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Asadi-JabehDar R, Dashti-Kalantar R, Mehri S, Mirzaei A, Soola AH. Assessing unsafe behaviors and their relationship with work-related factors among EMS staff in Iran: a cross-sectional study. BMC Emerg Med 2024; 24:70. [PMID: 38654181 DOI: 10.1186/s12873-024-00980-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Emergency Medical Services (EMS) staff often encounter various safety incidents. Work-related factors can lead to unsafe behaviors and safety incidents. This study assessed unsafe behaviors and their relationship with work-related factors among EMS staff. METHODS This descriptive-correlational study used census sampling method to select 284 EMS staff in Ardabil Province, northwest of Iran, from April to June 2023. The data collection tools were demographic and occupational information form, Mearns Unsafe Behavior Scale, Cohen Perceived Stress Scale, Michielsen Fatigue Scale, and Patterson Teamwork Scale. The data were analyzed using the SPSSv-16, descriptive statistics, Pearson correlation, and multiple linear regression. RESULTS The mean of unsafe behavior, fatigue, perceived stress, non-conflict of teamwork, and conflict of teamwork were 15.80 (± 4.77), 20.57 (± 6.20), 16.10 (± 6.13), 117.89 (± 17.24), and 40.60 (± 9.59), respectively. Multiple linear regression analysis showed that "partner trust and shared mental models (PTSMM)," "physical fatigue," "age," "type of shift," "employment status," and "overtime hours per month" were predictors of general unsafe behavior (P < 0.001) and "mild task conflict (MTC)," "employment status," "partner trust and shared mental models (PTSMM)" were predictors of unsafe behavior under incentives EMS staff (P < 0.001). CONCLUSION The present study showed that some work-related factors were predictors of unsafe behaviors. The negative consequences of unsafe behaviors should be considered, and long-term planning should be done to reduce them. Developing specific guidelines for addressing unsafe behaviors, implementing measures to reduce fatigue, managing overtime hours in the workplace, and Establishing a system where novice staff work with experienced staff during their first year can be beneficial in reducing these behaviors among EMS staff.
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Affiliation(s)
- Reza Asadi-JabehDar
- Department of Emergency Nursing, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Rajab Dashti-Kalantar
- Department of Critical Care Nursing, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Saeid Mehri
- Department of Emergency Nursing, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Alireza Mirzaei
- Department of Emergency Nursing, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Aghil Habibi Soola
- Department of Nursing, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran.
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Afshari A, Torabi M, Navkhasi S, Aslani M, Khazaei A. Navigating into the unknown: exploring the experience of exposure to prehospital emergency stressors: a sequential explanatory mixed-methods. BMC Emerg Med 2023; 23:136. [PMID: 37968617 PMCID: PMC10648310 DOI: 10.1186/s12873-023-00906-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 11/06/2023] [Indexed: 11/17/2023] Open
Abstract
INTRODUCTION The unpredictability of prehospital emergencies combined with constantly changing circumstances can lead to increased stress and mental health issues among Emergency Medical Technicians (EMTs). To accurately determine the stress-inducing factors in the prehospital environment, it is important to first identify the stressful events that occur in this environment. Therefore, this study strives to provide a thorough analysis of the stressors in the prehospital environment. METHODS Sequential explanatory mixed methods were conducted in Hamadan prehospital emergency centers in 2022. The study included 251 EMTs, who were selected through a method in the quantitative phase. The quantitative part used a questionnaire consisting of basic information and the Posttraumatic Stress Questionnaire (PCL-5). In the qualitative phase, 17 with extensive experience in dealing with prehospital stressors were selected based on their PCL-5 scores (above 33). The qualitative phase analysis was carried out using the contractual content method using the Graneheim and Ladman's approach. Statistical analyzes for the quantitative and qualitative phases were performed using SPSS 21 and maxqda 10, respectively. RESULTS The study revealed that the EMTs had an average PTSD score of 21. 60 ± 11. 45. Multivariate linear regression analysis showed that the number of shifts had a statistically significant relationship with PTSD scores (t = 26.38, P < 0.001). The qualitative phase of the study included 17 interviews, resulting in 14 subcategories, which consisted of four categories: "the overall impact of the stress crisis on technicians," "missing links in the communication network in incident management," "professional shortcomings in pre-hospital care," and "the complex and multifaceted context of stressful pre-hospital emergencies." Additionally, the study's theme was centered around "surveying the experiences of EMTs in stressful environments." CONCLUSION As the number of shifts increased, the primary cause of the high prevalence of PTSD in EMTs was revealed. Prehospital emergency stress can be reduced and managed more skillfully by adjusting various factors such as shortening workdays, offering continuous training, augmenting workforce, supplying ambulance equipment insurance, refraining from hiring personnel devoid of clinical training, hiring psychologists, hiring midwives in an emergency, updating prehospital protocols and guidelines, encouraging cooperation between EMTs and other relief groups, and utilizing cutting-edge technologies.
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Affiliation(s)
- Ali Afshari
- Department of Medical Surgical Nursing, Nursing and Midwifery School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Torabi
- Department of Nursing, Malayer School of Nursing, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Sasan Navkhasi
- Department of Prehospital Emergency Medicine, Asadabad School of Medical Sciences, Asadabad, Iran
| | - Marzieh Aslani
- Instructor of Critical Care Nursing, Department of Nursing, Asadabad School of Medical Sciences, Asadabad, Iran
| | - Afshin Khazaei
- Department of Prehospital Emergency Medicine, Asadabad School of Medical Sciences, Asadabad, Iran.
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Kearney J, Muir C, Smith K, Meadley B. Exploring factors associated with paramedic work-related psychological injury through data linkage. JOURNAL OF SAFETY RESEARCH 2023; 86:213-225. [PMID: 37718050 DOI: 10.1016/j.jsr.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/01/2023] [Accepted: 05/16/2023] [Indexed: 09/19/2023]
Abstract
INTRODUCTION In comparison to the general population and other emergency services workers, paramedics experience high rates of work-related psychological injury. However, there is limited understanding of the case and practitioner-related factors that increase the risk of psychological injury among these workers. This paper aims to identify case and practitioner-related factors associated with paramedic work-related psychological injury in Victoria, Australia, through data linkage. METHODS Data linkage of 7,223 paramedic injury reports with electronic patient care records, and paramedic demographic data from the single state-wide ambulance service in Victoria, Australia - Ambulance Victoria. Injuries reported between 1 January 2015 and 30 June 2020 were included. Factors associated with paramedic psychological injury were assessed using multivariable logistic regression analysis. RESULTS A total of 4,641 (64%) injury reports were successfully linked, of which, 244 (5%) were psychological injuries. Shift hours between 0401 and 0800 (AOR 1.83; 95%CI: 1.12-2.97), cardiac arrest or deceased patient attendances (AOR 2.15; 95%CI: 1.06-4.34), hospital or medical center case locations (AOR 2.44; 95%CI: 1.22-4.91), and Priority 0 (AOR 2.27; 95%CI: 1.26-4.09), Priority 2 (AOR 1.56; 95%CI: 1.04-2.33), and Priority 3 (AOR 1.95; 95%CI: 1.15-3.32) dispatch codes were associated with increased odds of psychological injury. Increasing patient age (AOR 0.98; 95%CI: 0.97-0.99), and the absence of other emergency services on scene (AOR 0.50; 95%CI: 0.34-0.72) were associated with decreased odds of paramedic psychological injury. CONCLUSIONS This is the first study to collectively examine and identify EMS case and practitioner-related characteristics associated with paramedic psychological injury through data linkage of EMS agency-level data sources. PRACTICAL APPLICATION The findings of this study highlight the dispatch case characteristics that may increase the risk of a paramedic sustaining a work-related psychological injury, and consequently facilitate the early identification, intervention, and support of the individuals most at risk.
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Affiliation(s)
- Jason Kearney
- Monash University Accident Research Centre, Monash University, Clayton, Victoria, Australia.
| | - Carlyn Muir
- Monash University Accident Research Centre, Monash University, Clayton, Victoria, Australia.
| | - Karen Smith
- Department of Paramedicine, Monash University, Frankston, Victoria, Australia; Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australia; Silverchain Group, Melbourne, Victoria, Australia.
| | - Ben Meadley
- Department of Paramedicine, Monash University, Frankston, Victoria, Australia; Ambulance Victoria, Melbourne, Victoria, Australia.
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Raposa ME, Mullin G, Murray RM, Shepler LJ, Castro KC, Fisher AB, Gallogly VH, Davis AL, Resick CJ, Lee J, Allen JA, Taylor JA. Assessing the Mental Health Impact of the COVID-19 Pandemic on US Fire-Based Emergency Medical Services Responders: A Tale of Two Samples (The RAPID Study I). J Occup Environ Med 2023; 65:e184-e194. [PMID: 36730580 PMCID: PMC10090321 DOI: 10.1097/jom.0000000000002745] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE This study aimed to examine the COVID-19 pandemic's impact on fire service safety culture, behavior and morale, levers of well-being, and well-being outcomes. METHODS Two samples (Stress and Violence against fire-based EMS Responders [SAVER], consisting of 3 metropolitan departments, and Fire service Organizational Culture of Safety [FOCUS], a geographically stratified random sample of 17 departments) were assessed monthly from May to October 2020. Fire department-specific and pooled scores were calculated. Linear regression was used to model trends. RESULTS We observed concerningly low and decreasing scores on management commitment to safety, leadership communication, supervisor sensegiving, and decision-making. We observed increasing and concerning scores for burnout, intent to leave the profession, and percentage at high risk for anxiety and depression. CONCLUSIONS Our findings suggest that organizational attributes remained generally stable but low during the pandemic and impacted well-being outcomes, job satisfaction, and engagement. Improving safety culture can address the mental health burden of this work.
