Charting a Path to Prevent Patient Lifting Injuries

Musculoskeletal injuries remain a major hazard for nurses and nursing assistants in hospitals, home health, and other settings, presenters stressed during an ASSP Safety 2019 session on June 11.

NEW ORLEANS -- Back injuries remain a major concern for nurses, nursing assistants, EMTs, firefighters, home health aides, and other workers who must help lift and move patients, two presenters said during a June 11 session at the American Society of Safety Professionals' #Safety2019 Professional Development Conference and Exposition here. Neal Wiggermann, Ph.D., CPE, a specialist research scientist in human factors and ergonomics for medical equipment manufacturer Hill-Rom, and Yeu-Li Yeung, MS, OT/L, CPE, CSPHP, patient care ergonomics coordinator at Duke University and Duke Health, discussed the scope of the injury problem among these workers and the successes so far of Duke's Safe Patient Handling and Mobility Program (SPHM).

"We have plenty of equipment that can help us move boxes and patients now -- but that's not enough. We need a program," Yeung explained.

Wiggermann said some of the activities in which workers and patients are frequently hurt include moving patients, transferring patients from a bed to a chair or toilet, repositioning patients in bed, and weighing patients. In 2017, the rate of musculoskeletal injuries for all health care workers was 32 per 10,000 employees, but it was 48 for registered nurses and about 200 for nursing assistants that year, he said. For firefighters, the rate was about 170 per 10,000. He mentioned a 2011 study involving 4,000 nurses in which many reported they frequently or mostly miss care that has been ordered by doctors, care that calls for getting patients turned or up and moving.

"What we're still seeing in nursing schools is body mechanics. They're still training nurses to lift with their legs, not their backs," he said, explaining that most current training in lifting techniques for nurses is not protecting them against back injuries.

Duke's SPHM program began in 2004. It has made use of the American Nursing Association's 2014 Safe Patient Handling and Mobility guidelines, Yeung explained. Now named DukeMOVES (for Move Often, Very Early, and Safely), the program acquired $1.2 million of new lifting and mobility equipment for three hospitals. Program managers ended up adopting a mobility assessment tool, she said.

"Just because you have equipment doesn't mean they're going to use it," said Yeung, adding that the lifting equipment must be accessible and available ("in their face," as she put it) to ensure the workers will indeed use it.

The program produced a 45 percent drop in the hospitals' DART rate for nursing personnel by FY2016 and is projected to achieve a 58 percent drop by FY2019, compared with FY2015, she said, and both patient falls and patient falls with injuries have declined.

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