OCCUPATIONAL
HEALTH NURSES
AND RESPIRATORY
PROTECTION
IMPROVING EDUCATION AND TRAINING
LETTER REPORT
Committee on the Respiratory Protection Curriculum for
Occupational Health Nursing Programs
Board on Health Sciences Policy
Linda Hawes Clever, M. E. Bonnie Rogers,
Andrea M. Schultz, and Catharyn T. Liverman, Editors
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
THE NATIONAL ACADEMIES PRESS
Washington, D.C.
THE NATIONAL ACADEMIES PRESS • 500 Fifth Street, N.W. • Washington, DC 20001
NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.
This study was requested by the National Institute for Occupational Safety and Health of the Centers for Disease Control and Prevention and supported by Award No. 200-2011-38580, T.O. #1, between the National Academy of Sciences and the Centers for Disease Control and Prevention. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.
International Standard Book Number-13: 978-0-309-21548-0
International Standard Book Number-10: 0-309-21548-X
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Copyright 2011 by the National Academy of Sciences. All rights reserved.
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Suggested citation: IOM (Institute of Medicine). 2011. Occupational health nurses and respiratory protection: Improving education and training: Letter report. Washington, DC: The National Academies Press.
“Knowing is not enough; we must apply.
Willing is not enough; we must do.”
—Goethe
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
Advising the Nation. Improving Health.
THE NATIONAL ACADEMIES
Advisers to the Nation on Science, Engineering, and Medicine
The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.
The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Charles M. Vest is president of the National Academy of Engineering.
The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.
The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council.
COMMITTEE ON THE RESPIRATORY PROTECTION CURRICULUM FOR OCCUPATIONAL HEALTH NURSING PROGRAMS
LINDA HAWES CLEVER (Co-Chair), California Pacific Medical Center, University of California, San Francisco
M. E. BONNIE ROGERS (Co-Chair), Occupational Safety and Health Education and Research Center, University of North Carolina at Chapel Hill
EDIE ALFANO-SOBSEY, Wake County Human Services, Raleigh, North Carolina
BARBARA DEBAUN, Cynosure Healthcare Consultants, San Francisco, California
OISAENG HONG, Occupational and Environmental Health Nursing Program, University of California, San Francisco
LESLIE M. ISRAEL, Department of Medicine, University of California, Irvine
JAMES S. JOHNSON, JSJ and Associates, Pleasanton, California
HERNANDO R. PEREZ, Drexel University School of Public Health, Philadelphia, Pennsylvania
PATRICIA QUINLAN, School of Medicine, University of California, San Francisco
Study Staff
CATHARYN T. LIVERMAN, Study Co-Director
ANDREA M. SCHULTZ, Study Co-Director
LARISA M. STRAWBRIDGE, Research Associate
JUDITH L. ESTEP, Program Associate
ANDREW M. POPE, Director, Board on Health Sciences Policy
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Reviewers
This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report:
Felicia Bayer, Alcoa, Inc.
Lisa M. Brosseau, University of Minnesota School of Public Health
Kathleen Buckheit, North Carolina Occupational Safety and Health Education and Research Center, University of North Carolina at Chapel Hill
Howard J. Cohen, Independent Consultant
Karen Coyne, U.S. Department of the Army
Sue L. Davis, College of Nursing and Health, University of Cincinnati
Joanna Gaitens, University of Maryland School of Medicine
Elaine L. Larson, Columbia University School of Nursing
Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations, nor did they see the final draft of the report before its release. The review of this report was overseen by Ada Sue Hinshaw, Graduate School of Nursing, Uniformed Services
University of the Health Sciences. Appointed by the Institute of Medicine, she was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.
Contents
Overview of Occupational Health Nursing
RESPIRATORY PROTECTION ROLES AND RESPONSIBILITIES
Assessing the Respiratory Protection Roles and Responsibilities of OHNs
Responsibility to Ensure Safety
RESPIRATORY PROTECTION EDUCATION AND TRAINING
Graduate-Level Curricula and Training
Continuing Education and Training
Challenges to Improving Respiratory Protection Education and Training
Essential Content of Respiratory Protection Education and Training for OHNs
Teaching Methods and Resources for Respiratory Protection Education and Training
AAOHN |
American Association of Occupational Health Nurses |
ABOHN |
American Board for Occupational Health Nurses |
ADN |
associate degree in nursing |
AIHA |
American Industrial Hygiene Association |
ANA |
American Nurses Association |
ANSI |
American National Standards Institute |
APIC |
Association for Professionals in Infection Control and Epidemiology |
BSN |
baccalaureate of science in nursing |
CDC |
Centers for Disease Control and Prevention |
CFR |
Code of Federal Regulations |
CM |
case management |
COHN |
certified occupational health nurse |
COHN–S |
certified occupational health nurse–specialist |
ERC |
Education and Research Center for Occupational Safety and Health (NIOSH) |
HRSA |
Health Resources and Services Administration |
ICOH |
International Commission on Occupational Health |
IH |
industrial hygiene |
IOM |
Institute of Medicine |
LLNL |
Lawrence Livermore National Laboratory |
NFPA |
National Fire Protection Association |
NIOSH |
National Institute for Occupational Safety and Health |
NPPTL |
National Personal Protective Technology Laboratory |
NSSRN |
National Sample Survey of Registered Nurses |
OHN |
occupational health nurse |
OSHA |
Occupational Safety and Health Administration |
PHRST |
Public Health Regional Surveillance Team |
PPE |
personal protective equipment |
RN |
registered nurse |
SM |
safety management |
UCLA |
University of California, Los Angeles |
UCSF |
University of California, San Francisco |