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Makrides T, Smith F, Ross L, Gosling CM, Acker J, O'Meara P. No Two Systems Are the Same: Paramedic Perceptions of Contemporary System Performance Using Prehospital Quality Indicators. Cureus 2023; 15:e35859. [PMID: 37033507 PMCID: PMC10078119 DOI: 10.7759/cureus.35859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2023] [Indexed: 03/09/2023] Open
Abstract
Introduction In recent years, researchers have identified two new models of paramedicine within the Anglo-American paramedic system known as the Directive and Professionally Autonomous paramedic systems. The research team now seek to compare paramedic perception of system performance between the two systems using prehospital quality indicators. Methods Paramedics employed within Anglo-American paramedic systems undertook a survey evaluating their experience and perception of system performance against a set of modified prehospital quality indicators. Data were collected using a survey combining single-choice questions with matrix multiple-choice questions. Key results were cross-tabulated with demographic (informant) and system factors to compare performance between the two new paramedic systems. Results The survey indicated a substantial difference in perceived clinical and operational performance between the Professionally Autonomous and Directive paramedic systems, with the Professionally Autonomous paramedic system performing consistently better in all 11 prehospital quality indicator domains. Conclusion The results of this survey are a vital step in helping paramedics, health leaders, and academics understand the complex relationship between paramedic system design and system performance, and, for the first time, provides empirical evidence upon which to make a conscious decision to adopt one system or the other.
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Shiri R, Turunen J, Karhula K, Koskinen A, Sallinen M, Ropponen A, Ervasti J, Härmä M. The association between the use of shift schedule evaluation tool with ergonomics recommendations and occupational injuries: A 4-year prospective cohort study among healthcare workers. Scand J Work Environ Health 2023; 49:108-116. [PMID: 36346248 PMCID: PMC10577015 DOI: 10.5271/sjweh.4068] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE This study aimed to find out whether utilizing a shift schedule evaluation tool with ergonomics recommendations for working hours has favorable effects on the incidence of occupational injuries. METHODS This 4-year prospective cohort study (2015-2018) consisted of a dynamic cohort of healthcare shift workers (N=29 237) from ten hospital districts and six cities in Finland. Working hour characteristics and occupational injuries were measured with daily registry data. Multilevel generalized linear model was used for the analyses, and the estimates were controlled for hierarchical structure of the data and confounders. RESULTS Ward heads of the cities used the shift schedule evaluation tool 3.2 times more often than ward heads of the hospital districts. Overall incidence of workplace and commuting injuries did not differ between users and non-users of the evaluation tool. The incidence of dislocations, sprains, and strains was lower in the users than non-users [adjusted odds ratio (OR) 0.88, 95% confidence interval (CI) 0.78-0.99]. Approximately 13% of this association was mediated by increase in realized shift wishes and 10% by increase in single days off. In subgroup analyses, the incidence of workplace injury (OR 0.83, 95% CI 0.69-0.99), and among types of injuries, the incidence of dislocations, sprains, and strains (OR 0.69, 95% CI 0.55-0.85) and falling, slipping, tripping, or overturning (OR 0.75, 95% CI 0.58-0.99) were lower in users than non-users among employees of the cities, but no association was found among employees of the hospital districts. CONCLUSION The use of ergonomics recommendations for working hours is associated with a reduced risk of occupational injuries.
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Affiliation(s)
- Rahman Shiri
- Finnish Institute of Occupational Health, P.O. Box 18, FI-00032 Työterveyslaitos, Helsinki.
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Kearney J, Muir C, Smith K. Factors Associated with Lost Time Injury among Paramedics in Victoria, Australia. PREHOSP EMERG CARE 2023; 28:297-307. [PMID: 36633514 DOI: 10.1080/10903127.2023.2168095] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 01/13/2023]
Abstract
BACKGROUND The dynamic and uncontrolled nature of paramedic work frequently exposes these workers to physical and psychological injury. Often paramedic injury rates are estimated based on national injury surveillance data or compensation databases. These data sources tend to only capture cases of a more serious nature and overlook the broader factors that contribute to injury. This limits our understanding of the true burden of paramedic injury and the characteristics associated with increased injury severity. OBJECTIVES To describe the incidence and proportions of paramedic occupational injury in Victoria, Australia, and to determine the injury-related characteristics associated with lost time from work. METHODS A retrospective analysis of paramedic injury report data from the single state-wide ambulance service in Victoria, Australia - Ambulance Victoria. Injuries reported between 1 January 2015 and 30 June 2020 were included. Chi-square tests of independence were used to explore shift and injury characteristic variables that may be associated with time lost from work. RESULTS Over the study period, 7,591 paramedic injuries were reported that met the inclusion criteria, of which 2,124 (28%) resulted in lost time from work. The cumulative incidence of paramedic injury was 333.8 injuries per 1,000 FTE workers per year, and the rate of lost time injury was 93.0 per 1,000 FTE workers per year. Musculoskeletal injuries were the most frequently reported injury type irrespective of lost time status. Manual handling followed by psychological stressors were the two leading mechanisms of injury based on incidence. Psychological injury was associated with lost time from work (X2= 384.2, p < 0.001). Conversely, injury to the head and neck (X2= 7.5, p = 0.006), and upper limb injuries (X2= 104.5, p < 0.001), were more strongly associated with no lost time from work. CONCLUSIONS Paramedics working in Victoria have a higher rate of work-related injury than other Australian workers. Injury-related factors that are often overlooked, such as time, shift type, location, and injury characteristics, all contribute to an increased risk of lost time injury. An understanding of the factors that contribute to an increase in injury severity may facilitate the development and targeting of appropriate interventions.
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Affiliation(s)
- Jason Kearney
- Monash University Accident Research Centre, Monash University, Clayton, Victoria, Australia
| | - Carlyn Muir
- Monash University Accident Research Centre, Monash University, Clayton, Victoria, Australia
| | - Karen Smith
- Department of Paramedicine, Monash University, Frankston, Victoria, Australia
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
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Gu L, Chang J, Wang J, Feng P, Xu H. Stress load of Chinese nurses in Fangcang Shelter Hospitals during the COVID-19 pandemic: A latent profile analysis. Front Public Health 2023; 10:1048358. [PMID: 36703822 PMCID: PMC9873243 DOI: 10.3389/fpubh.2022.1048358] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 12/19/2022] [Indexed: 01/12/2023] Open
Abstract
The Omicron wave of the COVID-19 pandemic significantly affected Shanghai, China, from March to June 2022. Numbers of Fangcang Shelter Hospitals (FSHs) were conversed from stadiums and exhibition centers to tackle the pandemic. This study aimed to identify the stress load profiles of nurses working in FSHs and explore the characteristics and factors influencing stress load profiles. Totally, 609 out of 700 FSH nurses (with an effective response rate of 87%) participated in an online survey investigating their socio-demographic information, work-related stressors, and stress load. Results of the latent profile analysis identified four classes of stress load, which were labeled as the low (Class 1), mild (Class 2), moderate (Class 3), and high (Class 4) stress load class. Maternity status and self-perceived health condition were significantly different between the four stress load classes by comparisons using the Chi-square test and the Kruskal-Wallis test. The contributors to the stress load profiles were determined by the multinomial logistic regression analysis, including age, education, maternity status, self-perceived health condition, working time in FSHs, and the four dimensions of work-related stressors. Participants who were less healthy (OR = 0.045, 95% CI:0.012,0.171), worked longer time in FSHs (OR = 40.483, 95% CI: 12.103,135.410), faced with more workload (OR = 3.664, 95% CI: 1.047,12.815), and worse working environment (OR = 12.274, 95% CI: 3.029,49.729) were more likely to be classified to the high stress load class. The task arrangement and working environment for FSH nurses should be optimized, and psychological training should be conducted routinely.
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Affiliation(s)
- Liyan Gu
- Department of Neurology, 905th Hospital of the PLA Navy, Shanghai, China
| | - Jian Chang
- Nursing Department, Shanghai General Hospital, School of Nursing, Shanghai Jiao Tong University, Shanghai, China,*Correspondence: Jian Chang ✉
| | - Ji Wang
- Nursing Department, 905th Hospital of the PLA Navy, Shanghai, China,Ji Wang ✉
| | - Ping Feng
- Nursing Department, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Hao Xu
- Department of Infectious Diseases, Changhai Hospital, Naval Medical University, Shanghai, China
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Awini AB, Opoku DA, Ayisi-Boateng NK, Osarfo J, Sulemana A, Yankson IK, Osei-Ampofo M, Zackaria AN, Newton S. Prevalence and determinants of occupational injuries among emergency medical technicians in Northern Ghana. PLoS One 2023; 18:e0284943. [PMID: 37098096 PMCID: PMC10129006 DOI: 10.1371/journal.pone.0284943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 04/11/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Emergency Medical Technicians (EMTs) are the primary providers of prehospital emergency medical services. The operations of EMTs increase their risks of being exposed to occupational injuries. However, there is a paucity of data on the prevalence of occupational injuries among EMTs in sub-Saharan Africa. This study, therefore, sought to estimate the prevalence and determinants of occupational injuries among EMTs in the northern part of Ghana. METHODS A cross-sectional study was conducted among 154 randomly recruited EMTs in the northern part of Ghana. A pre-tested structured questionnaire was used to collect data on participants' demographic characteristics, facility-related factors, personal protective equipment use, and occupational injuries. Binary and multivariate logistic regression analyses with a backward stepwise approach were used to examine the determinants of occupational injuries among EMTs. RESULTS In the 12 months preceding data collection, the prevalence of occupational injuries among EMTs was 38.6%. Bruises (51.8%), and sprains/strains (14.3%) were the major types of injuries reported among the EMTs. The key determinants of occupational injury among EMTs were male sex (AOR: 3.39, 95%CI: 1.41-8.17), an absence of a health and safety committee at the workplace (AOR: 3.92, 95%CI: 1.63-9.43), absence of health and safety policy at the workplace (AOR: 2.76, 95%CI: 1.26-6.04) and dissatisfaction with health and safety measures at the workplace (AOR: 2.51, 95%CI: 1.10-5.71). CONCLUSION In the twelve months before to the data collection for this study, the prevalence of occupational injuries among EMTs of the Ghana National Ambulance Service was high. The creation of health and safety committees, the creation of health and safety rules, and the strengthening of current health and safety procedures for EMTs are all possible ways to lessen this.
