Source: 
web site; www.cdc.gov
Noise Meter
Play around with the Noise Meter and hear the different sounds and sound intensities of everyday objects. The red bar below shows how long it takes before a particular sound level becomes dangerous to the human ear. For example, a chain saw has a sound intensity of about 110 dB. Without proper hearing protection, running a chain saw for only 2 minutes can become dangerous to the human ear!
Here is the meter: You can use it on this site, or download to your computer.
http://www.cdc.gov/niosh/topics/noise/abouthlp/noisemeter_flash/soundMeter_flash.html
Workplace INTEGRA is attending the 2010 Safety & Health Congress, August 1-4 in Murfreesboro, TN.
Workplace INTEGRA will feature Workplace Applications Software and INTEGRAfit at the 2010 Congress. The Tennessee Safety & Health Congress is being held at the Embassy Suites Hotel and Conference Center in Murfreesboro, TN.
Workplace Applications® occupational health and safety software provides companies an enterprise-wide solution to their workplace health and safety data management needs. The SQL server-based system is scalable from a single-user workstation up to hundreds of users on a corporate WAN. The Demographics driven software features the Audiometrics module for tracking a Hearing Conservation Program and the Health & Safety module for logging injuries, illnesses, OSHA logs, and much more.
A few of the Software Features:
- Extensive reporting and graphing capabilities
- Current users have said, "user friendly" and "easy to use"
- Use of Crystal Reports allows for the exporting and/or emailing of most reports in a variety of formats (.pdf, .xls, .doc) to managers and supervisors, or clients
- Use of data input "wizards" that guide you through the software
- All modules integrate with the Health and Safety module
- Medical spell checking in all of the modules
- Uses Microsoft's SQL Server database technology
- Can be installed on a standalone workstation or across a company-wide WAN connected to a corporate SQL Server database
- Workplace Applications is fully integrated with our hearing conservation, pulmonary consulting, and review programs
- Information can optionally be sent electronically to Workplace INTEGRA for professional review
Other modules include, INTEGRAfit, FMLA Tracking +, Safety, Pulmonary, and Surveillance. Here is a free access demonstration of Workplace Applications software.
In America today, many workers are receiving less than 5 decibels of protection from their earplugs. Why? Because achieving adequate hearing protection is not simple. It depends upon:
Selecting an earplug that fits each employee’s ears
Training that employee to properly use earplugs
Consistent proper use of those earplugs by the employee
INTEGRAfit is a hardware/software solution for the actual measurement of earplug noise reduction as the worker actually wears his/her earplugs.
No more reliance upon NRR ratings which can be grossly inaccurate for any person
No more guessing – measure it
Very powerful tool to train workers how to correctly insert earplugs
Takes less than 3 minutes
The best leading indicator of HCP effectiveness
Works with any earplug on the market
Workplace INTEGRA is holding a drawing for a gasoline card for the attendees of the TN Safety & Health Congress. Fill out the on-line registration form here.
Stop by booth number 621 at the Tennessee Safety & Health Congress or call for more information; 888.WPI.0001.
One of the many courses offered at the Summer Institute held at the Norfolk Waterside Marriott in Norfolk, VA is the CAOHC Initial and Refresher Training.
“We still have room for some additional student’s in these classes,” stated Kathleen Buckheit, the NC Occupational Safety and Health Education and Research Center Director.
The CAOHC Initial and Refresher courses at the Summer Institute are taught by Workplace INTEGRA’s newly appointed Director of Audiology, Dr. George R. Cook.
The CAOHC Initial Course description is as follows:
Initial course: This course is approved by the Council for Accreditation in Occupational Hearing Conservation (CAOHC) and is designed to help participants perform valid audiograms and develop hearing conservation programs according to OSHA 29 CRF 1910.95. Students who complete this 2 ½ day course are eligible to apply to CAOHC for certification as an Occupational Hearing Conservationist. The CAOHC application fee is included in the registration fee and is forwarded onto CAOHC upon successful completion of the course.
