Incorporating Environmental Health

into Nursing PracticeDenise Choiniere, RN, BSN

University of MarylandSchool of NursingJanuary 13, 2009

Florence Nightingale,Notes on Nursing,1860

“Unnecessary noise is the most cruel absence of care which can be inflicted either on sick or well”.

Common Noise Volumes

• Train horn: 120 dB(A)• Pneumatic drill: 100 dB(A)• Motorcycle: 90 dB(A)• Noise on busy urban street: 80- 90 dB(A)• Vacuum cleaner: 70 dB(A)• Washing machine: 65 dB(A)

Noise VolumesCommon Noises

• Train horn: 120 dB(A)• Pneumatic drill: 100 dB(A)• Motorcycle: 90 dB(A)• Noise on busy urban street:

80- 90 dB(A)• Vacuum cleaner: 70 dB(A)• Washing machine: 65 dB(A)

Common ICU Noises• Items falling onto the floor: 92

dB(A)• Equipment movement: 90 dB(A)• Pager: 84 dB(A)• Talking: 75- 85 dB(A)• Ventilator alarm: 70- 85 dB(A)• Telephone: 70- 80 dB(A)• Television: 79 dB(A)• Monitor Alarm: 79 dB(A)• IV infusion alarm: 65- 77 dB(A)

UMMC Green Team

• Patient Care Services Green Team

• Recruited through current committee structure.

• Over 50 members, representing over 30 patient care areas.

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Reusable Sharps Containers• 32,500 total pounds

collected in the 12 months of the program.

• Of that 32,500 pounds, only 23,600 pounds were actual sharps that were burned.

• 8,900 pounds was the weight of the needle boxes that we spared from burning.

Recycling Initiatives

• 380,000 pounds of cardboard was recycled in 2008.

• 43,000 pounds of mixed paper was recycled in 2008.

The MD H2E Team includes Technical Assistance,Nursing, and Sustainable Foods programs

Nursing Outreach Coordinator

• Educate nurses throughout the state

• Engage nurses on all MD H2E initiatives

• Guide nurses on where to begin

The Power of Nurses

• Highest percentage of employees in facility

• Nurses understand the connection between environmental issues and health

• Precautionary Principle

• Nurses are patient advocates

• Nurses bridge the gap between administrative executives and floor staff

• End user of most products