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Professional Issues and Policies in Nursing and Specialisations 

Introduction to Workplace Safety

The safety of nurses from workplace-induced illnesses and accidents is crucial both to the nurses concerned and to the patients they serve. Well-rested and healthy nurses are critical for treatment, patient satisfaction, and vigorous advocacy. Many stressors in the workplace can cause illnesses and accidents in health care professional environments. The stressors include variables that relate to the immediate job background, organizational dynamics, and developments that arise outside of the organization but within the healthcare industry (Ross et al., 2019). During their shifts, nurses face substantial psychological and physical pressures and even an unfavorable work-safety environment. The factors that are decided at an organizational level are stresses within organizations to liquidate, use nurses working under an alternative plan (pooling of staff), and return policy for patient care (higher patient loads and early discharge). The new system in which the nurse's practice includes lean-managed care contracts, the use of advanced technological technology, an aging nurse population, and the proportion of patients (age demographic) who are very sick (Armstrong, 2018). Influences at each of these levels may create risks to nurses' safety while they're at work. Factors of clinical care that affect the safety of nursing will be discussed, including the consequences of physical work environments such as patient lifting and awkward postures, protective devices to prevent needlesticks, hazardous occupational hazards, and the possibility of violence (Badri et al., 2018). Where appropriate, there will be approaches that have demonstrated success in reducing the risk of disease and injury, as well as information gaps that may inspire new policy for workplace safety.

Risks Associated with Workplace

Musculoskeletal Injuries

Impact on health care, including reform and modernization, have contributed to ever more expectations on nurses and other medical staff. Extended hours and accelerated work speed were linked to musculoskeletal injuries and disorders (MSD), with accelerated psychological and physical demands. These demands have also been shown to raise the risk of musculoskeletal pain/disorders in research and worker studies. Definitions for MSD differ, but most involve pain for a given period or intensity in the injured body area (e.g., the neck or back) with other associated symptoms such as tingling and numbness. Health care staff, in particular for back injuries, are at exceptionally high risk of MSD (Vendittelli et al., 2016).

Needlesticks

In a wide range of professions and health care environments, healthcare personnel continues to get exposed to the severe and often life-threatening risk of blood-borne infections. An estimated 600,000 to 800,000 needlestick accidents occur annually, of which approximately half go unreported. More than 1,000 healthcare workers are expected to develop a severe infection per year from a needlestick injury, such as hepatitis B or C virus or HIV (Cooke & Stephens, 2017).

Chemical Occupational Exposures

In health care settings, there are plenty of drugs and chemicals, and other dangerous materials that nurses are subjected to daily use. Harmful chemicals exposure can occur in a variety of ways from drugs used in practice, like aerosol particles, fumes, and surface pollutants. Levels of exposure can happen on an immediate basis, or up to persistent long-term exposures, based on sites of practice and applied molecules. The primary sources of entry are respiratory and dermal inside the body. According to a recent study, chemicals widely used in the healthcare environment can trigger allergies or induce asthma symptoms (Hittle et al., 2016).

Volatile Organic Compounds

Volatile organic compounds (VOCs) are substances which at room temperature evaporate rapidly, allowing the inhalation of these chemicals quickly. The fumes are normally contained in machines that either aerosolize the compounds in the air or remove the fumes from a solid base, resulting in VOCs (Su et al., 2018).

Sterilants

Glutaraldehyde and Ethylene oxide (EtO) is used widely for sterilization in the hospital setting. When appliances and work objects are washed clean, nurses as well as other medical staff are exposed. If any of these compounds are inactive or effective state, they can be associated with major human health impacts. Glutaraldehyde is known to be associated with respiratory disorders, similar to asthma, itchy skin and skin infections, and eye pain and eye infections. All the published studies of occupational asthma came from endoscopy nursing in a study of the health effects from exposure to glutaraldehyde (Ulrich & Kear, 2018).

Medications

Many drugs and chemicals that are used in household products have established toxic effects. While many drugs can be dangerous to staff, they include antineoplastics and anesthesia which are most frequently known as hazardous to health care workers. Anesthetic gases have also been described as being especially dangerous because gases flee into the atmosphere and it can be breathed by staff (Khalil & Lee, 2018). Data are also available to support the negative impacts of antineoplastic drug use, in particular an elevated incidence of spontaneous abortions among healthcare professionals. Such exposures involve cytotoxicity, genotoxicity, teratogenicity, and carcinogenicity.

