U.S. registered nurses have a safer work environment than they did a decade ago, but more can be done to reduce hazards, according to a new American Nurses Association (ANA) survey.

According to the U.S. Bureau of Labor Statistics, nursing ranks fifth of all occupations in work days missed due to occupational injuries and illnesses. ANA’s 2011 Health and Safety Survey survey shows 80 percent of nurses with neck, back or shoulder pain caused by the job frequently work despite pain, with 13 percent reporting on-the-job injuries more than three times within a year, compared to 7 percent in 2001.

The survey, which drew responses from 4,614 RNs, reveals the same top three work environment concerns as in a similar 2001 ANA survey: the acute or chronic effects of stress and overwork (74 percent of respondents); disabling musculoskeletal injury (62 percent); and risk of contracting an infectious disease (43 percent).

"Creating a healthier, safer workplace is crucial to building and maintaining an adequate nursing workforce, which has suffered from recurring shortages," according to a statement by the ANA. The group points to several recent studies indicating that stressful working conditions leading to burnout, heavy physical demands and difficult work schedules all influences nurses’ decisions to leave direct-care nursing.

The survey found that for six out of ten nurses, health and safety concerns influence the decision to continue practicing in the nursing field.

“Health care employers must ensure a safe and healthy work environment if they wish to recruit and retain nurses, who are key to the delivery of high-quality patient care,” said ANA President Karen A. Daley, PhD, MPH, RN, FAAN. “No one should have to go to work and worry that they are putting their health in jeopardy given what we know about prevention strategies.”

Nearly two-thirds of nurses say they have ready access to patient lifting and transfer devices, compared to less than half in 2001. ANA’s Handle With Care® campaign seeks to eliminate manual patient handling to prevent injuries and musculoskeletal disorders. But even though the devices are more available, less than one-third of nurses say they use them frequently, suggesting that selection and placement of patient lift and transfer devices need to be evaluated. Increased education and changes in workplace culture may also help increase safety.

Health care employers are more accountable in providing safe needle devices, with 96 percent of RN respondents saying they are available, compared to 82 percent in 2001. But the survey shows that RNs may benefit from a better understanding of their rights under the Needlestick Safety and Prevention Act (2000), which requires that direct-care professionals participate in identifying and selecting safer needle devices: 62 percent either don’t know if nurses are involved in the selection process, or say they aren’t involved.

Though concerns about on-the-job physical assault have increased since 2001 (25 percent to 34 percent), the percentage of RNs who say they were assaulted decreased from 17 percent to 11 percent. The majority of nurses still say they have been verbally abused or threatened on the job within a year, though the occurrence decreased since 2001 (57 percent to 52 percent).