2015-01-01 12:00 - Messages

Hospital unit safety climate

Relationship with nurses' adherence to recommended use of facial protective Equipment
Background : Despite the existence of formal guidelines for the acute health care sector, nurses' adherence to recommended use of facial protective equipment (FPE) to prevent occupational transmission of communicable respiratory disease remains suboptimal. In addition to individual factors such as knowledge and education, group factors such as shared perceptions of organizational support for safety may influence adherence. These group safety climate perceptions can differ depending on the pace and type of work, local leadership, and organizational structure of each unit.
Methods : An analysis of a data set from a cross-sectional survey of 1,074 nurses in 45 units of 6 acute care hospitals was conducted. Variance components analysis was performed to examine the variance in perceptions of safety climate and adherence between units. Hierarchical linear modeling using unit-level safety climate dimensions was conducted to determine if unit-level safety climate dimensions were predictors of nurses' adherence to FPE.
Results : Findings revealed statistically significant unit variances in adherence and 5 of the 6 unit-level safety climate dimensions (P < .05). Furthermore, a hierarchical model suggested that tenure and unit-level communication were significantly associated with increased adherence to FPE (P < .05).
Conclusion : Unit-level safety climate measures varied significantly between units. Strategies to improve unit-level communication regarding safety should assist in improving adherence to FPE.

Source: Diamant Rozenbojm, Michael, Nichol, Kathryn, Spielman, Stephanie, & Holness, Linn. (2014). AJIC : American Journal of Infetion Control. February 1, 2015, Volume 43, Issue 2, Pages 115–120.

Predicting the probability of slip in gait

Methodology and distribution study
The likelihood of a slip is related to the available and required friction for a certain activity, here gait. Classical slip and fall analysis presumed that a walking surface was safe if the difference between the mean available and required friction coefficients exceeded a certain threshold. Previous research was dedicated to reformulating the classical slip and fall theory to include the stochastic variation of the available and required friction when predicting the probability of slip in gait. However, when predicting the probability of a slip, previous researchers have either ignored the variation in the required friction or assumed the available and required friction to be normally distributed. Also, there are no published results that actually give the probability of slip for various combinations of required and available frictions. This study proposes a modification to the equation for predicting the probability of slip, reducing the previous equation from a double-integral to a more convenient single-integral form. Also, a simple numerical integration technique is provided to predict the probability of slip in gait: the trapezoidal method. The effect of the random variable distributions on the probability of slip is also studied. It is shown that both the required and available friction distributions cannot automatically be assumed as being normally distributed. The proposed methods allow for any combination of distributions for the available and required friction, and numerical results are compared to analytical solutions for an error analysis. The trapezoidal method is shown to be highly accurate and efficient. The probability of slip is also shown to be sensitive to the input distributions of the required and available friction. Lastly, a critical value for the probability of slip is proposed based on the number of steps taken by an average person in a single day.

Source: Gragg J, Yang J. Comput. Methods Biomech. Biomed. Eng. 2015, p. 1-8.

The Use and Effectiveness of Powered Air Purifying Respirators in Health Care

Workshop Summary
Protecting 18 million United States health care workers from infectious agents—known and unknown—involves a range of occupational safety and health measures that include identifying and using appropriate protective equipment (CDC, 2014a). The 2009 H1N1 influenza pandemic and the 2014 Ebola virus outbreak in West Africa have called attention to the importance of personal protective equipment (PPE) in different health care settings and have raised questions about how best to ensure appropriate and effective use of different kinds of PPE (such as respirators), not only to promote occupational safety but also to reduce disease transmission, in general.
Since 2005, the National Personal Protective Technology Laboratory (NPPTL) at the National Institute for Occupational Safety and Health (NIOSH) has sponsored the Institute of Medicine (IOM) Standing Committee on Personal Protective Equipment for Workplace Safety and Health. In mid-2014, NPPTL asked the IOM to convene a workshop, “The Use and Effectiveness of Powered Air Purifying Respirators in Health Care,” to help prioritize and accelerate NIOSH activities to update certification requirements for powered air purifying respirators (PAPRs) for use in health care.

Source: http://www.iom.edu/Reports/2015/Use-And-Effectiveness-of-Powered-Air-Purifying-Respirators-in-Health-Care.aspx

Compliance with the ANSI Z133.1 - 2006 safety standard among arborists in New England

INTRODUCTION: Arboriculture is hazardous work. A consensus safety standard exists, but little is known about compliance with it. This study aimed to determine whether accreditation and certification are associated with safety practices and to identify specific safety practices adhered to most and least.
METHOD: Sixty-three tree care companies in southern New England were directly observed on job sites. Adherence to the American National Standards for Arboricultural Operations (ANSI Z133.1 - 2006) was compared across companies that were accredited, non-accredited with certified arborists on staff, and non-accredited without certified arborists on staff.
RESULTS: Companies with accreditation or certified arborists demonstrated greater safety compliance than those without. However, low compliance was found across all company types for personal protective equipment (PPE) use, chain saw safety, and chipper safety.
CONCLUSIONS: Greater attention to PPE, chain saw, and chipper practices is warranted across the industry. Safety in non-accredited companies without certified arborists especially needs improvement. PRACTICAL APPLICATION: Only partial compliance was found among accredited companies and companies with certified arborists. Intervention strategies are needed for all company types for the use of PPE and safer use of chain saws and chippers.

Source: Julius AK, Kane B, Bulzacchelli MT, Ryan HD. J. Saf. Res. 2014; 51: 65-72.

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