RISK MANAGEMENT PRACTICES AND WORKERS SAFETY IN UNIVERSITY OF MEDICAL SCIENCES TEACHING HOSPITAL, ONDO STATE NIGERIA

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INTRODUCTION
Every employee has a right to a healthy and safe working environment. In the healthcare sector, the well-being of health providers is crucial to the continuous delivery of health care. Healthcare workers are prone to risks due to the nature of their job. Due to a lack of proper risk management, healthcare workers have become victims of limited safety resources, poor maintenance, low safety awareness, and other factors (Nwachukwu et al., 2020). These elements may have contributed to the high staff injury rate, fatalities, and near-misses.
Healthcare personnel are exposed to dangers such as radiation from ions, stress, injury, pathogenic substances, and toxins due to work-related activities. (Innocent et al., 2022). Complications, high morbidity rates, medical errors, and other problems are typical in healthcare organizations, particularly in Africa. However, risk management is a relatively new concept in Africa for healthcare organizations as opposed to developed countries. (Abor & Abor, 2021).
Risk management refers to identifying, regulating, and reducing the impact of uncertain events (Spross et al., 2017).
It is the recognition, evaluation, and ranking of risks, supported by the organized, systematic allocation of resources to minimize, track, and mitigate the probability and effect of undesirable events or to maximize the comprehension of opportunities. (Frempong et al., 2019).
Risk management can also be explained in healthcare as the medical and organizational processes used to assess, recognize, and lower the risk of harm to patients, hospital personnel, and third parties and the risk of losses to the organization. (Abor & Abor, 2021). Often referred to as clinical risk management (CRM), it entails the tools, frameworks, procedures, and practices to recognize, evaluate, avoid, keep track of, and manage healthcare risks. Risk management aims to protect patients, hospital workers, and guests from unwanted injury. (Abor & Abor, 2021;Gbadago et al., 2017).
Nurses playKeywords a crucial role in risk management by developing and implementing safety standards to protect patients and healthcare workers. Risk management is essential in the healthcare sector, and adhering to international risk management standards, such as ISO 31000, involves several critical stages, including risk identification, analysis, evaluation, treatment, and review, which require consultation and communication (Tasneem et al., 2018;Spross et al., 2017).
Risk management (R.M.) in health care refers to a system that is made up of multiple procedures that are used to estimate, assess, and prevent risk to lessen the likelihood of unfavourable effects being had on a variety of factors, including technical and economic aspects (Alessandro et al., 2018). Wu et al. (2015) opined that the likelihood of errors and adverse outcomes in healthcare systems could not be eliminated or reduced by implementing a recursive non-stop development process such as the Plan Inspires, Do, Check, and Act (PDCA) model. Risk analysis employs inherent and residual approaches, considering the probability and impact of risks. The risk manager identifies and analyses potential risk responses, such as evading, adopting, minimizing, and transferring risks, following the company's tolerance for risk. Based on the risk rankings, decision-makers can choose which hazards to manage. (Abor & Abor, 2021;Strametz, 2017). To address enterprise risk management (ERM), the focus of risk management in healthcare is shifting from a primarily reactive to a proactive strategy through the use of predictive modelling and risk classification (Park and Sharp, 2019). The risk management system includes a structure for reporting events for recognizing, reporting, tracking, and trending event patterns that may result in unfavourable patient outcomes or harm the organization's people, assets, or property. (Abor & Abor, 2021). Regular training and orientation on safety, and employee involvement, along with a formal documented risk reporting and management tools system, are crucial for healthcare risk management. This outlines how risks are handled and responses, response times, the chain of command, and records of relevant activities (Abor & Bonsu, 2020;Kaya et al., 2016).
A successful risk management program has various benefits, including ensuring compliance with safety standards, identifying deficiencies before an adverse event, minimizing loss after an incident, and enhancing safety to improve patient outcomes and reduce adverse event frequency, type, and severity (Abor & Abor, 2021) Alessandro et al. (2018 identified education and training as crucial risk management practices in healthcare, while Pascarella et al. (2021) emphasized the significance of a systematic risk management framework, including the use of a risk matrix, in healthcare organizations. Ferdosi et al. (2020) recommended that healthcare organizations utilize an array of risk management techniques and tools that are adapted to their specific requirements. However, there is a dearth of research on the impact of risk management on workers' safety in Nigerian healthcare organizations.
Therefore, this study aims to appraise the impact of risk management on workers' safety in Teaching Hospital, Ondo State, Nigeria, by assessing risk management practices, the influence of risk management on workers' safety, and the challenges associated with effective risk management implementation.

