Prevent & Reduce the Effect of NSI on Nurse-Samples for Students

Question: Discuss about the Occupational Health Management- Needle Stick Injuries (NSI) in Nurses in healthcare industry. Answer: Introduction According to WHO, an occupational health hazard is a harmful process, material, human action or situation that may lead to physical or mental injury, death or harm to other aspects of health at an individuals workplace. Nurses have a significant contribution in service provision in the healthcare system. However, they experience numerous occupational hazards while performing their duty. These hazards could be biological, chemical, physical or psychosocial in nature. In this assignment, the hazard of needle stick injury is reviewed. The review is prepared to evaluate that how needle stick injuries are manifested while healthcare delivery and the way they harm the nurses. The relevant legislations, codes and guideline pertaining to occupational health of Australian judicial system are also reviewed. The standard practice that should be followed by the healthcare organisation to eliminate or minimise the risk of development of needle stick injury are analysed. Lastly, the review is conc luded with the key findings from the main discussion. Literature Review In the 2006 World Health Report Working Together for Health on human resources, it was informed that there is a shortage of healthcare professional globally and the shortage has reached the level of crisis in 57 countries. It was also established that in several countries, one of the main causes of health staff attrition was unsafe working conditions. They reported the occupational hazards like injuries, occupational infection like HIV, etc. to be a demotivating cause for healthcare workforce. WHO global burden of disease from sharps injuries among health workers revealed that 37% of the cases of hepatitis B among health professionals was due to occupational exposure to the causal microorganism (WHO). The NSI is the one of the most common occupational accidents (Riddell, Kennedy, Tong, 2015) and hollow-bore needles and disposable syringes are the chief sources of injury (Cho, Lee, Choi, Park, Yoo, Aiken, 2013). Needle stick injuries are one of the leading causes of exposure to blood borne pathogens for nurses. It is reported that in 1999, there were 30 needle stick injury events per 100 beds in US hospitals (OSHA - Safer Needle Devices, 2012). Needle stick injuries lead to mild to severe infection and infection contributes to a significant number of morbidity and mortality cases associated with nursing and therapeutic procedures. According to a study conducted by Orji, Faasubaa, Onwudiegwu, Dare and Ogunniyi, needle stick injuries were the second most prominent occupational hazard followed only by work related stress in the obstetrics and gynaecology unit (Orji, Faasubaa, Onwudiegwu, Dare, Ogunniyi, 2009) According to Negin Masoudi Alavi, needle stick injuries result in development of communicable diseases and increases the likelihood to exposure to microorganisms present in infected blood which can cause fatal disease like HIV, HBV, etc. among the nurses which can impact their health severely (Willburn, 2004). The numbers of occurrences of needle-stick injuries in ayear in the healthcare facilities are estimated to be between 600000 and 80000 (Alavi, 2014). According to Perry, Jagger and Parker the leading causes of exposure are injections accounting for about 21% of incidents, suturing responsible for 17% incidents, and extracting blood owing to 16% of total cases (Perry, Jagger, Parker, 2003). According to Wilburn and Eijkeman, there are certain determinants of needle-stick injuries like over usage of syringes and other avoidable sharp equipment (WILBURN EIJKEMANS, 2004). Other factor responsible for NSI incidents are lack of throwaway syringes, harmless needle apparatuses, and disposal containers for sharp devices. Shortage of nursing staff, post-use recapping of needles, hand to hand handling of equipment in the OT, unawareness regarding hazards (Trim, 2004)and no training are some of the other risk factors of the NSI for nurses in the healthcare setting (Pruss-Ustun, Rapiti, Hutin, 2003). Nurses also don not have adequate information about the legislation, policies and procedures that manage the occupational health and safety in an organisation. According to Clarke, Sloane and Aiken, those nurses who were working in departments with shortage of staff and poor organizational climates faced two times more chances of reporting needle stick inuries and near misses as compared to the nurses working in adequately staffed unit with sound organizational climate. Therefore, it can be concluded that staffing and organizational climate also impacts the chances of nurses suffering from needle stick injuries. They suggested that eradicating the issues of understaffing, lack of support from administration, and bad morale can decline the rates of NSI (Clarke, Sloane, Aiken, 2002). According to Ghosh, nurses when get exposed to infected blood, blood products or other potential infectious materials, then they face the likelihood of developing blood borne infection. The nurses in different departments like emergency, laboratory, housekeeping, etc. are at the risk of occupational hazard. The extent of the risk is