Course Faculty:
George R. Cook, AuD, CCCA, Workplace INTEGRA, Greensboro, NC
Content:
Anatomy and physiology of the ear; Federal and state regulations relating to noise exposure; audiometric testing techniques; employee education, hearing protection, audiogram review, and follow-up; recordkeeping.
Meeting Times:
Course begins Monday, July 26 at 8:00 am and ends Wednesday, July 28 at 11:00 am.
Credit:
3.0 ABIH (Category 4)
1.85 CEUs
Tuition for the Initial course is $575.
The July 27th CAOHC Refresher Course description is as follows:
Refresher course: This one-day course is designed to satisfy the Council for Accreditation in Occupational Hearing Conservation (CAOHC) requirements for recertification. The certified Occupational Hearing Conservationist must complete an eight-hour refresher course within five years of the initial 20-hour course or previous eight-hour refresher course in order to be eligible for recertification.
Course Faculty:
George R. Cook, AuD, CCCA, Workplace INTEGRA, Greensboro, NC
Content:
Federal and state regulations, including hearing conservation programs and worker's compensation; review of audiometric techniques; audiogram review, referral, and employee follow-up; recordkeeping; role of the occupational hearing conservationist.
Meeting Times:
Course begins Tuesday, July 27 at 8:00 am and ends at 5:00 pm.
Credit:
1 ABIH (Category 4)
0.8 CEUs
Tuition for this Refresher course is $350.
To register online, click here.
You may also submit your registration via osherc@unc.edu. Please be sure to include the course title and date.
For further information on this course, contact the NC ERC office at osherc@unc.edu or call 919-962-2101 or toll free at 888-235-3320.
If you don’t know when your CAOHC certification is up, check here.
Source: Workplace INTEGRA Associate
The Board of Directors for Workplace INTEGRA, Inc. of Greensboro, NC appointed David J. Pinchot as President on July 7, 2010. Mr. Pinchot has served as Vice President of Workplace INTEGRA, Inc. since the company was founded in 2000.
Mr. Pinchot has been developing Database Management System solutions for business and manufacturing for over 25 years. As an early advocate of PC based data collection and analysis systems, his experience parallels the birth of the personal computer in manufacturing environments up to today’s complicated WAN/LAN, Intranet/Internet environments.
Mr. Pinchot worked as an Engineer-Systems Designer for both Duracell USA and Rayovac. In that capacity, he was involved in creating plant wide database systems encompassing all areas of manufacturing from incoming raw materials to finished product quality. He has also been heavily involved in statistical applications relating to product reliability and quality.
In 1997, Mr. Pinchot brought his talents to U.S. HealthWorks where he served as Manager of Information Services. In that capacity he oversaw the development and support of their Occupational Health & Safety software application.
Applying his many years of programming experience, Mr. Pinchot has developed the Workplace Applications Software suite, which includes modules for Hearing Conservation, Pulmonary Function Surveillance, Safety, FMLA, and Health & Safety.
One of Mr. Pinchot’s first moves was to bring aboard Dr. George R. Cook as Director of Audiology. Dr. Cook has over 30 years of experience in the occupational health setting. As a founder, major principal and vice president of hearing conservation for Oto-Data, Inc. and vice president of U.S. HealthWorks, he created initial service format and facilitated departmental growth to major players in the service market. He also served as Senior Occupational Audiologist consultant visiting plants to establish or evaluate hearing conservation programs. Dr. Cook is also a certified CAOHC course instructor.
Mr. Pinchot and Dr. Cook have worked together for a number of years and they are both excited about working together again. These management moves maintain Workplace INTEGRA’s position as a premier hearing conservation and health data management company who has clients from coast to coast, including Hawaii and American Samoa.
About Workplace INTEGRA, Inc: Workplace INTEGRA is a health & safety, data management company that offers consulting services and an in-house programmed and supported software product called Workplace Applications. Workplace Applications Software is available to companies to help with tracking critical health & safety data. This data can include hearing and pulmonary tests which can be brought over automatically from an audiometer or spirometer. Detailing any injury, illness, or health visit that a company needs to track, such as a fall or slip, is an easy task to complete with Workplace Applications Software. The "Nurses Notes" area is very popular with users, allowing a place to detail incidents. OSHA Logs and numerous reports round out the feature rich software. Workplace INTEGRA offers consulting services with its staff of occupational audiologists and also teaches a number of CAOHC Courses.
