Undergraduate Occupational Health Nursing Education in Chile, Colombia, Brazil, and Mexico

BACKGROUND

Occupational health nursing plays a fundamental role in addressing the health of the working population; however, training in this area differs around the world in terms of levels, duration, content, and requirements, and the current situation in Latin American countries is unknown. The objective of this study was to analyze undergraduate nursing education in occupational health from an international perspective considering Chile, Colombia, Brazil, and Mexico.

METHODS

We conducted a multicenter, descriptive study, based on bibliographic methodology, whose sample was documentary, consulting government databases in Chile, Colombia, Brazil, and Mexico.

FINDINGS

Heterogeneity was identified within the training in the countries analyzed, with a small number of courses in the course structures; in most cases, the courses were taught in the last years of training and predominantly as elective courses.

CONCLUSIONS

The authors recommend that training centers develop programs associated with occupational nursing, which is considered an imperative to strengthen public health in developing countries and an ethical and equitable response to the working population.

Occupational health nursing: realities and challenges

BACKGROUND

Designing and enhancing resilient occupational health and safety systems is a challenge. This fact makes it clear that occupational health professionals must be able to develop their full range of competencies. From this premise, it is appropriate to define and deepen the strengths and weaknesses of occupational health nursing (OHN), as well as to point out the opportunities and realities that address its performance.

SOURCES OF EVIDENCE

In the history of the professionalization of this speciality, different circumstances have conditioned its projection: the absence of its own body of doctrine, the lack of professional recognition, limited autonomy, and the definition of a clear regulatory framework. In addition to an epistemological limitation and the absence of clear leadership.

DISCUSSION

In the consolidation of this speciality, there is a limited capacity to implement its own competencies, the invisibility of nursing care, the absence of leadership that incorporates research findings and difficulties in the application of scientific evidence, in addition to the influence of regulatory provisions and the idiosyncrasies of the company.

CONCLUSIONS AND IMPLICATIONS FOR NURSING AND HEALTH POLICY

The analysis of classical models with a transformative approach invites a more fluid and coordinated communication between occupational health, occupational risk prevention, primary care and public health, a proposal that induces collaboration and a more holistic approach to care for workers.

Interprofessional Field Experiences in Occupational Safety and Health

Field trips are beneficial to students, because they provide experiences outside of the traditional classroom. Incorporating field trips into graduate programs can increase students' exposures to real world experiences so that they can incorporate that knowledge as they complete their program. The purpose of the project was to collect and analyze graduate student feedback on 13 in-person interprofessional field trips focused on occupational safety and health. Data were collected through post-field trip structured discussions. Content analysis was used to determine themes. Five themes emerged from the data: Personal Value, Networking and Meeting, Health and Safety Planning and Policy, Environment, and Logistics and Planning. Field trips are valuable learning experiences for graduate students. The field trips in this study offered concrete experiences in occupational safety and health. Post-field trip, students provided feedback through structured discussions, which allowed for reflective observation. Overall, students found personal value in the field trips, observed health and safety procedures and policies in action, learned about various work environments, and provided input on the logistics and planning of field trips.

A Systematic Review of the Impact of Remote Working Referenced to the Concept of Work-Life Flow on Physical and Psychological Health

BACKGROUND

COVID-19 accelerated the adoption of remote working in which employers' obligations for employees' health and well-being extended into the home. This paper reports on a systematic review of the health impacts of remote working within the context of COVID-19 and discusses the implications of these impacts for the future role of the occupational health nurse.

METHOD

The review protocol was registered with PROSPERO (CRD42021258517) and followed the PRISMA guidelines. The review covered 2020-2021 to capture empirical studies of remote working during the COVID-19 pandemic, their physical and psychological impacts and mediating factors.

RESULTS

Eight hundred and thirty articles were identified. After applying the inclusion criteria, a total of 34 studies were reviewed. Most studies showed low to very low strength of evidence using the GRADE approach. A minority of studies had high strength of evidence. These focused on the reduced risk of infection and negative effects in terms of reduced physical activity, increased sedentary activity, and increased screen time.

CONCLUSION/APPLICATION TO PRACTICE

The synergy of work and personal well-being with the accelerated expansion of remote working suggests a more active role in the lives of workers within the home setting on the part of occupational health nurses. That role relates to how employees organize their relationship to work and home life, promoting positive lifestyles while mitigating adverse impacts of remote working on personal well-being.

Construction and Validation of an Occupational Risks Scale for Intra-hospital Nursing Staff

Objective

To construct and evaluate initial validity indicators of an instrument on occupational risks for hospital nursing staff.

