Deck 30: Occupational Health

Question 1

Conduct a literature review to identify critical concepts in occupational health nursing, epidemiology, ergonomics, safety, industrial hygiene, and medicine, and describe how these disciplines work together to achieve optimal ends.

Answer 1

NO ANSWER

Question 2

Apply the nursing process and public health principles to worker and workplace health issues.

Answer 2

Occupational health nursing plays a major role in dealing with worker issues and workplace problems regarding the industry wherein they are employed. These challenges require a unique repertoire of skills and talents which set the occupational health nurses apart from other nursing professions.
Occupational health nurses are often the only, or one of the very few, qualified health professionals present in a workplace setting. This puts them in a unique position to coordinate and formulate holistic approaches to delivering quality healthcare to the workers.
The responsibilities of an occupational nurse in dealing with workplace issues is codified in the Standards of Occupational and Environmental Health Nursing Practice, devised by the American Association of Occupational Health Nurses (AAOHN). Additionally, occupational health nurses must also pay heed to the ethical framework codified in the Code of Ethics devised by the AAOHN.

Question 3

Discuss federal and state regulations that affect occupational health.

Answer 3

Like many professions, occupational health nursing is significantly affected by federal and state legislation. The new legal mandates enacted by lawmakers can cause multiple transformative shifts in the workplace, and as a result, the role of the occupational health nurse must also adapt.
The Occupational Safety and Health Act (OSHA) signed in 1970, places a lot of responsibilities on organizations for documenting safety provisions and work-related injuries, deaths and illnesses.
Organizations are subject to a review and inspection of their safety standards by safety inspectors. As a result, the occupational health nurse has had increased responsibilities both in regards to documenting safety provisions and ensuring proper care for the injured, but also with regards to serving as an interface between the organization and the OSHA inspectors.
Worker's Compensation Acts vary from state to state, and dictate provisions for compensation and income replacement for workers who sustain work-related injuries, illnesses, or death. As a result of rising healthcare costs and workers using lawyers to negotiate settlements, organizations have complained compensating workers hampers their competitiveness in the global market.
It is in the area of treating worker injuries and negotiating compensation that the occupational health nurse can play a major role. Nurses must ensure a proper diagnosis and treatment of employee injuries, as well as identify community resources that can provide affordable and quality healthcare.
Additionally, occupational health nurses also serve as a conduit between employee and employer when it comes to filing claims for compensation. Occupational nurses have a responsibility in honestly educating the employees regarding the benefits and opportunities provided by the Worker Compensation Act in their state.
The Americans with Disabilities Act was enacted in July 1990, and serves to prevent discrimination and provide reasonable accommodations to employees with disabilities. The occupational health nurse shoulders the responsibility for facilitating appropriate accommodations, since they have the requisite medical knowledge to assess the physical demands and hazards of the workplace.
Secondly, they also have the responsibility to conduct pre-placement health examinations and inquiries. These examinations relate to the ability of the employee to perform the task at hand, and they must be consistently conducted for all employees who are involved with similar tasks.
As can be seen from the given examples, the responsibilities of an occupational health nurse are significantly affected by the legislation regulating their workplace. Hence, it is imperative that occupational health nurses be aware of the myriad ways in which the law affects the nature of their workplace.

Question 4

Describe a multidisciplinary approach for resolution of occupational health issues.

Question 5

The occupational health nurse sometimes experiences ethical dilemmas because of dual responsibility to both the employer and the employees. In dealing with health information, the employee has a right to privacy and should "be protected from unauthorized and inappropriate disclosure of personal information" (AAOHN, 2004, p. 1). Exceptions can, and in some situations must, be made, however. These include (1) life-threatening emergencies, (2) authorization by the employee to release information to others (e.g., insurance company, health care provider), (3) workers' compensation information, and (4) compliance with government laws and regulations.
The AAOHN identifies three "levels of confidentiality" of health information. Level I relates to information required by law (e.g., data on occupational illness and injuries, exposure data, and information derived from special examinations [i.e., tests given to food handlers]). Level II covers information that will assist in management of human resources (e.g., information obtained from job placement and other health examinations to determine "workability status" of the employee). Finally, Level III focuses on "personal health information." This includes non-job-related health problems and health counseling. Disclosure of Level I and II information to management should be allowed only on a "need-to-know" basis, generally with reference to workability status and regulatory compliance.
Disclosure of level III information to management and regulatory agencies should be allowed only as required by law. Finally, disclosure of level III information health insurance providers should be made only with appropriate written authorization of the employee.

Question 6

A large automobile manufacturer needs a program designed to control respiratory disease among foundry workers. Workers in different areas of ferrous foundries are exposed to different respiratory hazards. The main problems are exposures to silica and formaldehyde. The corporation would like to develop a pilot program for one of its foundries that will then be applied to its other foundries. Health and industrial hygiene data will be collected. Both the corporation and the workers support the project, and both see the project as having the following three purposes:
• Detecting health effects in individuals who may benefit from intervention
• Determining the relationship of health effects with environmental exposures
• Identifying control strategies as appropriate
Outline a pilot program. Discuss the implications of discovering adverse health effects among current workers. Describe the roles of the occupational health nurse, physician, industrial hygienist, safety professional, manager, and employee.

Question 7

Describe the historical perspective of occupational health nursing.

Question 8

A weight-loss program was conducted during August. Ten people participated in the 6-week program. The total weight loss for the group was 185 pounds. The following chart indicates the weight loss for the individuals:

Is there a more effective way to show the results of the program Assume a peer distributed this report for critique. Be creative, filling in any data, facts, figures, or other information that may be missing. Redesign a report to send to management.

Question 9

Discuss emerging demographic trends that will influence occupational health nursing practice.

Question 10

Take an occupational history on five currently employed workers. Identify the occupation, associated job tasks, and potential health hazards. Describe control strategies that could minimize or eliminate the risk of adverse health effects.

Question 11

Identify the skills and competencies germane to occupational health nursing.