1st Edition

Healthcare Safety for Nursing Personnel An Organizational Guide to Achieving Results

By James T. Tweedy Copyright 2015
    366 Pages
    by Productivity Press

    Nursing personnel play an integral role in healthcare and medical delivery organizations. Nurses not only work to keep patients safe, but must also contend with a number of safety and health risks. Illustrating the occupational risks nurses face, Healthcare Safety for Nursing Personnel: An Organizational Guide to Achieving Results addresses healthcare safety as related to nursing personnel risks, hazards, and responsibilities in hospitals and healthcare facilities.

    The book begins with an introduction to nursing safety that supplies a fundamental understanding of patient, nursing, and facility safety. Next, it delves into the range of safety issues that nurses must contend with. Topics covered include administrative area safety, bloodborne pathogens, workplace violence, infection control and prevention, emergency management, fire safety, and radiation hazards.

    Examining the concepts and principles of patient safety as related to organizational dynamics, culture, system methods, and key patient safety initiatives, the book supplies essential knowledge of healthcare safety risks, challenges, and controls. It includes information on leadership, management, communication skills, and understanding accidents.

    The book includes helpful resources in the appendices, such as a nurse safety perception survey, an accident causal factor chart, sample ergonomics symptoms report, sample TB exposure control plan, and a model respirator plan for small organizations. Complete with review exercises in each chapter, this book is ideal for certification training in nursing programs and as a reference for developing nursing in-service safety sessions.

    Nursing Safety
         ANA Nurse Health & Safety Survey Results
         Safe Patient Handling and Mobility: Interprofessional National Standards
         New Patient Safety Survey: Few Nurses Call Their Hospitals Safe
         International Board for Certification of Safety Managers (IBFCSM)
    The Function of Safety
         Safety Responsibilities
         Nursing Supervisor Involvement
         Addressing Behaviors
         Employee Engagement
    Understanding Hazards
         Hazard Identification
         Preparing for Inspections
         Job Hazard Analysis (JHA)
         Job Design
         Hazard Control and Risk Management
         Hazard Control and Correction
              Active and Passive Controls
              Engineering Controls
              Administrative Controls
              Work Practice Controls
         Personal Protective Equipment (PPE)
         Areas to Evaluate
    System Safety
    Understanding Accidents
         Accident Reporting
         Accident Investigations
              Classifying Accident Causal Factors
              Interviewing Witnesses
              Accident Analysis
              Root Cause Analysis (RCA)
         Preparing Accident Reports
    Human Factors
         Error
         Motivating People
    Review Exercises

    Leadership and Management Overview
    Introduction
    Leadership
         Practical Leadership
         Leadership Ethics
    Management
         Knowledge Management
         Decision-Making
         Psychological Safety
         Crisis Management
         Traditional Organizational Structure
    Organizational Culture
         Covert and Overt Cultures
    Interfacing Support Functions
         Operational and Support Functions
         Human Resources
         Facility Management
         Employee Health
    Workers’ Compensation
         Return to Work/Modified Duty Positions
         Substance Abuse
    Orientation, Education, and Training
         Providing Adequate Sessions
         Safety Training
    Effective Speaking and Writing
         Communication
         Communication Barriers
         Effective Writing
    Review Exercises

