On-the-job safety risks for nurses rival those in construction and public safety,1 but it has not always been widely known to the public. Recent media reports, including a special series from National Public Radio, has shed light on what 3.4 million nurses, the largest workforce in the healthcare industry, have known for far too long: they face multiple workplace hazards to provide care every day.
To add to this, the healthcare industry lags behind other industries in workplace safety advancements.1 Over the past three decades, the construction and manufacturing industries have surpassed hospitals in reducing injuries and illnesses most effectively.
Early in 2015, OSHA stepped up enforcement resources in five major workplace hazards facing nurses: musculoskeletal disorders related to patient/resident handling; bloodborne pathogens; workplace violence; tuberculosis; slips, trips and falls. There have been various degrees of reaction from nurses I’ve spoken with across the country. While there is no doubt OSHA’s decision to step up review of workplace safety standards of facilities is the right thing to do, there seems to be inconsistency in actions taken by organizations.
Some healthcare organizations are clearly excelling. They are working diligently to ensure their nurses have not only the right tools for safe patient handling and infectious disease, but are asking their employees what else must be done so they can provide quality care, and are following through. I have seen other organizations work on skin health to ensure their nurses’ hands are not cracked, irritated or hurting from constant hand washing and sanitizing.
I have seen others work on reducing patient violence by conducting drills and simulations to ensure all employees are trained to de-escalate potentially violent situations. However, there are also many organizations trying to take action, but are distracted by competing priorities. Delivering care in a constant crisis management modality is not uncommon, but it does hinder organizations from reaching their patient and employee safety goals.
Combine an aging nursing workforce, a patient population that is growing more acutely ill and the constant expectation to jump into life-saving action instantly, and you have a perfect storm of many concerning workplace safety hazards.
Solutions to Workplace Hazards
To ensure organizations are protecting the safety of their nurses, organizations must develop goals, defined milestones, and proper metrics to measure success. Above all, nurses need champions committed to long-term solutions in their organizations. Organizations may consider the following best practices and solutions for common workplace hazards:
SEE ALSO: The Flu Center
· Back injury: Nursing assistants and RNs were two of the top six occupations suffering musculoskeletal disorders in 2011, BLS data shows. Hospitals can establish a safe patient handling program with a strong education component, and tools to prevent nurses from physical exertion. Think about mobile full-body floor lifts, sit-to-stand lifts, standing assistance aids, overhead ceiling track systems of slings and accessories.
Consider how these pieces of assist equipment fit into the everyday process of care. Implementation must be intuitive, simple and seamless for the nurse who has an innumerable amount of tasks to complete around the clock. When implementing a safe patient handling program, organizations need to offer simulation training of lifts, so proper lifting is understood across the board.
· Bloodborne pathogens: CDC estimates about 5.6 million workers in healthcare and related occupations are at risk of occupational exposure to bloodborne pathogens. Clinicians must wear eye gear to be cautious about the care they deliver. Organizations should also regularly practice and train staff on the donning and doffing of personal protective equipment properly.
· Highly contagious flu strains: Healthcare providers can be some of the worst when it comes to self-care. It is in their DNA to take care of others. They sacrifice themselves to meet their patients’ needs. Especially during this current flu season, it’s important for them to put themselves first. Flu prevention is extremely important, especially when dealing with an aging workforce. Start looking closely at the tools nurses use to prevent influenza. Besides hand sanitizer and the practice of good hand hygiene, use surface disinfectant wipes and encourage wide use of a facemask when staff are working in high-flu risk areas. Plan ahead and have these supplies available before an influx of influenza occurs.
· Dry, cracked hands resulting from handwashing and scrubbing: A study from the University of Manchester revealed nurses may suffer from contact dermatitis 4.5 times more than any other profession as a result of hand hygiene compliance measures. In another study, 88 percent of healthcare professionals believe that following proper protocols can lead to an onset of skin problems.2 Gloves tend to create an endless moist/dry cycle that leads to irritated skin. Nurses need a glove that helps soothe their hands. In an informal poll by Medline University, 14 percent of surveyed healthcare professionals had said they thought about leaving the healthcare field due to irritated or damaged hands.
Executing new solutions takes staff buy-in, comprehensive training, outcomes management, and follow-through. Additionally, staff must be engaged, as well as supportive of each other, to sustain safe work environments at their organizations. Safety must be talked about as a value firmly believed in and acted upon by all staff members. A true culture of safety also understands effective team work and communication are the building blocks for advancing safety. All nurses need to take action to improve safety for themselves and others.
Nurses must also find out if their organizations have existing processes or committees to improve safety. I have found many times that nurses may not know there is an infrastructure in place that they can tap into to help drive change.
Lastly, new nurses must especially feel supported. When I first started practicing, I was teased for wearing gloves to a delivery. The manager told me that a real nurse doesn’t need gloves. I was going to be resuscitating a newborn who had fetal decelerations and was projected to be compromised. I took off my gloves. The mother was later found to be positive for hepatitis. I underwent tests and prophylactic treatments-all because I gave into peer pressure. No one should impede safety for a caregiver. Nurses must be each other’s first advocates for staying safe, healthy and well.
1. Caring for Our Caregivers: Facts About Hospital Worker Safety, OSHA, September 2013.
2. McKenzie, SN, et al. Alcohol hand abuse: a cross-sectional survey of skin complaints and usage patterns at a large UK teaching hospital. JRSM. 2011; 2(8), 68.
Martie Moore is the chief nursing officer at Medline Industries Inc.