smart goals assignment for nurses treating sharp injuries

Question

Task: How to use smart goals assignment research strategies to assist nurses with care and treatment of sharp injuries?

Answer

Sharp Injurie
This smart goals assignment focuses on how nurses need to treat sharp injuries. Nursing, like all other occupations, has workplace hazards. The most noted among these hazards are sharp injuries, which can arise from the improper handling or disposal of the sharp objects that are used in healthcare. Nursing is one of the most hazardous occupations due to the frequent use of sharp implements. However, there are implements that have been engineered to provide more safety to medical workers. This smart goals assignment aims to find out the instances in which sharp injuries occur and the measures that have led to their reduction.

Objectives using Smart Goals
Smart goals refer to objectives that are specific, measurable, achievable, relevant and timely. This smart goals assignment aims to identify causes and preventative measures for sharp injuries and related infections for nurses in hospitals.

1. To find out the prevalence of sharp injuries in different geographical regions.
2. To learn of secondary factors that are associated with more sharp injuries in nursing such as age, work experience and gender.
3. To find out the safety strategies whose application has reduced the number of sharp injuries and infections.
4. To find out the role of government policies in the development of sharp safety.

Literature review
Sharp objects in a medical setting refer to all implements pertinent to healthcare practices which can cut and prick leading to cuts and injuries. They include needles, scalpels, cannulas, and trocars (HSE, 2022). According to Guest et al. (2014), injuries involving sharp objects were more prevalent in private facilities than public ones. In 2006-2007, the annual rate of needle stick injuries was 7.2%. Needle stick injuries are a known occupational hazard for healthcare professionals. They are associated with the risk of spreading blood-borne viruses such as the Hepatitis C virus (HCV), hepatitis B virus (HBV), and human immunodeficiency virus(HIV). These are among the more than 20 pathogens that healthcare professionals are exposed to every day in their duties.Probability of infection is dependent on the prevalence of the pathogens in the general public and rates of transmission of the pathogen.Elseviers, Arias-Guille´n, Gorke, and Arens (2014) found that 80% of all healthcare professionals are affected by sharp injuries. The most common way in which these nurses contract these illnesses is through cuts on the skin. A 2015 report by the CDC on HIV transmission at the workplace for helathcare professionsl stated that 0.23% of nurses who handle needles that hold HIV infected blood will be infected.

As per smart goals assignmentinvestigations, the CDC has recommended methods for the prevention of infection such as the use of barriers such as gloves and goggles between the nurses and body fluids (CDC, 2015). After contact with blood, nurses should wash their hands. The disposal of sharp objects afetr use should be careful. Data from The USA Exposure Prevention Information Network (EPINet) data indicated that contaminated sharps made up 93% of injuries, nurses experienced 42% of these injuries, with 34% of these being in the operating room, and 33% in the patient’s room. Most percutaneous injuries are related to poor disposal. There are safety devices meant to reduce infections by needle sticks when used properly. Containers denoted as ‘sharp containers’ are used for proper disposal to avoid accidental infections. Prevention of these infections in the healthcare sector requires a comprehensive policy that includes the educating, training, and raising awareness, limiting the use of needles to necessary situations, safe use and disposal strategies, banning of recapping, vaccination, safety equipment, availing devices to ensure user safety, and response and follow-up as required (Carli et al., 2014).The prevention of sharp injuries are not solely the responsibility of the healthcare provider. In order to prevent accidental infections, the following should be done (CDC, 2015);

1. Administrative efforts. In stitutions shouild train nurses on prevention techniqies, as well as the importance of immediate reporting whenever an accident occurs. According to (Guest et al., 2014), 90% of the nurses reported accidents, felt comfortabek making reports, and knew the steps to take when accidents occurred. It is an administrative duty to ensure that all healthcare practitioners know the importance of reporting all accidents. Research has found that some nurses do not report injuries due to being too busy, or the patient having no known illnesses (Akyol & Karg?n, 2016).

2. Development and promotion of safety devices. Devices to prevent injuries should be affordabel so that they can easily be made available to nurses stationed in high risk departments. Their correct and regular use should be enforced.

3. Monitoring effects of PEP. For nurses who are injured by sarps contaminated with HIV infected blood, a medication is given which is taken for 4 weeks. This treatment works best when started within 72 hours after contact. The effects of this treatement should be tracked. Opines that 67% of people complete the PEP dosage once started.

There are societal costs that nurses endure because of the possibility that they come into contact with infected body fluids and people. This became most apparent when during the COVID pandemic nurses were expected to take more precautions than the general public. While COVID is not blood-borne, the same principle applies to other pathogens.

