FALL 2008 VOL. XXVIII, NO. 4. · 2020. 1. 24. · Dedicated to the health and safety of healthcare...

Dedicated to the health and safety of healthcare workers

D E P A R T M E N T S

FALL 2008 VOL. XXVIII, NO. 4.

18Workplace Violence and Corporate Policy for Health Care SettingsBy Paul T. Clements; Joseph T. DeRanieri; Kathleen Clark; Martin S. Manno; Douglas Wolcik Kuhn

222008 AOHP National Conference Photos

25Next Generation WorkforceBy Cathy Swenson, BSN, RN

28Physical Activity and Obesity: Their Interaction and Implications for Disease Risk and the Role of Physical Activity in Healthy Weight ManagementBy Robert F. Zoeller Jr, PhD

36The Impact of Stress Management on Nurse Productivity and RetentionBy Tammi F. Milliken, PhD, NCC; Paul T. Clements, PhD, APRN, BC, DF-IAFN; Harry J. Tillman, PhD, MBA, MSN, RN

3 President’s Message

6 Vice President’s Update

8 Editor’s Column

9 Association Community Liason Report

11 Ready to Research

13 Spotlight on an AOHP Star

14 Bits and “Bytes”

16 Colleague Connection

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Fall 2008

President’s MessageBy Sandra Domeracki Prickitt, RN, FNP, COHN-S

Partnerships are relation-ships involving close coopera-tion between parties having specified and joint rights and responsibilities. Partnerships are very important to AOHP.

MaryAnn Gruden, AOHP’s Association Community Liai-son, shares updates with us regularly regarding our Alli-ance with the Occupational Safety and Health Administra-tion (OSHA,) our Memoran-dum of Understanding with The National Institute for Oc-cupational Safety and Health (NIOSH) and collaborative ef-forts with several other orga-nizations.

Since becoming Executive President, I have had the hon-or of following Denise Knob-lauch as AOHP’s delegate to The Joint Commission’s Nurs-ing Advisory Council. We en-tered into a partnership with the American Industrial Hy-giene Association (AIHA) this year. We also work in partner-ship with the Centers for Dis-ease Control and Prevention (CDC) related to bloodborne pathogen exposures, health and wellness, emergency pre-paredness and other topics as they arise that are pertinent to AOHP’s membership.

In this issue of the Journal, it is my pleasure to share with you our most recent partner-ships.

CDCAOHP was invited to attend the 2008 Leaders to Leaders Conference, Shaping Policy for a Healthier Nation, held July 8 and 9 in Washington,

DC. This was the third time this conference has been held. The conference was co-hosted by the Centers for Disease Control and Preven-tion (CDC,) the Association of State and Territorial Health Officials (ASTHO) and the Na-tional Association of County and City Health Officials (NACCHO.) The goal is to grow The Healthiest Nation Alliance.

The Healthiest Nation Alliance is a collaboration of people and organizations committed to rebalancing our nation’s health system and making sure that our investments prioritize health promotion, prevention of poor health and preparedness for new threats – just as much as they prioritize access to afford-able quality medical care for these conditions once they do occur. Members of the al-liance will provide leadership and foster actions by organi-zations and individuals that encourage or sustain health. The goal is to help Americans catch up to the health status that people in other countries already enjoy!

Julie Gerberding, MD, Direc-tor of the CDC, opened the conference with an inspir-ing talk about the concept of health. This was followed by plenary and panel sessions on Creating a Healthiest Nation, Health in All Policies, Finding the Voice of Public Health in the National Health Reform Dialogue and Innovations in Technology with Health Im-pact Potential.

In between these sessions, we attended breakout ses-sions where we discussed topics such as Health in All Policies, Creating our Pre-ferred Future and several others. These were great for networking, hearing differ-ent opinions, sharing ideas and then presenting them to the larger group. It was a nice blend of activities and knowledge exchange. That evening there was a Technol-ogy Showcase of some items being used in various sectors for health and wellness pro-grams. This was followed by a dinner and guest speakers from the sports arena. During this first day, I had the honor of introducing myself to Dr. Gerberding and chatting with her for a few minutes.

The second day was just as inspiring and information packed. It started off with a talk by Joe Ehrmann, who played professional football for 13 years. He has also been very active and influential with the health of his community of Baltimore. He shared some of his experiences and what he is doing for the young women and men in his area. This was followed by a panel discussion on Health Equity, Engaging Americans for a Healthier Nation, Engaging Leaders for a Healthier Na-tion, with breakout sessions on Using Health in All Policies to Reduce Health Disparities and Using the Language of Leadership to Shape Policy for a Healthier Nation.

The following is a sampling of groups represented at this

Partnerships

Sandra Domeracki PrickittAOHP Executive President

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of the Association of Occupational Health Professionals in Healthcare

conference: Home Safety Council; Unnatural Causes; Dow Chemical Company; Northrop Grumman Corpora-tion; Public Health Foundation; National Council on Aging; Humana; The Soap and De-tergent Association; Wal-Mart Stores; Target; Partnership for Prevention; The Kellogg Foun-dation; Entertainment Media Ventures; Pitney Bowes; Mi-crosoft; Google; Livable Com-munities Coalition; UPS; Veri-zon; Sodexo; AARP; AAOHN; ACOEM; IBM; and several universities; to list just a few.

It was a very exciting oppor-tunity for me to represent you and AOHP at this conference. I learned so much and plan to share more about this alli-ance with you in an upcoming Journal column. There where several things that were said that continue to resonate in my mind:• Healthismorethanhealth-

care and the managing of disease. It is our first wealth. It also encompasses more than what one individual does for their health. It is the total being and wellness of the community at large. Healthier people can make companies more produc-tive and, on a larger scale, make our nation in its en-tirety healthier. This in turn can make our nation more prosperous. It is our future, and we need to embrace it.

• Bybuildingthisallianceandpartnering around the topic of health, we can drive poli-cies.

• Dr. Gerberding shared twoquotes on leadership that Billy Jean King shared with her several years ago: lead-ership is a privilege; and champions know how to adjust.

As occupational health profes-sionals in healthcare, we are the leaders in our institutions

for the health of the health-care workers. We are in a per-fect position to effect change in the health of these workers through all of the functions and services that we provide in our departments. Let us share the knowledge and ex-citement we have for health with all of these people to the best of our ability.

Because of the work you do, the Board of Directors of AOHP has decided for AOHP to become a member of The Healthiest Nation Alliance. We will be providing you addi-tional information on this alli-ance as it develops. For more information, you can also visit the Web site http://www.healthiestnation.org/.

A Healthy Nation is a Wealthy Nation!

The Joint Commission – Nursing Advisory CouncilAOHP’s presence on The Joint Commission’s Nursing Advisory Council is one of the outcomes of our strategic marketing plan.

On June 9, 2008, on behalf of AOHP, I attended The Joint Commission’s Nursing Advi-sory Council annual meeting in Illinois (just outside Chi-cago.) It was such an honor and thrill to represent AOHP at this meeting. Each mem-ber is so visible, and they hold high credentials in their fields. It was a great pleasure to meet the chair of the com-mittee and the President of The Joint Commission, Mark Chassin, MD. It was also very coincidental that I flew home on the same plane as the Chair of the Nursing Advisory Council, Marilyn P. Chow. Dr. Chow and I were able to spend some time to-gether, and she extended the opportunity for AOHP to pro-pose topics for the council’s upcoming meetings.

The council has many activi-ties that they are and have worked on, such as: • Legislativeandpublicpolicy

initiatives related to nursing.• Publication of a nursing

white paper.• Performancemeasurement

issues related to nursing.• Nursingmeasuressettest-

ing.• Standards improvement

initiatives and the nursing chapter.