    Nursing Hazards
    Introduction
         Administrative Area Safety
    Shift Work and Job Stress
         Shift Work
         Stress
    Slip, Trip, and Fall Prevention
    Safety Signs, Colors, and Marking Requirements
    Electrical Safety (29 CFR Subpart S)
    Three Common Hazards
         Bloodborne Pathogens
         Hazardous Material Safety
         Nursing Personnel and Workplace Violence
    Helicopter Safety
    Noncompensated or Voluntary Worker Safety
    Home Health Safety
    Surgical Department
    Perinatal Nursing
    Intensive Care Units
    Emergency Department
    Dialysis Unit Safety
         Equipment
         Personal Protective Equipment
    Medical Equipment Management
         Medical Equipment Management
         Joint Commission Requirements
         Maintenance, Testing, and Inspecting
         Medical Equipment Reporting
         Safe Medical Device Act of 1990 (SMDA)
         SMDA Reportable Events
         Other Reporting Requirements
    Security
         NFPA 99-2012, Security Management (Chapter 13)
         Resources
         Incident Reporting
         Property Protection
         Sensitive Area Access
         Identification of Patients, Visitors, and Staff
         Traffic Control and Vehicle Access
         Weapons on Campus
         Handling Civil Disturbances
         Handling Situations Involving "VIPs" or the Media
         Access and Crowd Control
         Communications
         Orientation and Education
         Evaluation of Security
         Using Proven Practices to Improve Security
         Forensic Patients
         Workplace Violence
              Workplace Violence Protection for Nurses by Accrediting Bodies
              Workplace Violence Prevention (NIOSH Publication No. 2002-101)
              Management Commitment and Employee Involvement
    Ergonomics
         Evaluation of Ergonomics Efforts
         Workstation Evaluations
         Workstation Interventions
         Human Factors
         Musculoskeletal Disorders (MSDs)
         Administrative Issues
         Equipment Maintenance
         Facility Design Issues
         Mechanical Lift and Assist Devices
         Understanding the Body
         Injuries and Disorders
         Back-Related Problems
         Back Injury Prevention
              Lateral Transfers
              Ambulating, Repositioning, and Manipulating
              Performing Activities of Daily Living
              Useful Tips
              Lift Teams
              Guiding and Slowing Falls
              Transfer Task Safety
              Personal Factors
              Work Evaluation Tools
         Training and Education
    Patient Transport Functions
         Transporting Patients
         Patient Care
         Transport Team Development
              Wheelchair Safety
    Review Exercises

    Patient Safety
    Introduction
         Worker Fatigue and Patient Safety
    Leading Efforts
    IOM Reports
    Errors and Adverse Events
         Active and Latent Errors
         Factors Impairing Human Performance
         Error Reporting
              Reporting Using Technology
         Analyzing Events and Errors
         Common Error Causal Factors
         Medical Education and Error Acknowledgment
    Safety Cultures
         Safety Culture Perceptions
         Healthcare Bureaucratic Structure
         Proactive Organizations
         Understanding Change
         Organizational Change
         Teamwork
    Understanding Systems
         Systems Approach
         Key System Safety Elements
         System Reliability
         Failure Mode and Effect Analysis (FMEA)
         Technology and Safety
    Patient-Centered Healthcare
         Error Disclosure
         Medical Error Disclosure Guidance
         Evidence-Based Medicine (EBM)
         General Patient Safety Practices
         Using Patient Safety Checklists
    Human Factors
    Patient Safety Officers and Committees
    Quality Improvement
         Benchmarking
         Other Measurements
         Stakeholders
         Plan-Do-Study-Act (PDSA)
         Root Cause Analysis
         Patient Roles in Patient Safety
    Improving Patient Safety
         Wrong Surgeries
         Diagnostic Errors
         Display Confusion
         Air Embolism from Contrast Media Injectors
         Serious Reportable Events (SREs)
         Handoffs
              Implementing Structured Handoff and Sign-Out Procedures
         Foreign Bodies
         Surgical Fires
         Anesthesia Hazards Due to Inadequate Inspection
         Medical Device Alarm Safety
         Discharged Patient Events
    Healthcare-Associated Infections (HAIs)
         Central Venous Catheter–Related Bloodstream Infections (CRBSI)
         Surgical Site Infection (SSI)
         Ventilator-Associated Pneumonia (VAP)
         Catheter-Associated Urinary Tract Infection (CAUTI)
    Medication Safety
         Medication Errors
         Risk Factors for Adverse Drug Events
         Prevention of Adverse Drug Events
         Accomplishing Medication Reconciliation
         Medication Administration
         Reducing Medication Errors
         Reporting Medication Errors
         Investigating Medication Errors
         Computerized Provider Order Entry (CPOE)
    Emergency Department Patient Safety
    Other Key Patient Safety Issues
         Infusion Pumps
         Ambulatory Care
         Work Hours and Patient Safety
              ACGME 2010 Standards
         Rapid Response Systems
         Call System Operation
         Health Insurance Portability and Accountability Act (HIPAA)
         Patient Restraints
              Most Medical/Surgical Restraints Exempt
         Patient Fall Prevention
         Environmental Hazards
         Bed Safety
    Electronic Records
         Key Components of Electronic Health Records
         Electronic Charting
    Infant Abduction Prevention
         Preventive Measures
    Quality and Safety Education For Nurses (QSEN)
    Review Exercises

