By Debra Wood, RN, contributor
Caring for patients with traumatic injuries is not unusual, but nurses shouldn’t expect to experience such injuries themselves. Unfortunately, nurses can and do experience violence and injuries on the job. In fact, an April 2015 report from the National Institute for Occupational Safety and Health (NIOSH) indicated workplace violence injury rates nearly doubled for nurses from 2012 to 2014. Ninety-nine percent of those incidents were physical assaults.
Lowering the risk of workplace violence
The Centers for Disease Control and Prevention offers a free Workplace Violence Prevention for Nurses course to help health care workers understand the extent and type of violence occurring in health care settings. It advises nurses to employ personal strategies to reduce the risk, such as standing next to the door in case one needs to make a quick exit if a violent episode develops.
Good communication skills and the ability to recognize verbal and behavioral cues associated with escalating stress levels and the potential for violent behavior are essential. The course suggests using assessment tools to determine a patient’s risk level for assault or homicide and being careful with nonverbal communication, such as not folding arms or placing hands in pockets when talking with a patient; a paranoid patient could perceive you are hiding something. If a facility offers a training program, nurses should take it.
The American Nurses Association (ANA) convened a panel of experts in April to make recommendations on preventing and reducing workplace violence, bullying and incivility--behaviors identified by research as problematic in health care settings.
“A proactive stance to develop effective workplace violence prevention programs is critical to ensure the safety of patients, nurses and other health care workers,” said ANA President Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN, at the time. “We must completely dispel the notion prevalent in too many health care organizations, and held by too many health care workers and leaders, that being physically or verbally assaulted is just ‘part of the job.’”
Avoiding injuries with safe patient handling
NIOSH also reported nurses had high injury rates from patient handling and falls. Adult inpatient units had the highest nurse injury rates. Risk factors identified by NIOSH include caring for overweight and acutely ill patients, high patient-to-nurse ratios, long shifts and trying to get patients up after procedures.
Some nurses’ injuries could be mitigated with interventions such as lifting equipment and training, NIOSH authors suggest. The report found that 82 percent of the handling injures occurred when lifting equipment was not used.
Susan Wisnewski, RN, from Pelham, N.H., experienced an on-the-job injury and is now looking for a nursing management job. She urges nurses to protect themselves and to ask for assistance when lifting patients.
Safe patient handling has long been a priority for the ANA. In May, Cipriano addressed Congress during a briefing on Capitol Hill in support of the Nurse and Health Care Worker Protection Act, expected to be introduced by Rep. John Conyers (D-Mich.). The act would establish a national occupational safety standard that will eliminate the manual lifting of patients by direct-care nurses and health care workers through the use of modern technology and safety controls.
Cipriano reported that “nurses manually lifting an estimated 1.8 tons or 3,600 pounds per shift, leaving them at a 75 percent risk of injury with every manual lift or reposition performed.” However, she added that successful safe patient handling and mobility programs “have reduced the incidence of injury by up to 95 percent.”
Nurses should assess the patient’s functional ability before attempting to lift, transfer or reposition him or her. They then should ask for help or take the time to locate and employ equipment they have been trained to use and will make the move easier and safer.
“Safe patient handling and mobility has the potential to not only decrease staff injuries but increase patient safety and comfort, and lead to improved mobility outcomes,” concluded Cipriano at the Capitol Hill briefing. “Clearly, it is in everyone’s best interest to achieve safe patient handling and mobility.”
Resources:Workplace Violence Prevention for Nurses – CE course by the Centers for Disease Control and Prevention.Managing Assaultive Behavior for Healthcare Professionals – CE course by RN.com.Ergonomics and Safe Patient Handling and Mobility – CE course by RN.com. Workplace Safety Resources – American Nurses Association.
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