Workplace Safety of Health Care Sector - Essay Example

Workplace Safety in the Context of Healthcare UMUC and Section Number Turnitin Scores: There are a lot of health related problems in the healthcare sector today. Of utmost significance is the safety of employees together with the patients. As much as employees in health care institutions are exposed to unsafe conditions, patients are equally at great risk. In this respect, health care managers ought to implement strategies to evaluate, track, and subsequently report patient and employee safety within health care organizations. Other than health care manager, human resource (HR) personnel play a critical role in ensuring workplace safety. In essence, human resource personnel focuses on safety-related issues that have legal and ethical implications. Therefore, human resource personnel together with the management ought to formulate and implement action plans to help address these issues. This paper explicates workplace safety issues in healthcare, and specific HR role in assuring safety. This paper further focuses on safety issues unique to healthcare, how HR enters into safety issues with their clinicians, and case studies of hospitals that have successful safety projects. Introduction Improving workplace safety in health care organizations has been a global challenge affecting both industrialized and third world countries. Each and every aspect of health could potentially put the safety of health providers and their clients at risk. For instance, the fact that health care providers deal with patients who sometimes present themselves with communicable disease means that they have a higher risk of acquiring the infections. According to the United States Department of Labor (2010), 653,000 incidents relating to harm or occupational diseases were account in 2010. These incidents in healthcare were higher when compared to other areas of the economy. In an effort to reduce these incidents, HR ought to work hand in hand with clinicians. Keywords: Biological hazards, chemical hazards, toxicity, percutaneous exposure, blood borne pathogens Knowledge Definition of terms Before explicating HR issues relating to workplace safety, it is important to define safety and workplace safety in the context of healthcare. A definition of safety cited by Hughes and Ferrett (2010, p. 2) denote safety as "The protection of people from physical injury". The meaning of workplace safety is explicated by Hughes and Ferrett (2010) through a definition of work-related ill health. In elucidating the definition in laymans terms, work-related ill health can be referred to as diseases resulting from or prompted by processes characteristic of healthcare organizations Biological exposure Jong et al (2014) posits that a healthcare provider can acquire special infections such as methicillin-resistant Staphylococcus aureus (MRSA). MRSA can be transmitted when a healthy care provider comes into contact with infected sputum, when examining a dead body, when conducting an oral examination, or through breathing contaminated air (Jong et al, 2014) . In this regard, the safety of healthcare providers is compromised. Infections transmitted through blood can be transmitted when a care provider unintentionally pricks his or her skin with an infected object, or when infected fluids or blood comes into contact with injured parts of the skin. As an illustration, Jong et al (2014) asserts that approximately 1 million infections occur from needle stick injuries annually in Europe alone. Jong et al (2014, p. 56) further stipulates that "Among the 35 million healthcare workers worldwide, about 3 million receive percutaneous exposures to blood borne pathogens each year, 2 million to HBV, 0.9 million to HCV and 170,000 to HIV". In excess of 90 percent of these cases are reported in developing nations (Jong et al, 2014). Jong et al further states that infections from pricks accounts for 40 percent of HBV and HCV, and approximately 2.5 percent HIV cases in a global perspective. There are many factors that contribute to increased incidences of infections through pricks by infected needles and through injured sections of the skin. Some of these factors outlined by Jong et al (2014) include stressful working conditions and inadequate level of staff to handle high numbers of patients. Of relevance to current trends in healthcare is Ebola. According to Jong et al (2014), this virus is transmitted when healthcare providers come into contact with infected blood or any form of body fluid from an infected individual. Ebola virus has contributed to one of the greatest workplace safety issues in healthcare in parts of the developing nations. Chemical exposure and Toxicity from drugs Chemical infections are also included in workplace safety issues unique to healthcare. In healthcare, chemicals are used for an array of purposes. For instance Jong et al (2014) notes that chemicals are used for preserving samples and cleaning as they have antiseptic or bleaching agents. In the course of these activities, chemicals present safety concerns for users. Equally dangerous is exposure to hazardous drugs predominantly drugs used to treat cancer patients. These drugs present safety concern due to the fact that they can potentially initiate the development of cancers when swallowed or when breathed in (Jong et al, 2014). In cases of pregnant healthcare providers, Jong et al (2014) pronounces that exposure to these