[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.

[Occupational health nurse's role in health surveillance and workers' education: national and international state]. / Il ruolo dell'Infermiere del Lavoro nelle attività di sorveglianza e formazione dei lavoratori: panorama nazionale e internazionale.

OBJECTIVES: Occupational Health Nurses have gradually changed their role. To provide a national and international overview concerning the Occupational Health Nurse's role and to evaluate which are the regulatory/professional elements currently in force in Italy that may permit to better structure and develop Occupational Health Nurse's technical/scientific knowledges. METHODS: Literature and regulatory texts review in Italy and abroad; on sight research in some public and private Occupational Health services. RESULTS: Occupational Health Nurses' role abroad is well established and it's primarily aimed to preventive health interventions and health promotions. In Italy, on the contrary, the role of nurses in Occupational Health is almost always accessory in the implementation of health surveillance and workers' health education. This fact seems to be the result of the absence of a specific training course for those professionals, that could better define their legal profile. CONCLUSIONS: We verified the need that the training curricula of the Nursing Degree and of the Post-graduate Degree in Nursing and Midwifery Sciences give more space for teaching specific Occupational Health skills. It seems useful to propose the activation of specific post-graduate training courses for nurses who wish to focus specifically their professional activity in our disciplinary field.

[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.

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.

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.

The future of nursing--opportunities for occupational health nursing.

In this article, The Future of Nursing: Leading Change, Advancing Health report is summarized, and opportunities for occupational health nursing are proposed.

Promoting occupational health nursing training: an educational outreach with a blended model of distance and traditional learning approaches.

In 2009, occupational health nursing faculty and professionals at the University of Washington developed an innovative continuing nursing education offering, the OHN Institute. The OHN Institute was designed to meet the following objectives: (1) extend basic occupational health nursing training to non-occupational health nurses in Federal Region X, (2) target new occupational health nurses or those who possessed little or no advanced education in occupational health nursing, and (3) offer a hybrid continuing nursing education program consisting of on-site and distance learning modalities. Evaluation findings suggested that the various continuing nursing education modalities and formats (e.g., asynchronous vs. synchronous, online modules vs. live modules) were essentially comparable in terms of effectiveness. Perhaps most importantly, the OHN Institute evaluation demonstrated that quality continuing nursing education outcomes for occupational health nurses depended largely on knowledgeable and engaging faculty and a compelling vision of desired outcomes, including the application of learned content to professional practice.

Using problem-based learning for occupational and environmental health nursing education: pesticide exposures among migrant agricultural workers.

Problem-based learning, which emphasizes group collaboration to solve real-world case scenarios, is an instructional approach that is well suited to occupational and environmental health nursing education. Learners actively work through case studies rather than passively receive information presented through lectures. Problem-based learning methods promote critical thinking skills and motivate learning, preparing learners for professional practice in complex, ever-changing environments. Despite these advantages, problem-based learning is under-utilized in nursing education compared to more traditional lecture methods. This article presents key concepts of problem-based learning, discusses problem-based learning in educating occupational and environmental health nurses, and describes the development of a problem-based learning case aimed at increasing occupational and environmental health nurses capacity to address pesticide exposure among migrant and seasonal agricultural workers.

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.

[Search by specialized training in occupational health nursing by nurses]. / A busca pela formação especializada em enfermagem do trabalho por enfermeiros.

This article examines and discusses the search for specialized formation in Occupational Health Nursing for nurses. This is an exploratory descriptive qualitative study whose data were analyzed using content analysis. Data collection took place in May, 2010 with nine students from a specialization course that agreed to participate. All participants signed a free and informed consent term. The search for specialized formation is governed by the perspective for professional practice in Occupational Health Nursing and specificity of the curriculum in occupational health. Interfaces of the educational process confirm important contributions to a solid formation, projects nursing to theorical/academic levels and sets a path for the Stricto Sensu formation. Expectations, motivations and potentialities contributes to a contextualized governance of the educational process and the contemporary demands for Occupational Health Nursing.

[The relationship between the contents and the level of achievement of objectives in an occupational health nursing practicum].

The purpose of this study was to evaluate the program and teaching methods of the occupational health nursing practicum in order to enforce students' learning experience in the clinical practice. Self-evaluation sheets graded from levels 1 to 4 were from 63 students, and statistical analysis was performed in relation to their performance levels. The results of the analysis of 63 students' performance sheets indicated that the students achieved 3 points above average in all 14 course objectives. Scales analysis of the students' evaluation sheets also revealed that students' achievement levels were lower at the Industrial Health Organization in comparison with those at the industrial enterprises. To make students' practice more valuable, students' assessment skills of the workers and working environment should be emphasized in the classroom teaching and experience of learning at the laboratory. Moreover, the course objectives should be sufficiently linked to the practice areas in order to differentiate between the features of the Health organizations and enterprises.

Nurses' and therapists experiences with occupational musculoskeletal injuries.

