Community Health Nursing 1 - Lecture

STUDENT ACTIVITY SHEET BS NURSING / SECOND YEAR

Session # 21

LESSON TITLE: School Occupational Safety and Health

Materials:
Pen, paper, index card, book, and class List
LEARNING OUTCOMES:
Upon completion of this lesson, the nursing student can:
Reference:
1. Correlate the components of a comprehensive school
health program with interventions; Famorca, Z. U., Nies, M. A., & McEwen, M.
2. Correlate the nurse’s functions with the standard under (2013). Nursing Care of the Community. Elsevier
which school nurses’ practice; and, Gezondheidszorg.
3. Determine the appropriate control measures to prevent
hazards and risks.

LESSON PREVIEW/REVIEW (5 minutes)

Instruction: Differentiate mobile source from stationary source of air pollution? Explain briefly.
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MAIN LESSON (30 minutes)

Introduction: School health service is an important aspect of community health. It is possible to increase the health level
of community and achieve growth in the health of future generation through school health service.

School Health refers to a state of complete physical, mental, social and spiritual well-being and not merely the absence
of disease or infirmity among pupils, teachers and other school personnel

School Health Service refers to need based comprehensive service rendered to pupils, teachers and other personnel in
the school to promote, protect their health, prevent and control disease and maintain their health.

AIM OF SCHOOL HEALTH SERVICES: The ultimate aim of school health service is to promote, protect and maintain
health of school children and reduce morbidity and mortality among them.

PRINCIPLES OF SCHOOL HEALTH SERVICES:

 Planned in coordination with schools, health personnel, parents and community people.
 A school health council needs to be set up. Be based on health needs of school children.
 Emphasize on preventive and promotion aspect. Be a part of community health services.

HEALTH PROBLEMS OF SCHOOL CHILDREN:

These are:
 Malnutrition
 Infectious diseases
 Intestinal parasites
 Disease of skin, eye and ear
 Dental caries

COMPONENTS OF SCHOOL HEALTH PROGRAMME

 Health education
 Physical education
 Health services

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 Nutrition services
 Counselling, Psychological and social services
 Healthy school environment
 Health promotion for staff
 Family and community involvement

Health Education

Health education very important for school children. It creates awareness, makes them knowledgeable regarding health
matters o develops motivation and promotes changes in health behavior and attitude. Its main aim is helping students to
develop self- reliance and civic sense, take social responsibility and have better quality of life throughout the life span.

Health education areas includes

 personal hygiene
 environmental health nutrition
 prevention and control of communicable and non-communicable diseases
 first aid and emergency care
 home nursing
 family life and reproductive health
 prevention and control of psychosocial problems etc.
 education of handicapped children - Every child irrespective of the disability, should be encouraged to become
productive and self-supporting.

Physical Education:
Physical and recreational activities
 promote musculoskeletal development
 inculcate team spirit
 help in releasing physical and mental stress
 promotes mental health, growth and development of scholastic achievements

The school health team takes active interest and efforts to ensure that school authority organizes a regular program of
physical and recreational activities in the school.
 Walking
 Swimming
 Biking
 Jogging
 Playing
 Regular exercise

Health services:
Health Screening
 Periodical medical examination of school children, teacher, health personnel.
 Routine physical examination needs to be done.
 Clinical examination for nutritional deficiency
 Daily morning inspection by the teachers unusually flushed face, rashes, spots, signs of acute cold, coughing and
sneezing, sore throat, rigid neck, nausea, vomiting, watery eyes, headache, chills, fever, etc.
 Completeness of immunizations
 Annual individual health assessment (EENT, dental, mouth, skin, extremities, posture, nutritional status, heart and
lungs)
 Visual acuity test
 Height and weight measurement
 Rapid classroom inspection
 Appropriate referrals
 Deworming as part of the Integrated Soil Transmitted Helminthiasis Prevention and Control Program
 Maintenance and use of school health records, the schools have cumulative health records providing pertinent
information and serves as tool to evaluate the school health services.

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Nutrition Services
 Good nutrition is very essential not only for optimal health growth and development of the school child but also for
his/her educational achievement.
 A nutritious mid-day meal for children in the school is considered as a practical solution to combat malnutrition in
children.
 Nutritional education program must include parent, teachers and the child especially eating disorder, on
misconceptions surrounding about nutrition, dieting, and body composition.
 School meal should provide about one third of daily calorie requirements and half of daily protein requirement.

