Have you noticed a drop in productivity? A disinterest in details? A lack of lucidity caused by sunburn, swimmer’s ear and too many cervezas? The doldrums of summer are upon us! Each season, there’s an exodus of people from organizations in every industry, and whether it’s vacations or layoffs, there’s a noticeable reduction in staff. In this issue we take a look at sharps safety, and I was wondering what happens to healthcare institutions’ levels of occupational safety in the summer time. After all, fewer bodies on the floor could mean less time to accomplish patient-care tasks, leading to accidents or certainly a few more near-misses than usual. I couldn’t find any studies in the medical literature that address occupational injury incidence relating to seasonal staffing specifically, but I did find a study from 2002 indicating that nurses from units with low staffing and poor organizational climates were generally twice as likely as nurses on well-staffed and better-organized units to report risk factors, needlestick injuries and near-misses.
In their study, Sean P. Clarke, PhD, RN, Douglas M. Sloane, PhD, and Linda H. Aiken, PhD, RN, analyzed retrospective data from 732 nurses and prospective data from 960 nurses on needlestick exposures and near-misses over different one-month periods in 1990 and 1991. Staffing levels and survey data about working climate and risk factors for needlestick injuries were collected on 40 units in 20 hospitals. Additional prospective data dealing with exposures to sharps and near-miss injuries were collected from all nurses working on the study units; reports were obtained for 12,349 of the total 14,379 shifts worked by 960 regular and temporary staff nurses.
The researchers asked nurses a series of questions about how often they recapped used needles when they cared for patients with known and unknown HIV status (with responses ranging across four-point scales from “never” to “always”). A further series of questions asked nurses whether certain factors were present on their units that created a significant risk of exposure to bloodborne infections, including carelessness and inexperience of other staff and uncooperativeness of patients. Last, nurses were asked to estimate, on a four-point scale ranging from “not very good” to “excellent,” how good a job they thought their hospital had done in providing them with adequate knowledge about AIDS and with the supplies and equipment needed to protect themselves.
The researchers found that nurses working on hospital units with poorer work climates and lower staffing levels were substantially more likely to report the presence of risk factors associated with needlestick injuries. They also found that nurses on units with less adequate resources, lower staffing and less nurse leadership, and higher levels of emotional exhaustion were typically twice as likely to report the presence of risks due to staff carelessness and inexperience, patient uncooperativeness, frequent recapping of needles, and inadequate knowledge or supplies.
I would hazard a guess that infection preventionists and most healthcare professionals are so used to working in less-than-ideal conditions and with paltry resources, that they may lose sight of how these factors impact patient and healthcare worker safety and wellbeing.
Until next month, bust those bugs!
Kelly M. Pyrek, editor in chief
Reference: Clarke SP, Sloane DM and Aiken LH. Effects of hospital staffing and organizational climate on needlestick injuries to nurses. Am J Public Health. 2002 July; 92(7):1115-1119.