Developing a model for predicting safety performance of nurses based on psychosocial safety climate and role of job demands and resources, job satisfaction, and emotional exhaustion as mediators.

BACKGROUND: The present study aimed to develop a model for predicting the safety performance of nurses based on psychosocial safety climate (PSC) and the role of job demands and resources, job satisfaction, and emotional exhaustion as mediators. METHODS: A cross-sectional study using structural equation modeling (SEM) was carried out among nurses in Iran. Data were collected using the Psychosocial Safety Climate questionnaire, Neal and Griffin's Safety Performance Scale, the Management Standards Indicator Tool, the Effort-Reward Imbalance questionnaire, the Michigan Organizational Assessment Job Satisfaction subscale and the Maslach Burnout Inventory. RESULTS: Surveys were distributed to 340 nurses provided informed consent. After removing incplete surveys, data from 280 partipants were analysed. The completion rate was 82.35%. The SEM results indicated that PSC can directly and indirectly predict nurses' safety performance. The final model showed an acceptable goodness of fit (p = 0.023). It indicated that PSC, job demands, and job satisfaction were directly related to safety performance, and also that PSC, emotional exhaustion, job resources, and job demands were all indirectly related to safety performance. Also, PSC had a significant relationship with all mediator variables, and job demands had direct effect on emotional exhaustion. CONCLUSIONS: The current study presented a new model for predicting safety performance in nurses in which PSC, both directly and indirectly, plays an important role. In addition to paying attention to the physical aspects of the workplace, healthcare organizations should also take into account PSC to improve safety. Next steps in reducing safety issues in nursing is to develop intervention studies using this new evidence-based model as a framework.

Application of the HEART method to enhance patient safety in the intensive care unit.

BACKGROUND: The intensive care unit (ICU) is a complex, dynamic, high stress and time-sensitive place. While a variety of rules and regulations provided to reduce medication errors in recent years, many studies have emphasized that medication errors still happen. OBJECTIVE: The purpose of this investigation is to predict, reveal and assess medication errors among surgical intensive care unit (SICU) nurses. METHODS: This study was performed in one of the public hospitals in Shiraz, namely Shahid Faghihi hospital. The human error assessment and reduction technique (HEART) method was adopted to measure and assess medication errors in the ICU. RESULTS: Findings indicate that ICU nurses perform 27 main tasks and 125 sub-tasks. The results also showed that setting and using DC shock task has the highest human error probability value, and assessment of patients by a nutritionist has the lowest human error probability value. CONCLUSION: Medical errors are key challenges in the ICU. Therefore, alternative solutions to mitigate medication errors and enhance patient safety in the ICU are necessary. Although the technique can be used in healthcare; there is a need to localize the coefficients and definitions to achieve more accurate results and take appropriate controls. Employing experienced people and providing conditions that reduce the possibility of errors in nurses, increasing the number of staff, and developing specialized and simulated training were identified as the most important control strategies to reduce errors in nurses.

A scientometric study of unsafe behavior through Web of Science during 1991-2020.

Objectives. This scientometric study aimed to investigate research and hot topics on unsafe behavior. Methods. The study was performed using scientometric analysis mapping tools, such as CiteSpace, Gephi, MINITAB and VOSviewer, for statistical analysis. Studies published in Web of Science were included. Results. The first study was published in 1987. The results of the study showed that the Safety Science journal with 111 studies (10.45%) presented most of the published studies in this field. The USA and China were the two highest producing countries, with 289 and 229 published studies, respectively. The results of keywords and hot topics showed that between 1991 and 2000 safety climate, safety performance and modeling were ranked as the first to third most frequent words, and during 2001-2010 safety performance was removed from the list of top 10 keywords while safety climate and modeling were ranked, respectively, ninth and sixth most frequent. Finally, between 2011 and 2020, the keyword of organizational factors rose to first rank, indicating the significance of this keyword in the future. Conclusions. According to the results of the present study, it can be concluded that future studies on unsafe behavior can be conducted in the field of organizational factors.

Safety culture maturity and resilience engineering in an oil drilling industry: A comparison study among government-owned and private companies.