• Bestpracticemodelsandin-tegration strategies related to nursing (i.e. Transform-ing Care at the Bedside and Building Nurse Education Capacity Effort, Time and Motion Study, discussion of the Clinical Nurse Leader role, and Technology stud-ies.)

• Discussionofpotential im-provements to the Recom-mendations, Accountabili-ties, Actions Matrix.

• Providing input into thecontent of Joint Commis-sion Resources Educational Conferences.

The Nursing Advisory Council was established in 2003 to counsel The Joint Commis-sion on present and evolving nursing-related issues that are affecting health care qual-ity and patient safety. The council provides input to The Joint Commission on initia-tives that affect the nursing profession and seeks to ad-vance solutions to the nurse staffing crisis. The council is chaired by Marilyn P. Chow, RN, DNSc, FAAN, Vice Presi-dent of Patient Care Services at Kaiser Permanente, Oak-land, California. Dr. Chow is also the official at-large nurs-ing representative on The Joint Commission’s Board of Commissioners.

The council consists of organi-zation members from the Na-tional Council of State Boards of Nursing, National Black

Nurses Association, National Association of Hispanic Nurs-es, American Nurses Creden-tialing Center, American Acad-emy of Nursing, American Association of Community Colleges, American Associa-tion of Colleges of Nursing, American Federation of Gov-ernment Employees AFL-CIO, American Organization of Nurse Executives, American Nurses Association, and the National League for Nursing.

At-large members are from these various areas: Vander-bilt University Medical Center; Hackensack University Medi-cal Center; Kaiser Permanen-te; University of Virginia Health Systems; International Uni-versity of Nursing; VHA; Inc.; Hospital Corporation of Amer-ica; The Robert Wood John-son Foundation; Ascension Health System Office; Univer-sity of Pennsylvania – School of Nursing; UCLA School of Public Health; Department of Veterans Affairs; Institute for Healthcare Improvement; Nell Hodgson Woodruff School of Nursing – Emory University; Cross Country Staffing/Cross Country Healthcare, Inc.; SEIU – Nurse Alliance – Dis-trict 1199 NW; and the Citizen Advocacy Center.

There is also a special advisor from the University of Penn-sylvania – School of Nursing. There are two representa-tives from The Joint Commis-sion board on the council, as well from Banner Children’s Hospital and Case Western Reserve University.

AOHP and American In-dustrial Hygiene Associ-ation (AIHA) PartnershipVirginia (Ginny) Wester of the Northern California Chap-ter and Sylvia Beane of the North Carolina Chapter have volunteered to be AOHP’s representatives for our part-nership with AIHA. They will

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be participating in AIHA’s Oc-cupational Health sub team. This team is one of many teams formed out of AIHA’s Health Care Work Group. The work group consists of 120 AIHA members and was formulated based on annual polls of AIHA membership to identify their needs. The goal of the work group is to provide information, sharing of ideas and concepts, and education for members to do a better job and have as a ref-erence/resource. The Health Care Work Group consists of members from hospitals, re-search organizations, special interest, government entities (i.e. NIOSH, FDA,) consult-ing organizations and medical device organizations. Other sub teams include Ergonom-ics, Hazard Evaluation, Emer-gency Preparedness, Green Buildings, Construction-Re-lated Issues, and Pollution Prevention and Control.

The Occupational Health sub team works on hot topics in this area and writes articles to educate others via the AOHP Journal. It meets by conference call quarterly. Syl-via represented AOHP for the first time at the May 9, 2008 meeting. Some ideas for the next collaborative articles were Radiology/Oncology Risk Exposures, Respiratory Protection, Nanotechnology, Controlling Airborne Toxins, OSHA 300 Log, Hazards in Histopathology, Laser Safety, Noise, and the Importance of Ventilation in Hospitals. Ginny and Sylvia are also sent drafts of articles between meetings to provide feedback on behalf of AOHP. On behalf of AOHP, I would like to thank Ginny Wester and Sylvia Beane for their time, energy and will-ingness to take on this lead-ership role and support our partnership with AIHA.

Are you an occupational or an employee health nurse? If you answered, “Yes”, you should give strong consideration to becoming certified! Why?

Read on for the Top 10 reasons to become a certified occupational health nurse.1. Certification is a mark of prestige.2. Certification is a significant personal and professional accomplishment.3. Certification can advance your career.4. Certified OHNs earn significantly more.5. Employers regard certification as a mark of quality and rely on certification when making

employment decisions.6. The certified OHN provides knowledgeable management of occupational injuries and ill-

nesses and facilitates early return to work processes.7. The certified OHN can reduce the employer’s legal exposure through management of

regulatory requirements such as OSHA, FMLA, ADA, DOT, HIPAA, etc.8. Certification enhances your disease management and health promotion skills.9. Certified OHNs make a positive impact on the employer’s financial bottom line.10. Certification augments competence and on-the-job productivity.

The eligibility for COHN and COHN-S certification has changed. For further infor-mation please contact www.abohn.org or call the ABOHN office at 888-842-2646 or 630-789-5799.

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Vice President’s UpdateBy Diane Dickerson, RN, MS, COHN-S/CM, SPHR

Diane DickersonAOHP Executive Vice President

“Stand Up” . . . I have heard these two words many, many times during the past few weeks. Stand up for America . . . Stand up and vote . . . Stand up 2 Cancer . . . etc. These are two small but very important words!

Over the years, I have seen YOU—as individual occupa-tional health professionals and as AOHP members—standing up day after day for your employees. You are con-tinually advocating for their health and safety: by provid-ing essential treatments and counseling following work-re-lated injuries; by introducing and educating new employ-ees regarding your employ-er’s programs, policies and safety practices; and by de-veloping new programs and services to keep current with national safety standards. The list goes on and on.

2008 has proven to be an-other exciting year in the regulatory arena. With your input, AOHP has chosen to stand up and provide support and feedback to organiza-tions that advocate for em-ployee safety. AOHP stands up for employees by provid-ing comments and recom-mendations to various regu-latory agencies surrounding a variety of topics, including: respirator fit testing; post ex-posure treatments following mass casualty events; BLS coding systems; emergency preparedness and response goals; use of PPE for influen-za pandemic; and proposals

for issuing employer citations following safety violations.

AOHP also stands up for YOU—by providing excep-tional educational opportuni-ties, by providing membership growth incentives through our ROC campaign, by provid-ing scholarships and awards to recognize and encourage occupational health excel-lence, and by participating in alliances with OSHA, NIOSH and others. These are just a few examples of how AOHP stands up for programs to support our healthcare work-ers and YOU, as occupational health professionals.

As my term of office on the AOHP Executive Board comes to a close, I reflect back on these years. I am re-minded of what a fantastic as-sociation this is to which we belong, and what makes it so great is YOU! You stand up for our employees every day, and by doing so, you are making a difference in the lives of each and every employee within your organization. As you know, a safe environment is a happy and productive environ-ment. And, we cannot ever let our guard down because ensuring a safe environment is an ongoing journey in which we take one day at a time. Al-though some of your actions may seem “routine,” please never lose site of the tremen-dous impact that you are mak-ing during this journey!

When you stand up for what you believe in, you are on the

way to making a difference. I am reminded of a brief story that I would like to share with you that has had a great im-pact on my life—both person-al and professional.

An old man lived near the ocean, and many mornings he would start his day by taking a walk along the shore. On this one particular day, as he looked ahead, he saw an im-age of what appeared to be someone dancing. As he came closer to this image, he real-ized that it was a young boy. As he approached this young boy, he noticed hundreds of starfish that had washed ashore during the night. The old man greeted the young boy and asked him what he was doing. The young boy re-sponded, “Oh, I’m throwing these starfish back into the ocean so they can continue to live.” The old man frowned and chuckled and said to the young boy, “Oh son, there are hundreds of starfish. There’s no way that you can make a difference here.” At this point, the young boy reached down, picked up another starfish and threw it back into the ocean. He then turned to the old man and said, “Well sir, I just made a difference to that one!”