Call 888 WPI 0001 with questions or visit: Workplace INTEGRA.
Source: Workplace INTEGRA Associate
What does OSHA require regarding audiometer calibration?
The audiometer must function within certain tolerance limits in order to be considered as operating within the specifications set forth by OSHA.
Annually, OSHA requires the audiometer undergo an "acoustic calibration" whereby three functions are measured: dB output levels, frequency characteristics, and volume control linearity. In other words, the acoustic calibration answers the following questions:
- 1) If the audiometer's volume control says X dB HL (60 dB HL, for instance) is it really producing an X dB HL signal?
- 2) Does the volume control work appropriately?
- 3) If the frequency control is set to a particular frequency (1000 Hz, for instance), is the audiometer actually producing that frequency?
Every two years, OSHA requires an "exhaustive calibration" which is an acoustic calibration plus a few more functions. As a practical matter, few perform acoustic calibrations as it requires not much more time to conduct an exhaustive calibration.
Where are acoustic and exhaustive audiometer calibrations conducted?
One method is to carefully box the audiometer and headphones, then ship to the manufacturer. The major advantage of this method is that faulty internal components can be identified during the calibration and repaired using the manufacturer's parts.
A second method is similar to the first: ship to a provider of calibration services. If issues are uncovered that cannot be resolved (a rarity), the audiometer can be sent to the manufacturer.
A third method is to have a technician come on-site to perform the calibration. There are two major advantages to this method. First, no lost testing time associated with shipping the audiometer back and forth. Second, the calibration is conducted with all of the connecting cables in place as one would ordinarily conduct a hearing test. If the connecting cables or sound booth jack panel are causing issues, this can be determined during the calibration process and often resolved at the time.
What about daily listening checks?
Just because the audiometer passed an acoustic or exhaustive calibration check seven months ago does not mean that is functioning properly today. It is critical to conduct a daily listening check on the audiometer. This is not difficult to do, requires only a few minutes, and need only be done on a day that audiometric testing will take place. A daily listening check has two components:
Biological calibration check: most with any experience doing industrial audiometric testing are familiar with bio-acoustic simulators often known as "Oscars" or "Bio-Bettys" or "Monitors". One places the headphones on the simulator, gives the simulator a hearing test, and compares the result at each frequency to its baseline. If the output is within ± 10 dB at each frequency for each headphone (left and right), then the audiometer is considered to be "in calibration."
Self-Listening check: This can be performed either before or after the biological calibration check. This is done because the bio-acoustic simulators do not know the difference between a nice, clean pure tone and various noises that can interfere with an actual test. There is no need to do a full hearing test on yourself, just put the headphones on and check a few things. Do the tones sound like tones? Wiggle the cords, do you hear static? Are the tones fluctuating in loudness? Press the tone button, do you hear a loud click before hearing the tone? Increase and decrease the volume, does the loudness increase and decrease? When presenting the tone to the right ear, do you also hear it in the left ear (you should not)? Does the patient response button work? Are the various cables and cords plugged in as they should be?
If problems are suspected, call your service provider. Most of these issues can be addressed over the phone, but some issues will require professional repair.
I have an extra pair of headphones. Can I use them?
Do not swap the headphones! Headphones have different response characteristics. Because the audiometer is calibrated for a specific pair of headphones, swapping the headphones can produce inaccurate hearing tests. A better idea is to contact your service provider apprising them of the problem. They will assist you to determine the best course of action.
Are there other things I can do to take care of the audiometer?
