Occupational health nursing: Realities and challenges.

BACKGROUND: Designing and enhancing resilient occupational health and safety systems is a challenge. This fact makes it clear that occupational health professionals must be able to develop their full range of competencies. From this premise, it is appropriate to define and deepen the strengths and weaknesses of occupational health nursing (OHN), as well as to point out the opportunities and realities that address its performance. SOURCES OF EVIDENCE: In the history of the professionalization of this speciality, different circumstances have conditioned its projection: the absence of its own body of doctrine, the lack of professional recognition, limited autonomy, and the definition of a clear regulatory framework. In addition to an epistemological limitation and the absence of clear leadership. DISCUSSION: In the consolidation of this speciality, there is a limited capacity to implement its own competencies, the invisibility of nursing care, the absence of leadership that incorporates research findings and difficulties in the application of scientific evidence, in addition to the influence of regulatory provisions and the idiosyncrasies of the company. CONCLUSIONS AND IMPLICATIONS FOR NURSING AND HEALTH POLICY: The analysis of classical models with a transformative approach invites a more fluid and coordinated communication between occupational health, occupational risk prevention, primary care and public health, a proposal that induces collaboration and a more holistic approach to care for workers.

Assuming the Challenge of Developing Research Projects in Occupational Health Nursing.

In today's society of uncertainty, we are witnessing a transformation of the economic, social, demographic, digital, ecological, and employment model, which faces unforeseen challenges. These challenges require reflecting beyond their consequences, and new workplace risks call for a debate on solutions beyond traditional ones. In the specific context of companies, the main functions of occupational health nursing are to prevent, promote, protect, and restore workers' health. The integration of research into nursing practice entails the better implementation of scientific advances. Although in the real world of professional nursing practice, there is a discrepancy between the knowledge obtained through research and clinical practice, practicing based on care plans, solid practice guidelines, and scientific evidence is a maxim.

[Occupational Health Nurses Promote Oral Health].

Oral diseases are the most common, non-communicable diseases that affect people over their lifetime. These diseases often cause pain, discomfort, and defects, and may even lead to death. The 2016 Global Burden of Disease Study estimated that oral diseases affect half of the world's population, with dental caries in permanent teeth being the most prevalent condition assessed. Severe periodontal disease, which may result in tooth loss, was estimated to be the 11th most prevalent disease globally. However, periodontal disease occurs mostly in adults, and strengthening tooth cleaning habits is the most effective method of prevention. Adults spend one-third of their time in the workplace. Thus, workplace health promotion is very important for adults. However, oral health promotion programs in Taiwan's workplace are scarce. This article examines the health promotion experiences and recommendations of occupational health nurses. The findings may provide a reference for occupational health nurses in general.

[Reflections on Occupational Health Nursing in Taiwan: Challenges and Perspectives].

The development of the occupational health nursing profession has promoted stable and healthy human resources in Taiwan. In order to improve the occupational safety, health, and healthcare of workers, the professional core competencies and role functions of occupational health nursing is of utmost importance. This article investigated the current status of occupational health nursing education, role functions, practice scope, and the development and responsibilities of professional associations and proposed the challenges to and the future prospects of the development of occupational health nursing in Taiwan. The key findings include: (1) the role functions and practice scope of occupational health nursing; (2) occupational health nursing courses should be included in the required credits of Department of Nursing and master and doctor programs in occupational health nursing should be established; (3) a certification system of occupational health nursing should be established as soon as possible; (4) the professional associations for occupational health nursing should take responsibility for continuing education and training; and (5) interdisciplinary collaborations among relevant occupational health professionals should be strengthened.

[Role of the occupational health nurse]. / Rôle de l'infirmier de santé au travail.

The missions of occupational health nurses are exclusively preventive, except in the event of emergency situations. They are involved in the prevention of occupational stress, the assessment of psychosocial risks and the improvement of quality of life at work.

Core competencies for UK occupational health nurses: a Delphi study.