To me, this is a perfect ex-ample of how, in spite of the many challenges we may face, we must stand up and do what we think is right and stand up for what we believe in. We must always speak truthfully, tactfully and with respect for others. We

STAND UP . . . Make A Difference!

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Fall 2008

must never tire, and we must continually strive to move forward. By doing so, we are making a difference, and many times, it is one employ-ee at a time!

I would bet that you have saved more than one employ-ee’s career. Perhaps it was the nurse who sustained a

needlestick injury and felt like she just could not handle the environmental risks associ-ated with being a nurse. But, it was your counseling and your calm and professional response to her incident that helped her to get beyond this and continue in her profes-sion. Or, it could have been the employee whose work-

related injury prevented him from continuing in his job. But, it was you who identified another job position where he could use his skills, knowl-edge and expertise without concern for additional injury.

I could go on and on with other examples, but suffice it to say that I stand up for

YOU. I congratulate each and every one of you for your out-standing accomplishments as occupational health pro-fessionals because when you stand up for our employees, you are making a difference to create and promote a safe and healthy work environ-ment for healthcare workers everywhere! Thank YOU!

AOHP is Proud to Announce the Recipients of the Association’s Awards for 2008

Joyce Safian Scholarship AwardKim Stanchfield, RN, COHN-S

This award is presented to a past or present association officer who best portrays an occupational health professional in healthcare role model.

* * *

Ann Stinson President’s Award for Association ExcellenceNorthern California Chapter and

Michigan ChapterThis award recognizes a chapter that has demonstrated outstanding performance and enhanced the image of occupa-

tional health professionals in healthcare.

* * *

Extraordinary Member AwardSandi Buzar, RN, WWCP

This award recognizes a current association member who demonstrates extraordinary leadership.

* * *

Honorary Membership AwardLaura Canton, MD

This award recognizes a person who has made a significant contribution to the field of occupational health in healthcare.

* * *

Sandra Bobbitt ScholarshipMary Bliss, RN, COHN

Denise Knoblauch, RN, BSN, COHN-S/CMDelynn Lamott, RN, MS, COHN-S

Rose Yaptinchay, RN, MBAThis award honors current qualifying members with complimentary attendance to the national conference.

* * *

Julie Schmid Research ScholarshipPeter Lee, MD, MPH

This award encourages, promotes, and strengthens the knowledge base and expertise of the occupational health professional in healthcare.

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Editor’s ColumnBy Kim Stanchfield, RN, COHN-S

Kim StanchfieldAOHP Journal Editor

How did you end up em-ployed in your current posi-tion? I dare say all 1,000-plus AOHP members may share some commonalities in their journey, but most everyone’s path to get to employee/oc-cupational health is different.

My nursing career started in the mid 70s. Employee Health did not exist at that time. To be honest, nurs-ing was not my first career choice. I did not dream as a young girl about being a nurse. My dreams were to be a school teacher. I loved school, loved to play school and drove my younger sis-ter crazy “teaching” her. However, in my high school years, the market was abso-lutely flooded with teachers. There were few teaching jobs available. Mom wanted me to be a hairdresser. I am sure that was because she liked the way I teased her hair at the time. (It was the early 70s. We all had teased and sprayed “do’s”.)

Always loving color, fabrics and furniture, I aimed my ca-reer toward interior design. An ad for a design school in Atlanta captured my atten-tion, and I set my sights to go. Dad (much wiser at the time than I realized) encour-aged me to become a nurse.

Honestly, I had never even considered nursing as a ca-reer. I was always the kid that kicked and screamed, taking the pediatrician and nurses down with me anytime my parents had to drag me to the doctor. My dad, forever the “plain truth” speaker, advised me, “No one from Brandywine, West Virginia (my hometown) will ever need an interior designer. But they will get sick and need a nurse.”

So, off to college and nurs-ing I went, not really even liking it at all until a student rotation in the Emergency Room. I had found a part of nursing that fascinated me. When I graduated, green as grass, but smart enough to realize that I needed practical clinical experience, I went to work on our closest hospi-tal’s medical floor. Not their best new graduate, I moved to a surgical floor and greatly improved my nursing skills and confidence. During this

time I also joined the local rescue squad and prepared for my entry into Emergency Department nursing.

When I finally went to the Emergency Department, I thrived as a nurse. I felt I had come home. In the ED,

the work is crazy, break your back, non-stop everything. I learned some of my best skills in that ED, including multi-tasking, rapid assess-ment, mental health counsel-ing, and “telling the fakers from the really ill ones.” Af-ter eight years, I happened to see a job posting outside our Human Resources for “Em-ployee Health Nurse.” When I inquired about the job, no one could provide much in-formation. I was informed, “It is a new job. The Infection Control nurse needs help giv-ing TB tests and flu shots.” Recently re-married, the Monday through Friday day-light hours held high appeal. I applied and got the job. As they say, the rest is history.

Today, 21 years later and go-ing strong, Employee Health is my career, my passion and what I now know is the per-fect job for me. I get to be the teacher I always wanted to be, plus everything else I never even dreamed of. Dad was correct, except it is the employees at my hospital that need a nurse. And I am proud to be theirs.

I ask all of you, those new to Employee Health and those well experienced in this great nursing specialty, how did you end up here? The jour-ney is far less important than the wonderful destination.

How Did We End Up Here?

...most everyone’s path to get to employee/occupational health is different.

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MaryAnn GrudenAssociation CommunityLiaison

Partnership and Recognition in Washington, DC. She has provided the following infor-mation about the program.

OSHA Challenge offers busi-nesses and public sector or-ganizations an opportunity to develop or improve their safe-ty and health management system in a non-threatening, proactive manner. A step-by-step roadmap, based on the successful VPP model, guides participants through the Chal-lenge’s three stages. Each stage features clearly defined actions, documentation and outcomes. OSHA provides staged requirements and on-line tracking tools that enable participants to move at their own pace and to develop safety and health systems tailored to their unique work-place conditions and needs.

Participants work with a Chal-lenge Administrator, who pro-vides guidance and serves as the primary contact between the participant and OSHA. Administrators also perform the essential function of col-lecting and reporting informa-tion, such as stage progress and injury/illness data.

Recognition. Participants re-ceive recognition from OSHA for successfully complet-ing each stage – for exam-ple, their names posted on OSHA’s Web site and their achievements cited during OSHA presentations around the country. Program gradu-ates are encouraged to apply for VPP, which requires mini-mal additional effort.

Eligibility. OSHA Challenge is open to employers who need help developing and imple-menting their safety and health management systems. OSHA is particularly inter-ested in attracting employers who want to qualify for VPP. However, a commitment to VPP is not required to enjoy the benefits of Challenge.

Getting Started. For more in-formation about OSHA Chal-lenge, contact one of the Chal-lenge Administrators listed on OSHA’s Web site at www.osha.gov/dcsp/vpp/challenge.html or place a call to OSHA’s Office of Partnership and Rec-ognition at 202-693-2213.

OSHA also is seeking new Challenge Administrators. If you think you might want to serve in this valued capacity, providing guidance to busi-nesses in your industry or to individual facilities within your organization, give OSHA a call. Challenge Administrators may be corporations, non-profit associations and federal agencies. They may not be private safety and health con-sultants or for-profit associa-tions. Requirements include demonstrated knowledge and experience in safety and health management systems, availability of adequate re-sources and a commitment to Challenge. OSHA will re-view potential Administra-tors’ qualifications and make a decision.

