Hospital work environments, nurse characteristics, and sharps injuries

Overview of Occupational Injuries Among Registered Nurses in Washington State, 2007 to 2019

BACKGROUND

Registered nurses (RNs) represent the largest segment of the health care workforce and have unique job demands and occupational health considerations. The purpose of this study was to describe the incidence, cost, and causes of occupational injuries among RNs in Washington State and to quantify the cumulative cost and burden of each type of injury, relative to all injuries among RNs.

METHODS

Annual injury claims data covered under Washington State workers' compensation (WC) fund were analyzed over a 13-year period (2007-2019). Annual mean incidence and cost of injuries were calculated and stratified by nature, source, and event/exposure. Negative binomial regression models were used to examine trends in injury incidence over time, for injury incidence overall, and by the most common injury classifications.

RESULTS

Between 2007 and 2019, 10,839 WC claims were filed and accepted for Washington State RNs (annual M = 834), totaling more than US$65 million. No significant trend in overall injury incidence was observed (incidence rate ratio [IRR]: 0.99, 95% confidence interval [CI] = [0.94, 1.05]). The most common injury exposures were bodily reaction and exertion, contact with objects and equipment, falls, and assaults and violent acts.

DISCUSSION

To our knowledge, this is the first broad study of the incidence and costs of occupational injuries among RNs across all workplace settings. We identified high-cost, high-frequency incidence rates of musculoskeletal, sharp, and violence-related occupational injury claims, highlighting intervention targets. Implications for Occupational Health Practice: Policy makers, health systems, and occupational health nurse leaders can use this information to identify priority areas where evidence-based occupational health and prevention programs are most needed.

Identifying individual and organizational predictors of accidental exposure to blood (AEB) among hospital healthcare workers: A longitudinal study

BACKGROUND

Accidental exposure to blood (AEB) poses a risk of bloodborne infections for healthcare workers (HCWs) during hospital activities. In this study, we identified individual behavioral and organizational predictors of AEB among HCWs.

METHODS

The study was a prospective, 1-year follow-up cohort study conducted in university hospitals in Paris, France. Data were collected from the Stress at Work and Infectious Risk in Patients and Caregivers (STRIPPS) study. Eligible participants included nurses, nursing assistants, midwives, and physicians from 32 randomly selected wards in 4 hospitals. AEB occurrences were reported at baseline, 4 months, 8 months, and 12 months, and descriptive statistical and multilevel risk-factor analyses were performed.

RESULTS

The study included 730 HCWs from 32 wards, predominantly nurses (52.6%), nursing assistants (41.1%), physicians (4.8%), and midwives (1.5%). The incidence rate of AEB remained stable across the 4 visits. The multilevel longitudinal analysis identified several significant predictors of AEB occurrence. Individual-level predictors included younger age, occupation as nurses or midwives, irregular work schedule, rotating shifts, and lack of support from supervisors. The use of external nurses was the most significant ward-level predictor associated with AEB occurrence.

CONCLUSIONS

AEBs among HCWs are strongly associated with organizational predictors, highlighting the importance of complementing infection control policies with improved staff management and targeted training. This approach can help reduce AEB occurrences and enhance workplace safety for HCWs.

Work-Related Health Conditions Among American Nurses: A Scoping Review

Background

Working in the nursing profession is hazardous, and nurses report poor health. Risk factors associated with poor health outcomes have been documented. However, the extent of literature exploring the prevalence of health conditions among American nurses that may be attributable to their work has not been examined.

Method

A scoping review following the Joanna Briggs Institute recommendations was conducted of peer-reviewed quantitative studies to answer the question: What are health conditions experienced by American nurses that may be attributable to their work as nurses?

Results

Thirty articles met the inclusion criteria. Due to the methods used in many articles, studies of the prevalence of health conditions among the nursing population were lacking. Health conditions studied broke into six categories: (a) work-related injuries and hazards; (b) unhealthy lifestyles; (c) mental health conditions; (d) burnout; (e) fatigue, sleep, and migraines; and (f) reproductive health. The role of work in the health conditions studied varied from an immediate impact on health (e.g., a needlestick or injury) to a cumulative impact (e.g., scheduling or workplace demands). Within the work demands, the physical environment; physical, emotional, and cognitive demands of work; and shiftwork were all frequently identified as antecedents that could be further explored and addressed to improve nurse health.

Conclusions

Healthcare systems should seek to address the hazards and exposures that may be linked to health conditions in the nursing workforce. Understanding and mitigating the impact of the pandemic and nursing work on the workforce's health is crucial to the solvency of the workforce. Occupational health practitioners should assess for workplace hazards and exposures.

Relationship between nurses’ psychological capital and satisfaction of elderly cancer patients during the COVID-19 pandemic

Introduction

As a special vulnerable group, the physical and mental health of elderly cancer patients has attracted much attention. However, few studies have focused on the impact of nurses’ mental state on the mental health of elderly cancer patients during the COVID-19 pandemic. In response to this literature gap, this study aims to explore the impact of nurses’ psychological capital on the satisfaction of elderly cancer patients. The job demands-resources model (JD-R) is used to further investigate how work engagement and job resources of nurses affect this relationship.

Methods

The questionnaire survey was used to collect data, participants included 230 elderly cancer patients and their nurses from a tertiary first-class cancer hospital in China. Partial least squares structural equation modeling (PLS-SEM) was conducted with SmartPLS 3.3.9.

Results

Nurses’ psychological capital has a significant positive impact on the satisfaction of elderly cancer patients during the COVID-19 pandemic. Nurses’ work engagement is an important mechanism for their psychological capital to affect the satisfaction of elderly cancer patients. In addition, nurses’ job resources positively moderate the relationship between their psychological capital and work engagement. The positive relationship between psychological capital and work engagement of nurses is stronger when they have abundant job resources.

Discussion

These findings suggest that healthcare organizations should take the psychological capital of medical staff as an important means to improve their competitive advantage. It can improve the quality of medical services to obtain good performance by effectively developing and managing the psychological capital of medical staff. In addition, healthcare organizations should recognize the importance of providing adequate job resources for medical staff.

