1st Edition

Healthcare Safety for Nursing Personnel
An Organizational Guide to Achieving Results




ISBN 9781482230277
Published December 10, 2014 by Productivity Press
366 Pages

USD $105.00

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Book Description

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.

Table of Contents

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

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