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Assessing the health implications for healthcare workers of regulatory changes eliminating locally developed occupational exposure limits in favor of TLVs: an evidence-based bipartite approach.

https://arctichealth.org/en/permalink/ahliterature176240
Source
Int J Occup Environ Health. 2004 Oct-Dec;10(4):433-44
Publication Type
Article
Author
Philip Bigelow
David Moore
Annalee Yassi
Author Affiliation
Occupational Health and Safety Agency of British Columbia, Vancouver, BC, Canada.
Source
Int J Occup Environ Health. 2004 Oct-Dec;10(4):433-44
Language
English
Publication Type
Article
Keywords
British Columbia
Hazardous Substances
Health Personnel
Health Policy
Humans
International Cooperation
Occupational Exposure
Occupational Health
Policy Making
Risk assessment
Threshold Limit Values
Abstract
In response to the intention of the Workers' Compensation Board of British Columbia (WCB of BC) to eliminate made-in-BC occupational exposure limits (OELs) and adopt threshold limit values (TLVs), this study assessed the potential health impacts on healthcare workers (HCWs) of the proposed change, by (1) reviewing the processes used to establish the OELs and TLVs, (2) selecting of substances of health concern for HCWs, (3) identifying chemicals with discordances between existing OELs and the 2002 TLVs, and 4) reviewing the discordances and assessing the potential health implications. Differences in philosophies, policies and processes that influenced the setting of OELs and TLVs were substantial. The TLV process involves U.S. and international priorities; in BC, a tripartite committee determined OELs taking into consideration how OELs should be interpreted in the local context. 47 chemicals of concern to BC HCWs were discordant, with significant discordances totalling 57; 15 compounds had BC 8-hour OELs lower than their respective TLVs and three TLVs were lower than the 8-hour BC OELs. Review of six chemicals with discordances suggested a potential for increased risks of adverse health effects. Eliminating the local capacity and authority to set OELs is unlikely to cause major health problems in the short run, but as chemicals in use locally may not have up-to-date TLVs, eliminating the capacity for local considerations should be undertaken with great caution. While the WCB of BC did implement the change, the present report resulted in procedural changes that will provide better protection for the workforce.
PubMed ID
15702759 View in PubMed
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Characterizing violence in health care in British Columbia.

https://arctichealth.org/en/permalink/ahliterature150574
Source
J Adv Nurs. 2009 Aug;65(8):1655-63
Publication Type
Article
Date
Aug-2009
Author
Rakel N Kling
Annalee Yassi
Elizabeth Smailes
Chris Y Lovato
Mieke Koehoorn
Author Affiliation
School of Environmental Health, University of British Columbia, Vancouver, British Columbia, Canada. rkling@interchange.ubc.ca
Source
J Adv Nurs. 2009 Aug;65(8):1655-63
Date
Aug-2009
Language
English
Publication Type
Article
Keywords
Adult
Aged
British Columbia - epidemiology
Female
Health Care Sector - statistics & numerical data
Health Facilities - statistics & numerical data
Health Personnel - statistics & numerical data
Humans
Incidence
Male
Middle Aged
Nursing Staff, Hospital - statistics & numerical data
Risk factors
Risk Management - statistics & numerical data
Violence - prevention & control - psychology - statistics & numerical data
Workplace - statistics & numerical data
Abstract
The high rate of violence in the healthcare sector supports the need for greater surveillance efforts.
The purpose of this study was to use a province-wide workplace incident reporting system to calculate rates and identify risk factors for violence in the British Columbia healthcare industry by occupational groups, including nursing.
Data were extracted for a 1-year period (2004-2005) from the Workplace Health Indicator Tracking and Evaluation database for all employee reports of violence incidents for four of the six British Columbia health authorities. Risk factors for violence were identified through comparisons of incident rates (number of incidents/100,000 worked hours) by work characteristics, including nursing occupations and work units, and by regression models adjusted for demographic factors.
Across health authorities, three groups at particularly high risk for violence were identified: very small healthcare facilities [rate ratios (RR) = 6.58, 95% CI =3.49, 12.41], the care aide occupation (RR = 10.05, 95% CI = 6.72, 15.05), and paediatric departments in acute care hospitals (RR = 2.22, 95% CI = 1.05, 4.67).
The three high-risk groups warrant targeted prevention or intervention efforts be implemented. The identification of high-risk groups supports the importance of a province-wide surveillance system for public health planning.
PubMed ID
19493143 View in PubMed
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Choosing a model of care for patients in alternate level care: caregiver perspectives with respect to staff injury.