RESEARCH METHODOLOGY
This study employs a qualitative research approach to gather numerical data that can be statistically tested to support or refute alternate knowledge. The research is conducted at the University of Medical Sciences Teaching Hospital (UNIMEDTH), Akure, Ondo State, which is the sole teaching hospital in the state providing healthcare services to the residents and medical training to students at the University of Medical Sciences, Ondo. The study employed a Clustered sampling technique with a population of 124 health workers, including 35 Doctors, 46 Nurses, 33 Laboratory Scientists, and 10 Health Assistants. The study population focused on three departments: The accident and emergency unit, surgical ward, and medical laboratory of the teaching hospital Akure A structured questionnaire was administered to the respondents to collect data related to risk management practices. The reliability analysis was done using a qualitative approach, as the questionnaires were sourced from relevant literature and later modified via health practitioners. Descriptive statistics such as percentage, frequency, and mean, as well as inferential statistics such as correlation and regression analysis, were used to analyze the data. The Statistical Package for the Social Sciences (SPSS) software package v.25 was used for the data analysis. Total 124 100 Table 1 shows that the teaching hospital's workforce in the three departments where there is a high prevalence of risk has a fair distribution of gender equality, as evidenced by the fact that 52.4% of the workforce is male and 47.6% is female. The workforce analysis also revealed that the hospital workforce is dominated by youth, as about 41.9% of employees are between the ages of 39 and 40, 26.6% are between the ages of 21 and 29, 21.8% are under 20, and 9.7% are aged 40 years and above which will improve productivity. According to the study, 28.2% of the staff are doctors, 37.1% are nurses, 24.2% are laboratory workers, 6.5% are medical assistants, and the remaining 6.5% are Adhoc staff indicating that the workforce is medically inclined and capable of performing their duties. The year of experience shows that more than 45% of the workforce have been in the three departments where risks are prevalent for more than six years and 35.5% have between 1 -5 years of experience. This shows that the personnel have a good grasp of risk management from their experience with different scenarios.

Communication Risk Prevention Procedures Measures used for handling Risk Occurences Provision of Personal Protective Equipment Staff Training
The result indicated that the risk management strategy primarily utilized is incident reporting, with a mean value of 3.68, as respondents revealed consistency and adequacy in incident reporting. There is also effective risk communication, which is clear, accessible, and straightforward, with a mean value of 3.67. The use of risk prevention procedures ranked third with a mean value of 3.66. This indicates that employees take personal care of their health in their respective units and are also mindful of surfaces and contacts that can expose them to risk. safety. Analysis of Variance showed an F-value of 56.145 and a p-value of 0.000, which infers that risk management plays a significant role in the safety of workers.

CONCLUSION AND RECOMMENDATION
The study examined risk management practices and workers' safety in a healthcare facility in Ondo State, Nigeria.
Consequently, the study concluded that risk management practices significantly affect the safety of employees and patients at the University of Medical Sciences Teaching Hospital, Akure, Ondo state. It revealed that most respondents know about risk management and the occupation risk associated with the health sector, also showed that a risk management strategy is being carried out at the University of Medical Sciences Teaching Hospital, Ondo state, as indicated by high incidence reporting and frequency of safety training for employees.
The study revealed that risks are not proactively identified and prioritized, and risk managers employed are not committed to following risk management procedures in Ondo State Teaching Hospital. It also revealed that incident reporting and communication strategies are implemented but not a channel to the suitable sources, causing a delay in risk response and making the risk management procedure ineffective. The study recommended that a well-designed policy in risk management that details risk analysis procedures and reporting should be made and monitored for compliance. Additionally, systematic training for employees should be conducted regularly to promote health, safety, and environmental responsibility and awareness among all employees, to prevent exposure to risk or accidents, and acquire the skills and information required for healthy and safe working conditions.

SUGGESTION FOR FURTHER RESEARCH
Further Studies should look at developing an effective risk management system in a teaching hospital since there has not been an acceptable formulated framework of risk management for teaching hospitals in Nigeria. Further research can also be conducted to determine the effect of risk management practices on the quality of patient-centered care in hospitals.