Workplace Health & Safety最新文献

Background: Excessive heat stress led to more than 400 deaths in the United States from 2011 to 2021. Common methods for heat injury prevention revolve around measurements of the environment and fail to account for the unique individual response to stressors.

Methods: An observational approach was utilized with nine helicopter-based emergency medical services personnel during emergency flights to compare core temperature readings obtained from an ingestible temperature monitoring pill and the estimated core temperature reading of the Slate Safety Band V2 wearable device. Comparison of data was conducted within Microsoft Excel programming to determine the mean square error (MSE), root mean square error (RMSE), mean absolute error (MAE), mean biased error (MBE), and Bland-Altman plot development.

Findings: A significant bias (t = 17.58, p < .001) toward the Slate Safety device reading higher with an average difference of -0.48°C (-0.86°F) was found, meaning the average temperature reading is 0.48°C (-0.86°F) higher with the Slate Safety device. A significant correlation of .26 (p < .001) was noted between the ingestible pill and the wearable device with a 95% confidence interval of 0.23 to 0.29. Aggregate core temperature data demonstrated an MSE of 0.43, an RMSE of 0.65, an MAE of 0.54, and an MBE of -0.48.

Conclusions/application to practice: The ability to monitor the physiological parameters of a worker remotely adds safety tools relative to the risks of heat stress. The slightly higher reading associated with the Slate Safety wearable device provides an added safety margin to protect our workers.

Background: During shortages, elastomeric half-mask respirators (EHMRs) are an alternative to reusing N95 filtering facepiece respirators but require between-use disinfection. The objectives of this study were to (a) measure microbial reductions on EHMR surfaces under laboratory conditions by a standardized procedure using wipes impregnated with health care disinfectants and to (b) measure microbial reductions on EHMRs disinfected by volunteer health care providers.

Method: We inoculated EHMR (Honeywell model RU8500) surfaces with Pseudomonas aeruginosa, Bacillus atrophaeus spores, and bacteriophages MS2 and Φ6, and disinfected them using two wipes with hydrogen peroxide (HP), alcohols, and quaternary ammonium compounds (QACs). Then, we randomized 54 volunteer subjects into three groups (Group 1: two wipes with instructions, Group 2: five wipes with instructions, Group 3: no instructions or set number of wipes) and used 0.5% HP wipes without precleaning on EHMRs inoculated with Raoultella terrigena and MS2.

Findings: The laboratory study demonstrated that all organisms achieved at least 4 log₁₀ median reductions (HP>QAC/alcohol>QAC>QAC/saline). Pseudomonas was highly susceptible to HP and QAC/alcohol and Φ6 to all disinfectants. MS2 reduction was highest using HP and lowest using QAC/saline. Bacillus was least susceptible. The volunteer study showed a 3 to 4 log₁₀ average reductions of bacteria and virus; Raoultella reductions were greater than MS2, with variability within and between subjects. Conclusions: HP disinfectant wipes used in laboratory and by volunteers reduce bacteria and viruses on EHMRs by 3 to 4 log₁₀ on average.

Implications for practice: Commercially available hospital disinfectant wipes reduce bacteria and viruses on EHMRs and can fill the need for between-use disinfection. HP and combination QAC/alcohol have the greatest efficacy under our test conditions.

Background: Healthcare worker (HCW) well-being is essential for safe, high-quality patient care, but clinicians and front-line staff continue to experience alarming rates of burnout. This pilot study evaluated a novel 6-week program of remote wellness coaching supported by daily digital messaging to reduce burnout and increase well-being among HCWs.

Methods: In spring 2023, staff from a large community health center in California were invited to participate in this single-group pretest-posttest study in an academic-practice partnership. Thirty-four participants who were mostly female (91%), Latina (77%), 36 years old on average (range = 20-61), and represented all major job categories provided informed consent and completed the baseline survey. Of these, 17 completed 6 weekly 20-minute coaching sessions; received daily messages about stress management, self-care, workplace well-being, social connections, and lifestyle and health behaviors, and completed follow-up data collection. The Wilcoxon matched pair signed-rank tests assessed changes from baseline to 2-months follow-up.

