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.

Occupational health nursing and political action.

BACKGROUND: Occupational health and safety are central elements of work. Throughout its history as a speciality, occupational health nursing (OHN) has been expanding the development of academic competencies and the improvement of clinical skills. SOURCES OF EVIDENCE: The literature highlights that OHN is more involved in the application of policies with a public health perspective focused on the well-being of the worker than in their design and development. REFLECTIONS FROM A SOCIO-OCCUPATIONAL AND PROFESSIONAL PERSPECTIVE OF OCCUPATIONAL HEALTH NURSING: From this premise, the current reality contributes to establishing priorities for action, generates consensus as a discipline, induces self-criticism and favours development as a profession. The article points out the strategies that favour political participation in companies, the factors that limit public representation and some of the benefits of establishing this type of initiative in organisations. CONCLUSIONS AND IMPLICATIONS FOR NURSING AND HEALTH POLICY: The OHN is a key agent of change in the design and development of health policies in the workplace. From a panoramic view of how health strategies can influence companies, and the care of the working population, political awareness and civic participation in its different aspects are part of the commitment to this nursing speciality.

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 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.

[Occupational health nursing: a holistic perspective]. / Una enfermería del trabajo con perspectiva holística.

Occupational health nursing has a unique opportunity to identify the needs of the working population within the scope of its competences. In the different possible future of work scenarios, factors related to globalization, demographic changes, the massive use of tech - nology, the digitization of a significant number of processes, the multidisciplinary nature of the approach to worker care and some approaches close to public health, are driving a new approach to occupational health and safety, while eliciting an ethical debate. In this social, professional and occupational reality, interventions by this nursing subspecialty will need to be based on comprehensive, safe, collaborative, coordinated, quality care, focused on people and based on the best available scientific evidence.

La enfermería del trabajo se encuentra en una posición privilegiada para identificar las ne - cesidades de la población laboral en el ámbito de sus competencias. En los distintos esce - narios posibles del futuro de la actividad laboral, los factores relacionados con la globaliza - ción, los cambios demográficos, la utilización masiva de la tecnología, la digitalización de un número significado de procesos, el carácter multidisciplinar del abordaje de la atención al trabajador y unos planteamientos próximos a la salud pública, determinan un nuevo en - foque de la seguridad y salud ocupacional y suscitan un debate ético. En esta realidad socioprofesional y laboral, la intervención de esta disciplina enfermera tendrá un sustrato de actuación basado en una atención integral, segura, colaborativa, coordinada, de calidad, centrada en las personas y basada en la mejor evidencia científica disponible.

[Estudio sobre las competencias profesionales de Enfermería del Trabajo en España]. / A study of Occupational Health Nursing competencies and skills in Spain.

OBJECTIVE: To evaluate the importance and degree of development of the professional competences of occupational health nursing specialists in Spain described in Public Order SAS/1348/2009 in the areas of prevention, clinical care services, legal expertise, management, teaching and research. METHODOLOGY: This cross-sectional, descriptive study surveyed occupational health nurse members of specific and/or relevant multidisciplinary professional societies at the autonomous community or state levels in Spain. A questionnaire, designed by an expert panel and centered on approved professional competencies was administered in 2014. Descriptive statistics summarized the sociodemographic profile of respondents. Bivariate analysis, followed by multivariate linear regression analysis, was used to measure associations between specific independent variables and both the perceived importance and degree of development of each competency. RESULTS: In the descriptive analysis of perceived importance, there are three competencies that stand out: manage a registration system that ensures the confidentiality of the data; increase the health level of the worker through health promotion and risk prevention, and identify real or potential occupational health problems. Regarding highest degree of development, the following stand out: management of a confidentiality registration system; provide urgent and emergency care in the workplace and identify real or potential occupational health problems. DISCUSSION: Type of occupational health service, the economic sector to which the company belonged and years of professional experience were associated with both the importance and degree of development of each of the competencies.

OBJETIVO: Evaluar la importancia y el grado de desarrollo de las competencias profesionales de los/as Enfermeros/as del Trabajo descritas en la Orden SAS/1348/2009 en las áreas preventiva, asistencial, legal y pericial, gestión, docencia e investigación. METODOLOGÍA: Investigación de carácter observacional, descriptivo y transversal que utilizó como población a estudio los especialistas en Enfermería del Trabajo vinculados a sociedades profesionales específicas y/o multidisciplinares. La recogida de datos se realizó en 2014 mediante un cuestionario diseñado por un panel de expertos. El análisis descriptivo incluyó el perfil sociodemográfico del colectivo, el análisis bivariado determinó la importancia y el grado de desarrollo de cada competencia según las variables independientes definidas, y finalmente el modelo de regresión lineal múltiple explica los factores determinantes. RESULTADOS: En el análisis descriptivo de competencias en cuanto a la importancia atribuida, tres son las competencias que destacan: gestionar un sistema de registro que asegure la confidencialidad de los datos; incrementar el nivel de salud del trabajador mediante la promoción y prevención de riesgos e identificar problemas de salud laboral reales o potenciales. En cuanto al mayor grado de desarrollo resaltan las siguientes: gestión de un sistema de registro de confidencialidad; prestar atención de urgencia y emergencia en el centro de trabajo e identificar problemas de salud laboral reales o potenciales. DISCUSIÓN: La adscripción a cada modalidad de servicio de prevención, el sector económico de la empresa y los años de experiencia profesional, resultan determinantes en la importancia y el grado de desarrollo de cada una de sus competencias.