1 OO24: Nursing-sensitive indicator data related to nurse work-related injuries such as needle sticks, musculoskeletal injuries, and exposures (e.g., laser, chemicals, toxins, infectious agents). (EP5, EP15, & EP3). Nurse injury data related to needle sticks, musculoskeletal injuries, and exposures are provided below for 28 and 29. s Patient Safety/Employee Health (PSEH) Department collects this data via the organization s unusual occurrence database, Peminic, and from Riverside s Corporate Health Services where employee injuries are evaluated. Information from Peminic includes the employee s home department, the accident location, the date of the injury, body part(s) affected, type of injury, and the cause of the injury, The PSEH staff also tracks if and how much work time was lost and the cost to the hospital. The table below shows the broad category, the type, and the cause of nurse injuries collected by PSEH in 28 and 29. Broad Category Injury Types Injury Causes Needle Stick Injuries Punctures Needle sticks Needle Other sharp device Lacerations Musculoskeletal Injuries Sprain/strain Fractures Dislocation Slip, trip, fall Combative patient Patient assist Repetitive motion Pushing/pulling Struck by/against Bending Reaching Repositioning patient Lifting Stepped in/on Exposures Injuries No physical injury Infectious disease Superficial Injuries Abrasions Contusions Rubbed/cut Bites (human, animal, or insect Struck by/against Combative Patient Slip/trip/fall Caught between Stepped on The following graphs show 28 and 29 nurse injury data by unit. The graphs show units in different service or specialty areas. s are always zero injuries.
2 Medical-Surgical Units 2 Medical/Surgical is where general medical and surgical patients are housed. 3 Orthopedics/Neurosurgical houses non-critical patients with these diagnoses and surgeries, plus detoxification patients. 3 Medical/Telemetry is a smaller unit than 5 th Telemetry and opened to provide care for overflow telemetry units and short-stay patients such as those recovering from cardiac catheterizations. 4 Rehabilitation is a unit with a special designation for Medicare: patients being transferred from any other inpatient unit are discharged and readmitted to this service for reimbursement purposes. 1 8 28 & 29 Nurse injuries Medical-Surgical Units # Inuries 6 4 2 2 Med/Surg 3 Ortho/Neuro 3 Med/Tele 4 Rehab 5 Tele 28 8 4 9 2 8 29 3 2 1 3 Unit Name 28 29 Critical & Emergency Care Units Riverside has two critical care units. 2ICU houses non-cardiac medical-surgical and trauma patients. 5ICU is the coronary critical care unit. The Emergency Department is included in this graph.
15 28 & 29 Nurse Injuries Critical & Emergency Care Units 3 1 5 2ICU 5ICU E.D. 28 13 9 2 29 3 4 4 Units 28 29 Women s & Children s Services OBPP/Gyne is the unit where Postpartal and Gynecologic patients stay. This unit has two wings: post partum women are in rooms on the north-south corridor and gynecologic patients are on the east-west corridor. The nurses station is at the corner where these two hallways meet. 8 28 & 29 Nurse Injuries Women's & Children's Services 6 4 2 28 29 4 Med/Peds OBPP/ Gyne L&D Nursery 28 4 1 7 29 1 2 1 Unit Behavioral Services MHU is the Mental Health Unit where inpatients from 5 years and older stay. Children and adults are segregated. The Girls Specialty Unit is housed inside the Mental Health Unit in a special area, which is separate from the rest of the unit. Riverside opened a
4 Boys Specialty Unit in January of 21. No injury data for the Boys Unit is available at this time. 6 28 & 29 Nurse Injuries Behavioral Services 4 2 MHU GSU Resolve Center 28 5 2 29 Units 28 29 Perioperative Services The units/areas which include perioperative services include the Operating Room (OR), Cardiovascular Operating Room (CVOR), Special Procedures Lab (SPL), and Outpatient Surgery (OPS) and Post Anesthesia Care Unit (PACU). Nurses are hired into OPS or PACU, but are cross-trained in both areas. SPL nurses care for inpatients or outpatients have endoscopic exams and pain management procedures. 8 28 & 29 Nurse Injuries Perioperative Services 6 4 2 28 29 O.R/CVOR SPL OPS/PACU 28 7 1 29 3 Units
5 Cardiopulmonary Services These areas include Cardiac Rehabilitation, the Cardiac Catheterization Labs, and Cardiopulmonary Diagnostics (EKG, EEG, EMG, etc.). Nurses in all of these areas care for inpatients and outpatients. 28 & 29 Nurse Injuries Cardiopulmonary Services 1.2 1.8.6.4.2 Cardiac Rehab Cardiac Cath Lab 28 1 29 Units Cardiopulmonary Diagnostics 28 29 Other Areas Nursing supervision and float staff are included in the graph below. Nursing or house supervisors work nights and weekends. Also included in this group is one nurse who is the patient or bed placement coordinator who works days on Mondays through Fridays. There are less than 1 float nurses, those who are cross trained for multiple areas (usually medical-surgical areas). Not shown on any graphs are nurse injuries for Interventional Radiology, IV Team, or the Wound/Ostomy Services. There were no nurse injuries for any of these staff, who generally work days, Monday through Friday. Interventional Radiology was not formally recognized as a specific area until 29; however, RNs did work in the Radiology department prior to 29.