substances could contribute to developmental defects to the unborn child. Conversely, exposure to these drugs could also cause toxicity of body organs and genetic variations (Hughes and Ferrett, 2010). Therefore, it is important for healthcare organizations to ensure implementation of strategies aimed at averting or preventing any incidences that could potentially lead to exposure. Other dangerous substances that jeopardize safety in healthcare include latex (Jong et al, 2014). In a bid to cut down on operational costs, many healthcare organizations have resulted to the use of cheaper forms of gloves that contain latex. Reports cited by Jong et al (2014) shows that "between 8 percent and 17 percent of exposed healthcare workers, numbering well over 100,000 employees are at risk for latex reactions" (p. 69). Lifting weighty objects Safety concerns relating to injuries resulting from lifting weighty objects in healthcare are also an issues necessitating implementation of safety strategies. Nelson and Baptiste (2004) outlines practices relating to lifting weight objects to include "Vertical transfers of patients, repositioning patients in bed and chairs, toileting tasks, transferring patients on and off stretchers, and lifting or moving equipments" (para. 7). These activities contributes to musculoskeletal vulnerability and therefore efforts should be put into motion to help prevent extensive damages to the back or back pains. For instance, Nelson and Baptiste (2004) asserts that introduction of technological equipments to lift patients are permanent actions plans that could help prevent back pains. When such equipments are available, Nelson and Baptiste (2004) notes that healthcare organizations ought to adopt no-lift guidelines that prohibits employees from lifting weighty objects. Comprehension Restatement of issue There are numerous safety issues unique to healthcare that necessitates the intervention of HR. Goel, Gupta, and Singh (2014) espouse safety issues in healthcare to include exposure to chemicals, disease causing agents, physical vulnerabilities, susceptibility attributed to lifting weighty objects, and psychosomatic hazard. According to Goel, Gupta, and Singh (2014), physical vulnerabilities include noise, exposure to high-energy waves such as x-rays, and falls. Psychosomatic hazards in health care may include aggression and work related stress, and exposure to disease-causing agents that could lead to "TB, hepatitis, HIV/AIDS, H1N1, and influenza" (Goel, Gupta, and Singh, 2014, p. 292). As healthcare personnel particularly laboratory technicians analyze patients samples to identify the cause of illnesses, for instance when drawing blood from the patient, they are at high risk of needle stick injuries. In essence, needle stick injuries are inadvertent pricks or piercing of the skin done by unsterilized clinical instruments such as syringes. Exposure to chemicals is also one of the issues relating to workplace safety in healthcare. This may be in the form of formaldehyde, a chemical used preserve samples in the laboratory. Case illustration example In an illustration to substantiate the safety threat of chemicals in healthcare, a methodical investigation was conducted by healthcare experts, cited by Jong et al (2014). In this illustration, a sample group comprising of twelve doctors and eight nurses from different States was tested for presence of six frequently used chemicals in their blood. The chemicals under investigation in the illustration were: "Bisphenol A (BPA), mercury, perfluorinated compounds (PFCs), phthalates, polybrominated diphenyly ethers (PBDEs), and triclosan" (Jong et al, 2014, p. 61). Findings from the investigation proved the presence of atleast 24 chemicals in the bodies of those tested. This illustration presents sufficient proof that exposure to chemicals in healthcare is an issue of concern in healthcare. Application/Transfer Role of HR in assuring safety Shi (2007), in the book Managing Human Resources in Health Care Organizations, alludes to the fact that one of the major function of HR involves staffing and retention of employees. Staffing and retention of employees cannot be alluded to without stating the shortage of nurses and physicians in the contemporary healthcare setting. In 2002, shortage of nurses was estimated at 10.2 percent in the US. Shi (2007) additionally notes that shortage of nurses and physicians leads to congestion in ERs as well as congestion in the wards. In extrapolation, this shortage translates to stressful working environments that further jeopardizes safety. Under stressful and congested environment, needle stick injuries incidents are likely to be higher as compared to environments with adequate space. Needle stick injuries according to Jong et al (2014) can occur when a healthcare provider collides physically with a colleague carrying a needle, or even collides with a colleague using the needle hence risking exposure to blood borne illnesses. It is therefore the responsibility of the HR management to recruit adequate level of nurses and physicians to ensure such incidents do not occur. Goel, Gupta and Singh (2014) spells out that, in some organizations, the risk management function falls under human resources. This means that the responsibility of mitigating risks within the organization falls primarily on the HR. In reference to exposure to disease-causing organisms or percutaneous exposure and needle stick infections, the