Yes, indeed. The following are recommended:
- Plug the audiometer into a surge protector, not directly into a wall outlet
- Dust is the enemy! Cover the audiometer when not in use to keep dust out
- Organize the cords so that they are not crimped, or dragging on the floor where they could be accidentally damaged during cleaning and vacuuming
- Keep liquids away from the audiometer
- Keep a spare patient response button - this is usually the part that breaks first
- Use disposable earphone cushions for infection control to make the cushions last longer
- Use contact cleaner to periodically clean the jacks and the jack panel. Many a problem has been solved with this simple cleaning
- Keep spare batteries nearby for the bio-acoustic simulator. A leading cause of biological calibration values exceeding ± 10 dB is a weak battery.
How often does OSHA require a sound booth to be calibrated?
OSHA requires that the audiometric testing room - which can be an open room - be no louder than the maximum permissible ambient noise levels specified in the OSHA Noise Standard. These noise levels are:
|
500Hz
|
1000Hz
|
2000Hz
|
4000Hz
|
8000Hz
|
|
40 dB SPL
|
40 dB SPL
|
47 dB SPL
|
57 dB SPL
|
62 dB SPL
|
As a practical matter, it is not difficult to meet these numbers in a reasonably quiet and distraction-free room. However, there is near universal agreement among professional hearing conservationists that these maximum permissible noise levels are too high, particularly for persons with hearing loss who often have difficulty with background noise interfering with audiometric testing. Voluntary compliance with the more stringent criteria set forth in ANSI S3.1-1999 is recommended when feasible. These noise levels are:
|
125Hz
|
250Hz
|
500Hz
|
1000Hz
|
2000Hz
|
4000Hz
|
8000Hz
|
|
39 dB SPL
|
25 dB SPL
|
21 dB SPL
|
26 dB SPL
|
34 dB SPL
|
37 dB SPL
|
37 dB SPL
|
So back to the question: how often does OSHA require measurement of background noise levels? The answer is once, then again if something changes.
So what might change?
Relocating the booth, for one, but there is room for judgment. If the booth is moved from one corner of the room to another, there may be no need to re-measure the background noise levels unless there is reason to believe that the noise levels are higher in the new location.
Practically, what will change the most over time is the booth itself - it will get older. This means that the seal around the door will eventually degrade letting more sound into the booth. More importantly, the ventilation fan will grow noisier over time and eventually need replacement. The fans are not expensive, but can be tricky to replace. Please have your local maintenance person give it a try as a non-ventilated sound booth can become uncomfortably warm and "stuffy" in short order. A claustrophobic person will certainly be uncomfortable in a non-ventilated sound booth.
Bear in mind that ventilation is a major noise source when testing in an open room. Be sure to test the background noise levels with the air conditioning/heating system on and off. Background noise levels may be too high when the AC or heat is running.
For these reasons, it is recommended that background noise levels be measured at least every two years. The technician providing an on-site audiometer calibration will have the necessary equipment (a rather expensive sound level meter with an octave-band analyzer) to conduct this background noise measurement.
I use a mobile service provider for annual audiometric testing. Are they required to check background noise levels?
OSHA requires that all audiometric testing done for the purpose of compliance with the OSHA Noise Standard must be conducted in an environment where background noise levels do not exceed the maximum permissible (see the first chart above). Mobile service providers must verify that background noise levels do not exceed the maximum, and must do this at each location where testing takes place.
Mobile services
What about documentation?
Important! Acoustic and exhaustive audiometer calibrations must be documented on a form listing the specific functions tested and the results. Similarly, background noise levels in the audiometric testing room must be documented as well. This documentation is required by the OSHA Noise Standard and can be important in other legal proceedings (Workers' Compensation, for instance).
The daily biological calibration and self-listening checks should also be documented. This provides evidence that the audiometer functioned appropriately the day of the test.
How long should you keep these documents? The recommended time is 30 years plus the employees time at the company- as these documents could be used in Workers' Compensation cases involving long-term employees.
Can I do my own audiometer calibrations and testing room background noise level checks?
Certainly, you can and should do the daily listening checks described above.
There are no regulatory requirements stipulating who can and cannot do acoustic/exhaustive audiometer calibrations and background noise level checks in the audiometric testing room. Anyone can do it with proper training and the right equipment. The real issue is the cost of the equipment. An audiometer calibration kit can easily run five times the cost of the audiometer. Practically, only manufacturers and service providers doing many calibrations annually find it affordable to spend this much money on audiometer calibration equipment and to pay the cost associated with having that equipment calibrated annually.
