Posts Tagged ‘nurses’

One of America’s Most Dangerous Jobs

Wednesday, September 13th, 2017

Kicked, pummeled, taken hostage, stabbed and sexually assaulted … would you want a job that included these risks? In One of America’s Most Dangerous Jobs, the Washington Post shines a spotlight on the dangers in the nursing profession, specifically around the violence that they encounter on the job. Citing a recent GAO report on violence in healthcare profession, the article notes that, “the rates of workplace violence in health care and social assistance settings are five to 12 times higher than the estimated rates for workers overall.”

Here’s one excerpt from the article:

“In Massachusetts, Elise’s Law, which is named for the nurse who was attacked in June, is already on the fast track to set state standards for workplace protection. Legislators were working on this months before Wilson was stabbed.

Nurses in Massachusetts were attacked more frequently than police or prison guards. When association members testified about the violence epidemic this spring, they said nurses had been threatened with scissors, pencils or pens, knives, guns, medical equipment and furniture in the past two years alone, according to the Massachusetts Nurses Association.”

OSHA reports that in surveys conducted by various nursing and healthcare groups:

  • 21% of nurses and nursing students reported being physically assaulted and over 50% verbally abused in a 12-month period
  • 12% of emergency department nurses experienced physical violence and 59% experienced verbal abuse during a seven-day period
  • 13% of employees in Veterans Health Administration hospitals reported being assaulted in a year

 

While 26 states have workplace safety standards for health-care facilities, there are no federal standards. Nursing groups say that state efforts have helped increase awareness.

NIOSH worked with various partners – including nursing and labor organizations, academic groups, other government agencies, and Vida Health Communications, Inc. – to develop a free on-line course aimed at training nurses in recognizing and preventing workplace violence. The course has 13 units that take approximately 15 minutes each to complete and includes “resume-where-you-left-off” technology. Learn more about the courses at Free On-line Violence Prevention Training for Nurses and the actual course can be accessed here: Workplace Violence Prevention for Nurses CDC Course No. WB1865

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News Roundup: New must-read blog, opiate epidemic, nurses impact on claim costs & more more

Friday, June 12th, 2015

We’re catching up on the news with a Friday roundup — but first and foremost, we issue a warm welcome to Dr. Jennifer Christian, who has a new blog. Here at Workers Comp Insider, we’re unabashed fans of Dr.C – we have no doubt that her blog will be one to follow. See her recent post: Why aren’t we saying and doing THESE THINGS about the ADA?

Quest Data Shows Rise in Positive Test Rates for Workplace Illicit Drugs – Caroline McDonald, Risk Management Monitor: “Organizations in the United States that tested employees for drugs saw a 9.3% jump in the number of positive drug tests for illicit drugs in the general workforce, to 4.7% in 2014 from 4.3% in 2013, according to data from Quest Diagnostics. These results may mark a rising trend, as 2013 was the first year since 2003 in which the overall positivity rate for about 1.1 million tests increased in the general U.S. workforce. The analysis shows a potential reversal of a decades-long decline in the abuse of illicit drugs in the U.S. workforce, Quest said.”
Related:
NPR – Emergency Rooms Crack Down On Abusers Of Pain Pills
MCN: A Changing Landscape: America’s Opiate Epidemic
Boston Health News: Much Massachusetts news on the #heroin #overdose epidemic and #opioid abuse
Paradigm: Two New Approaches to Curbing the Opioid Epidemic

Health care cost drivers, or, Here’s where you’re getting screwed – Joe Paduda of Managed Care Matters covers two recent studies in Health Affairs and their likely effect on workers comp costs: one indicating that orthopedic fees paid by private insurers are measurably higher in those markets with higher concentration and the second on hospital markups, the 50 hospitals with the highest charge to cost ratios.

Proving Value – Roberto Ceniceros, Risk & Insurance: “Sellers of workers’ compensation products that fail to grasp shifting marketplace dynamics or help buyers with the pressure they are under will increasingly lose to competitors.
You can see evidence of these changing dynamics in the challenges workers’ comp underwriters face. Their inability to earn adequate investment income is reshaping their view of the vendors they buy from.
Other buyers, including third party administrators and self-insured employers, are also re-evaluating their purchasing arrangements.”

How do nurses impact workers’ comp claim costs? – Melissa Hillebrand, PropertyCasualty360.com: “Medical and total loss dollars are reduced by double digit percentages when nurses become involved on a workers’ compensation claim, according to a report from Liberty Mutual Insurance and its wholly owned third-party administrator, Helmsman Management Services.
Based on the findings from an internal study of 42,000 claims, a nurse’s participation in the workers’ comp process decreases a claimant’s future medical costs by 18% and overall costs by 26%. The study, “The N Factor: How Nurses Add Value to Workers’ Compensation Claims,” pulled data points across four categories.”

