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chapter 12 | Promoting a Healthy Workplace 175 CikguOnline
by the ANA Board of Directors, and represent The first step in development of a workplace
constituent member associations. Additionally, safety program is to recognize a potential hazard and
state member associations often offer their own then take steps to control it. Based on OSHA reg-
workplace advocacy information. Issues such as ulations (U.S. Department of Labor, 1995), the
collective bargaining, workplace violence, mandatory employer must inform staff members of any poten-
overtime, staffing ratios, conflict management, del- tial health hazards and provide as much protection
egation, ethical issues, compensation, needlestick from these hazards as possible. In many cases, ini-
safety, latex allergies, pollution prevention, and tial warnings come from the CDC, NIOSH, and
ergonomics are addressed. other federal, state, and local agencies. For example,
The ANA Web site (www.nursingworld.org) employers must provide tuberculosis testing and
keeps up-to-date information related to workplace hepatitis B vaccine; protective equipment such as
advocacy and safety available to all nurses. gloves, gowns, and masks; and immediate treat-
ment after exposure for all staff members who may
Joint Commission have contact with blood-borne pathogens.
The Joint Commission (JC) is an independent, Employers are expected to remove hazards, educate
nonprofit organization. Established more than employees, and establish institution-wide policies
50 years ago, it is governed by a board that includes and procedures to protect their employees
physicians, nurses, and consumers. The JC evalu- (Herring, 1994; Roche, 1993). Nurses who are not
ates the quality and safety of care for more than provided with latex gloves may refuse to participate
15,000 health-care organizations. To earn and in any activities involving blood or blood products.
maintain accreditation, organizations must have an The employee cannot be subjected to discrimina-
extensive on-site review by a team of JC health- tion in the workplace, and reasonable accommoda-
care professionals at least once every 3 years. Many tions for safety against blood-borne pathogens
of the national patient safety goals discussed in must be provided. This may mean that the nurse
Chapter 10 were influenced by the safety of the with latex allergies is placed in an area where expo-
health-care worker. For example, fatigue due to sure to blood-borne pathogens is not an issue
mandatory overtime has been identified as causing (Strader & Decker, 1995; U.S. Department of
increased medication errors. Labor, 1995). The OSHA also has information
available on exposure to chemical or biological
Institute of Medicine agents related to terrorism. Terrorism response
The Institute of Medicine (IOM) is a private, non- exercises are conducted through OSHA to train
governmental organization that carries out studies health-care workers on responding to terrorism
at the request of many government agencies. The threats (http://www.osha.gov/). The second step in
mission of the IOM is to improve the health of peo- a workplace safety program is a thorough assessment
ple everywhere; thus, the topics it studies are very of the amount of risk entailed. Staff members, for
broad (iom.edu). In 1996 the IOM began a quality example, may become very fearful in situations that
initiative to assess the nation’s health. Part of this ini- do not warrant such fear. For example:
tiative was the 2004 report: Keeping Patients Safe:
Transforming the Work Environment of Nurses. Nancy Wu is the nurse manager on a busy geriatric
The report identified concerns and issues related to unit. Most patients require total care: bathing, feed-
organizational management, workforce deployment ing, and positioning. She observed that several of
practices, work design, and organizational culture the staff members working on the unit use poor body
(Beyea, 2004). Each of these issues will be discussed mechanics when lifting and moving the patients. In
in the section of this chapter on enhancing the the last month, several of the staff members were
quality of work life. referred to Employee Health for back pain. This
week, she noticed that the patients seemed to remain
Programs in the same position for long periods and were rarely
The primary objective of any workplace safety out of bed or in a chair for the entire day. When she
program is to protect staff members from harm confronted the staff, the response was the same from
and the organization from liability related to that all of them: “I have to work for a living. I can’t
harm. afford to risk a back injury for someone who may