Retention, Recruitment and Facilitation of
Safe Work Environment Through Unified
Vehicles of Knowledge
by
Wendy E. McQuaid, Corinne Hardy-Adams
Committee for Injured Nurses of Prince Edward Island Proposal
for Safe Work Environments for Health Care Workers: Safe
Patient Handling - No Manual Lifting
September 2005
Amended December 2005
(c) Wendy E. McQuaid, Corinne Hardy-Adams 2005
Table of Contents
1) Introduction
2) Background
3) Research Question
4) Ethical Issues
5) Stakeholders
6) Evaluation Design and Methodology
7) Methodology
8) Budget and Time lines
9) Findings
10) Discussion
11)Recommendations
Introduction
Intent of Proposal
The Committee for Injured Nurses of Prince Edward Island will assess, plan,
implement and evaluate the environment of the health care population.
History
The Committee for Injured Nurses of Prince Edward Island was organized to
examine the working conditions of nurses across Prince Edward Island in response to the
concerns nurses have raised about workplace conditions, the number of nurses injured
and the lack of support provided following an injury. The Committee for Injured Nurses
of Prince Edward Island acknowledges the integrity and dignity of the professional nurse
and the valuable contribution nurses offer our society. The Committee has a commitment
to promote the physical, mental, social and environmental well being and occupational
effectiveness of nurses, their families and communities through a multi-disciplinary
approach to managing health risks.
The committee has been instrumental in the development of promoting a safe
work environment by incorporating a no-lift policy, promoting suitable mechanical
lifting equipment and training staff about identifying and managing risk situations
associated with transferring objects or clients, educating staff about their responsibility
and duties associated with creating and maintaining a safe work environment.
The Committee for Injured Nurses feels that it is important that Nurses consider injury as
an unacceptable factor in their workplace. Injuries must be reduced or eliminated to ease
pressures in the current nursing shortage. It is felt that improvement in all areas of
nursing will facilitate increased retention and possible recruitment of nurses into local
workforces.
The Committee for Injured Nurses has been working with nurses on Prince
Edward Island implementing a safer work environment since 2002. With the experience
of numerous meetings with nurses island wide the Committee has established a vast
amount of knowledge on the needs of safe working environments for nurses. The
membership for the Committee for Injured Nurses consists of a population of health care
providers with registered nurses membership greater than 50%. The Committee for
Injured Nurses will assess, plan, implement and evaluate the current environment of
health care providers and recipients.
Mission
The mission of the Committee for Injured Nurses of Prince Edward Island is to
improve the health of health care workers and recipients, by supporting and promoting
the development and practice of a safe work environment.
Statement of Philosophy
As our health care communities work together to meet the challenges of the day,
we shall continue to honour our past as we prepare for our futures. Our communities will
remain committed to a shared vision of justice, respect and care for all.
Background
There is an urgent need to repair the damage done to nursing through a decade of
health care reform and restructuring (Decker, CNA, 2002). The increase of need for
nurse safety in all nursing practices has placed great demands on nurses to be
accountable for their professional activities and behaviours.
Everyday nurses suffer debilitating and often career-ending and life-altering
injuries from lifting and moving patients. The healthcare industry has relied on people to
do the work of machines. "Although the Occupational Health and Safety Act of 1970
pledges to ensure so far as possible every working man and woman in the nation safe and
healthful working conditions and to preserve our human resources, it appears there are no
enforced safeguards against hazardous manual lifting by healthcare workers.", Dr.
Richard Edlich (2005).
Nursing work is comparable to the hardest labour with nurses lifting an estimated
1.8 tons per shift. 83% of nurses continue to work in spite of back pain, 60% fear a
disabling back injury, 88% are influenced by health and safety concerns about remaining
in nursing and the kind of nursing work they choose. An estimated 38% of nurses will
have a back injury during their careers requiring time off work Research has shown that
for every patient over four added to an RN's workload, the risk of patient death within 30
days of admission rises by 7% thus serious risk to patients increases as nurses are
needlessly forced out by preventable injuries. The problem of lifting a patient is not
simply one of overcoming a heavy weight. The nurse must also take into account the
size, shape and deformities of the patient along with any physical impairments of lower
limb function as well as balance and coordination some patients also may be combative,
contracted or uncooperative. Any unpredictable movement or resistance from the patient
may throw the nursing personal of balance during the transfer resulting in back injury.