Relationship between nurses' psychological capital and satisfaction of elderly cancer patients during the COVID-19 pandemic

Introduction

As a special vulnerable group, the physical and mental health of elderly cancer patients has attracted much attention. However, few studies have focused on the impact of nurses' mental state on the mental health of elderly cancer patients during the COVID-19 pandemic. In response to this literature gap, this study aims to explore the impact of nurses' psychological capital on the satisfaction of elderly cancer patients. The job demands-resources model (JD-R) is used to further investigate how work engagement and job resources of nurses affect this relationship.

Methods

The questionnaire survey was used to collect data, participants included 230 elderly cancer patients and their nurses from a tertiary first-class cancer hospital in China. Partial least squares structural equation modeling (PLS-SEM) was conducted with SmartPLS 3.3.9.

Results

Nurses' psychological capital has a significant positive impact on the satisfaction of elderly cancer patients during the COVID-19 pandemic. Nurses' work engagement is an important mechanism for their psychological capital to affect the satisfaction of elderly cancer patients. In addition, nurses' job resources positively moderate the relationship between their psychological capital and work engagement. The positive relationship between psychological capital and work engagement of nurses is stronger when they have abundant job resources.

Discussion

These findings suggest that healthcare organizations should take the psychological capital of medical staff as an important means to improve their competitive advantage. It can improve the quality of medical services to obtain good performance by effectively developing and managing the psychological capital of medical staff. In addition, healthcare organizations should recognize the importance of providing adequate job resources for medical staff.

Cardiovascular Nursing Workforce Challenges: Transforming the Model of Care for the Future

The complexities of acute and critical care cardiovascular management demand specialty trained and experienced nurses to ensure quality patient outcomes. An ongoing nurse labor shortage threatens to destabilize the healthcare system and presents a twofold challenge: a decreasing supply of registered nurses and increasing demand for nursing services. This article describes the numerous forces driving the current nursing shortage as well as the impact of the coronavirus-19 pandemic on nurse job satisfaction and turnover. We present a reinvented model of nursing care as a framework for healthcare organizations to address nurse staffing challenges.

Comparing the Nurse Work Environment, Job Satisfaction, and Intent to Leave Among Military, Magnet®, Magnet-Aspiring, and Non-Magnet Civilian Hospitals

OBJECTIVE

This study aimed to compare the nurse work environment, job satisfaction, and intent to leave (ITL) among military, Magnet®, Magnet-aspiring, and non-Magnet civilian hospitals.

BACKGROUND

The professional nurse work environment is an important, modifiable, organizational trait associated with positive nurse and patient outcomes; creating and maintaining a favorable work environment should be imperative for nursing leaders.

METHODS

Secondary data from the Army Nurse Corps and the National Database of Nursing Quality Indicators included the Practice Environment Scale of the Nursing Work Index (PES-NWI) and single-item measures of job satisfaction and ITL.

RESULTS

Magnet and military hospitals had identical PES-NWI composite scores; however, statistically significant differences existed among the subscales. Military nurses were the most satisfied among all groups, although this difference was not statistically significant, yet their ITL was highest.

CONCLUSIONS

Favorable work environments may exist in other organizational forms besides Magnet; however, the specific components must be considered.

Internal Quality and Job Satisfaction in Health Care Services

(1) Background: The main purpose of this study was to evaluate the health services' internal quality level in Greek public hospitals and to investigate whether there is a relation between internal quality and health care professionals' job satisfaction. (2) Material and Methods: A cross-sectional study was conducted in six public hospitals (four general and two specialized hospitals). The following tools were used to collect data: (a) the SERVQUAL questionnaire, which is designed to measure service quality through five dimensions, and (b) the Job Satisfaction Survey (JSS) questionnaire, which is designed to measure employees' job satisfaction. Convenience sampling was used as a sampling technique. (3) Results: The level of internal quality service was found to be low as regards the dimensions of: reliability, assurance, responsiveness, and empathy, while the "tangibles" dimension was the only one which was assessed as having a satisfactory internal quality level. Τhe results also revealed a positive correlation between the job satisfaction subscales and the quality dimensions. Regarding demographic characteristics and their effect on employees' perceptions of internal quality dimensions, the study found that the gender and the educational factor had no effect while younger employees have a more positive perception of the quality of responsiveness dimension in the health organizations where they work. In terms of profession, administrative staff had a lower perception of the quality of tangibles dimension than doctors and nurses. Concerning years of experience, the results indicated that employees with more previous working experience had a worse perception of the quality of reliability, responsiveness, and assurance dimensions. (4) Conclusions: According to the results, establishing a sense of trust and understanding between management and health professionals through effective communication, transparent evaluation, and reward is critical to developing, enhancing, and promoting an internal quality culture in a hospital setting.

Impact of the Work Environment on Patients' Safety as Perceived by Nurses in Poland-A Cross-Sectional Study

Numerous studies have found that organizational features connected with the work environment of nurses have a significant influence on patients' safety. The aim of this research was to capture nurses' opinions about patients' safety and discern relationships with work environment characteristics. This cross-sectional study surveyed 1825 nurses. The research used questionnaire consisting of four parts: (1) covered The Practice Environment Scale of the Nursing Work Index (PES-NWI); (2) assessed the quality of nursing care and care safety; (3) contained information on the most recent duty served by the nurses and (4) captured social and demographic data of participants. The research identified strong association between patient safety assessment and work environment of nurses in the aspect of employment adequacy, cooperation between nurses and doctors, support for nurses from the managing staff, the possibility to participate in the management as well as professional promotion of nurses employed in the hospital (p < 0.001). Nurses rated patient safety higher when responsible for a smaller number of patients. Work environment factors such as proper staffing, good cooperation with doctors, support from the management, as well as professional independence are significantly related to nurses' assessment of patients' safety.

Nursing workplace and its relation to occupational health outcomes and physical activity

BACKGROUND

Working in hospitals entails several risks to nurses. A better nursing workplace can help in improving physical activity and reducing adverse occupational health outcomes among nurses.

AIM

This study aimed to investigate the relationships of the nursing workplace with occupational health outcomes and physical activity.

METHODS

A cross-sectional correlation study was conducted with 623 nurses. Data were collected through report self-administered questionnaires that included employment and occupational conditions, hospital workplace environment, and adverse occupational health outcomes as well as physical activity pattern.

