Overview of work-related hazards in nursing: health and safety issues

Article Abstract:

Health care workers in hospitals are exposed to a wide variety of occupational health hazards. Hazardous substances that are encountered in the work environment can be divided into five different categories: biological agents, chemical agents, physical agents, psychosocial agents, and environmental-mechanical agents. Health care workers are constantly exposed to patients with bacterial and viral infections. The most serious infectious agents are the hepatitis B virus (HBV) and the human immunodeficiency virus (HIV), the virus that causes AIDS. It is estimated that 18,000 health care workers develop infections with HBV each year, and 200 of these workers die from the infection. The annual incidence of occupational HIV infection is currently less than 1 percent. Rubella (German measles), herpes simplex virus, and cytomegalovirus are common in the hospital environment. Proper handling and disposal of needles and syringes can prevent these types of infection. Hazardous chemical agents include drugs, solutions, and gases. These agents can be absorbed through the skin, accidentally ingested, or inhaled. Chemotherapeutic drugs, anesthetic gases, and agents used as sterilizers (ethylene oxide) can be very toxic following long-term exposure. Hazardous physical agents include radiation, electricity, noise, and extreme temperatures. Poor equipment, poor ventilation, and slippery floors are examples of environmental-mechanical hazards. Back injuries are common, and account for a large number of missed work days. Factors that create emotional strain, stress, and interpersonal problems are common psychosocial hazards. It is concluded that the hospital work environment posses many health hazards for the worker that should be recognized, and attempts should be made to provide protection and to minimize exposure. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Evaluation, Occupational health and safety, Occupational safety and health, Hospitals, Environmental aspects, Medical personnel, Occupational diseases, Nursing, Hazardous substances

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Effects of heparin versus saline solution on intermittent device irrigation

Article Abstract:

Intermittent infusion devices (IIDs, also called heparin locks) have been used for almost 20 years to maintain intravenous (IV) access without continuous fluid infusion. Irrigation with the anticoagulant heparin keeps the interior of the needle open, but heparin sometimes interacts with the prescribed medication, causing problems with the therapy. To avoid this problem, normal saline solution was proposed to irrigate heparin locks before and after administration of medication. Irrigations were performed before and after medication, and once again afterward to keep the needle clear. According to some research, there was no single protocol for administration, which varied from 0.9 percent sodium chloride solution to 1,000 units of heparin. The authors questioned both the type of solution used for irrigation and the need for multiple irrigations in maintaining a clear needle and reducing phlebitis (discoloration or tenderness at the site of insertion, along with fever). Other studies reached conflicting conclusions, but the statistical methods were sometimes suspect. Thirty-two subjects with an IID were selected, and were randomly assigned to receive either 10 units of heparin with 1 milliliter of sodium chloride, or 1 milliliter of sodium chloride alone. Both solutions contained 1 percent benzyl alcohol to prevent phlebitis. The two treatments were equally effective in keeping the needle open and clear, and preventing phlebitis. Confirmation of this study is needed, as are other studies of the effectiveness of sodium chloride in other needle sizes, especially those for neonatal and pediatric use. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Equipment and supplies, Intravenous catheterization, Heparin, Physiologic salines, Saline solution

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