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Affiliation(s)
- Ali Baba Awini
- Ghana National Ambulance Service, Upper East Region, Ghana
| | - Douglas Aninng Opoku
- Department of Occupational and Environmental Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Allen Clinic, Family Healthcare Services, Kumasi, Ghana
| | - Nana Kwame Ayisi-Boateng
- Department of Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Joseph Osarfo
- Department of Community Medicine, School of Medicine, University of Health and Allied Health Science, Ho, Ghana
| | - Alhassan Sulemana
- Department of Environmental Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Isaac Kofi Yankson
- Council for Scientific and Industrial Research-Building and Road Research Institute, Kumasi, Ghana
| | - Maxwell Osei-Ampofo
- Department of Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Sam Newton
- Department of Global and International Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Allison P, Tiesman HM, Wong IS, Bernzweig D, James L, James SM, Navarro KM, Patterson PD. Working hours, sleep, and fatigue in the public safety sector: A scoping review of the research. Am J Ind Med 2022; 65:878-897. [PMID: 35711032 PMCID: PMC9851314 DOI: 10.1002/ajim.23407] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND The public safety sector includes law enforcement officers (LEO), corrections officers (CO), firefighter service (FF), wildland firefighting (WFF), and emergency medical services (EMS), as defined in the National Occupational Research Agenda (NORA) of the National Institute for Occupational Safety and Health (NIOSH). Across these occupations, shiftwork, long-duration shifts, and excessive overtime are common. Our objective was to identify research gaps related to working hours, sleep, and fatigue among these workers. METHODS We used a scoping review study design that included searches of MEDLINE, Embase, CAB Abstracts, Global Health, PsychInfo, CINAHL, Scopus, Academic Search Complete, Agricultural and Environmental Science Collection, ProQuest Central, Cochrane Library, Safety Lit, Homeland Security Digital Library, and Sociological Abstracts using a range of occupational search terms and terms related to working hours, sleep, and fatigue. RESULTS Out of 3415 articles returned from our database search, 202 met all inclusion criteria. Six common outcomes related to working hours, sleep, and fatigue emerged: sleep, fatigue, work performance, injury, psychosocial stress, and chronic disease. Nearly two-thirds (59%, n = 120) of the studies were observational, of which 64% (n = 77) were cross sectional and 9% were (n = 11) longitudinal; 14% (n = 30) of the studies were reviews; and 19% (n = 39) were experimental or quasi-experimental studies. Only 25 of the 202 articles described mitigation strategies or interventions. FFs, LEOs, EMS, and WFFs were the most studied, followed by COs. CONCLUSIONS In general, more longitudinal and experimental studies are needed to enrich the knowledge base on the consequences of long working hours, poor sleep, and fatigue in the public safety sector. Few experimental studies have tested novel approaches to fatigue mitigation in diverse sectors of public safety. This gap in research limits the decisions that may be made by employers to address fatigue as a threat to public-safety worker health and safety.
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Affiliation(s)
- Penelope Allison
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Hope M. Tiesman
- Division of Safety Research, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Imelda S. Wong
- Division of Science Integration, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
| | - David Bernzweig
- Ohio Association of Professional Fire Fighters, Columbus, Ohio, USA
| | - Lois James
- Sleep and Performance Research Center, Washington State University, Spokane, Washington, USA
| | - Stephen M. James
- Sleep and Performance Research Center, Washington State University, Spokane, Washington, USA
| | - Kathleen M. Navarro
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
| | - P. Daniel Patterson
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Takei Y, Sakaguchi E, Sasaki K, Tomoyasu Y, Yamamoto K, Yasuda Y. Use of the Airstretcher with dragging may reduce rescuers’ physical burden when transporting patients down stairs. PLoS One 2022; 17:e0274604. [PMID: 36103565 PMCID: PMC9473625 DOI: 10.1371/journal.pone.0274604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 09/01/2022] [Indexed: 11/18/2022] Open
Abstract
Transporting patients down stairs by carrying is associated with a particularly high fall risk for patients and the occurrence of back pain among emergency medical technicians. The present study aimed to verify the effectiveness of the Airstretcher device, which was developed to reduce rescuers’ physical burden when transporting patients by dragging along the floor and down stairs. Forty-one paramedical students used three devices to transport a 65-kg manikin down stairs from the 3rd to the 1st floor. To verify the physical burden while carrying the stretchers, ratings of perceived exertion were measured using the Borg CR10 scale immediately after the task. Mean Borg CR10 scores (standard deviation) were 3.6 (1.7), 4.1 (1.8), 5.6 (2.4), and 4.2 (1.8) for the Airstretcher with dragging, Airstretcher with lifting, backboard with lifting, and tarpaulin with lifting conditions, respectively (p < 0.01). Multiple comparisons revealed that the Airstretcher with dragging condition was associated with significantly lower Borg CR10 scores compared with the backboard with lifting condition (p < 0.01). When the analysis was divided by handling position, estimated Borg CR10 values (standard error) for head position were 4.4 (1.3), 2.9 (0.9), 3.2 (0.8), and 4.0 (1.1) for the Airstretcher with dragging, Airstretcher with lifting, backboard with lifting, and tarpaulin with lifting conditions, respectively, after adjusting for participant and duration time (F = 1.4, p < 0.25). The estimated Borg CR10 value (standard error) for toe position in the Airstretcher with dragging condition was 2.0 (0.8), and the scores for the side position were 4.9 (0.4), 6.1 (0.3), and 4.7 (0.4) for the Airstretcher with lifting, backboard with lifting, and tarpaulin with lifting conditions, respectively, after adjusting for participant and duration time (F = 3.6, p = 0.02). Transferring a patient down stairs inside a house by dragging using the Airstretcher may reduce the physical burden for rescuers.
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Affiliation(s)
- Yutaka Takei
- Department of Emergency Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
- * E-mail:
| | - Eiji Sakaguchi
- Department of Prehospital Emergency Medical Sciences, Hiroshima International University, Hiroshima, Japan
| | - Koichi Sasaki
- Department of Prehospital Emergency Medical Sciences, Hiroshima International University, Hiroshima, Japan
| | - Yoko Tomoyasu
- Department of Prehospital Emergency Medical Sciences, Hiroshima International University, Hiroshima, Japan
| | - Kouji Yamamoto
- Department of Prehospital Emergency Medical Sciences, Hiroshima International University, Hiroshima, Japan
| | - Yasuharu Yasuda
- Department of Prehospital Emergency Medical Sciences, Hiroshima International University, Hiroshima, Japan
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12
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Taylor JA, Murray RM, Davis AL, Brandt-Rauf S, Allen JA, Borse R, Pellechia D, Picone D. Model Policies to Protect U.S. Fire-Based EMS Responders From Workplace Stress and Violence. New Solut 2022; 32:119-131. [PMID: 35322702 PMCID: PMC9280702 DOI: 10.1177/10482911221085728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The stress and violence to fire-based emergency medical service responders (SAVER) Systems-Level Checklist is an organizational-level intervention to address stress and violence in emergency medical service (EMS), focused on the development of policy and training. Fire and EMS leadership, first responders, dispatchers, and labor union representatives participated in the SAVER Model Policy Collaborative to develop model policies that resulted from the most feasible checklist items. ThinkLets technology was employed to achieve consensus on the model policies, and an Action SWOT analysis was then conducted to assess facilitators and barriers to policy implementation. The resultant model policies are a systems-level workplace violence intervention for the U.S. fire and rescue service that is ready for implementation. Expected improvements to organizational outcomes such as burnout, job engagement, and job satisfaction are anticipated, as are decreasing assaults and injuries. The SAVER Model Policies have the potential to inform national standards and regulations on workplace violence in EMS.