RESULTS

The current study showed that the nursing workplace environment and conditions had a negative effect on occupational health outcomes and physical activity among nurses in the study units. Nurses in this study reported a high prevalence of low back pain (82.7%), burnout (78.3%), and occupational injuries (70.5%). They also reported insufficient physical activities (90.6%). High prevalence of burnout and low back pain were associated with low levels of physical activities among nurses.

CONCLUSION

A fair working environment and conditions have been implicated as a causative factor of negative occupational health outcomes and limitations of physical activity among nurses. Adverse occupational health outcomes also affect the nurses engaging in physical activity.

Challenges facing oncology nurses in Jordan: A qualitative study

BACKGROUND

The literature shows that oncology nurses have more stressors than nurses in other units. They face many challenges both within and outside the work environment that affect them negatively. Most of the reviewed studies concerning these challenges were conducted in developed countries.

AIM

The purpose of this study was to explore the challenges experienced by oncology nurses in Jordan during their daily practice.

METHOD

A qualitative descriptive approach was adopted. Semistructured individual face-to-face interviews were conducted with 24 nurses. Participants were selected from oncology departments in one of the biggest governmental hospitals in Jordan.

RESULTS

Two main themes were drawn from the data analysis. The first discussed the personal challenges that oncology nurses encountered. These included emotional attachment to patients and difficulties in separating work and personal life. The second related to organizational challenges in the work environment, which included the nurses' lack of authority to inform patients about their diseases, nursing staff and supply shortages, and a lack of orientation programs. All of these factors affected the psychological status of the nurses.

CONCLUSIONS

The results of this study indicated that the working environment for oncology nurses is highly stressful and demanding and these nurses face many challenges in their work. The understanding and consideration of these challenges by stakeholders, managers, and organizational leaders would lead to improvements in the nurses' psychological state, thereby enhancing the quality of care in these units and helping with staff retention.

Organization of Work Factors Associated with Work Ability among Aging Nurses

The United States (U.S.) workforce is aging. There is a paucity of literature exploring aging nurses' work ability. This study explored the work-related barriers and facilitators influencing work ability in older nurses. We conducted a qualitative descriptive study of aging nurses working in direct patient care (N = 17). Participants completed phone or in-person semi-structured interviews. We used a content analysis approach to analyzing the data. The overarching theme influencing the work ability of aging nurses was intrinsically motivated. This was tied to the desire to remain connected with patients at bedside. We identified factors at the individual, unit-based work level and the organizational level associated with work ability. Individual factors that were protective included teamwork, and feeling healthy and capable of doing their job. Unit-based level work factors included having a schedule that accommodated work-life balance, and one's chronotype promoted work ability. Organizational factors included management that valued worker's voice supported work ability.

Awareness of needle-stick injuries among health-care workers in a tertiary health-care center

Context:

Needle-stick injuries (NSIs) pose a great occupational risk of blood-borne disease transmission in health-care workers (HCWs). Diseases of primary significance include hepatitis B, hepatitis C, and human immunodeficiency virus infection.

Aims:

This study aimed to check the awareness regarding the health hazards associated with NSIs and awareness regarding postexposure prophylaxis (PEP) and hepatitis B vaccination in HCWs.

Settings and Design:

This is a cross-sectional study conducted in a tertiary care government hospital.

Subjects and Methods:

A sample size of 100 HCWs, which consisted of 20 residents, 20 interns, 20 lab assistants, 20 nurses, and 20 Class IV workers, was taken. A predefined questionnaire was used and answers were documented.

Statistical Analysis Used:

Chi-square test was used for statistical analysis.

Results:

Out of the 100 HCWs enrolled in the study, 45% had a history of NSI during their career, the highest count was seen in Class IV workers i.e. 14 [70%]. Only 21% of the HCWs knew about the diseases transmitted by NSI. Only 30% of Class IV workers were aware of hepatitis B vaccination and none of them were vaccinated. Quite a good number of HCWs were aware regarding the first step to be undertaken in case of NSI. However, their knowledge regarding PEP was not up to the mark.

Conclusions:

NSIs were seen in all the categories of HCWs, but the awareness regarding health hazards due to NSI was inadequate. Except Class IV workers, rest of the HCWs were overall aware regarding hepatitis B vaccination. There is a need to give emphasis as regards to awareness of PEP in case of a NSI.

Prevalence of needle-stick and sharp object injuries and its associated factors among staff nurses in Dessie referral hospital Amhara region, Ethiopia, 2018

OBJECTIVE

The aim of this study was to assess the prevalence of needle-stick and sharp object injuries among staff nurses in Dessie referral hospital, Amhara region, Ethiopia, 2018.

RESULTS

Among the 151 study participants, 98 (65%) respondents were males. Seventy-five (48.1%) participants had 4-10 years of experience. The overall prevalence of needle stick and sharp object injury among staff nurses in Dessie referral hospital was 43%. In this study, nurses who worked in the emergency department were 11× more likely to experience needle stick and sharp object injury compared with nurses who worked in outpatient department P = 0.004 [AOR = 11.511 95% CI 2.134, 62.09)]. Participants who were worked in adult health department were 10× more likely experience needle stick and sharp object injury when compared with participants who were worked in outpatient department P = 0.006 [AOR = 9.742 95% CI 1.904, 49.859)]. The major implication of these study findings on the health system is the importance of given emphasis for nurses in relation with needle stick and sharp injury.

The associations of workload, individual and organisational factors on nurses' occupational injuries

AIMS AND OBJECTIVES

To determine the prevalence and type of occupational injuries in nurses and their associations with workload, working shift, and nurses' individual and organisational factors.

BACKGROUND

Nurses are vulnerable to occupational injuries due to the nature of their job.

DESIGN

A cross-sectional correlational design (based on STROBE Statement) was conducted.

METHODS

This study was conducted among 616 nurses of four public hospitals located in four different provinces in Iran. Data were collected using three questionnaires including an organisational and demographic questionnaire, an occupational injuries checklist and the NASA-TLX questionnaire (about mental workload). Chi-square test, one-way ANOVA and multivariate logistic regression were used in SPSS version 23.0 for statistical analysis.

