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