Nurse practitioner students as an essential workforce: The lessons of coronavirus disease 2019.

BACKGROUND: The coronavirus disease 2019 (COVID-19) disrupted the education and clinical training of nursing students. Clinical sites shut out students over low equipment supplies, physical distancing requirements, and redeployment of staff. PURPOSE AND METHODS: The purpose of this paper is to highlight a progressive solution to engage nurse practitioner students as part of the COVID-19 response given the disruption of their traditional clinical training environments so that student could continue to matriculate and graduate in a timely manner. FINDINGS: Nurse practitioner students swiftly responded and were deemed an essential part of the nursing workforce. DISCUSSION: Policy implications for advanced nursing practice and education for telehealth and simulation research moving forward is also provided.

Associations between daily-on-the job hassles with perceived mental exertion and depression symptoms in taxi drivers.

INTRODUCTION: Taxi drivers experience frequent hassles that may contribute to mental exertion and depression symptoms. AIM: Mental exertion and depression symptoms in taxi drivers are explored in association with hassles, effort-reward imbalance, job strain, and iso-strain. METHODS: Personal interviews were conducted with 130 drivers in San Francisco. RESULTS: Mental exertion averaged 4.5 (±2.68) and physical exertion averaged 3.71 (±2.1) on 0 to 10 Borg scales. Based on the Center for Epidemiological Studies-Depression scale, 38% had depression symptoms. Mental exertion and depression symptoms correlated with job strain, iso-strain and effort-reward imbalance in anticipated directions, lending construct validity to the Borg mental exertion scale. Physical exertion, night shift, stressful personal events, and being uninsured for healthcare predicted mental exertion. Lack of respect by dispatchers and stressful personal events predicted depression symptoms. CONCLUSION: Selected hassles may be remedied by communication trainings, emphasizing mutual respect. Recognition and treatment of depression in taxi drivers are important.

Hepatitis C Competency and Outreach of Occupational Health Nurses.

In the United States, approximately one half of individuals with chronic hepatitis C virus (HCV) are not aware of their status. Current HCV treatment is highly successful and is associated with a decrease in all-cause mortality. Occupational health nurses (OHNs) are often the sole health care providers at worksites and have a unique opportunity to provide HCV education, screening, and linkage to care. This project measured changes in OHN HCV competency and outreach, and identified barriers to screening. In June 2017, Survey 1 was emailed to 3,414 American Association of Occupational Health Nurse (AAOHN) members. For HCV competence, HCV knowledge and confidence in educating and counseling employees regarding HCV were assessed. HCV outreach and barriers to screening were identified. The HCV educational campaign launched in October 2017 with a webinar, a webpage/toolkit, and educational emails. Survey 2 was emailed in January 2018 to assess for changes in HCV competency and outreach. A total of 445 OHNs responded to Survey 1, and 111 completed both surveys, and participant demographics represented AAOHN membership base (95% female, mean age 56.4). The average HCV knowledge pretest score was 76% and posttest score was 77%. Confidence in educating/counseling employees about HCV increased from 2.6 to 2.9 (on a 1-5 scale; p = .052). Higher pretest scores were associated with bachelor's degree (BS/BA) education or above, greater confidence in HCV education/counseling of employees, and HCV education participation within the prior 12 months. There are ongoing HCV learning needs for OHNs and greater opportunities for HCV outreach in worksites.

Nursing Case Management Strategies for Adults with Serious Mental Illness Seeking Dental Services.

A university-community partnership initiated a dental screening and nursing case management program for Medicaid-insured adults with serious mental illness (SMI). Forty-three adults with SMI participated in dental screening; 72% participated in case management. Per client, an average of six case management contacts was made. After 6 months, 87% (27/31) had attended at least one dental appointment, with a 13% no-show rate; 8 completed treatment, 4 had ongoing treatment, 12 had interrupted care, and 3 were lost to follow-up. Adults with SMI experienced high unmet dental needs; nursing case management strategies aided clients to initiate and complete dental care.

Psychosocial work factors and low back pain in taxi drivers.

INTRODUCTION: Taxi drivers are at high risk for low back pain (LBP). AIM: Identify the association between psychosocial-work factors (Job strain, Iso-strain, effort-reward imbalance [ERI], unfairness, and mental exertion) and LBP in taxi drivers. METHODS: A cross-sectional study was done with 129 taxi drivers. RESULTS: Approximately 63% reported LBP in the prior 12 months. Chi square or t-test analyses identified the associations between demographic, work, health, and psychosocial work factors, and self-report of LBP in the prior 12 months. Depression, perceived physical exertion, dispatcher and manager support, unfair treatment at work, and unfair treatment due to nationality were significantly associated with LBP in bivariate analyses. Multivariate logistic regression was done to identify the predictors of LBP. High dispatcher support remained the sole significant predictor for lower prevalence of LBP (OR = 0.66, P = 0.017). CONCLUSION: Greater understanding of psychosocial work factors may aid in developing interventions to prevent LBP in taxi drivers.

