Evaluation of an occupational health nursing program through competency achievement: on-campus and distance education, 2005 and 2008.

This descriptive cross-sectional study was conducted in 2005 and 2008 to evaluate self-reported competency achievement by occupational health nursing program graduates. Twelve competencies were evaluated at three levels: competent, proficient, and expert. In 2005, most graduates believed they were at the proficient level in 10 of the 12 competencies, with three competencies approaching the expert level. In 2008, all graduates rated their competency achievement at the proficient level for all 12 competencies, with nine competencies approaching the expert level. Graduates entering the program with experience had higher competency scores compared to those without experience. Distance education learners had higher competency scores compared to on-campus graduates. From 2005 to 2008, reported competency achievement increased in all areas except research, which was only marginally reduced by a 0.1 score. Based on competency findings, curriculum and course assignments related to leadership role, policy development, professional development, and research were modified.

Occupational health nursing education.

Occupational health nursing academic education is generally provided at the specialty level through master's and doctoral degree preparation. This graduate education provides preparation for administrative, occupational health specialist, practitioner, academician, and researcher roles. Guided by nursing science, this specialty education encompasses a comprehensive curriculum that requires occupational health and safety coursework, practicum experience, and interdisciplinary learning.

Focus on the aging worker.

This article discusses select characteristics of the aging work force, health-related issues that can impact work productivity, and strategies and resources that can foster a more productive work environment. The older work force is vital to the future of the U.S. economy. Employers should recognize the value of older workers. Occupational health nurses can assist older workers in maintaining and optimizing their health.

Ethics and Total Worker Health®: Constructs for Ethical Decision-Making and Competencies for Professional Practice.

Work has become increasingly technologically driven and fast paced, with long work hours, new/emerging hazards, and rising health care costs. Threats to worker safety, health, and well-being including non-traditional work arrangements and practices, precarious work, uncertain hazardous exposures, and work organization issues, such as heavy workloads, design of work, uneven work hours, and difficult interpersonal relationships among workers and managers are apparent. Furthermore, the relationship between personal health risk factors and workplace risks and exposures has drawn increased attention and concern. As employer economic pressures continue to build, it is anticipated that ethical dilemmas for practitioners will become increasingly complex. A review of relevant Total Worker Health® (TWH) literature, related ethical constructs and competencies, an examination of codes of ethics for occupational safety and health and health promotion/education disciplines was conducted. A case study for TWH utilizing an ethical decision-making model for the analysis of key ethical issues and solutions was completed. TWH approaches to protecting safety, promoting health, and advancing well-being are increasingly being adopted. These approaches can reveal ethical dilemmas, and ethical constructs are needed to guide decision-making. A core set of proposed ethical competencies for TWH professionals are identified as a transdisciplinary framework to support workplace ethical culture.

Vaccine cold chain: part 1. proper handling and storage of vaccine.

The Center of Disease Control and Prevention reports that professionals in clinic setting may not be adequately storing and handling vaccine, leading to insufficient immunity of vaccinated individuals. This article provides information about proper cold chain storage and handling of vaccine and offers resources to begin, or reinforce, proper procedures in the occupational health unit to secure an effective immunization program.

Vaccine cold chain: Part 2. Training personnel and program management.

The Centers for Disease Control and Prevention reports that professionals in clinic settings may not be adequately storing and handling vaccine, leading to insufficient immunity of vaccinated individuals. Part 2 of this article provides information about the importance of adequate personnel training and program management policies and procedures needed to implement and maintain an effective vaccine cold chain program.

Education and Training to Build Capacity in Total Worker Health®: Proposed Competencies for an Emerging Field.

OBJECTIVE: Establishment of core competencies for education and training of professionals entering the emerging field of Total Worker Health®. METHODS: Compilation and distillation of information obtained over a 5-year period from Total Worker Health symposia, workshops, and academic offerings, plus contributions from key stakeholders regarding education and training needs. RESULTS: A proposed set of Total Worker Health competencies aligns under six broad domains: Subject Matter Expertize; Advocacy and Engagement; Program Planning, Implementation and Evaluation; Communications and Dissemination; Leadership and Management; and Partnership Building and Coordination. CONCLUSIONS: Proposed set of core competencies will help standardize education and training for professionals being trained in Total Worker Health. It serves as an invitation for further input from stakeholders in academia, business, labor, and government.

Health and gender comparisons in the long-haul trucking industry: a pilot study.