Counseling, Psychological, and Social Services:

1. Mental health
 The mental health of the child affects his physical health and the learning process.
 Juvenile delinquency, maladjustment and drug addiction are becoming problems among school children.
 Teachers need to plan and organize well-balanced curricular activities so that students are not over burden and
have sufficient relaxation and recreation, etc.

Healthful School Environment is essential for holistic development of school children coming from varying socio economic
and cultural backgrounds.
1. Location and site:
 away from the nuisance, traffic, dust etc.
 easily approachable
 proper drainage system.
 play grounds.
2. The building structure:
 heat proof single storied building
 Classrooms should be spacious, well ventilated and attached to verandas
 inside color of the classrooms should be white.
 Minimum space of 10sq. feet should be provided to each child
 proper trees and plantation.
3. Furnishing of classroom:
 single desk with chair along with the back rest.
 desks should be of ‘minus’ type.
 each classroom should have adequate teaching learning facilities according to the students and resources
available.
4. Sanitary and other facilities:
These facilities include:
 Water supply: There should be continuous, potable and safe water supplies from the tap or well and should be
chlorinated properly. Use of common glass for water should be avoided.
 Lavatory: There should be sanitary urinals and latrines with adequate water supply. There should be separate
arrangements for boys and girls. One urinal for 60 students and one latrine for 100 students is advocated.
 Disposal of waste water and refuse:proper system of drainage of waste water. In urban areas it should be
underground drainage system. The refuse should be collected in dust bins kept in each classroom and other
strategic areas. They should be emptied into compost pit or burnt in one of the corners away from class room
especially in the rural areas. In urban areas the refuse is collected at one place and removed to collecting areas
assigned by municipality for further processing.
 Canteen and eating facilities: own sanitary canteen facility on subsidized basis,approved vendors in the school
premises. A separate room should be there for taking mid-day meals. Facility for washing hands.
5. Health Promotion for Staff
 Periodical medical examination of school children, teacher, health personnel.
 Medical examination on entry- 4 years
 Routine physical examination needs to be done.
 Training of teachers should be equipping the teachers to observe the children under their care.
 Emergency care, management of acute and chronic health conditions the school must have an arrangement for
providing first aid and emergency care to children who get injured or sick at the school.
 The teachers should receive adequate training during teacher training program or in service training programs to
prepare themselves to carry out this obligation.
6. Family and Community Involvement
 Provides health content to families, parents and communities on a variety of topics such as sexuality, STI’s, HIV,
communicable diseases and substance abuse.
 The nurse can develop physical activity programs in the community that include both the child and the family.

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  The media can be a useful tool in assisting school nurses with health education advocacy.

SCHOOL HEALTH TEAM

 The school principal
 The school teacher
 The parents
 The community
 The children
 The medical officer
 The school health nurse/ community health nurse

ROLE OF SCHOOL NURSE

 Administrator
 Educationist
 Service provider
 Researcher
 Initiation and implementation
 Liaison activities
 Coordinator
 Evaluator
 Training and guidance
 The school health nurse/community health nurse
 The community health nurse working in school health setting is responsible for comprehensive health of the child.

School health services are offered to the students so that they can attain a healthy living including physical examination,
treatment of minor ailment and common diseases. It is the responsibility of the teachers and other sc hool staff to find out
any deviation from the normal condition and take appropriate steps in this direction.

OCCUPATIONAL SAFETY and HEALTH

Occupational safety and health (OSH), also commonly referred to as health and safety, occupational health and
safety (OHS), occupational health or occupational safety- is a multidisciplinary field concerned with the safety, health,
and welfare of people at work.

The Occupational Safety and Health Standards was formulated in 1978 in compliance with the constitutiona l mandate to
safeguard the worker’s social and economic well-being as well as his physical safety and health. Adopted through the
tested democratic machinery of tripartism, the 1978 Standards is considered as a landmark in Philippine labor and social
legislation.

Occupational Safety and Health (OSH) standards refers to a set of rules issued by DOLE which mandates the adoption
and use of appropriate practices, means, methods, operations or processes, and working conditions reasonably
necessary to ensure safe and healthful employment. (Philippines)

OSH aims at:

 The promotion and maintenance of the highest degree of physical, mental and social well-being of workers in all
occupations;
 The prevention of adverse health effects of the working conditions
 The placing and maintenance of workers in an occupational environment adapted to physical and mental needs;
 The adaptation of work to humans (and NOT the other way around). In other words, occupational health and

American Association of Occupational Health Nurses (AAOHN) is the union of public health nurse to the thrust
government for OSH gave rise to PHN subspecialty called Occupational health nursing.