https://arctichealth.org/en/permalink/ahliterature180190
Source
Can J Nurs Res. 2004 Mar;36(1):142-57
Publication Type
Article
Date
Mar-2004
Author
Aleck S Ostry
Katrina M Tomlin
Yuri Cvitkovich
Pamela A Ratner
Il Hyeok Park
Robert B Tate
Annalee Yassi
Author Affiliation
Department of Healthcare and Epidemiology, University of British Columbia, 5804 Fairview Avenue, Vancouver, British Columbia V6T 1Z3, Canada. ostry@interchange.ubc.ca
Source
Can J Nurs Res. 2004 Mar;36(1):142-57
Date
Mar-2004
Language
English
Publication Type
Article
Keywords
Absenteeism
Accidents, Occupational - prevention & control - statistics & numerical data
Adult
Aged
Attitude of Health Personnel
British Columbia
Choice Behavior
Follow-Up Studies
Geriatric Nursing - organization & administration
Health Services Misuse - statistics & numerical data
Health Services for the Aged - organization & administration
Humans
Lifting - adverse effects
Logistic Models
Models, Nursing
Models, organizational
Nursing Methodology Research
Nursing Staff, Hospital - organization & administration - psychology
Occupational Health
Outcome Assessment (Health Care)
Patient Selection
Qualitative Research
Questionnaires
Risk factors
Abstract
The population of alternate level care (ALC) patients utilizing acute-care hospital resources inappropriate to their needs is growing. The purpose of this study was to explore how the care of ALC patients was managed at 4 acute-care facilities in the Canadian province of British Columbia and to examine how this care impacts on outcomes of staff injury. Interviews were conducted to identify and characterize the different models of ALC. Injury outcomes for all caregivers were obtained (n = 2,854) and logistic regression conducted to compare staff injuries across ALC models. Injured workers were surveyed regarding their perceptions of injury risk and ALC. Five ALC models were identified: low-mix, high-mix, dedicated ALC units, extended care units, and geriatric assessment units. The risk for caregiver injuries was lowest on dedicated ALC units. These findings suggest that acute-care facilities faced with a growing ALC population should consider creating dedicated ALC units.
PubMed ID
15133924 View in PubMed
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Determinants of healthcare workers' compliance with infection control procedures.

https://arctichealth.org/en/permalink/ahliterature164936
Source
Healthc Q. 2007;10(1):44-52
Publication Type
Article
Date
2007
Author
Annalee Yassi
Karen Lockhart
Ray Copes
Mickey Kerr
Marc Corbiere
Elizabeth Bryce
Quinn Danyluk
Dave Keen
Shicheng Yu
Catherine Kidd
Mark Fitzgerald
Ron Thiessen
Bruce Gamage
David Patrick
Phil Bigelow
Sharon Saunders
Author Affiliation
Occupational Health and Safety Agency for Health Care, Vancouver, British Columbia.
Source
Healthc Q. 2007;10(1):44-52
Date
2007
Language
English
Publication Type
Article
Keywords
Adult
British Columbia
Cross Infection - prevention & control
Cross-Sectional Studies
Female
Guideline Adherence
Health Personnel
Humans
Infection Control - standards
Male
Middle Aged
Questionnaires
Abstract
The purpose of this study was to assess determinants of healthcare worker (HCW) self-reported compliance with infection control procedures. A survey was conducted of HCWs in 16 healthcare facilities. A strong correlation was found between both environmental and organizational factors and self-reported compliance. No relationship was found with individual factors. Only 5% of respondents rated their training in infection control as excellent, and 30% felt they were not offered the necessary training. We concluded that compliance with infection control procedures is tied to environmental factors and organizational characteristics, suggesting that efforts to improve availability of equipment and promote a safety culture are key. Training should be offered to high-risk HCWs, demonstrating an organizational commitment to their safety.
PubMed ID
17326369 View in PubMed
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Evaluation of a violence risk assessment system (the Alert System) for reducing violence in an acute hospital: a before and after study.

https://arctichealth.org/en/permalink/ahliterature138714
Source
Int J Nurs Stud. 2011 May;48(5):534-9
Publication Type
Article
Date
May-2011
Author
Rakel N Kling
Annalee Yassi
Elizabeth Smailes
Chris Y Lovato
Mieke Koehoorn
Author Affiliation
School of Environmental Health, University of British Columbia, Room 201 - 2206 East Mall, Vancouver BC V6T 1Z3, Canada.
Source
Int J Nurs Stud. 2011 May;48(5):534-9
Date
May-2011
Language
English
Publication Type
Article
Keywords
British Columbia
Case-Control Studies
Hospitals
Humans
Regression Analysis
Risk assessment
Violence
Abstract
To investigate the effectiveness of a risk assessment system in reducing the risk of violence in an acute care hospital in the Canadian province of British Columbia.
Hospital violence incident rates (number of incidents/100,000 work hours) were calculated and compared pre, during and post implementation of the Alert System, a violence risk assessment system, at one acute care hospital. Poisson regression models were used to examine the effect of the Alert System on hospital-level violent incident rates. Multivariable, conditional logistic regression was used to examine the effect of the Alert System on the individual-level risk of violent incidence using a case-control study.
The violent incident rate decreased during the Alert System implementation period only, but subsequently returned to pre-implementation levels. In the case-control analyses, the Alert flag was associated with an increased risk for a patient violent incident (odds ratio=7.74, 95% CI=4.81-12.47).
Although useful at identifying violent patients, the Alert System even though offered in conjunction with violence prevention training, does not appear to provide the resources or procedures needed by healthcare workers to prevent a patient from progressing to a violent incident once flagged. Violence in healthcare should be studied and prevented using a multifaceted approach.
PubMed ID
21145550 View in PubMed
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Evaluation of the effectiveness of portable ceiling lifts in a new long-term care facility.