Occupational musculoskeletal injuries are costly to the health care industry. It is estimated that 12% of nurses leave the profession annually because of back injuries. With the use of grounded theory methodology, 15 nursing personnel and physical therapists were interviewed about their perceptions of occupational musculoskeletal injuries. Analysis of the data identified major themes, including feelings of fear and frustration; chronic issue and part of the job; love of the profession and concerns about continuing in the profession; increased risk of injury; compliant with treatment; negative impact on quality of life; negative feelings about the occupational health department; and educational needs. A theory began to emerge in which health care workers accepted occupational injuries as part of the job and took no action or initiated only minor interventions to prevent work-related injuries. The study indicates a need for education and better communication.

The professional association and practice excellence.

Nursing practice in occupational settings is different from nursing practice in acute care settings. Due to the sparse professional practice resources available to most occupational health nurses at the worksite, belonging to the professional association is important for support and knowledge enhancement needed to maintain practice excellence and credibility.

A clinical ladder for occupational health nurses.

Occupational health nurses must have a growing, expanding knowledge base to remain current in practice. The American Board for Occupational Health Nurses, Inc. encourages advancement with the availability of certification examinations. Health care centers support clinical advancement programs for bedside nurses. Nurses who continue their education either through a degree program or via continuing education or certification advance up the clinical ladder, receiving a higher salary, recognition from their peers, and perhaps even financial assistance to continue climbing, yet occupational health nurses do not have their own clinical advancement ladder. This article examines the steps necessary to develop a clinical ladder and presents a clinical ladder specific to occupational health nursing developed by the author.

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.

Review of occupational health nurse data from recent national sample surveys of registered nurses-part I.

The U.S. Department of Health and Human Services obtains information about U.S. registered nurses through the periodic National Sample Survey of Registered Nurses (NSSRN). Occupational health nurses comprise less than 1% of the U.S. nursing population and published NSSRN reports usually include only estimates of the total occupational health nurse population and minimal information about occupational health nurses' characteristics. The objectives of this study were to develop a knowledge base of occupational health nurses' characteristics; examine characteristics that may influence entry and retention in occupational health nursing practice; and explore indications of demand for occupational health nurses. Descriptive and inferential statistics were used in a secondary analysis of data from recent (1992 to 2004) NSSRN. The findings are reported in two parts. This article, Part I, provides descriptive data about occupational health nurses based on responses to the 1992 through 2004 NSSRN questionnaires. Part II will provide findings from analysis of 2004 responses indicative of occupational health nurses' entry, retention, and demand characteristics.

Application of Bleeding Control Training in Occupational Settings.

Background: Uncontrolled blood loss is a primary source of preventable death after injury. Workplace injuries and fatalities are common, with most occurring in the agricultural/fishing/forestry/hunting or transportation/warehousing industries. Stop the Bleed (STB) training provides instruction on application of bleeding control methods to injured persons and is available to the general public. Method: We provided an overview of high-risk injury industries that could benefit from STB training. We also provided a review of the application of STB training and bleeding control methods in occupational settings with an emphasis on the role of the occupational health nurse. Findings: Suggested guidelines for occupational health nurses and employees in occupational settings who may respond to injured colleagues are provided. Implications for occupational health nurses are reviewed, including implementing STB training in the workplace and obtaining/storing bleeding control supplies. Resources for STB training, purchasing and storing bleeding control supplies, and general emergency response information are provided. Conclusions/application to practice: Occupational health nurses play a crucial role in emergency response in the workplace and have the ability to drive the implementation of STB training in their institution. Occupational health nurses often work in isolation or in small teams and serve as a primary resource for treatment of injured employees. Implementation of STB training for all employees is highly recommended given the limited availability of occupational health nurses in large or rural settings. Such training may reduce the morbidity and mortality associated with workplace injuries.

Occupational health nurses' roles, credentials, and continuing education in Ontario, Canada.

The role of the occupational health nurse is broad and includes health care provider, manager/coordinator, educator/advisor, and case manager and consultant, depending on the type of industry and the country in which the nurse practices. Regardless of the type of role, the occupational health nurse must participate in continuing nursing education (CNE) activities. This study describes the roles, credentials, and number of CNE activities undertaken by occupational health nurses working in Ontario, Canada. Using a nonexperimental descriptive design, a questionnaire was mailed to all practicing occupational health nurses who are members (n=900) of a local nursing association. Three hundred fifty-four questionnaires were returned. Nurses reported a variety of roles in the following categories: case management, health promotion, policy development, infection control/travel health, ergonomics, education, research, health and safety, direct care, consultation, disaster preparedness, and industrial hygiene. Sixty-five percent of nurses held an occupational health nurse credential, and 19% of nurses attended more than 100 hours of CNE annually. Occupational health nurses have multiple workplace roles. Many attend CNE activities and they often prepare for credentialing.

Safety certification--a path to job security and personal growth.

In 2005, the American Board for Occupational Health Nurses, Inc. introduced a new credential in safety management for certified occupational health nurses. To date, 11 nurses have attained this credential and several of those have advanced to the Certified Safety Professional designation. This article discusses the certification process and its benefits. It also discusses problems in the application process observed by the administrators, and offers suggestions to prepare for the examination. Nurses who have attained the Safety Manager credential were surveyed for advice to those considering certification.