The specialty practice that focusses on the promotion, prevention and restoration of health within the cont ext of a safe and
healthy environment. It includes the prevention, of adverse health effects from occupational and environmental hazards. It
provides for and delivers occupational and environmental health and safety programs and service to clients.
Occupational health nursing derived its theoretical, conceptual, and factual framework from a multidisciplinary base.

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Elements of this multidisciplinary base includes the following:
 Nursing Science
 Medical Science
 Occupational health science
 Epidemiology
 Business and economic theories, concepts, and principles
 Social and behavioral sciences
 Environmental health
 Legal and ethical issues

Occupational safety and health are a discipline with a broad scope involving three major fields:
1. Occupational Safety deals with understanding the causes of accidents at work and ways to prevent unsafe act and
unsafe conditions in any workplace. Safety at work discusses concepts on good housekeeping, proper materials
handling and storage, machine safety, electrical safety, fire prevention and control, safety inspection, and accident
investigation.
2. Occupational Health is a broad concept which explains how the different hazards and risks at work may cause an
illness and emphasizes that health programs are essential in controlling work-related and/or occupational diseases.
3. Industrial Hygiene discusses the identification, evaluation, and control of physical, chemical, biological and
ergonomic hazards.

In other words, occupational health and safety encompasses the social, mental and physical well-being of workers, that is,
the “whole person”. Successful occupational health and safety practice requires the collaboration

The way by which the occupational health team could classify occupational health concerns in workplace is to identify
 Health Hazard are the elements in the work environment that can cause work related diseases to the worker.
 Safety Hazard are the unsafe conditions or unsafe acts that significantly increase the risks of a worker to be injured.

Identified health hazard in the workplace as follows:

 Biological – infectious hazards: infectious biological agents such as bacteria, virus, fungi, or parasites transmitted via
contact with infected clients or coworkers and contaminated materials.
 Chemical hazards – various forms of chemical agents, including medications, solutions, gases, that interact with body
tissues and cells and are potentially toxic or irritating to body system
 Enviromechanical hazards – factors encountered in work environments that cause accidents, injuries, strain, or
discomfort (e.g., poor equipment, or lifting device, and slippery floors)
 Physical hazards – agents within work environments such as radiation, electricity, temperatures and noise that can
cause tissue trauma through transfer of energy from these sources.
 Psychosocial hazards - factors and situations encountered or associated with the job or work environment that create
stress, emotional strain, or interpersonal problems.

The key strategy principles of international and national occupational health and safety policies are:
 Avoidance of hazards (primary prevention)
 Safe technology
 Optimization of working conditions
 Integration of production and health and safety activities
 Government’s responsibility, authority and competence in the development and control of working conditions
 Primary responsibility of the employer and entrepreneur for health and safety at the workplace
 Recognition of employees’ own interest in occupational health and safety
 Cooperation and collaboration on an equal basis by employers and workers
 Right to participate in decisions concerning one’s own work
 Right to know and principle of transparency
 Continuous follow-up and development of occupational health and safety.

10 Easy Workplace Safety Tips

1. Train employees well. - Comprehensive training is a must for preventing workplace injury. Make sure that all of your
employees have access to – and complete – all safety training for their positions.
2. Reward employees for safe behavior. - Rewards are an easy way to encourage workplace safety. Giving out small
rewards to employees who follow safety policies keeps them engaged, which can make a big difference in reducing
workplace injuries.