Space limitations, equipment interference and unadjustable beds, chairs and commodes
may also contribute to an increase in the risk of an occupational injury (Edlich, 2005).
Nurses are faced with many risk factors in the workplace and it is time to address
this problem and identify these areas of high risk and establish programs whereby nurses
can perform their duties safely in a low risk workplace environment. The Nurses
Association of New Brunswick Position Statement 2005 states, "A safe and secure work
environment is an undeniable right of every nurse and is an essential element of
providing quality care."
September 2003, a Needs Assessment was completed by the Committee for
Injured Nurses of Prince Edward Island. The study consisted of a cross section of nurses
from various areas of work such as; emergency, recovery room, day surgery, intensive
care, medical/surgical floors, palliative care, nursing homes, clinics and professors from
the University of Prince Edward Island School of Nursing. The collated data was
analysed under the direction of scientific researcher Dr. David Cairns.
Findings consisted as follows and shows clearly that the North American
healthcare crisis which is expected in the near future to reach more than one hundred
thousand job vacancies Canada wide is being felt strongly today in our healthcare
centres. Massachusetts Nursing Association 2003 states, "According to the state's
Registered Nurses, under staffing in hospitals is not a crisis of the future - it is a crisis
of the moment." Edlich 2005 states, "In the face of nursing shortage that is fast
reaching crisis proportions, injuries are the major contributing factor in nurses
leaving the profession."
In our study, the majority of those nurses involved, 84% felt that their workplace
put them in an unexpected situation being exposed to greater risk of emotional or
physical damage, an overabundance of stress or chance of injury. The initial response
from nurses was the first point of interest even prior to the results of the study as there
seemed such a strong interest and need for further work on the subject of the workplace
environment with the hopes of identifying risks and chances for policy to correct them
and then guiding policy in providing a strong voice for nurses, guided by nurses. No
numbers can properly capture the energy and desire to help the healthcare community
that was encountered.
When nurses which worked directly with the public were asked to rate the
physical demands that are placed upon them do to their roles on a scale of one to ten the
result was an average of 7.8. The measure of mental strain however was that much more
pronounced as there was an average of 9 out of ten and approximately half of those
responding doing so at the median of 10/10, a workload doing so at the median of 10/10,
a workload slightly lower it seemed in the supervisory staff. Approx 90% of those who
were involved stressed the need for more staff and care for those which were in the labor
force now to prevent injury, premature retirement or a suffering in the quality of care
provided. Concerns were for the most part focused on the staffing needs but in more than
just the number of nurses as orderlies, porters and ward clerks were also of key
importance so allowing the trained and experienced nursing staff to apply their skills to
where they can do the most good and their labors not be wasted.
There was a more reasonable number who felt that they had appropriate time off
between working shifts to mentally and physically recover at 51% in the hands on staff
and a related 50% in the supervisory staff. It does speak of needed improvement to assist
in the maintaining a balance between family and work life given the stresses of the
workplace but somewhat lower than expected given other extreme values such as in the
case of what was available in support systems as 90% of nurses involved didn't feel that
there were appropriate support systems for them to make use of. So while the staff that
we have seem able to work the hours they do, there is a demand that was made clear by
P.E.I.'s healthcare community directly for new or recovered staff to be added to their
numbers so that the quality of our healthcare system and the safety of those men and
woman who strive day and night to maintain it are not jeopardized. The nurse to patient
ratio that was suggested was one nurse for every 3.5 to 4 patients. The highest recorded
nurse to patient ratio on our questionnaire response was one nurse for every 60 plus
patients.