This descriptive pilot study was conducted to determine whether health conditions and health care access differ between male and female long-haul truck drivers. Data indicated that 54% of men and 66% of women had a health care provider, but 21% of men and 35% of women had no health insurance. Male and female drivers both reported common health problems (e.g., back pain, sinus problems, hypertension, headaches, and arthritis). While working, drivers of each gender often waited until returning home to seek treatment for health problems. Approximately half of the drivers expressed dissatisfaction with health care while "on the road." Occupational and environmental health nurses could address the health needs of drivers by conducting examinations and distributing wellness information at truck stop clinics and from mobile health vans, posting health information within truck stop driver lounges, creating interactive websites with real-time health care information, attending trucker trade shows to conduct health screening, or providing health information through occupational or trade magazines and newsletters.

What makes a successful hearing conservation program?

Although preventable, hearing impairment is one of the most prevalent disabilities in Western societies. In the United States, approximately 30 million individuals are at risk for noise-induced hearing loss and 22 million individuals between the ages of 20 and 69 have permanently damaged their hearing by exposure to loud sounds or noise in their environment. Both work-related and recreational noise exposure affect an individual's hearing. Legislation in 1969 and later in 1983 established standards mandating that all workers exposed to noise levels at or greater than 85 dBA time-weighted average be placed in a hearing conservation program that includes provision of hearing protective devices. This article discusses components of an effective hearing conservation program, and the roles and functions of interdisciplinary team members in making a hearing conservation program successful.

The Family and Medical Leave Act: implications for occupational and environmental health nursing.

The Family and Medical Leave Act (FMLA) was enacted in 1993 to balance the demands of the workplace with the needs of families. Balancing work and family responsibilities will affect most workers as they experience their own serious illness or care for a child or a parent. The FMLA continues to present challenges regarding medical certifications, recordkeeping, intermittent leave management, and lack of understanding by employees and employers about rights and responsibilities under the law. This article discusses the rights and responsibilities of both parties. It also discusses how the occupational and environmental health nurse can bridge the gap between meeting the needs of the employee and those of the employer by serving as educator, advocate, and liaison/collaborator, leading to measurable cost savings for the employer and immeasurable benefits for the employee.

Development of Competencies for Respiratory Protection for Health Care Workers.

According to the Bureau of Labor Statistics, more than 18 million health care workers in the United States are currently employed in the health care field and at risk of infectious respiratory exposure. With the emergence of global infectious diseases such as Ebola and Severe Acute Respiratory Syndrome (SARS), there is a need for increased and more clinically competent use of respiratory protection among healthcare workers. In an effort to improve knowledge about the practice of respiratory protection against respiratory infectious agents, a NIOSH-funded project that included an educational program, observations of HCWs, and focus groups was conducted. This study aimed to develop, implement, and evaluate respiratory protection educational program for HCWs and hospital management. This study identified respiratory protection practice issues among HCWs and strategies for integration of respiratory protection standards and procedures into practice. Findings from these efforts were used to develop respiratory protection competencies. Any worker who has the potential for respiratory exposure to infectious agents should be protected and should be able to demonstrate these specific competencies to achieve a standard level of respiratory protection.

Nursing Assistants' Use of Personal Protective Equipment Regarding Contact With Excreta Contaminated With Antineoplastic Drugs.

PURPOSE: To examine the feasibility of observing and interviewing nursing assistants about handling of antineoplastic drugs contaminated with excreta, acceptability of a measure of personal protective equipment (PPE) use with nursing assistants, and predictors of PPE use. PARTICIPANTS & SETTING: 27 nursing assistants in an inpatient hematology-oncology unit at an academic medical center in the southeastern United States. METHODOLOGIC APPROACH: This was an exploratory, multimethod study using observation, verbally administered questionnaires, and interviews. Research variables included recruitment rates, acceptability of observation, and understandability of a safe-handling instrument. FINDINGS: Observed use of double gloves, chemotherapy gowns, and face shields was low; use of plastic-backed pads when flushing excreta was high. IMPLICATIONS FOR NURSING: Nursing assistants are willing to participate in research. Standardized training and education about PPE use are needed.

Application of the occupational health services model in Thai primary care units.

This study explored the elements of the occupational health services model in Thai primary care units. Seven focus groups with nurses and public health professionals working in primary care units, employees, employers, and occupational health service-related authorities were conducted. Content analysis of the focus groups revealed 15 practical elements in five domains: system inputs, throughputs, services, outputs, and feedback. Examples of existing elements in the five domains were occupational health staff competencies (inputs), collaborative network building (throughputs), on-site occupational health services (services), number of activities performed as on-site occupational health services (outputs), and evaluation (feedback) of occupational health services delivery. The findings have implications for further development of the occupational health services model in Thai primary care units, such as training the staff of primary care units to become competent in delivering effective occupational health services.

