Workplace Health & Safety最新文献

Background: Workplace violence (WPV) in healthcare has become an issue worldwide, with increasing prevalence after the COVID-19 pandemic. Notably, WPV in any setting has individual and systemic repercussions. However, despite extensive literature reporting the prevalence of WPV in healthcare worldwide, effective, standardized prevention policies have not been established. We developed and piloted a WPV initiative at an urban hospital in the state of Maryland. Here, we aim to describe our program development methods and implementation.

Methods: The 6-month program utilized a reporting tool developed within patients' electronic medical records (EMRs) to request the display of a Staff Safety Alert (SSA) banner to alert healthcare professionals of patients who engaged in violent behavior and are at increased risk of subsequent behavior. This tool was piloted on 21 patient care units. A review committee either approved or denied case requests filed by frontline workers, with holistic consideration involving patient status, potential biases, and communication flaws.

Results: Twenty-one banner requests were filed during the course of the pilot. Of which, eight were approved, and 13 were denied. The multi-trauma intermediate care floor filed the most case requests for a safety banner.

Conclusions/application to practice: Our pilot program offers a patient-centered intervention program where extensive personnel training and patient-focused considerations were applied prior to the approval or denial of a banner display. The SSA program was the initial step in institutionally combatting WPV in healthcare as staff are encouraged to officially document unsafe events followed by careful action in response.

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: Statistics from the Centers for Disease Control indicate that the use of e-cigarettes, vaping, and other electronic nicotine delivery systems (ENDS) are increasing although data on their safety is limited. While most employers ban smoking in the workplace, tobacco-free policies do not always extend specifically to e-cigarette products.

Methods: An IRB approved exploratory, cross-sectional study was conducted to investigate occupational health professionals' (OHPs) knowledge of e-cigarettes, vaping and ENDS and the ability to create change in tobacco-free workplace policies. A 91-item electronic survey was sent via email to 3248 OHPs who were members of the American Association of Occupational Health Nurses.

Findings: A total of 299 surveys were returned, but only 230 completed the entire survey. Of those who completed the entire survey, those with advanced education had higher attitude toward change summary scores (p = .043) and those with lower years of practicing had low scores for transformational leadership (p = .039). Approximately 40% of individuals did not have or were unsure that a tobacco-free program was in place that included e-cigarettes, but the majority (90%) perceived their organizational leaders as interested in safety changes.

Conclusions: The majority of respondents understood the health issues inherent in e-cigarettes, were open to implementing policies that included e-cigarettes but needed education and both managerial and employee support to implement policy changes.

Application to practice: OHPs are well positioned to be advocates for workplace education, policy development, and worker health promotion for smoking and vaping cessation by leading organizational change.

Background: Prior pandemic research has focused on physicians and nurses who provide direct patient care. Literature on the experiences of nonnurse/physician clinicians and nonclinical health care professionals is sparse.

Methods: An observational, cross-sectional study was conducted over threetime points to examine the impact of COVID-19 on clinical and nonclinical healthcare professionals (n = 464).

Findings: There were no significant differences in distress across survey waves, except for anger (p = .046). No significant differences in distress scores were found between job types. Multiple linear regression results varied. Both the threat and interrupted plans scores were significant predictors of distress. Resources available to healthcare providers (HCPs) were underutilized in all three waves.

Conclusions: Healthcare professionals' distress increases with exposure. Integrating self-care resources for staff may mitigate the impact and maintain a healthy work environment.

Application to practice: Occupational health providers should incorporate these findings when developing opportunities to address the needs of health care professionals in the workplace.

Background: The sedentary aspects of many U.S. occupations and the amount of time American workers spend in the workplace make it an ideal location to implement health promotion programs.

Methods: This study assessed the effectiveness of a free smartphone app with a goal-setting feature to increase physical activity (PA) and impact anthropometric, body mass (BM), and body composition (BC) changes among overweight and obese women within a community health workforce. Eighteen overweight and obese (body mass index [BMI] = 32.18 ± 4.48 kg/m²), adult (50.73 ± 8.76 years), female volunteers, tracked daily steps with a free smartphone app (Stridekick^TM) over an 8-week period. Pre- and post-program body composition (BC) measurements included: relative (%) body fat (BF), fat mass (FM), fat-free mass (FFM), and lean mass (LM), using dual X-ray absorptiometry (DEXA scan), and five anthropometric measurements (biceps, waist, abdomen, hips, and thigh).

Findings: Pre- to post-program average daily steps resulted in significant anthropometric changes for biceps, hips, and thigh measures, with encouraging changes in FFM, LM, and relative (%) BF. The goal-setting feature of the app did not result in significant differences between the experimental and control groups. No differences were noted in FM, BMI, waist, and abdomen or step goals compared with steps completed.

Conclusions: An occupational PA health promotion intervention program that tracked daily steps through the Stridekick^TM smartphone app resulted in anthropometric, BM, and BC changes.

Application to practice: The workplace is an ideal location to affect change in health behaviors via a free smartphone app to increase PA and improve health.

Background: This multilevel meta-analytic review is designed to analyze and quantify the effect size of the association between technostress and work-life fit among employees.

Method: By adhering to the PRISMA 2020 Statement, seven databases (i.e., PubMed, PsycARTICLES, PsycINFO, the Psychology and Behavioral Sciences Collection, MEDLINE, Wiley Online Library, and Web of Science) were searched for studies reporting the association between technostress and work-life fit.

Results: Out of the 476 articles that were screened, 7 met the established criteria and were subsequently included in this multilevel meta-analytic review. A majority of these studies highlighted the existence and intensity of the association between technostress and work-life fit, as evidenced by multiple Pearson's r. Our findings supported a medium association (Cohen's d = -0.41). Noteworthy differences were found when considering the interdependence of effect sizes within and between studies.

Conclusion: The results of this multilevel meta-analytic review underscore the significance of understanding this association to inform optimal choices in terms of welfare policies and organizational decisions that promote employee well-being. This knowledge may serve as a scientific foundation for viewing new technologies not merely as hurdles but also as potential resources.

Background: Farmers with chronic obstructive pulmonary disease (COPD) often face both respiratory issues and psychological distress, which can exacerbate their condition. However, no prior research has examined how the frequency of respiratory symptoms is associated to psychological distress in these individuals. Therefore, this study aimed to explore this relationship among U.S. farmers living with COPD.

Methods: A cross-sectional study involved 101 participants, a mix of on-site and online recruits, assessing respiratory symptoms and psychological distress in farmers with COPD. The study employed standard self-reported measures and utilized both simple and multiple linear regression to analyze the association between respiratory symptoms and psychological distress.

Findings: Participants reported notably higher levels of respiratory symptoms (61.6 [SD = 13.3]) compared to the reference score of 12, along with elevated psychological distress (25.9 [SD = 10.6]). Factors like COPD duration, income, smoking, and emergency department (ED) visits correlated with respiratory symptoms, while age, COPD duration, income, smoking, pesticide exposure, and farm type were associated to psychological distress. Notably, even after accounting for age, smoking, and pesticide exposure, a significant association remained between respiratory symptoms and psychological distress (β = 0.46, p < .001).

Conclusion: Respiratory symptoms were significantly associated to psychological distress, even when considering other factors. While this aligns with existing research, a future longitudinal study is crucial to establish the cause-effect relationship between these variables. Understanding this relationship could inform the development of targeted interventions to alleviate psychological distress in individuals with respiratory symptoms.

Implications for occupational health nursing practice: The correlation between COPD symptoms and psychological distress in farmers emphasizes the need for integrated nursing care. Occupational health nurses should prioritize combined respiratory and mental health assessments.