Determinants of Workplace Injuries and Violence Among Newly Licensed RNs

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

Background

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

Method

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

Results

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

Conclusions

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

Overtime and alertness of rotating-shift nurses: An observational study using ecological momentary assessment

AIMS AND OBJECTIVES

This study aimed to determine the effect of overtime on alertness at work among rotating-shift nurses in South Korea and to investigate whether these effects of overtime vary across the different types of shifts.

BACKGROUND

Nurse overtime is prevalent in healthcare settings to manage nursing shortages and staffing needs; however, it negatively affects patient and nurse outcomes. Furthermore, little attention has been paid to the effects of previous overtime shifts and overtime for consecutive shifts on alertness during work.

DESIGN

A prospective observational study was employed. The study followed STROBE checklist for observational studies.

METHODS

Data were collected between June 2019 and February 2020 from 82 nurses who worked in acute care hospitals. An ecological momentary assessment was used to capture real-time data of overtime and alertness. Alertness scores were estimated using the sleep/wake data measured by an actigraph. Mixed-effect models were employed to investigate the association between overtime and alertness.

RESULTS

A majority of the shift nurses worked overtime. Episodes of a decline in alertness scores to the level of increased accident or serious error risk (alertness score ≤80) were most frequently seen during night shifts (98.9%), followed by day (59.8%) and evening shifts (10.1%). Previous-day overtime hours and consecutive overtime days were associated with decreased alertness scores during work. A significantly positive correlation was observed between alertness scores ≤80 and previous-day overtime hours and consecutive overtime days in all shifts.

CONCLUSIONS

The study findings indicate that a majority of nurses who work overtime experience decreased alertness while on duty.

RELEVANCE TO CLINICAL PRACTICE

Policy development at the government, organisational and unit level is needed to guarantee adequate rest for shift nurses by adjusting work schedules and assignments and limiting overtime.

Attentes du personnel infirmier de la relève envers l’employeur pour favoriser l’engagement professionnel : un premier jalon pour la conception d’interventions organisationnelles au Québec (Canada)

Introduction: Poor work conditions jeopardize the quality of nursing jobs and increase turnover and attrition rates, especially for early career nurses and licensed practical nurses. Understanding perspectives of the nursing staff on work engagement is essential to develop innovative and responsive organizational interventions. Objectives: 1- Define the expectations of early career nursing staff with respect to their workplace in order to support work engagement 2- Identify priority actions to support work engagement at organizational level. Methods: A mixed-methods research design based on a conceptual mapping approach was used. Early career nurses and licensed practical nurses (N=14) working in a semi-urban integrated health and social services center in Quebec (Canada) were asked the following question: “What can the workplace do to promote work engagement?” Multidimensional scaling and cluster analysis were used to organize the 49 statements provided by the nursing staff. At the same time, participants prioritized actions by rating the “importance” and “probability of a successful implementation” of each statement. Results: Nursing staffs’ expectations toward their workplace in order to support work engagement were: attractive working conditions, positive leadership, safe working conditions, professional development opportunities, and personalized career path. More specifically, the priority actions identified were: showing respect, providing a healthy environment and avoiding transfer to unwanted departments. Discussion and conclusion: The results suggest several actions to promote work engagement of early career nursing staff working in semi-urban settings in Quebec, including providing human and material resources, implementing a positive organizational culture, and exercising benevolent leadership.

The Effect of Abuse and Mistreatment on Healthcare Providers (TEAM): A Survey Assessing the Prevalence of Aggression From Patients and Their Families and Its Impact

OBJECTIVE

Aggression from patients and families on health care providers (HCP) is common yet understudied. We measured its prevalence and impact on HCPs in inpatient and outpatient settings.

METHODS

Four thousand six hundred seven HCPs employed by a community teaching hospital received an anonymous survey with results analyzed.

RESULTS

Of 1609 HCPs (35%) completing the survey, 88% of inpatient staff reported experiencing different types of aggression compared to 82% in outpatient setting. Almost half did not report it to their supervisor. Younger staff were more likely to report abuse. Negative impacts on productivity and patient care were reported. A third of all responders' indicated negative effects on mental health.

CONCLUSIONS

Despite negative impacts on staff wellbeing and productivity, patient/family aggression toward HCPs is highly prevalent and underreported. Our healthcare system needs measures to address staff security and wellness.

Determinants of aggression against all health care workers in a large-sized university hospital

BACKGROUND

The paper aims to describe the 3-year incidence (2015/17) of aggressive acts against all healthcare workers to identify risk factors associated to violence among a variety of demographic and professional determinants of assaulted, and risk factors related to the circumstances surrounding these events.

METHODS

A retrospective observational study of all 10,970 health workers in a large-sized Italian university hospital was performed. The data, obtained from the "Aggression Reporting Form", which must be completed by assaulted workers within 72 h of aggression, were collected for the following domains: worker assaulted (sex, age class, years worked); profession (nurses, medical doctors, non-medical support staff, administrative staff, midwives); aggressive acts (activity type during aggressive acts, season, time and location of aggressive acts); and type of aggressive acts (verbal, non-verbal, consequences, aggressors).

RESULTS

Three hundred sixty-four (3.3%) workers experienced almost one aggression. The majority of the assaulted workers were female (77.5%), had worked for 6/15 years and were Nurses (64.3%). The majority of aggressive acts occurred during assistance and patient care (38.2%), in the spring and during the afternoon/morning shifts and took place in locations where patients were present (47.3%). The most prevalent aggression type was verbal (76.9%). The patient was the most common aggressor (46.7%). 56% of those assaulted experienced interruptions in their work. Being female, being < 50 years of age, having worked for 6-15 years were significant risk factors for aggression. Midwives suffered the highest risk of experiencing aggression (RR = 12.95). The risk analysis showed that non-verbally aggressive acts were related to assistance and patient care with respect to activity type, to the presence of patients and during the spring and afternoon/evening.

CONCLUSIONS

The findings suggest the parallel use of future qualitative studies to clarify the motivation behind aggression. These suggestions are needed for the implementation of additional adequate prevention strategies on either an organizational or a personal level.