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Executive Summary
It is no secret that the healthcare industry is one of the most dangerous ones due to the high prevalence of potentially harmful organisms, chemicals, and other hazards. this formal research report aims to catalog the four most common forms of risks that nurses confront on the job and then describe strategies for dealing with these dangers. Data on occupational health and safety and associated risks were culled from authoritative sources, such as nursing organizations and scholarly journals. Subtraction yielded four main classes: chemical, physical, psychological, and biological dangers. Such incidents are major setbacks for the nursing profession and pose a serious threat to patient safety.
Employers in the healthcare industry have a pivotal role in enforcing OHS policies and procedures in the workplace. To that end, healthcare industry employers’ proposed courses of action were debated. The need to monitor hazards and report incidents, as well as establish a culture of safety in the workplace, was stressed. The greatest standard of OHS can only be maintained by the implementation of a comprehensive training program for all nursing personnel. Many options for reducing chemical and environmental risks in the workplace were offered. Chemical, microwave, pyrolysis, and personal protective equipment (PPE) methods were among the unique approaches offered for disinfection and reprocessing. For nurses to work safely, employers must demonstrate a commitment to cutting-edge practices for identifying and mitigating risks.
Introduction
According to the International Council of Nurses (ICN, 2017), every nurse should be able to perform their job without fear of becoming sick or hurt on the job. Forecasting, recognizing, assessing, and managing hazards occurring in or from the workplace that could affect the overall health of workers, with due regard for the impact on neighboring communities and the general atmosphere, is what occupational health and safety is all about (Fan et al., 2019). Nurses frequently face health risks due to the prevalence of dangerous substances in the healthcare sector, which is widely regarded as one of the most hazardous work environments. Stress and discontent at work are exacerbated by diseases and injuries sustained on the job. This can lead to greater turnover rates, which in turn increases demands on the nursing staff and aggravates the scarcity. Many parties, including nurses, patients, families, communities, healthcare organizations, and healthcare delivery systems, stand to benefit from safeguarding nurses’ health and safety. Quality healthcare delivery and increased employment stability can only be achieved through the creation of secure workplaces for healthcare workers.
There is no healthcare-specific occupational health and safety law in all nations. In other cases, there simply needs to be more or any mechanisms in place to keep an eye on how well it is being put into practice or to hold scoffing employers accountable when they slip up. Moreover, the majority of governments do not routinely collect data on the frequency of accidents, injuries, and illnesses suffered by nursing employees and other healthcare workers. Increasing knowledge and understanding of the importance of nurse practitioners’ workplace safety is an immediate need. This study aims to highlight the four most significant threats to nurse practitioners’ health in the workplace and discuss methods for mitigating chemical and environmental hazards.
Common Occupational Hazards Experienced by Nurses
Although it takes much dedication, the nursing profession is crucial since it deals with the health and, more importantly, the life of patients and the public as a whole. High rates of injury and illness suffered on the job continue to be reported by nurses despite being aware of and prepared for the various potential risks they face in the course of their work. Due to the nature of their work, nurses are frequently exposed to potentially life-threatening workplace dangers. Walton and Rogers (2017) state that occupational health hazards in the healthcare industry include biological, physical, chemical, and psychosocial risks.
Biological Hazards
When nurse practitioners perform an invasive treatment, treat a wound, or collect a sample of body fluid, they risk contracting a disease. When nurses and nursing aides take care of patients who are unable to care for themselves or undergo clinical testing, they are frequently exposed to biological dangers. Nurses and other healthcare workers can be exposed to biological risks in the hospital environment through various tasks, including sanitizing, disinfecting, moving hazardous equipment, and working in infected locations.
Dangers from biological sources include any pathogens that could be spread by direct patient-to-patient contact or through the exchange of bodily fluids. Bloodborne, droplet, airborne, fecula-oral, and contact transmissions are the most common in healthcare facilities (Sacadura-Leite et al., 2018). Percutaneous sharp injuries caused by a contaminated needle or other sharp instrument are the most common way that healthcare workers contract blood pathogens like the hepatitis B, C, and D viruses or human immunodeficiency virus (HIV) while on the job (Walton & Rogers, 2017). Accidental contact with plasma or other biological fluids through a worker’s injured skin or mucous membranes is another potential method of transmission. Infected individuals can spread the Ebola virus through explicit or implicitly contacting with bodily fluids (Sacadura-Leite et al., 2018). Patients with tuberculosis of the respiratory system expel microscopic droplets or droplet nuclei into the air through coughs, sneezing, and talking, where they can linger for a long time and be carried by air masses (Sacadura-Leite et al., 2018). The risk of Mycobacterium tuberculosis, which causes tuberculosis, spreading from patient to healthcare provider is well-known.