Methods

A methodological study was conducted in four Chilean hospitals. The study was carried out in three stages: (i) integrative literature review on risk assessment instruments for nursing; (ii) descriptive qualitative study on 113 health professionals to identify their work conditions and experiences regarding occupational risks and construct three instruments proposals for nursing managers, clinical nurses, and technicians; and (iii) validity and reliability study of the three instruments in 503 nurses and nursing technicians. To collect the data from the qualitative study, individual interviews, focal groups, and non-participant observation were conducted. The data were analyzed thematically into predefined risk categories. Content validation was performed through expert judgment, and exploratory factor analysis of principal components was conducted for the preliminary construct validity study. Cronbach's alpha was used as an indicator of internal consistency.

Results

A total of 128 items were identified, distributed across 11 categories and 25 subcategories of occupational risks for the three instruments derived from the original proposal. After expert validation, pilot study, and instrument administration, Cronbach's alpha values between 0.88 and 0.93 were obtained. Exploratory factor analysis distinguished eight to eleven components, with unsatisfactory goodness-of-fit indicators.

Conclusion

The instruments demonstrated good parameters of content validity and reliability, although their construct validity needs further improvement.

COVID-19 infection in nursing staff: A cohort study

AIM

This study aims to identify the working conditions of Brazilian nursing professionals and the risk factors for these professionals to become infected by coronavirus disease.

BACKGROUND

Understanding the factors that affected nursing professionals during the pandemic can support better nursing management.

DESIGN

This is a quantitative, cross-sectional survey study.

METHODS

Data collection was carried out between February and March 2022 in Brazil. All nursing professionals registered in the national database received by e-mail the study instrument with the data collection variables: professionals' sociodemographic and comorbid, professional and institutional characteristics, and professionals' health conditions and disease-related aspects for COVID-19.

RESULTS

Four thousand eight hundred sixty-two nursing professionals reported a lack of personal protective equipment for patient care, and 4424 were infected by coronavirus disease. The risk factors to become infected were having cardiovascular disease, being under 60 years of age, living in the northern region, using public transportation, working in a hospital, an emergency department or reference institution for COVID-19, living with an infected person and lack of respirators or waterproof aprons.

CONCLUSION

Multiple risk factors for infection with SARS-CoV-2 were demonstrated for the nursing professionals during the pandemic, highlighting current and future pandemics factors that are modifiable in a worthwhile time frame to minimize nurses' infection risks, such as inadequate working conditions associated with lack of essential personal protective equipment.

Retirement Center Worker Sleep Health Assessment During the COVID-19 Pandemic

BACKGROUND

Sleep health disturbances can increase risks for workplace injury, error, and poor worker health. Essential workers have reported sleep disturbances since the COVID-19 pandemic onset, which may jeopardize their health and safety. The aims of this project were to assess sleep health among Continuing Care Retirement Community (CCRC) workers, examine potential differences between worker types, and describe the self-perceived impact of COVID-19 on workers' workload and sleep.

METHODS

Through an academic-practice partnership, this needs assessment used a cross-sectional design that collected self-report data during fall 2020 from CCRC workers. Guided by the Workplace Health Model, survey questions included work characteristics, sleep health, and COVID-19 impact on sleep and workload.

FINDINGS

Ninety-four respondents completed the survey across multiple departments. Respondents (n = 34, 36.2%) reported sleeping below recommended hours on workdays. The majority scored above the population mean on Patient-Reported Outcomes Measurement (PROMIS) measures of sleep disturbance (n = 52, 55.3%), sleep-related impairment (n = 49, 52.1%), and fatigue (n = 49, 52.1%). Differences in workday total sleep time and fatigue were noted among shift workers versus nonshift workers, with shift workers reporting less sleep and more fatigue. Shorter sleep duration was noted among respondents working shifts 10 or more hours compared with those working 8 hours. Pandemic-related workload increase was reported by 22.3% (n = 21) of respondents, with 17% (n = 16) noting more than one type of workload change. Since COVID-19 onset, 36.2% (n = 34) reported no sleep changes and 35.1% (n = 33) reported sleeping less. A medium, positive relationship was found between increased changes in work due to COVID-19 and increased difficulties sleeping (r = .41, n = 73, p = .000).

CONCLUSION/APPLICATION TO PRACTICE

Proper sleep health is essential to workplace safety and worker health. By assessing sleep health during a crisis, occupational health nurses can identify opportunities to support worker health and safety, through sleep education, monitoring for sleepiness and fatigue, ensuring countermeasures are available (e.g., caffeine), and assessing for opportunities to change organizational policies.

Workplace Psychological Distress: A Concept Analysis

BACKGROUND

Workplace psychological distress (WPD) significantly impacts employees' mental and physical well-being. However, WPD has not been well-defined in the literature as a concept. This concept analysis aims to clarify the concept of WPD and promote the use of the term in occupational health nursing research.