BACKGROUND: Organizational factors including a proper safety culture are among the important contributors of major accidents in process industriesOBJECTIVE: This study evaluates and compares the dimensions of safety culture maturity (SCM) and resilience engineering (RE) among 423 employees of government-owned drilling companies (GODC) and private drilling companies (PDC) located in Azar oilfield, Ilam province, southwest of Iran. METHODS: The maturity of safety culture was measured using the modified version of Hudson safety culture maturity questionnaire and RE performance was studied using the resilience analysis gird (RAG). The relationship between RE and the SCM was discussed according to Hollnagel conceptual model. RESULTS: The results showed that lowest and highest levels of SCM in all dimensions were observed in the pathological (11.75%) and reactive (28%) levels, respectively. However, high levels of SCM have not been established in any of the studied drilling companies. The status of SCM dimensions and levels as well as RE performance was better in PDC compared to GODC which is consistent with their safety performance lagging indicators. CONCLUSION: This study showed that RE abilities could be improved by establishment of high levels of safety culture maturity.

The Factors Affecting Unsafe Behaviors of Iranian Workers: A Qualitative Study Based on Grounded Theory.

BACKGROUND: Some researchers state that they are not yet able to provide a deep understanding of the underlying causes of unsafe behaviors (UBs). Therefore, the present study was conducted to investigate the attitudes and experiences of Iranian workers of UBs. METHODS: This present study was conducted in 35 industries using a semistructured interview based on grounded theory. Forty participants were interviewed, including 13 industrial safety and health experts and 27 workers and supervisors. The analysis of the present study consisted of a three-step coding process including open, axial, and selective coding. RESULTS: The results showed that the factors affecting UBs could be classified into three categories: organizational, individual, and socioeconomic factors. Organizational factors were divided into 6 parts: procedure and environmental conditions, communications, monitoring, organizational safety culture, resource allocation, and human resources. Socioeconomic factors had three subcategories: community safety culture, type of organizational ownership, and economic problems. Finally, the individual factors were classified into two categories of personality traits and individual competence. CONCLUSION: The results showed that organizational factors were the most categorized, and it is estimated that this factor has a more important role in the UBs. Of course, to better understand the close relationship between these factors and find the weight and importance of each factor, it needs to measure it with multicriteria decision systems.

Presenteeism and work ability: development of the Persian version of the Stanford Presenteeism Scale (P-SPS-6) and measurement of its psychometric properties.

BACKGROUND: Presenteeism is recognized in Iran's hospitals, however little research has been done to understand and tackle the phenomenon because of a lack of valid tools to measure presenteeism. This study aimed to develop a Persian version of the Stanford Presenteeism Scale (SPS-6) and measure its psychometric properties. Another goal was to examine the relationship between presenteeism and work ability using a sample of 250 nurses. METHODS: The forward-backward translation process and cross-cultural adaptation of the scale were performed according to a standard method. The psychometric properties of the scale were measured using face and content validity, construct validity based on confirmatory factor analysis (CFA), and internal consistency. Work ability score (WAS) was used to assess discriminative validity and examine the relationship between presenteeism and work ability. Measures of Job Satisfaction and Emotional Exhaustion were used to assess convergent validity with the developed presenteeism scale. RESULTS: Mean content validity index and content validity ratio were 1 and 0.93 respectively. CFA verified the two-dimensional structure of the scale. Cronbach's alpha was 0.77. There were positive relationships between P-SPS-6 and Job Satisfaction, and P-SPS-6 and WAS. There was a significant negative relationship between P-SPS-6 and Emotional Exhaustion. CONCLUSION: Our findings suggested that the P-SPS-6 had appropriate psychometric properties for studying presenteeism in employees using the Persian language. Given the negative relationship between presenteeism and work ability and the negative consequences associated with it, it is necessary to regularly evaluate this stressor and to emphasize purposeful intervention programs to control or reduce it.

Probabilistic health risk assessment of occupational exposure to isoflurane and sevoflurane in the operating room.

