© 1995 Public Health Institute (formerly the California Public Health Foundation)
The NURSE (Nurses Using Rural Sentinel
Events) project is conducted by the California Occupational Health Program of the
California Department of Health Services, in conjunction with the National Institute for
Occupational Safety and Health. The program's goal is to prevent occupational injuries
associated with agriculture. Injuries are reported by hospitals, emergency medical
services, clinics, medical examiners, and coroners. Selected cases are followed up by
conducting interviews of injured workers, co-workers, employers, and others involved in
the incident. An on-site safety investigation is also conducted. These investigations
provide detailed information on the worker, the work environment, and the potential risk
factors resulting in the injury. Each investigation concludes with specific
recommendations designed to prevent injuries, for the use of employers, workers, and
others concerned about health and safety in agriculture.
El proyecto NURSE
El proyecto NURSE--Enfermaras Usando Eventos Rurales Centinelas--se lleva a cabo por el Programa de Salud Ocupacional de California del Departamento de Salud en cooperación con el Instituto Nacional para Salud y Seguridad Ocupacional. La meta del programa es prevenir lastimaduras ocupacionales asociadas con la agricultura. Los hospitales, servicios de emergencia, clínicas y personal forense son los que reportan las lastimaduras. Se investigan casos seleccionados para lo cual se hace una entrevista del trabajador lastimado, compañeros de trabajo, patrones y todo aquel envuelto en el incidente. También se visita el lugar de los hechos para hacer una investigación sobre la seguridad. Estas investigaciones proveen información detallada sobre el trabajador, el ambiente del trabajo y los factores de riesgo potencial que resultaron en la lastimadura. Cada investigación concluye con recomendaciones específicas diseñadas para prevenir lastimaduras; y para el uso de trabajadores, patrones y todo aquel interesado en la salud y seguridad en al agricultura.
NURSES USING RURAL SENTINEL EVENTS (NURSE)
The Occupational Health Branch (OHB) has developed a model program for active surveillance linked with work-site specific and community-based prevention of occupational injuries occurring in the agricultural workers. The model links the reporting of fatal and severe injuries in the agricultural work place to investigations identifying potential risk factors, making recommendations for injury prevention, and facilitating on-site prevention programs, which integrate safety training, health promotion and education, and practical engineering solutions. Nurses are based in Fresno and Monterey counties which are major agricultural counties in California. Nurses facilitate reporting, coordinate investigations, and conduct work place specific and broad-based education and training programs. The ultimate goal of the project is to prevent work-related injuries to agricultural workers and others exposes to hazards associated with agriculture.
The basic approach used was to identify, select, and recruit the key emergency medical care providers, including emergency departments in hospitals and emergency medical services in each county to report injuries related to agriculture. Injured workers, co-workers, and employers are confidentially contacted and interviewed by nurses and other project staff. Nurses arrange work place visits, conduct work place investigations in conjunction with other safety and health professionals, and coordinate work place safety programs in collaboration with county agencies and health departments. Work place specific recommendations for preventive interventions are developed and disseminated. Demographic, health and risk factor exposure data are maintained in an automated database which is used for case management, descriptive epidemiology, statistical analyses, and report generation.
Nurses maintain ongoing contact with reporters in the surveillance system to give feedback on reporting and case follow-up. As part of an evaluation component, follow-up to employers is conducted to determine whether recommendations have been implemented, or to document barriers for implementation. Outreach is also conducted to medical, agribusiness, labor, governmental and community service organizations in each county and state-wide coalitions as well as other groups involved in agricultural safety.
Activities in year five will expand upon progress made in previous years and concentrate on disseminating information obtained through the surveillance system and investigations by submitting articles to peer reviewed journals, and conducting more community-based health promotion.