Promoting a Promoting a Healthy WorkplaceHealthy Workplace

1. Recognize threats to safety in workplace.1. Recognize threats to safety in workplace. 2. Compare agencies responsible for 2. Compare agencies responsible for

overseeing safety in the workplace.overseeing safety in the workplace. 3. Identify various potential hospital 3. Identify various potential hospital

hazards.hazards. 4. Discuss the objectives and steps in the 4. Discuss the objectives and steps in the

development of a workplace safety programdevelopment of a workplace safety program 5. Discuss the risk factors associated with 5. Discuss the risk factors associated with

violence in the workplace.violence in the workplace. 6. Describe methods of dealing with 6. Describe methods of dealing with

violence in the workplace.violence in the workplace. 7. Identify negative organizational 7. Identify negative organizational

outcomes due to workplace violence.outcomes due to workplace violence. 8. Identify steps that may be taken to 8. Identify steps that may be taken to

increase protection from workplace violence.increase protection from workplace violence.

9. Discuss the actions to be taken if 9. Discuss the actions to be taken if violence does occur in the workplace.violence does occur in the workplace.

10. Explain situations that may reflect 10. Explain situations that may reflect sexual harassment.sexual harassment.

11. Demonstrate how to communicate 11. Demonstrate how to communicate harassment appropriately and actions harassment appropriately and actions to be taken.to be taken.

12. Explore the issues related to latex 12. Explore the issues related to latex allergies.allergies.

13. Examine the employer and 13. Examine the employer and employee responsibilities related to the employee responsibilities related to the issue of needlestick injuries in the issue of needlestick injuries in the workplace.workplace.

14. Discuss ergonomic and repetitive 14. Discuss ergonomic and repetitive stress injuries in the workplace.stress injuries in the workplace.

15. Examine the issue of impaired 15. Examine the issue of impaired workers in the workplace.workers in the workplace.

16. Discuss how the nurse can 16. Discuss how the nurse can enhance the quality of work life.enhance the quality of work life.

17. Identify the role of the nurse in 17. Identify the role of the nurse in dealing with terrorism attacks.dealing with terrorism attacks.

18. Discuss cultural diversity in 18. Discuss cultural diversity in health-care organizations.health-care organizations.

19. Apply concepts related to 19. Apply concepts related to workplace issues, and critical thinking workplace issues, and critical thinking to client scenarios and NCLEX-style to client scenarios and NCLEX-style questions.questions.

Environmental hazardsEnvironmental hazards Physical safetyPhysical safety Emotional safetyEmotional safety

Occupational Safety and Health Occupational Safety and Health Administration (OSHA)Administration (OSHA)

Centers for Disease Control and Centers for Disease Control and Prevention (CDC)Prevention (CDC)

National Institute for National Institute for Occupational Safety and Health Occupational Safety and Health (NIOSH)(NIOSH)

American Nurses Association American Nurses Association (ANA)(ANA)

Joint Commission on the Joint Commission on the Accreditation of Healthcare Accreditation of Healthcare Organizations (JACHO)Organizations (JACHO)

Institute of Medicine (IOM)Institute of Medicine (IOM)

Workplace programsWorkplace programsSafety planSafety plan

Consult federal, state, and local Consult federal, state, and local governmentsgovernments

Distinguish between real and Distinguish between real and imagined riskimagined risk

Seek administrative supportSeek administrative support Calculate costs of programCalculate costs of program

Identify potential hazardIdentify potential hazard Assess degree of riskAssess degree of risk Develop a planDevelop a plan Implement the programImplement the program

Social issueSocial issue High rate of assaults on hospital High rate of assaults on hospital

workersworkersThreatsThreatsPhysical assaultsPhysical assaultsMuggingsMuggings

Situations that increase Situations that increase workers’ susceptibilityworkers’ susceptibilityRoutine contact with the publicRoutine contact with the publicWorking alone or in small numbersWorking alone or in small numbersWorking lateWorking latePoor securityPoor security

Situations that increase Situations that increase workers’ susceptibilityworkers’ susceptibilityPatients and families who carry Patients and families who carry weapons weapons

Lack of experienced staff membersLack of experienced staff membersUnits and patients that need Units and patients that need seclusion or restraint activitiesseclusion or restraint activities

Does violence in the surrounding Does violence in the surrounding community affect my workplace?community affect my workplace?

