Chapters 12, 13, &15
A first aid room must be equipped with the following items:
1. examining table 2. cot for emergency cases, enclosed by movable curtain 3. dust-proof cabinet for supplies - waste receptacle and biohazards-disposable containers -small table - chair with arms and one without arms -magnifying light on a stand - sink and washing facilities - dispensers for soap, towels, cleansing tissues, and paper cups - wheelchair - stretcher - blankets -bulletin board to post all important telephone numbers for emergencies - bed(s) - appropriate medications in locked cabinet - automated external defibrillator - oxygen - surgical-type mask - ambu-bag
management need the services and skills of several professionals to attain the best results in its OH & Safety programs. These professionals include:
1. physical specialists 2. occupational health nurses 3. industrial hygienists 4. safety specialists 5. other occupational health specialist such as health coordinators, toxicologists, epidemiologists, and employee assistance counselors
A first aid program should include the following:
1. properly trained and designated first-aid personnel on every shift 2. instructions for calling an ambulance or rescue squad 3. a posted method for transporting ill or injured employees 4. posted instructions for calling a physician and notifying the hospital that a patient is en route 5. a first aid unit and supplies or a first aid kit approved by the health care professional 6. a first aid manual with procedures 7. a list of reactions to chemicals and routes or exposure 8. an adequate first aid record system and follow up
workers' compensation board
1991
actual human cycle falls with in a ___ hour time frame
23-27 pg 364
Some exposure records may have to be maintained for
30 years whereas medical records must be retained for the duration of employment PLUS 30 YEARS.
in the year 2000 the median worker age was
39 (between the ages of 35-54)
there are more than 18 million clerical workers in the US and
75% are women
First aid attendant should be duly qualified and certified by the:
Mine safety and health administration, the national safety council or the american red cross and must be renewed at specific intervals
wellness
a way of life that promotes a state of health
the audio metric exam
accepted method of testing hearing acuity
Surveillance of workers' health status by qualified personnel is esential if
an occupational health program is to provide maximum benefits for both the employee and employer. therefore, the occupational health service should provide a regular physical examination program for all emplyees
a synthesis of data obtained from employees' personal and occupational histories
and a review of systems can help health professionals perform an individualized risk assessment the risk assessment would include: study of individual health data, workplace exposures,and toxicity of the chemicals to which the person is exposed
industrial hygienists
apply specialized knowledge in recognizing, evaluating, and controlling health hazards in the work environment
anticipated health problems with old people
arthritis hypertension cardiovascular disease hearing impairments diabetes mellitus and depression p 363
"wall of fatigue"
at 5 am
secondary prevention
begins after a condition or disease is present intervention at this state may lessen the complications and the disablilty resulting from disease or illness. ex: blood pressure screening; medical surveillance for occupational exposures; and preplacement, periodic, and termincation physicals.
reduction in attention span
begins as early as 20-35 minutes into the shift higher level thinking skills may also be affected, including decreased memory, recall, logic, reasoning, and decision making abilities
tertiary prevention or rehabilitiation
begins when the disease or conditiaon as stabilized and no further healing is expected. ex: chronic illness monitoring, on-site therapy, modified duty, or assisting an emplyee with a work-related injury to reuse an injured hand. the employee may need to learn new skills or new ways to use old skills in order to rreturn to work
sitting at a desk for a long period of time may cause
blood pooling and edema in the lower extremities
Courts, workers' compensation commissions, or heath authorities may request information on physical examination
by legal means, but it is preferable to obtain an employee's written consent to disclose their medical records
the values of different test procedures must be
carefully weighted against their cost in time and dollars
24 hour cycle is known as
circadian from latin circa dies or "about one day"
occupational health nurse
collaborates with the physical and other health care professionals to provide for rehab and return-to-work programs
Companies use physicians more as ____
consultants for treating serious illnesses and injuries and to provide limited direct care
trunk kits
contain wash basin, blankets, splints, and stretchers and is carried by only 2 people
pender and pender (1966)
define health promotion as "activities directed toward increasing the level of well being and actualizing the health potential of individuals, families, communities, and society"
limited duty
defined as a new job that is appropriate to an injured worker's skills, interests, and capabilities. it is designed for individuals who can't return to their original work area and is created for either temporary or permanent placement
health promotion
described as continuing activities that are in an integral part of one's lifestyle such as physial exercise or eating good food directed at achieving the highest level of health
occupational health history is designed to
determine previous work experiences and to help the occupational health care provider discover preexisting conditions that may be worsened by conditions of the job
Record and reports are necessary to
direct and evaluate preventive medical and safety engineering techniques, to chart progress in the reduction of accidents, and to meet the regulatory record-keeping requirements
lifestyle change programs
directed at helping individuals change their behavior, such as starting an maintaining exercise.
