Work-related injury among direct care occupations in British Columbia, Canada

Occupational and Environmental Medicine - Tập 64 Số 11 - Trang 769-775 - 2007
Hasanat Alamgir1, Yuri Cvitkovich2, Shicheng Yu3, Annalee Yassi2
1Statistics and Evaluation Department, Occupational Health and Safety Agency for Healthcare, Vancouver, BC, Canada.
2, University of British Columbia
3Occupational Health and Safety Agency for Healthcare (OHSAH) in BC

Tóm tắt

Objectives:To examine how injury rates and injury types differ across direct care occupations in relation to the healthcare settings in British Columbia, Canada.Methods:Data were derived from a standardised operational database in three BC health regions. Injury rates were defined as the number of injuries per 100 full-time equivalent FTE positions. Poisson regression, with Generalised Estimating Equations, was used to determine injury risks associated with direct care occupations registered nurses RNs, licensed practical nurses LPNs and care aides CAs by healthcare setting acute care, nursing homes and community care.Results:CAs had higher injury rates in every setting, with the highest rate in nursing homes 37.0 injuries per 100 FTE. LPNs had higher injury rates 30.0 within acute care than within nursing homes. Few LPNs worked in community care. For RNs, the highest injury rates 21.9 occurred in acute care, but their highest 13.0 musculoskeletal injury MSI rate occurred in nursing homes. MSIs comprised the largest proportion of total injuries in all occupations. In both acute care and nursing homes, CAs had twice the MSI risk of RNs. Across all settings, puncture injuries were more predominant for RNs 21.3 of their total injuries compared with LPNs 14.4 and CAs 3.7. Skin, eye and respiratory irritation injuries comprised a larger proportion of total injuries for RNs 11.1 than for LPNs 7.2 and CAs 5.1.Conclusions:Direct care occupations have different risks of occupational injuries based on the particular tasks and roles they fulfil within each healthcare setting. CAs are the most vulnerable for sustaining MSIs since their job mostly entails transferring and repositioning tasks during patient/resident/client care. Strategies should focus on prevention of MSIs for all occupations as well as target puncture and irritation injuries for RNs and LPNs.

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Tài liệu tham khảo

BC Academic Health Council (BCAHC). The Health Human Resource planning landscape in BC. Landscape Report, 2004. Available from, http://www.bcahc.ca/HHR-PD-LandscapeReport-April04.pdf .

Canadian Institute for Health Information. Workforce trends of Licensed Practical Nurses in Canada, 2004. Canadian Institute for Health Information (CIHI) Licensed Practical Nurses Database 2005.. Available fromhttp://secure.cihi.ca/cihiweb/products/Workforce_LPN_2004_e.pdf .

OBrien-Pallas L Murphy GT Laschinger H . Canadian survey of nurses from three occupational groups. Building the future: an integrated strategy for nursing human resources in Canada 2005, Available from: http://www.buildingthefuture.ca/e/study/phase1/reports/Step6_ENG_FINAL.pdf .

Engkvist, 1998, The accident process preceding overexertion back injuries in nursing personnel., Scand J Work Environ Health, 24, 367, 10.5271/sjweh.357

10.1377/hlthaff.22.6.199

College of Registered Nurses of BC . Practice expectations: registered nurses and licensed practical nurses. College of Registered Nurses of British Columbia, 2005 Pub.No.417. Available from, http://www.clpnbc.org/content_images/documents/practice_expectations_rev_august_2005.pdf .

Canadian Nurses Association. 2004 Workforce profile of registered nurses in Canada. Workforce Profiles 2005 cited 2006 September. Available from, http://www.cna-nurses.ca/CNA/nursing/statistics/2002highlights/default_e.as .

Jansen I Hassan N Greenlaw B . Licensed Practical Nurses and Care Aides in British Columbia. Research on Roles and Utilization, 2000. Available from, http://www.heu.org/~DOCUMENTS/Miscellaneous/Research/lpncareaidestudy_complete_1.pdf .