Figure 1:Healthcare practitioners involved in phlebotomy related injuries

The table above shows how much bigger the risk fro injury is for nurses as compared to other healthcare professionals.
In Australia, nurses and midwifes exprerience the highest number of sharp injuries. It is estimated that 180,000 healthcare workersmake reports these injuries annually (ANMF, 2013). An estimated 50% of injuries are not reported, and thus the real figure is potentially double. These unreported cases are at higher risk of contacting HBV, HCV and HIV which collectively account for most of the infections resulting from sharp injuries.

The ANMF has called for the use of safety engineering devices(SEMDs) in public hospitals. Further suggestions include never recappig needles, as well as placing needle disposal containers in close proximity with the nurses workstations, and never overfilled (ANMF, 2013). Carli, Abiteboul, & Puro (2014) noted that in france, some infections were caused by the disposal containers being both out of reach and overfilled.

Unlike other western countries, Australia is yet to institute a national mandate towards the safe utilisation and disposal of needlesticks by nurses and other medical professionals. Since sharp injuries are a foreseeable risk for nurses, they can be reduced or even eliminated by mandatory use of SEMDs, mandatory reporting of injuries, and education. A study in Heidelberg University Hospital in Germany found that raising awareness throug training on safety reduced overall needlestick injuries by 22% (Carli, Abiteboul, & Puro, 2014).

Figure 2:How to reduce sharp injuries (Retrieved from (Qlicksmart, 2022))

• Justification
Sharp implements are handled every day in the healthcare profession, and especially by nurses. Sharp injuries include those from needle sticks, injuries relating to the skin and mucous membrane, and percutaneous injuries (Elseviers, Arias-Guille´n, Gorke, & Arens, 2014). More than 100health workers globally have been infected by HIV on the line of duty, and thousands more have contacted HBV and HCV. As the effectiveness triangle above suggests, there are methods that will only reduce sharp injuries, while others will eliminate the hazard completely. This suggests that there are safety methods that are more effective than others, and this smart goals assignment will aim to analyze this through literature and surveys.

In addition to the physical health ramifications to a nurse when they are injured by sharp objects at work, there are psychological effects. This is true especially when this contact is with HIV infected fluids. This causes some nurses to be anxious while handling needles, and can lead to stress when there is threat of infection (Elseviers, Arias-Guille´n, Gorke, & Arens, 2014).

• Significance
Nurses suffer some of the highest numbers of workplace injuries. Healthcare providers are some of the most important parts of society, and they similar to other government workers need to be assured of their safety. Many western countries such as the US and Canada have policies that require SEMDs to be used by all medical personnel. In Australia, however, the different states have made suggestions on how to develop a sharp safety program, but there are no policies in place. When no safety procedures are instituted, sharp injuries are an unavoidable occupational hazard for nurses. This is because sharp safety does not only involve the proper use of these implements. It also includes safe disposal, single usage of needles, and the availability of reporting avenues and immediate attention when nurses are injured.

The importance of sharp safety became more apparent during the pandemic period in which healthcare profession was overstretched, with nurses overworked and understaffed. The fatigue made nurses more susceptible to injuries, and the shortage of the disposal containers worsened the situation. This indicates how aftercare is just as important as training and equipping the nurses.

smart goals assignment design
Action plan
This smart goals assignment is a replication study. This means that permission will be obtain to recruit respondents from the nurses who are active in hospitals. The research on the occurrence of sharp injuries has been done before. The nurses shall be asked to share the number of times they got sharp injuries at work, and the activities through which these injuries were gotten. This is a quantitative study, and so closed-ended questions shall be used. This replicates a study by (Akyol & Karg?n, 2016), with the difference being that public and private hospital nurses shall be surveyed for this smart goals assignment. The role of government involvement in workplace safety for nurses and other medical workers is also a focus of this study. Since Australia does not have policies of safety of medical practitioners against sharp injuries, it will be possible to make comparisons of individual hospitals that have safety practices and those that do not. All actions in this smart goals assignment will stem from the set objectives.

Tasks
1. Find out the annual number of injuries and infections on the line of duty.
a. Study online publications for the latest statistics on injuries and infections both in Australia and globally.
b. Compare the number of injuries and infections when SEMDs are used and when they are not.
2. Find out the hospital departments in which the most injuries and infections occur.
3. Find out the differences in workplace safety for nurses in public and private hospitals.
4. Find out more details, if possible, about the nurses that get more injuries and infections. For example, one research found that older nurses were injured more than young ones because they were likely to be left out of safety training sessions (Carli, Abiteboul, & Puro, 2014).

5. Contacting hospital, both public and private, to make a request for data on sharp injuries faced by nurses.
6. Contacting individual nurses to request help in conducting the survey.
7. Preparing a closed questionnaire to issues to nurses who agree to take part in the survey.