Mass Immunization/Prophylaxis Document DraftedThe AOHP National Asso-ciation Partnership Team

By MaryAnn Gruden, CRNP, MSN, NP-C, COHN/S-CM

Association Community Liaison Report

OSHA Alliance UpdateOSHA Introduces the Challenge ProgramOne of the goals of the Oc-cupational Health and Safety Association’s (OSHA) Alliance Program is to promote OSHA’s cooperative programs and to encourage participants and their members and worksites to get involved in these pro-grams. The following is infor-mation about a new program called the OSHA Challenge.

OSHA Challenge BackgroundOSHA’s Voluntary Protection Programs (VPP) are the most prestigious safety and health recognition programs in the United States. Approval into VPP is OSHA’s official recog-nition of employers and em-ployees who have achieved exemplary occupational safe-ty and health. Many employ-ers have asked for a program for organizations that are interested in VPP but need some help in meeting VPP requirements. OSHA estab-lished the OSHA Challenge Program to satisfy this need. OSHA recognizes that many employers are at different stages in the process of im-plementing successful safety and health management sys-tems. OSHA Challenge al-lows businesses and other organizations to implement safety and health manage-ment systems at their own pace and receive recognition from OSHA for their accom-plishments.

Components of the OSHA Challenge Judith Weinberg is a program analyst in OSHA’s Office of

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(formerly the OSHA Alliance Implementation Team) has drafted a new document ti-tled Beyond Getting Started: Preparing for Mass Immuni-zation/Prophylaxis of Health-care Workers. This docu-ment will be a resource for developing and implement-ing a facility plan to distribute mass immunizations or pro-phylaxis. At the time of this writing, the document is be-ing prepared to be reviewed by OSHA staff. The goal is to have it available for members before the end of the year.

OSHA Seeks Comments on PPE Training and ViolationsOn August 19, 2008 the Federal Register published proposed rule changes for OSHA’s Personal Protective Equipment (PPE) standard and other standards that have PPE requirements. The proposed rule is to clarify the remedy for violation of the re-quirement to provide PPE and train employees. Currently, language related to training in these standards is not con-sistent with regard to applica-tion of the PPE requirement. The question being clarified is whether or not the PPE requirement applies to “each employee” or to the “group” of employees covered by the standard. Making the distinc-tion between “each employ-ee” and a “group” of employ-ees will also have implications when citations are issued, as OSHA is also seeking in the proposed rule change to cite for “per employee” when a there is a “flagrant” violation. The “group citations” are the most common citations and would continue. OSHA is stating that the “per em-ployee” citation would only be enforced when there has been a “flagrant” violation of the standard.

Public comments were due on the proposed rule change by September 18, 2008. At the time of this publication, AOHP’s final comments are being drafted. In part, the association’s position has included that all of the PPE language in standards should have common language that makes it clear to employers that PPE must be made avail-able for each employee and that each employee must be trained in the proper use of the PPE. In cases where there is evidence that the em-ployer has made little or no effort to meet the PPE stan-dard, and the health and safe-ty of the employees is jeopar-dized, we support the ability of OSHA to cite employers for these violations. Howev-er, there is concern about the “per employee” citation and its impact. The association’s Government Affairs Commit-tee and the Executive Board will be reviewing the associa-tion’s final comments on the proposed rule change. Final comments will be posted on the Web.

NIOSH UpdateNo Fit Respirator ConferenceThe National Institute for Oc-cupational Safety and Health (NIOSH) continues its efforts to address respirators and fit testing through research. Comments from the NIOSH blog on the proposed respi-rator study generated great interest in the study and, as a result, a conference has been scheduled to obtain more in-put. On November 6, 2008 the University of Minnesota Centers for Public Health Ed-ucation and Outreach will be the sponsor of the No Fit Test Respirator Workshop with NIOSH in Pittsburgh. AOHP will be represented at this conference, and a report will

follow in the next issue of the Journal.

Dr. Hull to RetireMonthly conference calls con-tinue with Dr. DeLon Hull as part of the Memorandum of Understanding with NIOSH. The purpose of the calls is to update and share information both from AOHP and NIOSH. During our August call, Dr. Hull announced that he will be retiring in October. Transi-tion plans were made for the September call with Deputy Janice Huey. My thanks to Dr. Hull for his commitment to working with stakeholders and his support of AOHP’s work. We wish him the best and will miss him. I look for-ward to working with Ms. Huey.

CDC Publishes New GuidelinesOn August 1, 2008 the Rec-ommendations for Postex-posure Interventions to Pre-vent Infection with Hepatitis B Virus, Hepatitis C Virus, or Human Immunodeficiency Virus, and Tetanus in Persons Wounded During Bombings and Other Mass-Casualty Events --- United States, 2008 weas published in the MMWR Reports and Recom-mendations. This report out-lines recommendations for post exposure interventions to prevent infection with hep-atitis B virus, hepatitis C virus, or human immunodeficiency virus, and tetanus in persons wounded during bombings or other events resulting in mass casualties. Persons wounded during such events or in con-junction with the resulting emergency response might be exposed to blood, body flu-ids or tissue from other injured persons and thus be at risk for bloodborne infections. This report adapts existing gen-eral recommendations on the

use of immunization and post exposure prophylaxis for teta-nus and for occupational and non-occupational exposures to bloodborne pathogens to the specific situation of a mass-casualty event. AOHP reviewed this document and provided comments prior to its finalization. For the com-plete document go to http://www.cdc.gov/mmwr/pre-view/mmwrhtml/rr5706a1.htm?s_cid=rr5706a1_e.

The Joint Commission Publishes Sentinel Event Related to Culture of SafetyOn July 9, 2008 The Joint Commission’s published Sen-tinel Event #40 – Behaviors that undermine a culture of safety. The introduction of the document states, “intimi-dating and disruptive behav-iors can foster medical errors, contribute to poor patient sat-isfaction and to preventable adverse outcomes, increase the cost of care, and cause qualified clinicians, adminis-trators and managers to seek new positions in more profes-sional environments. Safety and quality of patient care is dependent on teamwork, communication and a collab-orative work environment. To assure quality and to promote a culture of safety, healthcare organizations must address the problem of behaviors that threaten the performance of the healthcare team.” There is additional background and root cause information, as well as citations of the existing standards that are applicable administratively and apply to all staff, including the medical staff. For more information, visit http://www.jointcommis-sion.org/SentinelEvents/Sen-tinelEventAlert/sea_40.htm.

Have a great holiday sea-son and a happy and healthy 2009!

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Fall 2008

Ready to ResearchBy MaryAnn Gruden, CRNP, MSN, NP-C, COHN-S/CM –Column Editor

A quantitative research study requires that the best instru-ment be used to measure a concept or variable of inter-est. If the researcher is fortu-nate, the literature contains information about the con-cept being studied, including instruments that might be used to measure the quantity or degree of the attribute of the variable that is present.

Some variables are easier to quantify than others. Mea-sures of heart rate, blood pressure, height, weight and other physiological variables are not difficult to quantify. But even these variables require that the researcher think about what specific equipment will be used to measure the data. All data collectors need to be using the same type or brand of equipment and follow the same exact procedures to as-sure accuracy of the data.

In nursing, many of the vari-ables that are studied are ab-

stract. If the concept under study is social support, the researcher must first define the concept for the study, operationalize it, and then ex-plore the literature to find an instrument that can be used to measure it. The degree of social support can be accu-rately quantified by choosing the appropriate instrument.

Just because an instrument has been used many times in research does not make it right for YOUR study. Thought has to go into the selection of an instrument. It may be a huge mistake to choose a tool because it “sounds like” what the study is about. The researcher needs to do some digging in the literature to find just the right tool. Some of the factors that need to be considered in the selection of an existing instrument in-clude:• Whatistheconceptualba-

sis for the instrument? Is it consistent with the con-ceptual model being used

in the study? The concep-tual and operational defini-tions for the study should be very similar or the same as the concepts that were used for the development of the instrument.