HR is obligated to conduct a risk assessment to identify probable avenues or instances that clinicians might be infected or exposed (Jong et al, 2014). Issues that ought to be spotlighted on in risk management should be eradication of any incidences of infection in totality. In this respect, the initial step in risk management would be to classify all employees or individuals under the risk of needle stick infections, and the second step ought to include stipulation and execution of action plans aimed at enhancing safety (Jong et al, 2014). Though nurses, physicians, and other clinicians involved in the process of care are directly are at higher risk, support staff are equally at risk. Therefore, safety action plans should focus in prevention of incidents in both direct care providers and support staff. The third function of HR as underscored by Goel, Gupta and Singh (2014) is employee management. In healthcare, the HR manager is obligated to conduct regular evaluations or assessment of the performance of all clinicians. Of significance in this context is the ability of a clinician to adopt, apply, and practice various disease preventive measures. For instance, patients with ailments that could potentially be communicate to other individuals should be kept in isolation and their movements subsequently be limited or controlled. In the evaluation process, clinicians can be gauged on their level of knowledge relating to how occupational infections can be acquired and measures that ought to be implemented to prevent them. In doing so, clinicians with low levels of knowledge in regards to transmission of occupational infections could be recommended for further training. For these reasons, both the HR personnel and clinicians plays an important role in assuring workplace safety on the context of healthcare. Other than the HR management, Goel, Gupta and Singh (2014) accentuates the fact that the human resource itself, in this case clinicians and support staff, has a leading role in assuring safety in the workplace. In the context of healthcare, individual behavior of manner of conduct, for instance as it relates to hand washing, can either avert infections or increase the rate of infection. As mentioned earlier, some infections in healthcare can be transmitted to healthcare personnel through contact. For instance, hand washing and using disinfectants to kill disease-causing organisms can curtail the spread of these illnesses. According to Wolper (2004), the HR department is mandated to oversee employee training and development processes. In reference to safety concerns relating to exposure to disease-causing organisms and other dangerous substances, it is imperative nurses, physicians, and other clinicians entering the healthcare sector to undergo thorough training programs. This is attributed to the fact that all manners of infections among employees can chiefly be averted through prevention and better care practices. Further highlight by Goel, Gupta and Singh (2014) is that HR personnel are involved in formulation of policies that relate to safety in healthcare organization. For instance, a no-lift policy can be a directive conferred by the HR. Owing to this mandate, the HR must therefore collaborate with clinicians to identify potential areas of exposure to any form or category of hazards. Controversies surrounding workplace safety in healthcare At this point, it is worth positing that workplace safety can be construed to include safety concerns of the patients. In other words, healthcare providers such as nurses or physicians can also transmit certain diseases to patients. As an example, a flu can easily be transmitted or passed from a healthcare provider to a colleague or to a patient. In many cases, employees in healthcare are required to undergo a compulsory vaccination procedure. One are of controversy surrounding workplace safety therefore relates to mandatory vaccinations in regards to whether an employee should be obligated to undergo compulsory vaccinations (Babcock et al, 2010). For instance, an employee may repudiate a vaccination on the basis of religious beliefs. Failure to undergo a vaccination may jeopardize the safety of individuals with lower levels of immunity such as those suffering from HIV/AIDs. In this respect, a question or controversy arises whether an employee should refuse to be vaccinated at the expense of risking the safety of individuals at risk. Subsequently, debates may arise on whether it is justifiable to put the safety of patients and other medical personnel at risk for the main reason of upholding individual religious beliefs. In simple terms, controversies arise whether individual clinicians rights are superior to the safety of colleagues and patients in general. Application: Case studies of successful safety strategies According to Babcock et al (2010, p. 459), "Influenza infection is associated with 36,000 excess deaths and more than 200,000 hospitalizations in the United States annually". In healthcare, Babcock et al (2010) brings forward the fact that influenza vaccination has been proved to minimize the rate or prevalence of flu as well as reduced cases of absenteeism from work. In this respect BJC HealthCare, a facility with approximately 26,000 workers, obligated all its employees to undergo a mandatory influenza vaccination as a provision for employment in the year 2008 (Babcock et al, 2010). However, employees who needed exclusion from the