https://arctichealth.org/en/permalink/ahliterature171387
Source
Appl Ergon. 2006 May;37(3):377-85
Publication Type
Article
Date
May-2006
Author
Aaron Miller
Chris Engst
Robert B Tate
Annalee Yassi
Author Affiliation
Occupational Health and Safety Agency for Healthcare (OHSAH) in BC, #301-1195 West Broadway, Vancouver, BC, Canada, V6 H 3X5. webmaster@ohsah.bc.ca
Source
Appl Ergon. 2006 May;37(3):377-85
Date
May-2006
Language
English
Publication Type
Article
Keywords
Adult
British Columbia
Equipment Design
Female
Humans
Lifting
Male
Middle Aged
Nursing Homes
Nursing Staff
Occupational Health
Patients' Rooms
Wounds and injuries - prevention & control
Abstract
Researchers and health and safety practitioners have advocated replacing manual patient handling techniques with ceiling lifts in long-term care. The majority of these studies have only evaluated the impact of fixed ceiling lifts on extended care residents where the ratio of ceiling lifts to resident beds is one to one. This pre-post intervention study assesses the effectiveness of portable ceiling lifts in a new multi-level care facility on risk of patient handling injuries where the ratio of ceiling lifts to resident beds is one to six. Results indicated that staff perceived they were at significantly (p
PubMed ID
16380072 View in PubMed
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Factors associated with staff injuries in intermediate care facilities in British Columbia, Canada.

https://arctichealth.org/en/permalink/ahliterature180570
Source
Nurs Res. 2004 Mar-Apr;53(2):87-98
Publication Type
Article
Author
Annalee Yassi
Marcy Cohen
Yuri Cvitkovich
Il Hyoek Park
Pamela A Ratner
Aleck S Ostry
Judy Village
Nancy Polla
Author Affiliation
Occupational Health and Safety Agency for Healthcare, and Institute of Health Promotion Research, University of British Columbia, Vancouver, British Columbia. AnnaleeY@aol.com
Source
Nurs Res. 2004 Mar-Apr;53(2):87-98
Language
English
Publication Type
Article
Keywords
Allied Health Personnel - psychology
British Columbia - epidemiology
Burnout, Professional
Data Collection
Humans
Intermediate Care Facilities - statistics & numerical data
Job Satisfaction
Wounds and Injuries - epidemiology - etiology
Abstract
Large variations in staff injury rates across intermediate care facilities suggest that injuries may be driven by facility-specific work environment factors.
To identify work organization, psychosocial, and biomechanical factors associated with staff injuries in intermediate care facilities, to pinpoint management practices that may contribute to lower staff injuries, and to generate a provisional conceptual framework of work organization characteristics.
Four representative intermediate care facilities with high staff injury rates and four facilities with comparable low staff injury rates were selected from Workers' Compensation Board (WCB) databases. Methods included on-site injury data collection and review of associated WCB data, ergonomic study of workloads, a telephone survey of resident care staff, manager-staff interviews, and focus groups. Pearson product-moment correlation coefficients identified associations between variables. Analysis of variance and t tests were used to determine differences between low and high staff injury rate facilities. Content analysis guided the qualitative analysis.
There were no significant differences between low and high staff injury rate facilities in terms of workers' characteristics, residents' characteristics, and per capita public funding. The ergonomic study supported the survey data in demonstrating a relation among low staffing levels, greater muscle loading, and greater risk of injury. As compared with facilities that had high staff injury rates, facilities with low staff injury rates had significantly more favorable staffing levels and supportive work environments. Perceived quality of care was strongly correlated with burnout, health, and satisfaction.
Safer work environments are promoted by favorable staffing levels, convenient access to mechanical lifts, workers' perceptions of employer fairness, and management practices that support the caregiving role.
PubMed ID
15084993 View in PubMed
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Implementing information technology to improve workplace health: a web-based information needs assessment of managers in Fraser Health, British Columbia.