1991 supreme court decision struck down these policies as
discriminatory to women because they may also bar them from higher paying jobs
There are two kinds of first-aid treatments
emergency and prompt attention.
must be given for immediate, life threatening conditions. First aid staff provides care until proper medical treatment can be given. Proper first aid measures reduce suffering and can lessen the severity of an injury or illness.
emergency care
vision and hearing tests
employees' near-sighted or far-sighted vision should be documented is the company fails to match the visual requirements of a job with the visual abilities of employees, workers may become easily fatigued, inefficient, and frustrated.
medical surveillance function includes three separate rolls:
examining overall changes in the work place population, with out regard to individual employee conditions; screening to examine individuals for health concerns such as diminished hearing ability; and examining hired applicants for their qualification to meed a job's physical parameters.
management should institute a program for workers who are
exposed to hazardous processes or material or whose work involves responsibility for the safety of others such as vehicle operators
chronic fatigue
failure to obtain sufficient sleep during nonworking hours shiftworker willl sleep only 4-6 hours at a time
health records contain
health and medical history examination and test results medical opinions and diagnoses descriptions of treatments and prescriptions employee medical complaints
occupational services personnel must strictly preserve the confidentiality of
health examination records
o'donnell and harris 1994
health promotion and protection programs should be targeted at three levels: awareness, lifestyle and behavioral changes, and supportive environments.
neck or wrist tags for medic alert
indicate that vital medical facts are recorded on a health information card in the bearer's purse or wallet or in another location the tag also gives a phone number for obtaining more info
light duty
is an adaptation of the employee's original job to reduce the worker's tasks
major component of the occupational health nurse's practice
is the development, implementation, and evaluation of activities that support health promotion and protection strategies through primary, secondary, and tertiary prevention approaches. This process may include conduction employee health needs assessments; administering and interpreting health risk appraisals; designing and developing programs to provide positive lifestyle changes such as exercise, nutrition,and wight control; and initiating programs that support regulatory mandates such as hearing conservation and respiratory protections
When there is a change in the employee's healht status or in work conditions that may place the employee's heath at risk,
job transfer exams are conducted to match the employee's capabilities with proposed new jobs
pulmonary function tests
less potentially hazardous exams. can detect loss of lung function before the disease reaches the stage where it can be seen on an x ray
sleep debt
loss of sleep that robs the worker of energy and alertness. length of sleep for night workers may only be 4-6 hours compared to the average 7-9 hours for day and afternoon workers sleep deficit can accumulate after three to four consecutive work nights some researchers believe that 6 consecutive nights may be too exhausting.
if the organization does not have vision-testing equipment available on site,
management can contract with outside examiners to perform annual eye exams and to fit prescription safety glasses, if needed workers with exposures of 85 dBA time weighted average or greater must also be placed in a hearing conservation program
The occupational health nurse is typically the
manager of the occupational health unit as well as the sole direct care provider of health services at the work setting
prevention services
maternal and infant health heart disease and stroke cancer diabetes and chronic disabling conditions HIV infection sexually transmitted diseases immunization and infectious diseases clinical preventive services surveillance and data systmes
periodic examinations
may be required or voluntary these are preformed for employees for both preventive health monitoring and health surveillance purposes. conducted at intervals during employment to determine the worker's continued compatibility with the job assignment, and to determine whether adverse health effects have occurred that may be attributable to the work or working conditions
maintaining and protecting good health is
more effective and less costly than tratment and cure
army stretcher
most commonly used stretcher
trunk kits
most complete and are carried easily to an accident site or stored near working areas far from well-equipped emergency first-aid rooms.
the first aid procedures manual should be developed by:
occupational health nurse and physician with input from the occupational health staff
An effective occupational health service program should be planned by the
occupational health staff in cooperation with management the program must have the full support of top management if it is to be successful only with top management support it is possible to establish and maintain an adequate program, professional staff, and facilities for examinations, emergency cases, and record storage
women comprise the largest group of workers in
office, health care, and hospital environments and face various types of hazards, including exposure to chemical and physical agents, unsuitable ergonomic work conditions and stress
service used by companies with fewer than 500 employees, companies with a low incidence of accidental injuries, or companies with a minimum heath service program for employees
on-call physician with a local physician
the preplacement exam is done
once an employee receives and accepts an offer of employment this exam is used to determin and record the health condition of the prospective worker in order to math each employee to the right job aid in selection and appropriate placement of all workers also provides baseline date for future evaluations
fetus
p 361
difference between personal and departmental kits
personal kit- essential articles only for the immediate treatment of injuries departmental kits- meet the needs of a group of workers
health promotion
physical activity and fitness nutrition tobacco alcohol and other drugs family planning mental health and disorders violent and abusive behavior educational and community-based programs
the physician , nurse, or industrial hygienist should inform the employer of
potentially harmful work-related exposures or hazards detected throught heir exmaination or workers and the environment
the various kinds of examinations may be classified as follows:
preplacement periodic special examinations
work hardening
progressive, individualized physical conditioning and training program designed to help injured workers return to the workplace asap this goal is accomplished by gradually increasing physical and psychological requirements of the job, within the employee's current capabilities, until the employee can perform once again at acceptable work levels
is used to treat minor injuries such as cuts, scratches, bruises and burns. Ordinarily, the injured person would not seek medical attention for these injuries. By requiring that all employees immediately report for treatment when they are injured, regardless of the extent of the injury, the company can help reduce workers' risk of infection, disability, and missed diagnoses.