South Dakota Supremes Declare Horseplay Compensable: Bob Wilson, Bob’s Cluttered Desk: “Workers’ compensation is no stranger to stupid stories. Lord knows we have seen our fair share of inane dumbassery. This story – make that this court decision – would be one of them.”

Overview of California Workers’ Compensation SystemConference Chronicles presents a recap of Dave Bellusci’s overview of California’s workers’ compensation system from the Workers’ Compensation Insurance Rating Bureau of California’s (WCIRB) perspective. Dave is the WCIRB Chief Actuary.
Related: Dave DePaolo offers his perspective on the WCRIB goings-on on two posts: The Whole Person and The Value Image.

Cognitive Therapy, Cognitive Dissonance – Michael Gavin, Evidence Based: “”One of the most frequent recommendations I see resulting from our peer-to-peer discussions on chronic pain claims is Cognitive Behavioral Therapy (CBT). CBT is a short-term, goal-oriented psychotherapy treatment that takes a hands-on, practical approach to problem-solving. Its goal is to change patterns of thinking or behavior that are behind people’s challenges and, thus, change the way they feel about and deal with those challenges.
Despite the growing body of evidence regarding the effectiveness of Cognitive Behavioral Therapy, it still seems to cause a great deal of cognitive dissonance in our industry. We want to mitigate chronic pain symptoms for injured workers so they can take fewer medications, have a higher quality of life, and perhaps even return to work. But we’re resistant to the idea that 6-12 CBT sessions can actually help with those goals, despite what the evidence suggests.”

Heat Hazard – Claire Wilkinson, Terms + Conditions – offers a variety of links to the growing risk posed by excessive heat and drought in various parts of the globe and in various industries.
Related: California Employers Take the Heat . . . of new Revised Heat Illness Standards

Other noteworthy news

Report on violence & aggression to Maine’s caregivers; Injuries include bites, kicks, being hit

Wednesday, August 15th, 2012

When it comes to on-the-job assaults, healthcare workers are on the front lines. Earlier this year, NCCI issued a report on Violence in the Workplace, which showed that homicides and assaults are trending down. Good news, overall, but let’s take a closer look at assaults:

“The decline in the rate of workplace assaults has lagged the steady decline in the rate for all lost work-time injuries and illnesses. This reflects a notable change in the composition of the US workforce and, in particular, the ongoing increase in the share of healthcare workers, who experience remarkably high rates of injuries due to assaults by patients. This is especially common in nursing homes and other long-term care facilities. In fact, 61% of all workplace assaults are committed by healthcare patients. For assaults, coworkers make up just 7%, and someone other than a healthcare patient or coworker comprises 23%. The remainder is unspecified.”

Now, a new research report from Maine offers a close-up snapshot of the issue of workplace violence as it relates to caregivers. The Research and Statistics Unit of the Maine Department of Labor compiled data from First Reports of Injury for 2011 and issued a report on 2011 Violence Against Caregivers in Maine.
The report encompassed about 100,000 workers in healthcare and affiliated professions. Of the nearly 10,000 thousand injuries reported by those workers, 13.4% were related to violent and aggressive acts by patients and care recipients.
Key report findings include:

  • Where incidents occurred – Mental health care settings and other residential care facilities accounted for 52% of all violent/aggressive incidents in 2011. These were followed by nursing care facilities for the elderly and people with disabilities, 18.9%, and general medical and surgical hospitals and services, 16.8%.
  • What types of jobs were involved – Nurses at all levels (including nursing assistants) were involved in 21.27% of the cases; education technicians were involved in 18.6% cases; direct support professionals (personal care, hygiene, life skills, etc) were involved in 9.4% cases; Other occupations with significant numbers of cases included psychiatric technicians, behavioral health technicians and analysts, mental health and social workers and child care and senior child care workers.
  • What types of assaults occurred – The most prevalent type of assault – being hit – accounted for 21.3% of all incidents. Bites were the second highest reports, at 16.6%, of the incidents. Other identifiable assault categories included kicks, 9.45%, and being grabbed, 9.4%.

