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 highest
degree of physical, mental and social well-being of workers in all
occupations, (Harrington & Gill,1992)
It is concerned with two-way relationship of WORK and HEALTH
it is also related 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
1. Prevention of occupational injuries
2. Prevention of occupational illness
3. Reducing work place hazards
4. Promotion of worker’s health
5. 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 are used are, vanish, pinace, cement, lime,
paraffin 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 personal 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 switch 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 health education on personal protective equipments
·We managed to advocate 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.
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