Does Workplace INTEGRA provide these services?
Yes. On-site exhaustive audiometer calibration checks and audiometric testing room background noise level checks are provided by:
- A licensed and certified Occupational Audiologist during the annual Audiologist Plant Visit, if this service is contracted
- A Technician for clients not receiving an Audiologist Plant Visit. For on-site services, see our website for our geographic service area: calibration services
Alternatively, audiometers can be shipped to our offices in Greensboro, NC or Indianapolis, IN for an exhaustive calibration check. Request this service
Workplace INTEGRA can also provide replacement components such as patient response buttons, various cables, and earphone cushions. Audiometric testing equipment
Source: hearing-aidsonline.com
H
earing loss is prevalent in modern societies as a result of the combined effects of noise, aging, disease, and heredity. Hearing loss is the number one disability in the world; approximately 28 million Americans suffer some type of hearing loss. In addition, 15 of every 1000 people under the age of 18 have a hearing loss, and nearly 90% of people over age 80 have a hearing impairment. The incidence of hearing loss is greater in men, than women. The sad part is, that hearing loss is the most preventable disability in the world.
Hearing is a complicated process involving both the sensitivity of the ear, as well as the ability to understand, and interpret the speech. When we hear sounds, we really are interpreting patterns of air molecules in the form of waves. The ear is able to pick up these waves, and convert them into electrical signals that are sent to the brain. In the brain, these signals are deciphered into meaningful information, such as language or music with qualities like volume and pitch. We can characterize sounds in terms of their frequency (or pitch) and intensity (or loudness).
An individual with hearing in the normal range can hear sounds that have frequencies between 20 and 20,000 Hertz. Speech includes a combination of low and high frequency sounds; vowels have lower frequencies and are easier to hear. Consonants, on the other hand have higher frequencies, and are harder to hear. Since consonants express most of the meaning of what we say, someone who cannot hear high frequency sounds will have a hard time understanding speech.
Intensity, or loudness, is measured in decibels. A normal hearing range usually ranges from 0 to 140 dB. A whisper is around 30 dB, and normal conversations are usually 45 to 50 dB. Sounds that are louder than 90 dB can be uncomfortable to hear. A loud concert might be as loud as 110 dB. Extreme sounds that are 120 dB or louder can be quite painful and can result in temporary or permanent hearing loss.
Rest of the story: http://www.hearing-aidsonline.com/
Source: OH&S online.com
BALTIMORE - Referring to ASSE as OSHA's "older brother," Assistant Secretary of Labor Dr. David Michaels repeatedly said the agency welcomes and needs the help of industry safety professionals to tackle the most pressing issues he has encountered in his first six months as OSHA chief. Directing his comments to the Safety 2010 attendees filling the Baltimore Convention Center Ballroom for Monday's afternoon Plenary Session, Michaels touched on everything from recent enforcement activity and "wrong-thinking" incentive programs to the need for updating Permissible Exposure Limits and the BP disaster in the Gulf of Mexico.
After outlining OSHA's recent activities and what he called an "aggressive" regulatory agenda, Michaels said, "We know we do not have - nor will we ever have - enough inspectors to go to every workplace in the nation." Instead, he called on employers to adopt the agency's new enforcement strategy on their own: "To plan, to prevent, and to protect - that's become our mantra," he said. "It requires employers to implement injury and illness prevention programs that are tailor-made for their particular worksite, and it requires employers to be proactive, and not wait for OSHA to issue citations."
Referring to the tailor-made programs as "I2P2" programs for short, Michaels noted that more than 5,000 men and women die on the job every year in the United States and thousands more become ill in later years from exposure to hazardous material such as asbestos, diacetyl, and bisphenol A. "This must stop," he said.