Rahim-Jamal S . Continuing Care workforce: general analysis. Health Human Resources Unit Research Reports, 2001. Report HHRU 01: 1W, Available from: http://www.chspr.ubc.ca/files/publications/2001/hhru01-01W.pdf .

Lipscomb, 2004, Health care system changes and reported musculoskeletal disorders among registered nurses., Am J Public Health, 94, 1431, 10.2105/AJPH.94.8.1431

Greenlaw B . Licensed practical nurses: Current utilization. LPN Utilization, 2003. Available from, http://www.heu.org/~DOCUMENTS/Miscellaneous/Research/lpn_current_utilization_2003_1.pdf .

Kenney, 2001, Maintaining quality care during a nursing shortage using licensed practical nurses in acute care., J Nurs Care Qual, 15, 60, 10.1097/00001786-200107000-00007

Bongers, 1993, Psychosocial factors at work and musculoskeletal disease., Scand J Work Environ Health, 19, 297, 10.5271/sjweh.1470

Fuortes, 1994, Epidemiology of back injury in university hospital nurses from review of workers compensation records and case-control survey., Occup Med, 36, 1022

Workers Compensation Board of BC . Browse the 2007 preliminary rates. Key trends for healthcare rate groups. Retrieved November 2006 from, http://www.worksafebc.com/insurance/premiums/2007_prelim_rates/classification/browse_rate_groups/ .

10.1097/00043764-199901000-00009

10.1136/oem.57.3.211

Daraiseh, 2003, Musculoskeletal outcomes in multiple body regions and work effects among nurses: the effects of stressful and stimulating working conditions., Ergonomics, 46, 1178, 10.1080/0014013031000139509

10.1136/oem.60.7.497

10.1136/oem.59.5.323

10.1007/s00420-005-0033-z

Menzel, 2004, Back pain prevalence in nursing personnel: measurement issues., AAOHN J, 52, 54, 10.1177/216507990405200204

10.1016/S0749-3797(02)00639-6

10.1046/j.1365-2648.2001.02037.x

10.1136/oem.59.3.182

10.1016/j.jelekin.2003.09.015

Forde, 2002, Pathomechanisms of work-related musculoskeletal disorders: conceptual issues., Ergonomics, 45, 619, 10.1080/00140130210153487

10.1136/oem.59.10.696

Marras, 1999, A comprehensive analysis of low back disorder risk and spinal loading during the transferring and repositioning of patients using different techniques., Ergonomics, 42, 904, 10.1080/001401399185207

Ariens, 2002, High physical and psychosocial load at work and sickness absence due to neck pain., Scand J Work Environ Health, 28, 222, 10.5271/sjweh.669

10.1097/00007632-200212010-00003

10.1136/oem.59.4.269

10.1002/(SICI)1097-0274(199903)35:3<295::AID-AJIM10>3.0.CO;2-#

Bureau of Labor Statistics. Workplace injuries and illnesses in 2004. Bureau of Labor Statistics (BLS) 2005, USDL 052195. Available from, http://www.bls.gov/iif/oshwc/osh/os/osnr0023.pdf .

Workers Compensation Board of BC (WorkSafeBC). Fact sheet Workers Compensation Board of British Columbia Healthcare Projects Forum held at Vancouver, 26 November 2002.

10.1002/ajim.10277

Canadian Institute for Health Information. Health personnel trends in Canada: 1995 to 2004 (Revised July 2006). Canadian Institute for Health Information (CIHI) Health Personnel Database 2006. Available from, http://secure.cihi.ca/cihiweb/products/Health_Personnel_Trends_1995-2004_e.pdf .

10.1097/00007632-199807150-00013

Islam, 2001, Gender differences in work-related injury/illness: analysis of workers compensation claims., Am J Ind Med, 39, 64, 10.1002/1097-0274(200101)39:1<84::AID-AJIM8>3.0.CO;2-T

College of Licensed Practical Nurses of BC . Practice guidelines: appropriate utilizations of LPNs. College of Licensed Practical Nurses of British Columbia, 2004. Available from, http://www.clpnbc.org/content_images/documents/Appropriate20Utilization20of20LPNs.pdf (accessed September 2006).

10.1136/oem.2003.011635