RESULTS

Blood and body fluid exposures had the highest prevalence (47.4%) among all injuries. Needlestick injuries showed a significant relation with gender, age, number of shifts in a month and work experience. With increase in mental workload, needlestick injuries increase by 35%. Also, injuries reported by nurses working in rotating shifts were 15%-53% more than nurses working in fixed shifts.

CONCLUSION

Working in rotating shifts and work overload was significantly related to all injuries. Decreasing nurses' mental workload, introducing guidelines and efficient training in shift work schedules can help decrease occupational injuries among nurses.

RELEVANCE TO CLINICAL PRACTICE

In order to reduce occupational injuries among nurses, in addition to incorporating advanced management and technology, it is necessary to pay attention to psychosocial, individual and organisational risk factors related to occupational injuries and their frequency in nurses. Also, reducing personnel's mental and occupational pressure should be considered.

The state of the science of nurse work environments in the United States: A systematic review

A healthy nurse work environment is a workplace that is safe, empowering, and satisfying. Many research studies were conducted on nurse work environments in the last decade; however, it lacks an overview of these research studies. The purpose of this review is to identify, evaluate, and summarize the major foci of studies about nurse work environments in the United States published between January 2005 and December 2017 and provide strategies to improve nurse work environments. Databases searched included MEDLINE via PubMed, CINAHL, PsycINFO, Nursing and Allied Health, and the Cochrane Library. The literature search followed the PRISMA guideline. Fifty-four articles were reviewed. Five major themes emerged: 1) Impacts of healthy work environments on nurses' outcomes such as psychological health, emotional strains, job satisfaction, and retention; 2) Associations between healthy work environments and nurse interpersonal relationships at workplaces, job performance, and productivity; 3) Effects of healthy work environments on patient care quality; 4) Influences of healthy work environments on hospital accidental safety; and 5) Relationships between nurse leadership and healthy work environments. This review shows that nurses, as frontline patient care providers, are the foundation for patient safety and care quality. Promoting nurse empowerment, engagement, and interpersonal relationships at work is rudimental to achieve a healthy work environment and quality patient care. Healthier work environments lead to more satisfied nurses who will result in better job performance and higher quality of patient care, which will subsequently improve healthcare organizations' financial viability. Fostering a healthy work environment is a continuous effort.

Determinants of Workplace Injuries and Violence Among Newly Licensed RNs

Workplace injuries, such as musculoskeletal injuries, needlestick injuries, and emotional and physical violence, remain an issue in U.S. hospitals. To develop meaningful safety programs, it is important to identify workplace factors that contribute to injuries. This study explored factors that affect injuries in a sample of newly licensed registered nurses (NLRNs) in Florida. Regressions were run on models in which the dependent variable was the degree to which the respondent had experienced needlesticks, work-related musculoskeletal injuries, cuts or lacerations, contusions, verbal violence, physical violence, and other occupational injuries. A higher probability of these injuries was associated with greater length of employment, working evening or night shifts, working overtime, and reporting job difficulties and pressures. A lower probability was associated with working in a teaching hospital and working more hours. Study findings suggest that work environment issues must be addressed for safety programs to be effective.

Factors Influencing the Eating Practices of Hospital Nurses During Their Shifts

The purpose of this study was to identify factors influencing hospital nurses' dietary practices during their shifts. Semistructured interviews grounded in the Social Ecological Model focused on individual, interpersonal, organizational, and public policy factors affecting intake. Responses from 20 female nurses were qualitatively coded and categorized based on common themes. Four major themes emerged: occupational characteristics, hesitation to take breaks, influence of unhealthy food, and organizational and industry policies. Of note, nurses' perceived inability to take breaks was due to patient load, unpredictability of patient needs, reluctance to burden other nurses, a tendency to prioritize patient care over self-care, and the repercussions of working longer hours to complete work. Other influential factors included the presence of unhealthy food options, regulations restricting nurses' ability to eat and drink in the workplace, and the need for more staff. Multilevel interventions are necessary to ensure nurses take appropriate meal breaks and maintain satisfactory dietary habits.

An Integrative Review of the Hands-Free Technique in the OR

Sharps injury rates are proportionally higher in perioperative areas than in other practice settings. The hands-free technique (HFT) has been shown to decrease the hazards of sharps injuries when passing sharps during surgery. We reviewed and synthesized research studies regarding compliance with the HFT and factors facilitating its use using a key word search of online databases and a secondary search of references. We reviewed English language studies published since 2001 regarding HFT compliance rates or related factors using the Johns Hopkins Nursing Evidence-Based Practice Model and Guidelines. We found 14 articles reporting a wide range of HFT compliance rates (ie, 5% to 84%), which identified that a number of organizational factors and health care workers' perceptions of infection risks influenced the use of the HFT.

Association of nurse work environment and safety climate on patient mortality: A cross-sectional study

BACKGROUND

There are two largely distinct research literatures on the association of the nurse work environment and the safety climate on patient outcomes.

OBJECTIVE

To determine whether hospital safety climate and work environment make comparable or distinct contributions to patient mortality.

DESIGN

Cross-sectional secondary analysis of linked datasets of Registered Nurse survey responses, adult acute care discharge records, and hospital characteristics.

SETTING

Acute care hospitals in California, Florida, New Jersey, and Pennsylvania.

PARTICIPANTS

The sample included 600 hospitals linked to 27,009 nurse survey respondents and 852,974 surgical patients.

METHODS

Nurse survey data included assessments of the nurse work environment and hospital safety climate. The outcome of interest was in-hospital mortality. Data analyses included descriptive statistics and multivariate random intercept logistic regression.

RESULTS

In a fully adjusted model, a one standard deviation increase in work environment score was associated with an 8.1% decrease in the odds of mortality (OR 0.919, p<0.001). A one-standard deviation increase in safety climate score was similarly associated with a 7.7% decrease in the odds of mortality (OR 0.923, p<0.001). However, when work environment and safety climate were modeled together, the effect of the work environment remained significant, while safety climate became a non-significant predictor of mortality odds (OR 0.940, p=0.035 vs. OR 0.971, p=0.316).

CONCLUSIONS

We found that safety climate perception is not predictive of patient mortality beyond the effect of the nurse work environment. To advance hospital safety and quality and improve patient outcomes, organizational interventions should be directed toward improving nurse work environments.