Rest of the story: http://ohsonline.com/articles/2010/06/16/osha-chief-calls-for-criminal-penalties.aspx
Source: The Hearing Review
Stafa, Switzerland - South African soccer fans' instrument of choice, the vuvuzela horn, was already controversial before the World Cup began there last week, with authorities concerned that their excessive volume could prevent people from hearing announcements should a stadium need to be evacuated. Now, new tests have shown that the instrument is so loud, it poses a more immediate health risk to fans and players, according to Hear the World, a global initiative by Phonak.
The long, plastic, trumpet-shaped vuvuzela was found to emit an ear-piercing noise of 127 decibel - louder than a lawnmower (90 decibels) and a chainsaw (100 decibels). Extended exposure at just 85 decibels puts people at a risk of permanent noise-induced hearing loss, and when subjected to 100 decibels or more, hearing damage can occur in just 15 minutes, says Phonak.
Rest of article:
http://www.hearingreview.com/insider/2010-06-17_07.asp
by Yolanda C. Lang, MSN, MEd, DrPH
Article posted with permission from Dr Lang.
ABOUT THE AUTHOR
Dr. Lang is X, University of Pittsburgh Medical Center, Pittsburgh, PA. The author discloses that she has no significant financial interests in any product or class of products discussed directly or indirectly in this activity, including research support. Address correspondence to Yolanda C. Lang, MSN, MEd, DrPH. E-mail: Langyc@upmc.edu
Occupational health nurses must have a growing, expanding knowledge base to remain current in practice. The American Association of Occupational Health Nurses, Inc. encourages advancement with the availability of certification examinations. Health care centers support clinical advancement programs for bedside nurses. Nurses who continue their education either through a degree program or via continuing education or certification advance up the clinical ladder, receiving a higher salary, recognition from their peers, and perhaps even financial assistance to continue climbing, yet occupational health nurses do not have their own clinical advancement ladder. This article examines the steps necessary to develop a clinical ladder and presents a clinical ladder specific to occupational health nursing developed by the author.
All professions, including nursing, are defined by a commitment to lifelong learning that can provide opportunities for career advancement and satisfaction (Casanas & Coello, 2005). As members of the nursing profession, occupational health nurses must have opportunities for career advancement and satisfaction. One way to provide career advancement to occupational health nurses is a clinical advancement ladder.
Nursing clinical ladders have been used since the 1970s, when they were developed as a retention and recruitment tool and a way to recognize and reward nurses' contributions to the clinical environment and nursing profession (Martin & McGuire, 1990). However, a thorough literature search using EBSCO, Medline, CINAHL, and ERIC did not reveal a clinical ladder specific to occupational health nursing. In an attempt to use the clinical ladder concept as both a retention and an advancement tool in occupational health nursing, a clinical ladder specific to occupational health nursing was developed.
The literature review did reveal that most current clinical ladders were developed from a theory or model. Use of a theory or model provides organization, perspective, explanation, prediction, and application. To provide organization while mirroring clinical ladders currently used by the employing institution, the transformational model (TTM) was chosen. The TTM emphasizes transforming, creating, or changing into a new form, function, or structure (Daszko & Sheinberg, 2005), a perfect fit for an occupational health nursing clinical ladder. Using the
TTM concepts (Sidebar), the following steps were followed.
AWAKENING
Hospitals have developed different pay scales for nurses in various departments (e.g., those working at the bedside receive higher salaries than those working outside the hospital environment). As unemployment rates reach record highs, nurses may become the main breadwinners in families, so the burden of shift work is sometimes ignored when financial rewards are greater. Excellent occupational health nurses may leave the field and return to the inpatient clinical setting, a setting encouraging professional and educational advancement through clinical ladders. Such ladders are generally not available in business and industry.
INTENTION
Retention of experienced occupational health nurses should be a priority for both the profession and the workplace. With the development of a clinical ladder specific to occupational health nursing, the nurse could advance without leaving the field. Nurses need not return to the inpatient setting to gain the advantages offered by clinical ladders.
LEARNING
The first learning experience was discovering that a clinical ladder specific to occupational health nursing did not exist. Investigation of various theories was another part of the learning process envisioned by the TTM and the clinical ladder.
