Work Domain Analysis for understanding medication safety in care homes in England: an exploratory study

Medication safety and errors are a major concern in care homes. In addition to the identification of incidents, there is a need for a comprehensive system description to avoid the danger of introducing interventions that have unintended consequences and are therefore unsustainable. The aim of the study was to explore the impact and uniqueness of Work Domain Analysis (WDA) to facilitate an in-depth understanding of medication safety problems within the care home system and identify the potential benefits of WDA to design safety interventions to improve medication safety. A comprehensive, systematic and contextual overview of the care home medication system was developed for the first time. The novel use of the Abstraction Hierarchy (AH) to analyse medication errors revealed the value of the AH to guide a comprehensive analysis of errors and generate system improvement recommendations that took into account the contextual information of the wider system.

How precarious employment affects health and safety at work : the case of temporary agency workers

International studies indicate temporary agency workers are more likely to be injured at work than other types of employees. However explanations for this have been less forthcoming. This paper seeks to begin filling this gap. A study was undertaken in Victoria, Australia, of occupational health and safety (OHS) amongst temporary agency workers drawing upon workers' compensation claim files for injured agency and directly hired workers from 1995-2001, and focus groups of temporary agency workers conducted in 2003. In analyzing the results, use was made of risk factors identified in a model that has been developed to explain how precarious employment affects OHS--the pressure, disorganization and regulatory failure (PDR) model (Quinlan and Bohle, 2004, 2009). Drawing principally on qualitative data, the paper finds that whilst agency workers share common risk factors with other forms of precarious workers, unique characteristics associated with the triangular nature of agency employment heighten their vulnerability further.

Managing work health and safety : recent developments and future directions

Effective management of occupational health and safety ( OHS) continues to pose a challenge to many organisations. While significant advancement has occurred in knowledge about traditional workplace risks, organisational and labour market changes have created new risks, psychosocial risks are more prevalent, and the trend towards the adoption of OHS management systems has produced only mixed results. These issues are the focus of this review of recent developments in workplace health and safety. We argue there is a need for organisations to refocus systematically on a collaborative approach to identifying and controlling workplace risks, and on improving the integration of OHS into broader systems and every day management to better meet existing and future OHS challenges.

Safety illusion and error trap in a collectively-operated machine accident

Workplace accidents involving machines are relevant for their magnitude and their impacts on worker health. Despite consolidated critical statements, explanation centered on errors of operators remains predominant with industry professionals, hampering preventive measures and the improvement of production-system reliability. Several initiatives were adopted by enforcement agencies in partnership with universities to stimulate production and diffusion of analysis methodologies with a systemic approach. Starting from one accident case that occurred with a worker who operated a brake-clutch type mechanical press, the article explores cognitive aspects and the existence of traps in the operation of this machine. It deals with a large-sized press that, despite being endowed with a light curtain in areas of access to the pressing zone, did not meet legal requirements. The safety devices gave rise to an illusion of safety, permitting activation of the machine when a worker was still found within the operational zone. Preventive interventions must stimulate the tailoring of systems to the characteristics of workers, minimizing the creation of traps and encouraging safety policies and practices that replace judgments of behaviors that participate in accidents by analyses of reasons that lead workers to act in that manner.

Safety illusion and error trap in a collectively-operated machine accident

Workplace accidents involving machines are relevant for their magnitude and their impacts on worker health. Despite consolidated critical statements, explanation centered on errors of operators remains predominant with industry professionals, hampering preventive measures and the improvement of production-system reliability. Several initiatives were adopted by enforcement agencies in partnership with universities to stimulate production and diffusion of analysis methodologies with a systemic approach. Starting from one accident case that occurred with a worker who operated a brake-clutch type mechanical press, the article explores cognitive aspects and the existence of traps in the operation of this machine. It deals with a large-sized press that, despite being endowed with a light curtain in areas of access to the pressing zone, did not meet legal requirements. The safety devices gave rise to an illusion of safety, permitting activation of the machine when a worker was still found within the operational zone. Preventive interventions must stimulate the tailoring of systems to the characteristics of workers, minimizing the creation of traps and encouraging safety policies and practices that replace judgments of behaviors that participate in accidents by analyses of reasons that lead workers to act in that manner.