• How was the instrumentdeveloped? There should be a description of how the items were generated. How were the items ana-lyzed and refined to pro-duce the end product?

• Whattypeofvalidityisre-ported? Validity is a charac-teristic that can be defined as whether an instrument actually measures what it claims to measure. Validity is a matter of degree, not “all or none.” One instru-ment may be more valid than another because it does a better job of mea-suring what it is supposed to measure. Different types of validity may be re-ported. o An instrument is said

to have face validity if it “looks like” it is going to

MaryAnn GrudenColumn Editor

Measurement of Research Variables—Are You Using the Right Instrument?By Carol Haus, RN, PhD, CNE

It is a pleasure to introduce Carol Haus as the author of this column. She is the Assistant Director at The Western Pennsylvania Hospital School of Nursing in Pittsburgh, PA. She has many years of experience in curriculum and program evaluation and has taught in all levels of nursing education. Carol co-authored the book Nursing School Success for students entering nursing school. She has completed research in the areas of clinical education, gerontology and adherence. She is a site coordinator for a National League for Nursing/Laerdal study us-ing simulation to teach basic life support skills. She is also an active member of the Nursing Division’s Nursing Research Committee, sharing her expertise and supporting clinical nursing research.

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measure what it is sup-posed to measure.

o Content validity requires more rigorous review than face validity, which only requires an intuitive judgment. Do the items thoroughly cover all rel-evant aspects of the conceptual domain they are intended to mea-sure? A panel of experts in the field is asked if the characteristic measured by an item is essential or not necessary to the performance of the con-struct. There is greater content validity if more than half of the experts agree that an item is es-sential.

o Construct validity is a judgment based on the accumulation of corre-lations from numerous studies using the instru-ment being evaluated. Construct validity refers

to whether an instru-ment measures or cor-relates with a theorized construct (such as de-pression.) It is related to the theoretical ideas be-hind the construct under consideration.

• Is the instrument reliable?Reliability is another very important characteristic to consider in evaluating an instrument. Reliability refers to the consistency, stability and repeatability of a data collection instru-ment. Reliability says noth-ing about the validity of an instrument. The tool could be measuring the wrong data in a consistent man-ner. Three types of reliabil-ity can be reported: stabili-ty, equivalence and internal consistency. o A stable research instru-

ment is one that can be repeated on the same in-dividual more than once

and achieve relatively the same results.

o Tests of equivalence at-tempt to determine if the same results can be ob-tained using different ob-servers at the same time (inter-rater reliability) or if similar tests (alternate forms) given at the same time yield the same re-sults.

o Internal consistency refers to the extent to which all parts of the in-strument are measuring the same concept. Typi-cally, the most common estimate of an instru-ment’s reliability is a cor-relation coefficient which may range between 0.0 and 1. The closer the cor-relation coefficient is to 1, the more reliable the instrument.

• Has the instrument beenused with the population to be studied? A tool may

be appropriate for use with older adults, but the same measure may not be good for use with adolescents.

• Is the instrument practi-cal to use? Is the reading level and print appropriate? Is the length of the instru-ment prohibitive? Are there instructions for administra-tion and scoring?

If the researcher determines that all of the characteristics of the instrument are appro-priate for the study, permis-sion must be obtained from the instrument developer for its use. The request should include information on the in-strument title, the journal in which it was found and the purpose for its use. It is good to include a short description of the study. Offer to share the results of the study and give full credit to the devel-oper.

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Fall 2008

Spotlight on an AOHP StarAnna Hook

AOHP and this Journal are pleased to honor another outstand-ing member, Anna Hook, Occupational Health Coordinator for Sarah Bush Lincoln Health System in Mattoon, Illinois.

Anna was nominated for AOHP Star by her fellow AOHP Il-linois Chapter colleague, Denise Knoblauch. Denise shares, “Ann (as she is known by friends and colleagues) works diligently to ensure that her workforce is protected from any possible safety or health hazards. When she attends the AOHP national conference, she plots out what vendors she must see to obtain the most valuable ‘latest and greatest’ to take back to every area of her workplace. She is very thorough in exploring all avenues to improve the health and safety of her workforce. Ann is also very progressive in her occupational health leader-ship role at her facility. She was one of the first in her area to implement Quantiferon gold testing.”

Denise also describes, “Ann is a trusted colleague in our AOHP Illinois Chapter. She is our current Treasurer and is one of our most respected ‘go to’ members for advice, because she is always willing to share. Our chapter was very proud that Anna recently stepped up for AOHP and ran for the AOHP Executive Board as Executive Treasurer. It speaks to Ann’s true dedication to her profession and to AOHP.”

Ann, a nurse for 36 years, is a 1972 diploma graduate and received her BS in Health Arts in 1999. She has been with Sarah Bush Lincoln for 27 years, having worked in Critical Care, Post Anesthesia Care, Med/Surg and Employee/Occupational Health. She has held the position of Occupational Health Coor-dinator for four years.

As Occupational Health Coordinator, Ann is responsible for co-ordinating Employee Health functions including Pre-Placement Screening, TB testing and surveillance, TB mask fit testing and PAPR training, BBP follow up and counseling, overseeing the sharps injury prevention program, coordination of immuniza-tions and maintenance of health records, just to name a few.

Ann enjoys much of what her position brings her daily, espe-cially the many wonderful people she comes in contact with. Those include the 1,700 staff members at Sarah Bush Lin-coln, as well as volunteers there. Also included are the AOHP colleagues she meets and works with on local, state and national levels. Ann shares, “All of these play some small but vital part in the vast make-up of my occupational health world. Employee/Occupational Health has such a wide range of du-ties that entangle so many people and situations. You can’t help but touch so many lives. I joked years ago that I couldn’t decide what I wanted to do when I grew up: teacher, business woman, or perhaps computer worker? In the end, I didn’t have

to make a choice – I became a nurse and found a way to do all three.”

An AOHP member for nine years, Ann describes AOHP to colleagues, friends and relatives with a genuine sense of pride. She explains, “I belong to such a wonderful organiza-tion that offers tremendous support, resources and leader-ship. Eleven years ago I had the opportunity to transfer to a wonderful department to become an occupational health nurse. I had the privilege of learning from, working with and being mentored by many outstanding occupational health professionals. One of these outstanding professionals was my first medical director, Dr. Geoffrey Kelafant. In those formative years, I learned both who and what AOHP was and the many benefits of being a member. Four years ago, I had the opportunity to assume the role of Occupational Health Coordinator. Although I knew what I was getting into, it is amazing how things change when ‘you’re it.’ I feel the mentoring I have received over the years and continue to receive through AOHP, both at the chapter level and nation-ally, is invaluable. The networking and friendships are worth millions!”

Ann has served her AOHP Illinois Chapter as Nomina-tions Chair and is the chapter’s current Treasurer. She was awarded the Sandra Bobbitt Continuing Education Scholar-ship in 2007. Aside from work and AOHP, Ann loves visiting her three wonderful grandchildren and daughter in Atlanta. Gardening, renovating her 100-year-old home, learning to play golf and serving as a volunteer in various community activities also keep her busy when not working.

“I am so thankful to AOHP for the connection of all we do,” Ann tells us. “Just that ability to connect with others who sit in a similar seat aids so much. Denise Knoblauch has been my rock, with endless encouragement that greatly aided my professional growth. Also, Mary Bliss, our chapter President, has been wonderful in keeping us connected and is always willing to help with questions and to share infor-mation. I have to admit, I have taken the Getting Started workshop three times because it is so beneficial to me each time I take it. The AOHP national conferences are so well organized and always filled with important information. I leave the conference overwhelmed, but inspired with great tips, plans and ideas to improve the health and safety of the employees and volunteers I care about. I have known many of these great people for the 27 years I have been with Sarah Bush Lincoln Health System.”

