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PubMed2001

Procedures nurses use to remove central venous catheters and complications they observe: a pilot study.

BACKGROUND: Removal of internal jugular and subclavian central venous catheters is a common nursing intervention. Venous air embolism is a serious complication of catheter removal. Although some procedures have been recommended to prevent venous air embolism, whether nurses use these procedures and what complications patients experience are unknown. OBJECTIVES: The purposes of this pilot study were (1) to determine what procedures nurses use to remove internal jugular and subclavian central venous catheters, (2) to find out what complications patients are experiencing, (3) to find out if complications experienced are related to the procedures used, and (4) to develop a questionnaire about central venous catheters. METHODS: A descriptive and correlational design was used. The subjects were 29 nurses whose job description included removal of internal jugular and subclavian central venous catheters. Two questionnaires were used: a demographics questionnaire and the questionnaire about central venous catheters. RESULTS: Descriptive statistics were used to analyze the sample, to determine the percentage of nurses sampled who use the recommended procedures, and to describe the frequency of complications observed. The sample size was not sufficient for observed complications to be correlated with procedures. CONCLUSIONS: None of the nurses sampled had venous air embolism diagnosed in their patients. They reported observing dyspnea, pain, bleeding from the insertion site, and arrhythmias. Many of the nurses reported that they did not always use all the recommended procedures; only 9 nurses (31%) reported always using all the recommended procedures.

Catheterization, Central Venous↗
PubMed2005

Impact of the September 11 attack on flight attendants: a study of an essential first responder group.

This paper discusses a study (funded by the Center for Substance Abuse Prevention) of the health/mental health and work-related well-being of flight attendants in the aftermath of September 11. Flight attendants, as an occupational group, had a distinctive exposure to September 11. In addition to work-related exposure in the immediate aftermath of the attacks, flight attendants have experienced major and ongoing changes in their work environment and job description and many have been exposed to potentially traumatic incidents on the job. Analysis of survey and focus group data from flight attendants in the Association of Flight Attendants showed high reported stress and related mental health and behavioral impacts among flight attendants since September 11. A significant new finding is that the effect of continued trauma in the flight attendants' work environment impacted their ability to recover from the original trauma associated with the events of that day. This study highlights the role of the after-effects of a traumatic event on trauma response and suggests that direct exposure, as traditionally defined, is not necessarily a primary mediating factor in trauma response for this occupational group.

Aviation↗
PubMed2004

Effects of a work injury prevention program for housekeeping in the hotel industry.

OBJECTIVE: The aim of this retrospective study was to determine the effectiveness of a work injury prevention program in the housekeeping department of a hotel. Studies have validated the use of different injury prevention strategies to decrease the incidence of work-related injuries. Few studies, however, have reported the efficacy of an on-site work injury prevention program by a physical therapist. STUDY DESIGN: In 1995, implementation of a work injury prevention program by a physical therapist to 50 housekeeping supervisors, 60 house persons and 340 guest room attendants at a large hotel began. This program included a detailed work risk analysis of the work environment, development of job descriptions, identification of injury-related problematic work situations, and implementation of a job specific supervisor-training program. Supervisor, house person and guest room attendant training was also conducted at the end of 1995 and the beginning of 1997. RESULTS: Data of injury reports in 1995, 1996, and 1997 were analyzed to determine the results of the program. There was a reduction in total injury claims, total medical expenses, total lost work time and total restricted duty time. CONCLUSION: These results demonstrate the cost effectiveness of implementing a work injury prevention program for housekeeping guest room attendants in the hotel industry.

Household Work↗
PubMed1975

Task analysis in health manpower development and utilization.

Job analysis and tast analysis are systems methods which examine the functions of individuals and allocate these functions into job descriptions which can make for a better utilization of health manpower by a restructuring of the jobs of health professionals and a restructuring of curricula as a reflection of the jobs to be performed. These analytic methods have had limited application to the health field. This methodology was applied to the education of a nonphysician family health team for an inner-city prepaid comprehensive health center and staff development at a health maintenance organization, and has served as the basis for the curriculum of an associate degree physician's assistant program and a baccalaureate degree health associate program. Among the advantages for the application of this method are the interrelationship of resulting jobs rather than isolation and career mobility in both the work situation and curricula. Constraints include the lack of entry level jobs, the prestige of the Bachelor's Degree, the need for proficiency tests for advanced standing, tuition costs, and the traditional attitudes of health agencies on release time and educational institutions on basic requirements.

Health Occupations↗
PubMed2003

Statewide study of the direct support staff workforce.