Statements from nurses:
"It is often expressed by the administration that they understand how overworked nurses
are. What baffles me is why nurses are continuously given more and more work .. I
entered nursing to be a nurse and after I go home feeling that I didn't have enough time
to give the type of care my patients deserve."
"Most assessment tools for nurse/patient ratio do not account for more than task
orientated approach (mental, emotional, spiritual needs not met) .Stressful to always be
left feeling that client needs are not met."
"Physical care can be heavy and with only one RN and one LPN to staff the unit, staff is
often exhausted mentally and physically at the end of the shift with many feeling
inadequate in the quality of care that they were able to give that day."
"Not having 12-16 emergency room admissions per day-these people need better beds
and a place to stay out of the view of the public."
"High risk factors, physical injury, needle sticks and infections, e.g.; VRE, MSRA, Hep C
& B and HIV."
"require better service and respect from Workers Compensation Board."
"Always the causes and roots of the problems confronting registered nurses in the
workplace have not been addressed so other nurses continue to be injured."
"There never seems to be action taken on stated concerns."
"We work with high risk situations frequently."
"Stress and physical demands are decreased greatly when the floor is staffed according
to acuity of it's patients."
"Assessment tools for nurse / patient ratio do not account for more than task oriented
approach. It's stressful to always be left feeling that client needs are not being met. This
feeling is stressful for anyone. Nurses live with this constantly. Stress leaves one more
prone to injury and illness of all kinds."
On the evaluation questionnaire, nurses requested that there be follow-up research
on the statistics on how many nurses have been injured at work, how many were able to
get back to work and what resources are available for prevention of injury in nurses and
what resources are available for nurses already injured. "Nurses Aids consistently
suffer 3-4 times the number of back injuries of Registered Nurses." Edlich, 2005.
Research Question
Will the implementation of a safe working environment decrease injury in the
health care provider and recipient populations?
Rationale
The effects of workload and overtime on nurses health is clear. In any given
week, more than 13,000 Registered Nurses - 7.4% of all Registered Nurses - are absent
from work because of disability (CLBC, 2002). According to the Canada Labour Force
Survey, the rate of absenteeism is 80% higher than the Canadian Average (8.1% for
Nurses, compared with a 4.5% average among 47 other occupational groups. Over the
course of a year, more than 16 million nursing hours are lost to injury and illness - the
equivalent of almost 9,000 full time nursing positions (CLBC, 2002). Health Canada
notes that injury in Canada results in overtime, absentee wages and replacement of
Registered Nurses, which costs between $962 million and $1.5 billion annually.
In the Canadian research report called Effects of Job Strain, Hospital
Organizational Factors and Individual Characteristics on Work-Related Disability
Among Nurses (2001), it is noted that the future recruitment and retention of nurses has /
will continue to diminish. Injury in nursing in Canada results in overtime, absentee
wages and replacement workforce. Retention of our current nursing population and the
prospect of recruitment of nursing students is greatly dependant upon the prevention of
injury in the workplace. "In the face of nursing shortage that is fast reaching crisis
proportions, injuries are the major contributing factor in nurses leaving the profession."
Edlich, 2005.
The employer will work in partnership with the health care providers and the
Committee for Injured Nurses of Prince Edward Island providing support for safe
working environments.
We are challenged to teach our health care providers how to critically assess their
workplace to recognize risk, realize their rights and reflect upon effective problem
solving in order to promote a safe working environment for both health care provider and
health care recipient. The development model by Ornsteins, 2004, notes, "People
working closest to the job best understand what is required to improve their
performance."
Health care providers must become informed advocates, challenge their
organizations to incorporate a mandate that will exercise their rights as citizens to
influence policy for a safe work environment. As health care provider educators, we
must develop strategies to integrate into health care provider curriculum the issues of
power, politics and control as it relates to a safe work environment for our health care
provider population. Through dialogue of both verbal and written word, health care
providers can develop guiding policy in providing a strong voice for health care
providers, guided by health care providers.
