safe work environment.
Creating Safety for Our Social Brains
Kate Kelley, PhD, MA, BSN, RN
Occupational health nursing has evolved into an interdependency on the collaboration and sharing of nurses strengths and talents to best serve dispersed populations. Occupational health nurses are no longer operating in clinics that are separate and independent from one another. To understand the global economy where the corporate environment often consists of a dispersed workforce, it is clear that a high premium is placed on building trust, teamwork in workplace environments, and skills and talents that create outstanding results. Present and future research should focus on the remarkable plasticity of brain functioning and illustrate the nurturance of human beings’ social needs that are linked to survival. “Creating Safety for Our Social Brains” illustrates that the success of future occupational health nursing practice will depend on nurses creating environments to meet worker needs for “Love and Belonging” as they currently meet workers’ “physiological” and “safety” needs. The idea is to incorporate an understanding of how responsive human brains are to social interactions that are either inhibiting or enhancing productivity and creativity.
CPAP on the Road—The Experience of Long-Haul Truck Drivers: A Pilot Study
Kenya Kirkendoll, MSN, MPH, RN; Karen Heaton, PhD, FNP-BC
Obstructive sleep apnea (OSA) is a chronic health condition characterized by recurrent episodes of upper airway collapse and obstruction that result in episodes of apnea and hyperpnea during sleep. The prevalence of OSA in the general population is estimated at 4% among males and 2% among females, in stark contrast to estimated OSA prevalence of 13% to 28% among commercial motor vehicle (CMV) drivers. Untreated or ineffective treatment of OSA is associated with changes in cognition, increased risk of motor vehicle crashes, and daytime sleepiness. Treatment of OSA with continuous positive airway pressure (CPAP) for as few as 2 to 7 days has been associated with improved performance on a driving simulator. Much of the sleep disordered breathing research among CMV drivers focuses on OSA prevalence. With high estimations of OSA among CMV drivers, it is imperative that empirical research explores CPAP use in this population. The purpose of this qualitative descriptive study was to describe long-haul truck drivers’ experiences with CPAP when they were on the road. Individual interviews were conducted with long-haul drivers who were diagnosed with OSA and used CPAP. Content analysis was used to identify themes and subthemes. Interviews were conducted until data saturation was achieved. Findings from the study can be used to raise awareness about the challenges faced by long-haul truck drivers in their efforts to adhere to CPAP therapy and to inform CPAP adherence initiatives and policies in the trucking industry.
Infectious Disease Transmission via Conjunctiva: Occupational Contamination Risk and the Role of Eyewear
Ellen Hassett Cahill; Victor R. Lange, JD, MSPH, BS, BA, ICP, CRC, CRA
A recent clinical study investigated eyewear contamination to assess infection risk and inform protocol development. The study found 37.7% of disposable and 94.9% of reusable eyewear pieces cultured positive for microbial contamination post use. More than 74% of reusable eyewear still cultured positive following disinfection. Reusable eyewear may carry ongoing bio burden and, thus, contribute to environment health and safety risks. This presentation informed health care staff in advocating for safer working environments as well as assisting health care management in future decision making regarding personal protective equipment decisions.
Factors Associated With Safe Patient Handling Behaviors and Lift Use Among Hospital Nurses: A Statewide Survey of California Nurses
Soo-Jeong Lee, PhD, RN; Joung Hee Lee, MSN, RN
Unsafe patient handling is the primary cause of musculoskeletal injury among nurses. Safe work practices can prevent musculoskeletal injury. This study investigated factors associated with safe patient handling behaviors and lift use among hospital nurses. This cross-sectional study analyzed data from a statewide random sample of 212 California hospital nurses who performed patient handling. Data were collected using postal and online surveys on sociodemographics, organizational safety practices, physical and psychosocial job factors, musculoskeletal symptoms, risk perception, perception about lift use, frequency of lift use, and safe patient handling behaviors. Lift equipment was available for 65.6% of the participants (n = 139); these nurses reported using lifts ≤25% of the time (51.5%), 26% to 50% of the time (18.1%), 51% to 75% of the time (10.9%), and 76% to 100% of the time (19.6%) when lifting/transferring physically dependent patients. Positive perceptions about lift use (ease, patient comfort, time, access, storage) were associated with frequent use of lifts (p < .05). In multiple linear regression analysis, safe patient handling behavior was associated with safety climate (β = .29, p = .0004), availability of lifts (β = .25, p = .0002), older age (β = .14, p = .041), and day shifts (β = .13, p = .048). For physical workload, job strain, and musculoskeletal symptoms, only bivariate associations were observed with safe patient handling behaviors. Risk perception was not correlated with safe patient handling behaviors. The findings suggest that safety climate, lift availability, and perceptions about lifts are significant factors for safe work practices of nurses. Special attention should be given to younger nurses working non-day shifts to promote safe work practices.
