Many employers have initiated successful safe patient handling programs. The following examples provide a brief description of successful programs in various healthcare settings.
- San Francisco General Hospital, California This 275 bed acute care hospital was experiencing many back injuries and high employee turnover due to lifting and moving of patients. A new policy was implemented to reduce the risk of injuries during lifting. A specially trained “lifting team” performed almost all lifting or moving of patients on the day shift. The policy of the lifting team was to use mechanical lifting devices for all total body transfers.In the first year of implementation, lost-time back injuries dropped from 16 to 1 and lost work days dropped from 215 to 6. By the second year, the nursing staff did not have one single back injury during the lifting team’s shift. In the following six years, workers’ compensation costs dropped approximately 90 percent.
- Citizens Memorial Healthcare, Missouri This is an intermediate care facility with 1,500 employees. This employer was looking to reduce the number and severity of work-related injuries and focused on improving their ergonomics at the facility. Each job within the company was evaluated for ergonomic risk factors and employees received training in body mechanics and injury avoidance. Assistive devices are available for lifting and transferring patients/residents, and stationery workstations are individualized. Employee involvement is a key element of the program.The company’s subsequent injury incident rate was decreased by 66 percent.
- Kennebec Long-term Care, Maine This nursing home had 250 employees and 300 resident beds. Employees were experiencing low back strains, herniated discs, and shoulder strains from lifting residents and poor body mechanics. Resident falls and combative Alzheimer patients added additional risks. Solutions included:
- an employee committee (primarily certified nursing assistants) to evaluate mechanical lift-assist equipment;
- systematic resident mobility assessments;
- use of gait belts;
- full body and stand-assist lifts for lifting or moving residents;
- comprehensive employee training;
- safety rewards and newsletters; and
- modified-duty programs for injured workers.
As a result of these efforts, over a 5-year period, workers’ compensation premiums dropped 50 percent and the number of lost work days dropped from 573 to 12.
Demonstration Projects from NIOSH/CDC
The research literature on healthcare worker musculoskeletal disorders, including back injuries, includes testing the effectiveness of solutions. According to the National Institute for Occupational Safety and Health (NIOSH), a strong body of research evidence has recently been amassed demonstrating that mechanical lifting equipment and repositioning aids as part of a safe patient handling and movement program can significantly reduce musculoskeletal injuries among healthcare workers. Here are summaries of a few of these landmark studies:
- Safe patient handling reduces worker injuries. One of the first comprehensive intervention evaluation studies demonstrating the effectiveness of mechanical lifting equipment in the context of a comprehensive safe patient handling program was conducted at the University of Wisconsin-Milwaukee [Garg and Owen 1992]. The study concluded that ergonomic intervention programs were effective in reducing the risk of low back pain to the small sample of nursing personnel in the study. Building on these findings, a larger study assessed the long-term effectiveness of patient-handling programs in seven nursing homes and one hospital. Fifty-one months after the resident lifting program was introduced, injuries from resident transfers decreased by 62 percent, lost workdays decreased 86 percent, restricted workdays decreased 64 percent, and workers’ compensation costs decreased 84 percent.
- Safe patient handling reduces worker compensation rates. In a study conducted by the National Institute for Occupational Safety and Health [Collins et al. 2004], a safe resident handling and movement program reduced resident handling workers’ compensation injury rates by 61 percent, lost workday injury rates by 66 percent, and restricted workdays by 38 percent. Additionally, the number of workers suffering from repeat injuries was reduced. During the 36 months before the intervention there were 129 workers’ compensation claims attributed to resident handling, with 11 workers filing more than one workers’ compensation claim for musculoskeletal injuries. During the 36-month post-intervention period, 56 workers’ compensation claims were attributed to resident handling and only 3 employees filed more than one workers’ compensation claim associated with resident-handling tasks.
- Veteran’s Health Administration program reduces injuries in long-tern care. The Veteran’s Health Administration (VHA) evaluated a multifaceted program in 23 high-risk, long-term care units in 7 facilities including 780 nursing personnel [Nelson et al. 2006]. The multifaceted program included mechanical patient lifts, patient-care assessment protocols, no-lift policies, and training on the proper use of patient-handling equipment. During the post intervention period, there was a significant decrease in the rate of injuries and modified duty days, an increase in caregiver satisfaction, and a decrease in the number of “unsafe” patient-handling practices performed daily as reported by nurses. Ninety-six percent of the nurses ranked lifting equipment as the most important program element.
- Extended care unit reduces injuries with ceiling lift equipment. A study was conducted in the extended care unit of a Canadian hospital to examine the marginal benefit of replacing a traditional patient lifting program (which uses mechanical floor lifts) with overhead ceiling lifts [Ronald et al. 2002]. During the pre-intervention period there were five mechanical floor lifts, one manual transfer aid, and four beds serviced by two ceiling lifts. After completion of the resident lifting program, the unit included three floor lifts, 62 ceiling lifts, and three tubs serviced by ceiling lifts. The rate of musculoskeletal injuries caused by lifting/transferring patients was significantly reduced by 58 percent after the installation of ceiling-mounted lifts, but the rate of musculoskeletal injuries caused by repositioning did not decline. Although the ceiling lifts are designed for both lifting and repositioning residents, the ceiling lifts were actually not used for repositioning residents because of problems with the repositioning slings.