METHODS

Strategies introduced by Walker and Avant's conceptual analysis method will be utilized to conceptualize WPD and its impact on employees. A literature search was conducted using Cumulative Index of Nursing and Allied Health Literature (CINAHL), Business Source Complete, and APA PsycArticles. The keyword search included the terms "workplace" AND "employee" AND "psychological distress."

RESULTS

Antecedents of WPD are an increase in job demands, lack of control, low support, and workplace bullying. Defining attributes for WPD are extreme fatigue, role conflict, and time pressures. Consequences of WPD were identified as mental disorders, physical disorders, and loss in productivity. This concept was further illustrated using a model, borderline, and contrary case.

DISCUSSION/CONCLUSION

Identifying signs of WPD is of great importance in caring for employees in the workplace. Occupational health nurses can use information obtained from a workplace assessment to develop policies, implement well-being programs, and provide employee referrals.

Cost Analysis of Providing Overtime to Current Nurses Versus Hiring a Dedicated Nurse for COVID-19 Management in a Processing Plant

BACKGROUND

U.S. meat and poultry processing workers experienced a disproportionate burden of COVID-19 illness following the declaration of the COVID-19 pandemic. Managing prevention and surveillance activities for COVID-19 prevention required additional work for occupational health nurses. The purpose of this project was to conduct a cost analysis for two staffing options to address the increased workload for occupational health nurses.

METHODS

An economic quality improvement design was used for this study. The project was performed at a meat and poultry processing plant with 1,800 employees and six occupational health nurses. Two staffing options were considered. Option 1 was to continue to pay current occupational health nurses overtime, and Option 2 was to hire a COVID-dedicated nurse to manage the increased workload. A cost analysis was conducted for wages per hour plus benefits at three time points: 3 months, 1 year, and 3 years.

FINDINGS

Costs for Option 1 (continuing overtime) at 3 months, 1 year, and 3 years were estimated at US$27,370, US$109,517, and US$328,550, respectively. Costs for Option 2 (hiring a COVID-dedicated nurse) at 3 months, 1 year, and 3 years were estimated at US$44,279, US$94,979, and US$230,179, respectively.

CONCLUSIONS/APPLICATION TO PRACTICE

Hiring a dedicated COVID nurse would save the processing plant extensive salary costs by Year 3. Reducing overtime had the potential to decrease the COVID-19-related workload and potential experiences of fatigue and burnout in occupational health nurses.

Health hazard allowance for Nursing professionals: A reflective analysis under the principle of human dignity

OBJECTIVE

to discuss the classification of the health hazard allowance due to exposure to biological agents attributed to Nursing professionals, based on legal and occupational parameters supported on the principle of human dignity.

METHOD

an original reflection study with theoretical analysis on legislation, jurisprudence and Occupational Health focused on the biological risks, health hazard and rights of Brazilian workers. The discussions were based on the current legislation and on scientific evidence.

RESULTS

the classification of the health hazard allowance due to exposure to biological agents attributed to Nursing professionals is not in line with the factual situation experienced by them.

CONCLUSION

it becomes necessary to broaden the discussion on the subject matter and to review the effective and fair compensation of Nursing professionals due to exposure to potentially contaminated biological agents in their work environments, given that the health hazard allowance is a worker's right and is based on human dignity.

Systematization of nursing care: an instrument in the occupational health work process

The environment where workers perform their activities and the way the work is accomplished can harm workers' health. This study aimed to discuss the systematization of nursing care in occupational health by means of a theoretical, reflective essay on this topic. The discussion was supported by three guiding points: occupational health nursing; the role of occupational health nurses; and the applicability of the systematization of nursing care in occupational health. Occupational health nurses should have adequate technical-scientific knowledge and use the systematization of nursing care as an instrument in their work processes.

Cardiovascular Risk Factors in Colombian Penitentiary Staff: An Interdisciplinary View of a High-Risk Occupation

INTRODUCTION

Cardiovascular risk factors have been measured under different conditions, there is some missing information related to specific occupations, such as penitentiary staff which due to their characteristics could have an increased cardiovascular risk. Objective: To determine cardiovascular risk factors on military staff from penitentiary institutions in Santander-Colombia. Methods: Cross-sectional study conducted with 182 workers. Anthropometric parameters, blood pressure, serum lipid profile, and glucose levels were measured. Univariate and bivariate analyses were carried out to establish differences between individuals. Results: Anthropometric and biochemical measures showed that 71.3% participants were overweight or obese, 29.4% presented high blood pressure with increased levels of total cholesterol (27.5%), triglycerides (40.7%), glucose (9.3%), and 84.1% presented low levels of HDL cholesterol. Bivariate analysis found a negative correlation between BMI and HDL cholesterol (p < .05) and a positive correlation between BMI with triglycerides (p < .01), systolic and diastolic blood pressure (DBP) (p < .01). Conclusion: The studied military population presented increased levels of cardiovascular risk in comparison with a similar group in age, gender of nonmilitary individuals. However, it is important to carry out comparative studies between military staff in order to determine the prevalence and other risk predicting factors present in this specific population.