exercise were required to submit prove of religious conviction that prohibits its members from vaccinations or medical prove that flu vaccines could have harmful effects on their health. Conversely, employees whose requests for exclusion from the exercise were approved were required to wear face-masks when attending patients in order to prevent flu transmission (Babcock et al, 2010). Babcock et al (2010) additionally asserts that this exercise was successful in that the vaccination resulted to a mild flu infection in the periods the action plan was implemented. A second case study of a successful workplace safety strategy also involved mandatory flu vaccinations in Virginia Mason Hospital in the year 2004 (Babcock et al, 2010). In this healthcare organization, Babcock (2010) further explicated that the flu vaccination exercise resulted to a 98 percent reduction of flu cases within the organization. Analysis As an illustration of effects on exposure to hazards, facilities lacking proper preventive systems could be characterized high incidences of needle stick injuries due to congestion. This could alter the moods of employees in terms of job dissatisfaction, increase stress levels, and subsequently lead to a decrease in the quality of overall care. According to Stone, Hughes, and Dailey (2008), protective equipments are some of the components that make-up a safe working environment. In extension, Stone, Hughes, and Dailey (2008) reiterates that protective clothing translates to reduced incidences of work-related injuries and exposure to dangerous chemicals. In comparison, implementation of ways to reduce exposure to hazards in the workplace is characterized by reduced incidences of injuries which could in the long-run lead to increased levels of job satisfaction and a collaborative work environment that transforms services to quality and safe care. There are different forces at play in relation to attainment of safety in healthcare. Firstly, the HR and the clinicians must comprehend their roles and responsibilities in ensuring safety and align them with organizational objectives. Secondly, there must be collaboration between the HR and clinicians if safety is to be achieved. However, there are challenges in current practice. For instance, Goel, Gupta and Singh (2014) notes that the level of skills of clinicians, shortage of clinicians particularly nurses and physicians, poor working conditions, and interdisciplinary conflicts encompass some of the challenges that hinder the attainment of safe working conditions in healthcare. In terms of strengths, mission, vision, and philosophy statements in many healthcare organizations outlines projected safety targets that the organization ought to achieve. This can be viewed as s strength in the sense that mission, vision, and philosophy statements act as guiding principles that form the basis for the achievement of all safety targets (Goel, Gupta and Singh, 2014). Synthesis A new and unique idea It is clear from the presented evidence that workplace safety is viewed in the context of occupational ailments. There are various ways that can be used to prevent these infections or contaminations. In my opinion, creating a superior design for a healthcare facility during construction is imperative. In preventing needle stick injuries, for instance, special containers or chambers to hold used needles could be created to eliminate the likelihood of healthcare personnel re-handling them during disposal. Secondly, the design should include plenty of space in order to eliminate the likelihood of healthcare personnel bumping or colliding into each other. It is very probable for an individual to be pricked by an contaminated needle if he or she collides with a colleague in using a needle. Thirdly, the design must include an air conditioning system. This system can guarantee proper aeration within the organization hence preventing any infections that may arise from breathing contaminated air. In addition, it would be important to place hand washing requirements coupled with disinfectants to ensure that no infections are transmitted through hand-to-hand contact. According to Hughes and Ferrett (2010), use of incentives has been proved to lead to the achievement of desired outcomes. Safety, as further elucidated by Hughes and Ferret (2010) has been achieved in many healthcare organization by way of rewarding or giving incentives to employees proved to have abided by rules and regulations laid down by the organization to ensure prevention of occupational infections or ailments. For instance, the use of protective clothing can help prevent infections that could arise from direct contact with infected objects or dangerous substances such as chemicals. Giving incentives in the form of cash rewards motivate employees to always ensure laid down requirements and guidelines are followed. Conversely, encouraging employees to report any incidents of infections or contaminations is also an approach that has been proved to help prevent hazards (Hughes and Ferrett, 2010). This is attributed to the fact that reporting forms the basis for identification of risk areas and thus the implementation of action plans to avoid analogous infections or contaminations. Evaluation Using the approach of the facility design could have both positive and negative benefits. One of the benefits relates to the cost of disposing medical wastes. Creating a disposal mechanism early enough particularly