Just-in-Time Methods for Understanding Near-Misses, Injuries & Risk Factors

Details

• Personal Author:
  Daraiseh NM ; Davis K ; Davis LS ; Macaluso M
• Description:
  Healthcare personnel routinely encounter work hazards with outcomes that affect the employee through: turnover, job satisfaction, and overall health. Employee health consequences can further impact the patient through poor quality of care and safety; and the organization through lost work-time, compensation claims, and job replacement training. Accurate data on the incidence of near-misses and injuries and their risk factors are essential for developing interventions to reduce the burden of work-related health outcomes. The importance of near-misses has long been integrated in the surveillance systems of high-risk industries such as aviation, nuclear facilities, and the military because each occurrence contributes to an understanding of potential failure patterns that may be antecedents of more severe injuries. However, research has shown that injury under­ reporting in healthcare is common due to time constraints, reluctance to report, symptom self-management, a sense of 'normalcy' of being injured, and fear of reprisal. To facilitate accurate and timely injury reporting, surveillance systems need to be supported by clear practice policies encouraging injury and near-miss reporting, that if ignored may lead to harm for both staff and patients. To address these issues our study's aims were to: 1) Determine the number of near-misses and injuries experienced by pediatric healthcare providers (PHCPs) due to the lack of research for this population; 2) Compare voice recording of near-misses and injuries to conventional data collection; 3) Evaluate the feasibility of active injury surveillance based on voice recording; and 4) Evaluate the association of individual and work factors on near-misses and injuries. To achieve these aims, 652 randomly selected PHCPs in medical/surgical and psychiatric units recorded near­ misses and injuries on hand-held digital voice recorders. Injuries reported through the institution were compared to voice-recorded reports to examine under-reported injuries. Surveys and focus groups assessed reporting preference and feasibility. Surveys at baseline and study completion measured risk factors. Overall, the rate of injuries was 70.7 events/1000 days - nearly twice as high as for near-misses at 35.6. Injuries and near-misses were primarily physical at 53.1, 32.5 respectively. A preference of using active surveillance for event reporting (68.2%); a nearly 22-fold increase in injury reports; and findings that employees experienced 1,314 near-misses/100 employees/year established feasibility for using voice recording and active surveillance. Finally, individual and work factors were primary risk factors for injuries while no factors showed significant associations for near-misses alone. All but four risk factors (i.e. breaks/day, missed work, physical work demands, and safety culture) were associated with both near-misses and injuries indicating possible common causal risk pathways. Findings emphasize that PHCPs experience high rates of injuries like their adult-care colleagues, albeit different injury types with different primary risk factors. The majority of risk factors examined are associated with both near-misses and injuries providing important information for prevention and mitigations strategies. Finally, real-time, active surveillance of both injuries and near-misses can successfully supplement passive injury surveillance and can capture information not previously available through traditional reporting systems. [Description provided by NIOSH]
• Subjects:
  Health Personnel Occupational Health Risk Assessment Risk Factors Safety Workplace
• Keywords:
  Employee Health Health Care Workers Injury Prevention Medical Personnel Recording Systems Risk Factors Safety Culture Surveillance Programs Workplace Studies
• Series:
  Grant Final Reports
• Publisher:
  National Institute for Occupational Safety and Health
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Final Grant Report
• Place as Subject:
  Ohio ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  OEP - Office of Extramural Programs
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-56
• NIOSHTIC Number:
  nn:20052498
• NTIS Accession Number:
  PB2018-101545
• Citation:
  Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, R21-OH-010035, 2016 Nov; :1-56
• Contact Point Address:
  Nancy M. Daraiseh, Assistant Professor, Cincinnati Children's Research In Patient Services, James M. Anderson Center for Health Systems Excellence, and Division of Biostatistics & Epidemiology, 3333 Burnet Ave MLC 7014, Cincinnati, OH 45229-3206
• Email:
  nancy.daraiseh@cchmc.org
• Federal Fiscal Year:
  2017
• Performing Organization:
  Cincinnati Children's Hospital Medical Center
• Peer Reviewed:
  False
• Start Date:
  20130901
• Source Full Name:
  National Institute for Occupational Safety and Health
• End Date:
  20160831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:be3c8c2763ea842a63aeb3a61659a869043d3f7f45f57a8675e6c6fada63cefad786969e5146690f3b5801e3613606bd1469f250e5394576ac71bc024e803735
• Download URL:
  https://stacks.cdc.gov/view/cdc/218709/cdc_218709_DS1.pdf
• File Type:
  [PDF - 1.08 MB ]