Does the layout of the facility Does the layout of the facility invite violence?invite violence?

Is there a prompt response by Is there a prompt response by administration to violence?administration to violence?

Are incidents being reported Are incidents being reported and addressed by management?and addressed by management?

Would training that deals with Would training that deals with workplace violence be adequate workplace violence be adequate for employees and for employees and management?management?

Which types of patients are Which types of patients are more prone to violence?more prone to violence?

History of violent behaviorHistory of violent behavior

Delusional, paranoid, or Delusional, paranoid, or suspicious speechsuspicious speech

Aggressive and threatening Aggressive and threatening statementsstatements

Rapid speech and angry tone of Rapid speech and angry tone of voicevoice

Stiff posture, clenched fists, tight Stiff posture, clenched fists, tight jaw jaw

Alcohol/drug useAlcohol/drug use

Male gender or a youthMale gender or a youth

Unrealistic policiesUnrealistic policies

Victim genderVictim gender Women receive more blame than menWomen receive more blame than men

Subject genderSubject gender Female victims receive a greater amount of Female victims receive a greater amount of

blame from women than from men blame from women than from men

SeveritySeverity The more severe the assault, the more The more severe the assault, the more

often the victim is blamedoften the victim is blamed  

BeliefsBeliefs The world is a just place; therefore, the The world is a just place; therefore, the

person deserves the misfortuneperson deserves the misfortune

Age of VictimAge of Victim The older the victim, the more he or she is The older the victim, the more he or she is

held responsible for the assaultheld responsible for the assault

Look for clues indicating Look for clues indicating potential violencepotential violence

Call patients, family members, Call patients, family members, and visitors by their namesand visitors by their names

Encourage the patient or the Encourage the patient or the patient’s family to vent angerpatient’s family to vent anger

If you feel uncomfortable, trust If you feel uncomfortable, trust your intuitionyour intuition

Know your institution’s Know your institution’s policies and procedurespolicies and procedures

Ongoing prevention programOngoing prevention program

Report all violent incidentsReport all violent incidents

Hold all patients, visitors, staff Hold all patients, visitors, staff members, and management members, and management accountable for their behavioraccountable for their behavior

Adopt a zero-tolerance policyAdopt a zero-tolerance policy

Assess the workplace regularlyAssess the workplace regularly Be alert for suspicious behaviorBe alert for suspicious behavior Maintain behavior that helps to Maintain behavior that helps to

defuse angerdefuse anger If situation escalates, remove self If situation escalates, remove self

and call securityand call security Know your clientsKnow your clients

Report situation to supervisorReport situation to supervisor Call the policeCall the police Get medical attentionGet medical attention Contact collective bargaining or Contact collective bargaining or

state nurses associationstate nurses association Participate in policymakingParticipate in policymaking

Pressuring another to participate in Pressuring another to participate in sexual activitiessexual activities

Asking another person about his or Asking another person about his or her sexual activities, fantasies, or her sexual activities, fantasies, or preferencespreferences

Making sexual innuendos, jokes, Making sexual innuendos, jokes, comments, or suggestive facial comments, or suggestive facial expressions to another personexpressions to another person

Continuing to ask for a date after the Continuing to ask for a date after the other person has expressed disinterestother person has expressed disinterest

Making sexual gestures with hands or Making sexual gestures with hands or body movements or showing sexual body movements or showing sexual graffiti or visualsgraffiti or visuals