evaluated by the total infected patients in the setting, the incidence of exposure, duration of exposure to infected substance but there is always a chance that infection can occur with a single NSI too (Ghosh, 2013). Legislations, codes and guidelines According to Australian Government, the Work Health and Safety Act 2011 offers an outline to safeguard the health, safety and welfare of all the staff at work, in this case that is nurses at the healthcare establishments and everyone who may get impacted by the work. The Act provides a definition for the primary health and safety duty on a worker performing a business or undertaking (PCBU). Also there is a code of Practice, which offers practical guidelines for employees who have duties under the WHS Act. It also provides regulations to tackle health risks and safety. Apart from that, large firms should develop specific health and safety policies and procedures to affirm their duties and responsibilities for the employees. The policies must involve appropriate employees responsibilities as well(Tatelbaum, 2001). Standard practices to prevent and reduce the effect of NSI on nurses in healthcare settings The best practice to deal with the risks and harms of occupational hazard is to remove the hazard. The injections should be substituted by changing route of administration of medicines like medications can be given via mouth, nose or local application. All the unnecessary sharp instruments and needles must be removed from the practice (Sossai., et al., 2016). Other options that can be used as an alternative for syringes and sharps are jet injectors, towel clips and needleless intravenous systems. The healthcare organisations must ensure to practice engineering controls like retractable needles, or needles that blunt immediately after use (Harris Handelman, 2011). Equal focus should be put on administrative controls. The healthcare organisations should ensure that the required policies and guidelines are formulated and practiced. They should also ensure that adequate hazard training is given to the nurses in order to minimise exposure to the hazard (Nsubuga Jaakkola, 2005). The training should be reviewed at regular intervals (KEOREKILE, 2015). The healthcare organisations can create a dedicated committee, the needlestick injury prevention group to eliminate this occupational hazard from their settings. The healthcare employers must also allocate resources for the purpose of safety of healthcare workers especially nurses who are prone to this hazard. An exposure control strategy should be devised by the hazard professionals. Likewise work practice controls should also be placed by the healthcare professional. Syringes that can be recapped should not be used, sharps containers should be held at eye level within an arms reach, the sharps containers should be checked frequently as stated in the policy guidelines. The sharps containers should be emptied before they are completely full. A safe means to handle and pass the sharps should be established prior to initiating any procedure. The Personal protective equipment (PPE), that is the hurdles and enablers of a hazard should be specifically taken care of by the nurses. The examples involve eye goggles, face shields, gloves, masks, and gowns (Ndejjo, Musinguzi, Yu, Ssempebwa, 2015). There are certain steps that can be taken to avoid infections from exposure of nurses to infected blood. Apart from that certain measures after the exposure via NSI should also be taken like prophylaxis with antiretroviral drugs can lower the risk of HIV infection by 80% (Owie A panga, 2016) Conclusion It is important to understand that nurses form an essential element of the healthcare system. The global shortage of nurses proves their significance as well as the aversion associated with this profession. One of the biggest off-putting reasons for nursing profession is the immense number of occupational hazards that are linked with it like musculoskeletal pain, stress, fatigue, NSI and subsequent infections. The data related to NSI are alarming and indicates that practical standard policies should be formulated, reviewed and maintained at every level beginning from governmental to organisational. A thorough risk assessment should be done along with the regular hazard audit. There are certain engineering, administrative and work place controls that should be followed by the healthcare facilities as well as the nurses. Bibliography Alavi, N. M. (2014). Occupational Hazards in Nursing. Nurs Midwifery Stud, 3(3). Cho, Lee, Choi, Park, Yoo, Aiken. (2013). Factors associated with needlestick and sharp injuries among hospital nurses: a cross-sectional questionnaire survey. Int J Nurs Stud., 50(8), 1025-32. Clarke, Sloane, Aiken. (2002). Effects of Hospital Staffing and Organizational Climate on Needlestick Injuries to Nurses. Am J Public Health, 92(7), 1115-1119. Ghosh, T. (2013). Occupational Health and Hazards among Health Care Workers. International Journal of Occupational Safety and Health, 3(1), 1-4. Harris, J., Handelman, E. (2011). Needlestick Safety and Prevention Law. KEOREKILE, O. (2015). OCCUPATIONAL HEALTH HAZARDS ENCOUNTERED BY NURSES AT LETSHOLATHEBE II MEMORIAL HOSPITAL IN MAUN, BOTSWANA. UNIVERSITY OF LIMPOPO, SOUTH AFRICA. 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