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3. Partner with occupational clinicians. - As mentioned above, occupational medicine clinicians can provide valuable
insight into workplace injury and prevention. These clinicians can help you prevent work injuries by visiting your
worksite and identifying areas where there’s a high risk for employee injury. Physical and occupational therapists can
also improve work place ergonomics and develop human performance evaluations to help you screen candidates for
physically demanding roles and aid in the return-to-work process.
4. Use labels and signs. Labels and signs are a cheap and effective way to quickly communic ate important information.
They’re usually simple and rely on pictures to detail hazards and proper procedures. These tools are good reminders
and warnings for even the most experienced worker.
5. Keep things clean --messy workplace can lead to unnecessary accidents. Make sure boxes are stacked safely and
spills are cleaned up quickly. Conduct regular inspections to check for potential dangers such as tangled cords,
messy floors, and disorganized tools. Programs like 5S often provide beneficial improvements in organization that can
lead to reduced clutter.
6. Make sure employees have the right tools and have regular equipment inspections. - The right tools and equipment
create a better product and a safer work environment. It’s also important that all equipment is cleaned, serviced, and
inspected regularly. Machine malfunctions are one of the most dangerous workplace hazards.
7. Encourage stretch breaks. - Stretch breaks are an easy way to improve workplace ergonomics and employee health.
Taking even five minutes to stretch can ease muscle tension and loosen joints, reducing the potential for repetitive
motion injuries. Active movements have been shown to be more effective than passive stretching alone.
8. Implement safety protocols from the start. - Workplace safety starts from day one, which means hiring qualified people
who pay attention to detail. A safe workplace starts with employees who follow safety requirements and perform their
jobs per the established procedures. Some employers work with physical therapists to analyze the physical demands
of each job role. The findings are used to create functional job analyses and post-offer pre-placement functional
testing.
9. Keep an open dialogue. - Make it easy for your employees to come to you with health and safety concerns. They can
report hazards right away and identify potential areas of concern you may not have noticed. Appoint or nominate a
safety captain who is empowered to communicate concerns identified by employees to leadership on a consistent
basis.
10. Have regular meetings on workplace safety. - It never hurts to be over-prepared. Regular meetings to review safety
rules and discuss prevention keep workplace safety top of mind so that when something does happen, everyone
knows what to do right away.

As an employer, it’s your responsibility to protect your employees and provide a safe workplace. Use these ten tips to get
started, and partner with Concentra® to help make your workplace safe, healthy, and productive.

The job duties of an occupational health nurse may include:

 Developing and implementing health and safety programs
 Developing disease prevention programs, such as smoking cessation, exercise, and healthy eating programs
 Documenting all employee injuries and illnesses within the workplace
 Observing and assessing the work environment for potential dangers and hazards
 Treating injuries and illnesses for employees, including follow-ups and referrals
 Overseeing and implementing emergency and disaster preparedness programs and planning
 Serving as a gatekeeper for healthcare services, including rehabilitation and disability matters
 Counseling employees on physical and mental health issues and guiding them toward community resources and/or
employee assistance programs
 Monitoring the health status of employees
 Conducting research on the effects of hazardous work conditions or workplace exposures, which may include
gathering data and reporting findings to the employer

CHECK FOR UNDERSTANDING (20 minutes)

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to correct
answer and another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed.
You are given 20 minutes for this activity:

Multiple Choice

1. When presenting student health assessment data in a professional meeting or published document, the school nurse is
ethically bound to ensure that:
A. students whose assessment results have been presented are described using only their defining characteristics.
B. individual students cannot be identified on the basis of any of the data presented.

