Update on occupational health nursing through 21st century requirements: A three-round Delphi study

BACKGROUND

Occupational health nurses have promoted health and practiced at a strategic level for many years, and are closely aligned with public health and policies, workplace and environmental regulations, and changes in the nursing profession.

OBJECTIVE

This study was carried out to create a consensus text on the definition, qualifications, responsibilities, and education of occupational health nurses based on the 21st century requirements.

DESIGN AND METHODS

A Delphi panel of public health nursing academicians, occupational health nurses, other health professionals, faculty members of public health, and occupational physicians. A consensus-building approach using three rounds of e-Delphi technique were used, with 45 participants in the first round, 41 in the second round, and 36 in the third round. Data were collected in all three rounds with Google Forms between October 28, 2021, to February 28, 2022. Qualitative content analysis was performed in the first round, and mean, standard deviation, median, and mode values were presented based on the answers to the 5-point Likert questions in the second and third rounds. Values of at least 80 % and above were used for the consensus text in the third round.

RESULTS

62.2 % of the participants were female. The mean age was found 47.71 ± 11.03 years. The experts reached a consensus on the definition of occupational health nurse by emphasizing professionalism, effective communication, record keeping, nursing knowledge, skills, equipment, and competence in the field, with a participation of 91.7 %. A consensus was reached on the qualifications including observation, examination, evaluation, research, health promotion, compliance with confidentiality and ethical rules, and working in harmony with the team, with a participation of 94.4 %. The responsibilities of occupational health nurses included to create a healthy and safe workplace, participate in periodic health examinations, maintain effective communication with employees, acting in accordance with ethical principles, provide continuous professional development, and perform health education and promotion, guidance, and counseling. Experts specified that occupational injuries and diseases, duties, authorities, and responsibilities of the occupational health nurse, occupational health and safety legislation, health education, risk assessment, effective communication, and health literacy need to be integrated into the content of certificate program with 97.7 % participation. A maximum of 500 h for the total duration of the certificate training was suggested.

CONCLUSIONS

The expert panel opinions provide a wide perspective for competencies, and educational standards of occupational health nurses. The results could assist in initiating the infrastructure of multidisciplinary postgraduate education programs, developing national and international collaborations, and increasing the number of scientific events should contribute to the professional development of occupational health nursing. Future research should focus on imbedding these consensus items in national and international certificate programs to prepare qualified advanced occupational health nurses.

Form Follows Function

Role, often designated by a given title, e.g., manager, has been one of the most common means of defining occupational health nursing practice. A function based model provides an opportunity to reframe the occupational health nurse as a member of the management team. This descriptive study characterized the functions of a random sample (40%) of members of the American Association of Occupational Health Nurses from eight Midwestern states (463) in 1994. With a 78% response rate, the most frequently performed function for all respondents was “evaluate status of employees returning to work after absence” (68%). The relative frequencies for functions performed by the associates degree nurses were very similar to those for diploma nurses (r=.889 based on a perfect relationship value of 1). Subjects with baccalaureates in nursing performed more educational programming than subjects with non-nursing baccalaureates who performed more frequently in a policy area. Type of masters preparation represented different functional activities. The department to which the respondent reported affected functions. Reviewing function by salary level revealed a linear relationship with certain functions by frequency. To facilitate the investigation of the role construct based on functions, the researchers conducted a principle components analysis of the data. Four principle components were found representing groups of functions that tended to be performed by the same sets of respondents. The functions in each component tended to cluster around common skills as defined by Hersey (1988).