Gender differences and health inequality: Evolution of cardiovascular risk in workers

The aim was to find out if there are any such differences due to gender in a cohort of workers followed for ten years, comparing their lifestyles and following the evolution of the main cardiovascular risk factors (CVRF) and their impact on cardiovascular risk. An observational longitudinal study of 698 civil servants workers (186 women and 512 men) of a local government office from Córdoba (Spain), was conducted over the period 2003-2014. We compared the initial and final prevalence of physical activity, smoking, obesity, hypertension, metabolic syndrome and diabetes. Cardiovascular risk was also assessed using the REGICOR (Registre Gironí del Cor) and SCORE (Systematic Coronary Risk Evaluation) equations. There was a greater rise in the prevalence of hypertension and hypercholesterolemia in the cohort in women than in men (94.2% vs. 38% and 92% vs 21.1%), while the reduction in smoking also differed by gender (26.4% vs. 36.5%). It could be that since women present a lower cardiovascular risk profile, they are treated less or less effort is made to keep the risk factors low, resulting in a worse evolution of smoking, hypercholesterolemia and hypertension in women.

"Looking for Better (Job) Opportunities": A Qualitative Analysis of the Occupational Health of Immigrants in Southern Spain

BACKGROUND

Spain hosts the fourth largest number of immigrants in Europe, resulting in a large proportion of migrant workers. To date, few studies have examined the working conditions of immigrants in Southern Spain who are known to be at risk for adverse working conditions. This study aimed to investigate the patterns of work and working conditions of immigrants living in southern Spain and to understand how these factors may affect their health.

METHODS

A qualitative study using semi-structured interviews was conducted throughout 2019 and included 93 immigrants. Transcription, literal reading, and theoretical categorization were performed and a narrative content analysis was carried out.

RESULTS

Three themes emerged on working conditions of this study population, including social and labor-related characteristics, working conditions, and occupational health issues. Four employment sectors were most commonly occupied by these immigrants, including caregiving and food service for women and agriculture and construction for men. Most immigrants were from Latin America, unemployed or working part-time jobs, and not hired under an employment contract. Most worked in low-qualified jobs, and were exposed to occupational hazards such as falls from heights, manual handling of materials, and psychological strain. The lack of training on occupational risk prevention and labor rights was related to a low identification of work situations having a negative impact on the health of immigrants.

CONCLUSIONS/APPLICATION TO PRACTICE

These findings should be taken into account by the government and public health managers to provide better assistance to immigrant workers in Europe.

Workplace violence in nursing: A concept analysis

OBJECTIVES

To clarify the concept of workplace violence in nursing and propose an operational definition of the concept.

METHODS

The review method used was Walker and Avant's eight-step method.

RESULTS

Identification of the key attributes, antecedents, consequences, and empirical referents of the concept resulted in an operational definition of the concept. The proposed operational definition identifies workplace violence experienced by nurses as any act or threat of verbal or physical violence, harassment, intimidation, or other threatening disruptive behavior that occurs at the worksite with the intention of abusing or injuring the target.

CONCLUSIONS

Developing insights into the concept will assist in the design of new research scales that can effectively measure the underlying issues, provide a framework that facilitates nursing interventions, and improve the validity of future studies.

Women-centred workplace health promotion interventions: a systematic review

AIM

To analyse workplace health promotion interventions implemented exclusively for the female population.

BACKGROUND

The differences in biological, psychological and social characteristics, as well as the type of work carried out by men and women, make it necessary for workplace health promotion to be specific for each group. This study focussed on working women.

INTRODUCTION

Workplace health promotion interventions are centred on increasing the well-being and health of the employees. Occupational health nurses play an essential role in the implementation of these interventions.

METHODS

A systematic review was carried out using the MEDLINE and Scopus databases, following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines.

RESULTS

Twelve articles met the inclusion criteria. Two lines of interventions were found: (1) promotion of breastfeeding (16.6%) and (2) promotion of physical activity and other healthy lifestyles (83.4%). The interventions studied underlined promoting breastfeeding, preventing a sedentary lifestyle, improving body composition, reducing cardiovascular risk, relieving premenstrual symptoms, time of breastfeeding after returning to work, and showing favourable results.

DISCUSSION

The lack of studies on the subject and the medium-to-low quality of the articles included in the review have made it difficult to analyse workplace health promotion interventions, making it necessary to continue research in this area.

CONCLUSION

There are very few occupational health promotion interventions targeting women (1.9%), and the majority of them focus on promoting physical activity. It is worrying that specific aspects of women's health are poorly addressed.