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Affiliation(s)
- Jennifer A. Taylor
- Department of Environmental and Occupational Health, Drexel University School of Public Health, Philadelphia, PA, USA
| | - Regan M. Murray
- Health, Human Performance and Recreation, University of Arkansas College of Education and Health Professions, Fayetteville, AR, USA
| | - Andrea L. Davis
- Department of Environmental and Occupational Health, Drexel University School of Public Health, Philadelphia, PA, USA
| | - Sherry Brandt-Rauf
- Department of Environmental and Occupational Health, Drexel University School of Public Health, Philadelphia, PA, USA
| | | | | | | | - David Picone
- San Diego Fire-Rescue Department, San Diego, CA, USA
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13
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Power N, Perreault M, Ferrari M, Boudreau P, Boivin DB. Sleep of Healthcare Workers During the COVID-19 Pandemic and the Role of Atypical Work Schedules: A Scoping Review. J Biol Rhythms 2022; 37:358-384. [PMID: 35773789 DOI: 10.1177/07487304221103376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The COVID-19 pandemic has negatively impacted the well-being of healthcare workers (HCWs). HCWs are highly exposed to shift work and their work schedules have been subject to increasing unpredictability since the start of the pandemic. This review aims to: (1) map the studies providing information about factors associated with sleep characteristics in HCWs working in the context of the COVID-19 pandemic during the first and second waves and (2) examine the state of the evidence base in terms of the availability of information on the influence of atypical work schedules. A literature search was performed in PubMed. Studies containing information about factors (demographic; psychological; occupational; COVID-19-specific; work schedule; lifestyle; medical; or other) associated with various sleep characteristics among HCWs working in the context of the COVID-19 pandemic were included. Particular attention was paid to the availability of information on the role of atypical work schedules on HCW sleep. Fifty-seven articles met the inclusion criteria. Most studies were reports of quantitative cross-sectional surveys using self-report measures. Associations between female sex, frontline HCW status, psychological factors, and poorer sleep were observed. Six studies included a measure of shift work in their analyses, 5 of which reported an association between shift work status and sleep. A wide range of factors were investigated, with female sex, frontline HCW status, and psychological factors repeatedly demonstrating associations with poorer sleep. Sleep was predominantly measured in terms of self-reported sleep quality or insomnia symptoms. Few studies investigated the influence of atypical work schedules on HCW sleep in the context of the COVID-19 pandemic. Research on this topic is lacking in terms of reliable and consistent measurements of sleep outcomes, longitudinal data, and knowledge about the influence of covariates such atypical work schedules, comorbidity, and medical history on HCW sleep.
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Affiliation(s)
- Niamh Power
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Michel Perreault
- Douglas Mental Health University Institute, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal QC, Canada
| | - Manuela Ferrari
- Douglas Mental Health University Institute, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal QC, Canada
| | - Philippe Boudreau
- Douglas Mental Health University Institute, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal QC, Canada.,Centre for Study and Treatment of Circadian Rhythms, Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Diane B Boivin
- Douglas Mental Health University Institute, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal QC, Canada.,Centre for Study and Treatment of Circadian Rhythms, Douglas Mental Health University Institute, Montreal, QC, Canada
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14
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Barth J, Greene JA, Goldstein J, Sibley A. Adverse Health Effects Related to Shift Work Patterns and Work Schedule Tolerance in Emergency Medical Services Personnel: A Scoping Review. Cureus 2022; 14:e23730. [PMID: 35509733 PMCID: PMC9060748 DOI: 10.7759/cureus.23730] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/31/2022] [Indexed: 11/05/2022] Open
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15
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Muskat B, Anand A, Contessotto C, Tan AHT, Park G. Team familiarity—Boon for routines, bane for innovation? A review and future research agenda. HUMAN RESOURCE MANAGEMENT REVIEW 2022. [DOI: 10.1016/j.hrmr.2021.100892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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16
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Kearney J, Muir C, Smith K. Occupational injury among paramedics: a systematic review. Inj Prev 2021; 28:175-184. [PMID: 34972683 DOI: 10.1136/injuryprev-2021-044405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 12/10/2021] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Paramedics are frequently exposed to acute and/or chronic environmental, operational and patient-related factors that increase their risk of physical and psychological injury. However, there has been wide variation in reported paramedic injury rates. This systematic review aims to synthesise the evidence to examine the incidence and nature of occupational injury among paramedics. METHODS This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO 2020: CRD42020164556). A systematic search of four electronic databases was conducted for the years 2004-2019. Peer-reviewed studies examining the incidence and proportions of paramedic occupational injury within civilian emergency medical services (EMS) were included. Injury types, mechanisms, contributing factors and incidence of injury were synthesised narratively. RESULTS Twelve studies met the inclusion criteria. The incidence of injury ranged from 29.7 to 345.6 injuries per 1000 workers per year. Sprains and strains were the most reported injury types, and the trunk and upper limbs were the main sites. Body motion was the most frequently reported mechanism of injury, accounting for 35%-55% of all injuries. Female paramedics had a proportionally higher rate of injury compared with male paramedics. Paramedics aged 25-34 years accounted for the majority of fatal (mean 34.0%) and non-fatal (mean 51.7%) injuries. CONCLUSION This review highlights the increased risk of occupational injury among paramedics and provides further insight into their overall injury profile.
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Affiliation(s)
- Jason Kearney
- Monash University Accident Research Centre, Monash University, Clayton, Victoria, Australia
| | - Carlyn Muir
- Monash University Accident Research Centre, Monash University, Clayton, Victoria, Australia
| | - Karen Smith
- Research and Evaluation, Ambulance Victoria, Melbourne, Victoria, Australia
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Patterson PD, Weiss LS, Weaver MD, Salcido DD, Opitz SE, Okerman TS, Smida TT, Martin SE, Guyette FX, Martin-Gill C, Callaway CW. Napping on the night shift and its impact on blood pressure and heart rate variability among emergency medical services workers: study protocol for a randomized crossover trial. Trials 2021; 22:212. [PMID: 33726840 PMCID: PMC7962082 DOI: 10.1186/s13063-021-05161-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 02/27/2021] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND There is an emerging body of evidence that links exposure to shift work to cardiovascular disease (CVD). The risk of coronary events, such as myocardial infarction, is greater among night shift workers compared to day workers. There is reason to believe that repeated exposure to shift work, especially night shift work, creates alterations in normal circadian patterns of blood pressure (BP) and heart rate variability (HRV) and that these alterations contribute to increased risk of CVD. Recent data suggest that allowing shift workers to nap during night shifts may help to normalize BP and HRV patterns and, over time, reduce the risk of CVD. The risk of CVD related to shift work is elevated for emergency medical services (EMS) shift workers due in part to long-duration shifts, frequent use of night shifts, and a high prevalence of multiple jobs. METHODS We will use a randomized crossover trial study design with three study conditions. The targeted population is comprised of EMS clinician shift workers, and our goal enrollment is 35 total participants with an estimated 10 of the 35 enrolled not completing the study protocol or classified as lost to attrition. All three conditions will involve continuous monitoring over 72 h and will begin with a 36-h at-home period, followed by 24 total hours in the lab (including a 12-h simulated night shift), ending with 12 h at home. The key difference between the three conditions is the intra-shift nap. Condition 1 will involve a simulated 12-h night shift with total sleep deprivation. Condition 2 will involve a simulated 12-h night shift and a 30-min nap opportunity. Condition 3 will involve a simulated 12-h night shift with a 2-h nap opportunity. Our primary outcomes of interest include blunted BP dipping and reduced HRV as measured by the standard deviation of the inter-beat intervals of normal sinus beats. Non-dipping status will be defined as sleep hours BP dip of less than 10%. DISCUSSION Our study will address two indicators of cardiovascular health and determine if shorter or longer duration naps during night shifts have a clinically meaningful impact. TRIAL REGISTRATION ClinicalTrials.gov NCT04469803 . Registered on 9 July 2020.
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Affiliation(s)
- P. Daniel Patterson
- Department of Emergency Medicine, University of Pittsburgh, School of Medicine, 3600 Forbes Ave., Iroquois Building, Suite 400A, Pittsburgh, PA 15261 USA
- Division of Community Health Services, Emergency Medicine Program, University of Pittsburgh, School of Health and Rehabilitation Sciences, Pittsburgh, PA 15261 USA
| | - Leonard S. Weiss
- Department of Emergency Medicine, University of Pittsburgh, School of Medicine, 3600 Forbes Ave., Iroquois Building, Suite 400A, Pittsburgh, PA 15261 USA
| | - Matthew D. Weaver
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA 02115 USA
- Harvard Medical School, Division of Sleep Medicine, Boston, MA 02115 USA
| | - David D. Salcido
- Department of Emergency Medicine, University of Pittsburgh, School of Medicine, 3600 Forbes Ave., Iroquois Building, Suite 400A, Pittsburgh, PA 15261 USA
| | - Samantha E. Opitz
- Department of Emergency Medicine, University of Pittsburgh, School of Medicine, 3600 Forbes Ave., Iroquois Building, Suite 400A, Pittsburgh, PA 15261 USA
| | - Tiffany S. Okerman
- Department of Emergency Medicine, University of Pittsburgh, School of Medicine, 3600 Forbes Ave., Iroquois Building, Suite 400A, Pittsburgh, PA 15261 USA
- Division of Community Health Services, Emergency Medicine Program, University of Pittsburgh, School of Health and Rehabilitation Sciences, Pittsburgh, PA 15261 USA
| | - Tanner T. Smida
- Department of Emergency Medicine, University of Pittsburgh, School of Medicine, 3600 Forbes Ave., Iroquois Building, Suite 400A, Pittsburgh, PA 15261 USA
| | - Sarah E. Martin
- Department of Emergency Medicine, University of Pittsburgh, School of Medicine, 3600 Forbes Ave., Iroquois Building, Suite 400A, Pittsburgh, PA 15261 USA
| | - Francis X. Guyette
- Department of Emergency Medicine, University of Pittsburgh, School of Medicine, 3600 Forbes Ave., Iroquois Building, Suite 400A, Pittsburgh, PA 15261 USA
| | - Christian Martin-Gill
- Department of Emergency Medicine, University of Pittsburgh, School of Medicine, 3600 Forbes Ave., Iroquois Building, Suite 400A, Pittsburgh, PA 15261 USA
| | - Clifton W. Callaway
- Department of Emergency Medicine, University of Pittsburgh, School of Medicine, 3600 Forbes Ave., Iroquois Building, Suite 400A, Pittsburgh, PA 15261 USA
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Friedenberg R, Kalichman L, Ezra D, Wacht O, Alperovitch-Najenson D. Work-related musculoskeletal disorders and injuries among emergency medical technicians and paramedics: A comprehensive narrative review. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2020; 77:9-17. [PMID: 33073742 DOI: 10.1080/19338244.2020.1832038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The aim of this article was to review the current knowledge relating to work-related musculoskeletal disorders (WRMDs) and non-fatal injuries in emergency medical technicians and paramedics (EMTs-Ps). A literature search was conducted in PubMed, Google Scholar, and Clinical Key. The annual prevalence of back pain ranged from 30% to 66%, and back injuries and contusions from 4% to 43%. Falls, slips, trips, and overexertion while lifting or carrying patients or instruments ranged from 10% to 56%, with overexertion being the most common injury. Risk factors were predominantly lifting, working in awkward postures, loading patients into the ambulance, and cardiopulmonary resuscitation procedures. Lack of job satisfaction and social support was associated with WRMDs and injuries. EMTs-Ps had the highest rate of worker compensation claim rates compared to other healthcare professionals. Positive ergonomic intervention results included electrically powered stretchers, backboard wheeler, descent control system, and the transfer sling.