Issues of recruitment and retention related to the direct support staff and how these issues affect the lives of people with developmental disabilities were investigated. Major findings included the following: (a) High direct support staff turnover and vacancy rates have negative consequences for many people who receive supports. (b) Direct support staff provide a vast array of services and have numerous job titles and job descriptions. (c) Direct support staff are inadequately compensated and often have to work more than one job. (d) Turnover rate and recruitment is a serious problem. The need to develop the role of the direct support staff into a valued profession is discussed and considerations for research and practice are provided.

Child↗
PubMed1977

Occupational exposure to chloromethyl ethers. A retrospective cohort mortality study (1948-1972).

This industry-wide epidemiologic study to evaluate the human carcinogenicity of the chloromethyl ethers (CME) included 1827 CME-exposed workers and 8870 controls. Duration and relative intensity of exposure were classified by job description in the personnel records. This information permitted assigning relative magnitude of exposure scores for each job category at several plants, with allowance for temporal changes in the plant processes. Social security records were used for the ascertainment of deaths among separated employees. Death certificates were obtained for virtually all known deaths, and hospital pathology reports were obtained where possible for the cancer-related deaths. No differences in noncancer death rates were found. An increased risk of respiratory cancer death in CME-exposed workers was found at only one firm where high exposures are known to have occurred. A clear dose-response relationship with risk ratios exceeding ten for the longest duration and greatest exposure subgroups was demonstrated for this firm.

Bis(Chloromethyl) Ether↗
PubMed1975

Mortality patterns among workers exposed to chloromethyl ethers--a preliminary report.

Chloromethyl methyl ether (CMME) has been used extensively as a crosslinking agent for ion-exchange resins. Commercial grades of CMME are contaminated to the extent of 2-8% with bischloromethyl ether, an alkylating agent which has been shown to be a very potent lung carcinogen in animals. Reports by other investigators in this and other countries have implicated CMME as a lung carcinogen in chemical workers. The purpose of the study reported here was to examine the lung cancer mortality experience with respect to intensity and duration of exposure in six of the seven chemical companies that account for virtually all of the CMME use in the United States. The study included about 1800 workers who were exposed in the period 1948 to 1972 and about 8000 workers not exposed to CMME from the same plants who served as controls. Exposed workers were characterized according to job description and duration of exposure. In several plants the intensity of exposure was numerically graded for each job category with adjustment for temporal changes in the plant processes. Social Security records were used to identify deaths among workers who had left the companies and death certificates have been obtained for virtually all known deaths. The age-adjusted death rate for respiratory cancer in the CMME exposed group as a whole was 2.5 times that in the control group, whereas death rates due to other causes were comparable. There was also a gradation of lung cancer risk according to intensity and duration of exposure and the time elapsed since the onset of exposure.

Adolescent↗
PubMed2005

How to play to your strengths.

Most feedback accentuates the negative. During formal employee evaluations, discussions invariably focus on "opportunities for improvement," even if the overall evaluation is laudatory. No wonder most executives--and their direct reports--dread them. Traditional, corrective feedback has its place, of course; every organization must filter out failing employees and ensure that everyone performs at an expected level of competence. But too much emphasis on problem areas prevents companies from reaping the best from their people. After all, it's a rare baseball player who is equally good at every position. Why should a natural third baseman labor to develop his skills as a right fielder? This article presents a tool to help you understand and leverage your strengths. Called the Reflected Best Self (RBS) exercise, it offers a unique feedback experience that counterbalances negative input. It allows you to tap into talents you may or may not be aware of and so increase your career potential. To begin the RBS exercise, you first need to solicit comments from family, friends, colleagues, and teachers, asking them to give specific examples of times in which those strengths were particularly beneficial. Next, you need to search for common themes in the feedback, organizing them in a table to develop a clear picture of your strong suits. Third, you must write a self-portrait--a description of yourself that summarizes and distills the accumulated information. And finally, you need to redesign your personal job description to build on what you're good at. The RBS exercise will help you discover who you are at the top of your game. Once you're aware of your best self, you can shape the positions you choose to play--both now and in the next phase of your career.

Administrative Personnel↗
PubMed1982

Job satisfaction of dietitians in the United States.

The purpose of this study was to determine the level of job satisfaction of dietitians in the United States. Job satisfaction scores using the Job Descriptive Index (JDI) were studied in relation to marital status, age, years of employment, place of employment, salary, job responsibilities, and dietitian category. The sample consisted of 529 dietitians in the following categories: consultant, clinical, other, generalist, administrative, community, research, and teachers. When compared with norms, total job satisfaction scores were low. Few significant differences were observed among dietitian categories. There were no significant differences between total job satisfaction scores and any of the job-related variables studied.