6 1.2 1.8.6.4.2 Nursing Supervision 28 & 29 Nurse Injuries Other Areas Area Float 28 1 1 29 28 29 Aggregate Nurse Injury Data The following graph is compilation of all nurse injuries for the hospital for 28 and 29. There was a significant decrease in nurse injuries from 28, when there were 85 nurse injuries, to 29, when there were 27 nurse injuries. Several reasons exist for this dramatic decrease: (1) minimal lift equipment re-training was done for all nurses in 28 because we saw an increase in patient-lift related injuries for all nursing staff (this will be described in EP3 and EP3EO), and (2) re-training for Code 99 situations was also begun. Code 99 signifies help is needed to manage aggressive or potentially aggressive individuals. Training covers physical, verbal, and non-verbal de-escalation techniques.
7 28 & 29 Nurse Injuries All Units/Areas 9 85 8 7 6 5 4 3 27 28 29 2 1 TOTAL All Units/Areas The pie charts below show the 28 and 29 injury data for the number and percentage of nurse injuries in which there was lost work time. From 28 to 29, the percentages remained relatively stable: 13% (28) and 11% (29) of injuries resulted in lost work time, while 87% (28) and 89% (29) of injuries resulted in no lost work time. 28 Nurse Injuries Lost vs. No Lost Work Time 29 Nurse Injuries Lost vs. No Lost Work Time Lost Work Time No Lost Work Time Lost Work Time No Lost Work Time 11, 13% 3, 11% 74, 87% 24, 89%
8 Types of Injuries The following pie charts show the types of nurse injuries for 28 and 29. Exposure injuries were the same for both years at 7%. The percentage of needle stick injuries and superficial injuries rose from 28 to 29, but the muscuoloskeletal injuries dropped from 28 to 29. Musculoskeletal injuries tend to be more severe than the other three types of injuries. As noted previously, the re-training for minimal lift equipment and Code 99 interventions most likely had a positive effect on reducing the severity of nurse injuries between 28 and 29. 28 Nurse Injury Types 5, 6% 29 Nurse Injury Types 4, 15% 29, 34% 11, 41% 45, 53% 6, 7% Needle Stick Injuries Musculoskeletal Injuries Exposures Injuries Superficial Injuries 1, 37% 2, 7% Needle Stick Injuries Musculoskeletal Injuries Exposures Injuries Superficial Injuries Summary Overall, the entire hospital nursing division saw a significant decrease in all types of injuries to nurses and non-nurse staff, from 128 in 28 to 51 in 29. Of the 128 injuries to non-nurse staff in 28, 1 nurses and 4 non-nurse staff, lost work time due to injuries. Of the 51 nursing staff injuries in 29, 2 non-nurses and 2 nurses lost work time due to injuries. The minimal lift and Code 99 re-training was provided to all nursing staff in 28. Non-nurse staff and nurses benefited from completing this training. The organization benefited in having less lost work time and lower costs associated with treatment and follow-up care. These data demonstrate the organization s vigilant attention to reducing nurse and non-nurse injuries.