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Affiliation(s)
- Rivi Friedenberg
- Recanati School for Community Health Professions, Faculty of Health Sciences, Department of Physical Therapy, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Leonid Kalichman
- Recanati School for Community Health Professions, Faculty of Health Sciences, Department of Physical Therapy, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - David Ezra
- School of Nursing Science, The Academic College Tel Aviv-Yaffo, Yaffo, Israel
| | - Oren Wacht
- Department of Emergency Medicine, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Deborah Alperovitch-Najenson
- Recanati School for Community Health Professions, Faculty of Health Sciences, Department of Physical Therapy, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Patterson PD, Weaver MD, Guyette FX, Martin‐Gill C. Should public safety shift workers be allowed to nap while on duty? Am J Ind Med 2020; 63:843-850. [PMID: 32761915 PMCID: PMC7540594 DOI: 10.1002/ajim.23164] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 12/12/2022]
Abstract
Fatigue and sleep deficiency among public safety personnel are threats to wellness, public and personal safety, and workforce retention. Napping strategies may reduce work-related fatigue, improve safety and health, yet in some public safety organizations it is discouraged or prohibited. Our aim with this commentary is to define intra-shift napping, summarize arguments for and against it, and to outline potential applications of this important fatigue mitigation strategy supported by evidence. We focus our discussion on emergency medical services (EMS); a key component of the public safety system, which is comprised of police, fire, and EMS. The personnel who work in EMS stand to benefit from intra-shift napping due to frequent use of extended duration shifts, a high prevalence of personnel working multiple jobs, and evidence showing that greater than half of EMS personnel report severe fatigue, poor sleep quality, inadequate inter-shift recovery, and excessive daytime sleepiness. The benefits of intra-shift napping include decreased sleepiness and fatigue, improved recovery between shifts, decreased anxiety, and reduced feelings of burnout. Intra-shift napping also mitigates alterations in clinician blood pressure associated with disturbed sleep and shift work. The negative consequences of napping include negative public perception, acute performance deficits stemming from sleep inertia, and the potential costs associated with reduced performance. While there are valid arguments against intra-shift napping, we believe that the available scientific evidence favors it as a key component of fatigue mitigation and workplace wellness. We further believe that these arguments extend beyond EMS to all sectors of public safety.
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Affiliation(s)
- P. Daniel Patterson
- Department of Emergency Medicine, School of Medicine University of Pittsburgh Pittsburgh Pennsylvania
- Division of Community Health Services, Emergency Medicine Program, School of Health and Rehabilitation Sciences University of Pittsburgh Pittsburgh Pennsylvania
| | - Matthew D. Weaver
- Division of Sleep and Circadian Disorders Brigham and Women's Hospital Boston Massachusetts
- Division of Sleep Medicine Harvard Medical School Boston Massachusetts
| | - Francis X. Guyette
- Department of Emergency Medicine, School of Medicine University of Pittsburgh Pittsburgh Pennsylvania
| | - Christian Martin‐Gill
- Department of Emergency Medicine, School of Medicine University of Pittsburgh Pittsburgh Pennsylvania
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20
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Goulart LS, Rocha LP, Carvalho DPD, Tomaschewski-Barlem JG, Dalmolin GDL, Pinho ECD. Work accidents and occupational risks identified in the Mobile Emergency Service. Rev Esc Enferm USP 2020; 54:e03603. [PMID: 32901657 DOI: 10.1590/s1980-220x2018056903603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 10/24/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the occurrence of work accidents among Mobile Emergency Service workers and the association with the identified occupational risks. METHOD A quantitative, exploratory, descriptive and cross-sectional study conducted with Mobile Emergency Service workers in Rio Grande do Sul, between January 2016 and November 2017, using an online instrument. RESULTS A total of 265 workers participated. There was a significant association between the occurrence of accidents at work and professional category (p = 0.041); as well as the occurrence of work accidents and the mesoregion (p = 0.015). In the significant associations between the occurrence of accidents at work and occupational risks, accidents with sharps, physical aggression, animal bites, verbal aggression, traffic accidents during commuting and falls were highlighted. In addition, a significant association between the occurrence of an accident at work and work leave (p = 0.000) was found. CONCLUSION The occurrences of work accidents during pre-hospital service activities are related to the professional category of workers, the work mesoregion, work leave and the exposure of workers to different occupational risks.
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Affiliation(s)
| | | | | | | | | | - Eliana Cardia de Pinho
- Instituto Federal de Educação, Ciência e Tecnologia do Rio Grande do Sul, Rio Grande, RS, Brasil
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21
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Work-Family Conflict among Iranian Emergency Medical Technicians and Its Relationship with Time Management Skills: A Descriptive Study. Emerg Med Int 2020; 2020:7452697. [PMID: 32455023 PMCID: PMC7238339 DOI: 10.1155/2020/7452697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 02/02/2020] [Accepted: 02/27/2020] [Indexed: 11/23/2022] Open
Abstract
Background Work-Family Conflict (WFC) is a form of interrole conflict in which an active participation in occupational activities causes strain and interferes with family roles of workers and vice versa. It is a major source of occupational stress among workers and personnel. Emergency Medical Technicians (EMTs) are an important part of the healthcare system that respond to emergencies. The EMTs experience high level of job stress, which may affect their ability to perform their family roles, and, on the other hand, actively performing their family responsibilities may interfere with the effective delivery of the already stressful activities at workplace. Objective The aim of this study was to determine the prevalence of WFC among Emergency Medical Technicians in Iran and its relationship with time management skills. Methods This was a descriptive study. In this study, 271 EMTs from the western part of Iran completed the questionnaire for the assessment of WFC. The Carlson Family-Conflict Questionnaire and the “Time Management Behaviors Scale” developed by Macan were used as evaluation instruments. The data were analyzed by SPSS software version 16. Appropriate statistical analysis such as mean and standard deviation, Pearson correlation, and Spearman rank correlation was applied for analyzing the data in SPSS. Results The majority of the participants reported some degrees of WFC. Statistical analysis showed a significant inverse correlation between total WFC score and total “Time Management Behaviors scale” score (r = −0/381، p < 0/0001). In the present study, there was no significant correlation between total WFC score and demographic factors such as educational level, age, sex, marital status, number of family members, need for family member care, and work experience (p > 0.05). Conclusions The findings of this study indicate that time management behaviors and skills can reduce WFC among Emergency Medical Technicians. Therefore, it is recommended that prehospital emergency authorities and policymakers plan and implement measures such as reducing the duration of shift-work schedules, decreasing shift-change restrictions, and organizing regular time management courses. Also, employment of local inhabitants is preferred to geographically distant individuals with similar qualification as this will reduce the distance between home and workplace.
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D'Ettorre G, Pellicani V, Greco M. Job stress and needlestick injuries in nurses: a retrospective observational study. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:45-49. [PMID: 32168312 PMCID: PMC7944662 DOI: 10.23750/abm.v91i2-s.8824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 02/27/2020] [Indexed: 12/02/2022]
Abstract
Background: The prevention of needlestick injuries (NSIs) in nurses employed in Emergency Departments (EDs) represents a special issue for healthcare organizations globally. Stressful working conditions, lack of organizational arrangements and lack of supporting one another at work, may contribute to increase the risk of NSIs. Methods: We conducted an observational study to analyze: 1) the effectiveness of organizational interventions to minimize the occurrence of NSIs in ED nurses; 2) to measure the impact of such interventions on the safety budget. Results: The occurrence of NSIs detected after organizational level interventions was significantly lower than the occurrence observed previously such interventions (p<0,05). By results, cost saving from managing fewer NSIs than the previous period was found. Conclusion: The study shows that the proactive, integrated and comprehensive management of organizational features at workplace brings benefits to employees and reduces the burden of the occurrence of NSIs. As result of the reduced NSIs frequency, the overall costs for follow-up of injured workers were reduced. (www.actabiomedica.it)
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Affiliation(s)
| | | | - Mariarita Greco
- Department of Mental Health, Local Health Authority of Brindisi, Italy.