Bloodborne pathogen exposures: Difference in reporting rates and individual predictors among health care personnel

BACKGROUND

Employees in health care settings are at varying risk for bloodborne pathogen (BBP) exposures. We compared differences in reporting rates of BBP exposures among health care personnel during 2 different time periods, assessing job category, years of experience, and sex as potential predictors for exposure.

METHODS

A retrospective review of the employee health department BBP database at 2 time periods (September 1, 2012-April 30, 2013, and September 1, 2013-April 30, 2014) in which 2 different reporting protocols (call center vs pager) was used. A survey was administered to assess reported and unreported exposures within a 12-month period.

RESULTS

BBP exposures were highest among residents and lowest among students. Physicians' reporting rate doubled when the call center was no longer used (relative risk, 2.40; 95% confidence interval [CI], 1.04-5.52). Percutaneous injuries were the most common (78.3%), and most occurred in the operating room or postanesthesia unit (30.8%) and patient rooms (28.9%). Of 1,105 survey respondents, 103 (9.3%) recalled some type of exposure, but only 80 (77.7%) reported these exposures. When accounting for years of experience and sex, job category was significantly associated with injury or exposure within the previous 12 months (P < .001). Risk of exposure among residents was 3 times higher (odds ratio, 3.10; 95 CI, 1.60-6.00) than nurses.

CONCLUSIONS

Risk and reporting behaviors of BBP exposures vary widely across different providers. Training and education to prevent BBP exposures may need to be tailored toward different provider types.

Occupational exposure to sharps injury among healthcare providers in Ethiopia regional hospitals

BACKGROUND

Sharps injury is a penetrating stab wound from a needle, scalpel, or another sharp object that may result in exposure to blood or other body fluids. According to World Health Organization pooled estimate, the annual incidence of sharps injury in Africa was ranged from 2.10 to 4.68 per person per year, but research data in Ethiopia is limited. The aim of the study was to investigate sharps injury prevalence and associated risk factors.

METHODS

Institution based cross-sectional study was conducted with 200 healthcare providers (HCP) in Northeast Ethiopia. Proportionate stratified sampling was used to select HCP. Sharps injury during the last 12 months was an outcome variable whereas demographic characteristics, behavioral attributes, and job environment characteristics were independent variables. Data was collected from April to May 2016 using self-administered questionnaire; which was adapted from World Health Organization best practices for injections and related procedures toolkit. Bivariate and multivariate logistic regression analysis was carried out to identify sharps injury associated risk factors. Epi Info version 3.5.1 software package was used for data coding and entry whereas Statistical Package for Social Sciences (SPSS) version 20 software package was used for analysis.

RESULTS

In total, 195 HCP participated with a response rate of 97.5%. The prevalence of sharps injury was 32.8%. Following adjustment for covariates, lack of in-service job training and previous exposure to sharps injury were statistically significant risk factors for sharps injury. HCP who had no in-service job training were 4.7 times more likely sustained sharps injury compared with those who had in-service job training (p < 0.001, OR = 4.7, 95% CI = 2.05-10.56). HCP who had previous exposure to sharps injury were 3.7 times more likely sustained sharps injury compared with those who were not exposed (p-value = 0.002, OR = 3.7, 95% CI = 1.62-8.27).

CONCLUSIONS

This study revealed 32.8% or at least three out of ten HCP exposed to sharps injury. This was found statistically significant among HCP who had no in-service job training and who had previous exposure to sharps injury. Thus, training HCP perhaps increase their skill and curiosity to reduce exposure to sharps injury.

A Review of Design and Policy Interventions to Promote Nurses' Restorative Breaks in Health Care Workplaces

The nursing profession in the United States is on the precipice of a crisis. Nurses are essential to the health care industry, and maintaining quality nursing care is a primary concern of today's health care managers. Health care facilities report high rates of staff burnout and turnover, and interest in the nursing profession among younger students is declining. Health care leaders must improve nurses' job satisfaction, performance, and retention. However, they often overlook the need for nurses' respite and underestimate the value of well-designed staff break areas. An exhaustive and systematic literature search was conducted in the summer of 2014, and all studies found on the topic were reviewed for their relevance and quality of evidence. The existing literature about the main causes of nurses' fatigue, barriers that prevent nurses from taking restorative breaks, and consequences of nurses' fatigue for staff, patient, and facility outcomes demonstrates the pressing need for interventions that improve nurses' working conditions. Additional literature on the restorative effects of breaks and the value of well-designed break areas indicates that efforts to improve breakroom design can play an important role in improving nurses' job satisfaction and performance.

Long work hours and chronic insomnia are associated with needlestick and sharps injuries among hospital nurses in Taiwan: A national survey

BACKGROUND

Needlestick and sharps injuries are prevalent work-related injuries among nurses. Safety devices prevent only one-quarter of related injuries. More studies of modifiable risk factors are needed.

OBJECTIVES

To examine whether long work hours and chronic insomnia are associated with needlestick and sharps injuries among hospital nurses in Taiwan.

DESIGN

Cross-sectional survey.

SETTINGS/PARTICIPANTS

This analysis included 19,386 full-time bedside nurses working in 104 hospitals across Taiwan.

METHODS

Participants filled out an anonymous questionnaire from July to September 2014. Chronic insomnia, needlestick injuries, and sharps injuries during the past year were each measured by a yes/no question. Multivariate logistic regression models were applied to examine the effects of long work hours and chronic insomnia on needlestick and sharps injuries, given with control for sex, marital status, educational level, age, years of practice, work unit, and hospital level in the model.

RESULTS

More than 70% of study nurses worked long hours during the previous week (>50h: 27.5%; 41-50h: 43.2%), and 15.5% of nurses reported chronic insomnia. The percentage of sharps injuries (38.8%) was higher than that for needlestick injuries (22.4%) during the previous year among nurses. After adjusting for potential confounders, logistic regression yielded significant results showing that those who worked 41 to 50h per week, >50h per week, and had chronic insomnia were 1.17 times (95% C.I.=1.04-1.32), 1.51 times (95% C.I.=1.32-1.72), and 1.45 times (95% C.I.=1.25-1.68) more likely to experience needlestick injuries, and 1.29 times (95% C.I.=1.17-1.42), 1.37 times (95% C.I.=1.23-1.53), and 1.56 times (95% C.I.=1.37-1.77) more likely to experience sharps injuries, respectively, than those who worked fewer hours and did not have insomnia.

