Evaluation of Occupational Risk Factors for Nurses and Cnas
Total Page:16
File Type:pdf, Size:1020Kb
University of South Florida Scholar Commons Graduate Theses and Dissertations Graduate School January 2013 Evaluation of Occupational Risk Factors for Nurses and CNAs: Analysis of Florida Workers' Compensation Claims Database Sheila Mohammed University of South Florida, [email protected] Follow this and additional works at: http://scholarcommons.usf.edu/etd Part of the Occupational Health and Industrial Hygiene Commons, and the Toxicology Commons Scholar Commons Citation Mohammed, Sheila, "Evaluation of Occupational Risk Factors for Nurses and CNAs: Analysis of Florida Workers' Compensation Claims Database" (2013). Graduate Theses and Dissertations. http://scholarcommons.usf.edu/etd/4731 This Dissertation is brought to you for free and open access by the Graduate School at Scholar Commons. It has been accepted for inclusion in Graduate Theses and Dissertations by an authorized administrator of Scholar Commons. For more information, please contact [email protected]. Evaluation of Occupational Risk Factors for Nurses and CNAs: Analysis of Florida Workers’ Compensation Claims Database by Sheila Mohammed A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy Department of Environmental and Occupational Health College of Public Health University of South Florida Major Professor: Raymond Harbison, Ph.D. Giffe Johnson, Ph.D. James McCluskey, M.D., Ph.D. Steve Morris, M.D. Date of Approval: June 3, 2013 Keywords: Musculoskeletal Injuries, Violence, Lifting, Falls, Puncture Wounds, Cost, Prevention Copyright © 2013, Sheila Mohammed Dedication I dedicate this dissertation to my mother, Zorida Mohammed, who did her very best to see that I got an education and never hindered my aspirations, and to Lisa Davis who shouldered much of my responsibilities so that I could have the time to explore and write this scientific work. I also dedicate this dissertation to my guru, Mahavatar Babaji, who has watched over me for many lifetimes and with whose guidance I now prepare for graduation from life itself. Acknowledgments I wish to acknowledge Professor Raymond Harbison with whom it has been an honor and privilege to study. Dr. Giffe Johnson always knows the right words to keep a student inspired and ready for the next lesson. I have had the pleasure of watching him develop into the fine scientist and professor he is today. A special thanks to all my committee members which also included Dr. James McCluskey and Dr. Steve Morris, for seeing me through thus far and whose input has been priceless. There have been many others in the background such as Melinda Tyler, Dr. Eve Hanna, Dr. Karen Olson, Dr. Rosemary Szollas and Dr. Stuart Brooks who paved the path to my academic development. I have been truly blessed by everyone who touched my life-a heartfelt thanks to all of you. Table of Contents List of Tables ........................................................................................................ iv List of Figures ...................................................................................................... vii List of Abbreviations .............................................................................................. x Abstract ................................................................................................................. xi Chapter One: Introduction ..................................................................................... 1 Background of Florida ................................................................................. 1 Culture .............................................................................................. 2 Economy .......................................................................................... 2 Healthcare ........................................................................................ 3 Occupational Health ......................................................................... 4 Statement of the Problem ........................................................................... 5 Magnitude of the Problem ........................................................................... 5 Cost ......................................................................................................... 6 Risk Factors ................................................................................................ 7 Obesity Epidemic ........................................................................................ 7 Inadequate Staffing ..................................................................................... 7 Shortage of Nurses ..................................................................................... 8 Factors with Limited Progress..................................................................... 8 Interventions for Injury Prevention .............................................................. 9 Study Objectives ....................................................................................... 10 Hypotheses ............................................................................................... 11 Chapter Two: Literature Review .......................................................................... 13 Risk Factors .............................................................................................. 13 Ergonomic Risk Factors ................................................................. 13 Lifting .............................................................................................. 15 Patient Handling ............................................................................. 16 Falls ................................................................................................ 18 CNAs at Greater Risk ..................................................................... 18 Disproportionate Share of Costs .................................................... 19 Temporal Risk Factors ................................................................... 20 Age, Gender, and Marital Status as Risk Factors .......................... 20 Occupation as a Risk Factor .......................................................... 21 Environmental and Activities Risk Factors ..................................... 21 i Rurality ........................................................................................... 21 Exposure to Body Fluids ................................................................ 22 Worker Characteristics as Risk Factors for Injury .......................... 23 Ineffective Training of Nursing Students ........................................ 23 Obesity as a Risk Factor for Injury ................................................. 24 Lack of Safe Patient Handling Legislation ..................................... 25 Lifestyle Risk Factors ..................................................................... 25 Job Stress as a Risk Factor for Injury ............................................ 27 Physical Assault ............................................................................. 29 Sexual Assault ............................................................................... 30 Horizontal Violence among Nurses ................................................ 31 Opioid Treatment as a Risk Factor for Prolonged Disability and Re-injury .................................................................................. 32 Workers’ Compensation and Chronic Pain ............................................... 32 Chapter Three: Methods ...................................................................................... 34 Data Source .............................................................................................. 34 Descriptive Data Analysis ......................................................................... 36 Logistic Regression Analysis .................................................................... 37 Linear Regression Analysis ...................................................................... 38 Chapter Four: Findings and Analysis .................................................................. 40 Data Analysis ............................................................................................ 87 Logistic Regression Analysis Results ............................................ 87 Linear Regression Analysis Results .............................................. 91 Chapter Five: Discussion and Recommendations ............................................... 93 Evaluation of Research Hypotheses ......................................................... 93 Body Part Injured .................................................................................... 110 Limitations of the Study .......................................................................... 112 Medical Management of Workers Compensation Injuries ...................... 115 Somatization and Malingering ................................................................ 116 Work Status after Workers Compensation Claims ................................. 117 Haddon’s Matrix and Guidelines for Treatment of Lower Back Pain ...... 117 Research Summary ................................................................................ 120 References ..................................................................................................... 122 Appendix 1: Workers Compensation Insurance Organizations Injury Description Codes – Cause of Injury ........................................... 130 Appendix 2: Workers