prompt attention
to help achieve goals, the physician should
promptly submit medical reports to those agencies that need to receive them equitable administration of workers' compensation may depend on a physician's medical testimony regarding the injury and its possible consequences
any justification for these services lies in their
record of accomplishments and emphasis on an improved quality of life
occupational health nursing
requires a registered professional nurse who is licensed to practice in the state where he or she is employed should know the basic principles of occupational health, health promotions and protection, occupational disease, related work processes and hazards, workers' compensation laws, insurance, health and safety regulations, sanitation, first aid, and record keeping
occupational health nurse
responsible for direct care services, preplacement, periodic, and other types of examinations, and workplace monitoring surveillance programs.
emergency medical planning procedures should include:
selection, training and supervision of allied health and other personnel transportation and caring for the injured transfer of seriously injured personnel to hospitals coordination of these plans with he safety department, security, police, road patrols, fire departments, and other interested community groups
data suggest that 75% of the hospital labor force are women and
several occupations women make up more than 90% of the total work force pg 361
professional occupational health nurses practice under the:
state Nurse practice Act. They must be cognizant of their legal scope of practice as defined by their specific state and the derogatory functions they can handle legally.
process controls are usually established for
substances such as lead, carbon tetra-chloride and many others that can cause occupational diseases
the occupational health nurse may play a major role in implementing many OSHA-mandate programs
such as hazard communication
physician services in industry depend on
such considerations as the hazards in operations, the number of employees, and the type and extent of the occupational health program The company can arrange for full, part or consultant services
primary prevention
takes place befor disease or illness occurs increase awarness and knowledge related to toxic and hazardous exposures and their effects and promote lifestyle interventions such as smoking cessation, stress management, improved exercise and nutrition, use of seat belts, and proper use of medications
25% of labor force is engaged in some type of industrial or service activity
that requires work around the clock
EMS
the ____ should be called whenever possible to move a person with a back, spine, or head injury
the key to accurate diagnosis and treatment often lies in
the adequacy and completeness of this profile; therefore, record maintenance is a professional responsibility
The nurse may not divulge information contained in individual employee health records without
the employees written consent. The employee health files should be accessible only to health personnel
if a company does not have a resident medical director or nurse, its medical records are usually filed in
the human resources department and must be kept strictly confidential by the HR personnel
the longer workers are away form their jobs,
the less likely they are to return fully to productive employment
health care providers determine the scope of a physical examination based on the type of operation involved
the nature of the industry; its inherent hazards; and variation in jobs, physical and mental demands, and health exposures.
laboratory tests
the use of general lab screening panels is controversial the test are relatively nonspecific and can be affected by many unrelated problems, such as alcohol and viral infections x- ray tests may be appropriate in alerting a physical to a particular condition.
the OSHA access to medical records standard permits
the worker, the worker's representative, and regulatory authorities to have access to employer-maintained health/medical and toxic exposure records allowed to all employers in general industry, maritime, and construction whose employees are exposed to toxic substances or harmful physical agents
Today, more primary-care services are being provided at
the worksite
state and local health departments often supply, without charge, medical, nursing, and engineering consultation
they can also conduct industrial hygiene and radio-logical surveys for industries within their areas
challenges for occupational safety specialists
to educate workers in off-the-job safety at home, in recreational activities, and during travel sot hey will be able to return safely to work each day.
the health professional should use job descriptions, job analyses, and discussions with employees in the same positions and the workers' supervisiors
to identify details and demands of each job
physician specialists
trained in occupational and preventive medicine. They are assisted by specialists in orthopedic surgery, ophthalmology, radiology, surgery, dermatology, psychiatry, and other areas
health protection
unintentional injuries occupational safety and health environmental health food and drug safety oral health
exit examinations
upon termination of employment, some companies give employees physical exam and document the findings. this procedure is particularly appropriate where operations exposed workers to health hazards such as lead, benzene, silica, asbestos dust, and excess noise levels, or where required by standards
safety specialists
use specialized knowledge to design and implement strategies aimed at preventing and controlling workplace exposures that result in unnecessary injuries and deaths
occupational health nurses
use specialized knowledge, not only in basic nursing procedures and health maintenance, but also when dealing with legal, economic, and social issues; labor laws; and OH sciences. Nurses are the only full-time health care providers in a company
occupational health coordinatior
used to interact with vendors who provide many of the detection and treatment services may work with employee assistance counselors, psychologists, and testing professionals and will aid with the billing and insurance difficulties that are virtually inevitable for today's complex heath systems
occupational health nurse
uses the interdisciplinary approach, the nurse works closely with the health care professionals to develop strategies to reduce employee risk
how often workers are examined for periodic examinations
varies according to the quality of engineering controls, the types of hazards, the findings produced on each examination, and the regulatory standards thus, worker exposure to substances may require that employees receive exams or lab tests on some sort of basis
1994 NSC occupational health nursing newsletter
wellness programs should include the physical aspects of health issues and also should deal with emotional, spiritual, and social dimentions