Development of a safe working environment will be attained through unanimous
commitment to prevent injury, providing suitable mechanical lifting equipment and
training staff about identifying and managing risk situations, ie; associated with
transferring objects or patients, educating staff about their responsibilities and duties
associated with creating and maintaining a safe work environment. Improvements made
to the work environment will decrease the risk of injury allowing hcp to remain on the
job.
Ethical Issues
Ensuring the protection of the rights of the health care providers and recipients they shall:
·Declare their bias.
·Design evaluations to promote excellence in educational and training programs.
·Inform the stakeholders of the purposes of the evaluation.
·Use evaluation to identify program effects on learners .Examine program effects against
the assessed needs of the targeted participants.
·Provide interim evaluation findings citing strengths and deficiencies and suggestions
for improvement.
·Include an agreement. Develop a formal written agreement that explains the procedures
to be followed by the Health Care Providers and health care recipients to protection of participants rights.
·.Maintain good communication through established channels with participants.
·Fully report findings (full disclosure) that indicate strengths and weaknesses , whether
intended or unintended ,and justify each.
·Identify and clearly describe possible sources of conflict of interest in initial discussions
with employer, health care providers and recipients.
·Arrange for met evaluations in cases where conflict of interest is unavoidable.
Stakeholders
Stakeholders include the representatives and agencies such as Labour Unions,
Worker`s Compensation Board, Occupational Health and Safety Board, professional
associations such as the Association for Licensed Practical Nurses, Association for
Resident Care Workers, health care representatives, Medical Society of Prince Edward
Island, members of the Atlantic/Island Network for Injury Prevention, Veterans Affairs
Canada Falls Prevention, Prince Edward Island Centre for the study of Health and Aging
at the University of Prince Edward, and injured workers themselves. This collaboration
will engage stakeholders, system agencies and the evaluator /facilitator (Committee for
Injured Nurses of Prince Edward Island ) to review existing workplace risks and the
implementation of a safe workplace environment for health care providers and recipients.
Evaluation Design and Methodology
The Committee for Injured Nurses of Prince Edward Island will seek to enhance
its professional stature by developing the scientific body of knowledge that is
fundamental to its practice through the use of applied research including both qualitative
and quantitative components. The applied research will focus on finding information on
whether or not a safe working environment is effective in the prevention of injury to
health care providers. A questionnaire will be submitted to health care providers from all
departments in the Geneva Villa. The objectives will be to assess if staff have been
properly trained in safety in the environment (ie. manual handling), if the staff apply a
safe practices in their workplace and if so does this program prevent injury in the health
care provider workforce.
The data analysis will acknowledge if there is a consistent pattern identified in the
improvement of prevention of injury in the workplace and if environments are being
accurately being assessed to acknowledge high risk environments. A cover letter is
submitted to each unit within the Geneva Villa to inform all health care providers of the
upcoming questionnaire and their needed participation.
Questionnaire
The Committee for Injured Nurses of Prince Edward Island is a research based
committee designed to address workplace concerns of health care provider safety and
injury prevention.
Thank you for your valuable time and assistance in completing this questionnaire
.
1) Did you receive the Safe Manual Handling Program educational inservice?
(Please circle comment)
Yes No
2) If your response is no to the above question please indicate why?
3) If your response is yes ,was the program appropriate to the workplace
conditions?
Yes No
4) From whom did you receive the Safe Manual Handling program ?
Queen Elizabeth Hospital Worker`s Compensation Board Nurses Union
Nurses Association Independent Organization Other
5) Do you feel this training addressed nurse safety in the workplace?
Rate on a scale of 1 very unhelpful to 10 very helpful
1 2 3 4 5 6 7 8 9 10
6) What level of nursing education have you received?
(please circle response)
Diploma Bachelor Masters Doctorate Other___________
7) How many years have you worked as a nurse?
0-5years 5-10years 10-15years 15-20years 20-25 years
Other______
8) What is the status of you position?
