Tuesday, January 29, 2008

Nursing Safety: Safety Issues on the Job

Nursing personnel have one of the highest job-related injury rates of any occupation (Foley, 2004). The Bureau of Labor Statistics reported that 11,800 registered nurses and 40,800 nurses aides lost time away from work due to musculoskeletal injuries alone (Wood, 2004). Why are the injury rates in the nursing profession so staggering? With the demands placed on nurses in the fast-paced, high technologic health care environment (Sedlack, 2004) and with the lack in funding of preventive measures such as vaccines, tests, and supplies (Grace, 1997), nurses are constantly exposed to hazards that can inhibit them from providing quality care for their patients. Though the safety issues that nurses face have yet to be fully addressed, the paradigm for promoting nurse safety is progressively changing (Sedlack, 2004). In order for nurses to be able to attend to their patients and practice beneficence and nonmaleficence, they must first focus on taking care of themselves.

Major Areas of Health and Safety Concern
There are five major categories of safety risk hazards. The first major category, infectious/biological risks include respiratory illnesses, such as Severe Acute Respiratory Syndrome (SARS), Tuberculosis (TB), and other communicable bloodborne diseases that can be spread through needlestick injuries, such as Hepatitis B, Hepatitis C, and Human Immunodeficiency Virus (HIV). The second major category, chemical risks, can result from sterilizing agents and chemotherapeutic agents, such as disinfectants and cold sterilants.  These can provoke reactive airway symptoms and skin problems.  Ethylene oxide has produced cancer in animals. The third major category, environmental/mechanical risks, poses physical risks to nurses and assistive health personnel as they try to move the patient by lifting them. The fourth major category, physical risks, refers to physical agents that cause tissue trauma, such as heat and cold, vibration, and noise. The last major risk category is that of psychosocial risks. Violent behaviors towards health care workers by hospitalized medical, surgical, and psychiatric patients, as well as nursing home patients are well known to those who work in those areas (Foley, 2004). Stress also affects nurses as the demand for care increases for each individual nurse due to the growing shortage of nurses.

How Safety Issues Have Been Addressed
Though these problems are still prevalent on the job today, considerable measures have been taken to address these issues. Investments in equipment and technology have led to the development of mechanical lifts that allow patients to be transported without requiring nurses to physically lift them and risk straining their backs. Also, after recognizing that accidental needlestick injuries were a significant cause of the Hepatitis virus among hospital employees, Occupational Safety and Health Administration now requires yearly training on preventive strategies and offers the Hepatitis B vaccine to anyone who might have bloodborne exposure on the job (Contillo, 2007). A Hierarchy of Controls has been developed to assist in systematically identifying hazards and prioritizing intervention strategies (Foley 2004), and nurses have been made aware of the dangers that result from the stress of dealing with more patients than one nurse can handle, and have developed ways to deal with stress on the job.

Related Links
1. Nursing World
2. NurseZone
3. National Institute for Occupational Safety and Health
4. American Journal of Nursing: 2006 Columns
5. Centers for Disease Control and Prevention
6. Needlestick.org

  • Contillo, Christine. (2007, November 5). Vaccinations for Healthcare Workers. Working Nurse, 64, 6-7.
  • Foley, M., (September 30, 2004). "Caring for Those Who Care: A Tribute to Nurses and Their Safety". Online Journal of Issues in Nursing. Vol. #9 No. #3, Manuscript 1. Available: www.nursingworld.org/ojin.
  • Grace, H. K., & McCloskey, J. C. (1997). The costs of safety precautions to reduce risk of exposure to bloodborne pathogens. Current Issues in Nursing, 5, 500-503.
  • Sedlak, C. (September 30, 2004). "Overview and Summary: Nurse Safety: Have We Addressed the Risks?". Online Journal of Issues in Nursing. Vol. #9 No. #3, Overview and Summary. Available: www.nursingworld.org/ojin.
  • Wood, Debra. (2008). Nurse Safety: Investments in Equipment, Training Help Prevent Back Injuries. NurseZone. Retrieved January 27, 2008 from http://www.nursezone.com/stories/SpotlightOnNurses.asp?articleID=10820.