BACKGROUND: Occupational health nurses (OHNs) play a pivotal role in the delivery of occupational health (OH) services. Specific competency guidance has been developed in a number of countries, including the UK. While it is acknowledged that UK OHN practice has evolved in recent years, there has been no formal research to capture these developments to ensure that training and curricula remain up-to-date and reflect current practice. AIMS: To identify current priorities among UK OHNs of the competencies required for OH practice. METHODS: A modified Delphi study undertaken among representative OHN networks in the UK. This formed part of a larger study including UK and international occupational physicians. The study was conducted in two rounds using a questionnaire based on available guidance on training competencies for OH practice, the published literature, expert panel reviews and conference discussions. RESULTS: Consensus among OHNs was high with 7 out of the 12 domains scoring 100% in rating. 'Good clinical care' was the principal domain ranked most important, followed by 'general principles of assessment & management of occupational hazards to health'. 'Research methods' and 'teaching & educational supervision' were considered least important. CONCLUSIONS: This study has established UK OHNs' current priorities on the competencies required for OH practice. The timing of this paper is opportune with the formal launch of the Faculty of Occupational Health Nursing planned in 2018 and should inform the development of competency requirements as part of the Faculty's goals for standard setting in OHN education and training.

Scientific evidence of dockworker illness to nursing clinical reasoning.

OBJECTIVE: To identify scientific evidence of occupational illness of dockworkers published in the literature. METHOD: systematic review of the literature, developed according to the Cochrane method. The databases searched were: Cochrane, LILACS, MEDLINE/PubMed, CINAHL and SciELO. Studies from 1988 to 2014 were selected. The data were analyzed according to the level of evidence and Strengthening the Reporting of Observational Studies in Epidemiology. RESULTS: We included 14 studies, in which 11 (78.6%) were from international journals. The year of 2012 showed greater number of studies. All studies were classified as: Level of Evidence 4, highlighting lung cancer, musculoskeletal and ischemic diseases, causal link in chemical risks. CONCLUSION: The development of preventive measures should especially include chemical exposure of workers applying the clinical reasoning of nurses' environmental knowledge to care for illnesses. OBJETIVO: Identificar evidências científicas de adoecimento ocupacional do trabalhador portuário publicadas na literatura. MÉTODO: Revisão sistemática da literatura, construída conforme o método Cochrane. As bases de dados pesquisadas foram Cochrane, LILACS, MEDLINE/PubMed, CINAHL e SciELO. Foram selecionados artigos publicados de 1988 a 2014. Os dados foram analisados conforme o Nível de Evidência e Strengthening the Reporting of Observational Studies in Epidemiology. RESULTADOS: Foram selecionadas 14 publicações, das quais 11 (78,6%) de revistas internacionais. O ano de 2012 reuniu maior número de publicações no período de estudo. Todas as publicações pertenciam ao Nível de Evidência 4, destacando o câncer pulmonar, doenças osteomusculares e isquêmicas, com nexo causal nos riscos químicos. CONCLUSÃO: A elaboração de medidas preventivas deve prever especialmente a exposição química do trabalhador, aplicando ao raciocínio clínico do enfermeiro um conhecimento ambiental para a assistência aos adoecimentos.

Medical training and nurses of Family Health strategy on worker health aspect.