AOHP thanks Ann for being such a wonderful member. She truly is a role model for all of us, and we are pleased to spotlight her in this Journal.

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Bits and “Bytes“New Guide on Osteoporosis Treatment and Prevention Available Online

The National Osteoporosis Foundation has released a new guide to assist clinicians with treatment decisions and assess-ing fracture risk. The full guide, as well as other information on osteoporosis, is available at www.nof.org/professionals/Clini-cians_Guide.htm.

NIOSH Updates

Recent submissions to the NIOSH Docket 129 “Personal Pro-tective Equipment (PPE) for healthcare workers action plan” have been added to http://www.cdc.gov/niosh/docket/niosh-docket0129.html.

“Preventing Work-Related Musculoskeletal Disorders in Sonog-raphy,” DHHS (NIOSH) Publication Number 2006-148, is available in English at www.cdc.gov/niosh/docs/wp-solutions/2006-148. The recently released Spanish version can be found at www.cdc.gov/spanish/niosh/docs/wp-solutions/2006-148_sp.

A new NIOSH Topic Page, “Tick-Borne Diseases,” is now avail-able at www.cdc.gov/niosh/topics/tick-borne.

NIOSH has an online resource to help with workplace stress ex-perienced by healthcare workers. This important resource may be accessed at www.cdc.gov/niosh/docs/2008-136/.

AOHP 2008 Election Results

Executive Vice PresidentLynne Karnitz, RN, BSN, MS, COHN-S

Executive Treasurer

Christine Pionk, MS, RN, COHN-S (re-elected)

Region 1 DirectorShari Lyons, RN, BSN, CIC, COHN-S

Region 2 Director Jan Wesselmann, RNBS, PNP

(appointed to fill one year vacancy)

Region 3 Director Delynn Lamott, RN, MS, COHN-S

(re-elected)

Region 5 Director Lydia Crutchfield, RN, BSN

(re-elected)

2008 Conference on DVD

Several presentations at the 2008 conference were recorded on DVD and will be available for sale from AOHP. Watch for further information about this new way to learn!

We also have the complete syllabus available for sale in binder format ($40 – limited quantities available) and CD ($20).

Contact AOHP HQ ([email protected] or 800 362-4347) to order your copy.

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Fall 2008

Q AQUESTION From: L.W., AOHP MemberI have a question about the statement on page 12 regarding post exposure pro-phylaxis to infectious disease. This issue has come up several times in the health-care setting. I spoke to an individual at NIOSH at the end of last year who was adamant and provided several references that clearly indicate that these events are OSHA recordable. The one time dose of medication is considered an immunizing dose, not prevention. I also spoke to our contact with the BLS, and he checked with the Chicago office, which concurred that employees treated with a prescrip-tion dose of medication are OSHA record-able. Who is correct? Certainly, recording the numbers of exposed workers affects

the OSHA incidence rate and other data figures that we monitor. Any clarification would be appreciated.

ANSWER From: Joyce Hood, Co-AuthorFrom my recent inquiries, here is what I have found:One OSHA compliance officer that I know in Kansas said these are not recordable since they meet neither the injury nor the illness criteria. One OSHA compliance officer at a seminar I attended last year said the same thing. My area OSHA of-fice contact felt it was OSHA recordable. That being said, I think this is an issue that needs to be resolved. When I queried

other children’s hospitals (the ones who would be most affected by this,) there was a 50-50 split as to whether pertussis prophylaxis would be recorded. In reality, the children’s hospitals would be greatly affected (disproportionally,) especially in areas where pertussis is almost endemic (such as our area.) If recorded, there is the potential for these hospitals to have an additional 100-200 OSHA-recordable cases each year, which would most likely cause them to be labeled as “hazardous employers,” a label that would be unjust and inaccurate.

I know that’s sitting on the fence, but I would challenge this issue should it ever arise in real life.

and

Editor’s Note: This follow-up question and answer relates to the Industrial Hygiene in Healthcare column in the Summer 2008 Journal. The answer is written by a co-author of that column, “OSHA 300 Log Record-keeping Basics for Hospital Employee Health Nurses.”

Thank you to Gold sponsor ARJO, Inc./Diligent Inc. for supporting the opening reception at AOHP’s 2008 National Conference in Denver.

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Colleague Connection

Initiative for Improving Vaccination Rates in Healthcare Personnel

By Susan M. Skelly, RN, COHN-S, BS, MBA, PHR

On September 10, 2008, I had the honor of representing AOHP at the Department of Health and Human Services (HHS) meeting to discuss the HHS Initiative for Improving Vaccination Rates in Health-care Personnel. Along with representa-tives from other special interest groups and professional organizations, we heard presentations on how healthcare sys-tems achieved success in breaking down the barriers preventing healthcare work-ers from receiving annual flu vaccina-tions.

Anand Parekh, MD, MPH, Office of Pub-lic Health and Science, HHS reminded the audience that influenza continues to cause frequent and serious illnesses in the United States. The vaccine is under-utilized, including by healthcare person-nel (HCP.) Statistically only 42 percent of HCP were immunized to prevent the transmission of the flu in 2006. This percentage falls significantly below the Healthy People 2010 objective of vacci-nating 60 percent of HCP for flu.

The Joint Commission (TJC)The Joint Commission has recognized the importance of increased immuniza-tion rates for (HCP). As of July 1, 2007, institutions are required to implement immunization programs as part of the accreditation process under TJC’s stan-dard IC.4.15. The infection control stan-dard requires accredited organizations to offer influenza vaccinations to staff, which includes volunteers and licensed independent practitioners with close pa-tient contact.

TJC developed the standard in response to recommendations by the Centers for Disease Control and Prevention (CDC) making the reduction of influenza trans-mission from healthcare professionals to patients a top priority in the United States. The CDC has urged annual influ-enza vaccination for HCP since 1981.

The new standard requires organizations to:

• Establish an annual influenza vacci-nation program that includes at least staff and licensed independent prac-titioners.

• Provideaccesstoinfluenzavaccina-tions on-site.

• Educate staff and licensed indepen-dent practitioners about flu vaccina-tion; non-vaccine control measures (such as the use of appropriate pre-cautions;) and diagnosis, transmission and potential impact of influenza.

• Annually evaluate vaccination ratesand reasons for non-participation in the organization’s immunization pro-gram.

• Implement enhancements to theprogram to increase participation.

Successes David A. Nace, MD, MPH, Director, Long Term Care and Flu Programs at the Uni-versity of Pittsburgh Institute on Aging, explained how his group developed the RISE Program. RISE stands for Raising Immunizations Safely & Effectively. As a result of his efforts and the work of the steering committees, facility champions, employee educational programs and in-centives, the long term care facilities were successful in achieving a sustain-able flu vaccination rate of 80 percent or above.

Mary G. Cooney, RN, BSN, COHN-S from the Children’s Hospital of Philadelphia (CHOP) and her team of Employee Health nurses took a hard look at their annual participation rates and were not pleased with the results. CHOP has 4,225 em-ployees on their main campus and 735 surgical and anesthesia affiliates.

CHOP’s system-wide team recognized that to succeed they needed to change the culture of the organization to one that

conveys a strong endorsement for em-ployee flu vaccine. Through mass com-munication and education programs and holding managers accountable for their staff participation, CHOP achieved an outstanding 95 percent participation in the program.