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23
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Goulart LS, Rocha LP, Carvalho DPD, Barlem ELD, Tomaschewski-Barlem JG, Brum RG. RISK PERCEPTION AMONG WORKERS WITH PREVIOUS OCCUPATIONAL ACCIDENTS IN PRE-HOSPITAL SETTINGS. TEXTO & CONTEXTO ENFERMAGEM 2020. [DOI: 10.1590/1980-265x-tce-2018-0513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: to identify the risk perception of workers with previous occupational accidents in Mobile Emergency Care Services. Method: this quantitative and analytical study with a cross-sectional design was conducted with 265 professionals working in pre-hospital settings from 57 cities in the state of Rio Grande do Sul, Brazil. An online questionnaire addressed sociodemographic characteristics, previous occupational accidents and the workers’ occupational risk perceptions rated on a five-point Likert scale. The analysis included descriptive statistics, mean, standard deviation, median, and associations were verified using the Mann-Whitney test; the level of significance was established at p<0.05. Results: the occupational risks the workers more frequently reported were: exposure to blood (4.43); exposure to contaminated secretion/excretion (4.36); contact and handling of hygienization products (4.28); exposure to bacteria (4.25); lifting and transporting heavy loads (4.25); and exposure to viruses (4.23). A significant association was found between the risk perception of workers with previous occupational accidents and chemical (p=0.001), physical (p=0.006), ergonomic or psychological (p=0.000) risks, and accidents (p=0.000). Conclusion: association between the risk perception of workers who had previously experienced occupational accidents was significant, suggesting that workers may not identify or trivialize risks before they experience an accident. Therefore, actions are needed to encourage changes in behavior so that workers identify risks and prevent occupational accidents, such as adopting personal and collective protective equipment and improving the work conditions in pre-hospital settings.
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Investigating the Relationship between Teamwork and Professional and Demographic Factors of Emergency Medical Technicians (EMTs) in Zanjan Province in 2019. PREVENTIVE CARE IN NURSING AND MIDWIFERY JOURNAL 2020. [DOI: 10.52547/pcnm.9.4.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Alhazmi RA, Parker RD, Wen S. Standard Precautions Among Emergency Medical Services in Urban and Rural Areas. Workplace Health Saf 2019; 68:73-80. [PMID: 31650905 DOI: 10.1177/2165079919864118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Backround: Emergency medical services (EMS) workers are at risk of exposure to bloodborne pathogens and frequently exposed to blood and bodily fluids through percutaneous injuries. This study aimed to assess the consistency with which standard precautions (SPs) among rural and urban EMS providers were used. Methods: This study consisted of a cross-sectional survey conducted with a sample of certified EMS providers in West Virginia in which we ascertained details about sociodemographic characteristics, and the frequency of consistent SP. An email invitation was sent to a comprehensive list of agencies obtained from the Office of West Virginia EMS. Findings: A total of 248 out of 522 (47%) EMS providers completed the survey. The majority of the EMS providers (76%) consistently complied with SPs; however, more than one third (38%) of urban EMS providers indicated inconsistent use compared with 19% of rural EMS providers (p = .002). Most EMS providers reported low prevention practices to exposure of blood and body fluids in both areas. Conclusion/Application to Practice: The results emphasize the need to enhanced safe work practices among EMS providers in both rural and urban areas through education and increasing self-awareness. Occupational health professional in municipalities that serve these workers are instrumental in ensuring these workers are trained and evaluated for their compliance with SPs while in the field.
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Schewe JC, Kappler J, Dovermann K, Graeff I, Ehrentraut SF, Heister U, Hoeft A, Weber SU, Muenster S. Diagnostic accuracy of physician-staffed emergency medical teams: a retrospective observational cohort study of prehospital versus hospital diagnosis in a 10-year interval. Scand J Trauma Resusc Emerg Med 2019; 27:36. [PMID: 30940205 PMCID: PMC6446382 DOI: 10.1186/s13049-019-0617-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 03/20/2019] [Indexed: 02/06/2023] Open
Abstract
Background In Germany, emergency medical teams are staffed with physicians but evidence regarding their prehospital diagnostic accuracy remains poor. Objective To evaluate the out-of-hospital diagnostic accuracy of physician-staffed emergency medical teams (PEMTs). Methods A retrospective observational cohort study involving the Emergency Medical Service Bonn, Germany, from January to December 2004 and 2014 respectively. A total of 8346 patients underwent medical treatment by PEMTs, of which 1960 adult patients (inclusion criteria: ≥18 years of age, hospital diagnosis available) were included for further analysis. Reasons for non-inclusion: death on scene, outpatient, interhospital transfer, mental illness, false alarm, no hospital medical history available. The overall diagnostic accuracy (correct or false) of PEMTs was measured after matching the prehospital diagnosis with the corresponding diagnosis of the hospital. Secondary outcome measures were incidence of common PEMT diagnoses (acute coronary syndrome (ACS), dyspnea, stroke/intracerebral bleeding), recognition rate of a given disease by PEMTs, and prehospital diagnostic accuracy in elderly patients. Results PEMT calls increased 2-fold over a decade (2004: n = 3151 vs. 2014: n = 5195). Overall diagnostic accuracy of PEMTs increased from 87.5% in 2004 to 92.6% in the year 2014. The incidence of common PEMT diagnoses such as ACS, dyspnea or stroke/intracerebral bleeding increased 2-fold from 2004 to 2014. The recognition rate of a given disease by the PEMT varied between 2004 and 2014: an increase was observed when a stroke/intracerebral bleeding was diagnosed (2004: 67% vs. 2014: 83%; p = 0.054), a decreased rate of recognition occurred when a syncope/collapse was diagnosed (2004: 81% vs. 2014: 56%; p = 0.007) and a sepsis appears to be a rare event for EMS personnel (2004: 0% vs. 2014: 23%). Linear regression analysis revealed that the prehospital diagnostic accuracy decreases in the elderly patient. Conclusions The overall prehospital diagnostic accuracy of PEMTs improved between the year 2004 and 2014 respectively. Our findings suggest that the incidence of common diseases (ACS, dyspnea stroke/intracerebral bleeding, sepsis) increased over a 10-year period. Diagnostic accuracy of different diseases varied but generally decreased in the elderly patient. Regular training of EMS personnel and public campaigns should be implemented to improve the diagnostic accuracy in the future. Electronic supplementary material The online version of this article (10.1186/s13049-019-0617-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jens-Christian Schewe
- Department of Anesthesiology and Critical Care Medicine, University Hospital of Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn, Germany
| | - Jochen Kappler
- Department of Anesthesiology and Critical Care Medicine, University Hospital of Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn, Germany
| | - Katharina Dovermann
- Department of Anesthesiology and Critical Care Medicine, University Hospital of Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn, Germany
| | - Ingo Graeff
- Department of Anesthesiology and Critical Care Medicine, University Hospital of Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn, Germany.,Department of Emergency Medicine, Bonn, University Hospital Bonn, Bonn, Germany
| | - Stefan Felix Ehrentraut
- Department of Anesthesiology and Critical Care Medicine, University Hospital of Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn, Germany
| | - Ulrich Heister
- Department of Anesthesiology and Critical Care Medicine, University Hospital of Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn, Germany.,Emergency Medical Service Bonn, Bonn, Germany
| | - Andreas Hoeft
- Department of Anesthesiology and Critical Care Medicine, University Hospital of Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn, Germany
| | - Stefan Ulrich Weber
- Department of Anesthesiology, Critical Care and Pain Medicine, Heilig Geist Krankenhaus, Cologne, Germany
| | - Stefan Muenster
- Department of Anesthesiology and Critical Care Medicine, University Hospital of Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn, Germany.
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Patterson PD, Weaver MD, Markosyan MA, Moore CG, Guyette FX, Doman JM, Sequeira DJ, Werman HA, Swanson D, Hostler D, Lynch J, Templin MA, Rozario NL, Russo L, Hines L, Swecker K, Runyon MS, Buysse DJ. Impact of shift duration on alertness among air-medical emergency care clinician shift workers. Am J Ind Med 2019; 62:325-336. [PMID: 30734328 DOI: 10.1002/ajim.22956] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND Greater than half of Emergency Medical Services (EMS) shift workers report fatigue at work and most work long duration shifts. We sought to compare the alertness level of EMS shift workers by shift duration. METHODS We used a multi-site, 14-day prospective observational cohort study design of EMS clinician shift workers at four air-medical EMS organizations. The primary outcome was behavioral alertness as measured by psychomotor vigilance tests (PVT) at the start and end of shifts. We stratified shifts by duration (< 24 h and 24 h), night versus day, and examined the impact of intra-shift napping on PVT performance. RESULTS One hundred and twelve individuals participated. The distribution of shifts <24 h and 24 h with complete data were 54% and 46%, respectively. We detected no differences in PVT performance measures stratified by shift duration (P > 0.05). Performance for selected PVT measures (lapses and false starts) was worse on night shifts compared to day shifts (P < 0.05). Performance also worsened with decreasing time between waking from a nap and the end of shift PVT assessment. CONCLUSIONS Deficits in performance in the air-medical setting may be greatest during night shifts and proximal to waking from an intra-shift nap. Future research should examine alertness and performance throughout air-medical shifts, as well as investigate the timing and duration of intra-shift naps on outcomes.
