Patient safety is key for employee health workers  


Employee safety is patient safety. After all, those employees are your patients, and by improving their work environment and teaching them about safety measures, you help them protect their patients.

That is the main message of Barb Maxwell, MHA, RN, COHN-S, CCM, CWCP, division director of company care for the HCA West Florida division in St. Petersburg, who will speak at the upcoming annual conference of the American Association of Occupational Health Nurses (AAOHN). (For more information on the conference, see editor’s note, see below)

Demonstrating that link between overall patient safety and employee safety also can enhance your value as part of risk management, safety and other hospital operations, Maxwell says. “We’re no longer Band-Aid nurses,” she says. “[Occupational health is] a profession within itself, and we need to evolve to another level to touch upon our patient population.”

For example, influenza immunization of health care workers has become a hot patient safety concern, as a way to protect vulnerable patients from the serious complications of influenza. Fatigue also has been identified as a contributing factor in medical errors. Employee health professionals can educate employees about the dangers of fatigue from long shift work and can raise concerns with management about employees who work an extended stretch of long shifts.

Meanwhile, employee health nurses need to face up to patient safety issues of their own, says Maxwell. For example, they often allow employees to drop in if they have health concerns. But that means that the employee health nurse is constantly interrupted, which could lead to errors, such as miscommunication of orders, she says.

“It doesn’t matter if they’re with another employee or if they’re writing up a report,” she says. “It distracts the health professional from their medical tasks.”

Instead, employee health professionals should ask for a courtesy phone call so they can prepare to see the employee/patient, she says. Maxwell offers other patient safety issues to consider:

• Make sure you have complete information on your employee/patients. Always check for allergies before providing even an over-the-counter medication. Be aware of interactions. For example, patients on digoxin could have a reduced effect from their medication if they eat quantities of licorice, and thus could be at risk for atrial fibrillation. By asking appropriate questions and checking medical history, you also are modeling a patient safety process for employees, she says.

• Don’t work outside your scope of practice. Employee health nurses are accustomed to working with autonomy, notes Maxwell. But don’t cross the line to actual solo practice. Be aware of what your state nurse practice act allows, and make sure you function under the purview of a medical director.

• Keep track of near-misses. Perhaps a medication error was discovered at the last moment, or an employee didn’t receive proper care instructions while being managed for a workers’ compensation claim. There should be a mechanism for examining errors and near-misses so you and others can learn from them, says Maxwell.

“We need to move from pointing blame and focus on the process of safety,” she says. “We need to look at error-prone situations and near-misses. It takes a collaborative approach to reduce errors.”

[Editor’s note: The AAOHN 2006 Symposium & Expo will be held from May 9-11 in Albuquerque, NM. More information is available at the AAOHN web site,, or from AAOHN headquarters. Phone: (770) 455-7757.]