Etiology and injury

Etiology of Injury and Illness

• Injuries and illnesses in the workplace occur across almost every profession; nurses face hazards when performing routine patient care.

• Major injury/illness types for nurses include:

  • Overexertion and body movements leading to slips, trips, falls, and back injuries.

  • Exposure to potentially harmful substances: radiation, drugs, cleaning chemicals, and unintentional needlesticks.

  • Transmission of infectious pathogens through contact, droplets, or air (examples: methicillin-resistant Staphylococcus aureus (MRSA), COVID-19, tuberculosis).

• Projection for nursing workforce: between 2018 and 2028 there will be an increase of $12\%$ in hiring of registered nurses (BLS, 2020).

Prevalence and Demographics (2016 data)

• 2016 nonfatal injuries and illnesses from workplace hazards in private industries: $19{,}790$.

• Hospital settings accounted for $74.1\%$ of these injuries, reflecting higher incidence than in other settings (e.g., long-term care facilities).

• Musculoskeletal disorder injuries (sprains and tears) requiring time away from work accounted for $51\%$ of all reported injuries and illnesses to RNs in 2016.

• Back injuries numbered $5{,}490$ cases, with an average recovery time of $7\,\text{days}$.

• Age distribution of injured RNs in 2016:

  • 35 to 44 years: $23.3\%$

  • 45 to 54 years: $27\%$

  • 55 to 64 years: $24.7\%$

• Age-related observations: older RNs experienced more severe injuries and illnesses than younger RNs.

• Three key observations about nurse injuries in 2016 (BLS, 2018):

  • The majority of nonfatal nurse injuries occurred in a hospital setting.

  • Nurses experienced more musculoskeletal disorders than workers in many other occupations.

  • Injuries and illnesses have social and economic implications for workers and their families, and for employers and society as a whole; data collection relies on national surveillance systems to document new cases and inform prevention efforts to reduce hazards and health issues among healthcare personnel.

Risk Factors and Protective Resources

• Nurses are at high risk for musculoskeletal system and connective tissue injuries due to:

  • Work patterns

  • Increased patient acuity

  • Need to keep patients mobile

  • Increasing numbers of obese patients

• Protective resources and strategies include:

  • Training, lifting devices, and lift teams to reduce injuries.

  • Establishing and supporting a safety culture within healthcare facilities.

  • Emphasis on occupational safety and health practices to promote safer work environments and patient safety.

• The COVID-19 pandemic highlighted PPE shortages and raised national awareness of safety needs.

• NIOSH (part of CDC) helps facilities identify hazards and provides tools/materials to improve employee safety and health (CDC, 2018c).

Implications for Safety Practice and Policy

• Social and economic consequences include medical costs, reduced quality of life, pain and suffering for workers and families.

• Employers and society share the burden of occupational safety and health hazards.

• Data collection, via national surveillance systems, is essential to record new cases and to inform strategies to prevent injuries, illnesses, and deaths among healthcare personnel.

• Emphasis on building a robust safety culture, implementing protective equipment and devices, and leveraging expert resources (e.g., NIOSH/CDC guidance) to continually reduce occupational hazards in healthcare settings.