UNLABELLED: Considering the worker's health one of the Unified Health System (SUS) tasks, the Primary Health Care (PHC) and the Family Health Strategy (FHS) play an important role in the development of health actions in the field health-work. In Brazil, where the number of informal and domiciled jobs is high, the FHS becomes a reference in the workers' health actions. Therefore, if the FHS is not attentive to the relation between professional occupation and disease, several diseases that affect workers can overload the system without obtaining a cure. The aim of this study is to evaluate doctors and nurses recognition of the Family Health Strategy on occupational diseases in Aparecida de Goiânia. This is a qualitative descriptive study and the data analysis was done by content analysis. The setting for this study contemplates FHS units in the municipality of Aparecida de Goiânia, Goiás. There were 8 Basic Health Units and 16 health professionals were interviewed. The data was collected in the participants of the interview workplaces, from February through April, 2013, after being approved by the Ethics and Research Committee. The discourses were analyzed according to Minayo (2007), using thematic analysis. The interviews were recorded and later transcribed for analysis. Among the 16 professionals interviewed we observed that only 3 (18.75%) received professional training on occupational health in their Institution, however the aim of the courses were towards situations of biological hazards and not about workers care. Practitioners reported lack of knowledge in the occupational health area, and also observed that the area is still undervalued and underexplored in the academic and professional fields, and even by the Municipality health management. Evaluating the academic education it is possible to observe the inadequacy of the subject workload, where professionals reported the lack of knowledge in the area and the low workload of the subject in the academic field. CONCLUSION: There is a need to raise awareness and interest of the municipality health managers and the health professionals, doctors and nurses, towards the relations work-health-disease and the need to capacitate these professionals, in order to assist the workers in a better way. Considerando a saúde do trabalhador uma das atribuições do Sistema Único de Saúde (SUS), a Atenção Primária à Saúde (APS) e a Estratégia Saúde da Família (ESF) assumem papel importante no desenvolvimento de ações no campo saúde-trabalho. No Brasil, como é grande o número de trabalhos informais e domiciliados, a ESF se torna referência nas ações de saúde do trabalhador. Assim, se a ESF não estiver atenta à relação entre atividade profissional e o adoecimento, várias doenças que acometem os trabalhadores podem sobrecarregar o sistema sem a obtenção de cura. O objetivo deste estudo foi avaliar o reconhecimento de médicos e enfermeiros da Estratégia Saúde da Família de Aparecida de Goiânia sobre doenças ocupacionais. Trata-se de um estudo qualitativo descritivo, a análise dos dados foi feita pela análise de conteúdo. O cenário deste estudo constitui-se das unidades de ESF do município de Aparecida de Goiânia, Goiás. Foram 8 Unidades Básicas de Saúde selecionadas e 16 profissionais de saúde entrevistados. Os dados foram coletados nos respectivos locais de trabalho dos participantes da entrevista, nos meses de fevereiro a abril de 2013, após aprovação pelo Comitê de Ética e Pesquisa. Os discursos foram analisados de acordo com Minayo (2007), utilizando a análise temática. As entrevistas foram gravadas e posteriormente, transcritas para sua análise. Dos 16 profissionais entrevistados, observamos que somente 3 (18,75%) passaram por capacitação profissional em saúde do trabalhador na Instituição, porém os cursos eram voltados para situações de riscos biológicos e não para o atendimento ao trabalhador. Os profissionais relataram falta de conhecimento na área de saúde do trabalhador, observaram o quanto a área ainda é desvalorizada e pouco explorada no meio acadêmico, profissional e até mesmo pela gestão de saúde do município. Na avaliação da formação acadêmica é possível observar a inadequação da carga horária da disciplina, onde os profissionais relataram o pouco conhecimento na área, a baixa carga horária da disciplina na área acadêmica. Conclusão: Observa-se a necessidade de despertar o interesse dos gestores de saúde do município e dos profissionais, médicos e enfermeiros, para as relações trabalho-saúde-doença e a necessidade de capacitação desses profissionais para o melhor atendimento ao trabalhador.

[Taiwan occupational health nursing: practices, policies and future trends].

The steady evolution of domestic industries and the continued expansion of the workforce have outdated Taiwan's traditional model of occupational health nursing, which focuses on preventing work-related diseases and ensuring workplace safety. Professional-competency evaluations, now widely used within the medical and other professional communities to confirm that individuals have mastered relevant knowledge and skills, are a fixture in service quality management and related strategies. Occupational health nurses have a critical role in promoting and ensuring the quality of occupational-health related services. A multifaceted strategy is needed to update the domestic model of occupational health nursing. This strategy should include: 1) Set professional standards and create standard teaching materials for national occupational health nurses; 2) Enhance the professional efficacy of nurses in this field; 3) Survey the relevant role functions and education/training needs of occupational health nurses; 4) Develop relevant elective courses; and 5) Format courses/curricula for e-learning and for multimedia platforms. Furthermore, after implementation of this strategy, the model should be evaluated in terms of the knowledge and skills acquired by occupational health nurses. It is hoped that by reflecting local needs and experiences this new model will update the field of occupational health nursing to meet the needs of the current and future workplace in Taiwan and increase nursing knowledge and skills in order to foster and sustain healthy workplace environments.