    Emergency Management & Fire Safety
    Introduction
    Joint Commission Requirements
    Other Emergency Planning Issues
         Hospital Evacuation Planning
    Community Involvement
         Partnership for Community Safety
         Hospital Roles in Community Emergencies
    Incident Command System (ICS)
         Incident Commander Responsibilities
    Strategic National Stockpile
    Planning for Terrorism
    Pandemic Planning
    Fire Safety
         Life Safety Code Comparisons
         Design Considerations
         Fire Prevention
         Inspections
         Fire Warning and Safety
              Manual Alarm Stations
              Electrically Supervised Systems
              Special Requirements for Cooking Areas
              Fire System Inspections
         Fire Confinement
         Emergency Egress
              OSHA Egress Standards
    Fire Extinguishers
              How Fire Extinguishers Work
              Proper Maintenance
    Surgical Fires
              ATSM Surgical Fire Standard
              Fire Blankets
    Life Safety
         Interim Life Safety
    Review Exercises

    Hazardous Materials
    Introduction
    Hazardous Substance Safety
         Hazardous Substance Exposures
         Hazardous Chemical Determination
         Reproductive Hazards
         Threshold Limit Values (TLVs)
         Chemical Properties
         Flash Points
         Airborne Exposure
         Emergency Showers and Eyewashes
         Compressed Gas Safety
    OSHA Hazard Communication Standard (29 CFR 1910.1200)
         Globally Harmonized System (GHS)
         Major Hazard Communication Standard Changes
         Safety Data Sheet (SDS) Changes
         Managing and Communicating Changes to the Hazard Communication Standard 
         Employee Training
    Healthcare Hazardous Materials 
         Acetone 
         Acryl Amide 
         Ammonia 
         Cadmium (29 CFR 1910.1027)
         Chlorine Compounds
         Iodine
         Isopropyl Alcohol 
         Methyl Methacrylate 
         Peracetic Acid 
         Pesticides 
         Phenol Substances 
         Quaternary Ammonium Compounds 
         Solvents 
         Ethyl Alcohol 
         Glutaraldehyde 
         Orthopthalaldehyde (OPA)
         Ethylene Oxide (29 CFR 1910.1047)
         Formaldehyde (29 CFR 1910.1048)
    Hazardous Drugs
         Hazardous Pharmaceutical Wastes
    Medical Gas Systems
         Anesthetic Gas Hazards
         Scavenging
         Nitric Oxide
         Nitrous Oxide
    Managing Waste
    A. Medical Waste
    Respiratory Protection (29 CFR 1910.134)
         Types of Respirators
    Review Exercises

    Infection Control and Prevention
    Introduction
    Healthcare Immunizations
         Guidelines of the Advisory Committee for Immunization Practice
         Other Vaccination Considerations
    Centers for Disease Control and Prevention (CDC)
         CDC Guidelines for Hand Hygiene in Healthcare Settings
         Guidelines for Environmental Infection Control in Healthcare Facilities
         CDC Standard Precautions
         Disease and Infection Transmission Routes
              Airborne Precautions
              Droplet Precautions
              Contact Precautions
         New Infection Risk
    Centers for Medicare & Medicaid Serivces (CMS) Hospital-Acquired Conditions (HAC) and Present on Admission (POA) Indicators
    Disinfectants, Sterilants, and Antiseptics
         Germicidal Effectiveness
         Regulatory Approval of Disinfectants
         EPA’s Registered Sterilizers and Tuberculocidal and Antimicrobial Products
         CDC Recommendations
         Selecting a Disinfectant
    OSHA Bloodborne Pathogens Standard (29 CFR 1910.1030)
         Exposure Control Plan
         OSHA Hand Hygiene Requirements
         Employee Involvement
         Recordkeeping
         Engineering Controls
         Needleless Systems
         Exposure Determination
         Control Measures
         Personal Protective Equipment
         Housekeeping, Laundry, and Waste Practices
         Hepatitis B Virus (HBV)
              Hepatitis B Vaccination
         Hepatitis C (HCV)
         Human Immunodeficiency Virus (HIV)
         Other Key Topics
         Latex Allergies
         Information and Training
              Training Methods and Interactive Question Opportunities
              Trainer Qualifications
         Medical Recordkeeping
              Training Recordkeeping
         Hazardous Waste Operations and Emergency Response (29 CFR 1910.120).
         Post-Exposure Evaluation and Follow-Up
    Tuberculosis (TB) 
         TB Screening Procedures for Settings Classified as Low Risk
         TB Screening Procedures for Settings Classified as Medium Risk
         TB Screening Procedures for Settings Classified as Potential Ongoing Transmission 
         OSHA Tuberculosis Exposure Enforcement Guidelines
              OSHA Citations for TB Exposures
              OSHA Abatement Methods
              OSHA Tuberculosis Respirator Requirements
         TB Exposure Control Plan
              Administrative Controls
              Environmental Controls
              Respiratory-Protection Controls
              Engineering Controls
    Healthcare Opportunistic Infections
         Bacteria
         Methicillin-Resistant Staphylococcus Aureus
         Viruses
         Aspergillus
         Anthrax
         Severe Acute Respiratory Syndrome (SARS)
         Pseudomonas
         Legionella
         Infection Control Risk Assessment (ICRA)
    Medical Waste
         Sharps Containers
         Separating Medical and Hazardous Wastes
         Infectious Wastes
         Medical Waste Best Practices
         Waste Handling for Offsite Transfer
         Containers
         Medical Waste Disposal
    DOT Infectious Shipping Requirements
    Review Exercises

