OCCUPATIONAL HEALTH FEEDBACK REPORT.pptx

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1. OCCUPATIONAL HEALTH FEEDBACK REPORT BY CATHOLIC UNIVERSITY 3RD YEAR STUDENTS

2. MEMBERS SAMUEL EVANCE COSMAS MAGOMBO KELVIN NAMAONA PATIENCE GONA EDWARD NYUNDO CYNTHIA MWINAMA PRECIOUS MACKENZIE MEMORY NKHULA

3. INTRODUCTION This is a report on clinical experience on occupational health nursing from catholic university of malawi third year students which was done at zomba mental hospital for two weeks. It started on 17th April, 2024 to 26th April, 2024. We were allocated in Maintenance department, kitchen and laundry department.

4. OVERVIEW OF OCCUPATIONAL HEALTH Occupational health is the promotion and maintenance of the highes t degree of physical, mental and social well-being of workers in all occupations , (Harrington & Gill,1992) It is c oncerned with two-way relationship of WORK and HEALTH it is also r elated to the effects of working condition and / or environment on health of worker that influence the ability to perform tasks in the workplace

5. AIMS OF OCCUPATIONAL HEALTH NURSING Promotion and maintenance of the highest degree of physical,mental and social well-being of workers in all occupations ; by preventing injuries from health caused by their working conditions . protecting the workers in their employment from risks resulting from factors adverse to health and adaptation of work to the workers and workers to their jobs

6. The Scope of OHN practice Prevention of o ccupational injuries Prevention of o ccupational illness Reducing work place hazards Promotion of worker’s health Restoration of worker’s health (maintenance of worker’s health)

7. OUR OBJECTIVES Our objectives were the following: to create a positive working relationship with workers in the departments to state the objectives of the department to assess the physical and social environment of the workplace to identify the health related policies of the department to identify health concerns/problems of members of the department

8. objectives ct’d to discuss the appropriate interventions of the health related problems identified in the department to assess the employees satsifaction in the departments to implement health promotion and disease prevention activities in the departments to conduct feedback meetings with management in the department to submit a written report to the relevant authorities at the end of experience

9. OBJECTIVES THAT WE HAVE ACHIEVED We managed to create a positive working relationship with the workers in the de[artments because they were too open and helping We were able to assess the physical and social environment in all departments that we were allocated We were able to adequately identify the health problems in the departments and intervene because we had a full support from the staffs who were so interactive

10. We were able to know the objectives of each department We managed to implement health promotion and disease prevention activities in the departments i.e. providing health education on how to protect themselves from injuries and accidents We were able to assess employees satisfaction in each department through chatting with every worker

11. OBJECTIVE OF THIS REPORT To give a feedback in reference to experience of third year students from the Catholic University of Malawi during the clinical experience at Zomba Mental Hospital It comprises of a quick summary of the allocation, strength and weaknesses in each department allocated to, suggestions on problems found and conclusion

12. KITCHEN DEPARTMENT The kitchen is run by a private institution known as (GrandMa’s kitchen) . Located between the laundry department and occupational therapy (OT) department. There are 8 workers and one supervisor . The objectives of the department is to provide with high food quality and good quantity, to promote food hygiene, to promote safety of the workers, to do laboratory investigations and promote infection prevention

13. The following are activities done by the kitchen team preparing and cooking food, serving food to the patients and cleaning utensils, cleaning the surrounding that is inside and outside the kitchen preparing special menu for special groups e.g clients with special nutritional problems. The end product is the kitchen are the nutritious and hygienic food and internal and external conducive environment. The chemicals that are used are chlorine and soap powder for cleaning the flour and utensils.

14. The kitchen department do not use gas but they use electric appliances. The kitchen has one kitchen, two changing rooms, two toilets, two bathrooms,one for ladies and one for gentlemen respectively thereby promoting hygiene It has a big and clean store room with refrigerators where different foods are stored this promotes safe storage of food therefore preventing multiplication of microbes. the passage and walking surfaces are not in good condition for example the corridoors are not big enough which is a problem when transporting from the kitchen to the designeted areas this may put workers at risk for injuries.

15. ctn On occuoational safety: The major health risks are problems associated with smoke which may lead to pneumo infections for example Chronic obstructive pulmonary disease (COPD) as well as other injuries for example burns as a result of electric current, steam and hot water. Workers were not putting on their PPE despite having them this may put them at the risk of injuries like cut and pneumo infections

16. According to the head of kitchen he reported that from the past 12 months no any injury has happened There is no first aid kit at the the kitchen as well as availability of the first aid training programme. There is no occupational health nurse however The Principal Nursing Officer is the head of catering who trains the workers on how to prevent and manage the emergency.