Exploring career anchors among occupational health nurses in Japan: A qualitative study.

AIM: This study examined the career anchor characteristics that are possessed by Japanese occupational health nurses. METHOD: Sixteen occupational health nurses participated in the semistructured interview. Data analyses were conducted using descriptive qualitative methods. RESULTS: The data showed the following five categories: practices concerning relationships and positions; development of occupational health practices; management skills for effective work; practices that are approved inside and outside the organization; and work and private life considerations. CONCLUSIONS: This study described the career anchors among occupational health nurses in Japan. The participants emphasized the following: the importance of maintaining good cooperative relationships with workers and supervisors; balancing professional and organized labor; and practicing effective occupational health services. Moreover, the occupational health nurses emphasized receiving approval from inside and outside of the organization. These results were consistent with the actual practices of occupational health nursing.

Development of the Career Anchors Scale among Occupational Health Nurses in Japan.

OBJECTIVES: This study aimed to develop the Career Anchors Scale among Occupational Health Nurses (CASOHN) and evaluate its reliability and validity. METHODS: Scale items were developed through a qualitative inductive analysis of interview data, and items were revised following an examination of content validity by experts and occupational health nurses (OHNs), resulting in a provisional scale of 41 items. A total of 745 OHNs (response rate 45.2%) affiliated with the Japan Society for Occupational Health participated in the self-administered questionnaire survey. RESULTS: Two items were deleted based on item-total correlations. Factor analysis was then conducted on the remaining 39 items to examine construct validity. An exploratory factor analysis with a main factor method and promax rotation resulted in the extraction of six factors. The variance contribution ratios of the six factors were 37.45, 7.01, 5.86, 4.95, 4.16, and 3.19%. The cumulative contribution ratio was 62.62%. The factors were named as follows: Demonstrating expertise and considering position in work (Factor 1); Management skills for effective work (Factor 2); Supporting health improvement in groups and organizations (Factor 3); Providing employee-focused support (Factor 4); Collaborating with occupational health team members and personnel (Factor 5); and Compatibility of work and private life (Factor 6). The confidence coefficient determined by the split-half method was 0.85. Cronbach's alpha coefficient for the overall scale was 0.95, whereas those of the six subscales were 0.88, 0.90, 0.91, 0.80, 0.85, and 0.79, respectively. CONCLUSIONS: CASOHN was found to be valid and reliable for measuring career anchors among OHNs in Japan.

Cardiovascular Risk Factors of Taxi Drivers.

In the United States (U.S.), cardiovascular disease (CVD) is a major leading cause of death. Despite the high mortality rate related to CVD, little is known about CVD risk factors among urban taxi drivers in the U.S. A cross-sectional design was used to identify the predictors of high cardiovascular risk factors among taxi drivers. Convenience sampling method was used to recruit 130 taxi drivers. A structured questionnaire was used to obtain the data. The sample was male (94 %), age mean (45 ± 10.75) years, married (54 %), born outside of the USA (55 %), had some college or below (61.5 %), night drivers (50.8 %), and driving on average 9.7 years and 41 h/week. About 79 % of them were eligible for CVD prevention, and 35.4 % had high CVD risk factors (4-9 risk factors). A CVD high-risk profile had a significant relationship with the subjects who were ≥55 years old; had hypertension, diabetes, or hyperlipidemia; were drinking alcohol ≥2 times/week; and had insufficient physical activity. Subjects who worked as a taxi driver for more than 10 years (OR 4.37; 95 % CI 1.82, 10.50) and had mental exertion from cab driving >5 out of 10 (OR 2.63; 95 % CI 1.05, 6.57) were more likely to have a CVD high-risk profile. As a conclusion, system-level or worksite interventions include offering healthy food at taxi dispatching locations, creating a work culture of frequent walking breaks, and interventions focusing on smoking, physical activity, and weight management. Improving health insurance coverage for this group of workers is recommended.

Work-Related Health Complaints and Injuries, and Health and Safety Perceptions of Latino Day Laborers.

This study describes socio-demographic, health, and work factors as well as health and safety perceptions of day laborers who reported work-related health complaints and injuries. The researchers completed a secondary data analysis of 217 interviews conducted in 2009 with day laborers in a large city. The participants reported 83 health complaints or injuries (38%) that had occurred during the prior 12 months, with 57 of these complaints or injuries resulting in lost work time. Pain and soreness of the back were the most prevalent health complaints or injuries; 66% of participants did not report their injuries, 62% reported no health and safety training, 96% reported they needed personal protective equipment (PPE), and 63% were provided with PPE. Latino day laborers reported a high 12-month prevalence of work-related health complaints and injuries. Ongoing policy work is needed to encourage injury reporting by day laborers and the provision of health and safety training and PPE to this group of workers.