    Radiation, Lab, and Drug Hazards
    Radiation Safety
         OSHA Ionizing Radiation Standard (29 CFR 1910.1096)
         Restricted Areas
         Surveys and Monitoring
         Radiation Areas
         Caution Signs
         Airborne Radioactivity
         Storage Areas
         TB Exposures
         Ergonomics
         Slips, Trips, and Falls
         Bloodborne Pathogens
         Storage and Handling Procedures
         Medical Radioactive Materials
         Shielding
         ALARP
    Nuclear Medicine
         Brachytherapy (Implant) Patients
         Medical, Reproductive, and Fertility Considerations
    Nuclear Regulatory Commission (NRC)
         NRC Performance-Based Standards
         Radiation Control Planning
         Radiation Safety Committee
         Radiation Safety Officer (RSO)
         Regulatory and Occupational Dose Considerations
         National Council on Radiation Protection (NCRP)
    Food And Drug Administration (FDA) and Radiation Safety
         The Radiological Society of North America (RSNA)
         The American College of Radiology (ACR)
    Radioactive Waste Management
    Nonionizing Radiation (29 CFR 1910.97)
         Ultraviolet (UV) Radiation
         Radiofrequency (RF) and Microwave (MW) Radiation
         Wireless Medical Telemetry
         FDA/CDRH Recommendations for EMC/EMI in Healthcare Facilities
         Consensus Standards
         Other Recognized Standards
    Lasers and Electrosurgery
         Laser Safety
         Laser Safety Officer (LSO)
         Laser Standards
         Laser Classifications
              Class 1 Laser
              Class 1M Laser
              Class 2 Laser
              Class 2M Laser
              Class 3R Laser
              Class 3B Laser
              Class 4 Laser
         Laser Plumes
         Laser Skin Protection
         Fires Prevention Tips during Laser Surgery
    Magnetic Resonance Imaging (MRI)
         FDA MRI Safety Guidelines
         Other MRI Safety Recommendations
         MRI Burns
    Other Clinical Risks
         CT Radiation Doses
         Fiber-Optic Light Burns
         Sonography
    Laboratory Safety
         Clinical Laboratory Improvement Amendments (CLIA)
         Joint Commission Laboratory Accreditation
         College of American Pathologists (CAP) Accreditation
         College of American Pathologists (CAP) Accreditation Program
         COLA Accreditation
         OSHA Laboratory Standard (29 CFR 1910.1450)
         Summary of Lab Safe Work Practices
         Centrifuges
         Laboratories and the OSHA Bloodborne Pathogens Standard
         Tuberculosis (TB)
         Morgue
         Chemical and Fire Hazards
         Chemical Exposure Response
         Standard Operating Procedures
         Laboratory Equipment
         Microtome Safety
         Pressure and Vacuum Systems
         Fume Hoods and Laboratory Ventilation
         Employee Training
         Medical Examinations and Consultations
         Supervisor Responsibilities
         Safety Personnel Responsibilities
         Laboratory Personnel Safety Responsibilities
         Animal Research Facilities
         Laboratory Hazardous Waste Disposal
         Autoclaves
         Good Clinical Laboratory Practices (GCLP)
         Laboratory Physical Environments
    Drug Hazards
         Clinical Pharmacy
         General Safety Considerations
         Pharmacy Safety
         OSHA Hazard Communication Standard
         Pharmacy Ergonomics
         Workplace Violence
         General Medication Labeling
         Closed Pharmacy Procedures
         Drug Recalls or Safety Alerts
         High-Risk Medications
         Investigational Medication Safety
         Evaluation of Medication Management
         Drug Quality and Storage
         Current Standards
         NIOSH Revision of ASHP Definition
         Developing a Hazardous Drug List
         Where to Find Information Related to Drug Toxicity
         2010 NIOSH Update of Hazardous Drug Alert for Healthcare Settings
         Hazardous Drug Safety Plan
         Transfer Procedures
         Caregiver Exposure Precautions
         Administering Aerosolized Drugs
         Hazardous Drug Waste
         Spill Control
         Medical Surveillance
              Ventilated Cabinets
         Recordkeeping
    Proposed Universal Waste Rule for Pharmaceuticals
         Current RCRA Requirements
         USP 797: Pharmaceutical Compounding—Sterile Preparations
         USP 797 2008 Revision
    Review Exercises

