Introduction to Occupational Health and Safety (OHS)
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Published: 18 August 2022
194 is the number of Australians killed at work in 2020.
120,355 is the number of serious workers’ compensation claims accepted in 2019-2020.
563,600 is the total number of people who experienced work-related injury or illness in 2017-2018.
(Safe Work Australia 2021; ABS 2018)
OHS regulations vary from state to state. It's vital to be aware of the OHS regulations of your state, which can be accessed here.
Why is Occupational Health and Safety a Healthcare Concern?
Rates of workplace injury are particularly high in the healthcare sector in comparison to other industries.
In fact, in 2019-2020:
Healthcare and social assistance had the highest number of serious workers’ compensation claims made among all industries (18% of all serious claims)
Community and personal service workers had the second highest number of serious workers’ compensation claims made among all occupations (19% of all serious claims).
(Safe Work Australia 2021)
The rate of musculoskeletal disorders in healthcare is 71.2%, compared to 54.8% elsewhere; back injuries are at 31.8% compared to 22%; and manual handling related injuries are at 58.9% compared to 43.9% elsewhere (WorkSafe Victoria 2007).
Why is this?
Healthcare is inherently associated with a variety of OHS risks, including:
Stress, burnout, fatigue and moral injury caused by pressure, shift work, long working hours etc., especially in light of the COVID-19 pandemic
High levels of abuse, bullying and harassment in the workplace
Thermal discomfort (e.g. caused by prolonged work wearing PPE), noise and poor lighting
Slips, trips and falls
Road injuries (e.g. ambulance crashes)
Exposure to environmental hazards such as biological material and clinical waste.
(WHO 2022; Leo et al. 2021; ACN 2021)
Hazards Specific to Allied Health
OHS hazards related to allied health include:
Awkward/uncomfortable postures and pressure associated with supporting and assisting a patient to learn to stand and walk
Awkward/uncomfortable bending and twisting to perform hands-on mobilising treatments (exercises); making and fitting orthoses and artificial limbs; and treating patients’ feet/hands
Awkward/uncomfortable postures and high pressure working in confined spaces to assist toileting and\or showering
Bending, twisting, pushing and pulling to use treatment equipment in small cubicles
Assisting patients to practise independence and outside skills in an outdoor environment.
(WorkSafe Victoria 2007)
Manual Handling
As stated above, physical injuries are prevalent among healthcare workers.
The following strategies can help to decrease the risk of injury in the process of carrying out manual handling tasks:
Reducing the size and/or weight of objects where possible
Eliminating bending or reaching by storing objects at waist height
Eliminating clutter
Maintaining floor surfaces with good slip resistance
Using adjustable height trolleys to move objects
Attaching lockable casters to wheels or objects
Providing step platforms and handrails where necessary
Placing equipment on firm non-slip surfaces
Identifying weight and size instructions before moving objects.
(de-Vitry Smith 2022)
Tasks that include lifting; supporting and moving clients or heavy objects; bending; twisting; or reaching (client transfer, pushing a wheelchair) should be eliminated or minimised where possible (e.g. by using assistive devices) (de-Vitry Smith 2022).
Steps you can take as an individual include:
Asking for help and making use of teamwork
Learning and adhering to proper body mechanics
Using the right equipment
Using equipment correctly.
(de-Vitry Smith 2022)
How Can We Plan for a Safer Workplace?
People-handling tasks continue to be a major cause of injury to healthcare staff. The manual lifting of patients should be eliminated, except for in emergency situations.
A revised system should include:
A ‘no lifting’ policy
The provision of patient handling equipment such as hoists and trolleys, which are appropriate and sufficient in number
Provision of training to staff in the system of work, including assessing patients’ needs, specific handling techniques and the use of patient handling equipment
Monitoring of the ‘no lifting’ system.
(WorkSafe Victoria 2007)
Design and equipment considerations to lessen risks for allied health staff:
Space (in the gymnasium or equipment usage area):
Space around equipment must allow for a person on each side of the patient
A walking race (parallel bars) must have space at each side to allow two carers to supervise and assist
There should be space for a wheelchair turning circle at each end of walking races to eliminate the need to lift and manoeuvre wheelchairs into place.