ACTION
Many minor changes occurred as the occupational health nursing staff became excited about developing and using a clinical ladder. They were concerned about the unknown in relation to the next step, but review of past actions led to confidence and helped allay anxiety about the next step in clinical ladder development.
COACHING
The nurses needed to support the development of the clinical ladder. One way to ensure support was to inform nurses about progress and anticipated positive outcomes. Asking for and receiving feedback allowed coaching to be individualized, although the outcome was a team solution.
VISION
Incorporating organizational, departmental, and professional visions of clinical ladder development ensured necessary administration support. Administration assisted in revising job descriptions and performance review criteria and developed appropriate financial incentives.
METHOD
The Objective was to develop a clinical ladder. The specific steps in the process were not predictable.
LEARNING
The learning process continued through the development, implementation, evaluation, and refinement phrases. Once the revised, reworded, peer-reviewed clinical ladder was implemented, the staff continued to support the process. (The clinical ladder appears after the References in this article.) For advancement, both financially and within the institution, the clinical ladder incorporated educational requirements and a variety of avenues to achieve success. The various strategies included formal coursework as well presenting, publishing, and attending occupational health nursing continuing education offerings.
INTEGRATION
All staff had the opportunity to discuss their "slotting" into the developed clinical ladder, although not every nurse was slotted in the same category. Depending on the division, implementation was completed either in phrases or all at once. Workers' personalities resulted in different degrees of acceptance. Over time, nurses either accepted the new system or transferred to other areas in the workplace (Daszko & Sheinberg, 2005).
CONCLUSION
Without the use of a model, the clinical ladder could not have been developed. The model provided a framework for the clinical ladder and direction for development.
The steps needed to ensure development were evident from the beginning.
Review of the American Association of Occupational Health Nurses, Inc. (AAOHN) Professional Practice Standards and Competencies (Sidebar) resulted in clinical ladder language being used that was accepted by occupational health nurses' professional organization. Because of the collaborative nature of the clinical ladder development process and the chaos associated with the development and implementation of a new tool, the staff needed support.
Transformational Model (TMM) Concepts
-
Hardiness
-
Empowerment
-
Vision
-
Decentralization
-
Participative management
-
Organizational culture
-
Operating system
Note. Data from Grossman and Valiga (2005).
American Association of Occupational Health Nurses, Inc. Practice Standards and Competencies
Practice standards
-
Assessment
-
Diagnosis
-
Outcome identification
-
Planning
-
Implementation
-
Evaluation
-
Resource management
-
Professional development
-
Collaboration
-
Research
-
Ethics
Competencies
-
Clinical practice
-
Case management
-
Work force, workplace, and the environment
-
Regulatory/legislative
-
Management, business, and leadership
-
Health promotion and disease prevention
-
Health and safety education and training
-
Research
-
Professionalism
Note. Data from www.aaohn.org/press-room/fact-sheets/aaohn cfm and the American Association of Occupational Health Nurses, Inc. (2007).
FOR A FREE PDF OF THIS ARTICLE THAT INCLUDES THE SUMMARY, Please E Mail Jim Kurzec with Workplace INTEGRA.- jkurzec@wpintegra.com
REFERENCES
American Association of Occupational Health Nurses, Inc. (2007). Competencies in occupational and environmental health nursing. AAOHN Journal, 55(11), 442-447.American Nurses Association Cabinet on Nursing Services. (1983). Career ladders: An approach to professional productivity and job satisfaction. Kansas City, MO: AuthorCasanas, J. A., & Coello, H. M. (2005). On the road to clinical advancement. Image, 18(7). Daszko, M., & Sheinberg, S. (2005). Survival is optional: Only leaders with new knowledge can lead the transformation. Retrieved from http://www.mdaszko.com/Grossman, S., & Valiga, T. M. (2005). The new leadership challenge: Creating the future of nursing (2nd ed.). Philadelphia: F. A. Davis. www.aaohn.org/press-room/fact-sheets/aaohn , S. D., & McGuire, M. (1990). A clinical ladder for the community health-care setting. Journal of Community Health Nursing, 7(4), 189-197.McKay, J. I. (1986). Career ladders in nursing: An overview. Journal of Emergency Nursing, 12, 272-278.