Age Factors↗
PubMed1999

General practitioners caring for terminally ill patients resident in a hospice.

The goal of this study was to investigate why GPs have little or no involvement in the medical process relating to any of their patients when they are admitted to a palliative care unit (PCU) and what solutions they suggest. The study took the form of a descriptive pilot study based on a short questionnaire. It emerged that GPs felt their involvement was influenced by their job description, by practical factors (time investment, distance between practice and PCU, remuneration, referral) and personal issues (e.g. dealing with dying). It is concluded that GPs need education in palliative/supportive care and approved remuneration as well as knowledge about their task in the PCU.

Attitude of Health Personnel↗
PubMed2007

Task- and time-dependent weighting factors in a retrospective exposure assessment of chemical laboratory workers.

A chemical exposure assessment was conducted for a cohort mortality study of 6157 chemical laboratory workers employed between 1943 and 1998 at four Department of Energy sites in Oak Ridge, Tennessee, and Aiken, South Carolina. Previous studies of chemical laboratory workers have included members within professional societies where exposure assessment was either limited or not feasible, or chemical processing employees where laboratory and production workers were combined. Because sufficient industrial hygiene records were unavailable for all four sites, weighted duration of employment was used as a surrogate for the magnitude of exposure. Potential exposure indices were calculated for each worker using number of days employed and weighting factors for frequency of contact and year of employment. A total of 591 unique laboratory job titles indicative of a chemical laboratory worker were collapsed into 18 general job title categories. Through discussions with current and retired workers, along with examination of historical organizational charts and job descriptions, the percentage of time with activities involving the direct handling of chemicals in the laboratory was estimated for each job title category. Scaled weighting factors of 1, 0.6, 0.3, and 0.05 were assigned to the job title categories representing 100%, 60%, 30%, and 5% of daily activities handling chemicals, respectively. Based on limited industrial hygiene monitoring data, personal radiation monitoring records, and professional judgment, weighting factors that declined 4% annually were applied to each year to account for improvements in laboratory technique, advancements in instrumentation, improvement in engineering controls, and increased safety awareness through time. The study cohort was separated into three categories of chemical exposures based on department level information: (1) inorganic, (2) mixed inorganic and organic, and (3) unknown. Potential exposure indices ranged from 0.15 to 6824.5 with a median value of 377.5 and a mean equal to 884.2. This exposure assessment method is useful for epidemiologic analyses when quantitative exposure data are absent or insufficient.

Air Pollutants, Occupational↗
PubMed1997

Retrospective assessment of occupational exposure to chemicals in community-based studies: validity and repeatability of industrial hygiene panel ratings.

BACKGROUND: Occupational hygiene panels are increasingly being used to rate retrospective occupational exposures to chemicals in community-based studies. This study aimed to assess the validity, reliability and feasibility of using such an expert panel in a brain tumour case-control study. METHODS: A panel of five experts was recruited to rate exposure to 21 chemicals for 298 job descriptions to investigate the level of agreement. Validity was assessed by comparing the ratings of the experts for 49 of the jobs with objective quantitative exposure data which existed for these jobs. Repeatability was assessed by comparing the results for 50 resubmissions. RESULTS: Specificity was high for reporting that exposure occurred (all above 90%), but sensitivity was variable with values between 48% and 79%. Weaker validity was found for rating exposure level and exposure frequency. The raters showed the greatest inter-rater agreement for exposure to three of the 21 chemicals considered (kappa = 0.64 for cutting fluids, kappa = 0.57 for welding fumes and kappa = 0.42 for lubricating oils). Intra-rater reliability, based on the 50 resubmitted jobs, was fair to good (kappa = 0.46, 0.73). CONCLUSIONS: The potential effect of exposure misclassification from using expert panels was quantified and found to be a significant source of bias. The optimum situation occurred where three of the five raters concurred, where an odds ratio of 2.2 was observed for a true odds ratio of 4.0. Future studies which plan to use expert panels should screen the experts for their suitability by validating their performance against jobs with known exposure data.

Bias↗
PubMed1980

Job satisfaction and perception of social climate in a mental health facility.

21 members of a staff process group at a mental health treatment and research center were administered the Job Descriptive Index and the Work Environmental Scale once a month for a 3-mo. period. A two-day analysis of variance (job satisfaction x time) was computed for each of the 10 subscales. The three administrations did not significantly vary on any of the dimensions, nor were significant interaction effects found. Subjects high in satisfaction significantly differed from those who scored low on the dimensions of involvement and peer cohesion, staff support, autonomy, and innovation. However, no significant differences were found on the dimensions of task orientation, work pressure, clarity, control, or physical comfort. Results were discussed in terms of the importance of the variables, relationship and responsibility, to job satisfaction in a mental health setting.