during construction stage of the facility would help reduce operational costs as the funds that could have be used to implement waste disposal strategies are otherwise directed to other areas of need. Air conditioning could also help improve services within the organization. Beuzekom (2012) asserts that medical errors and safety issues may result from poor designs and maintenance failures. In comparing the novel approach to safety and the best and proved approaches to safety, it is worth noting that both approaches are preventive in nature. However, creating an effective design can be construed to be more superior to using incentives and reporting incidents. There are a number of studies that have been conducted to explicate the effects of facility design on safety in healthcare organizations. A methodical investigation conducted by Hughes (2008) showed that latent conditions such as poor lighting within a healthcare organization elevates the likelihood of medical errors. In the context of our discussion, medical errors may include needle stick injuries, exposure to other biological hazards, chemicals, and also physical hazards such as falls. In their study, Hughes (2008, p. 167) found out that "Efforts to improve patient and staff outcomes can target latent conditions for clinicians by using evidence-based designs to decrease distractions, standardize locations of equipment and supplies, and ensure adequate space for documentation and work areas". This shows that facility design has been proved through research to help improve safety of employees and patients in general. The use of incentives, on the other hand, is a patient-centered approach. Incentives according to Goel, Gupta and Singh (2014) are geared towards motivating employees to achieve better results. In this regard, it must be a continuous process if positive outcomes are to be achieved as opposed to the facility design approach that is performed once during construction. Based on the presented facts therefore, the facility design approach is a better option. Ethics Ethical challenges associated with workplace safety in healthcare One of the ethical issues or challenges that relates to safety include reporting unsafe processes or activities. The ANA Code of Ethics, as outlined by Lachman et al (2012), outlines that nurses are obligated to report any hazardous, immoral, and prohibited conduct by a healthcare provider. In essence, reporting ought to be directed towards individuals in positions of authority who are mandated to take action against perpetrators of illegitimate behaviors. However, nurses and other healthcare providers may shun away from reporting such cases for fear of reprisals. In this regard, it is the duty or responsibility of the management to ensure implementation of reporting structures that allow or facilitate confidentiality of whistle-blowers. The second form of ethical issue relevant to safety relates to failure to disclose. According to Scheirton, Lohman, and Cochran (2007), healthcare providers may fail to disclose exposure to a dangerous chemical, an injury, or a patient fall for fear of subsequent consequences. Failure to disclose constitutes a moral issue on the basis of the fact that it delays treatment (Scheirton, Lohman, and Cochran, 2007). In cases of exposure to ailments that could be transmitted to other individuals, Scheirton, Lohman, and Cochran (2014) further notes that failure to disclose jeopardizes the safety of other healthcare personnel and patients as well in terms of transmission. Failure to disclose is in fact contrary to professional code of ethics in healthcare. Conclusion The issue of workplace safety in the context of healthcare has indeed generated a lot of attention over the recent past. This has been attributed to epidemics such as Ebola that have risked the safety of healthcare practitioners in terms of exposure and contamination. Safety concerns in healthcare are viewed in terms of exposure to biological hazards, chemical hazards, emotional vulnerabilities, and other vulnerabilities involved with lifting weighty objects. action plans ought to be implemented to reduce exposure to these hazards. HR plays an important role in training personnel on how to protect themselves from exposure, identifying areas of risk that could potentially elevate chances of exposure, and recruiting individuals with the capacity to abide to safety rules and regulations. Prevention of these hazards can be achieved by the use of protective clothing, proper infrastructure or designs that include air conditioning, and proper clinical waste disposal to reduce chances of exposure. An array of action plans have been implemented in the past to minimize the spread of illnesses in healthcare facilities. For instance, BJC Healthcare implemented a compulsory influenza vaccination exercise that significantly reduced the prevalence of flu within the organization. There are also ethical issues that are linked to safety in healthcare. These include failure to report exposure for fear of being reprimanded and whistle-blowing or reporting witnessed incidents of hazardous practices or conduct to individuals in management. References Babcock, H. M., Gemeinhart, N., Jones, M., Dunagan, C., & Woeltje, K. (2010). Mandatory Influenza Vaccination of Health Care Workers: Translating Policy to Practice. Infectious Diseases Society of America, 50(4), 459-464. Beuzekom, M. 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