Making remarks about a person’s Making remarks about a person’s gender or bodygender or body

Two forms of sexual harassment Two forms of sexual harassment areare

1.1. Quid pro quoQuid pro quo2.2. A hostile environmentA hostile environment

Fight sexual harassment per Fight sexual harassment per American Nurses Association (ANA)American Nurses Association (ANA)

ConfrontConfront ReportReport DocumentDocument SupportSupport

Contact dermatitis (most Contact dermatitis (most common)common)

Generalized hivesGeneralized hives UrticariaUrticaria RhinitisRhinitis WheezingWheezing AnaphylaxisAnaphylaxis

Reducing unnecessary exposureReducing unnecessary exposure Using alternative gloves (nitrile)Using alternative gloves (nitrile) Employee education programsEmployee education programs Identifying workers at riskIdentifying workers at risk

Passed in 2001Passed in 2001

Revised blood-borne Revised blood-borne pathogens standardspathogens standards

Obligates employers to Obligates employers to consider safer needle devicesconsider safer needle devices

Always use universal Always use universal precautionsprecautions

Use and dispose of sharps Use and dispose of sharps properlyproperly

Get immunized against hepatitis Get immunized against hepatitis BB

Report all exposuresReport all exposures Know the human Know the human

immunodeficiency virus/hepatitis immunodeficiency virus/hepatitis B virus (HIV/HBV) status of your B virus (HIV/HBV) status of your patientpatient

Comply with post exposure Comply with post exposure follow-upfollow-up

Support others who have been Support others who have been exposedexposed

Become active in safety Become active in safety committeescommittees

Educate othersEducate others

Participate in safety committeesParticipate in safety committees

Work in teams; do not be afraid Work in teams; do not be afraid to ask for helpto ask for help

Use transfer and lifting Use transfer and lifting equipmentequipment

Do back exercisesDo back exercises

Usually affects individuals who Usually affects individuals who spend long hours at computersspend long hours at computers

Most common injury is carpal Most common injury is carpal tunnel syndrometunnel syndrome

Mouse elbowMouse elbow Badly designed computer stations Badly designed computer stations

present the highest riskpresent the highest risk

Monitor placementMonitor placement Keyboard alignmentKeyboard alignment Mouse positionMouse position Body alignmentBody alignment Vary tasksVary tasks Use fingertips when typingUse fingertips when typing Keep fingernails shortKeep fingernails short

Witnessing an employee Witnessing an employee consuming alcohol or other consuming alcohol or other substances on the jobsubstances on the job

Apparent in employee’s dress, Apparent in employee’s dress, appearance, posture, and gesturesappearance, posture, and gestures

Employee’s use of slurred speech Employee’s use of slurred speech and abusive/incoherent languageand abusive/incoherent language

Reports from Reports from patients/coworkerspatients/coworkers

Witnessing unprofessional Witnessing unprofessional employee conductemployee conduct

Employee has significant lack Employee has significant lack of attention to detailof attention to detail

Witnessing an employee Witnessing an employee stealing controlled substancesstealing controlled substances

Most employers and 37 boards Most employers and 37 boards of nursing have strict of nursing have strict guidelinesguidelines

INPs conducted by boards of INPs conducted by boards of nursing work with employers nursing work with employers to assist impaired nursesto assist impaired nurses

Compassion from coworkers is Compassion from coworkers is of utmost importanceof utmost importance

Nurses need to uphold the Nurses need to uphold the standards of their professionstandards of their profession

Ignoring substance abuse Ignoring substance abuse places clients and other nurses places clients and other nurses in dangerin danger

It is important to “help a It is important to “help a colleague obtain help”colleague obtain help”

SARSSARS TuberculosisTuberculosis

MDR-TBMDR-TB

Rotating shiftsRotating shifts Mandatory overtimeMandatory overtime Staffing ratiosStaffing ratios