Casual Temporary /Part-time Temporary /Full time
Permanent Part-time Permanent Full -time
Budget and Time Line
Budget
Please refer to submitted budget by Mr. Brian Shea accountant of Bradley and
Shea.
Time Line
The pilot project shall take two years to complete.
1. By the Spring of 2007, the Committee for Injured Nurses of Prince Edward Island will
have implemented the theory, practices and standards of the Committee thus promoting a
safe working environment for health care providers.
2. By the Spring of 2008, the Committee for Injured Nurses Program will have promoted
safe work environments thus enhancing retention of health care providers in the
workforce on Prince Edward Island.
3. By the Spring of 2007, the Committee for Injured Nurses of Prince Edward Island will
have facilitated with the health care providers of Prince Edward Island the development
and implementation of educational programs that support health care providers both
injured and non-injured. An education committee directed by health care providers will
be established to advance this direction. The Committee will organize participatory
health care provider forums to contribute information to the content and design of
educational programs.
4. By the Spring of 2008, the Committee for Injured Nurses will have set agenda for
research and partner with others in research regarding injury prevention in the health care
provider population.
5. By the Spring of 2008, health care providers on Prince Edward Island will be better
able to assess and implement safe working conditions in their organizations.
6. By the Spring of 2008, we anticipate a minimum of 10% decrease in injury among
health care providers.
Implementation
The Committee will develop wellness and educational programs, improve venues
of communication through seminars and workplace modules for each clinical or
administrative work environment that will incorporate awareness to the physical,
emotional and nosocomial risk factors specific to each workplace environment and
circumstance of the injured nurse.
a. Health Care Providers in community, clinical practice, education, administration
and research will identify areas of varying risk by application of their knowledge,
skill and judgement by implementing safety programs.
b. Education of health care providers will take the form of role playing / simulation
and case study and will be the primary focus enabling health care providers to
reflect and seek out solutions to risk situations in the workplace through problem
solving.
c. Research outcomes will be incorporated into the policies and workplace
environments through a developed communication and liaison with health care
administrators, union and association representatives.
d. Through the installation of a Health Safety Facilitator for each health care
institution will assist in directing health care providers in assessing high risk
environments.
e. Health Care Providers will be aware of their responsibilities and duties as well as
the responsibilities and duties of the employer taking action to ensure these
responsibilities and duties are realized in timely manner through utilization of:
security guards, orderlies, porters, resident care workers, licenced nursing
assistants, registered nurses and doctors where recommended to lower the stress
levels and promote a safer work environment.
f. Health Care Providers will make meaningful contributions to their organization,
by having a voice in assessment and decision making in workplace wellness and
safety.
It was unanimously decided upon that a Health Safety Facilitator and not a Risk
Coordinator would best serve the needs of health care providers on Prince Edward Island.
The health care providers asked the Committee to facilitate as a unified vehicle of
knowledge allowing health care providers to support and educate each other. Health care
providers of Prince Edward Island have asked the Committee of Injured Nurses of Prince
Edward Island if the Committee will;
1. Facilitate as a unified vehicle of knowledge allowing health care providers to support
and educate each other.
2. Allocate information and resources that will promote a safe work environment.
3. Speak on behalf of the health care providers when areas of high risk are addressed.
4. Facilitate in assessing and identifying high risk areas for health care providers of
Prince Edward Island.
5. Acknowledge the expertise, skills and judgement of PEI health care providers.
6. Establish a network of correspondence with other health care providers provincially,
in the Atlantic region and nationally to draw on a body of knowledge in promotion of
safe work environments.
7. Facilitate health care providers in implementing and legislating safe workplace policy
(National Healthcare Worker Safety Act).
8. Allow health care providers to take ownership in addressing high risk environments.
9. Facilitate the evolution of health care provider practice into a self sufficient, efficient
and safe profession.
10. Liaison with managers, administrators, executives and government representatives in
promoting safe work environment.
As part of the on-going formative evaluation process, the facilitator will maintain
up-to-date descriptions of the program from different information sources such as
minutes from staff meetings, interviews of participants and progress reports .