CONCLUSIONS

This nationwide nurse survey showed that high rates of needlestick and sharps injuries persist in hospital nurses in Taiwan. The common problems of long work hours and chronic insomnia increase the risk of these injuries. We suggest that hospital managers follow regulations on work hours and optimize shift schedules for nurses to decrease related injuries.

Differences in Hospital Managers', Unit Managers', and Health Care Workers' Perceptions of the Safety Climate for Respiratory Protection

This article compares hospital managers' (HM), unit managers' (UM), and health care workers' (HCW) perceptions of respiratory protection safety climate in acute care hospitals. The article is based on survey responses from 215 HMs, 245 UMs, and 1,105 HCWs employed by 98 acute care hospitals in six states. Ten survey questions assessed five of the key dimensions of safety climate commonly identified in the literature: managerial commitment to safety, management feedback on safety procedures, coworkers' safety norms, worker involvement, and worker safety training. Clinically and statistically significant differences were found across the three respondent types. HCWs had less positive perceptions of management commitment, worker involvement, and safety training aspects of safety climate than HMs and UMs. UMs had more positive perceptions of management's supervision of HCWs' respiratory protection practices. Implications for practice improvements indicate the need for frontline HCWs' inclusion in efforts to reduce safety climate barriers and better support effective respiratory protection programs and daily health protection practices.

Prevalence and risk factors of needlestick injuries, sharps injuries, and blood and body fluid exposures among operating room nurses in Thailand

BACKGROUND

Operating room nurses are at high risk for occupational exposure to bloodborne pathogens. This study examined the prevalence of and risk factors for needlestick injuries (NSIs), sharps injuries (SIs), and blood and body fluid exposures (BBFEs) among operating room nurses in Thai hospitals.

METHODS

A cross-sectional study was performed in 247 Thai hospitals. Questionnaires eliciting demographic data and information on injury occurrence and risk factors were distributed to 2500 operating room nurses, and 2031 usable questionnaires were returned, for a response rate of 81.2%. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using multiple logistic regression analysis.

RESULTS

The prevalence of NSIs, SIs, and BBFEs was 23.7%, 9.8%, and 40.0%, respectively. Risk factors for NSIs were training without practice (OR, 1.67; 95% CI, 1.29-2.17), haste (OR, 4.81; 95% CI, 3.41-6.79), lack of awareness (OR, 1.36; 95% CI, 1.04-1.77), inadequate staffing (OR, 1.60; 95% CI, 1.21-2.11), and outdated guidelines (OR, 1.69; 95% CI, 1.04-2.74). One risk factor was identified for SIs: haste (OR, 2.43; 95% CI, 1.57-3.76). Risk factors for BBFEs were long working hours per week (OR, 2.07; 95% CI, 1.06-4.04), training without practice (OR, 1.55; 95% CI, 1.25-1.91), haste (OR, 1.66; 95% CI, 1.30-2.13), lack of awareness (OR, 1.54; 95% CI, 1.22-1.95), not wearing protective equipment (OR, 1.61; 95% CI, 1.26-2.06), and inadequate staffing (OR, 1.63; 95% CI, 1.26-2.11).

CONCLUSION

This study highlights the high prevalence of NSIs, SIs, and BBFEs among Thai operating room nurses. Preventable risk factors were identified. Appropriate guidelines, adequate staffing, proper training, and self-awareness may reduce these occurrences.

Scheduling and shift work characteristics associated with risk for occupational injury in newly licensed registered nurses: An observational study

BACKGROUND

Registered nurses across the globe bear a heavy injury burden. Every shift, nurses are exposed to a variety of hazards that can jeopardize their health, which negatively impacts their ability to provide high-quality patient care. Previous research suggests that inexperienced, or newly licensed nurses, may have an increased risk for certain occupational injuries. However, the current knowledge base is insufficient to fully understand how work hours influence newly licensed nurses' occupational injury, given the significant variation in hospital organization and work characteristics.

OBJECTIVE

To describe newly licensed nurses' shift work characteristics and determine the association between shift type and scheduling characteristics and nurse injury, before and after adjusting for individual and combined effects of demographics, external context, organizational context, and work context, following the Organization of Work model.

DESIGN

This study is a secondary analysis of a nationally representative survey of newly licensed registered nurses using a cross-sectional design.

PARTICIPANTS

The analytic sample includes 1744 newly licensed registered nurses from 34 states and the District of Columbia who reported working in a hospital and were within 6-18 months of passing their state licensure exam at the time of survey administration.

METHODS

Descriptive statistics were calculated, followed by bivariate and multivariate Poisson regression models to assess the relationship between shift type and scheduling characteristics and nurse injury. Lastly, full models with the addition of demographics, external context, organizational context, and work context variables were calculated.

RESULTS

The majority (79%) of newly licensed nurses worked 12-h shifts, a near majority worked night shift (44%), and over half (61%) worked overtime (mandatory or voluntary) weekly. Nurses working weekly overtime were associated with a 32% [incidence rate ratio (IRR) 1.32, CI 1.07-1.62] increase in the risk of a needle stick and nurses working night shift were associated with a 16% [IRR 1.16, CI 1.02-1.33] increase in the risk of a sprain or strain injury.

CONCLUSIONS

Overtime and night shift work were significantly associated with increased injury risk in newly licensed nurses independent of other work factors and demographic characteristics. The findings warrant further study given the long-term consequences of these injuries, costs associated with treatment, and loss of worker productivity.

Examining the Relationship Among Ambulatory Surgical Settings Work Environment, Nurses' Characteristics, and Medication Errors Reporting

PURPOSE

To describe work environment characteristics (leadership style and safety climate) of ambulatory surgical settings and to examine the relationship between work environment and nurses' willingness to report medication errors in ambulatory surgical settings.

DESIGN

Descriptive correlational design using survey methodology.

