Page 375 - Encyclopedia of Nursing Research

342 n NuRSING PRACTICe MODeLS

can result in a wide variety of injuries and rates than the rates of those with less contact.
illnesses for the worker as well as medical emergency departments were associated
N errors, shortages of health care workers, and with higher assault rates in one study, mental
automobile crashes while commuting to and health and geriatrics units in the other than
from work. other areas. Better lighting, shorter working
Health care workers are often exposed hours, and personal alarms (e.g., cell phones)
to shift work and long work hours because were associated with lower assault rates
their services are needed around the clock (Gerberich et al., 2004; Hodgson et al., 2004).
and because shortages of workers put pres- Buerhaus (2005) found that more than
sure on those available to work longer hours. 75% of RNs believe that the nursing shortage
A large number of studies report an associa- presents a major problem for the quality of
tion between shift work and long hours and their work life, the quality of patient care, and
health and safety risks (NIOSH, 2004b). For the amount of time nurses can spend with
example, disturbances may occur leading patients. Looking forward, almost all nurses
to reductions in the length and quality of surveyed see the shortage in the future as a
sleep and may increase fatigue; sleepiness; catalyst for increasing stress on nurses (98%),
worker errors; and gastrointestinal, psycho- lowering patient care quality (93%), and caus-
logical, and cardiovascular symptoms and ing nurses to leave the profession (93%). In a
disorders; breast cancer; and adverse repro- report by the Bernard Hodes Group (2006),
ductive outcomes (Megdal, Kroenke, Laden, 55% of nurses surveyed reported their inten-
Pukkala, Schernhammer, 2005). Long hours tion to retire between 2011 and 2020.
may also increase exposure times to work- There are many areas ripe for research
place hazards and may reduce time available related to the numerous exposures nurses
for exercise or nutritious meals. face every day while at work. Although a
Health care workers are at risk for verbal, wide range of hazards exist, a key barrier to
psychological, and physical violence. violent addressing them is the misconception that
acts occur during interactions with patients, health care work is safer than other work
family, visitors, coworkers, and supervisors. involving exposure to chemical and physi-
Working with volatile people or people under cal hazards. We must continue to be vigilant
heightened stress, long wait times for service, about the work-related health hazards and
understaffing, patients or visitors under the put in place strategies designed to eliminate
influence of drugs or alcohol, access to weap- and mitigate these risks.
ons, inadequate security, and poor environ-
mental design are among the risk factors Bonnie Rogers
for violence (Gerberich et al., 2005; McPhaul
et al., 2006). The HCSA sector leads all other
industrial sectors in the incidence of nonfa-
tal workplace assaults. In 2006, 60% of the NursiNg practice models
assaults and violent acts (by person) requir-
ing days away from work occurred in HCSA
and mainly involved assaults by health care A nursing practice model can be described
patients (BLS, 2006b). The Minnesota nurses as a guide, a road map, or a framework that
study documented an overall violence rate of provides a structure for the organization
14.2/100 person-years; over 25% of nurses in and the delivery of care. There have been
the veterans Health Administration study several types of nursing practice models
experienced at least one assault each year. In developed over time. They include adminis-
both surveys, occupations with closer physi- trative, theory-based, and transitions-based
cal contact with patients had higher assault models. With the emergence of American