IMPLICATIONS FOR NURSING PRACTICE AND HEALTH POLICY

The work of the occupational nurse essentially is to guarantee the health of women in the workplace, being the key figure in the research and development of gender-related policies in the field of public health.

Factors Associated with the Health Literacy on Social Determinants of Health: A Focus on Socioeconomic Position and Work Environment

Though impressive progress has been made in healthcare worldwide, many people still experience disproportionate health burdens and inequities in healthcare services. For establishing sustainable development goals, health literacy on social determinants of health (HL-SDH) has been recognized as a key to creating better social and physical environments. In particular, low levels of health literacy among industrial workers are considered as a major barrier to benefitting from the progress made in healthcare. This study aimed to describe levels of HL-SDH and to examine the relationships among socioeconomic status, working environment, and HL-SDH among workers in Korea. A total of 660 workers from an online panel participated in Korea from 30 May to 7 June 2018. The Korean version of HL-SDH instrument consisted of 33 items and four dimensions: access, understand, appraise, and apply. Descriptive statistics, a t-test, ANOVA, and multiple regression analysis were conducted. The mean score of HL-SDH was 2.48. Perceived mental health status, annual income, and the number of employees per worksite were found to be statistically significant factors related to HL-SDH (F = 3.64, p = <0.001). The HL-SDH score was considerably higher, indicating that nursing interventions to enhance HL-SDH are required for health promotion, especially among workers in poor social and working environments.

Occupational health nursing in civil construction: contributions based on Roy's adaptation theory

Reflecting on the role of the nursing staff in civil construction has paramount importance, because it enables improving knowledge and making discoveries. Such reflection is further useful for managers and workers to jointly develop disease prevention and health promotion strategies. The aim of the present study is to describe a nurse's contributions to a civil construction company. It consists of an experience report according to Callista Roy's adaptation theory. The analyzed experience took place from August 2017 through March 2018. We describe the activities carried out by the nurse jointly with other healthcare workers. We believe that the present study evidences the significance of occupational health nursing actions, particularly within civil construction, as well as the relevance of providing theoretical scientific grounds to such actions to contribute to make working environments healthier for all the involved actors without neglecting the aspect of productivity.

Prevalence and characteristics of prediabetes in workers in industry

AIM

To examine the prevalence of work stress and prediabetes in computer technology company employees; to analyse the relationships among stress, work stress, and prediabetes; and to explore the potential mediating effects sleep on the relationship between work stress and prediabetes.

DESIGN

A descriptive, cross-sectional design was used. A convenience sample included employees from a large computer technology company in central Texas.

METHODS

Data collection during March-October 2015 included: retrospective electronic medical record review and online surveys. Electronic medical record review data included: height, weight, waist circumference, blood pressure, high-density lipids, triglycerides, and fasting glucose. Online surveys collected demographic, global stress, diet, exercise, coping, sleep and work stress data from participants. Spearman rho calculations analyzed associations between demographic, socio-cultural factors, health behaviours, work stress, and prediabetes variables. Logistic regression analyses identified probability variables. A structural equation model examined mediating variables.

RESULTS

Prediabetes prevalence was lower and prevalence of work stress was higher in the participant sample than in the USA population. Findings suggested that low job imbalance increases the probability for prediabetes. Job imbalance was inversely related to prediabetes. Three variables increased the probability prediabetes: alcohol, job imbalance, and sleep. Sleep potentially modified the relationship between job imbalance and prediabetes. Participants were college-educated males working in white-collar, technical jobs. Participants had high rates of work stress. Job imbalance was inversely related to prediabetes, which challenges previous empirical data. Future research should continue to explore the relationship between work stress and prediabetes in this population.

CONCLUSIONS

This study explored the relationship between work stress and prediabetes in a white-collar worker population in technical industry. Findings suggested that workers in industry have a unique type of stress. Nurses who learn to recognize the non-traditional risk factors for prediabetes can improve screening for prediabetes by including work stress and poor sleep questions.

Screening, Brief Intervention, and Referral to Treatment: Implementation Into an RN-BSN Curriculum

Background: The incidence of alcohol and substance misuse continues to be a problem in the workplace. Methods: A partnership between two universities and a federal agency implemented SBIRT (Screening, Brief Intervention, and Referral to Treatment) into a three-credit, 7-week online Community and Environmental Health Course for licensed nurses earning their Bachelor of Science in Nursing degree. SBIRT is an early intervention, targeting nondependent substance users before needing specialized treatment. Findings: Over seven semesters, 119 students completed the SBIRT curriculum. We observed a significant increase in knowledge about standard drink sizes and recognizing the most reliable alcohol use questionnaire (Alcohol Use Disorders Identification Test [AUDIT]). Students perceived themselves as competent in assessing patient readiness to change, making the best treatment decisions, and referring patients for appropriate care. Most students found significant value of SBIRT in their current practice setting. Conclusion/Application to Practice: The SBIRT curriculum was found to be a valuable tool for nurses in screening and referring patients to care who are at risk of alcohol and drug misuse. It is important for occupational health nurses to learn the necessary skills for assessing workers for alcohol and drug misuse. The occupational health nurse is encouraged to practice their skills at every patient encounter for purposes of refining their skills. Employers are concerned about drug and alcohol misuse in the workplace and occupational health nurses are the optimal group to intervene with workers who need assistance.