[Promoting occupational health in a Parisian department store]. / Promouvoir la santé au travail dans un grand magasin parisien.

Astrid Tellier has found her professional footing within the occupational health department of a Parisian department store. The coordinator of the nursing team, she feels fulfilled in this practice which combines various missions of organisation, prevention and care.

[The past and future of occupational health nursing research in Japan].

OBJECTIVES: This study aimed to review the trends in "occupational health nursing research" conducted in Japan and determine research areas that need strengthening eventually. METHODS: All articles published in Ichushi Web since 1903 were searched using the keywords "occupational health nursing" and "research." The 486 papers identified were extracted and categorized according to type and publication year. The research content of 194 original and review papers was categorized according to whether they addressed practical methods and abilities. RESULTS AND DISCUSSION: According to publication type, out of the 486 papers, 230 (47.3%) were conference proceedings, whereas 194 (39.9%) were original and review papers. Among practical methods-related papers, 107 (55.2%), 86 (44.3%), and 1 (0.5%) were on general, health, and work environment management, respectively, whereas none addressed work management and occupational health education. Among practical ability-related papers, 125 (64.4%), 23 (11.9%), and 46 (23.7%) were on knowledge, technology, and competency, respectively. The overview of annual trends showed that the papers of all types have increased progressively. While conference proceedings accounted for 80% of the papers until 1992, recent proportions have shown a decrease to < 50%. Conversely, original papers accounted for < 20% of the papers early on, but observed a progressive increase, with recent proportions of > 40%. Regarding content, almost no papers addressed work environment management, work management, and occupational health education. Additionally, practical ability-related papers highlighted that although some research on technologies and competencies has been conducted, some areas remain inadequately addressed. CONCLUSIONS: In Japan, occupational health nursing papers have been steadily increasing since the first conference proceeding was published in 1980. Among papers addressing practical methods, those related to general management were most common, of which occupational health management accounted for approximately 80%, indicating efforts aimed at the development of occupational health nursing through research. Moreover, limited papers addressed work environment management, work management, and occupational health education, suggesting the need for future research. Among papers addressing practical ability, > 60% were related to knowledge, with research on competencies was only > 20%, suggesting the need for further research eventually.

Undergraduate Occupational Health Nursing Education in Chile, Colombia, Brazil, and Mexico.

BACKGROUND: Occupational health nursing plays a fundamental role in addressing the health of the working population; however, training in this area differs around the world in terms of levels, duration, content, and requirements, and the current situation in Latin American countries is unknown. The objective of this study was to analyze undergraduate nursing education in occupational health from an international perspective considering Chile, Colombia, Brazil, and Mexico. METHODS: We conducted a multicenter, descriptive study, based on bibliographic methodology, whose sample was documentary, consulting government databases in Chile, Colombia, Brazil, and Mexico. FINDINGS: Heterogeneity was identified within the training in the countries analyzed, with a small number of courses in the course structures; in most cases, the courses were taught in the last years of training and predominantly as elective courses. CONCLUSIONS: The authors recommend that training centers develop programs associated with occupational nursing, which is considered an imperative to strengthen public health in developing countries and an ethical and equitable response to the working population.

[Features and evaluations of organizational support provided by occupational health nurses in private practice for the implementation of sustainable health and productivity management in medium-sized enterprises].