Physical Hazards
While transporting patients between rooms, repositioning them on hospital beds, and other similar tasks, nurse practitioners are frequently exposed to lifting and holding patients. There is a danger of hurting one’s back or some other joint or section of one’s body if one does this. As with any nursing profession, home health care nurses are vulnerable to physical harm on the job as they support the patient with routine tasks. Needlestick injuries are only one example of the physical risks that nurses face on the job, which can lead to the spread of infection (Denge & Rakhudu, 2022). Nurse practitioners face a variety of physical risks on the job, including those related to electricity/fire, temperature extremes, noise, and radiation. Absorption of laser radiation, for instance, can cause thermal harm to bodily tissue because laser therapy causes the tissue to overheat (Walton & Rogers, 2017). Injuries to the eyes are the most prevalent side effect of laser operations, but skin burns and electric shock are also possible.
Psychological Hazards
All potential threats, including those to one’s mental health, must be accounted for. Nurses face a number of psychosocial risks on the job, including concerns regarding exposure to potentially harmful substances, fear of physical harm, an excessive workload, a lot of responsibility, being treated poorly by superiors, and being bullied by peers (Walton & Rogers, 2017). There are a number of unpleasant conditions, including understaffing, a lack of supervisory support, long hours, multiple shifts, physical exertion, and sexual harassment (Walton & Rogers, 2017). Many of these risks may also be considered organizational variables, but they all contribute to the stress and mental health problems that employees face on the job.
Harmful behavior through attitudes acts, and words aimed at workers by coworkers is a common kind of horizontal violence. An analogous term is bullying, which refers to the repetitive, harmful mistreatment of one or more persons by one or more perpetrators through verbal abuse, threats, humiliation, or offensive behaviors or deeds (Walton & Rogers, 2017). Injuries are much more likely to occur when working overtime is mandatory and is required on a regular basis. The problem of sexual harassment and violence against nurses is multifaceted, and it has evolved into an occupational hazard. Nurses are more likely than other workers to be subjected to offensive behavior on the job (Kahsay et al., 2020). The highest percentage of sexual harassment occurs in the nursing profession because of the close proximity that nurses must maintain with patients and other staff members, and it is experienced by one in four nurses (Kahsay et al., 2020). Sexualizing and harassment are happening to the group that looks to be in the greatest danger of workplace incivility, those whose professional duty is to care for others.
Chemical Hazards
Healthcare facilities often house a variety of potentially dangerous chemicals that could harm those who are exposed to them. Treatment of patients, as well as cleaning, disinfecting, and sterilizing surfaces, equipment, and tools, all rely on these chemicals. A wide variety of chemicals, as well as germs and viruses, can be found in the surgical smoke produced by lasers and electrosurgical instruments. Nurses may be exposed to chemicals such as those found in antibiotics, chemotherapeutic drugs, antiseptics, ethylene oxide, formaldehyde, bleaches, rubber goods, cleaning supplies, soaps, detergents, and solvents while on the job (Walton & Rogers, 2017). During liquid chemotherapy spills, nurses might be exposed through inhalation, dermal touch, and ingestion. Workers in the medical field are often tested positive for antineoplastic medications concentration, indicating that these environments can be chemically hazardous.
Occupational Health and Safety Practices
Hospital Responsibilities
It is the employer’s obligation to supply and maintain, to the fullest extent feasible, a working atmosphere free from hazards to employees’ health. The “Occupational Health and Safety Team” is responsible for a variety of tasks inside the facility, including risk evaluation, monitoring and surveillance of employee health, and dissemination of relevant information. Nurses’ accounts, however, suggested that the hospital’s “Work Health and Safety Board,” part of the Employee Health and Safety Department, was not meeting its responsibilities (Denge & Rakhudu, 2022). Therefore, it is imperative that all healthcare facilities emphasize culture and management of safety. One’s personal beliefs, as well as those of one’s peers and superiors, all have an impact on an organization’s safety culture. When discussing safety management, it is important to make reference to the established procedures and assigned duties that make up the safety monitoring system. With a strong emphasis on safety work and assessment procedures, an organization may maintain and improve a secure performance.