The implications of isolation for remote industrial health workers

INTRODUCTION

Recent literature has explored the health and social implications of industrial workers who are involved in a variety of long-distance commute (LDC) work arrangements including fly-in, fly-out; bus-in, bus-out; and drive-in, drive-out. However, the role of an industrial health worker in caring for this special population of workers is poorly understood and documented in current literature. In Australia, the health role has existed primarily to meet minimum standards of safety legislation and carry out compliance activities. The combination of low social risk tolerance, increasingly remote locations and changing health and safety legislation are driving changes to accountability for the health as well as the safety of remote industrial workers. Health staff are recruited from the ranks of registered nurses, paramedics and diploma-qualified medics. Often, they work in autonomous transdisciplinary roles with little connection to other health workers. The lack of a clear professional identity contributes to increased tension between the regulatory requirements of the role and organisations who don't always value input from a specialist health role. The aim of this study was to understand the experience of isolation for health workers in industrial settings to better inform industry and education providers.

METHODS

A phenomenological methodology was chosen for this study owing to the paucity of qualitative literature that explored this role. This study utilised face-to-face or telephone interviews with nurses and paramedics working in remote offshore and onshore industrial health roles seeking to understand their experience of working in this context of health practice.

RESULTS

Three thematically significant experiences of the role related to role dissonance, isolation, and gaining and maintaining skills. The second theme, isolation, will be presented to provide context for nurses' and paramedics' experiences of geographical, personal and professional isolation.

CONCLUSIONS

Nurses and paramedics working in remote industrial roles are not prepared for the broad scope of practice of the role, and the physical and profession isolation presents barriers to obtaining skills and confidence necessary to meet the needs of the role. Limited resources in rural and remote areas combined with the isolation of many industrial sites pose challenges for industrial staff in accessing primary healthcare services, yet industrial organisations are resisting attempts to make them responsible for the health as well as the safety of their onsite workers, particularly in off-duty hours. Health workers in remote locations have to cope with their own experience of isolation but also have to treat and counsel other industrial workers experiencing chronic illness complications, separation from family and other consequences of the fly-in, fly-out 'workstyle'. In addition to the tyranny presented by distance and the emotional isolation common to all remote industrial workers, health workers are isolated from professional networks, access to education/professional development opportunities and other remote industrial peers. Their inclusion within a professional network and educational framework would help to mitigate these factors and provides opportunities for collaboration between industrial and rural health staff.

[Reflections on Occupational Health Nursing in Taiwan: Challenges and Perspectives]

The development of the occupational health nursing profession has promoted stable and healthy human resources in Taiwan. In order to improve the occupational safety, health, and healthcare of workers, the professional core competencies and role functions of occupational health nursing is of utmost importance. This article investigated the current status of occupational health nursing education, role functions, practice scope, and the development and responsibilities of professional associations and proposed the challenges to and the future prospects of the development of occupational health nursing in Taiwan. The key findings include: (1) the role functions and practice scope of occupational health nursing; (2) occupational health nursing courses should be included in the required credits of Department of Nursing and master and doctor programs in occupational health nursing should be established; (3) a certification system of occupational health nursing should be established as soon as possible; (4) the professional associations for occupational health nursing should take responsibility for continuing education and training; and (5) interdisciplinary collaborations among relevant occupational health professionals should be strengthened.

Chronic Hepatitis C Screening, Evaluation, and Treatment Update in the Age of Direct-Acting Antivirals

Globally, hepatitis C virus (HCV), the cause of one of the most common infectious diseases, infects approximately 4 million to 5 million Americans with approximately half of infected individuals undiagnosed. Some workplaces screen employees for HCV exposure and other bloodborne pathogens (BBP) after needlestick injuries, but it is not well known whether employers screen employees for HCV without an occupational exposure. New guidelines from the Centers for Disease Control and Prevention (CDC) recommend that all individuals born between 1945 and 1965 should be screened for HCV regardless of risk; this provides an opportunity at the worksite for HCV outreach to employees, dependents, and retirees. To understand this recommendation, the management of HCV in the age of direct-acting antivirals (DAAs) should be reviewed. Now that new DAA treatment can cure HCV, occupational health nurses should identify potential HCV-positive individuals at the worksite via HCV education, screening, testing, and, if positive, linking to specialists for treatment.

