Regulations, Legislation and Guidelines
The Occupational Safety and Health Administration (OSHA) continues to cite and fine employers for occupational musculoskeletal hazards under their “General Duty Clause” that requires employers to provide workers with a workplace that is “free from recognized hazards.” OSHA has classified overexertion injuries from lifting people as workplace hazards. OSHA explicitly recommends the use of assistive technology and notes that enforcement can be applied in healthcare settings wherever patient handling occurs. OSHA has a full web page on Safe Patient Handling.
The National Institute for Occupational Safety and Health (NIOSH) provides guidelines for safe lifting and movement of patients as well as safe patient handling training.
The Joint Commission addresses ergonomic hazards related to patient handling with expectations that healthcare organizations will address these hazards by utilizing patient lift equipment and lateral transfer devices in compliance with its Environment of Care standard and by incorporating recognized best practices in their facilities. Also, surveyors may review OSHA Injury and Illness records and then ask about preventative measures taken for the most frequent and/or costly types of injury, many of which are musculoskeletal disorders.
The United Kingdom, Australia, and Canada have instituted national “no lift” policies that banned manual patient handling techniques instead of mandating the use of assistive devices to move and lift patients. Although there is no federal legislation in the U.S, many states have already passed legislation to address this issue. For example, California legislation enacted in October 2011, (AB 1136) requires employers to adopt a patient protection and health care worker back and musculoskeletal injury prevention plan, including a safe patient handling policy, trained lift teams and the use of lift devices.