The facilitator will record obtained descriptions of the object in a technical report,
paying special attention to discrepancies between intended characteristics of the program
and characteristics of the program as implemented.
Deliverables
Health Care Providers will know their legal rights in the workplace.
Health Care Providers in clinical settings, education, administration and research
will identify areas of varying risk by application of their knowledge, skill and
judgement.
Health Care Providers will know how to prioritize risks / dangers to themselves /
patients in the workplace.
Health Care Providers will be critically aware of risks in the workplace.
Health Care Providers will know the responsibilities of the employer.
Health Care Providers will know what resources are available.
Health Care Providers will know what resources are available if they become
injured.
Health Care Providers will be able to reflect and seek out solutions to risk
situations in the workplace through problem solving.
Health Care Provider Absenteeism / injury / illness will decrease; retention,
recruitment and morale will be enhanced.
Health Care Providers will educate the employer about their responsibilities,
duties and required low risk working environment for staff and patients.
A unified vehicle of knowledge will be established for health care providers to
have direct influence over their work environment and actualize their ability to perform
duties within this environment. Development of a safe working environment will be
attained through commitment to prevent illness and injury, incorporation of a no-lift
policy, providing suitable mechanical lifting equipment and training staff about
identifying and managing risk situations associated with transferring objects or clients,
educating staff about their responsibility and duties associated with creating and
maintaining a safe work environment. Improvements made to the work environment will
decrease the risk of illness and injury allowing the health care provider to remain on the
job. Support systems will be established for health care providers to express their
concerns in regards to workplace stress. Support groups will be formed for health care
providers who have become injured to assist them to return to their optimum level of
health and assistance to their return to a safe and healthy work environment.
This program will be initially introduced as an optional basis as a career building
course and it may be mandatory in two years time. It also has use in self preservation
and protection. It will be an optional program for established nurses; conjointly a
comparable course will be established in university / college nursing programs so that
new nurses will have these skills integrated into their education prior to graduation. As
new staff are expected to have this skill set, what was once optional for established health
care workers should become a required upgrade.
September 2003 the Committee for Injured Nurses began corresponding with the
Injured Nurses Group of Victoria, Australia. This group has successfully implemented
programs that have prevented injury in the nursing workforce in the State of Victoria.
Their recent research evaluation shows that the implemented programs are not only
promoting nursing retention but are also saving the government multi-millions of dollars.
Their evaluation shows a 74% decrease in absentee time in the nursing profession in the
State of Victoria.
The goals of the Committee to promote wellness, provide education, prevent
injuries and illness, develop and implement excellent assessment skills / tools and
support of health care providers and their families are being implemented. Within the
next several months the second research questionnaires will be submitted to health care
providers on Prince Edward Island. The information will be compiled and discussed at a
provincial "Think Tank" session. The Committee will work in collaboration with other
health professionals such as physiotherapists, occupational therapists, medical doctors,
nursing colleagues, licensed practical nurses, resident care workers, professional and
federal governments, UPSE, CUPE, WCB. Department of Education, Universities and
other resources to develop and implement a successful injury prevention program. The
Committee is presently networking in the provinces of Prince Edward Island, New
Brunswick, Nova Scotia, Newfoundland, Ontario, Manitoba and British Columbia.
On 28th of April2005 the Canadian Labour Congress and the Canadian Federation
of Nurses asked the Committee for Injured Nurses to represent nurses who have been
injured or have died as a result of a workplace accident at the National day of Mourning
in Ottawa. Two of the committee members did attend this service and laid a wreath on
behalf of Canadian nurses and their families that have been affected by workplace injury
and illness.
