Literature Review

Empirical Literature:

Safety in the workplace is a necessary aspect to ensure that workers feel secure and safe while conducting their duties. Within the health industry, the protection of nurses from workplace-induced injuries as well as consequential illnesses is pertinent to the working nurses and patients. Nonetheless, numerous work stressors including the immediate work environment, characteristics of the organization and occurring external factors have been indicated as the number one causes of work-related injuries. As a result, a broad spectrum of research has been conducted to improve the working conditions of nurses and as a result, has developed the work ethic and motivation among nurses based on external factors. Despite the extensive research conducted emerging issues including patient health traits have been pointed out as primary causative stressors for work-related injuries.

Current data on work-related injuries among nurses indicates an increased rate since 2011 (OSHA, 2018). Similarly, the United States Bureau of Labor Statistics as of 2015, concur that the rate of physical injuries associated with nurses (both full-time and part-time) have escalated before the preceding years.  According to OSHA (2018), for every 6 in 100 nurses, the cases reported on physical injuries are filed. Lepane et al. (2017) summarise that the statistics make the health industry one of the most hazardous industries to work in compared to riskier industries including manufacturing and construction. Consequentially, this has affected work efficiency in most hospitals based on cost-analysis. According to OSHA (2018), $ 15, 860 are spent on average on nurse’s compensation on workplace injury from 2006 to 2011. In total, from a national perspective ranks at an annual expense of $ 2 billion.

The data on work-related injuries in hospitals in the country, United States of America, indicated a difference in the work environment. In the United States, hospitals are divided into state-government, local, privately owned and ownership-interim hospitals (U.S. Bureau of Labor Statistics, 2018). Comprehensibly, state-owned hospitals, approximately 3.7 cases per 100 working nurses are reported to have physical injuries. Conversely, in privately owned hospitals, cases were close to 6 per 100 working nurses. The statistics are worse in state-government hospitals where 8.1 cases in 100 nurses are reported. The worst rate of work-related injuries is in government hospitals from which nearly 8.1 cases in 100 nurses discover physical injuries(U.S. Bureau of Labor Statistics, 2018). The characteristic information indicates that hospitals run by governments are worse compared to those privately owned. Regardless, the report highlights a limitation in understanding how physical injuries have been on the rise despite comprehensive research on how to avert the dangers of work-related injuries.

There is a need to investigate the underlying factors on what is causing the rise in work-related injuries from a different perspective. A lot of information is published on the existential factors including organizations and work-environments, but, limited concern has been placed on the patient-nurse relationship. The reason to investigate from this perspective is that nurses, during their work time, handle patients of diverse health conditions. According to the report by U.S. Bureau of Labor Statistics, (2018), most of the work-related injuries are related to patient handling. For example, state-run hospitals handle psychiatric and substance abuse patients who are linked to increased cases of non-fatal and fatal physical injuries in working nurses. Congruently, all three hospital-ownerships indicate a patient related work hazard that increases work-related injuries. As noted, there is a need to investigate whether nursing injuries in the workplace are related to patient care.

Obesity in Pregnant Patients

Caring for patients is considered as fast-paced, stressful and highly demanding based on the work design and technological environment (Shea, 2015). The state has not been easy based on the increased number of pregnant patients admitted with clinical obesity. According to the CDC (2018), on a report on health concerns in the United States of America, it is estimated that 72 million adults in America suffer from obesity. In translation, nearly 15% of adults in every state are obese. This presents the probability that for every pregnant patient admitted there is a higher probability of health concerns on obesity. According to a cross-sectional study done by Chen et al. (2018) on obesity and overweight issues in pregnant women, most of the women admitted for pregnancy cases are highly likely to have been obese prior. Putting into regard that nurse-patient relationship based on patient care and work intensity a lot of work-related injuries can occur (U.S. Bureau of Labor Statistics, 2018).

Types of Injuries Among Nurses

According to a study report by OSHA (2018), work-related injuries are diverse and occur both in fatal and non-fatal capacities. Based on the statistics, nearly 48% of work-injuries are related to over-exertion or bodily reaction. They include lifting, bending or reaching. On the other hand, close to 54% of the injuries result from sprains and strains. These are considered to be non-fatal injuries which still accrue a lot of medical expenses and day-offs by the nurses. As for the fatal injuries, nurses report of musculoskeletal injuries which are determined to be detrimental to nurses (OSHA, 2018). The physical injuries that nurses go through have been linked to the aging workforce and caring for patients who are overweight and obese (OSHA, 2018). It is possible that larger patients pose new challenges for safe handling.

Obesity is referred to an excess amount of body fat which develops as a result of the number of calories consumed in food and beverages that exceed the recommended daily content consumption (U.S. Department of Health and Human Services, 2018). The National Health Institute sets the standards of obesity at Body Mass Index (BMI) 25-29.9. Care for patients diagnosed with obesity indicate increase psychological, emotional and holistic care for the patients so as not to hurt them and ensure they get the proper medical care. Additionally, the U.S. Department of Health and Human Services, (2018) indicates that caring for pregnant and obese patients requires a lot of attention from the nurses to ensure a good and safe environment. Assessment of the extensive research suggests that limited notice is given to nurses when it comes to handling patients that are obese and are pregnant. In reality, there are a lot of concerns about the high-risk exposure to the occurrence of physical injuries among nurses. To be specific, there is a need to analyze the type of physical injuries associated with nurses handling patients that are obese and pregnant. The study may provide in-depth insight into the manner of injuries that nurses who care for pregnant patients who are overweight. In particular, this may open up avenues through which nurse-patient relationship is assessed for correlation between the type of hospital-based on ownership and extremities in caring for nurses who care for such patients.