Latex Exposure

Another serious problem for health care workers is latex allergy which is because of exposure to protein molecules in rubber latex. Indeed, the hazard of aerosolizing latex particulates connected to powder in rubber gloves or bursting latex balloons is of significant concern, since these exposure levels can lead to respiratory disorders (Dumas et al., 2017). These such as the use of decreased-allergen powder-free gloves and the elimination in the facility of latex-containing items from the workplace to minimize contamination at that facility. Healthcare facilities that have taken initiative for latex-free materials and they must ensure they do not enable latex to reach the building.

Mental Health Effects

Serving in healthcare raises the risk of developing minor as well as major psychiatric morbidity with the work burden that leads to this result. Minor psychological morbidity involves feelings of stress, frustration, anxiety, depressive symptoms, mental exhaustion, and sleep disruption; these are commonly categorized as burnout, subthreshold depression, or conduct disorder. Mental illnesses like severe anxiety disorders, depression, and psychological conditions are far less common, but job stress can cause or intensify them. Psychiatric morbidity correlates with several forms of treatment (Sauer & McCoy, 2017).

Violence

Workers in the emergency department often face considerable risk of patients or their families being injured from assaults. Those in hospital emergency rooms holding arms provide a potential for serious or fatal injury. California and the state of Washington have adopted requirements that include protections for staff in the emergency room. While the center of attention and study on the subject has been on mental disorders and hospital emergency rooms, no division within a health care environment is exempt from violence at the workplace. Abuse reduction services will also be of benefit to all agencies (Shea et al., 2017).

Policies for Workplace Safety

Patient protection is important and cannot be overlooked — and the protection of nurses in work cannot be overlooked either. Nurses and midwives are committed to a secure and healthy environment and if injured on the job, to reimbursement and recovery. The ANMF expects employers to ensure that workers' work health and safety, and calls for all governments to adopt and implement legislation that provides for the highest standards of workplace safety (Fedele, 2017). the Bureau of Labor Statistics reported unique health care settings, such as hospitals and long-term care facilities, for every 100 full-time workers had a cumulative case rate of 6.4 work-related accidents and illnesses. Knowledge of the effects of exposure to contaminants and pollutants has prompted intervention in healthcare settings to reduce certain exposures. Promoting the use of safer options as a way of limiting exposures has gained popularity. Resources are available to support activists and decision-makers (Fedele, 2017).

Occupational Health and Safety

The Australian Nursing and Midwifery Federation's (ANMF) policy is that the midwives, nurses, and nursing assistants have all the freedom to live in a professional and secure working atmosphere and conduct their jobs with no threat to the physical and psychological health and security. The policies also state that workers have occupational safety and health rights, and they are protected by applicable occupational health and safety laws and related legislation, through codes and regulations of practice. Mitigation of injury, disease, and infection has to be the first goal of workplace health and safety according to this proposal. Governments must have a sufficiently resourced regulator to implement effective occupational health and safety standards (Aljabri et al., 2020).

Employers must provide employees with securely designed premises, work environments, installations, fittings, facilities, and work systems. The nursing staff should be provided with safe plants and substances and facilitate the safe use, handling, storage, and transportation of plants and toxins. Employers are also required to develop policies and procedures, programs, and work systems to prevent hazards, assess risk levels of those working with them. Remove or minimize hazards at the source following the control hierarchy or otherwise enforce the most appropriate hazard management strategies before last resort steps are enforced, such as the availability of protective gear (Reese, 2018).

Policies for Hazardous Manual Tasks

All workers are entitled to work inside a workplace where dangerous manual activities are eliminated or reduced to the extent reasonably feasible. The layout and design of buildings, furniture, fixtures, and fittings are beneficial to healthy work practices in manual handling. Sufficient manual handling equipment, aids, and furniture are accessible and in good condition managed. The policy also stresses the required staffing ratios and skill mix to promote the safe management of work activities and training in recognizing hazardous manual tasks. It provides for performing risk management and establishing healthy work practices (Power & Coyne, 2018).