The International Council of Nurses (ICN, 2017) also emphasizes the role healthcare employers should play in the occupational health and safety of nurses. This necessitates abiding by all applicable statutes, rules, and recent instructions about workplace safety. Having enough people on staff, reasonable workloads, supportive management, and capable leadership all contribute to productive workplaces. In order to reduce the number of accidents, injuries, and infections that occur on the job, it is the responsibility of employers to create and implement programs to assess potential health risks in the workplace. In order to achieve the best possible results, it is imperative that all employees have free, unrestricted access to PPE (ICN, 2017). Developing or facilitating accessible, secure, and efficient reporting methods is another strategy for reducing adverse health outcomes. Employers in the healthcare industry should prioritize providing their staff with education on how to identify, evaluate, and control potential risks on the job.
In light of these concerns, businesses should conduct a more in-depth analysis of the efficiency of complying with legislation pertaining to safety programs. It implies assessing the effectiveness of these measures in terms of foreseeing, avoiding, and dealing with potential, in addition to monitoring the effects of non-compliance on daily performance in occupational health and safety management. That is why governments and businesses alike need to work toward better working conditions by creating guidelines and regulations that encourage compliance. During the same timespan, researchers should be developing scientific studies that focus on the interaction between legislators and practitioners in health and safety management during the process of legal standard adoption.
Training Programme
For nurses to be able to perform their jobs safely, their employers must provide ongoing training on the many potential dangers they may encounter on the job and how they may help reduce those risks. This viewpoint suggests that OHS knowledge is valuable and can be utilized when businesses aim to reduce the incidence of workplace injuries. The inference is that workers will be better able to avoid injuries on the job if they are taught about occupational health and safety risks. Furthermore, administrative counseling and education on how to cope with such threats on the job would be beneficial for healthcare personnel. This fits in with the conclusion that organizations that invest in their nurses by providing them with training and advancement opportunities are the safest work environments (Denge & Rakhudu, 2022). Nurses need a pleasant and secure workplace that prioritizes their well-being rather than simply expecting them to get work done.
Strategies for Mitigating Chemical and Environmental Hazards
Increasing pollutants continue to come from bio-medical waste (BMW), which is produced during medical procedures such as the diagnosis, therapy, and vaccination of disease, as well as during biomedical research activities conducted on animals (Datta et al., 2018). Iodinated contrast media, pharmaceutical residues, active components of medications, etc., are all examples of medicine excreted by patients. Infectious, hazardous wastes account for about 15% of BMW’s total volume (Ilyas et al., 2020). A nurse practitioner’s safety is seriously threatened by the inappropriate disposal of hazardous biomedical waste (HBMW). That is why it is crucial to have a solid waste management plan in place and to use proper sanitation and disposal measures—especially during a Covid-pandemic.
Disinfection and Reprocessing Techniques
Chemical Disinfection
When combined with mechanical processing, the chemical disinfection method is commonly used to treat waste. Disinfectants used in-house or on-site have the power to remove virus spores, allowing for efficient virus management. Benefits such as low appropriate dosage, stability, speed, and a wide sterilizing range are inherent to this method. In addition to being highly successful in killing microorganisms, chemical disinfectants can also inactivate bacterial spores, meaning that their usage leaves no residual dangers (Wang et al., 2020). This method has a wide range of sterilizing potential and a fast and steady performance. When used in hospitals, it can protect nurses from harmful chemicals and prevents the spread of infectious diseases.
Microwave Disinfection
This method employs high-energy microwaves in a vacuum to induce inverse polymerization at temperatures between 177 and 540 degrees Celsius, to decompose organic substances (Ilyas et al., 2020). The Chinese Ministry of Ecology and Environment found that this method of disinfection is very effective for on-site waste decontamination, with logarithmic ratios of eliminating hydrophilic pathogens (Wang et al., 2020). Waste transportation concerns are eliminated, and time is saved, thanks to on-site sterilization. Microwave disinfection is used in conjunction with autoclaving, a steam sterilization method, to treat COVID-waste. Occupational health and safety for hospital staff can also be improved by the construction of a mobile microwave treatment center.