Core competencies for UK occupational health nurses: a Delphi study

Background

Occupational health nurses (OHNs) play a pivotal role in the delivery of occupational health (OH) services. Specific competency guidance has been developed in a number of countries, including the UK. While it is acknowledged that UK OHN practice has evolved in recent years, there has been no formal research to capture these developments to ensure that training and curricula remain up-to-date and reflect current practice.

Aims

To identify current priorities among UK OHNs of the competencies required for OH practice.

Methods

A modified Delphi study undertaken among representative OHN networks in the UK. This formed part of a larger study including UK and international occupational physicians. The study was conducted in two rounds using a questionnaire based on available guidance on training competencies for OH practice, the published literature, expert panel reviews and conference discussions.

Results

Consensus among OHNs was high with 7 out of the 12 domains scoring 100% in rating. 'Good clinical care' was the principal domain ranked most important, followed by 'general principles of assessment & management of occupational hazards to health'. 'Research methods' and 'teaching & educational supervision' were considered least important.

Conclusions

This study has established UK OHNs' current priorities on the competencies required for OH practice. The timing of this paper is opportune with the formal launch of the Faculty of Occupational Health Nursing planned in 2018 and should inform the development of competency requirements as part of the Faculty's goals for standard setting in OHN education and training.

Predictive Capacity and Cutoff Value of Waist-to-Height Ratio in the Incidence of Metabolic Syndrome

The purpose of this study was to compare the predictive ability of waist-to-height ratio (WHtR) compared with other anthropometric indicators in the incidence of metabolic syndrome (MetS) and to propose cutoff values for its early detection in nursing practice. A longitudinal cohort study was conducted on a sample of 630 workers (137 exposed and 493 nonexposed), free of MetS at baseline. WHtR was compared with body mass index (BMI), waist circumference (WC), and the percentage of body fat (BF%). In the Cox regression, the adjusted values of hazard ratio (HR) were 5.4 (confidence interval [CI] = [3.1, 9.5]) for WHtR and 7.4 (CI = [3.7, 14.9]) for components of MetS. WHtR obtained the largest area under the curve 0.82 (CI = [0.76, 0.88]), and with a cutoff value of 0.54, values were obtained for sensitivity (70%) and specificity (77%). WHtR was the best predictor of incidence of MetS, with a cutoff value of 0.54. Nursing can improve the early detection of MetS by measuring WHtR.

Effect of occupational health nursing practice on musculoskeletal pains among hospital nursing staff in South Korea

OBJECTIVE

The purpose of this study was to identify whether occupational health nursing variables serve as the contributing factors to musculoskeletal pains (MSP).

METHODS

A self-administered questionnaire composed of demographic characteristics, the practice of occupational health nursing and information regarding MSP was designed based on in-depth interviews with eight nurses. This study included 226 hospital nursing staff who worked at three university hospitals located in Seoul, South Korea. Statistical analysis was performed by using SPSS and AMOS 19.0.

RESULTS

Shoulder and neck pains occurred when subjects worked more than 46 h/week. Subjects who performed 'work-time adjustment' had lesser chance of having shoulder, leg/foot and wrist/finger pains. Overtime work hours showed an indirect effect on multiple sites of MSP by mediator variable, which was 'work-time adjustment'. Organized night duty days eventually decreased multiple sites of MSP.

CONCLUSION

Administration strategies for nurses to adjust work-time within 46 h/week should be considered.

The Future of Occupational Health Nursing in a Changing Health Care System

Repealing the Affordable Care Act (ACA) has significant implications for the future of occupational health nursing practice. As changes are proposed and implemented, occupational health nurses must continue to prioritize preventive care, chronic disease management, healthy communities, environmental health, and sustainability. In particular, immigrant workers are a vulnerable population needing attention by occupational health nurses.

Occupational health nursing in Turkey: an international update

This article discussed Turkey's occupational health system and the current education, legislation, and practice of occupational health nursing.

Feelings of nurses faced with death: pleasure and suffering from the perspective of psychodynamics of Dejours

OBJECTIVES

To analyze the feelings of nurses confronting death, according to the Dejourian psychodynamic.

METHODS

This is a qualitative, exploratory study, analyzed, interpreted and discussed emphasizing the suffering and pleasure, proposed by Dejours.

RESULTS

Participants were 11 nurses, mostly woman, single, white, Catholic, between two sixteen years of profession. The analysis of responses allowed finding some driving and potentiating factors of feelings of pleasure and suffering. It was identified as pleasure: feeling of accomplishment, comfort and relief; as suffering, sadness, frustration, difficulty with grief, impotence and incapacity. They also have defense mechanisms to prevent suffering, as not to think about suffering and death, taking refuge in work.

CONCLUSIONS

The factors related to the pleasure and the pain of Nurses when facing death were identified. Therefore, education is necessary regarding the process of death in academic training and studies that approach the nurse to this natural process.