On 3rd of May 2005 representatives from the Committee for Injures Nurses met
with Ms. Norma Freeman, Director of Policy for the Canadian Nurses Association. At
this time there was a relationship established with the Canadian Nurses Association and
the Committee for Injured Nurses and a working partnership with them culminated in the
evolvement of the Committee to a national association to be called the Association for
Prevention of Injury in Nurses of Canada. The Committee for Injured Nurses has a close
working relationship with Senators; Elizabeth Hubley, Percy Downe and Catherine
Callbeck, Members of Parliament; Lawrence MacAulay, Shawn Murphy, Wayne Easter
and Joe MacGuire and Health Canada Provincial Director Sarath Chandrasekere. We are
also working with the Canadian Nurses Association, Federation of Nurses, Aboriginal
Nurses Association of Canada, Canadian Occupational Health Nurses Association,
Canadian Association for Rural and Remote Nursing and Canadian Nursing Students
Association. Other partners are the Department of Veterans Affairs, Atlantic Network
for Injury Prevention, Association of Nurses of Prince Edward Island, University of
Prince Edward Island, Acadia University and University of Toronto. We are working
with Occupational Health (Transfer, Lift and Reposition Program), medical societies and
federal and provincial governments.
On 4th February 2005 the Committee for Injured Nurses received a letter of
support from the Canadian Minister of Health Hon. Ujjal Dosanjh. We have also been in
correspondence with Dr. Carolyn Bennett Minister of State for Public Health. 16th May
2005 committee representatives met with Prime Minister Paul Martin and discussed the
mandate, expected outcomes of the Committee for Injured Nurses and its correspondence
with Health Canada, Human Resource Skills Development and Atlantic Opportunities
Agency. On 31 August 2005 committee members met with the PEI Minister of Health
Chester Gillan and Deputy Minister Dave Reily. From this meeting a commitment was
made by Minister Gillan that he would introduce the mandate of the Committee for
Injured Nurses to his fellow Ministers at the National Ministers Meeting. The committee
representatives will be meeting with Dr. Carolyn Bennett on 23rd September 2005 and
Prime Minister Paul Martin on 24th September 2005.
Evaluation
In the Spring of 2007, the Program shall be evaluated to determine the outcome of
learning; the implementation of policy and future safety planning; for its contribution to a
body of knowledge; for its cost effectiveness; for increased effectiveness in injury
prevention and safety promotion; and for its impact on absenteeism / injury / illness in
the workplace and retention, recruitment and morale to the health care provider
workforce.
Findings
The results shall be presented with tables, bar graphs, questionnaire report and a
power presentation on the findings. The evaluator will analyse how the context of the
program being evaluated is similar to and different than selected contexts where the
program might be adopted, and report those contextual factors that appear to have
significant influence on the program and that are likely to be of interest to anyone who
might adopt the program.
Discussion
The evaluation will address if the organization`s staff can;
·Demonstrate competence in safe workplace techniques.
·Comply with safe workplace techniques.
·Use equipment when it is provided to avoid hazardous manual lifting.
·Use equipment as instructed and for its intended purpose.
·Inform the employer of any physical condition they have which will negatively affect
his/her ability to preform workplace safety.
·Identify any new activity or equipment that requires a risk assessment.
·Identify any equipment that is broken or faulty.
Recommendations
Introduction of Safe Work Environment for Health Care Workers and Safe
Manual Handling / No Lift Policy that strongly enforces that safe workplace programs be
taught to all health care providers with follow-up regular and mandatory refresher
courses.
A Health Safety Facilitator would monitor the work environment and assess the
workplace for safety risks to both health care worker and health care recipient. High risk
work environments must be identified and health care worker and health care recipients
must be educated that preventable injury is unacceptable.
A Provincially and Federally legislated Health Care Worker Safety Act and Code
there will be a safe work environment established for health care workers and health care
recipients.
An exercise program introduced into the institution for regular exercise
strengthens muscles, decreases risk of injury develops body awareness, relaxes muscles,
energies the body, reduces physical and mental fatigue. An education program on
stretching techniques could be introduced for stretching promotes good circulation to the
muscles, helps to improve our body awareness, improves muscle coordination, promotes
muscle relaxation and decreases muscle tension, that helps to decrease the risk of injury
to the muscles tendons and joints and stretching improves joint range of movement.