Disinfection Technique for Reprocessing Personal Protectives
Nursing professionals must pay close attention to the usage of personal protective equipment. Because of this, there are currently active efforts to develop procedures for recycling used safety equipment, despite the substantial health risk associated with incorrect disinfection (Singh et al., 2020). High-temperature sterilization methods, as described above, are unsuitable for dealing with human safety concerns due to the heat-sensitive qualities of the materials involved. On the other hand, studies show that the most popular chemical disinfectant spray compromises the integrity of safety gear. Vaporized hydrogen peroxide (vH2O2) is a proven method for disinfecting and sanitizing surfaces and equipment from harmful microorganisms, pathogens, and infections (Barcelo, 2020). This enabled the recycling and reusing of protective goods following thorough disinfection, significantly enhancing the safety of nurses’ working environments.
Pyrolysis Disinfection
When it comes to sterilization, pyrolysis is an advanced technological method. Typical processes performed in this range include pyrolysis-oxidation, plasma pyrolysis, induction-based pyrolysis, and laser-based pyrolysis, all of which occur between 540 and 830 degrees Celsius (Datta et al., 2018). Toxins are completely neutralized, which is an unusual property. This method reduces waste volume by a significant amount and uses less energy than traditional methods. What is more, this technique has not been shown to pose any risks; thus, it is generally believed to be a secure technological option. It can be used in hospitals to eliminate the spread of disease and the use of harmful chemicals.
Conclusion
Given that all workplaces are different, it is impossible to know every kind of risk one may face in a healthcare setting. This study looked specifically at four significant occupational risks that all nurses face on the job, such as chemical, psychological, physical, and biological. Another objective was to provide suggestions for how employers might enhance occupational health and safety and implement strategies to reduce chemical and environmental risks. Risk assessment, health monitoring and surveillance, information distribution, and the promotion of a culture of safety management were all cited as best practices for healthcare facilities to implement. Chemical, microwave, pyrolysis, and personal protective equipment (PPE) reprocessing were all proposed as ways to deal with chemical and environmental threats. Although the research report does not include an exhaustive list of practices and solutions, it raises awareness on the topic of OHS in nursing and proposes novel and effective practices.
References
Barcelo, D. (2020). An environmental and health perspective for COVID-19 outbreak: Meteorology and air quality influence, sewage epidemiology indicator, hospitals disinfection, drug therapies and recommendations. Journal of Environmental Chemical Engineering, 8(4), 104006. Web.
Datta, P., Mohi, G., & Chander, J. (2018). Biomedical waste management in India: Critical appraisal. Journal of Laboratory Physicians, 10(01), 006–014. Web.
Denge, T., & Rakhudu, M. (2022). Perceptions of nurses on occupational health hazards and safety practices in Ditsobotla public hospitals in North West province. Curationis, 45(1). Web.
Fan, D., Zhu, C. J., Timming, A. R., Su, Y., Huang, X., & Lu, Y. (2019). Using the past to map out the future of occupational health and safety research: where do we go from here?The International Journal of Human Resource Management, 31(1), 90–127. Web.
Ilyas, S., Srivastava, R. R., & Kim, H. (2020). Disinfection technology and strategies for COVID-19 hospital and bio-medical waste management. Science of the Total Environment, 749, 141652. Web.
International Council of Nurses. (2017). Occupational health and safety for nurses. ICN. Web.
Kahsay, W. G., Negarandeh, R., Dehghan Nayeri, N., & Hasanpour, M. (2020). Sexual harassment against female nurses: a systematic review. BMC Nursing, 19(1). Web.
Sacadura-Leite, E., Mendonça-Galaio, L., Shapovalova, O., Pereira, I., Rocha, R., & Sousa-Uva, A. (2018). Biological hazards for healthcare workers: Occupational exposure to Vancomycin-resistant Staphylococcus aureus as an example of a new challenge. Portuguese Journal of Public Health, 36(1), 26–31. Web.
Singh, N., Tang, Y., & Ogunseitan, O. A. (2020). Environmentally sustainable management of used personal protective equipment. Environmental Science &Amp; Technology, 54(14), 8500–8502. Web.
Walton, A., & Rogers, B. (2017). Workplace hazards faced by nursing assistants in the United States: A focused literature review. International Journal of Environmental Research and Public Health, 14(5), 544. Web.
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