OBJECTIVES: This study aimed to clarify the features and evaluations of the organizational support provided by occupational health nurses (OHNs) in private practice to promote sustainable health and productivity management (HPM) in medium-sized enterprises. METHODS: Corporate managers and employees of four enterprises with fewer than 300 employees received support from an experienced OHN in private practice through five support sessions per company, primarily targeting company managers. The OHNs documented their support steps and evaluations. After completing the support process, we conducted semi-structured interviews with company managers and OHNs to evaluate the support provided by the OHNs. The support processes were organized for each company according to an analytical framework based on the consolidated framework for implementation research; the support features of OHNs were extracted. The evaluations of the support provided by OHNs from the perspective of company personnel were categorized using content analysis. RESULTS: Six features of support by OHNs for the promotion of HPM were extracted, including clarifying corporate needs while focusing on relationships of trust with company representatives, providing appropriate health information, and introducing external resources to facilitate independent and continuous efforts in the company to promote sustainable HPM. The managers' evaluations of the support provided by the OHNs included the following six categories: 1) identified and recognized current internal health issues; 2) received specific assistance tailored to the company; 3) gained an opportunity to work on health promotion measures; 4) considered the development and continuation of future health promotion measures; 5) learned about the existence of OHNs as easy to consult with; and 6) identified aspects of support from OHNs that were different from what they expected. CONCLUSIONS: This study clarified the features and evaluations of the support provided by OHNs in private practice in medium-sized enterprises for the promotion of HPM. Our findings suggest that the involvement of OHNs in private practice may increase the number of medium-sized enterprises that can autonomously commit themselves to HPM in a sustainable manner.

Implementation of a COVID-19 Closed/Open POD Partnership: A Creative Professional Practice Exemplar for Occupational and Environmental Health Nurses.

BACKGROUND: For more than 15 years, the U.S. Centers for Disease Control and Prevention has recommended that all community agencies and workplace environments create structured communication and collaborative plans for emergency or disaster events (2008). This recommendation is aligned with the U.S. Department of Homeland Security's (2022) National Infrastructure Protection Plan. The Coronavirus Disease 2019 (COVID-19) pandemic ultimately demonstrated the importance of having organized plans and processes in place for the effective and rapid dispensing of medical countermeasures (MCMs) to the general populace. Occupational and environmental health nurses (OHNs) can utilize examples of successful MCM dispensing programs and adjust details to fit individual organizational needs. METHODS: This report examines a closed point of dispensing (Closed POD) mass vaccination program as a guide for designing successful workplace partnerships. FINDINGS: Closed PODs are public or private sites that have set up a memorandum of understanding (MOU) with local health authorities to dispense MCMs to their populations during a public health emergency. The desired outcome of a closed POD agreement is the facilitation of employee health and safety, as well as enabling workplace continuity of operations. CONCLUSIONS/APPLICATIONS TO PRACTICE: OHNs will play a pivotal role in any future disaster or emergency event. Because OHNs understand the critical need for anticipatory planning, they are in a prime position to drive the creation and implementation of a closed POD partnership between their workplace and their local health department.

Embracing a competency-based specialty curriculum for community-based nursing roles.

The Quad Council competencies for public health nursing (PHN) provide guidance in developing curricula at both the generalist and specialist level. However, these competencies are based on nursing roles in traditional public health agencies and community/public health is defined more broadly than official agency practice. The question arises as to whether community-based specialties require largely the same knowledge and skill set as PHN. The purpose of the competency cross-mapping project reported here was to (a) assess the intersection of the Quad Council competencies with four community-based specialties and (b) ensure the appropriateness of a Quad Council-based curriculum to prepare graduates across these four specialties (home health, occupational health, environmental health, and school nursing). This article details the multistep cross-mapping process, including validation with practice leaders. Results indicate strong alignment of community-based specialty competencies with Quad Council competencies. Community-based specialty-specific content that did not align well is identified, along with examples of didactic and clinical strategies to address gaps. This work indicates that a Quad Council-based curriculum is appropriate to prepare graduates in community-based specialties when attention to the specialty-specific competencies in the clinical setting is included. This work guides the development of a doctorate of nursing practice curriculum in PHN, encompassing the four additional community-based specialties.

[The role and future task of the occupational health nurse].

The Industrial Safety and Health Act was enacted focusing on occupational disease prevention in 1972. It has been revised over the years to include consideration of work associated diseases, and the participation and cooperation of employer and employees. From now, positive participation of employer-and-employees in occupational health activity becomes important in order to achieve the expanded purpose of the law. It is necessary to empower all workers to be able to perform occupational health activity independently. Florence Nightingale defined nursing in the 1850's. "Nursing is to put the patient in the best condition by improvement of environment, including a population approach. The goal of nursing is to enable the patient to use his faculty fully." The Public Health Nurse is, "assistance to the process of solving one's health, identifying health issues based on a community, using systematic measures which lead to prevention, and aiming at public responsibility." The daily activity of Nurses including Occupational Health Nurses (OHNs) is based on the theory and technology of "empowerment". In promoting the employer-and-employees independent Occupational Safety and Health Activity, the OHN's professional specialty of "empowerment" can play an important role.