Noise Exposure Monitoring and Hearing Protection Devices: Assessment, Education, and Compliance Among Machine Operators in Manufacturing
Jennifer Leslie, BSN, BSME, RN
Noise is more than a nuisance; it is a hazard to health, safety, and overall well-being. Repeated, unprotected exposure to hazardous noise is the cause of this occupational illness that commonly affects employees in the U.S. manufacturing sector. According to the Bureau of Labor Statistics, one in nine recordable illnesses is due to occupational hearing loss. Noise-induced hearing loss is an irreversible sensorineural hearing impairment characterized by the loss of auditory sensory cells in the cochlea. Sensorineural cells cannot be regenerated or repaired. Because the condition is permanent, noise studies and prevention efforts to preserve hearing are an important focus of occupational health specialists. The purpose of this project was to conduct a noise dosimetry exposure assessment and area noise survey in compliance with 29 CFR 1910.95, summarize findings and include or exclude employees in a Hearing Conservation Program (HCP), synthesize findings applying critical thinking skills to counsel employees on the selection of hearing protection devices meeting regulatory requirements, and provide optimized worker health and productivity. The project had three aims: (a) accurately report the noise levels meeting the company’s regulatory compliance requirement, (b) validate inclusion or exclusion of the employees in the HCP, and (c) enable workers to make the “right” choice of hearing protection devices, and provide education and counsel specific to health and productivity needs. The results of the study were shared with facility management and identified personnel; the HCP was also updated.
Nursing Beyond Nursing: A Workplace Health and Safety Stewardship Model
Cathy Loisell, MS, RN, CEES, COHN-S
Occupational health is nursing beyond nursing. The workplace presents an opportunity for nurses to use strategic thinking and apply critical reasoning in support of clinical excellence and business objectives. The author dubbed this opportunity “nursing beyond nursing.” Optimally, employers view occupational health nurses as experts, not only in employee health management but as progressive leaders capable of assisting with the development of business initiatives through on-site services and clinics. Strategic thinking has been defined as the generation and application of business insights on a continual basis to achieve a competitive advantage (R. Horwath). Strategic thinking enables occupational health nurses to combine their roles as health services managers and business partners to address the needs of frontline workers as well as those in the corner office. Meanwhile, critical reasoning in occupational health allows nurses to use their experience to formulate individual treatment plans and design health promotion programs for entire working populations. Nurses who practice in work settings typically function as gatekeepers for all health care–related services. Strategic thinking and critical reasoning are necessary for occupational health nurses to successfully balance these demands. In acute care, patient delivery is predictable, and the nurse’s role is relatively well defined. Not so in the workplace, where worker populations are as varied as their needs. Occupational health nurses must develop the skill set to define and legitimize their role in the business environment. Taking the time to leverage experience and prioritize business objectives facilitates nurses’ leadership role.