Evaluation of 9 health care organizations' respiratory protection programs and respiratory protective device practices: Implications for adoption of elastomerics.

Interview, observational, and discussion group data at 9 health care organizations (HCOs) were collected to better understand elastomeric half-facepiece respirators' (EHFRs) use. We found that HCOs do not routinely use EHFRs as a respiratory protection device (RPD) for health care workers; compliance with other respirator types was less than expected. This finding has important training implications for proper use of all RPDs and EHFRs as an alternative RPD stockpiled for use during a respiratory infectious outbreak.

Disaster preparedness: occupational and environmental health professionals' response to Hurricanes Katrina and Rita.

In disaster-related events such as these, this survey demonstrates clear need for improved preparedness efforts and communication strategies to help reduce health risks for at-risk populations. The role of occupational health nurses and occupational and environmental medicine physicians requires knowledge and skills in many areas. This includes not only clinical skills related to illness and injury that will occur, but also skills in such areas as surveillance, management, community coordination, risk management and risk communication, and health protection. The psychological impact of disasters will have far-reaching effects resulting in emotional and behavioral changes requiring both immediate and long-term interventions. Comprehensive disaster management guidance should be in place to assist health care providers and workers in pre-event, event, and post-event phases of the disaster.

Heat-related illnesses: the role of the occupational and environmental health nurse.

Heat-related illnesses can occur in workplaces where hot environments pose a threat to at-risk workers. Operations involving high air temperatures and humidity, radiant heat sources, direct physical contact with hot objects, or strenuous physical activities have potential for inducing heat stress in employees engaged in job functions in specific industries. Exposure to high temperatures can lead to a progression of symptoms in the body, which can result in widespread tissue damage, organ damage, and even death if not treated in a timely and effective manner. Strategies to reduce the effects of heat in the workplace include engineering controls, administrative controls, and personal protective equipment. Occupational and environmental health nurses must be able to recognize and treat the broad range of symptoms that can result from exposure to high temperatures. They must work together with interdisciplinary teams to provide training and education to the work force so that workers are able to take appropriate measures to prevent the onset of a heat-related illness, recognize the early symptoms, and seek treatment. Interdisciplinary teams must ensure that appropriate controls in the work environment reduce the risk of heat exposure and related heat stress disorders. Education and early intervention are key to avoiding heat-induced illness and eliminating or minimizing the effects of high temperature environments.

Growing Concerns With Workplace Incivility.

Workplace incivility (WPI) is a growing issue across all public and private sectors. Occupational and environmental health nurses can educate employees and management about WPI, its risk factors and characteristics, and ways to reduce incidents of WPI.

Workplace Hazards Faced by Nursing Assistants in the United States: A Focused Literature Review.

Nursing assistants (NAs) make up a large share of the healthcare provider workforce and their numbers are expected to grow. NAs are predominantly women who earn a low wage and report financial, work, and family demands. Working as a NA is hazardous; this manuscript specifically examines the biological/infectious, chemical, enviromechanical, physical and psychosocial hazards that appear in the literature to date. A focused search strategy was used to review literature about hazards that fell into each of the five aforementioned domains. While some hazards that were documented were clear, such as exposure to influenza because of close contact with patients (biological/infectious), or exposure to hazardous drugs (chemical), literature was limited. The majority of the literature we reviewed fell into the domain of psychosocial hazards and centered on stress from workplace organization issues (such as mandatory overtime, lack of managerial support, and feeling rushed). More research is needed to understand which hazards NAs identify as most concerning and tailored interventions are needed for risk mitigation.

An Update on Travel Vaccines and Issues in Travel and International Medicine.

The fields of travel and international medicine are rapidly changing and growing. The role of occupational and travel health nurses is expanding and should be a focus for the future. At the American Association of Occupational Health Nurses Annual meeting on March 24, 2015, in Boston, five presentations were included in the session, An Update on Travel Vaccines and Issues in Travel and International Medicine. This article summarizes three of the presentations and includes a portion of the information generated by the Centers for Disease Control and Prevention (CDC) included in the fourth presentation. The first section focuses on the Essential Elements of Travel Medicine Programs including the pre-travel care assessment, trip research and risk identification, medication intervention review, non-pharmaceutical and prevention strategies, and post-travel care. The next section is an overview of key issues for business travelers. The growth in the number of international business travelers and unique aspects of business travel are emphasized in a comprehensive travel health program. This section also includes a discussion of expatriates and their special risks identified in recent literature (e.g., an assessment of the significant costs of health events and productivity losses by both business travelers and expatriates). The final section offers a specific example of a vaccine-preventable disease, namely, Japanese encephalitis (JE) virus, and needed changes in JE vaccine recommendations.