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Affiliation(s)
- P. Daniel Patterson
- Department of Emergency Medicine; University of Pittsburgh; School of Medicine; Pittsburgh Pennsylvania
- Division of Community Health Services; University of Pittsburgh, School of Health and Rehabilitation Sciences; Pittsburgh Pennsylvania
| | - Matthew D. Weaver
- Harvard Medical School, Division of Sleep Medicine, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology; Brigham and Women's Hospital; Boston Massachusetts
| | - Mark A. Markosyan
- Department of Emergency Medicine; University of Pittsburgh; School of Medicine; Pittsburgh Pennsylvania
- Division of Community Health Services; University of Pittsburgh, School of Health and Rehabilitation Sciences; Pittsburgh Pennsylvania
| | - Charity G. Moore
- Department of Physical Therapy; University of Pittsburgh; School of Health and Rehabilitation Sciences; Pittsburgh Pennsylvania
| | - Frank X. Guyette
- Department of Emergency Medicine; University of Pittsburgh; School of Medicine; Pittsburgh Pennsylvania
| | - Jack M. Doman
- Department of Psychiatry, University of Pittsburgh; School of Medicine; Pittsburgh Pennsylvania
| | - Denisse J. Sequeira
- Department of Emergency Medicine; University of Pittsburgh; School of Medicine; Pittsburgh Pennsylvania
| | | | - Doug Swanson
- Carolinas HealthCare System; Charlotte North Carolina
| | - David Hostler
- Department of Exercise and Nutrition Sciences; The State University of New York; University at Buffalo; Buffalo New York
| | - Joshua Lynch
- MercyFlight of Western New York; Buffalo New York
- Department of Emergency Medicine; Jacobs School of Medicine and Biomedical Sciences; The State University of New York; University at Buffalo; Buffalo New York
| | | | | | - Lindsey Russo
- Department of Exercise and Nutrition Sciences; The State University of New York; University at Buffalo; Buffalo New York
| | | | | | | | - Daniel J. Buysse
- Department of Psychiatry, University of Pittsburgh; School of Medicine; Pittsburgh Pennsylvania
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Arbour M, Tanner T, Hensley J, Beardsley J, Wika J, Garvan C. Factors That Contribute to Excessive Sleepiness in Midwives Practicing in the United States. J Midwifery Womens Health 2019; 64:179-185. [PMID: 30806490 DOI: 10.1111/jmwh.12945] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 11/11/2018] [Accepted: 11/14/2018] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Excessive daytime sleepiness is defined as difficulty maintaining wakefulness and alertness during normal waking hours. Excessive daytime sleepiness can lead to clinical errors in health care workers and is associated with dangerous driving. Little is known about the level of daytime sleepiness in midwives in the United States. The purposes of this study, conducted by the American College of Nurse-Midwives (ACNM) Sleep and Safety Taskforce, were first to identify the sleepiness level of US certified nurse-midwives (CNMs) and certified midwives (CMs) by calculating Epworth Sleepiness Scale scores for CNM/CMs in full-scope practice, and then to determine factors that significantly contribute to elevated Epworth Sleepiness Scale scores (>10). METHODS Participants in this descriptive, correlational survey study were active ACNM members in full-scope midwifery practice. Descriptive statistics, bivariate analysis, and logistic regression were used for data analysis. Surveys were emailed to all active members of ACNM (N = 4358). RESULTS A total of 753 (17.3%) survey responses were returned, of which 639 (14.7%) were eligible for analysis. Within this group, 639 (84.9%) self-identified as being in full-scope midwifery practice, and one-fourth (n = 164; 25.7%) had elevated Epworth Sleepiness Scale scores. Duration of work shifts was the only variable found to significantly contribute to differences in Epworth Sleepiness Scale scores, with midwives working shifts longer than 12 hours having higher rates of excessive daytime sleepiness compared with midwives who worked shifts of 12 hours or less. DISCUSSION Midwives, midwifery services, and maternity care centers can work together to ensure that clinicians obtain adequate sleep. Reducing excessive sleepiness will contribute to increased safety for midwives, women, newborns, and the general public.
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Affiliation(s)
| | | | | | | | | | - Cynthia Garvan
- College of Medicine, University of Florida, Gainesville, Florida
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30
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Reichard AA, Al-Tarawneh IS, Konda S, Wei C, Wurzelbacher SJ, Meyers AR, Bertke SJ, Bushnell PT, Tseng CY, Lampl MP, Robins DC. Workers' compensation injury claims among workers in the private ambulance services industry-Ohio, 2001-2011. Am J Ind Med 2018; 61:986-996. [PMID: 30417397 DOI: 10.1002/ajim.22917] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND Ambulance service workers frequently transfer and transport patients. These tasks involve occupational injury risks such as heavy lifting, awkward postures, and frequent motor vehicle travel. METHODS We examined Ohio workers' compensation injury claims among state-insured ambulance service workers working for private employers from 2001 to 2011. Injury claim counts and rates are presented by claim types, diagnoses, and injury events; only counts are available by worker characteristics. RESULTS We analyzed a total of 5882 claims. The majority were medical-only (<8 days away from work). The overall injury claim rate for medical-only and lost-time cases was 12.1 per 100 full-time equivalents. Sprains and strains accounted for 60% of all injury claims. Overexertion from patient handling was the leading injury event, followed by motor vehicle roadway incidents. CONCLUSIONS Study results can guide the development or improvement of injury prevention strategies. Focused efforts related to patient handling and vehicle incidents are needed.
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Affiliation(s)
- Audrey A. Reichard
- Division of Safety Research; National Institute for Occupational Safety and Health; Morgantown West Virginia
| | | | - Srinivas Konda
- Division of Safety Research; National Institute for Occupational Safety and Health; Morgantown West Virginia
| | - Chia Wei
- Division of Surveillance, Hazard Evaluations, and Field Studies; National Institute for Occupational Safety and Health; Cincinnati Ohio
| | - Steven J. Wurzelbacher
- Division of Surveillance, Hazard Evaluations, and Field Studies; National Institute for Occupational Safety and Health; Cincinnati Ohio
| | - Alysha R. Meyers
- Division of Surveillance, Hazard Evaluations, and Field Studies; National Institute for Occupational Safety and Health; Cincinnati Ohio
| | - Stephen J. Bertke
- Division of Surveillance, Hazard Evaluations, and Field Studies; National Institute for Occupational Safety and Health; Cincinnati Ohio
| | - P. Timothy Bushnell
- Economic Research Support Office, Office of the Director; National Institute for Occupational Safety and Health; Cincinnati Ohio
| | - Chih-Yu Tseng
- Division of Surveillance, Hazard Evaluations, and Field Studies; National Institute for Occupational Safety and Health; Cincinnati Ohio
| | - Michael P. Lampl
- Division of Safety and Hygiene; Ohio Bureau of Workers’ Compensation; Columbus Ohio
| | - David C. Robins
- Division of Safety and Hygiene; Ohio Bureau of Workers’ Compensation; Columbus Ohio
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Walters SJ, Stern C, Stephenson M. Fatigue and measurement of fatigue: a scoping review protocol. ACTA ACUST UNITED AC 2018; 17:261-266. [PMID: 30451709 DOI: 10.11124/jbisrir-2017-003699] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
REVIEW QUESTION/OBJECTIVE The objectives of this review are to identify and present definitions of fatigue and theoretical, conceptual and mechanistic models of fatigue, and to identify the commonly used instruments that measure fatigue in humans and the settings in which they are used.Specifically, the review questions are.
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James FO, Waggoner LB, Weiss PM, Patterson PD, Higgins JS, Lang ES, Van Dongen HPA. Does Implementation of Biomathematical Models Mitigate Fatigue and Fatigue-related Risks in Emergency Medical Services Operations? A Systematic Review. PREHOSP EMERG CARE 2018; 22:69-80. [DOI: 10.1080/10903127.2017.1384875] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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33
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Sedrez JA, Kasten APDS, Chaise FDO, Candotti CT. Risk factors for work-related cardiovascularand musculoskeletal diseasesamong prehospital urgent care workers: a systematic review. Rev Bras Med Trab 2017; 15:355-363. [PMID: 32377592 DOI: 10.5327/z1679443520170050] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 08/22/2017] [Indexed: 11/05/2022] Open
Abstract
Background Studies conducted with prehospital urgent care workers investigated work-related stress and its repercussions on the workers' mental and physical health. Objective To identify risk factors for development of work-related cardiovascular (CVD) and musculoskeletal (MSD) diseases among prehospital emergency care workers. Methods We conducted a systematic search on databases PubMed, EBSCO, EMBASE and Science Direct. The inclusion criteria were: risk factors for CVD and MSD among prehospital emergency care workers. Results From 370 articles, 11 were included for review. The included studies identified risk factors for CVD, such as body mass index and sedentary lifestyle, however, with limited level of evidence. For MSD, age and working as first responder were shown to behave as risk factors, with high level of evidence. We were not able to determine the cardiovascular risk factors due to lack of studies that analyzed this aspect. Conclusion The most evident musculoskeletal risk factors reported in the literature are age and working as first responder. Registration PROSPERO: CRD42016042390.