Risk assessment is an important tool in predicting the possible risk to health. It heightens awareness by estimating the probability of adverse health effects in humans who are exposed to chemicals in the course of their work. Therefore, the present work aims to determine the occupational exposure of operating room staff to the volatile anesthetic gases, isoflurane and sevoflurane, and estimates non-cancer risk using the United States Environmental Protection Agency method. Air samples from the breathing zone of staff members were collected using the Occupational Safety and Health Administration Method 103 and analyzed using gas chromatography-mass spectroscopy. The results indicate that the measured concentrations of isoflurane and sevoflurane are below the National Institute of Occupational Safety and Health standard (2 ppm) for technicians and nurses, but not for anesthesiologists and surgeons. Moreover, the estimated non-cancer risk due to isoflurane is above the acceptable value for anesthesiologists (but acceptable for other occupational categories). A sensitivity analysis indicates that exposure time has the most effect on calculated risk (53.4%). Occupational exposure to anesthetic gases may endanger the health of operating room personnel. Therefore, control measures, such as daily testing of anesthetic devices, ensuring the effectiveness of ventilation systems, advanced scavenging methods, and regular training of staff are highly recommended.

An ergonomic intervention to relieve musculoskeletal symptoms of assembly line workers at an electronic parts manufacturer in Iran.

BACKGROUND: Prolonged, awkward postures among assembly line workers can lead to work-related musculoskeletal disorders (WMSDs). OBJECTIVE: This study determined the prevalence of WMSDs and ergonomic risk factors among assembly line workers at an electronic parts manufacturer, and introduced a low-cost ergonomic intervention. METHODS: Data were gathered by means of a questionnaire. The Rapid Upper Limb Assessment (RULA) technique was used to determine ergonomic risk factors. A low-cost intervention, designed to improve working postures was introduced. RESULTS: Most musculoskeletal symptoms were associated with the lower back (73.6%), wrist/ hands (71.7%), and neck (67.9%). Most (80%) of the working postures analyzed using the RULA were at action levels 3 or 4. CONCLUSIONS: The ergonomic intervention resulted in a significant reduction in posture scores for the neck and trunk. This indicated that the intervention helped to improve workplace ergonomics.

Evaluation of Respiratory Protection Program in Petrochemical Industries: Application of Analytic Hierarchy Process.

BACKGROUND: Respiratory protection equipment (RPE) is the last resort to control exposure to workplace air pollutants. A comprehensive respiratory protection program (RPP) ensures that RPE is selected, used, and cared properly. Therefore, RPP must be well integrated into the occupational health and safety requirements. In this study, we evaluated the implementation of RPP in Iranian petrochemical industries to identify the required solutions to improve the current status of respiratory protection. METHODS: This cross-sectional study was conducted among 24 petrochemical industries in Iran. The survey instrument was a checklist extracted from the Occupational Safety and Health Administration respiratory protection standard. An index, Respiratory Protection Program Index (RPPI), was developed and weighted by analytic hierarchy process to determine the compliance rate (CR) of provided respiratory protection measures with the RPP standard. Data analysis was performed using Excel 2010. RESULTS: The most important element of RPP, according to experts, was respiratory hazard evaluation. The average value of RPPI in the petrochemical plants was 49 ± 15%. The highest and lowest of CR among RPP elements were RPE selection and medical evaluation, respectively. CONCLUSION: None of studied petrochemical industries implemented RPP completely. This can lead to employees' overexposure to hazardous workplace air contaminants. Increasing awareness of employees and employers through training is suggested by this study to improve such conditions.

Prevalence of self-reported work-related illness and injuries among building construction workers, Shiraz, Iran.

The construction industry is one of the largest and most hazardous industries in the world, which has a direct role in the development of countries. The purpose of this study was to investigate the prevalence of self-reported work-related illness and injuries among construction workers in Shiraz, Iran. 850 randomly selected workers from 2450 construction sites completed a self-statement questionnaire regarding the prevalence of self-reported work-related illness and injuries (WRIIs), in Shiraz, Iran. The association of WRII with demographic variables were studied. The overall prevalence rate of occupational injuries was 31 %. Musculoskeletal disorders (53.3 %), eye diseases (34.1 %) and skin diseases (30.1 %) have been the most prevalent work-related illnesses among construction workers, respectively. The prevalence of WRIIs among construction workers was significantly associated with age, education, marriage, work experience, safety training programs and number of workers in the workplace as well as employment status. Considering the high prevalence of WRIIs among construction workers, more stringent occupational safety and health interventions are recommended in construction workplaces.

Evaluation of the Quality of Occupational Health and Safety Management Systems Based on Key Performance Indicators in Certified Organizations.

