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As Senior Risk Control Specialist for PMA Companies, Christine Zichello draws from her extensive nursing experience to help clients better protect healthcare workers from occupational hazards and injuries. In this interview, Zichello provides her views on occupational safety among healthcare workers and explains how they can best make use of risk management to protect themselves from injury.

Please provide a brief description of your professional background and of your role as Senior Risk Control Specialist for PMA Companies.

I have 15 years of experience in critical care and emergency department (ED) nursing. I grew concerned with seeing so many worker injuries and decided to switch to occupational health nursing, which focuses on prevention of injuries, accidents and, where possible, elimination of work-related environmental hazards among healthcare workers.

In my role as a Senior Risk Control Specialist, my major area of responsibility includes assessing clients’ knowledge in relation to employee work-related hazards and potential exposures, advising clients on exposures, risk reduction and measures available to protect employee health and safety and assisting in the implementation of occupational and environmental health and safety education and training.

You have extensive nursing experience. What events in your career made you decide to get involved in the occupational safety of healthcare workers?

I saw work-related injuries that could have been prevented. The approach to treating an injured employee is a sport-medicine model. We want appropriate aggressive treatment so that the employee is back in the workplace as soon as possible with the best long-term outcomes. I saw a need to change the culture of the environment by preventing injuries and illnesses among employees, promoting health, safety and wellness in the workplace and establishing an environment with safety as a top priority.

What are the greatest safety hazards facing healthcare workers today? How have these hazards changed over the years?

Healthcare employees face a wide range of hazards on the job, including needlestick injuries, back injuries, violence and stress. Although it is possible to prevent or reduce healthcare employee exposure to these hazards, healthcare workers actually experience increased numbers of occupational injuries and illnesses. It is imperative to function within the realm of a team to identify hazards, develop a program to prevent employee injuries and establish controls.

The emergence of unknown hazards and diseases, such as working with bariatric patients and newly identified diseases, is also a challenge.

What services does PMA Companies offer to protect healthcare workers?

Our greatest strength is our risk control department’s ability to partner with organizations to make necessary safety improvements in their processes. Our consultants have the experience and knowledge to identify specific areas of risk within a healthcare organization, analyze the trends and work with the organization to develop a plan of action to address the key loss drivers. Our healthcare team is comprised of consultants with years of experience not only in nursing, but in healthcare safety. This is a major asset. This team is able to develop educational material not only internally, but for clients. Healthcare-specific web events are also held quarterly.

What do you believe is the most challenging aspect of managing risk in the healthcare field?

Changing the mindset and eliminating old beliefs. We still hear from management and administration that an injured employee cannot return to work until “they are 100%.” They say, “We cannot take the person back unless s/he can lift.” Employees are hired for their knowledge, skills and education, and in the current healthcare environment, equipment should be used to lift patients. We must instill in the management team that employees are their greatest asset, and we must take necessary precautions to minimize their job-related injuries. We must look at the total job and not isolate down to one aspect of it. A nursing assistant has many skills to offer a healthcare organization other than lifting of patient/residents. If an assistant is injured, how can that person return to work? What can that person do? This not only promotes the healing process, but offers better outcomes, and the employee remains productive.

How can healthcare workers best make use of risk management to protect themselves from injury? Of what should they be aware? What kinds of questions should they ask?

Healthcare organizations must look at losses, do trending and drill down to determine their key loss drivers. This can be done in partnership with their risk control consultant and by analyzing loss runs. Nursing is the largest department in healthcare, but we must evaluate other departments like radiology, housekeeping and dietary to determine what their exposures are and develop a plan to address those exposures. Risk management must be all-inclusive for all departments and employees. This includes off-shifts and input and involvement from all levels.

Healthcare organizations may want to ask how risk management/insurance companies can assist in developing a comprehensive safety plan. We can provide guidance, but the organization must establish a plan that is unique to their environment so it becomes “their” program.

What do you consider your greatest professional accomplishment, and what are your future ambitions?

I have worked for some phenomenal managers who promoted and mentored me. With their encouragement, I have obtained my certifications. My future ambition is to promote occupational health nursing. Most hospitals have an employee health nurse, but I do not see employee health nurses in manufacturing or other organizations. We must promote the knowledge and abilities of occupational health nurses through certification.

What is your personal outlook for occupational safety among healthcare workers? What new measures are insurance companies and SH&E professionals taking to help reduce injuries and accidents among healthcare workers?

We must consider healthcare employees our greatest asset and put as much emphasis on their safety as we do on patient and resident safety. I would like to further promote wellness. We must have healthy and well employees—a correlation exists between fitness and lower accident rates. Promotion of wellness within the work environment will be a key factor.


Christine Zichello, COHN-S, CSHM, ARM, FAAOHN is Senior Risk Control Specialist for PMA Companies. She has 15 years of experience in critical care and ED nursing and has held various leadership positions within the Tri-County New Jersey Association of Occupational Health Nurses and the American Association of Occupational Health Nurses (AAOHN). Her articles have appeared in previous issues of HealthBeat and in AAOHN publications, and she volunteers regularly for the Caregivers Coalition of Morris County, Kinnelon Health Department and Health Promotion Advocates.

Zichello holds a bachelor of science degree in allied health/management from Montclair State College.