Most employers have policies Most employers have policies regarding reporting behaviors regarding reporting behaviors that affect the workplace that affect the workplace environmentenvironment

Code for NursesCode for Nurses (2001) is (2001) is specific regarding this specific regarding this responsibilityresponsibility

Endangering a client’s health Endangering a client’s health or safetyor safety

Abuse of authorityAbuse of authority

Violation of rules, regulations, Violation of rules, regulations, or standards of professional or standards of professional ethicsethics

Gross waste of fundsGross waste of funds

Describes an employee who Describes an employee who reports employer violations reports employer violations to an outside agencyto an outside agency

Do not assume “doing the Do not assume “doing the right thing” will protect youright thing” will protect you

Gather the factsGather the facts Does the practice violate any Does the practice violate any

actual law?actual law? Know the state law requiring Know the state law requiring

mandatory reportingmandatory reporting Type your documentation and Type your documentation and

include day, date, time, and include day, date, time, and circumstancescircumstances

Identify witnessesIdentify witnesses Do not breach confidentiality Do not breach confidentiality

in any wayin any way Send a copy of your complaint Send a copy of your complaint

to the CNO or nursing to the CNO or nursing department or any other department or any other department affecteddepartment affected

Utilize the ethics committee of Utilize the ethics committee of your institutionyour institution

Keep copies of your recordsKeep copies of your records

Know the evacuation procedures Know the evacuation procedures and routes in your facilitiesand routes in your facilities

Develop your knowledge Develop your knowledge regarding the most likely and regarding the most likely and most dangerous biological most dangerous biological weaponsweapons

Monitor for unusual disease Monitor for unusual disease patternspatterns

Know the back-up systems for Know the back-up systems for communication and staffingcommunication and staffing

Social environmentSocial environmentWorking relationshipsWorking relationshipsSupport your peers and supervisorsSupport your peers and supervisors

Involvement in decision-makingInvolvement in decision-making

Professional growth and innovationProfessional growth and innovation Encourage critical thinkingEncourage critical thinking Seek educational opportunitiesSeek educational opportunities Encourage new ideasEncourage new ideas Reward professional growthReward professional growth

CommunicationCommunication

SpaceSpace

Social organizationSocial organization

TimeTime

Environmental controlEnvironmental control

Biological variationsBiological variations

Personnel reflect the current and Personnel reflect the current and potential population that the potential population that the organization servesorganization serves

Silence and gestures are respectedSilence and gestures are respected

Awareness of special family and Awareness of special family and holiday celebrationsholiday celebrations

Individuals first; culture secondIndividuals first; culture second

Be aware of and sensitive to Be aware of and sensitive to your own culture-based your own culture-based preferencespreferences

Explore your own biases and Explore your own biases and valuesvalues

Be knowledgeable about other Be knowledgeable about other culturescultures

Be respectful of and sensitive to Be respectful of and sensitive to diversity among individualsdiversity among individuals

Be skilled in using and selecting Be skilled in using and selecting culturally sensitive intervention culturally sensitive intervention strategiesstrategies

DO DON’T

Recognize diversity Pretend everyone is alike

Value diversity Expect everyone to conform to the prevailing culture

Develop informal supports Seek a quick solution

Ensure fairness Develop different standards of performance

Make the preceding principles an integral part of your philosophy

Expect one workshop to solve the problem

Leadership and planningLeadership and planning

Delivery systemDelivery system

Legislation/regulation/policyLegislation/regulation/policy

Professional/nursing cultureProfessional/nursing culture

Recruitment/retentionRecruitment/retention

Economic valueEconomic value

Work environmentWork environment

Public relations/communicationPublic relations/communication

EducationEducation

DiversityDiversity

Workplace safety is a Workplace safety is a growing concerngrowing concern

IOM and JCAHO will continue IOM and JCAHO will continue to impact workplace safety to impact workplace safety issuesissues

Support the ANASupport the ANA