METHODS

The sample of this study consisted of 40 unit-based registered nurses, working as full time, part time, or as needed in four ambulatory surgical settings affiliated with one health care system located in Northeast Ohio.

FINDINGS

The results of two separate regression analyses, one with three nurse manager's leadership styles and another with five safety climate dimensions as independent variables, explained 44% and 50%, respectively, on variance of nurses' willingness to report medication errors.

CONCLUSION

To increase nurses' willingness to report medication errors, ambulatory surgical settings administrators should invest in nurse manager leadership training programs and focus on enhancing safety climate aspects, particularly errors feedback and organizational learning.

Incidence of ambulatory care visits after needlestick and sharps injuries among healthcare workers in Taiwan: a nationwide population-based study

Healthcare professionals have a high risk of needlestick and sharps injuries (NSIs), which have a high potential for disease transmission. Ambulatory care follow up is essential, but is usually overlooked. This study aimed to investigate the annual and cumulative (age-, sex-, and subtype-specific) incidences of ambulatory care visits after NSIs. This study was also designed to evaluate the incidences of blood-borne diseases associated with NSIs among Taiwanese health professionals in Taiwan between 2004 and 2010. Data were obtained from the National Health Insurance Research Database, which contains anonymized records representing approximately 99% of the Taiwan population. A total of 4443 nurse healthcare workers (NHCWs) and 3138 non-nurse healthcare workers (NNHCWs), including physicians, medical technologists, and other health professionals were included in this longitudinal study. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. The Mantel-Haenszel method was used to adjust for sex, age, and type of affiliation. Results showed that the annual incidence of ambulatory care visits of NHCWs increased from 0.7% in 2004 to 1.9% in 2010; this incidence was significantly higher than that of NNHCWs (from 0.3% in 2004 to 0.5% in 2010) in any yearly comparison (p < 0.05). The sex-adjusted 7-year cumulative incidence rate was 3.23 (95% CI = 1.23-8.45) in males and 3.92 (95% CI = 2.70-5.69) in females (p < 0.05). The age-adjusted 7-year cumulative incidence rate was 2.74 (95% CI = 1.99-3.77) and 2.14 (95% CI = 1.49-3.07) in subjects ≤ 30 and ≥31 years old, respectively (p < 0.0005). The affiliation-adjusted 7-year cumulative incidence rate was 1.89 (95% CI = 1.21-2.94) in medical centers and 3.33 (95% CI = 2.51-4.41) in nonmedical centers (p < 0.01). In conclusion, NSIs increased steadily from 2004 to 2010 in Taiwan with NHCWs having higher NSIs incidences than NNHCWs. A routine ambulatory care visit after NSIs can prevent blood-borne transmission, especially for NHCWs. Educational programs may be helpful for reducing the incidence of NSIs and increasing ambulatory care visit ratios after NSIs.

Evaluating and improving nurses' health and quality of work life

This article discusses evaluating and improving the health and quality of work life (QOWL) of nurses. Nurses are reported to have higher illness, disability, and absenteeism rates than all other health care workers. Research suggests that QOWL impacts nurses' health and the provision of quality health care, particularly patient safety. Occupational health nurses have a pivotal role in evaluating and improving nurses' QOWL and health. This will ensure quality health outcomes for nurses and patients and reduce costs for the health care system.

Evaluating and improving nurses' health and quality of work life

This article discusses evaluating and improving the health and quality of work life (QOWL) of nurses. Nurses are reported to have higher illness, disability, and absenteeism rates than all other health care workers. Research suggests that QOWL impacts nurses' health and the provision of quality health care, particularly patient safety. Occupational health nurses have a pivotal role in evaluating and improving nurses' QOWL and health. This will ensure quality health outcomes for nurses and patients and reduce costs for the health care system.

Is a larger specialist nurse workforce in cancer care associated with better patient experience? Cross-sectional study

Objectives:

To assess whether variation in the provision of cancer specialist nurses is associated with the experiences of care for patients undergoing treatment for cancer.

Methods:

This is a cross-sectional study using routinely collected national survey data in 158 acute hospital National Health Service (NHS) Trusts in England. Patients with a primary diagnosis of cancer who attended hospital as inpatients or day cases in the first three months of 2010 responded to a national survey ( n = 67,713, response rate 67%). Patient perceptions of coordination of care, quality of information provision, emotional support and support for symptom management were studied.

Results:

Patients in Trusts that had the fewest patients per specialist nurse were more likely to report that people treating and caring for them worked well together (adjusted odds ratio 1.08, 95% confidence interval 1.01–1.15; p = 0.02) and provided enough emotional support during ambulatory treatment (1.15, 1.01–1.32; p = 0.04), but were no more likely to report being given the right amount of information (0.96, 0.88–1.05; p = 0.38) when compared to patients in Trusts with the most patients per specialist nurse. Breast cancer patients undergoing chemotherapy in the Trusts with fewer patients per specialist nurse were more likely to report good support for the control of side effects from chemotherapy (1.34, 1.02–1.75; p = 0.03).

Conclusions:

Cancer patients’ experience of care coordination and emotional support was better in Trusts with more specialist nurses. The absolute differences were small, and it was unclear whether particular roles or service configurations are associated with better experience.

Association between perceived inadequate staffing and musculoskeletal pain among hospital patient care workers

OBJECTIVE

To examine association between perceived inadequate staffing and musculoskeletal pain and to evaluate the role of work-related psychosocial and physical work factors in the association among hospital patient care workers.

METHODS

A cross-sectional study was conducted among 1,572 patient care workers in two academic hospitals. Perceived inadequate staffing was measured using the "staffing adequacy subscale" of Nursing Work Index, which is a continuous scale that averages estimates of staffing adequacy by workers in the same units. Musculoskeletal pain (i.e., neck/shoulder, arm, low back, lower extremity, any musculoskeletal pain, and the number of area in pain) in the past 3 months was assessed using a self-reported Nordic questionnaire. Multilevel logistic regression was applied to examine associations between perceived inadequate staffing and musculoskeletal pain, considering clustering among the workers in the same units.