(WorkSafe Victoria 2007)
Equipment
Provision of ample equipment to prevent the need to reposition it
Equipment on trolleys with castor wheels, brakes and controls that are accessible to staff without bending and twisting
Treatment tables, benches and treatment chairs that are easily adjustable with electric controls for height and tilt, where necessary
Adjustable patient equipment, for example, tilting tables with electric control
Ceiling-mounted hoist with extra-long track and walking sling to assist with ambulation
Reinforced ceilings in the gymnasium for bariatric patients requiring rehabilitation
Gas assist chairs with height-adjustable seats/inflatable cushion to assist patients to move from sit to stand.
(WorkSafe Victoria 2007)
Stress
Stress is an issue present in many workplaces, but healthcare workers must navigate additional challenges such as upset or volatile patients, irregular schedules and high-pressure situations.
Workplace factors that may contribute to stress in healthcare professionals include:
Dealing with life-threatening illnesses and injuries
Exposure to suffering and death
Pressure from employers, patients and patients' family members
Working in an environment where there is exposure to various hazards, such as infection
Demanding physical work and risk of injury
Long and/or irregular work
Unstable and unpredictable work life
The effects of the COVID-19 pandemic (e.g. increased workload, shortages of staff and PPE).
(NIOSH 2022)
These factors may be mitigated through the implementation of a combination of the following:
Frequent staff meetings
Stress management programs
Employee assist programs
Flexibility and worker participation in the development of work schedules
Appropriate training and educational sessions
Recognition and action on legitimate complaints
Therapy support.
(IMCEEHCNP 1995)
For your own wellbeing, monitor signs of stress and/or burnout such as affected sleep; increased dependence on alcohol, drugs and/or tobacco; and behavioural changes.
Violence
In certain healthcare settings, the risk of violence is very high.
An area that is particularly prone to violence is the emergency department. There are many contributing factors to this, the most prominent being long waiting times and the prevalence of drugs and alcohol (Morphet et al. 2014).
Preventative measures should be in place to eliminate the risk of a violent act being carried out. These measures may include:
Increased security
Enforcement of a zero-tolerance policy
Support from managers
Establishing follow-up reports and procedures.
(Morphet et al. 2014)
Ensure that you know who to turn to in an instance of violence (before it occurs) so that if/when it does occur, you won’t have the additional stress of needing to determine who is best placed to handle the issue.
Risk Assessment and Management
Risk assessment involves identifying potentially dangerous actions and situations. The purpose of risk assessment is to determine:
How severe a risk is
Whether any existing control measures are effective
Every person has the right to return home from work without injury, and should not have to fear for their own mental and physical wellbeing simply because of their line of work. The expectation and association of danger in healthcare settings only delays the implementation of procedures that could eliminate risk.
Remember that there are behaviours you can implement as an individual to decrease your risk of experiencing harm. Always speak up if you feel that your safety or the safety of a co-worker is being compromised by your work environment.
Institute of Medicine (US) Committee on Enhancing Environmental Health Content in Nursing Practice 1995, ‘Environmental Hazards for the Nurse as a Worker’, in Pope, A M, Snyder, M A & Mood, L H (eds) Nursing Health, & Environment: Strengthening the Relationship to Improve the Public's Health, National Academies Press, Washington (DC), US, viewed 18 August 2022, https://nap.nationalacademies.org/read/4986/chapter/11
Morphet, J, Griffiths, D, Plummer, V, Innes, K, Fairhall, R & Beattie, J 2014, 'At the Crossroads of Violence and Aggression in the Emergency Department: Perspectives of Australian Emergency Nurses', Australian Health Review, vol. 38, no. 2, pp. 194-201, https://www.publish.csiro.au/ah/AH13189
The National Institute for Occupational Safety and Health 2022, Healthcare Workers: Work Stress & Mental Health, Centers for Disease Control and Prevention, viewed 18 August 2022, https://www.cdc.gov/niosh/topics/healthcare/workstress.html
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