Barriers toward successDr. Nace categorizes the common bar-riers to successful participation into the following areas:

Organizational Barriers• Inadequatevaccinesupplies• Generalvaccineinaccessibility• Lackofpositiveincentivesforimmu-

nization• Requirementofawrittenconsent• Limitedrecordkeepingability• Lackofanyfeedbackorsharedlearn-

ing• Staffturnover

Individual Barriers• Limited leadership knowledge and

support• Poor staff knowledge about influ-

enza• Negative staff attitudes about the

vaccine and injections

While vaccine supplies have been ad-equate the last few years, I think AOHP members will relate to some or all of the other barriers identified above.

The Nursing Process Approach As professionals, we are trained in using the nursing process approach to develop our plan of care. Unconsciously, we use this process on a daily basis to problem solve. This process is applicable in proj-ect management, and flu vaccination programs are just that, project manage-ment. The following example applies to a flu vaccine program.

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Fall 2008

Assessment: Does the hospital offer a flu vaccine program? Is there funding for the program? Is top management sup-portive? Assessment helps identify orga-nizational barriers particular to the culture of the workplace.

Diagnosis: Formal identification of the obstacles identified in the assessment process. An example may be inadequate funding to hire additional resources to hold flu clinics.

Planning: What process or controls can be developed and implemented to manage obstacles identified in the as-sessment process? Specifically, planning helps to establish priorities; write goals and develop an evaluative strategy; and select controlling measures.

Implementation: This stage involves carrying out the plan while continuing to collect data and modifying the plan as needed.

Evaluation: Identify the factors that positively or negatively influenced goal achievement and revise the plan as nec-essary.

Strategies for successPart of the meeting was an open forum to discuss strategies that have worked in other organizations. Some of the ideas presented include:

• UsethelevelofHCPinfluenzavac-cination coverage as one measure of your patient safety quality program.

• Make an organizational decision torequire mandatory flu vaccinations as a condition of employment.

• Requireemployeeswhoarenotvac-cinated to wear masks during patient contact to prevent spread of infec-tion during the active flu season.

• Acknowledge units or work groupsachieving full participation in the newsletters and posters or by pro-viding lunch to the group.

• Holdcontestsbetweenworkgroupsto see who can achieve the most participation to encourage the com-petitive team spirit.

• Provide frequent communicationgeared toward educating the HCP about the most common reasons they reject the influenza vaccination, namely: concerns about vaccine safety or efficacy; they feel they are not at risk (healthy immune system;)

lack of understanding of transmis-sion of influenza; and/or fear of nee-dles.

• Communicationfocusedonthefactwe are protecting our patients from harm.

• Makethefluvaccineavailableatallhours of the day on all shifts.

Use and Timing of Declination StatementsThe audience discussion turned to the use and timing of declination statements. To comply with the new JC standard, most in attendance plan to or are already using this form to determine why employees chose not to participate in the program. Using this form allows employers to de-velop strategies for improvement for the consecutive year.

Some felt this form was an invasion of privacy. To counteract this issue, employ-ees need to be reassured that signing the declination statement will not impact their position, and the form will be filed in their employee file and remain confi-dential. Additionally, if a flu outbreak or adverse event does occur, having a re-cord of who received and did not receive influenza vaccine will be helpful.

When is the best time to ask a non-par-ticipating employee to sign a declination statement? The consensus was to wait until the program is in full swing. If you use the form at the start it is too easy for HCPs to sign the form and move on. Bringing the form out later in the flu cam-paign allows those who are not sure if they want to be vaccinated to investigate their options and perhaps be influenced by internal and external communication about the flu, how fast it is spreading and how many people have been infected in their local community.

Declination statements are recom-mended by the CDC. Research shows that vaccination rates were significantly higher for those institutions that required signed declination statements.

Health Care Personnel Initiative to Improve Influenza Vaccination ToolkitUnfortunately, flu vaccination programs do not follow the “one size fits all” mod-el. This should not prevent or dissuade Occupational and Environmental Health nurses from reaching new heights.

To assist with the journey, HHS devel-oped a resource for HCPs about influ-enza. The toolkit is comprised of links to several Web sites (CDC, Food and Drug Administration, NFID, American College of Physicians and the State of Massachu-setts,) a presentation, journal articles, fact sheets, and posters to be used for promo-tion and education about influenza vacci-nation. The Internet links were carefully chosen because of their proven success and novel approaches to prevention and education about influenza and influenza vaccination. This information is available at: http://www.hhs.gov/ophs/programs/initiatives/vacctoolkit/index.html

References1 Centers for Disease Control and Prevention. Influenza vaccination of health-care personnel: recommendationsof the Healthcare Infection Control Practices Advisory Committee (HICPAC) and the Advisory Committeeon Immunization Practices (ACIP). MMWR 2006; 55(No. RR-2): [1-2].

2 http://edcp.org/pdf/2006_MDHCW_Initiative_toolkit.pdf

3 Hofman F, Ferracin C, Marsh G, Dumas R. Infection 2005;34:142-147

National Foundation for Infectious Diseases. Call to ac-tion: Influenza immunization among health care person-nel. Bethesda, MD, 2008. www.NFID.org

National Vaccine Program Office, DHHS. Influenza Vac-cination of Health-care Personnel: An Initiative to Im-prove a Serious Public Health Problem. PowerPoint pre-sentation by Anand Parekh, MD, MPH, Office of Public Health and Science Department of Health and Human Services, September 10, 2008.

Joint Commission Perspectives®, June 2006, Volume 26, Issue 6. Joint Commission on Accreditation of Healthcare Organizations: [10-11].

Talbot MD, MPH, Thomas R., et.al. SHEA Position Paper: Influenza Vaccination of Healthcare Workers and Vaccine Allocation for Healthcare Workers During Vaccine Short-ages. From the Departments of Medicine and Preven-tive Medicine, Vanderbilt University School of Medicine; Department of Internal Medicine, University of Michigan Medical School; Veterans Affairs Ann Arbor Healthcare System; Department of Medicine, Johns Hopkins Uni-versity School of Medicine; Division of Infectious Dis-eases and Hospital Epidemiology, Hospital Epidemiology Unit, University Hospital of Zurich, Switzerland; Depart-ment of Pediatrics, University of Texas Southwestern Medical Center; and the Departments of Medicine and Pediatrics, University of North Carolina at Chapel Hill. http://www.shea-online.org/Assets/files/HCW_Flu_Posi-tion_Paper_FINAL_9-28.pdf or http://www.immuniza-tion-sd.org/eng/sdhiip/vaccine-tracking.html#oc

Susan M. Skelly, RN, COHN-S, BS, MBA, PHR, is the Director of Employee Occu-pational Health Services for Inova Health Systems in Falls Church, Virginia. She has 20 years of experience in the safety and occupational health field. Her previ-ous positions include Safety Coordinator, Human Resources Generalist, Occupa-tional and Environmental Health Nurse and Workers’ Compensation Manager for both local and national corporations.

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Workplace Violence and Corporate Policy for Health Care Settings

By Paul T. Clements; Joseph T. DeRanieri; Kathleen Clark; Martin S. Manno; Douglas Wolcik Kuhn

Copyrighted content. Please contact AOHP Headquarters at 800-362-4347 or [email protected] to

purchase a copy of this Journal issue.

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2008 AOHP National Conference Denver, CO September 17-20, 2008

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Fall 2008

2008 AOHP National Conference Denver, CO September 17-20, 2008

25

Fall 2008

Next Generation Workforce

By Cathy Swenson, BSN, RN



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Fall 2008

CALL FOR SPEAKERSAOHP 2009 NATIONAL CONFERENCEPortland, OR September 16-19, 2009

Do you have a success story of how you conquered a challenge or problem in your clinical practice? Do you know someone who would be a great presenter at the AOHP 2009 National Conference? The AOHP 2009 Conference Committee invites those interested in presenting at the National Conference to submit a proposal.