Update on occupational health nursing through 21st century requirements: A three-round Delphi study.

BACKGROUND: Occupational health nurses have promoted health and practiced at a strategic level for many years, and are closely aligned with public health and policies, workplace and environmental regulations, and changes in the nursing profession. OBJECTIVE: This study was carried out to create a consensus text on the definition, qualifications, responsibilities, and education of occupational health nurses based on the 21st century requirements. DESIGN AND METHODS: A Delphi panel of public health nursing academicians, occupational health nurses, other health professionals, faculty members of public health, and occupational physicians. A consensus-building approach using three rounds of e-Delphi technique were used, with 45 participants in the first round, 41 in the second round, and 36 in the third round. Data were collected in all three rounds with Google Forms between October 28, 2021, to February 28, 2022. Qualitative content analysis was performed in the first round, and mean, standard deviation, median, and mode values were presented based on the answers to the 5-point Likert questions in the second and third rounds. Values of at least 80 % and above were used for the consensus text in the third round. RESULTS: 62.2 % of the participants were female. The mean age was found 47.71 ± 11.03 years. The experts reached a consensus on the definition of occupational health nurse by emphasizing professionalism, effective communication, record keeping, nursing knowledge, skills, equipment, and competence in the field, with a participation of 91.7 %. A consensus was reached on the qualifications including observation, examination, evaluation, research, health promotion, compliance with confidentiality and ethical rules, and working in harmony with the team, with a participation of 94.4 %. The responsibilities of occupational health nurses included to create a healthy and safe workplace, participate in periodic health examinations, maintain effective communication with employees, acting in accordance with ethical principles, provide continuous professional development, and perform health education and promotion, guidance, and counseling. Experts specified that occupational injuries and diseases, duties, authorities, and responsibilities of the occupational health nurse, occupational health and safety legislation, health education, risk assessment, effective communication, and health literacy need to be integrated into the content of certificate program with 97.7 % participation. A maximum of 500 h for the total duration of the certificate training was suggested. CONCLUSIONS: The expert panel opinions provide a wide perspective for competencies, and educational standards of occupational health nurses. The results could assist in initiating the infrastructure of multidisciplinary postgraduate education programs, developing national and international collaborations, and increasing the number of scientific events should contribute to the professional development of occupational health nursing. Future research should focus on imbedding these consensus items in national and international certificate programs to prepare qualified advanced occupational health nurses.

[Occupational health nursing and professional associations: a reality in need of further development]. / El asociacionismo en la enfermería del trabajo, una realidad con un desarrollo pendiente.

Scientific and professional and societies constitute an element of social transformation. The nursing associative trend has run parallel to the social reality of the profession and its historical evolution. The late incorporation is conditioned by a delay in the conception of the discipline as a scientific profession with its own body of knowledge. Among others, the purpose of an association in this field is to promote updating in the professional skills of its members, identify the demands of its affiliated, provoke an open debate, promote collaborative research, favor the generation of knowledge and transfer that academic content to society. The text proposes a panoramic view of this polyhedral reality in which professional and scientific societies of this nursing discipline find themselves.

Las sociedades científicas y profesionales constituyen un elemento de transformación social. La tendencia asociativa enfermera ha discurrido paralela a la realidad social de la profesión y su evolución histórica. La incorporación tardía viene condicionada por un retraso en la concepción de la disciplina como una profesión científica con un cuerpo de conocimientos propio. Entre otros, la finalidad de una asociación en este ámbito es promover la actualización en las competencias profesionales de los integrantes, identificar las demandas de sus miembros, provocar un debate abierto, promover la investigación colaborativa, favorecer la generación de conocimiento y trasladar ese contenido académico a la sociedad. En el texto se propone una visión panorámica de esta realidad poliédrica en la que se encuentran las sociedades profesionales y científicas de esta disciplina enfermera.