Confused! Environmental Hazards Project

[Nurse Kyles, BSN, RN]

Ok. So I am having a little trouble with my environmental hazards project. My teacher did not explain or provide an example. I am also concearned because she didn't provide a rubric. These are the directions.

• After reviewing the questions on the occupational & environmental health history sheet, arrange a date and time to interview worker(s). The following are examples of appropriate occupational areas: construction, automotive, production, mining, and farming, heathcare, and EMS.
  
• Complete the Assessment Tool
  
• Annalyze the data
  
• On a separate sheet of paper type a summary of all the risk factors
  
• Develop a nursing care plan based on the top two priority problems (e.g. "risk for")
  
• Make realistic recommendations on how this person can eliminate/reduce their risks to prevent injury or illness. Include rationale and site references.
  
• This assignment is worth a total of 4% of your grade
  
• Points Will be deducted for inadequate/missing data, inaccurate analysis, inappropriate/insufficient recommendations and poor spelling.
  

I dont really know where to find interventions with rationale for work safety. I filled out an environmental assessment tool and this is the summary of the results. Here is what I have so far.

Environmental Hazards

Summary:

Work Exposures:

MR has been a laborer at a local manufacturing plant for the last nine years. His past work injuries have included accidental dismemberment of distal portion of thumb (2007), tendentious of left elbow (2009), and intermittent back pain. He works 40+ hours per week. Known exposures in his direct work environment are orificenic, loud noise, and fine stainless steel powder. The personal protective equipment that is utilized consists of earplugs, safety glasses, and gloves. There are no ventilation systems in place in his immediate work area. MR denies presence of chemical odors, but states that he works with chemically treated lumber. He allocates specific clothing for work; however, the clothing is laundered at home. There are no sinks available in the work area, so hand washing is limited to the 3 break times throughout the 10-hour shift. He denies physical symptoms associated with work.

Home Exposures:

MR lives in a home built in 1975 with central air conditioning, oil heating, and an electric stove. He states the last home improvement project took place two years ago with the installation of laminate flooring, and finishing of a portion of his basement. There has been no new installation of carpet, new furniture or refinishing of furniture within the last five years. He denies use of pesticides around home or in garden. Chemical cleaning supplies used in the house consist of Swiffer, Pine sol, Clorox Surfaces, and Kaboom. MR states that hobbies done in the household are scrapbooking, wood work, random house projects, and videogames. He denies any adverse exposures while participating in these activities. He states coveralls, safety glasses and gloves are utilized during hobbies as appropriate. MR's partner works as a laborer at a distribution center. Chemical exposures in the distribution center environment include occasional cleaning supply, detergent, oil, carb cleaners, and fuel additives spills.

Community Exposures:

MR denies the presence of industrial plants, major air pollution, landfills, toxic spills, or waste cites near his home. His drinking water is from the city.

Risk Factors:

*Heavy Lifting

*40+ hour weeks

*orificenic

*Loud Noise

*Inhalation of fine stainless powder/ other chemicals

*No ventilation Systems

*Contaminated clothing washed at home

*Limited hand washing availability

Analysis:

MR works long hours in a physically demanding production job. The movements are repetitive and he works with large, potentially dangerous, equipment. Not only has he had several injuries in the past, but this is also common among his coworkers. These above risk factors place him at a risk for injury. Exposure to orificenic and fine stainless steel powder with absence of ventilation systems and hand washing stations puts him at an increased risk for poisoning.

Risk For Injury & Poisoning r/t heavy lifting, repetitive movements, long hours, chemical exposures and no ventilation

MR will remain free of injuries and/or poisoning.

Client Will.....

1. Describe 3 specific ways he can prevent injury by 5-2-11Met: Client stated being aware of surroundings, use of PPE and using lock-out-tag-out when working on equipment as ways to prevent injury.

2. Demonstrate proper use of personal protective equipment by 5-2-11 Met: Client demonstrated proper use of PPE

3. Prevent inadvertent ingestion of toxins or poisonous substances by 5-2-11 Met: No chemicals have been ingested

4. Identify location of MSDS information in work environment by 5-2-11. Met: Client states MSDS information is located in break room area on a community computer.

Nursing Interventions:

• Provide written educational matterials related to injury in the workplace.
  
• Educate about proper use of safety glasses, ear plugs and gloves. Include demonstration.
  
• Demonstrate proper hand washing technique.
  
• Provide phone number and website of American association of poison control centers.
  

Recommendations:

*Take a first aid class. Rationale: First aid & safety programs raise the participants' level of emergency preparation. (Ackley, 738)

I need more recommendations? I would like to say things like Wash your hands thoroughly at every break time, Stretch out before work and other things like that. I just wonder where I can find rationale?

I also think my analysis is weak too. I don't really know what to say? Any help would be great. Thank you so much!!

[ImThatGuy, BSN, RN]

Go back and make the idiot give you an example or rubric. Your assignment is foolishly vague.

Stupid busy work.

I think your summary is thorough and sound. I've never had to do anything like that. Hopefully I won't. Reads well though. :)

[KristeyK]

I don't know what your instructor would want, but I can tell you mine would HAMMER us for combing the risk for injury and poisoning. Any of the ones I've had would want to see those as two separate dx's.

But yeah, I'd go ask for some clarification. Otherwise, it reads well to me too!

[Moogie]

I agree. The assignment is vague and you're at a disadvantage not having a rubric or an example of what the instructor expects.

You've done a good job here. Check your spelling (e.g., tendinitis) because poor spelling will cost you points that you otherwise would not lose.

If I was grading your paper, I would want you to expand your analysis just a little to consider exposure to carcinogens at work and at home. Is your client a smoker? Is he exposed to secondhand smoke on a regular basis? I'd also want you to explore the risk of repetitive stress injury or back injury on the job. You mentioned that he has intermittent back pain. What does he do to relieve the pain? Does he wear any safety devices to protect his back? Does he know how to lift correctly and does he understand proper body mechanics? I think you're also on the right track in terms of the loud noises being a risk factor for hearing loss. Maybe you could go into a little more detail on that.

Here's a website you might find helpful: http://www.osha.gov/

I agree with KristeyK. Separate the two nursing diagnoses. Also, if you're supposed to cite sources, make sure to do so. Many (but not all) schools require that papers are formatted to conform with APA 6th edition. Depending on the instructor, not following the correct format or citing the sources properly can cost you points.

I think you're doing well with this assignment but agree that the instructions are vague and confusing.