17. There are no health policies in the kitchen except hand washing policy. This made us not to provide health education on those policies. On disaster plan The kitchen team was trained how to handle disasters like cholera, typhoid and any form of disaster life fire accidents. The Catering Head who happens to be a Nurse (though not an Occupational Nurse in nature) trains the worker on how to prevent and manage emergencies.

18. On roles of an Occupational Health in the department We observed that there is no a permanent health nurse assigned to the kitchen department to provide professional roles, ehtical roles, administrative roles as well as educational roles however sometimes the Head of Catering Department provides education to the workers on issues like hygiene, infection prevention, safety as well as waste disposal.

19. On health promotion programs Workers are given health talks on different issues like prevention of injuries and emergencies workers are screened for infections like asthma, tuberculosis, Blood pressure as well as wadal testing like typhoid. On Health Education There are no health policies that facilitates health education however there are programs that are presented like safety and infection prevention

20. The target group of these education are the kitchen workers The methods of presentation prefered is group discussion The frequency is an ongoing depending on the situation These education are evaluated through monitoring and evaluation rule and weekly assessment which takes place every Thursday most of the times, these education are presented by team assessors and catering supervisors

21. Through the information gathered above that facilitated our learning and achievement of our objectives, we established the following strength and challenges of which we took actions on some of them.

22. STRENGTH Through the assessment we observed that there is socializaton among the kitchen members which can contibute positively to their overall well-being, as strong social connections can help to reduce stress levels and improve mental health among the kitchn staff. The provision of quality food ensures that the kitchen provides nutritious diet which reduces the risk of nutritional deficiencies and related health issues Daily kitchen cleaning is crucial for maintaining hygiene and preventing the spread of foodborne illness

23. Timely food services; serving food in timely manner is beneficial for the kitchen staff’s health since it promotes efficient workflow and reduces stress associated with hunger. The kitchen has the menu for special clients e.g. malnourished patients which reduces the risk of patient’s malnutrition.

24. Through the assessments of all members of the staff at the kitchen on health related issues, out of 8 workers assessed, one worker complained of abdominal pain. the rest were fine. psychologically, the the workers were fine. We provided the intervention on their problems identified for example the worker with the health problem was sent to the clinic for further management and he is scheduled to meet the doctor on 26th April. Employee’s job satsifaction was assessed and we found out that they are satisfied with their salaries, terms of contract as well as working hours and holidays There is availability emergency plan, where workers are alerted interms of disease break outs by the Principal Nursing Officer, such as cholera and typhoid

25. On occupatinal hygiene We observed that there are two change rooms, one gents and one for ladies, there two toilets, one for ladies and one for gents, there are also two bathrooms, one for gents and one ladies. the kitchen has a very big and storeroom with five refredgerators where different perishable food stuff are kept.

26. CHALLENGES No availabilty of the first aid kit as well as first aid training programme, the absence of first aid kit contains essential supplies and equipment needed to provide medical assistance. this may put workers at risk as they may fail to manage minor injuries such as cuts, burns or sprains. Lack of occupational health nurse; the abscence of an occupational health nurse means there is no dedicated healthcare professional available to adress the specific health needs and concerns of the kitchen staff. The fire extinguisher is not updated in terms of gas; fires in the kitchen can spread rapidly and lead to severe injury this may put their life at risks.

27. There were not health policies in the kitchen which made us not to provide health education to the workers Workers did not put on their PPEs which put them at health risks

28. ACTION TAKEN We conducted health education on safety, infection prevention, waste management and food hygiene. We met with the Principal Nursing officer (Mrs. L. Moosa) who heads catering department to find out more about the welfare of the workers and discuss way forward We conducted a meeting with the Human Resource Manager to share the concerns of the workers for example job establishment of the worker at CSSD and she told us that the job establisment of a worker at CSSD is one. For socialization, she join ECT department

29. We visited the Kitchen Supervisor an discuss about health policies that are supposed to be pasted in the kitchen. We demonstrated the proper handling of food in the kitchen so as to equip the workers of food hygiene

30. RECOMMENDATIONS We appreciate the strength being done in the kitchen department that we would like them to be continued so that the objectives of the kitchen department should be successfully achieved. There should be an ongoing supervision in order to maintain the cleanliness inside and outside the kitchen If possible the management should allocate a special nurse responsible for occupational health nursing despite having the Head of Catering

31. Workers in the kitchen should be oriented to different schemes e.g medical schemes as it has been observed that non of them is on any scheme If possible the management should provide a training to the kitchen department about safety particularly how to use fire extingusher. There is a need to provide a well updated first aid kit to be used in case of emergencies