    Agencies, Associations, and Organizations
    Administrative Law
    Occupational Safety and Health Administration (OSHA)
         Summary of General Duties
         Priorities
         Citations
         State-Approved Plans
         Recordkeeping (29 CFR 1904)
         Recording Work-Related Injuries And Illnesses
              Medical Treatment
              Restricted Work
              Classifying Injuries
              Classifying Illnesses
              Posting the Summary
              Form 301 Injury and Illness Incident Report
         Access to Employee Exposure and Medical Records (29 CFR 1910.1020)
    Environmental Protection Agency (EPA)
         Resource Conservation and Recovery Act (RCRA)
         Comprehensive Environmental Response, Compensation and Liability Act (CERCLA)
         Superfund Amendments and Reauthorization Act of 1986 (SARA)
         Clean Air Act (CAA)
         Clean Water Act (CWA)
         Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA)
         Toxic Substances Control Act (TSCA)
    Other Federal Agencies
         Nuclear Regulatory Commission (NRC)
         National Institute for Occupational Safety and Health (NIOSH)
         Centers for Disease Control and Prevention (CDC)
         Food and Drug Administration (FDA)
         Agency for Healthcare Research and Quality (AHRQ)
         National Institutes of Health (NIH).
         Centers for Medicare & Medicaid Services (CMS)
         Institute Of Medicine (IOM)
    Accreditation Organizations
         The Joint Commission
              EOC Management
         American Osteopathic Association (AOA)
         Det Norske Veritas (DNV) National Integrated Accreditation for Healthcare Organizations (NIAHO)
         Accreditation Canada
         Commission on Accreditation of Rehabilitation Facilities (CARF)
         College of American Pathologists (CAP) Laboratory Accreditation
    Standards Organizations
         American Conference of Governmental Industrial Hygienists (ACGIH).
         American National Standards Institute (ANSI)
         National Council on Radiation Protection and Measurements (NCRP)
         National Fire Protection Association (NFPA)
    Voluntary Associations
         American Health Care Association (AHCA) 
         American Hospital Association (AHA) 
         American Society of Healthcare Risk Management (ASHRM) 
         American Association of Occupational Health Nurses (AAOHN) 
         Association for the Healthcare Environment (AHE) 
         Association of Occupational Health Professionals (AOHP) 
         ECRI 
         American Association of Colleges of Nursing (AACN) 
         Academy of Medical-Surgical Nurses (AMSN) 
         American Association of Critical-Care Nurses (ACCN) 
         American Nurses Association (ANA)
         The American Academy of Ambulatory Care Nursing (AAACN)
          American Association of Managed Care Nurses (AAMCN)
         American Nephrology Nurses’ Association (ANNA)
         American Organization of Nurse Executives (AONE)
         American Psychiatric Nurses Association (APNA)
         Association of periOperative Registered Nurses (AORN)
         National Student Nursing Association (NSNA)
         American Association of Nurse Anesthetists (AANA)
         American Holistic Nurses Association (AHNA)
         Emergency Nurses Association (ENA)
         American Nursing Informatics Association (ANIA)
         Association of Rehabilitation Nurses (ARN)
    Review Exercises

    References


    Appendices:
    Nurses Safety Perception Survey
    Safety Improvement Principles
    Accident Causal Factor Chart
    Ergonomic Symptoms Report
    Sample Personal Protective Equipment Hazard Assessment Form
    Workplace Violence Prevention Policy
    Bloodborne Training Requirements
    Patient Handling Guidance
    Patient Safety Plan Development Considerations
    Sample TB Exposure Control Plan
    Model Respirator Plan for Small Organizations
    Glossary of Terms
    AHRQ Patient Safety Tools and Resources

    Index

    Biography

    James T. Tweedy