BACKGROUND: Occupational Health and Safety Management Systems are becoming more widespread in organizations. Consequently, their effectiveness has become a core topic for researchers. This paper evaluates the performance of the Occupational Health and Safety Assessment Series 18001 specification in certified companies in Iran. METHODS: The evaluation is based on a comparison of specific criteria and indictors related to occupational health and safety management practices in three certified and three noncertified companies. RESULTS: Findings indicate that the performance of certified companies with respect to occupational health and safety management practices is significantly better than that of noncertified companies. CONCLUSION: Occupational Health and Safety Assessment Series 18001-certified companies have a better level of occupational health and safety; this supports the argument that Occupational Health and Safety Management Systems play an important strategic role in health and safety in the workplace.

Health consequences of shift-work: the case of iranian hospital security personnel.

BACKGROUND: Shift-work, which is an ergonomics issue in workplaces, can negatively affect workers. The security personnel of medical centers in Iran have multiple responsibilities and consequently are exposed to such unwanted situations as observing patients, disputing with patient's attendants, unwanted shift schedules, and being away from family for long periods. OBJECTIVE: This study assessed health problems of Iranian hospital security personnel (shift-worker personnel) using the Survey of Shift-workers (SOS) questionnaire (Persian version). METHODS: This cross-sectional study was conducted in seven medical centers (4 hospitals and 3 clinics). A total of 416 workers were surveyed: shift-workers (exposed group) (n=209) and non-shift-workers (unexposed group) (n=207). RESULTS: The prevalence of adverse health effects was higher in shift-workers than day-workers. The level of education and mean Body Mass Index (BMI) in shift-workers were significantly higher compared with day-workers. The prevalence of gastrointestinal disorders, cardiovascular and psychological problems were also significantly higher in shift-workers compared with day-workers. CONCLUSIONS: Overall, the prevalence of health problems among the security personnel of medical centers was high. Hence, it is recommended that personnel be put under periodic monitoring and receive medical counseling and treatment if there is any disorder.

Noise Induced Hearing Loss in Iran: (1997-2012): Systematic Review Article.

Noise-induced hearing loss, which is one of the 10 leading occupational diseases, is a debilitating and irreversible disease. During the recent 15-years period (1997-2012), several studies have investigated the association between noise, hearing damage and other side effects of noise in Iran. The aim of this study was to review systematically the relevant literature related to noise-induced hearing loss, lead to developing noise exposure limits. In this systematic review, two researchers independently extracted the data from 31 past studies that had considered noise-induced hearing loss (including hearing loss, temporary and permanent hearing threshold shift and auditory trauma). The data were then recorded in a modified form and Statistical analyses were performed using SPSS, version 16.0. In analyzed studies the weighted average equivalent sound pressure level [L Aeq ] was 90.29 dB(A) and average hearing loss was 26.44 dB(A). The Highest degree of hearing loss in the right ear was associated at 4000 Hz, and the highest degree of hearing loss in the left ear was associated to 1000 and 4000 Hz. The majority of the reviewed studies have confirmed that exposure to a noise level above 85 dB (A) can lead to an increased chance of hearing loss. Furthermore, the results of the present review indicated that as L Aeq increased up to 85 dB(A), so did the severity of the hearing loss.

Postural loading assessment in assembly workers of an Iranian telecommunication manufacturing company.

BACKGROUND: Changes in industries and work practices have coincided with work-related musculoskeletal disorders (MSDs). This study was conducted to determine the prevalence of MSDs and to assess postural loading in assembly workers of an Iranian telecommunication manufacturing company. METHODS: Data were collected from 193 randomly selected workers in 4 units of the company. The Nordic musculoskeletal disorders questionnaire and the UBC ergonomic checklist were used as data collection tools. Loading on the upper body assessment (LUBA) was used to assess postural loading. RESULTS: Lower back symptoms were the most prevalent problems among the workers (67.9%). LUBA showed that most assembly workers (94.3%) had experienced considerable and high postural loading (postural load index, PLI > 5). Regression analyses revealed that lighting, rotation, contact stress, repetition, gender and age were factors associated with symptoms. CONCLUSION: Work-related MSDs occurred at a high rate among workers. Postural loading requires consideration. Any ergonomic intervention should focus on eliminating ergonomic factors associated with symptoms.