Policies for Bloodborne Pathogens and Other Infectious Diseases

All workers have the right to protection from body and blood contaminants and this safety requires appropriate safeguards like safe construction personal protective equipment and nurses from use. The nursing staff must be shielded whenever possible from sharp objects, including the use of needle-free systems and detachable needles. Vaccination for infectious diseases where vaccines are available needs to be given to the nursing staff. Regulation and guidelines on infection prevention should discuss concerns related to diseases born in the blood (Hoftman, 2017). All health systems must follow and maintain healthy blood and body fluid handling procedures by supplying nurses with information, policies, and tools, and by implementing normal and additional protocols for the treating of both blood and other body fluids. Employers should encompass nurses in developing policies, procedures, and controls to control infections, and achieve consistent policy development processes are in place (Kommogldomo, 2016). Employers must have the tools necessary to allow workers to enforce successful infection control laws, policies, and procedures, such as the use of regular and specific measures.

Policies for Hazardous Substances

According to this regulation, all workers have the right to be vaccinated from dangerous chemicals, including glutaraldehyde, peracetic acid, formaldehyde, latex, and cytotoxic medicines. Workers should ensure they obtain sufficient information on contaminants they may be subjected to and related risks, such as accessibility (including online) to danger reports, material safety data sheets, and monitoring systems. The hospital should introduce appropriate risk management policies related to the use of hazardous materials. Personnel must be equipped with personal protective equipment for use in the handling of hazardous substances and properly qualified in the use of hazardous substances and performing controls like wearing PPE. Management and the staff should be briefed on work procedures, options for personal protective equipment, health protection, and other hazardous material use concerns (Gul et al., 2017).

Evaluation of The Outcome of The Policy

The Hospital Evaluation Method, released by the Occupational Safety and Health Administration, recommends that healthcare professionals should devise recommendations for assessing the performance of the enterprise health and safety management system. It is critical that management includes both managers and staff in relevant decision-making processes and conduct frequent overall organizational assessments to promote compliance with health and safety protocols. A complex measure of whether an entity has achieved expected results is generated by frequent reviews (Pousette et al., 2017). Administrators may also use this knowledge to change organizational policies according to need. Employees and managers need to recognize their positions in safety at the company. In parallel to educating each new worker on hospital protection, supervisors should periodically update members of staff on changes in policy related to it. Employees will need to consider the roles involved in ensuring patient safety. Besides, each medical institution should outline clearly the safety rules and regulations. Employees need to feel confident in expressing complaints. Efficient security training also provides assurances that managers can gather information with objectivity, along with a clearly outlined process for handling and documenting matters (Wagner et al., 2019).

As a result of occupational safety issues, Healthcare staff are almost four times more likely to get injured and take days off work than all private-sector workers combined. Several states have implemented legislation to address occupational safety concerns by introducing policies to eliminate workplace injuries targeting health-care workers. Both health-care systems provide workplace facilities and policies. Although inpatient hospital systems have gained significant publicity in terms of policies and facilities, it is recognized that other environments such as home care, learning centers, and hospice care have detrimental effects on occupational intervention programs (Morphet et al., 2018). The policies were analyzed to determine the main obstacles to successful workplace prevention initiatives in hospitals. As a first step towards a deeper understanding of obstacles to successful occupational injury reduction strategies in groups of nurses and related health care practitioners. Although many of these barriers to the successful implementation of occupational safety programs are both within the program itself and apply to larger business and societal concerns, innovative approaches will help to resolve these problems and strengthen safety and prevention programs (Baylina et al., 2018).

Conclusion on Workplace Safety

The relationship between job patterns and safety and health is complex and is affected by work times features as well as career, employee, and workplace environment dynamics. The emphasis in this essay has been on the major accidents and work nurses' safety steps. Some of these concerns have been thoroughly studied, with systematic evidence-based research for epidemiology and prevention possible, while others have yet to be explored and identified. As suggested, while several lifestyle factors have yet to be discussed, there is tremendous potential for avoiding nurse injury. The benefits of improving nurse safety are significant both for retaining nurses and for bringing new nurses into the profession. Given that many hospitals require significant financial investment and system-level improvements to improve patient safety, these measures also need to be employed to enhance worker safety. The ANMF expects employers to ensure that workers' work health and safety, and calls for all governments to adopt and implement legislation that provides for the highest standards of workplace safety. These reforms would also benefit patients in the long run, as steps taken to increase safety for nurses could lead to a happier and more sustainable workforce. The policies of workplace safety are used to analyze or determine the main obstacles to successful workplace prevention initiatives in hospitals. As a first step towards a deeper understanding of obstacles to successful occupational injury reduction strategies in groups of nurses and related health care practitioners.

