Hospital work environments, nurse characteristics, and sharps injuries

Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA 19104-6096, USA.
American Journal of Infection Control (Impact Factor: 2.33). 07/2007; 35(5):302-9. DOI: 10.1016/j.ajic.2006.07.014
Source: PubMed

ABSTRACT A growing body of research links working conditions, such as staffing levels and work environment characteristics, with safety for both patients and workers in health care settings, including sharps injuries in hospital staff nurses.
Surveys of 11,516 staff nurses from 188 Pennsylvania general acute care hospitals in 1999 were analyzed. Hospital work environments, measured using the Practice Environment Scales of the Nursing Work Index--Revised, and staffing were tested as predictors of experiencing at least one sharps injury in the preceding year, both before and after controlling for nurse risk factors, use of safety-engineered devices, and hospital structural characteristics.
Nurses with less than 5 years of experience, perioperative nurses, and those performing routine venipuncture for blood draws were more likely to be injured. Nurses working in hospitals with the most favorable working environments were one-third less likely to be injured. Staffing levels were not associated with sharps injuries.
Across a large state, nurses working in acute care hospitals with better practice environments had fewer sharps injuries. Work environment conditions and specialty- and setting-specific risk factors deserve continued attention in sharps injury research.

Download full-text


Available from: Sean P Clarke, Oct 07, 2014
1 Follower
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This article discusses evaluating and improving the health and quality of work life (QOWL) of nurses. Nurses are reported to have higher illness, disability, and absenteeism rates than all other health care workers. Research suggests that QOWL impacts nurses' health and the provision of quality health care, particularly patient safety. Occupational health nurses have a pivotal role in evaluating and improving nurses' QOWL and health. This will ensure quality health outcomes for nurses and patients and reduce costs for the health care system. [Workplace Health Saf 2013;61(4):173-181.].
    04/2013; 61(4):173-81. DOI:10.3928/21650799-20130327-18
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND: Patient safety is a priority for health services in all countries. The importance of the nurse's role in patient safety has been established. Effective nurse staffing levels, nurse education levels, and a positive work environment for nurses are factors which are known to impact on patient safety outcomes. OBJECTIVES: This study sought to explore the relationship between the ward environment in which nurses practice and specific patient safety outcomes, using ward level variables as well as nurse level variables. The outcomes were nurse-reported patient safety levels in the wards in which they work, and numbers of formal adverse events reports submitted by nurses in the last year. DESIGN: This cross-sectional quantitative study was carried out within a European FP7 project: Nurse Forecasting: Human Resources Planning in Nursing (RN4CAST) project. SETTINGS: 108 general medical and surgical wards in 30 hospitals throughout Ireland. PARTICIPANTS: All nurses in direct patient care in the study wards were invited to participate. Data from 1397 of these nurses were used in this analysis. METHODS: A nurse survey was carried out using a questionnaire incorporating the Practice Environment Scale of the Nursing Work Index (PES-NWI). Ethical approval was obtained from the authors' institution and all ethics committees representing the 30 study hospitals. Multilevel modelling was carried out to examine the impact of ward level factors on patient safety. These included proportions of nurses on the ward educated to degree level, and aggregated ward-level mean for PES-NWI scores. RESULTS: The study results support other research findings indicating that a positive practice environment enhances patient safety outcomes. Specifically at ward level, factors such as the ward practice environment and the proportion of nurses with degrees were found to significantly impact safety outcomes. The models developed for this study predicted 76% and 51% of the between-ward variance of these outcomes. The results can be used to enhance patient safety within hospitals by demonstrating factors at ward-level which enable nurses to effectively carry out this aspect of their role. CONCLUSIONS: The importance of ward-level nurse factors such as nurse education level and the work environment should be recognised and manipulated as important influences on patient safety.
    International journal of nursing studies 10/2012; 50(2). DOI:10.1016/j.ijnurstu.2012.08.020 · 2.25 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To examine the differences between characteristics of the work environment of nurses working in mental health and general acute inpatient nursing settings. Secondary analysis of data collected on 96 randomly selected medical and surgical (general) wards and six mental health wards in 24 public acute general hospitals across two Australian states between 2004 and 2006. All nurses on the participating wards were asked to complete a survey that included the Practice Environment Scale of the Nursing Work Index (NWI-PES). Responses were received from 2,556 nurses (76.3% response rate). Using the five-domain structure, comparisons were made between mental health and general nurses. Across the entire sample of nurses, those working in mental health settings scored more highly in regard to nurse-doctor relationships and staffing adequacy. Nurses in general wards reported more participation in hospital affairs, stronger leadership, and the presence of more of the foundations of nursing quality care such as access to continued education. Differences between the groups on each of the domains was statistically significant at p=.05 or greater, but not for the composite practice environment scale. A wide range of responses was seen when data were aggregated to the ward level. The work environment of mental health nurses is different from that of their colleagues working in general settings. Specific areas of the mental health environment, such as participation in the hospital, leadership, and the foundations of quality, may be enhanced to improve nurses' job satisfaction and, potentially, other nurse and patient outcomes. Factors in the medical and surgical nursing practice environment have been established as significant influences on nurse and patient outcomes. It is important to understand the existence and potential impact of these factors in mental health inpatient settings.
    Journal of Nursing Scholarship 06/2010; 42(2):195-206. DOI:10.1111/j.1547-5069.2010.01348.x · 1.77 Impact Factor