Cooperation within physician-nurse team in occupational medicine service in Poland - Knowledge about professional activities performed by the team-partner

BACKGROUND

The goal of the study has been to learn about physicians' and nurses' awareness of the professional activities that are being performed by their colleague in the physician-nurse team.

MATERIAL AND METHODS

Postal questionnaires were sent out to occupational physicians and nurses in Poland. The analysis includes responses from 232 pairs of physician-nurse teams.

RESULTS

The knowledge among occupational professionals about tasks performed by their colleagues in the physician-nurse team seems to be poor. Respondents were asked about who performs tasks from each of 21 groups mentioned in the Occupational Medicine Service Act. In the case of only 3 out of 21 groups of tasks, the rate of non-consistence in answers was lower than 30%. A specified number of professionals performed their tasks on the individual basis. Although in many cases their team colleagues knew about those activities, there was a major proportion of those who had no awareness of such actions.

CONCLUSIONS

Polish occupational physicians and nurses perform a variety of tasks. Occupational nurses, besides medical role, also play important organizational roles in their units. The cooperation between the two professional groups is, however, slightly disturbed by the deficits in communication. This issue needs to be improved for the betterment of operations within the whole system.

A Safe and Healthful Work Environment: Development and Testing of an Undergraduate Occupational Health Nursing Curriculum

Occupational health nursing focuses on promotion and restoration of health, prevention of illness and injury, protection from work-related and environmental hazards, and corporate profitability. Quality education about the relationship between work and health is critical for nurses' success regardless of work setting, and is consistent with Healthy People 2020 goals, but is lacking or limited in some programs. This report introduces an innovative occupational health nursing curriculum for students enrolled in baccalaureate nursing programs. The process of designing and pilot testing this novel curriculum, its alignment with nursing competencies, and its format and learning activities are described. Preparing professional nurses to understand the role of the occupational health nurse and the relationship between work and health is an essential curricular consideration for contemporary nursing education.

Developing blended online and classroom strategies to deliver an occupational health nursing overview course in a multi-state region in the United States

This article describes how hybrid online and classroom learning approaches were used to design and offer an occupational health nursing review course throughout a multi-state region of the northwest United States. In response to demand from practicing occupational health nurses for board certification preparation, a series of asynchronous and synchronous continuing education modules was created covering a range of occupational health nursing topics. This review course illustrates how innovative educational delivery models can serve the needs of occupational health nurses challenged by geographic and time constraints.

Does occupational health nursing exist in India?

Background:

Occupational health services are important to develop healthy and productive work forces, which should be delivered through occupational health team. Occupational health nurse (OHN) is an important member of this team and is required to apply nursing principles in conserving the health of workers in occupational settings.

Purpose:

This article attempts to map the occupational health nursing courses in India and design competencies and curriculum for such a course.

Materials and Methods:

Information through the Internet, printed journals, and perspectives of the key stakeholders were the principal sources of data.

Discussion:

In India, there is a need to initiate a course on occupational health nursing to provide occupational health services for the organized and unorganized sector workforce. A certificate course for occupational health nursing for 3–4 months duration offered through contact session mode can be an opportune beginning. However, to cater employed nurses an online course can be another effective alternative. The theoretical part should essentially include modules on occupational diseases, industrial hygiene, and occupational health legislation, whereas the modules on practical aspects can include visits to industries. Taking into account the existing norms of Indian Factories Act for hazardous units of organized sector an estimated 1,34,640 OHNs are required.

Conclusion:

There is a need–supply gap in the number of occupational health nursing manpower in India, which can be attributed to the absence of any course to train such manpower.

Embracing a competency-based specialty curriculum for community-based nursing roles

The Quad Council competencies for public health nursing (PHN) provide guidance in developing curricula at both the generalist and specialist level. However, these competencies are based on nursing roles in traditional public health agencies and community/public health is defined more broadly than official agency practice. The question arises as to whether community-based specialties require largely the same knowledge and skill set as PHN. The purpose of the competency cross-mapping project reported here was to (a) assess the intersection of the Quad Council competencies with four community-based specialties and (b) ensure the appropriateness of a Quad Council-based curriculum to prepare graduates across these four specialties (home health, occupational health, environmental health, and school nursing). This article details the multistep cross-mapping process, including validation with practice leaders. Results indicate strong alignment of community-based specialty competencies with Quad Council competencies. Community-based specialty-specific content that did not align well is identified, along with examples of didactic and clinical strategies to address gaps. This work indicates that a Quad Council-based curriculum is appropriate to prepare graduates in community-based specialties when attention to the specialty-specific competencies in the clinical setting is included. This work guides the development of a doctorate of nursing practice curriculum in PHN, encompassing the four additional community-based specialties.