References for Workplace Safety

Aljabri, D., Vaughn, A., Austin, M., White, L., Li, Z., Naessens, J., & Spaulding, A. (2020). An investigation of healthcare worker perception of their workplace safety and incidence of injury. Workplace Health & Safety68(5), 214-225.

Armstrong, N. (2018). Management of nursing workplace incivility in the health care settings: A systematic review. Workplace Health & Safety66(8), 403-410.

Badri, A., Boudreau-Trudel, B., & Souissi, A. S. (2018). Occupational health and safety in the industry 4.0 era: A cause for major concern?. Safety science109, 403-411.

Baylina, P., Barros, C., Fonte, C., Alves, S., & Rocha, Á. (2018). Healthcare workers: Occupational health promotion and patient safety. Journal of Medical Systems42(9), 159.

Cooke, C. E., & Stephens, J. M. (2017). Clinical, economic, and humanistic burden of needlestick injuries in healthcare workers. Medical Devices (Auckland, NZ)10, 225.

Dumas, O., Wiley, A. S., Quinot, C., Varraso, R., Zock, J. P., Henneberger, P. K., & Camargo, C. A. (2017). Occupational exposure to disinfectants and asthma control in US nurses. European Respiratory Journal50(4).

Fedele, R. (2017). Leaders of the pack: Our commited ANMF REPS. Australian Nursing and Midwifery Journal25(4), 16.

Gul, M., Ak, M. F., & Guneri, A. F. (2017). Occupational health and safety risk assessment in hospitals: A case study using two-stage fuzzy multi-criteria approach. Human and Ecological Risk Assessment: An International Journal23(2), 187-202.

Hittle, B., Agbonifo, N., Suarez, R., Davis, K. G., & Ballard, T. (2016). Complexity of occupational exposures for home health‐care workers: Nurses vs. home health aides. Journal of Nursing Management24(8), 1071-1079.

Hoftman, M. M. (2017). U.S. Patent No. 9,750,891. Washington, DC: U.S. Patent and Trademark Office.

Khalil, H., & Lee, S. (2018). Medication safety challenges in primary care: Nurses’ perspective. Journal of Clinical Nursing27(9-10), 2072-2082.

Kommogldomo, E. D. (2016). Needle stick and sharps injuries among health care workers at the 37 Military Hospital (Doctoral dissertation, University of Ghana).

Morphet, J., Griffiths, D., Beattie, J., Reyes, D. V., & Innes, K. (2018). Prevention and management of occupational violence and aggression in healthcare: A scoping review. Collegian25(6), 621-632.

Pousette, A., Larsman, P., Eklöf, M., & Törner, M. (2017). The relationship between patient safety climate and occupational safety climate in healthcare–A multi-level investigation. Journal of Safety Research61, 187-198.

Power, L. A., & Coyne, J. W. (2018). ASHP guidelines on handling hazardous drugs. American Journal of Health-System Pharmacy75(24), 1996-2031.

Reese, C. D. (2018). Occupational health and safety management: a practical approach. CRC press.

Ross, C., Rogers, C., & King, C. (2019). Safety culture and an invisible nursing workload. Collegian26(1), 1-7.

Sauer, P. A., & McCoy, T. P. (2017). Nurse bullying: Impact on nurses’ health. Western Journal of Nursing Research39(12), 1533-1546.

Shea, T., Sheehan, C., Donohue, R., Cooper, B., & De Cieri, H. (2017). Occupational violence and aggression experienced by nursing and caring professionals. Journal of Nursing Scholarship49(2), 236-243.

Su, F. C., Friesen, M. C., Stefaniak, A. B., Henneberger, P. K., LeBouf, R. F., Stanton, M. L., & Virji, M. A. (2018). Exposures to volatile organic compounds among healthcare workers: Modeling the effects of cleaning tasks and product use. Annals of Work Exposures and Health62(7), 852-870.

Ulrich, B. T., & Kear, T. M. (2018). The health and safety of nephrology nurses and the environments in which they work: Important for nurses, patients, and organizations. Nephrology Nursing Journal45(2), 117-139.

Vendittelli, D., Penprase, B., & Pittiglio, L. (2016). Musculoskeletal injury prevention for new nurses. Workplace Health & Safety64(12), 573-585.

Wagner, A., Rieger, M. A., Manser, T., Sturm, H., Hardt, J., Martus, P., & Hammer, A. (2019). Healthcare professionals’ perspectives on working conditions, leadership, and safety climate: A cross-sectional study. BMC Health Services Research19(1), 1-14.

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