Results: Self-reported burnout decreased from 59% at baseline to 35% at follow-up. Work exhaustion (p < .05), stress (p < .05) and sleep problems (p < .01) reduced significantly, and wellness practices (p < .05), moderate physical activity (p < .01), and healthy daily eating (p < .05) improved.

Conclusions/applications to practice: Our pilot study suggests that a brief digital wellness program may address burnout and increase health and well-being among front-line staff and clinicians. Healthcare settings should consider this type of program for their workers, especially given the added burden of COVID-19 on the healthcare system.

Background: Post-traumatic stress disorder (PTSD) can result in severe depression. Yet, it is not clear how to improve health-promoting behavior and reduce depressive symptoms. This study aimed to examine whether social support mediates the link between PTSD, depression, and health-promoting behaviors.

Methods: A cross-sectional study was conducted with 308 Korean Coast Guards in Gangwon-do, South Korea, in October and November 2020. The variables of PTSD and depressive symptoms were assessed using the Korean versions of the Impact of Event Scale-Revised and the Center for Epidemiologic Studies Depressive Scale-Revised. Health-promoting behaviors and social support were assessed using the Health-Promoting Lifestyle Profile-II and the Korean version of the Personal Resource Questionnaire 85-Part 2. Multiple regression analysis and Sobel tests were performed.

Findings: Higher levels of PTSD symptoms and lower levels of social support were significantly associated with higher levels of depressive symptoms. Social support had a significant partial mediating effect on the association between PTSD and depressive symptoms. In addition, lower levels of PTSD symptoms and higher levels of social support were significantly associated with higher levels of health-promoting behaviors. Social support has a full mediating effect on the association between PTSD symptoms and health-promoting behaviors.

Conclusions/application to practice: Our findings indicate that social support may mediate the association between PTSD symptoms and health outcomes. Occupational health nurses can use these findings to proactively develop interventions which improve social support for coast guard workers who are at risk of developing PTSD due to exposure to traumatic events on their job.

Background: Workplace violence has a significant impact on patients, families, and staff safety. Workplace violence can produce traumatic results for those involved; the importance of preventive measures needs to be paramount in health service policy and process. Health care staff are required to document their experiences of violent incidents after every occasion, usually via an incident reporting system, which allows for a free text description of the event. There is a lack of understanding of how health care staff document reports of violence and how they explain the events. Methods: This study aims to determine the circumstances surrounding workplace violent events as documented by health care staff. The four-step Review, Extract, Analyze, and Document (READ) approach to document analysis was used to examine workplace violence incident reports over 12 months (September 2021-September 2022) in a tertiary referral hospital. Findings: Six categories of workplace violence were found: (a) "Escalation Dynamics"-patterns and progression of how violence incidents intensify; (b) "Warning Behaviors"-verbal or non-verbal signals that may foreshadow physical violence if not addressed; (c) "Authoritative Institutional Interventions"-how aggression correlates to protocols involving security personnel or law enforcement; (d) "Care Delivery Methods"-how certain treatment procedures and approaches might inadvertently elicit violence; (e) "Situational Stressors"-external circumstances or changes that act as triggers for violence; and (f) "Unprovoked triggers"-sudden and seemingly unprovoked violent outbursts. Conclusions and application to practice: Workplace violence in health care is a multifaceted interplay of events with the nurse involved in all aspects of the process. These findings can be used by occupational health nurses in education and policy development. The findings can be used to focus education on how violent incidents may escalate and provide more opportunities for de-escalation by health care staff.

Background: Access to preventive healthcare improves health outcomes and reduces risk of chronic disease. Annual examinations were integrated into an underutilized clinic at the University of Utah to improve access to preventive care.

Methods: Nurse practitioners conducted these examinations, which included history, physical examination, age-based screenings, and immunizations. The service was part of a wellness program offering health premium discounts for participants. With employee permission, visit documentation was shared with primary care providers (PCPs) or used to help establish a PCP. Human resources received monthly reports of participating employees identification numbers, validating participation in order to receive premium discount.

Results: In 2023, 373 examinations were performed, including 719 preventive services and screenings, with 143 referrals for specialty and primary care. Patient satisfaction remained high throughout implementation.