Observations and modeling of the Marginal Ice Zone

Global climate change in recent decades has strongly influenced the Arctic generating pronounced warming accompanied by significant reduction of sea ice in seasonally ice-covered seas and a dramatic increase of open water regions exposed to wind [Stephenson et al., 2011]. By strongly scattering the wave energy, thick multiyear ice prevents swell from penetrating deeply into the Arctic pack ice. However, with the recent changes affecting Arctic sea ice, waves gain more energy from the extended fetch and can therefore penetrate further into the pack ice. Arctic sea ice also appears weaker during melt season, extending the transition zone between thick multi-year ice and the open ocean. This region is called the Marginal Ice Zone (MIZ). In the Arctic, the MIZ is mainly encountered in the marginal seas, such as the Nordic Seas, the Barents Sea, the Beaufort Sea and the Labrador Sea. Formed by numerous blocks of sea ice of various diameters (floes) the MIZ, under certain conditions, allows maritime transportation stimulating dreams of industrial and touristic exploitation of these regions and possibly allowing, in the next future, a maritime connection between the Atlantic and the Pacific. With the increasing human presence in the Arctic, waves pose security and safety issues. As marginal seas are targeted for oil and gas exploitation, understanding and predicting ocean waves and their effects on sea ice become crucial for structure design and for real time safety of operations. The juxtaposition of waves and sea ice represents a risk for personnel and equipment deployed on ice, and may complicate critical operations such as platform evacuations. The risk is difficult to evaluate because there are no long-term observations of waves in ice, swell events are difficult to predict from local conditions, ice breakup can occur on very short time-scales and wave-ice interactions are beyond the scope of current forecasting models [Liu and Mollo-Christensen, 1988,Marko, 2003]. In this thesis, a newly developed Waves in Ice Model (WIM) [Williams et al., 2013a,Williams et al., 2013b] and its related Ocean and Sea Ice model (OSIM) will be used to study the MIZ and the improvements of wave modeling in ice infested waters. The following work has been conducted in collaboration with the Nansen Environmental and Remote Sensing Center and within the SWARP project which aims to extend operational services supporting human activity in the Arctic by including forecast of waves in ice-covered seas, forecast of sea-ice in the presence of waves and remote sensing of both waves and sea ice conditions. The WIM will be included in the downstream forecasting services provided by Copernicus marine environment monitoring service.

Resident work hour restrictions do not improve patient safety in surgery: a critical appraisal based on 7 years of experience in Switzerland

In 2005 the Swiss government implemented new work-hour limitations for all residency programs in Switzerland, including a 50-hour weekly limit. The reduction in the working hours of doctors in training implicate an increase in their rest time and suggest an amelioration of doctors' clinical performance and consequently in patients' outcomes and safety - which was not detectable in a preliminary study at a large referral center in Switzerland. It remains elusive why work-hour restrictions did not improve patient safety. We are well advised to thoroughly examine and eliminate the known adverse effects of reduced work-hours to improve our patients' safety.

A multi-site pilot test study to measure safety climate in the university work setting

Next to leisure, sport, and household activities, the most common activity resulting in medically consulted injuries and poisonings in the United States is work, with an estimated 4 million workplace related episodes reported in 2008 (U.S. Department of Health and Human Services, 2009). To address the risks inherent to various occupations, risk management programs are typically put in place that include worker training, engineering controls, and personal protective equipment. Recent studies have shown that such interventions alone are insufficient to adequately manage workplace risks, and that the climate in which the workers and safety program exist (known as the "safety climate") is an equally important consideration. The organizational safety climate is so important that many studies have focused on developing means of measuring it in various work settings. While safety climate studies have been reported for several industrial settings, published studies on assessing safety climate in the university work setting are largely absent. Universities are particularly unique workplaces because of the potential exposure to a diversity of agents representing both acute and chronic risks. Universities are also unique because readily detectable health and safety outcomes are relatively rare. The ability to measure safety climate in a work setting with rarely observed systemic outcome measures could serve as a powerful means of measure for the evaluation of safety risk management programs. ^ The goal of this research study was the development of a survey tool to measure safety climate specifically in the university work setting. The use of a standardized tool also allows for comparisons among universities throughout the United States. A specific study objective was accomplished to quantitatively assess safety climate at five universities across the United States. At five universities, 971 participants completed an online questionnaire to measure the safety climate. The average safety climate score across the five universities was 3.92 on a scale of 1 to 5, with 5 indicating very high perceptions of safety at these universities. The two lowest overall dimensions of university safety climate were "acknowledgement of safety performance" and "department and supervisor's safety commitment". The results underscore how the perception of safety climate is significantly influenced at the local level. A second study objective regarding evaluating the reliability and validity of the safety climate questionnaire was accomplished. A third objective fulfilled was to provide executive summaries resulting from the questionnaire to the participating universities' health & safety professionals and collect feedback on usefulness, relevance and perceived accuracy. Overall, the professionals found the survey and results to be very useful, relevant and accurate. Finally, the safety climate questionnaire will be offered to other universities for benchmarking purposes at the annual meeting of a nationally recognized university health and safety organization. The ultimate goal of the project was accomplished and was the creation of a standardized tool that can be used for measuring safety climate in the university work setting and can facilitate meaningful comparisons amongst institutions.^

Educational Needs and Future Prospects in the Field of Health and Safety at Work in Spain

Aiming to identify educational needs to promote employment in the field of Occupational Health and Safety in Spain, this paper analyses the matching degree between the existing university educational offer and the professional demand. Results indicate that the new official Masters are well driven but, at graduate level, a broad range of topics regarding occupational hazards should be promoted and the scope of cross subjects should be expanded. New profiles that are emerging within this field are also identified.