32. MAINTENANCE DEPARTMENT maintenance department has 6 sections which are carpentry, welding, electrical, plumbing, brick laying, and painting. has 7 employees and 7 internees currently Their objective is to repair things that are broken and maintain, therefore improving quality patient care TYPES OF ACTIVITIES DONE repairing broken things e.g. chairs, beds, drainage systems, toilets, water pipes, and many more painting walls, plumbing, carpenting, electrical, brick laying, welding

33. ct... The maintainance department is located near laundry and paying ward . The department has one supervisor and seven workers . the department produces doors, beds, printed clothes, infrastructures e.tc some of the chemicals that ar e used are, vanish, pinace, cement, lime, para f fin and some pesticides e .g. solignum . Maintenance department has 3 offices which are not enough because all 6 sections share the same offices. the offices are surrounded by many things e.g. broken chairs, beds,metals, pipes, woods. same with the internal environment of the offices, it is so congested with many materials from different sections which are not well arranged and sorted. This may cause harm or injuries to the workers in a way that things can fall on them and it might also be difficult to find some materials in the office

34. ct... About occupational hygiene; the department has no change rooms so they just use the same offices for changing, they do not have toilets, bathrooms, enough storerooms and resting rooms, these may affect the workers health even the effectiveness and sufficiency of work because they do not have rooms to store their equipments, it is difficult for them to rest when they are tired due to lack of resting rooms and it is also uncomfortable when they want to visit the toilet immediately but the toilet is far from the offices.

35. on occupational safety, some of the health risks in the department are the following; things may fall on the workers e.g. bricks,metals, ceiling, e.t.c skin diseases e.g. dermatitis which may come due to skin contact with chemicals chronic obstructive pulmonary disease(COPD), broncopulmonary cancer, inhalation fevers, occupational asthma e.t.c these may come due to inhalation of some chemicals, however these may come if the workers do not put on full protective equipments.

36. upon assessment we found that the workers have the equipments but not full and not enough which may put their health at risk. the do not have enough tools to the point that some workers use their owns tools which makes the work not so effective and sufficient. the department have a supervisor who provide supervision of workers on safety measures

37. the department do not have a fire extinguisher therefore putting workers health at risk for injuries and accidents in case of fire outbreaks especially welding section. They do not have a first aid kit and in case of injuries they just use the OPD There has not been any report of injuries and fatalities over the past 12 months The workers are given health education when being employes on how to use personal protective equipments

38. CT... On social welfare of employees; the workers play different games like football, netball, they also do an end of year get together. The workers are given a chance to persue with education after two years There is a plan/policy on accident and disease prevention.

39. STRENGTHS The maintenance department staffs report for duties everyday and there is strong team working spirit in the department. there is availability of some equipments and tools which make their work done when they are needed. They have a supervisor at the department. their social welfare is good, they are educated about PPEs, they also have a scheme to motivate the workers. They have a policy in case of accidents and diseases

40. CHALLENGES The following are some of the challenges that maintenance department has; the internal and external environment of the offices is not conducive for the workers in such a ways that materials are just scattered without proper arrangements therefore it possess a danger to the workers because some materials might fall on them The offices are not enough for the sections because they are six sections but only two offices, some sections even use the store rooms. These make the offices to be congested and putting the workers health at risk for injuries and accidents Personal Protective Equipments and tools are not enough for the workers to the point that some workers use their own equipments, these also put workers health at danger and the work is not sufficiently done

41. ACTIONS TAKEN We managed to clean the surrounding and arranged the materials that were scattered outside. The internal environment of the offices ; we managed to sort the materials in place in a way that the workers can not be at risk for injuries we found some workers working without personal protective equipments because some had no equipments , some had the equipments but they did not put them on, so we managed to give health education to all the workers about the importance of putting on PPEs and the disadvantages of not putting on PPEs

42. The department has no changing rooms and toilets, they use the ones from OT department which are very far The department do not have a fire extinguisher to use in case of fire outbreaks most of the times, the employees work overtime but their duty offs are not considered, this affect their health in a way that they fail to met some of their needs

43. RECOMMENDATIONS The management should make sure the offices are enough for the workers including bathrooms, toilets and change rooms The management should make sure that the worker’s health is not at risk by providing them with enough PPEs and working tools including a fire extinguisher The employees should be considered on the extra time that they work ADDITIONS the workers do enjoy their work so much and there is a strong multidisplinary approach