Research Portfolio

The literature review presented above is a conglomerate of research done on types of injuries that nurses incur when caring for patients that are obese and pregnant. Peer-reviewed journals, articles, government websites, and institutional websites were used. The databases ranged from Google.com, U.S. National Library of Medicine (National Institutes of Health) (NIH), PLOS One, U.S. Centre for Diseases Control and Journal oF Nursing. Other secondary databases including U.S. Bureau of Labor Statistics, U.S. Department of Health and Human Services and Occupational Safety and Health Administration (OSHA).

The studies and reports used in the present research were gathered from different dates but, limited to five to six years since publication. The dates range from 2015 to 2018. The reason for choosing the limited period is to ensure that the data used is latest to enhance the primary objective of the study. The search terms that were used for the present research revolved around the nurse-patient relationship, obese and pregnant patients, caring for patients and work-related injuries among nurses. To be precise, the specificity of the terms included physical injuries incurred by nurses while caring for nurses and statistics on injured reported in the United States of America since 2011.

Theoretical and Conceptual Framework

The theoretical and conceptual framework describes the direction of research and the basis of the theoretical construct. The present investigation was developed under the following conceptual framework: what is the research problem and what is the approach to a feasible solution (Gallagher et al., 2007). The present problem or research question is what types of physical injuries do nurses go through when caring for obese and pregnant patients. By observing and determining the research objective, the researcher has been able to create the conceptual framework that has been used throughout the research.

The first step to creating an excellent conceptual and conceptual framework was to identify the concept and model that underpins that current study(Gallagher et al., 2007). This included understanding the nurse-patient relationship and how it affects both parties’ ability to help each other. From this context, the nurse-patient relationship theory defines the relationship between theory and practice. Each nurse is required to provide the directive aid to their patients regardless of the situation. In certain circumstances, the nurse may be unable to care for the patient. As such, from this perspective, based on the primary objective, there is a need to understand what factors especially physical injuries are attained when nurses care for patients with obesity and are pregnant.

The belief is that the conceptual framework that was developed for the current research would improve on the conceptual understanding of the relationship between types of physical injuries attained by nurses while caring for obese and pregnant patients(Gallagher et al., 2007). The framework aided the researcher in presenting and identifying the phenomenon being investigated using the peer-reviewed journals. As such, the research has borne fruits to an extensive research portfolio.

According to a review by (Gallagher et al., 2007), the conceptual framework has been used in multiple studies especially in nursing and medicine. The studies are peer-reviewed and have surpassed the criteria for credibility and authenticity. Studies include those that revolve around nurse-patient relationship and description of the two entities. Gallagher et al., (2007) explains more than fifty studies that have used to the nurse-patient relationship under the presented framework and have been able to solve the phenomenon in-depth.

Gallagher et al., (2007) focuses on explaining how the concept, the nurse-patient relationship can be used to define study under research. This includes the evaluation of the specific entities that are used including nurses. Gallagher et al. (2007) describe how the wellbeing of a nurse can affect the holistic cure of a patient significantly. As such, Gallagher et al. (2007) indicates that there is a need to comprehend the internal and external factors that affect the nurse-patient relationship.

Inherently, in the present study, the comprehension of how the nurse-patient relationship is affected based on the injuries that nurses attain will be investigated. By borrowing a leaf from Gallagher et al. (2007), the study will focus on the objective- which is what type of injuries do nurses attain while attending to patients that are obese and pregnant. From this perspective, there would be a more detailed understanding of the concept such as the relationship between nurses and patients diagnosed with obesity and are pregnant. There is a need to understand both standpoints from both entities to comprehend how injuries arise. Besides, there will be more investigation on the issues handled with patients being overweight and how they affect the wellbeing of the nurses. This includes the evaluation of the factors on types of physical injuries including the non-fatal injuries and the fatal injuries. Further, the study will investigate the rate of occurrence of each type of injuries to present a correlation between the nurse-patient relationship between care and physical injuries attained.

References

CDC. (2018). Adult obesity: Obesity rises among adults. Vital Signs. Retrieved from https://www.cdc.gov/vitalsigns/pdf/2010-08-vitalsigns.pdf

Chen, C., Xu, X., & Yan, Y. (2018). Estimated global overweight and obesity burden in pregnant women based on the panel data model. PloS one, 13(8), e0202183. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/30092099

Gallagher, P., &Ousey, K. (2007). The theory-practice relationship in nursing: a participatory debate. Retrieved from http://eprints.hud.ac.uk/id/eprint/4615/

Lapane, K., Dube, C., &Desdale, B. (2016). Worker injuries in nursing homes: Is safe patient handling legislation the solution. The Journal of Nursing Home Research Sciences, 2, 110-117. Retrieved from http://www.jnursinghomeresearch.com/775-worker-injuries-in-nursing-homes-is-safe-patient-handling-legislation-the-solution.html

Shea, J. M., & Gagnon, M. (2015). Working With Patients Living With Obesity in the Intensive Care Unit: A Study of Nurses’ Experiences. ANS. Advances in nursing science, 38(3), E17.

OSHA. (2018). Worker safety in your hospital. Retrieved from https://www.osha.gov/dsg/hospitals/documents/1.1_Data_highlights_508.pdf

U.S. Bureau of Labor Statistics. (2018).  Hospital workers: An ease of occupational injuries and illnesses. Monthly Labor Review. Retrieved from https://www.bls.gov/opub/mlr/2017/article/pdf/hospital-workers-an-assessment-of-occupational-injuries-and-illnesses.pdf

U.S. Department of Health and Human Services. (2018). Medical Care for Patients with Obesity. National Health Institute of Diabetes and Digestive and Kidney Diseases. Retrieved from https://www.niddk.nih.gov/-/media/Files/Weight-Management/medical_care_508.pdf

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