Hospitals, Psychiatric↗
PubMed2003

Job satisfaction of hospital nurses: an empirical test of a causal model in Taiwan.

AIM: The purpose of this research was to empirically test a model of job satisfaction in Taiwan. METHODS: The model represents a revision of the Price-Mueller model, which is based on empirical research conducted since 1972 at the University of Iowa. This empirical test contributes to the generalization, on cross-national settings, of results from American-based research on job satisfaction. FINDINGS: The results, based on a sample of 308 non-supervisory hospital nurses in Taiwan, indicate that 45% of the variance in job satisfaction was accounted for by the revised model. The work characteristic variable "routinization" had the greatest impact on job satisfaction, followed by the personality traits "positive affectivity" and "job involvement". Although it is difficult to change the routine nature of nursing, the manager should make efforts to diversify the job description and empower his/her subordinates. CONCLUSIONS: It is suggested that having information on a nurse's personality will help to predict her/his future job satisfaction and may lead to improved selection of personnel. In addition, different management styles or reward systems that are sensitive to different personalities should be carefully studied and implemented, as appropriate.

Humans↗
PubMed1991

Relations of job characteristics from multiple data sources with employee affect, absence, turnover intentions, and health.

Much of the evidence in support of job characteristics theory is limited to incumbent reports of job characteristics. In this study, job characteristics data from three independent sources--incumbents, ratings from job descriptions, and the Dictionary of Occupational Titles--were used. Convergent validities of incumbent reports with other sources were quite modest. Although incumbent reports of job characteristics correlated significantly with several employee outcomes (job satisfaction, work frustration, anxiety on the job, turnover intentions, and number of doctor visits), the other sources showed few significant correlations, except for number of doctor visits. Caution is urged in the use of incumbent self-reports of job characteristics as indicators of actual work environments. New methods for studying job characteristics are suggested.

Absenteeism↗
PubMed2000

Perceived overqualification and dimensions of job satisfaction: a longitudinal analysis.

The present study is an investigation of the effects of perceived overqualification on dimensions of job satisfaction. The data for this study came from a two-wave panel study of members of a midwestern American Postal Workers Union local. Job satisfaction was operationalized with 4 subscales from the Job Descriptive Index (P. Smith, L. Kendall, & C. Hulin, 1969). The following three hypotheses were tested: (a) Perceived overqualification will be negatively related to facets of job satisfaction; (b) there is stability in the test-retest correlations of facets of job satisfaction; and (c) the effects of perceived overqualification on facets of job satisfaction will not change from Time 1 to Time 2 because of adaptation. The cross-sectional results supported the hypotheses and suggested that perceived overqualification has a negative effect on job satisfaction. However, the relationships varied by dimension of perceived overqualification and dimension of job satisfaction. Future researchers of overqualification and dimensions of job satisfaction should consider relative deprivation as a source of work-related deprivations.

Adult↗
PubMed1976

Personality and job satisfaction of medical technologists.

The personality characteristics and job satisfaction patterns of a volunteer group of practicing medical technologists were measured by the Myers-Briggs Type Indicator and the Job Description Index. Data analysis was based on three groups of female subjects: clinical practitioners, educators, and administrators. There was little primary impact of personality upon job satisfaction, although definite patterns of personality are identifiable in the three groups. Implications for counseling students and placing practitioners in satisfying jobs were suggested, and additional studies to be conducted were identified.

Administrative Personnel↗
PubMed1989

Quantitative muscle strength testing: a comparison of job strength requirements and actual worker strength among military technicians.

In this study the authors investigate the percentage of mismatch between job demands and worker physical capacity in Utah National Guard mechanics. This population had demonstrated a higher incidence of low back trouble than other job descriptions reviewed. The authors utilized onsite still and videotape photography and a computerized biomechanical strength prediction model to assess loads on the lumbosacral spine due to various job tasks. Job demands were then compared to the actual physical capacity of the individual workers based on static strength testing in job-related positions. A load cell on the testing apparatus entered the force generated into a computer which averaged the force of the last three seconds of a five-second lift. It was determined that as much as a 38% mismatch existed within this population for some job tasks which these workers were exposed to. Suggestions for preventing job-related low back cumulative trauma disorders are presented, including: engineering redesign, worker selection programs, work hardening, and others.

Back Pain↗