https://arctichealth.org/en/permalink/ahliterature170443
Source
Healthc Manage Forum. 2005;18(4):6-16
Publication Type
Article
Date
2005
Author
Jag S Sandhu
Keith Anderson
Dave Keen
Annalee Yassi
Author Affiliation
Sandhu Consulting & Research. phc-jags@telus.net
Source
Healthc Manage Forum. 2005;18(4):6-16
Date
2005
Language
English
French
Publication Type
Article
Keywords
Administrative Personnel - psychology
Attitude of Health Personnel
British Columbia
Database Management Systems
Decision Making, Organizational
Delivery of Health Care, Integrated - organization & administration
Humans
Internet
Needs Assessment
Occupational Health
Organizational Objectives
Pilot Projects
Program Development
Questionnaires
Records as Topic - standards
Regional Health Planning
Workplace - standards
Abstract
A web-based questionnaire-survey was administered primarily to determine what information is useful to managers in Fraser Health, of British Columbia to support decision-making for workplace health and safety. The results indicated that managers prefer electronic quarterly reports, with targets, goals, and historical trends rated as "very important." Over 85.7% "agree" that if information was readily available in the "most beneficial" format, they would be able to improve workplace health. Recommendations include that managers be presented with clear and concise workplace health reports that facilitate analysis for decision-making.
PubMed ID
16509276 View in PubMed
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Injury rates, predictors of workplace injuries, and results of an intervention program among community health workers.

https://arctichealth.org/en/permalink/ahliterature165001
Source
Public Health Nurs. 2007 Mar-Apr;24(2):121-31
Publication Type
Article
Author
Kevin J P Craib
Georgina Hackett
Chris Back
Yuri Cvitkovich
Annalee Yassi
Author Affiliation
Occupational Health and Safety Agency for Healthcare in BC, Vancouver, British Columbia, Canada.
Source
Public Health Nurs. 2007 Mar-Apr;24(2):121-31
Language
English
Publication Type
Article
Keywords
Accidents, Occupational - prevention & control - statistics & numerical data
Adult
Aged
Allied Health Personnel - education - statistics & numerical data
British Columbia - epidemiology
Female
Humans
Incidence
Male
Middle Aged
Questionnaires
Risk assessment
Wounds and injuries - epidemiology - prevention & control
Abstract
Few incidence studies of workplace injuries among community health workers exist, and evidence regarding the effectiveness of interventions in this population is lacking.
To determine the incidence of workplace injury among community health workers in British Columbia; to identify predictors of injury; and to assess the effectiveness of a multicomponent intervention program in this population.
Data were collected from an intervention study of 648 community health workers from six agencies to calculate injury rates. Interventions included an education and training module, a risk assessment tool and resource guide, and a lift equipment registry.
The majority of injuries were attributed to overexertion and falls. Annual incidence rates were 20.7% for reported injuries, and 8.1% for time-loss injuries. A history of previous injuries and working full time were predictors of time to first injury report. Participants who received an intervention were significantly more likely to report workplace injuries than participants in the comparison group, but were less likely to incur a time-loss injury.
The interventions used in this study led to increased awareness and an increase in reported injuries but resulted in fewer time-loss injuries. The mechanisms that led to these findings need to be explored further.
PubMed ID
17319884 View in PubMed
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Joint health and safety committee education and the value of bipartite cooperation in the healthcare sector in British Columbia, Canada.

https://arctichealth.org/en/permalink/ahliterature173123
Source
Int J Occup Environ Health. 2005 Jul-Sep;11(3):305-12
Publication Type
Article
Author
Annalee Yassi
Aleck S Ostry
Bobbi Hatter
Henriette M De Boer
Author Affiliation
Department of Health Care and Epidemiology, University of British Columbia, Vancouver, BC, Canada. annaleey@aol.com
Source
Int J Occup Environ Health. 2005 Jul-Sep;11(3):305-12
Language
English
Publication Type
Article
Keywords
British Columbia
Cooperative Behavior
Evidence-Based Medicine
Health Care Sector
Humans
Inservice Training - organization & administration
Occupational Health
Retrospective Studies
Wounds and injuries - prevention & control
Abstract
In 1999, in British Columbia, Canada, the healthcare workforce, healthcare employers and unions partnered to develop the Occupational Health and Safety Agency for Healthcare (OHSAH), a bipartite (labor-management)-governed organization with a mandate to implement evidence-based programs to reduce injury rates in health care. Within a year of its establishment, OHSAH began delivery of a province-wide joint committee education and development (JCED) program. A telephone survey after six months showed that the training program had modestly increased the establishment of new programs and had significantly increased positive health and safety behaviors and quality of JC functioning. The spirit of bipartite collaboration fostered by this and other OHSAH programs has been hugely successful at reducing injuries, time loss, and cost, and should be promoted.
PubMed ID
16130973 View in PubMed
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22 records – page 1 of 3.