Work-related violence experienced by urban taxi drivers.

OBJECTIVES: This study measured violence (physical assault, robbery, or weapon confrontation) in taxi drivers, and determined socio-demographic/work factors associated with violence. METHODS: In 2010, 130 taxi drivers, working in a large city in the Western US, were administered a survey evaluating workplace violence events. RESULTS: The study population was male (94%), mean age 45, married (54%), foreign-born (55%), with 24% speaking Arabic at home. Drivers drove at night (51%), for an average of 9.7 years and 41 hr/week. Almost half reported a history of violence during their driving careers: physical assault, weapon confrontation, or robbery. In the prior 12 months, 12% were physically assaulted, 8% robbed, and 6% confronted with a weapon. Night drivers reported more assaults over their lifetime compared to day drivers (mean = 1.64 [sd 4.29] vs. mean = 0.53 [sd 1.05], P = 0.047). CONCLUSIONS: Taxi drivers experience violence at work. Strategies are needed to prevent violence especially in night drivers.

Occupational health nurses' achievement of competence and comfort in respiratory protection and preferred learning methods results of a nationwide survey.

Additional findings are presented from a 2012 nationwide survey of 2,072 occupational health nurses regarding how they achieved competence in respiratory protection, their preferred methods of learning, and how they motivated employees to use respiratory protection. On-the-job training, taking a National Institute for Occupational Safety and Health spirometry course, or attending professional conferences were the primary ways occupational health nurses gained respiratory protection knowledge. Attending professional conferences was the preferred method of learning, varying by type of industry and years of occupational health nurse experience. Employee motivational strategies were not widely used; the most common strategy was to tailor respiratory protection training to workplace culture. Designing training methods that match learning preferences, within the context of the organization's safety and quality improvement culture, is a key recommendation supported by the literature and these findings. Including respiratory protection content and competencies in all levels of academic nursing education is an additional recommendation. Additional research is needed to link training strategies with consistent and correct use of respiratory protection by employees.

Snapshot of the AAOHN Membership-Health Risk Appraisal Priority Areas.

A 2012 American Association of Occupational Health Nurses, Inc. (AAOHN) web-based membership survey of 5,138 members was designed to identify occupational health and safety issues facing members. A total of 2,123 members responded to the survey (41% response rate). Of the AAOHN members who responded to this survey, 61% reported health risk appraisal (HRA) priorities for 2012. HRA priority areas are identified among various subgroups of the AAOHN responders in this article. The top three HRA priority areas identified were weight management/nutrition/healthy eating, physical activity, and mental health/stress management. These priority areas were consistent across three industry sectors, three occupational health nurse job titles, and the smallest and largest employers. These results suggest that occupational health nurses should consider prioritizing their employee wellness efforts in these areas.

Perceived competence and comfort in respiratory protection: results of a nationwide survey of occupational health nurses.

In response to the Institute of Medicine (2011) report Occupational Health Nurses and Respiratory Protection: Improving Education and Training, a nationwide survey was conducted in May 2012 to assess occupational health nurses' educational preparation, roles, responsibilities, and training needs in respiratory protection. More than 2,000 occupational health nurses responded; 83% perceived themselves as competent, proficient, or expert in respiratory protection, reporting moderate comfort with 12 respiratory program elements. If occupational health nurses had primary responsibility for the respiratory protection program, they were more likely to perceive higher competence and more comfort in respiratory protection, after controlling for occupational health nursing experience, highest education, occupational health nursing certification, industry sector, Association of Occupational Health Professionals in Healthcare membership, taking a National Institute for Occupational Safety and Health spirometry course in the prior 5 years, and perceiving a positive safety culture at work. These survey results document high perceived competence and comfort in respiratory protection. These findings support the development of targeted educational programs and interprofessional competencies for respiratory protection.

Development of a respiratory protection survey instrument for occupational health nurses: an educational project.

The Institute of Medicine (2011) report Occupational Health Nurses and Respiratory Protection: Improving Education and Training outlined seven recommendations to improve the competency of occupational health nurses in respiratory protection. An advisory group was convened in December 2011, with stakeholder representation from the Centers for Disease Control and Prevention/National Institute for Occupational Safety and Health/National Personal Protective Technology Laboratory, American Association of Occupational Health Nurses, Inc., American Board for Occupational Health Nurses, Inc., Association of Occupational Health Professionals in Healthcare, American Nurses Association, and Institute of Medicine Standing Committee on Personal Protective Equipment for Workplace Safety and Health. The initial work of the advisory group included developing and administering a survey to assess current occupational health nurse roles and responsibilities relevant to respiratory protection. Development of the survey was led by a master's student and advisor who worked with the advisory group. The process of tool development and preliminary findings are presented in this article.