44. LAUNDRY DEPARTMENT The laundry department is located near kitchen and maintainance department. The department has one supervisor and 10 workers . The objective of the department is to promote infection prevention by providing clean linen to all patients. The laundry department produces clean linen and clothes for the hospital. some of the chemicals that they use are chroline, soap and Jick when washing clothes and beddings, the surrounding of the laundry is clean and there is short grass, hence promoting hygiene. On internal environment the floor is always dry and clean hence minimising accidents There is no enough space in the working station which may lead to some injuries when moving things from one place to another

45. ct... On occupation hygine they have one working station, no changing rooms but they use working station as a changing room, they have one toilet which is used for all workers in the department,they do not have a bathroom , they have no kitchen but they use the working station as the kitchen. they also have a store room rather they use the corner of the laundry to store their equipments

46. ct... On occupation safety; some of the risks in the department are risk for fire outbreaks and electric shock. As safety precautions to protect the workers, they are provided with personal protective equipments but others do not have the PPEs. they are offered safety trainings on how to to use fire extengisher and fire alarms in the department.they are also supervised by the department supervior everyday when working. On social welfare of the workers The workers are involved in different sporting activities e.g. football, netball, e.t.c the also have an organisation within the department where they keep money for emmegiencies. workers are given chance to pursue with education after two years of working experience as a scheme to motivate the workers

47. The department do not have a first aid kit as such they go to outpatient department when they have an emergency. On disaster plan they have a fire alarm and extinguisher The department has not registered any injuries the last 12 months

48. STRENGTH They have two washing working machine and one drier making work more effective and sufficient They have a supervisor who guides the workers Motivation programes are available after four years of working experience. This helps workers to achieve their desired careers. They are provided with working necessities, for instance, soap and chlorine, to prevent cross infection and facilitate cleaning of clothes They are provided with person al protective equipments, e . g . gamboots, guggles, heavy duty aprons and gloves.This protect workers from infection and injuries

49. challenges Some workers do not have full personal protective equipments which can put workers at risk of communicable diseases and injuries. The space is not enough to work effectively putting workers at risk of injuries. The department does not have a store room, therefore the equipments are well arranged, putting the workers health at risk because things might fall and injure them The department has one toilet which is not enough against the number of workers one changing room for workers reduces their comfortability.

50. ct... Unavailability of first aid kit makes it hard for workers to access first aid treatment when injured. The fire alarm is not working. Increases the risk of late detection in times of fire emergency They do not have posters for danger signs and some procedure manual. This may affect in detecting early malfunction of washing machines. There is poor installation of electrical cables [mainly swit ch board], thereby workers are at risk of electric shock. They do not have iron roller and weighing scale. Absence of weighing scale may result in overloading of the washing machines hence reduction of the machines halflife. They have fire extinguisher which can be used during fire accidents, but it is not refilled with gas hence it can be difficult to set off fire accidents.

51. ct... ACTION TAKEN · We managed to do h ealth education on personal protective equipments · We managed to a dvoca te for personal protective equipments and installation of electrical cables. RECOMENDATIONS The department surpervisor should reinforce on the procurement of PPEs of some members that do not have the PPEs There should be labelling of places that seems to be dengerous to prevent accidents, there should also remind each other on the importance of wearing PPEs, the management should provide the materials that the laundry department is lacking for them to achieve the goal of providing clean linen and clothes to the hospital eg weighing scale and iron roller.

52. IMAGE OF THE LAUNDRY STORE

53. OCCUPATION HEALTH NURSE upon our assessment we found that there is no occupation health nurse at the facility which is a challenge to the workers because an occupational health nurse helps in playing different roles, some of the roles are the following; promote an interdisciplinary approach to health care and advocate for the employees right to prevention oriented, cost effective health and safety programs encourage workers to take responsibilities for their own health through health education and disease management programs, such as smoking cessation, exercise/fitness, nutrition and weight loss, stress management, control of chronoc illness and effective use of medical services

54. ct... monitor the health status of workers, work population and community groups updating new information The management should ensure that the facility has an occupational health nurse

55. CONCLUSION In conclusion this allocation equiped us with the knowledge of occupational health nursing. we have managed to achieve our objectives by having opportunities to communicate effectively with the hospital authorites thereby creating a therapeutic relationship in collection of data, assessing internal and external environment of the different departments, assessing workers job satisfaction that promote their social, economic and psychological well-being, just to mention a few. We have also been equiped of how to assist workers in terms of safety, infection prevention, waste disposal, health education and other areas of their needs

56. Many thanks goes to the management of Zomba Mental Hospital for granting us opportunity to practice at this institution. We appreciate the hospitality that was rendered throughout the allocation that facilitated us learning despite our shortfalls. We also thank our lecturers for their time to time supervision. Thanks