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Presented by Kelly Moed, MSN, RN-BC Nursing Logic LLC November 10,2011 Quality Care Community Conference “Transforming Nursing Homes for Generations---Let’s Make It Happen”
Presented byKelly Moed, MSN, RN-BC
Nursing Logic LLC
November 10,2011Quality Care Community Conference
“Transforming Nursing Homes for Generations---Let’s Make It Happen”
Identify healthcare workers who are at risk for musculoskeletal disorders.
Describe the key components of a safe resident handling program.
State the direct and indirect benefits of reduction of staff and resident injuries through elimination of manual lifting.
Not to become injured
Early in My Career (1982) High touch – Low Tech Culture Use of gloves considered an insult to the patient Blood on the uniform was “cool”Mid to late 1980’s
Blood and Body Fluid Precautionsfor fever of unknown origin (FUO)
Universal/Standard Precautions (PPE) Needlestick Safety and Prevention
Illustrations by K. Rinker, WNYCOSH
Include conditions such as:
low back pain sciatica rotator cuff injuries epicondylitis carpal tunnel syndrome
Http://www.osha.gov/ergonomics/guidelines/nursinghome/final_nh_guidelines.html
Nursing aides, orderlies and attendants are listed in the top 10 occupations for work-related musculoskeletal disorders (MSDs) according to the Bureau of Labor Statistics (2009).
The MSD rate for nursing aides, orderlies and nursing attendants is 7 times higher than the average of ALL occupations.
American Nurses Association (2004) says that over 52% of nurses complain of chronic back pain.
http://www.bls.gov/spotlight/2009/safety_and_health/data.htm#figure07_fulltime_occupational
12.5
11.9
7.9
6.9
5.9
2.6
0.0 2.0 4.0 6.0 8.0 10.0 12.0 14.0
Nursing and residential care facilities (NAICS 623)
Hospitals (NAICS 622)
Correctional institutions (NAICS 92214)
Construction (NAICS 23)
Police protection (NAICS 92212)
Colleges and Universities (NAICS 6113)
Incidence rate of nonfatal occupational injuries and illnesses per 100 full time workers by industry, State governments, 2008
Source: Bureau of Labor Statistics, U.S . Department of Labor, October 2009
Since 1980’s “Proper Body Mechanics” Education
(Orientation and Annual Mandatory Training) Select use of Hoyer lifts for “heavy” patients Staff accepts that an “aching back” is part of the job
Early 1990’s Battery operated patient lifts introduced Back Injury Prevention Program- BIPP
The average healthcare worker manually lifts 1.8 tons per 8 hour shift.
That is equal to lifting one sedan per shift!
Zeroliftforny.org/slidebyCathyGillingham
In one year, healthcare workers lift the equivalent of an airplane that is at 50% capacity.
*Zeroliftforny.com/slidebyCathyGillingham
Photo courtesy of http://en.wikipedia.org/w/index.php?title=User:The_Silent_Wind_of_Doom&action=edit&redlink=1
The number of manual lifting injuries to healthcare workers in one year exceeds the number of attendees at a sold-out game in the new Yankee Stadium*.
*ZeroliftforNY.org
Manual Patient HandlingIs broadly defined as the transporting or supporting of a patient by hand or bodily force, including: • Pushing• Pulling• Carrying• Holding• Supporting of the patient or a body part
Manual Handling Operations Regulations (MHOR),1992
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Situations which may cause staff or resident injury:
• Manual lifting• Repositioning• Bedpan placement• Confined Workspaces • Awkward postures• Ambulation • Lack of Assessment
CDC,NIOSHslidebyCathyGillingham
People: Are getting larger. Have no handles! Can be unpredictable. Cannot be held close
to your body.
The amount of weight manually handled by workers in other industries is limited to 50 pounds under
IDEAL conditions.(NIOSH Lifting Equation,1993)
Researchers have reported that no caregiver should lift more than 35
pounds of a patient’s weight.(Waters T, When is it safe to manually lift a patient, American Journal of Nursing, 107(8), 53-59., 2007)
Resident handling is NOT an ideal condition!
Position statement supporting actions and policies that result in elimination of manual patient lifting to promote a safe work environment of care for nurses and patients (ANA, 2003)
IllinoisMarylandMinnesotaNew JerseyNew York* Ohio*Rhode Island TexasWashingtonwith a resolution from Hawaii*
http://www.nursingworld.org/MainMenuCategories/ANAPoliticalPower/State/StateLegislativeAgenda/SPHM/Enacted-Legistation.aspx
Federal Policy regardingSafe Patient Handling
Federal Legislation :H.R. 2381 and S. 1788
Nurse and Health Care Worker Protection Act(introduced May 2009)
American Nurses AssociationHandle With Care® Campaign
Handling Residents Safely
Slide created by Cathy Gillingham, North Shore LIJ-SIUH
No Manual Lift Policy(non-punitive)
Ergonomic Hazard Assessment Investment in Equipment Staff training Care planning for resident handling
and movement Review and Evaluation Process
Residents?
WNYCOSH,2010
Frontline workers?Employers?
Improved quality of care Improved resident safety More comfortable/secure patient transfers Early mobility efforts enhanced Skin integrity improvement More skilled staff retained at the bedside
Safe workplace without a threat of injury Decreased fatigue Increased job satisfaction Not working in pain Sustainability of professional careers Retention of staff Recruitment of staff to the facility
ANA, 2004
Direct Cost Savings:$ Workers compensation $ Medical treatment costs for musculoskeletal disorders
Indirect Cost Savings: $ Lost work days$ Modified duty time$ Investigation time$ Replacement of injured employee $ Education & training$ Liability costs $ Overtime pay
ANA, 2004
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Equipment Availability
Staff Training
Caregiver Participation
What do you have? What do you need?
WNYCOSH,2010
EquipmentLateral Transfer Devices• Friction-reducing devices
– Gel filled pads/mats– Roller boards or mats– Nylon slippery sheets– Transfer boards
Slide sheets and turning discs
Friction reducing device
Slide Boards
WNYCOSH, 2010
WNYCOSH, 2010
WNYCOSH, 2010
EquipmentBathtub, Shower and Toileting
Activities• Height adjustable and easy entry
bath tubs• Height adjustable shower gurney• Bath lift• Shower/toileting chairs• Toilet Seat Risers• Grab bars/stand • Long handled tools for hygiene
Weighing• Beds and lifts with scales• Recessed floor scales
WNYCOSH, 2010
Listed in your handout
“Because the people who are crazy enough to think they can change the
world are the ones who do.”
RIP Steve Jobs
American Nurses Association Safe Patient Handling Website http://www.anasafepatienthandling.org/
NIOSH Web-based Training for nursing students http://www.cdc.gov/niosh/docs/2009-127/safe.html
NYS Zero Lift Task Force http://www.zeroliftforny.org/
Patient Safety Center of Inquiry of the Veteran’s Health Administration. http://www.visn8.va.gov/PatientSafetyCenter/safePtHandling/FacilityChampionResources.asp
Preventing Back Injuries: Safe Patient Handling and Movement Brochure http://nursingworld.org/MainMenuCategories/OccupationalandEnvironmental/occupationalhealth/handlewithcare/PreventingBackInjuries.aspx
United States Department of Labor. Healthcare Ergonomics: http://www.osha.gov/SLTC/etools/hospital/hazards/ergo/ergo.html
Waters T, When is it safe to manually lift a patient, American Journal of Nursing, 107(8), 53-59., 2007
Western New York Council on Occupational Safety & Health-WNYCOSH Workplace Safety through SRH and Ergonomics Programs (2010)