Health and safety strategies of urban taxi drivers.

This study describes health and safety concerns and self-care strategies of San Francisco taxi drivers. Focus groups and a written cross-sectional survey were done in a convenience sample of taxi drivers working in San Francisco. Sessions were audiotaped, transcribed in English, and independently coded to identify major health and safety themes, using thematic content analysis. Strategies to manage health and safety issues are the focus of this analysis. Five focus groups were held in 2009 with 36 participants. Major health and safety themes included stress, body pain, danger, vulnerable employment status, and concerns related to unhealthy working conditions. Self-care strategies included diffusion/decompression to manage stress, maintaining a positive attitude, maintaining power and control, and practicing proactive self-care. Creative self-care strategies were described by taxi drivers to keep healthy and safe at work. These data will inform future self-care interventions to reduce health and safety risks of taxi driving.

Sociodemographic characteristics, health, and success at obtaining work among Latino urban day laborers.

BACKGROUND: The purpose of this study was to examine the health and social circumstances, knowledge of and access to health and social services, and success at getting work among urban day laborers. METHODS: We conducted an interview survey of 217 men waiting for work at several sites in San Francisco. RESULTS: Day laborers were generally unsuccessful at obtaining work and had less than optimal housing, but supported a number of family members. Over half reported fair or poor health, associated with longer time as a day laborer, poor English proficiency, and financially supporting three or more other people. Awareness of health and social services available to them was low. DISCUSSION: The stress of seeking work daily, separation from family, inadequate housing and lack of health care puts this population at increased risk for disease conditions associated with poor physical and mental health.

The occupational health nurse as the trusted clinician in the 21st century.

Occupational health nurses as trusted clinicians use their direct care skills in both on-site and off-site roles to protect human resources and contain health care costs. On-site clinics leverage the knowledge, skills, and abilities of occupational health nurses. To maximize the health of the work force, occupational health nurses use strategies aimed at improving health, engaging employees, enhancing accountability of employees, linking provider strategies, using technology creatively, and promoting healthy work environments. Occupational health nurses maintain a proactive and effective impact on occupational health and safety as part of a broader framework of holistic primary care.

Snapshot of the AAOHN membership.

The American Association of Occupational Health Nurses, Inc. (AAOHN) conducted a web-based membership survey of 2123 members (41% response rate) in May and June 2012. This column presents educational, certification, and selected industry data for registered nurse and advanced practice nurse AAOHN members. Members are highly experienced, with 57% reporting more than 16 years of experience. Sixty-eight percent of AAOHN members are educated at or above the baccalaureate level. An additional 8.4% are currently enrolled in an educational program. Seventy-six percent are nationally certified as occupational health nurses or occupational health nurse specialists (COHN/COHN-S), case managers, safety professionals, ergonomists, or nurse practitioners. The majority (89%) work full-time as employees of their facility (85%), with manufacturing (34%), hospital/health care (26%), and government/military (10%) being the top three industry sectors. Ten percent work for small employers (fewer than 500 employees), whereas 12% work with more than 50,000 employees. Thirteen percent of AAOHN members work globally. Future columns will present additional 2012 AAOHN member survey data.

The future of nursing--opportunities for occupational health nursing.

In this article, The Future of Nursing: Leading Change, Advancing Health report is summarized, and opportunities for occupational health nursing are proposed.

Psychosocial work factors and shoulder pain in hotel room cleaners.

BACKGROUND: Hotel room cleaners have physically demanding jobs that place them at high risk for shoulder pain. Psychosocial work factors may also play a role in shoulder pain, but their independent role has not been studied in this group. METHODS: Seventy-four percent (941 of 1,276) of hotel room cleaners from five Las Vegas hotels completed a 29-page survey assessing health status, working conditions, and psychosocial work factors. For this study, 493 of the 941 (52%) with complete data for 21 variables were included in multivariate logistic regression analyses. RESULTS: Fifty-six percent reported shoulder pain in the prior four weeks. Room cleaners with effort-reward imbalance (ERI) were three times as likely to report shoulder pain (OR 2.99, 95% CI 1.95-4.59, P = 0.000) even after adjustment for physical workload and other factors. After adjustment for physical workload, job strain and iso-strain were not significantly associated with shoulder pain. CONCLUSIONS: ERI is independently associated with shoulder pain in hotel room cleaners even after adjustment for physical workload and other risk factors.