Conclusion/application to practice: This initiative effectively increased access to preventive care for employees, demonstrating the feasibility of offering annual examinations in worksite clinics. The program addresses common barriers to preventive care such as long wait times, PCP shortages, and travel time to appointments.

Objectives: Establishing collaboration with occupational health staff is essential to support workers and organizations in the field of occupational health. Accordingly, occupational health nurses (OHNs) have recognized the need to collaborate with other professionals, including non-health care professionals. This review aimed to examine the components of collaboration in OHNs.

Methods: This review was conducted using Walker and Avant's eight-step analysis method on 267 papers (174 in Japanese and 93 in English) identified through an extensive literature review.

Results: Key attributes, antecedents, consequences, and empirical referents helped shape an operational definition of the concept of collaboration. Collaboration among OHNs is a process that integrates individuals, organizations, and systems. Further, OHNs are responsible for ensuring that employers and workers collaborate to actively promote and facilitate occupational health activities. In addition, OHNs assess the health status of individuals and organizations to determine whether collaboration is needed through the occupational nursing process. The quality and outcomes of collaboration are influenced by social trends and the health culture of each organization. Through collaboration with various stakeholders, OHNs contribute to making the workplace a better environment, improving labor efficiency, increasing worker productivity, and ensuring health and safety.

Conclusions: This review provides a comprehensive understanding of collaboration in occupational health nursing. Collaboration among OHNs is notably characterized by its "integration." OHNs can facilitate collaboration between employers and employees in occupational health activities, potentially benefiting both businesses and health care. The clarification of collaboration in this review has the potential to enhance OHN practices and guide future research.

Background: The training of farmers in pesticide safety is of prime importance for reducing pesticide use and exposure through the implementation of sustainable management practices. This study aimed to assess the impact of compulsory training on the knowledge and perceptions of cereal farmers, with the help of a safety climate scale. Method: We approached cereal farmers throughout France during compulsory training and certification procedures for pesticide-related activities. Trainees were asked to complete a safety climate questionnaire at the start and end of the course. In total, 733 cereal farm managers or workers completed the questionnaire at the start of the study, 131 of whom declined to complete the questionnaire at the end of the training session, leaving 602 subjects available for pre-training/post-training comparisons. Statistical analyses were based on paired t-tests and mixed models for repeated measures. Findings: The mean safety climate score increased from 82.37 to 88.22 after the training course (7.1 %, p < .001) in both univariate and multivariate analyses. Mean increases were also found for each of its seven dimensions (p < .001), ranging from 2.8% for "rules and best practices" to 12.4% for "communication and feedback." Few covariate-by-time interactions were found to be significant. Conclusion/Application to Practice: This study demonstrates that pesticide training is highly effective in increasing safety climate perception among cereal farmers and provides hints for improving the design of educational programs. Promoting the development and facilitation of lifelong learning with continuously updated training programs should be a top priority for minimizing pesticide exposure.

Background: Nurses experience high job demands, which makes recovery particularly necessary to maintain well-being and performance. However, these demands also make recovery challenging. Short mindfulness meditations could potentially help alleviate this paradox.

Methods: Two ecological momentary intervention studies were conducted among geriatric nurses (Study 1: break study) and hospital nurses (Study 2: after-work study) to investigate whether short audio-guided mindfulness meditations are beneficial for recovery during breaks and psychological detachment after work. Furthermore, break recovery and after-work detachment were examined as mediators of the associations between mindfulness meditations and after-break/after-sleep mood and attention after respective recovery periods. Multilevel path models were based on a sample of 38 nurses and 208 after-break surveys in the break study and 26 nurses and 192 after-sleep surveys in the after-work study.

Results: Compared to breaks spent as usual, breaks that incorporated short mindfulness meditations were associated with higher break recovery, which mediated the positive associations between mindful breaks and after-break calmness, valence, and energetic arousal. Only with certain constraints did mindfulness meditations predict a lower rate of attention failures. In the after-work study, short mindfulness meditations were positively related to psychological detachment, which mediated the positive associations between the intervention and after-sleep valence and calmness.

Conclusion/application to practice: Both pilot studies showed that short mindfulness meditations aid in recovery among nurses. However, to fully utilize the advantages of recovery-promoting breaks, structural changes are necessary to ensure that breaks of an appropriate duration are consistently implemented.