Equipment and supplies
Time is the most important resource to this research. While the exploration of online and library sources for information remains a continuous process, it is done in the discretion of the researcher. However, more time has to be given for the survey process because responses need to be received from institutions and nurses who are often very busy.

Administrative support
This smart goals assignment shall require the intervention of a mentor or lecturer from the learning institution for the survey to be done. A mentor shall also help to ascertain that the questionnaire prepared is appropriate for use in research. The mentor shall write an introduction letter to ascertain that the researcher is carrying out legitimate research.

Availability of subjects
The success of this smart goals assignment’s survey is subject to the willingness of the nurses to give responses. This might pose a problem, because the prospective respondents might already be involved in other research or unwilling to be part of a research. So as to have an adequate pool of respondents to choose from, this smart goals assignment shall aim survey at least 5 separate hospitals. In this way there will be more nurses aware of the research and willing to participate.

Time chart using Gantt chart

Possible challenges
There might be a shortage of insufficient or even incorrect data on injuries. This is because of estimations suggesting that up to 50% of all injuries are not reported. Another reason for this can be the government failing to collect and keep these statistics. Lack of cooperation from the people from whom data is being collected. This smart goals assignment shall collect data from nurses, who will report their experiences with sharp objects, ease of communication with management to make reports and get the necessary attention upon injury, and the number of injuries they have incurred. For further analysis, the study subjects shall give their age and gender.

• Design the smart goals assignment data analysis
Pearson’s correlation coefficient shall be used to find out the relationship between secondary factors like age, work experience, and gender and sharp injuries.
The rest of the statistical data shall be analyzed through graphs and charts.

Conclusion
The treatment of essential workers is a reflection of the society of which they are part. The safety of nurses, as an essential part of healthcare, should be a priority which warrants both guidelines and policies. Several infections are still being reported despite there being a vaccine for hepatitis B and PEP for HIV when reported early.Drastic measures need to be taken in order to reduce injuries and infections. All stakeholders, including the government, should take up a more active role in ensuring workplace safety for nurses rather than giving recommendations that are only followed by a few individual institutions. In the same way that NHQHS standards define the quality of service a patient should receive. As per NHQHS smart goals assignment policies, there should be standards that govern the safety of a workplace in which healthcare practitioners work.

References
Akyol, A. D., & Karg?n, C. (2016). Needle Stick and Sharp Injuries among Nurses. Global Journal of Nursing & Forensic Sciences, 1(4), 1-5.
ANMF. (2013, October 14). Retrieved from Austalian nursing and midwifery association smart goals assignment : https://www.anmf.org.au/news/entry/nurses-and-midwives-bear-the-brunt-of-sharps-injuries
Carli, G. D., Abiteboul, D., & Puro, V. (2014). The importance of implementing safe sharps practices in the laboratory setting in Europe. Biochemia Medica 2014;24(1):, 24(1), 45–56.
CDC. (2015, June). Retrieved from CDC HIV website: https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwj4jDl6Ib4AhX5QvEDHZ6zCHIQFnoECC0QAQ&url =https%3A%2F%2Fwww.cdc.gov%2Fhiv%2Fpdf%2Fworkplace%2Fcdc-hiv healthcareworkers.pdf&usg=AOvVaw0i0tq7OgDO52lvpmtGSNX1
Elseviers, M. M., Arias-Guille´n, M., Gorke, A., & Arens, H.-J. (2014). Sharps injuries amongst healthcare workers: review of incidence, transmissions and costs. Journal of Renal Care, 1-7.
Garus-Pakowska, A., Szatko, F., & Ulrichs, M. (2017). International Journal of Environmental Research and Public Health. Work-Related

Accidents and Sharp Injuries in Paramedics—Illustrated with an Example of a Multi-Specialist Hospital, Located in Central Poland, 14.
Guest, M., Kable, A. K., Boggess, M. M., & Friedewald, M. (2014). Nurses’ sharps, including needlestick, injuries in public and private healthcare facilities in New South Wales, Australia. Healthcare Infection, 2014, 19, 65–75, 19, 65-75.
HSE. (2022). HSE Policy on the Management of Sharps and Prevention of Sharp Injuries 2022. HSE.
Kur?un, ?., & Arslan, S. (2014). Needlestick and Sharp Injuries among Nursing and Midwifery Students. International Journal of Caring Sciences 2014 May-August Vol 7 Issue 2, 7(2), 661-669.
Qlicksmart. (2022). Retrieved from qlicksmart, smart goals assignment.website: https://www.qlicksmart.com/sharps-injury-rates-rise-during-the-covid-19-pandemic/