Source: Agricultural Safety and Health Bureau Chief
By: By Regina Luginbuhl
Several years ago, the NCDOL Agricultural Safety and Health Bureau had a problem: workers were dying from heat stress/heat stroke.
There were four farm-worker deaths in 2005, and three in 2006.
The ASH Bureau got help: a survey of 1,000 North Carolina growers indicated that the problem was not an isolated one: both farm-workers and farm operators suffered from heat stress. It was also a community problem: high school athletes suffered from heat stress, as did firefighters, and those who worked in hot, unventilated areas during the summer months.
Farm-workers who were unfamiliar with North Carolina's deadly combination of heat and humidity were especially vulnerable. Many arrived ready to work in July and came from areas that were hot but arid. They were not prepared for work in tobacco fields with little shade where humidity was high.
The Agricultural Safety and Health Bureau prepared materials and programs to attack the problem: bilingual educational news bulletins, posters, DVDs and other materials discussing heat stress/stroke symptoms and prevention methods. These materials were shared with North Carolina farm operators.
In 2008, the Agricultural Safety and Health Bureau's summer intern Lauren Bauer had a conversation with Kevin King, staff athletic trainer at the University of North Carolina at Chapel Hill, regarding the ASH Bureau's interest in preventing heat stress and heat stroke.
Prior to coming to UNC, Kevin spent more than three years as a staff assistant athletic trainer working football in the ACC. He also served as a sports medicine intern with the following teams: Cleveland Browns, New York Giants, Pittsburgh Pirates, San Diego Padres, and the Carolina Mudcats. Currently working with UNC athletes, and particularly with football players in the summer months when heat and humidity are high, King knows a lot about heat prevention. He provided several very practical ideas.
Former intern Lauren Bauer graduated with a dual major in biology and Spanish in May 2010. She plans to enter medical school in the fall.
We wanted to share their discussion of heat prevention with you, our readers.
Bauer: What is the best way to cool someone down when they are overheated?
King: The best method of cooling (lowering the body's core temperature) is ice water immersion.
There is nearly a 100 percent success rate documented when utilizing this technique. However, this care must occur during the "Golden Half Hour"-the first 30 minutes after a person begins to exhibit signs of heat injury. The goal is to lower the body's core temperature to 100-102°F. Ice water immersion can be performed in a 100-gallon tub.
King: Dehydration is one of the primary causes of heat illness. Therefore, one of the key factors for prevention is staying well-hydrated. One of the easiest ways that employees can assess dehydration is by voiding their bladder and doing a "color check." When you have been drinking enough fluids (and are well-hydrated), your urine will be a very pale color.
see chart below..
The light colors indicate good hydration and the darker colors indicate a need to increase fluid
Bauer: What are some of the suggested supplies for a heat illness prevention program?
King: Use this list. These supplies are readily available and none are expensive. They should be part of a good heat stress prevention program. 100-gallon rubber tub or child's wading pool and ice Scale Fan/air conditioner Rehydration fluids (sports drinks/water) Shaded area (tent/building) Thermometer Means of monitoring the temperature and relative humidity. All of these are relatively inexpensive, easy to use, and effective. If you have employees who work in the heat and humidity, keep this article and be prepared to use its information to prevent heat stroke. If an employee becomes overheated, remember the Golden Half Hour and begin these steps to cool down the overheated employee immediately after dialing 911 and the outcome will be a positive one.
Since 2006, there have not been any heat stress fatalities in agriculture in NorthCarolina. We will keep working on the programs available, creating others as needed, and partnering with the agricultural community so that we can to keep this positive news-no heat stress fatalities-current for the summer ahead.intake. In addition, weight loss can also be an indicator of hydration status. Obtain a weight before an activity and compare the measure to the weight post-activity. A loss of more than 2 percent of body weight indicates dehydration and can lead to dysfunction.Bauer: What's the best way for someone to know when they are not drinking enough liquid?