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Affiliation(s)
- Juliana Adami Sedrez
- Exercise Research Laboratory, Federal University of Rio Grande do Sul (Universidade Federal do Rio Grande do Sul - UFRGS) - Porto Alegre (RS), Brazil
| | - Ana Paula da Silva Kasten
- Exercise Research Laboratory, Federal University of Rio Grande do Sul (Universidade Federal do Rio Grande do Sul - UFRGS) - Porto Alegre (RS), Brazil
| | - Fabiana de Oliveira Chaise
- Exercise Research Laboratory, Federal University of Rio Grande do Sul (Universidade Federal do Rio Grande do Sul - UFRGS) - Porto Alegre (RS), Brazil
| | - Cláudia Tarragô Candotti
- Exercise Research Laboratory, Federal University of Rio Grande do Sul (Universidade Federal do Rio Grande do Sul - UFRGS) - Porto Alegre (RS), Brazil
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Associations of Shift Work and Its Duration with Work-Related Injury among Electronics Factory Workers in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14111429. [PMID: 29160849 PMCID: PMC5708068 DOI: 10.3390/ijerph14111429] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 11/20/2017] [Accepted: 11/20/2017] [Indexed: 02/06/2023]
Abstract
This study aimed to explore the association between shift work and work-related injuries. We collected data on workers from an electronics factory. This cross-sectional study included 13,610 subjects, who were assessed based on a self-reported questionnaire about their shift work experiences, work-related injuries, and other covariates. Multiple logistic regression models were used to evaluate the associations between shift work and work-related injuries and were estimated using the odds ratio. We found that the current and past shift workers, compared to non-shift workers, were associated with a 2.7- and 1.7-fold higher risk of work-related injury. There was a dose-response relationship between shift work duration and work-related injury among current female shift workers. Shift work increased the risk of work-related injuries, and the impact could be different depending on gender.
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Crowe RP, Bower JK, Cash RE, Panchal AR, Rodriguez SA, Olivo-Marston SE. Association of Burnout with Workforce-Reducing Factors among EMS Professionals. PREHOSP EMERG CARE 2017; 22:229-236. [PMID: 28841102 DOI: 10.1080/10903127.2017.1356411] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Emergency medical services (EMS) professionals often work long hours at multiple jobs and endure frequent exposure to traumatic events. The stressors inherent to the prehospital setting may increase the likelihood of experiencing burnout and lead providers to exit the profession, representing a serious workforce and public health concern. Our objectives were to estimate the prevalence of burnout, identify characteristics associated with experiencing burnout, and quantify its relationship with factors that negatively impact EMS workforce stability, namely sickness absence and turnover intentions. METHODS A random sample of 10,620 emergency medical technicians (EMTs) and 10,540 paramedics was selected from the National EMS Certification database to receive an electronic questionnaire between October, 2015 and November, 2015. Using the validated Copenhagen Burnout Inventory (CBI), we assessed burnout across three dimensions: personal, work-related, and patient-related. We used multivariable logistic regression modeling to identify burnout predictors and quantify the association between burnout and our workforce-related outcomes: reporting ten or more days of work absence due to personal illness in the past 12 months, and intending to leave an EMS job or the profession within the next 12 months. RESULTS Burnout was more prevalent among paramedics than EMTs (personal: 38.3% vs. 24.9%, work-related: 30.1% vs. 19.1%, and patient-related: 14.4% vs. 5.5%). Variables associated with increased burnout in all dimensions included certification at the paramedic level, having between five and 15 years of EMS experience, and increased weekly call volume. After adjustment, burnout was associated with over a two-fold increase in odds of reporting ten or more days of sickness absence in the past year. Burnout was associated with greater odds of intending to leave an EMS job (personal OR:2.45, 95% CI:1.95-3.06, work-related OR:3.37, 95% CI:2.67-4.26, patient-related OR: 2.38, 95% CI:1.74-3.26) or the EMS profession (personal OR:2.70, 95% CI:1.94-3.74, work-related OR:3.43, 95% CI:2.47-4.75, patient-related OR:3.69, 95% CI:2.42-5.63). CONCLUSIONS The high estimated prevalence of burnout among EMS professionals represents a significant concern for the physical and mental well-being of this critical healthcare workforce. Further, the strong association between burnout and variables that negatively impact the number of available EMS professionals signals an important workforce concern that warrants further prospective investigation.
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Patterson PD, Moore CG, Guyette FX, Doman JM, Sequeira D, Werman HA, Swanson D, Hostler D, Lynch J, Russo L, Hines L, Swecker K, Runyon MS, Buysse DJ. Fatigue mitigation with SleepTrackTXT2 in air medical emergency care systems: study protocol for a randomized controlled trial. Trials 2017; 18:254. [PMID: 28583143 PMCID: PMC5460424 DOI: 10.1186/s13063-017-1999-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 05/19/2017] [Indexed: 11/10/2022] Open
Abstract
Background Most air medical Emergency Medical Services (EMS) clinicians work extended duration shifts, and more than 50% report inadequate sleep, poor sleep quality, and/or poor recovery between shifts. The SleepTrackTXT pilot trial (ClinicalTrials.gov, NCT02063737) showed that use of mobile phone text messages could impact EMS clinician self-reported fatigue and sleepiness during long duration shifts. The purpose of the SleepTrackTXT2 trial is to leverage lessons learned from the first SleepTrackTXT study and test an enhanced intervention targeting air medical EMS clinicians. Methods/design We will conduct a multi-site randomized trial with a sample of adult EMS clinicians recruited from four air medical EMS systems located in the midwest, northeastern, and southern USA. Participants will be allocated to one of two possible arms for a 4-month (120-day) study period. The intervention arm will involve text-message assessments of sleepiness, fatigue, and difficulty concentrating at the beginning, every 4 hours during, and at the end of scheduled shifts. Participants reporting high levels of sleepiness, fatigue, or difficulty with concentration will receive one of nine randomly selected intervention messages to promote behavior change during shift work to improve alertness. Intervention participants will receive a text-message report on Friday of each week that shows their sleep debt over the previous 7 days followed by a text message to promote paying back sleep debt recovery when feasible. Participants in the control group receive text messages that only include assessments. Both arms will receive text-message assessments of perceived recovery since last shift, sleepiness, fatigue, or difficulty with concentration at noon (1200 hours) on days between scheduled shifts (off-duty days). We have two aims for this study: (1) to determine the short-term impact of the enhanced SleepTrackTXT2 intervention on air medical clinician fatigue reported in real time during and at the end of shift work, and (2) to determine the long-term impact of the SleepTrackTXT2 intervention on sleep quality and sleep health indicators including hours of sleep and recovery between shift work. Discussion The SleepTrackTXT2 trial may provide evidence of real-world effectiveness that would support widespread expansion of fatigue mitigation interventions in emergency care clinician shift workers. The trial may specifically support use of real-time assessments and interventions delivered via mobile technology such as text messaging. Trial registration ClinicalTrials.gov, NCT02783027. Registered on 23 May 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1999-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- P Daniel Patterson
- Department of Emergency Medicine, University of Pittsburgh, School of Medicine, 3600 Forbes Avenue, Iroquois Bldg, Suite 400A, Pittsburgh, PA, 15260, USA.
| | | | - Frank X Guyette
- Department of Emergency Medicine, University of Pittsburgh, School of Medicine, 3600 Forbes Avenue, Iroquois Bldg, Suite 400A, Pittsburgh, PA, 15260, USA
| | - Jack M Doman
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA
| | - Denisse Sequeira
- Department of Emergency Medicine, University of Pittsburgh, School of Medicine, 3600 Forbes Avenue, Iroquois Bldg, Suite 400A, Pittsburgh, PA, 15260, USA
| | | | - Doug Swanson
- MedCenter Air, Department of Emergency Medicine, Carolinas HealthCare System, Charlotte, NC, USA
| | - David Hostler
- Department of Exercise and Nutrition Sciences, The State University of New York, University at Buffalo, Buffalo, NY, USA
| | - Joshua Lynch
- MercyFlight of Western New York, Buffalo, NY, USA.,Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Lindsey Russo
- Department of Exercise and Nutrition Sciences, The State University of New York, University at Buffalo, Buffalo, NY, USA
| | | | | | - Michael S Runyon
- Department of Emergency Medicine, Carolinas HealthCare System, Charlotte, NC, USA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA
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Reuter E, Camba JD. Understanding emergency workers' behavior and perspectives on design and safety in the workplace. APPLIED ERGONOMICS 2017; 59:73-83. [PMID: 27890162 DOI: 10.1016/j.apergo.2016.08.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 08/23/2016] [Accepted: 08/26/2016] [Indexed: 06/06/2023]
Abstract
Emergency Medical Services (EMS) is a demanding and hazardous industry. Because of the changing roles in the emergency response system, EMS workers are increasingly expected to provide treatment and care in addition to transport, which increases their task load and susceptibility to harm. This paper serves to outline the EMS field from the worker's perspective with the purpose of understanding their views on health, safety, and the work environment, and identify where gaps in worker well-being are exposed. Through direct observation, field studies, and formal interviews with EMS professionals, we discuss where reluctance lies in addressing safety issues and the current efforts to address them. A high prevalence of responses regarding the inadequacy of ambulance restraining systems was reported, as existing interventions do not take into account medic needs.
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Affiliation(s)
- Elizabeth Reuter
- Industrial Design, Gerald D. Hines College of Architecture and Design, University of Houston, 4200 Elgin St., Houston, TX 77204-4000, USA.
| | - Jorge D Camba
- Industrial Design, Gerald D. Hines College of Architecture and Design, University of Houston, 4200 Elgin St., Houston, TX 77204-4000, USA.
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Reichard AA, Marsh SM, Tonozzi TR, Konda S, Gormley MA. Occupational Injuries and Exposures among Emergency Medical Services Workers. PREHOSP EMERG CARE 2017; 21:420-431. [DOI: 10.1080/10903127.2016.1274350] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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