Topics may include any of the following:• Immediateoradvancenewtreatment;post-exposure

prophylaxis• Wellnessintheworkplace• Effectofwellnessondisabilitycosts• Makingtheappropriatereferrals• Needlesticks• ReturntoWorkPrograms• DisabilityManagement• PreplacementExamination&FitnessforDuty• Influenzavaccination• BloodAssayforTB-QuantiFERON-TBGold

These are just a few suggestions. Speaker application form is available on the AOHP Web site at www.aohp.org/education/national_conference.Submit your abstract by January 5, 2009.

Make My Job Easier!The Getting Started On the Road (GSR) Workshop will help you

• Communicatethevalueofoccupationalhealthwithinyourorganization

• Identifyfederal,stateandlocalregulations• Teachinfectioncontrolandsafetyinyourworkplace• CNEcontacthoursawarded

Interested? Get involved in Getting Started! This 8-hour program offers valuable resources to new and seasoned occupational health professionals.

Consider hosting or participating in a GSR Workshop in your area. Contact AOHP HQ ([email protected] or 800 362-4347) for details.

What others are saying about Getting Started:

“As a physician newly assuming the position of Employee Health Physician it was very beneficial for me to attend the Getting Started workshop.” – Edward Celmer, MD, Richmond University Medical Cen-ter, Staten Island, NY

“Thanks so much for the valu-able information provided in the workshop. I just told my manager I believe this was the best work-shop I have every attended. The information was relevant, concise and delivered very well.” – Susan L. Suggs, RN, Brunswick Community Hospital, Supply, NC

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Physical Activity and Obesity: Their Interaction and Implications for Disease Risk and the Role of Physical Activity in Healthy Weight Management

By Robert F. Zoeller Jr, PhD



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The Impact of Stress Management on Nurse Productivity and Retention

By Tammi F. Milliken, PhD, NCC; Paul T. Clements, PhD, APRN, BC, DF-IAFN; Harry J. Tillman, PhD, MBA, MSN, RN



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AOHP Journal Executive EditorKimberly Stanchfield, RN, COHN-SEditor, Journal of AOHP—in Healthcare235 Cantrell Avenue, Harrisonburg, VA 22801(540) 433–4180 [email protected]

AOHP HeadquartersJudy Lyle, Executive Director109 VIP Drive, Suite 220, Wexford, PA 15090(800) 362-4347; Fax: (724) 935-1560E-mail: [email protected] Web: www.aohp.org

AOHP Editorial BoardExecutive Board Officers

President: Sandra Domeracki [email protected]

Vice President: Lynne [email protected]

Secretary: Deborah [email protected]

Treasurer: Christine [email protected]

Regional Directors

Region 1: Shari [email protected]

Region 2: Jan [email protected]

Region 3: Delynn [email protected]

Region 4: Carol [email protected]

Region 5: Lydia [email protected]

Chapter Presidents

Alabama: Kelley [email protected]

CaliforniaNorthern: Diane [email protected]

Sierra: Betty [email protected]

Southern: Vicky [email protected]

Colorado: Dana Jennings [email protected]

Florida: Audrey [email protected]

Georgia: Lynn [email protected]

Heart of America:Kansas City: Shellie [email protected]

Houston Area: Maitine [email protected]

Illinois: Mary [email protected]

Maryland: Cheryl [email protected]

Michigan: Liane [email protected]

Midwest States: Mary [email protected]

New England: Donna [email protected]

New York:Nassau/Suffolk: Wendy [email protected]

North Carolina: Pam [email protected]

Oregon: Portland: Linda [email protected]

Pacific Northwest: Beverly [email protected]

Pennsylvania: Central: Gail [email protected]

Eastern: Stephanie [email protected]

Southwest: Mary Beth [email protected]

South Carolina: Dianne [email protected]

Virginia: Betsy [email protected]

Wisconsin: Carla [email protected]

MissionThe AOHP is dedicated to promoting the health and safety of workers in healthcare. This is accomplished through:

Advocating for employee and safety•Occupational health education and •networking opportunities.Health and safety advancement through •best practice and research.Partnering with employers, regulatory •agencies and related associations.

Journal of Association of Occupational Health Professionals (AOHP) —in Healthcare (© 2008 ISSN 0888-2002) is published quarterly by the Association of Occupational Health Pro-fessionals in Healthcare and is free to members. For Information about republication of any article, visit www.CopyrightClearancecenter.comThe AOHP Journal is indexed in the CINAHL® database.

Statement of Editorial Purpose The occu-pational health professional in healthcare is in a key position to help insure the health and safety of both the employees and the patients. The fo-cus of this Journal is to provide current healthcare information pertinent to the hospital employee health professional; provide a means of network-ing and sharing for AOHP’s members; and thereby improve the quality of hospital employee health services.

The Association of Occupational Health Profes-sionals in Healthcare and its directors and editor are not responsible for the views expressed in its publications or any inaccuracies that may be contained therein. Materials in the articles are the sole responsibility of the authors.

Guidelines for AuthorsAuthors may submit articles via e-mail attachment in Word (version 6) to the editor at [email protected].

Manuscript GuidelinesManuscript guidelines are available through your chapter president or by writing to the editor. (See address below.)

Advertisement GuidelinesAdvertisement guidelines are available from AOHP Headquarters (800) 362-4347; Fax: (724) 935-1560; E-mail: [email protected].

All AuthorsInclude your full name, credentials, and hospital/business affiliation. Include your supervisor’s name and address so that a copy of your printed article may be forwarded.

Send Copy to Kimberly Stanchfield, RN, COHN-SAOHP Journal Executive Editor235 Cantrell AvenueHarrisonburg, VA 22801

Publication deadlines for the Journal of AOHP—in Healthcare:Issue Closing DateSpring February 28Summer May 31Fall August 31Winter November 30

Subscription RatesOne year (4 issues), $150; Back issues when available, $35.00 each. Reader participation welcome.

Membership/SubscriptionsAddress requests for information to AOHP Head-quarters, 109 VIP Drive, Suite 220, Wexford, PA 15090; (800) 362-4347; Fax: (724) 935-1560; E-mail: [email protected].

Journal AdsAddress requests for information to AOHP Headquarters at (800) 362-4347

Moving?Bulk mail is not forwarded! To receive your Journal, please notify our business office of any changes: AOHP Headquarters, 109 VIP Drive, Suite 220, Wexford, PA 15090; 1-800-362-4347; Fax: (724) 935-1560; E-mail: [email protected]. Upcoming AOHP Conferences2009 September 16-19: Portland, OR

All material written directly for the Journal of the Association of Occupational Health Professionals in Healthcare is peer reviewed.

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ROC out with the 2008-2009 Recruit Our Colleagues” campaign. Why? Membership has benefits! Contact colleagues in your area and encourage them to ROC out with AOHP. And, when a new member lists you as their recruiter (see membership application,) you are eligible to win an AOHP “reward.” Listed below are the results of the past year’s campaign which ended on June 30.

Grand Prize – 2008 Conference Registration is awarded to Maggie Kelley, New England Chapter

2nd Place – Free one-year AHOP membership is awarded to Deb Rivera, Heart of America – Kansas City Chapter

Chapter Winner – Northern California Chapter recruited the most members (24). They received $500 to be used at their discretion to support their members.

Be a “ROC” STAR!!!!Our 2008 membership at the time of printing is 1,121 members and we have grown by 261 new members, 60 of whom were recruited through ROC.

So, start Recruiting Your Colleagues today!!

FALL 2008 VOL. XXVIII, NO. 4. · 2020. 1. 24. · Dedicated to the health and safety of healthcare...

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