RESULTS

We found significant associations of perceived inadequate staffing with back pain (OR 1.50, 95 % CI 1.06, 2.14) and the number of body area in pain (OR 1.42, 95 % CI 1.01, 2.00) after adjusting for confounders including work characteristics (job title, having a second job or not, day shift or not, and worked hours per week). When we additionally adjusted for physical work factors (i.e., use of a lifting device, and the amount of the time for each of five physical activities on the job), only the association between perceived inadequate staffing and back pain remained significant (OR 1.50, 95 % CI 1.03, 2.19), whereas none of the associations was significant for all of musculoskeletal pains including back pain (OR 0.96, 95 % CI 0.66, 1.41) when we additionally adjusted for work-related psychosocial factors (i.e., job demands, job control, supervisor support, and co-worker support) instead of physical work factors.

CONCLUSIONS

Perceived inadequate staffing may be associated with higher prevalence of back pain, and work-related psychosocial factor may play an important role in the potential pathway linking staffing level to back pain among hospital workers.

Prevalence of and risk factors for needlestick and sharps injuries among nursing students in Hong Kong

BACKGROUND

Although nursing students are at greater risk for needlestick injuries (NSIs) and sharps injuries (SIs) than staff nurses, there is a lack of research on NSIs and SIs in students, especially in different years of study. The purpose of this study was to identify the risk factors for and prevalence of NSIs and SIs among nursing students in different years of study.

METHODS

This was a cross-sectional survey study using a questionnaire confirmed to be valid and reliable, with a content validity index of 0.96 and reliability index of 0.82.

RESULTS

A total of 878 nursing students (response rate, 76.61%), participated in the study. NSIs/SIs, NSIs, and SIs were significantly increased by year of study (P < .001) in both the study period and 12-month prevalence. Four predictors for NSIs/SIs were final-year study (odds ratio [OR], 11.9; 95% confidence interval [CI], 3.9-36.7), perception of not receiving prevention training (OR, 2.8; 95% CI, 1.1-7.5), perception of not using a kidney dish to contain used needles and sharps (OR, 4.2; 95% CI, 1.7-10.3), and perception of not immediately discarding used needles and syringes into a sharps box (OR, 2.9; 95% CI, 1.2-7.4).

CONCLUSIONS

Preclinical training, reinforcement of kidney dish use, immediate discarding of used needles, and adequate clinical supervision are essential elements in reducing the risk of NSIs and SIs.

Factors associated with needlestick and sharp injuries among hospital nurses: a cross-sectional questionnaire survey

BACKGROUND

The current status of needlestick or sharp injuries of hospital nurses and factors associated with the injuries have not been systematically examined with representative registered nurse samples in South Korea.

OBJECTIVE

To examine the incidence to needlestick or sharp injuries and identify the factors associated with such injuries among hospital nurses in South Korea.

DESIGN, SETTINGS AND PARTICIPANTS

A cross-sectional survey of hospital nurses in South Korea. Data were collected from 3079 registered nurses in 60 acute hospitals in South Korea by a stratified random sampling method based on the region and number of beds.

METHODS

The dependent variable was the occurrence of needlestick or sharp injuries in the last year, and the independent variables were protective equipment, nurse characteristics, and hospital characteristics. This study employed logistic regression analysis with generalized estimating equation clustering by hospital to identify the factors associated with needlestick or sharp injuries.

RESULTS

The majority (70.4%) of the hospital nurses had experienced needlestick or sharp injuries in the previous year. The non-use of safety containers for disposal of sharps and needles, less working experience as a registered nurse, poor work environments in regards to staffing and resource adequacy, and high emotional exhaustion significantly increased risk for needlestick or sharp injuries. Working in perioperative units also significantly increased the risk for such injuries but working in intensive care units, psychiatry, and obstetrics wards showed a significantly lower risk than medical-surgical wards.

CONCLUSIONS

The occurrence of needlestick or sharp injuries of registered nurses was associated with organizational characteristics as well as protective equipment and nurse characteristics. Hospitals can prevent or reduce such injuries by establishing better work environments in terms of staffing and resource adequacy, minimizing emotional exhaustion, and retaining more experienced nurses. All hospitals should make safety-engineered equipment available to registered nurses. Hospitals as well as specific units showing higher risk for needlestick and sharp injuries should implement organizational strategies to prevent such injuries. It is also necessary to establish a monitoring system of needlestick and sharp injuries at a hospital level and a reporting system at the national level in South Korea.

Needlestick injuries among nursing staff: association with shift-level staffing

BACKGROUND

Despite the advent of safety measures to protect the health care workforce from contracting blood-borne diseases, nurses still sustain percutaneous injuries. We investigated the association between shift-level staffing and needlestick injuries.

METHODS

Shift-level staffing, patient occupancy, and acuity data were collected between 2003 and 2006 for the Military Nursing Outcomes Database (MilNOD), a multisite project that examined nurse staffing and adverse patient and nurse events. Data on needlestick injuries were obtained from occupational health/risk management reports and merged with MilNOD specific shift data. Hierarchical logistic regression, with Bayesian modeling, was used to analyze shift-level staffing, patient acuity, and workload as associated with needlestick injuries among nursing staff.

RESULTS

Of 108,000 shifts, 80 (<0.1%) had at least one needlestick injury occurrence, with 62 (78%) involving a contaminated needle. There was no difference in rate by unit type. Factors associated with needlestick occurrences on shifts were lower RN skill mix, a lower percentage of experienced staff, and fewer nursing care hours per patient per shift.

CONCLUSION

Needlestick injuries continue to occur. An organizational culture of safety should emphasize the need for adequate staffing on every shift and extra vigilance during periods of high workload.

Hospital staff nurses' work hours, meal periods, and rest breaks. A review from an occupational health nurse perspective

Registered nurses are the largest group of health care providers in the United States. To provide 24-hour care, hospital staff nurses often work long hours and consecutive shifts, without adequate meal or rest breaks. Serious declines in functioning related to provider fatigue can lead to safety issues for patients and nurses alike. The occupational health nurse can assess the effects of nurses' work hours and break periods on employee health, educate staff on the importance of sleep and deleterious effects of fatigue, and implement programs to improve the work environment. This article examines nurses' work hours, break and meal period laws and regulations, and the role of the occupational health nurse in caring for this group of employees. Overall findings suggest that the expertise of an occupational health nurse in the hospital setting could significantly improve the health and safety of staff nurses.