Safe Patient Handling and Musculosketal Disorders

Introduction

Hospitals have high rates of non-fatal occupational injuries and illnesses. More than 50 percent of injuries and illnesses reported in 2013 among nursing assistants were musculoskeletal disorders (MSDs). On average, U.S. hospitals recorded 6.4 work-related injuries and illnesses for every 100 full-time employees in 2013. This is compared with 3.3 per 100 full-time employees for all U.S. industries combined. In 2013, 34 percent of recorded hospital worker injuries nationwide that resulted in days away from work were associated with patient interactions.

Many MSDs in the healthcare field are due in large part to overexertion related to repeated manual patient handling activities, often involving heavy manual lifting associated with transferring, and repositioning patients and working in awkward postures.

Sprains and strains are the most often reported injuries, and the shoulders and lower back are the most affected body parts.

Here are some interesting statistics regarding back pain from the American Nurses Association:

• 52% of nurses complain of chronic back pain.
• 12% leave nursing because of back pain.
• 20% transfer to different units because of back pain.
• Back pain is the leading cause of disability in those less than 45 years old.

Many healthcare employees who experience pain and fatigue may also be less productive.

Consequences of Work-Related Injuries

The consequences of work-related muscular injuries among nurses is substantial. Along with the higher employer costs due to medical expenses, disability compensation, and litigation, nurse injuries also are costly in terms of chronic pain, missed work days, and employee turnover.

As many as 20% of nurses leave their direct patient care positions because of the risks associated with the tasks required when handling patients.

The direct (insured by workers compensation) and indirect (unisured) costs associated with back injuries in the healthcare industry alone are estimated to be $20 billion annually.

Many healthcare employees who experience pain and fatigue, may also be less productive, less attentive, and more susceptible to further injury and may be more likely to affect the health and safety of others.

Most Susceptible Industries

The radiology department could be identified as high-risk.
(Click to enlarge)

According to the Bureau of Labor Statistics (BLS), the average number of overexertion injuries is around 35 per 10,000 workers. Industries where patient handling injuries are above the national average include:

Some examples of areas of a facility that may be identified as high-risk include:

• bathing rooms
• extended care wings
• diagnostic units (for example, radiology, emergency department, spinal unit and orthopedics department)

MSD Assessment

The first step in addressing the issue of patient handling is to assess the scope and nature of the problem. Comprehensive reporting of worker injuries helps ensure you have the data available to develop your hospital's safe patient handling program. Here are some steps you can take to assess your safe patient handling concerns and needs:

1. Review injury data for your facility: Injury data can be a useful diagnostic tool. This data includes the OSHA 300 Log; the OSHA Form 301 (Injury and Illness Incident Report); workers' compensation claims summaries; internal incident, investigation, and corrective action reports; and employee turnover and recruitment data. OSHA already requires many workplaces (including any hospital with more than 10 employees) to use the OSHA 300 Log to report serious job-related injuries. Employers must also complete the Form 301 for every recordable injury.
2. Examine your overall injury rates: See how you compare to others. Administrators and safety managers can use OSHA's self-assessment checklist to examine the hospital's injury rates and compare them with national averages and high-performing hospitals. You can also visit the Bureau of Labor Statistics to learn more about injury and illness rates in hospitals and other workplaces nationwide.
3. Examine your patient handling injury rates: This will help you pinpoint areas of concern. Use OSHA's patient handling self-assessment tool to review and reflect on the number, nature, and cost of patient handling injuries in your hospital.
4. Be proactive: A more forward-looking approach, to be used in combination with reviewing injury and illness records, is to be proactive in identifying potential problems that have gone unnoticed, before they result in injuries. Observations of workplace conditions and work processes, job analyses, workplace surveys, and worker interviews are common proactive methods for identifying problems before they result in injury.

Stages of MSDs

The symptoms experienced when acquiring MSDs typically occur in three stages:

1. Early stage: pain may disappear after a rest away from work.
2. Intermediate stage: body part aches and feels weak soon after starting work and lasts until well after finishing work.
3. Advanced stage: body part aches and feels weak, even at rest. Sleep may be affected and light tasks are difficult on days off.

You should NOT ignore signs and symptoms of MSDs. Employees should report any pain to their manager or supervisor and seek treatment immediately to prevent further pain.

The video on this page demonstrates patient handling tasks that put the nurse at risk of developing MSDs. The video discusses anatomy and risks to the lower back, the shoulder, the wrist, and the knee.

Management Support

An important aspect of any safe patient handling program is top hospital administration support. Employees appreciate knowing managers care about their well-being. They are more likely to follow safe patient handling policies if management stands behind them.

In hospitals who have successfully reduced patient handling injuries, it is common to find administrators who support and promote a culture of safety. Administrators must weigh the benefits of investing in safe patient handling programs against the costs. Hospital administrators must fully understand how these investments impact their bottom line.

Managers should support more than the workers who directly care for patients. Departments such as laundry, maintenance, and engineering are vital to supporting safe patient handling as well. This includes maintaining equipment and supplying clean slings to troubleshooting facility design issues.

Studies show the initial capital investment in programs and equipment can be recovered in two to five years, particularly when equipment purchases are coupled with training and policies to produce a lasting impact.

Although there can be considerable equipment, training, and infrastructure costs associated with implementing safe patient handling, hospitals with successful programs have found the long-term benefits far outweigh economic costs. Click on the button to see some of the benefits of a successful patient handling program.

Safe Patient Handling Equipment

Given the increasingly hazardous biomechanical demands on caregivers today, it is clear the healthcare industry must rely on technology to make patient handling and movement safe.

Using patient handling equipment and devices is beneficial for both healthcare staff and patients. Explaining planned lifting procedures before lifting will increase patient understanding, safety, and comfort and enhance their sense of dignity.

Program Evaluation

By establishing evaluation procedures and a process for enhancing your safe patient handling program, you can periodically evaluate the effectiveness of your hospital’s efforts and ensure continuous safe patient handling improvement and long-term success. Below are a few evaluation steps to include.

Check your Work

Read the material in each section to find the correct answer to each quiz question. After answering all the questions, click on the "Check Quiz Answers" button to grade your quiz and see your score. You will receive a message if you forgot to answer one of the questions. After clicking the button, the questions you missed will be listed below. You can correct any missed questions and check your answers again.

VIDEO

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