Due to the high number of bite incidents, a specific section of the report focuses on bite injuries and references information from the Federal Bureau of Prisons’ 2009 Clinical Guidelines regarding viral and bacterial exposures and the potential for infections if the skin is broken. The report also cites NIOSH publications and reports, including common risk factors for violence and a list of potential prevention strategies.
The full report is available in PDF: Maine’s Caregivers, Social Assistance and Disability Rehabilitation Workers Injured by Violence and Aggression in the Workplace in 2011.
(Hat tip to WorkersCompensation.com for pointing us to this news item.)

OSHA Announces National Emphasis Program for Nursing and Residential Care Facilities

Monday, April 30th, 2012

According to the U.S. Bureau of Labor Statistics, nursing and residential care facilities experienced some of the highest rates of lost workdays due to injuries and illnesses. In response to this, OSHA has announced a new National Emphasis Program for Nursing and Residential Care Facilities to protect workers from serious safety and health hazards that are common in medical industries. These hazards include exposure to blood and other potentially infectious material; exposure to other communicable diseases such as tuberculosis; ergonomic stressors related to lifting patients; workplace violence; slips, trips and falls, and exposure to hazardous chemicals and drugs. See OSHA’s complete directive PDF).
Safe Lifting
Injuries resulting from patient transfer and patient lifting are a particular area of concern. According to OSHA:

“The incidence rate for cases involving days away from work in the nursing and residential care sector was 2.3 times higher than that of all private industry as a whole, despite the availability of feasible controls to address hazards. The data further indicate that an overwhelming proportion of the injuries within this sector were attributed to overexertion as well as to slips, trips and falls. Taken together, these two categories accounted for 62.5 percent of cases involving days away from work within this industry in 2010. For this NEP, OSHA will target facilities with a days-away-from-work rate of 10 or higher per 100 full-time workers.”

According to the American Nurses Association, 12% of nurses leave the profession due to back pain. Nursing is one of the top 10 most hazardous jobs for injuries to muscles and joints. Many heavy labor industrial jobs have weight lifting limits of 50 pounds, yet nurses routinely bear many times that weight when transferring, repositioning or lifting patients. Nursing home workers in particular are at higher risk of injury than underground coal miners, construction workers, and tire manufacturers. Of the 16 million US workers employed in health care and social assistance, more than 3 million are employed in US nursing and residential care facilities.
NCCI study on safe lifting programs for long-term care facilities
A few years ago, an important NIOSH study on nursing home lifting equipment demonstrated that the benefits outweigh the costs. In addition to recapping the equipment investment in less than three years, NIOSH found a 61% reduction in resident-handling workers’ compensation injury rates; a 66% drop in lost workday rates; and a 38% decline in restricted workdays. Plus, the rate of post-intervention assaults during resident transfers dropped by 72%. Study authors found that the initial investment in equipment was recovered in less than three years based on post-intervention savings in workers’ compensation costs
More recently, further evidence was released via a study by NCCI: Safe Lifting Programs at Long-Term Care Facilities and Their Impact on Workers Compensation Costs (PDF). The study was a collaborative effort with the University of Maryland School of Medicine. It was limited to facilities that have had safe lift programs in place for more than three years. Originally, researches intended to compare the experience of facilities with and without such programs, but during the course of the research, the rate of adoption of safe lifting devices was so great that close to 95% of facilities had them and about 80% of those used them regularly.
NCCI summarizes the study results:

“After controlling for ownership structure and differences in workers compensation systems across states, the statistical analysis performed as part of this study shows that an increased emphasis on safe lift programs at long-term care facilities is associated with fewer workplace injuries and lower workers compensation costs. More precisely, higher values of the safe lift index are associated with lower values for both frequency and total costs. The safe lift index captures information on the policies, training, preferences, and barriers surrounding the use of powered mechanical lifts. The institution’s commitment to effectively implementing a safe lift program appears to be the key to success.”

According to the earlier NIOSH study, training alone is ineffective as a prevention strategy because “lifting the weight of adult patients is intrinsically unsafe.” It’s also important to note that the equipment alone won’t do it – workers also need to be trained how to use the equipment and management must implement and enforce a “zero lifting” policy.
Many states have safe patient handling laws
In recent years, a number of states have enacted legislation mandating safe patient lifting – and that no doubt has contributed to the rapid adoption rate noted by NCCI researchers. According to the American Nursing Association, a strong advocate for such legislation, 10 states have implemented safe patient handling laws. These include California, Illinois, Maryland, Minnesota, New Jersey, New York, Ohio, Rhode Island, Texas, and Washington, with a resolution from Hawaii. In addition, they are tracking 6 states with pending legislation currently: California, Illinois, Maine, Massachusetts, Missouri and Vermont.
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