focus on prevention through the culture and climate of safety that permeates any workplace ,” Persaud says . “ This includes plans , controls , mechanisms , and feedback loops that encourage full-facility engagement of leadership , management , supervisors , union representatives , and frontline staff . Engagement and accountability at all levels lead to safer workplace and working conditions . They improve worker retention and recruitment and serve as the foundation of occupational health . Rather than placing accountability on a singular entity , we suggest sharing responsibility across all entities .”
Surveillance data and studies have documented some healthcare institutions ’ inability to address and eliminate hazards , citing budgetary- , personnel- and resource-related barriers to successful implementation of controls . Mitchell clarifies that traditional application of the hierarchy includes “ elimination ” and “ substitution ” of a hazard . “ For example , can a hazardous chemical be removed from a process like ethylene oxide ? Can a less toxic substance be used in its place , like hydrogen peroxide ? As it relates to COVID-19 , it may not be possible to eliminate or substitute the SARS-CoV-2 itself , but if possible , workers can be encouraged to work from home remotely . Pending the effectiveness of the vaccine over time , this may be another way to eliminate some risk . We do need to remain conscientious about having robust engineering controls in place to isolate the worker as much as possible from the hazard itself . This means making sure ventilation systems are in high performance to maximize air flow and that people can be distanced from each other as much as possible . These controls need to be in place , long before focus on PPE is addressed . COVID-19 seems to have moved us one step forward and two steps back regarding this practice . Future worker populations will rely on adherence to the hierarchy to protect them from what ’ s to come . We must not sacrifice occupational health and safety for the sake of broader public health . All American workplaces are struggling with personnel issues including short staffing , adequate pay and benefits , and health and safety . It ’ s because of this that we need to remain diligent about institutional and engineering controls , so that the environment within which we all work is safer for us to be in .”
Advancing the injury prevention awareness agenda in hospitals and other healthcare-delivery sites in the era of COVID-19 entails acknowledging breakdowns in policies and practices .
“ Regardless of how robust a workplace health and safety program may be , workers will still get injured if employers fail to execute that plan every moment of every day or if they fail to have robust institutional controls in place . A breakdown at any level at any point of time can lead to hazardous conditions ,” Mitchell emphasizes . “ This includes careful attention to selection of engineering controls , like devices with sharps injury prevention features – retracting or sheathing needles , for example – as well as safe activation and disposal . It also must incorporate better , safer , and more innovative device design from manufacturers – this could mean vaccines in the future that use alternative vehicles – microneedles or patches , for example .”
Persaud points to the need for institutions to address other psycho-social factors that impact healthcare professionals ’ job performance . “ In the article , we also highlight the importance of focus on personal mental health , including when nurses can be at increased risk of needlestick injuries when their work hours are variable , are feeling rushed to complete tasks , or have lack of confidence in a skill or practice ,” he says . “ Driving improvement
means solving other problems such as staffing ratios , effective and timely training , and a worker ’ s confidence in the safety of the working environment .”
Persaud continues , “ The greatest majority of people around the world work . This means there needs to be a better alignment of public health efforts with occupational health ones . The public health community has often ignored the role occupational health and safety plays in the health and wellness of its global citizens . We shouldn ’ t have to sacrifice our lives to ensure either our own longevity or the economic viability of our communities . If workplace leadership is not committed to injury and exposure prevention , then organizing a labor force and exploring collective bargaining may better elicit the safer work conditions we all deserve and need .”
And as Persaud and Mitchell ( 2021 ) emphasize , “ Establishing health and safety programs that incorporate the hierarchy of controls , workplace training , and institutional controls can be a successful strategy for preventing HCW NIs during efforts to vaccinate the population against COVID-19 . Developing and implementing health and safety programs in this way may address longstanding healthcare workplace health and safety issues that have been exacerbated by the COVID-19 pandemic .”
References :
Nguyen , LH , Drew , DA , Graham , MS , et al . Risk of COVID-19 among front-line healthcare workers and the general community : a prospective cohort study . Lancet Public Health 2020 ; 5 : e475 – e483 .
Persaud E and Mitchell A . Needlestick Injuries Among Healthcare Workers Administering COVID-19 Vaccinations in the United States . New Solutions : A Journal of Environmental and Occupational Health Policy . March 15 , 2021 .
https :// doi . org / 10.1177 / 10482911211001483
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