Mining Career Firefighter Injury Data to Build a Proactive Occupational Health Program
Cynthia M. Lyons, BSN, RN, OHN-S; Karyl A. Kinsey, PhD; Stephanie Phelps, PhD Candidate; OiSaeng Hong, PhD, RN, FAAN, NP
This poster described occupational injuries among career firefighters in Austin, Texas, and the settings where these injuries are most likely to occur; the impact of treatment delays on costs and days lost by comparing compensable claims that started as “incident only” (IO) reports with those that started as medical. Firefighting results in a high incidence of occupational injury. The National Fire Protection Association estimated that 65,880 firefighter on-the-job injuries occurred in 2013. This report examined the prevalence and characteristics of occupational injuries among Austin firefighters to identify areas where occupational health nurses could take a more proactive approach to care. Data were coded from 472 First Report of Injury forms filed by Austin firefighters in 2013. Seventy-two percent of injury reports started as IO, meaning no intent to seek medical treatment; however, 14% (n = 68) were later converted to medical care. On average, compensable claims that started as IO cost US$1,437 more and had 39.6 more hours lost than claims started as medical and were more likely to occur for training and exercise injuries involving the abdomen, foot, hip, and groin. Overall, the major injury-producing activities were fitness exercises (27%), dispatched incidents (23%), and training (17%). Weight-lifting exercises had 4 times the cost and days lost than all other exercise injuries combined. Higher costs/days lost for nonexercise injuries involving lifting/lowering or pushing/pulling suggest moving heavy objects as a possible common factor across settings. Occupational nurses can play a key role in reducing unnecessary treatment delays by reviewing reports to determine the need for prompt treatment and intervening if necessary before problems worsen. The higher costs of weight-related injuries point to a need for more training on proper lifting techniques, given the necessity of moving heavy patients, tools, and objects in the course of job duties.
Comparing the MRSA Containment Tactics of Two Neighbors—Is Less Actually More?
Latrice Moss, RN; Janie Allen-Blue, BS, RN
The purpose of the proposed study was to determine whether a difference existed between methicillin-resistant Staphylococcus aureus (MRSA) health care carrier rates and health care–acquired infections at two health care facilities in Cincinnati, Ohio. The two hospital systems serve the people of Greater Cincinnati, although they use distinctly different policies to prevent the transmission of MRSA. It is unclear whether or not the more stringent policies of one facility effectively reduce the spread of MRSA. MRSA nasal colonization is a risk factor for MRSA infections. MRSA infections are the source of a significant number of hospital-acquired infections, including respiratory infections, surgical site infections, pneumonia, and cardiovascular infections. Of the estimated 80,461 cases of MRSA infections in the United States in 2011, 78% were considered health care–associated infections. Study results could potentially lead to a reevaluation of MRSA isolation practices at the two hospitals. To determine the MRSA carrier rates, 250 nonphysician participants in direct patient care from non-ICU units of each facility were selected using a convenience sampling technique. The nares and axilla of each participant were swabbed and tested for the presence of MRSA. Education on the transmission and prevention of MRSA was provided at the time of data and specimen collection. Project activities were assessed to determine how to improve participants’ knowledge of infection control practices, the effectiveness of the research, and the impact of the conclusions.
Occupational Health Impact of a Nonsurgical Treatment for Carpal Tunnel Syndrome
Michael Politis, PhD
Individuals who can avoid the expense and uncertainties of surgery for carpal tunnel syndrome (CTS) by effectively managing their symptoms should be able to maintain job productivity. One such management tool is a popular home therapy device called Carpal Rx, yet little is known about its impact on job productivity. This study followed workers using the device for 6 months to ascertain (a) if they avoided surgery and (b) if the device affected their job productivity. Workers were interviewed monthly for 6 months. Thirty-one workers completed the survey, answering a series of subjective questions pertaining to occupation, symptoms, and the device. Other health and demographic parameters were recorded. Each question required a numerical response, and results were analyzed using rank-sum nonparametric analyses. Participants came from 20 distinct industries (e.g., food service, assembly line, secretarial), and they all used the Carpal Rx at least once daily for 30 days. Device use frequency and duration generally curtailed nonlinearly during the 6-month study period. No participants scheduled surgery during this time. Except for three participants who quit or were terminated for non-CTS reasons, all reported working at the same job. This research demonstrated that an effective nonsurgical therapy can help CTS sufferers maintain their jobs. It is concluded that the Carpal Rx can relieve carpal tunnel symptoms substantially so that workers can avoid surgery and maintain their jobs.
Probiotics: What the Occupational Health Nurse Needs to Know
Candace Sandal, DNP, MBA, ARNP, COHN-S
Probiotics are a multimillion dollar business in the United States and readily available to individuals and families. Yet, the selection of the appropriate probiotic for a specific concern is not well understood. Occupational health professionals should develop a working knowledge of probiotics, their actions on the digestive tract, and ways to counsel workers appropriately.