Further recommendations may be to have sit / stand lifts on each unit and ceiling
lifts in each room. Further recommendations will be determined as per institutional
assessment.
The conclusions of an evaluation, which represent judgements and
recommendations must be defensible and defended. If the stakeholders do not receive
sufficient information for determining whether the conclusions are warrant, they may
disregard them also, conclusions with inadequate justifications may be incorrect thereby
leading the stakeholders to inappropriate action.
The Health Care Safety Evaluator shall solicit feedback from a variety of program
participants about the credibility of interpretations, explanations, conclusions and
recommendations before finalizing the final report to the stakeholders.
References
Edlich, E. F.,Hudson, M. A., Buschbacher, R. M.,Winters, K. L.,Britt, L. D.,Cox, M. J., Becker, D. G, McLaughlin, J. K., Gubler, K. D., Zomerschoe, T. S. P., Latimer, M. F., Zura, R.D., Paulsen, N. S., Long, W. B., Brodie, B. M., Berenson, S., Langenburg, S. E., Borel, L., Jenson, D. B., Chang, D. E., Chitwood, W. R . Jr., Roberts, T. H., Martin, M. J., Miller, A., Werner, C. L., Taylor, P.T., Lancaster, J., Kurian, M.S., Falwell, J. L. Jr., Fadwell, J. Devastating Injuries in Healthcare Workers: Description of the Crisis and Legislative Solution to the Epidemic of Back Injury from Patient Lifting. Journal of Long -Term Effects of Medical Implants, 15(2)225-241(2005).
Mc Quaid, W. E., Hardy-Adams ,C.,Cairns, D.,Nursing Survey, Federation of Nurses of Canada media release, October 17, 2003.
Nurses Association of New Brunswick, Position Statement (2005).
Shamian, J., O`Brien-Pallus, L., Kerr, M., Koehoorn, M., Effects of Job Strain Hospital Organizational Factor and Individual Characteristics or Work -Related Disability Among Nurses (2001).
Villeneuve, J., The ceiling lift: an efficient way to prevent injuries to nursing staff . J. Healthcare Safety, Complic Infect );2(1):19-23.Contr (1998);2(1):19-23
Injured nurses say they’re exposed to stress, risk of injury
CHARLOTTETOWN - A preliminary study by the Committee for Injured Nurses of Prince Edward Island found the majority - 84 per cent - felt their workplace posed greater risk of emotional or physical damage and an overabundance of stress or chance of injury.
Participants consisted of a cross section of nurses from various areas of work, such as emergency, recovery room, day surgery, intensive care, medical and surgical floors, nursery, palliative care, nursing homes, clinics and professors from the nursing school at UPEI.
The study included nurses from all there counties. Approximately 167 pages of data were returned and analysed under the direction of scientific researcher Dr. David Cairns.
When nurses who worked directly with the public were asked to rate the physical demands that are placed upon them, on a scale of one to 10, the result was an average of 7.8. However more than a quarter reported in the highest extreme (10) and 75 per cent responded in the 10-8.
The measure of mental strain was an average of nine out of 10.
An overwhelming 90 per cent of the nurses responding stressed the need for more staff and care for those now in the labour force to prevent premature retirement or a reduction in the quality of care provided.
Concerns were, for the most part, focussed on staffing needs of orderlies and ward clerks as well as other nurses, so nursing staff can apply their skills to where they can do the most good and their labours are not to be wasted.
About half of resonants felt they had appropriate time off between working shifts to mentally and physically recover.
However, 90 per cent of them didn’t feel there were appropriate support systems available.
The following are comments from some of the resonants:
"It is often expressed by the administration that they understand how overworked nurses are. What baffles me is why nurses are continuously given more and more work...I entered the nursing to be a nurse...I go home feeling that I didn’t have enough time to give the type of care my patients deserve."
"Most assessment tools for nurse/patient ratio do not account for more than the task- oriented approach (while mental, emotional, spiritual needs are not met)."
Reprinted with permission of The Journal Pioneer
