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184 unit 3 | Professional Issues CikguOnline
will need to take the time to learn new devices, and Ergonomic Injuries
make certain that the current safety requirements
are enforced with employees. Volunteer to partici- Occupational-related back injuries affect more
pate in evaluation committees, or work on teams than 75% of nurses over the lifetime of their
testing new devices. Follow these guidelines in your career. Poor ergonomics is a safety factor for both
daily nursing practice (ANA, 1993; Brooke, 2001; nurses and patients, whose safe nursing care is
nursingworld.org/dlwa/osh/wp2; Perry, 2001): already in jeopardy by the escalating nursing short-
age (Durr, 2004).
■ Always use universal precautions.
■ Use and dispose of sharps properly. Back Injuries
■ Be immunized against hepatitis B.
Back injuries are the most critical of ergonomic
■ Immediately wash all exposed skin with soap
injuries. Annually, 12% of nurses leave the profes-
and water.
sion as a result of back injuries, and more than
■ Flush affected eyes or mucous membranes with
52% complain of chronic back pain. Nursing aides,
saline or water.
orderlies, and attendants ranked second and regis-
■ Report all exposures according to your facility’s
tered nurses sixth in a list of at-risk occupations for
protocol.
strains and sprains (DOL, 2002). The problem
■ If possible, know the HIV/hepatitis B virus
with lifting a patient is not just one of overcoming
status of your patient.
heavy weight. Size, shape, and deformities of the
■ Comply with postexposure follow-up.
patient as well as balance and coordination, com-
■ Support others who are exposed.
bativeness, uncooperativeness, and contractures
■ Become active in the safety committee—be a
must be considered. Any unpredictable movement
change agent.
or resistance from the patient can throw the nurse
■ Educate others.
off balance quickly and result in a back injury.
Although health-care providers are aware of the Environmental considerations such as space,equip-
need to use gloves as a protection against blood- ment interference, and unadjustable beds, chairs,
borne pathogens, only one evidence-based summary and commodes also contribute to back injury risk
has been reported regarding blood-borne pathogens (Edlich, Woodard, & Haines, 2001).
and glove safety. The summary explored double This issue of back injuries and other ergonomic-
gloving versus single gloving in reducing the number related injuries has become so severe that in July
of infections. This includes postoperative wound 2001 the OSHA began to develop a comprehensive
infections or blood-borne infections in surgical approach to ergonomics. Public forums, meetings
patients and blood-borne infections in the surgical with stakeholder groups and individuals, and writ-
team and to determine if double gloving reduces the ten comments were analyzed. Out of this work, a
incidence of glove perforations compared with single four-pronged comprehensive approach to ergonom-
gloving. A total of 18 randomized controlled trials ics was developed to include (osha.gov/ergonomics/
met the inclusion criteria and were included in the ergofact02):
review.There is clear evidence from this review that
1. Task- or industry-specific written guidelines
double gloving reduces the number of perforations
2. Enforcement
to the innermost glove.There does not appear to be
3. Outreach/assistance
an increase in the number of perforations to the out-
4. Research
ermost glove when two pairs of gloves are worn.
Korniewicz et al. (2004) participated in the first The OSHA issued an ergonomics guideline for the
clinical trial to test the barrier integrity of nonlatex nursing home industry on March 13, 2003. The
sterile surgical gloves after use in the operating room. back injury guide for health-care workers
During the 14-month study, more than 21,000 (dir.ca.gov/dosh/dosh_publications/backinj.pdf )
gloves were collected from more than 4000 surgical and the OSHA guidelines for nursing homes
procedures. Based on results, Korniewicz et al. con- (osha.gov/ergonomics/guidelines/nursinghome/in-
cluded that nonlatex or intact latex gloves provide dex) are comprehensive resources. Although guide-
adequate barrier protection but that nonlatex gloves lines are less than legislated standards, the OSHA
may tear more frequently than latex during use. uses the General Duty Clause to cite employers for