Physical Inactivity, Stress, and Injury Among Emergency Responders
Jean Schemtman, BSN, RN, COHN-S/CM; Sara Gamble, BSN, RN
To decrease stress and increase cardiovascular well-being in firefighters, a simple exercise regimen using stretch bands was developed. This regimen included split squat exercises that work the quadriceps, gluteus maximus, and hamstring muscles. Data collection included vital signs at baseline and postintervention, wall squat timing pre- and postintervention, as well as self-reported physical and psychological stress, sleep pattern, and physical activity. Forty firefighters comprised the convenience sample. The aim of the study was to determine whether a simple activity could decrease stress and increase cardiovascular well-being without undue physical exertion.
Health Effects of Van Pooling to Work
Dawn Stone, PhD Candidate RN, ANP-BC, COHN-S; Wendie Robbins, PhD, RN
Shared commutes to work such as vanpooling benefit the environment and provide economic gain for riders in terms of fuel cost and personal vehicle wear and tear. Although ride sharing is commonly believed to promote health through stress reduction, publications on this topic are limited and findings vary. The authors explored perceived health and well-being of vanpoolers using a qualitative, descriptive study. Five focus groups of vanpoolers and two individual interviews with drivers were conducted. Stress, change in sleep patterns, and interpersonal relationships emerged as major themes. Employee insights about the impact of vanpooling on work and implications for van pool programs were also important findings in this study.
Emergency Preparedness: A Case Study in Massachusetts Hospitals
Mary Taschner, MS, ANP-BC
Emergency preparedness in Massachusetts hospitals has evolved since 9/11 and has been challenged by threats of terrorism, meteorological disasters, and public health emergencies. Understanding the development and implementation of emergency preparedness policy and practice in Massachusetts hospitals may illuminate areas for improvement in disaster response as the country faces future events. The study objective was to examine the development and implementation of emergency preparedness policy and practice in Massachusetts hospitals following the 9/11 terrorist attacks to identify areas for improvement and areas of success in future response. This case study used a qualitative descriptive approach. Data sources included documents and archival records related to emergency preparedness in hospitals and federal and state emergency preparedness policy. In addition, a systematic literature review of emergency preparedness in the hospital setting for nurses and other first responders was conducted. A snowball technique was used to recruit key informant nurses and other leaders with historical and present knowledge of emergency preparedness policy and practice in Massachusetts hospitals. Twelve semistructured interviews were conducted, and content analysis was completed to identify emerging themes and lessons learned. Four key findings were identified as follows: the importance of standardized training and interprofessional collaboration across health care and other first responder disciplines; the value of all-hazards planning and regional cooperation among organizations; the impact of meteorological events, public health emergencies, and terrorist incidents have had on emergency preparedness planning and response; and the impact of decreased funding. Findings will inform current emergency preparedness efforts in Massachusetts.
Really Cool Stuff I Learned About Lead While Helping Set a More Protective Blood Lead Level
Carol Tobias, MBA, BSN, RN, COHN-S
Setting a new blood lead level for the entire Department of Defense has taken more than 2 years of research, discussion, and analysis. During the time that the working group of a toxicologist, industrial hygienist, and occupational health nurse met to determine the level, a great deal of in-depth knowledge was gained. Some of the information is not only interesting, but it is also helpful in teaching employees and other health care workers about why the lower level is needed.
The OSHA Graduate Nurse Internship
Donna Zankowski, BS, RN, COHN
This poster presentation described the Occupational Safety and Health Administration (OSHA) Graduate Nurse Internship, including internship objectives and activities, and informs the viewers of eligibility and application requirements. An in-depth description of the intern’s project, analyzing workplace violence citations and hazard alerts, is discussed. A brief description of three past internship projects was also included to demonstrate the range of potential internship projects for future interns.
The Role of Occupational Medicine in Saudi Aramco
Saeed Zahrani, MSc, RN
This poster presented the progress in occupational health services in Saudi Aramco and the prevention programs provided to the workforce of the company.