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C. the data is distributed before publication to the families of the students whose assessment results have been used.
D. data are presented as individual results rather than as aggregate data or data in summary form
ANSWER: ________
RATIO:__________________________________________________________________________________________
_________________________________________________________________________________________ ________
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2. According to state guidelines related to responsibilities of school health program staff, which of the following functions is
most appropriate for a school nurse to assign to a health services clerk?
A. assessing the nutritional needs of the overall student population in the school
B. overseeing medical treatment regimens that are self-administered by student
C. carrying out developmental screening tests that involve observation and interviewing
D. collecting, maintaining, and updating emergency information for all students
ANSWER: ________
RATIO:__________________________________________________________________________________________
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3. At the beginning of the school year, in addition to developing a diabetic management plan for the student, it is most
important for the school nurse to:
A. confer with the student, his family, and his health-care provider regarding interventions for blood sugar fluctuations.
B. review with the student and his family current recommended nursing interventions for treating and monitoring episodes
of diabetic ketoacidosis.
C. ensure that the student's family understands the etiology of diabetes as a pancreatic cell abnormality that is initiated by
a viral or autoimmune disorder.
D. discuss the pathology and physiology of diabetes and what the future might hold for the student in relation to the
disease.
ANSWER: ________
RATIO:__________________________________________________________________________________________
_______________________________________________________________________________________ __________
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4. The school nurse would like to collaborate with the student's middle school teachers in managing his health-care
needs. Which of the following strategies is the most appropriate way of involving teachers in a health care plan for this
student?
A. suggesting to teachers that they buy and store healthful snacks in the classroom in case of an acidosis or
hypoglycemic reaction
B. increasing teachers' understanding of diabetes, signs of early insulin reaction, and what to do if symptoms appear
C. asking teachers to designate a private corner or place in the classroom where the student can test and record his blood
levels
D. developing a protocol and training course for teacher administration of medication in emergencies
ANSWER: ________
RATIO:__________________________________________________________________________________________
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5. The school nurse checks the emergency care plan on file that outlines steps to take if the student exhibits signs of
hypoglycemia. According to current standards of school nursing practice, which of the following actions is most
appropriate to take first in response to a hypoglycemic reaction in a conscious student?
A. administering warm clear fluids or diet soda in sips
B. administering a quickly digestible protein source and monitoring the student for 15 minutes
C. administering insulin according to the dose specified in the student's insulin schedule
D. administering glucose tabs or a fast-acting carbohydrate such as juice, cake gel, or candy
ANSWER: ________
RATIO:__________________________________________________________________________________________
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6. The home health nurse visits the home of a client diagnosed with moderate-stage Alzheimer’s disease. The patient is
pleasantly confused and lives with his son-in-law and daughter. Which of the following observations, if made by the nurse,
is MOST concerning?
A. The rugs are secured safely to the floor.
B. The stovetops do not turn on without activation of a hidden switch in the nearby drawer.
C. There are extension cords on the floors behind furniture.
D. The door has a lock with a bolt.
ANSWER: ________
RATIO:__________________________________________________________________________________________
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7. The company nurse is caring for a patient who had an attack of vertigo while working inside the company. The nurse
knows that the most important consideration in regard for patient safety is to:
A. Offer the patient alternative meal choices from the cafeteria.
B. Ask the nursing assistant to walk with the patient when she needs to use the bathroom.
C. Raise the side rails on the patient’s bed.
D. Remind the patient to wash her hands frequently, especially after voiding or before meal times.
ANSWER: ________
RATIO:__________________________________________________________________________________________
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8. The occupational nurse is correctly implementing the prescribed transmission-based precaution when she does
throat/mouth swab to every company worker. Which of the following is the correct method?
A. The nurse placed a supply of clean masks in the child’s room.
B. The nurse sends specimens to the laboratory in a zip-closure biohazard bag.
C. The nurse assigned the child in a semi-private room.
D. The nurse wipes the thermometer with alcohol every after use.
ANSWER: ________
RATIO:__________________________________________________________________________________________
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9. A nurse working in an occupational health setting will most likely work as a nurse
A. Guardian
B. Clinician/Practitioner
C. Public health nurse
D. Physical therapist
ANSWER: ________
RATIO:__________________________________________________________________________________________
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10. Which is the best method an occupational health nurse can use when assessing workplace hazards?
A. Stay in the clinic
B. Wait for the worker to approach the nurse
C. Walk through the work site
D. Work with the workers
ANSWER: ________
RATIO:__________________________________________________________________________________________
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RATIONALIZATION ACTIVITY (THIS WILL BE DONE DURING THE FACE-TO-FACE INTERACTION)
The instructor will now rationalize the answers to the students. You can now ask questions and debate among yourselves.
Write the correct answer and correct/additional ratio in the space provided.

1. ANSWER: ________
RATIO:_______________________________________________________________________________________
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2. ANSWER: ________
RATIO:_______________________________________________________________________________________
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3. ANSWER: ________
RATIO:_______________________________________________________________________________________
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4. ANSWER: ________
RATIO:_______________________________________________________________________________________
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5. ANSWER: ________
RATIO:_______________________________________________________________________________________
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6. ANSWER: ________
RATIO:_______________________________________________________________________________________
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7. ANSWER: ________
RATIO:_______________________________________________________________________________________
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8. ANSWER: ________
RATIO:_______________________________________________________________________________________
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9. ANSWER: ________
RATIO:_______________________________________________________________________________________
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10. ANSWER: ________

RATIO:_______________________________________________________________________________________
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LESSON WRAP-UP (5 minutes)

You will now mark (encircle) the session you have finished today in the tracker below. This is simply a visual to help you
track how much work you have accomplished and how much work there is left to do.

You are done with the session! Let’s track your progress.

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AL Activity: Minute Paper:

1) What was the most useful or the most meaningful thing you have learned this session?
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_________________________________________________________________________________________________
2) What question(s) do you have as we end this session?
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