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Background on SPH

Despite the recognition that manual patient handling is a high-hazard task, few health care organizations in the United States (U.S.) today have adequate equipment, designed specifically to lift and move patients, or safe patient handling programs including ergonomic training and leadership support to meet the needs of nurses and other health care personnel who repetitively lift and moving patients.

According to the Bureau of Labor Statistics (BLS), nursing aides, orderlies, and attendants reported the highest numbers of work-related musculoskeletal disorders (WMSDs) requiring days away from work in 2009 (BLS, 2009). This group was ranked first on the top ten list of occupations in the U.S. reporting the highest numbers of WMSD’s requiring days away from work. Registered nurses were ranked sixth on this top ten list of selected occupations (BLS. In 2009).

In 2009, over 46,000 registered nurses, licensed practical nurses, nurse’s aides, orderlies, attendants, emergency medical technicians, paramedics, home health aides and personal care aides reported WMSDs injuries (BLS, 2009). More than one-third of back injuries among nurses have been associated with the handling of patients and the frequency with which nurses are required to move them. It is estimated that the cost to the nation in 2008 was 7.4 billion dollars in direct and indirect costs for worker’s compensation claims, medical bills, and staff replacements for health care workers (U.S. Senate, 2010; UMass, 2011). Injured nurses constitute about one-fourth of all claims and one-third of total compensation costs.

The BLS tracks injuries reported by the private and public sectors which are used to plan strategies to reduce numbers of injuries in targeted occupations such as nursing. The following two tables provided to the ANA demonstrate that between 2000 and 2009, the numbers of WMSDs reported by RNs changed little over the last decade, demonstrating the need for continued efforts on a national scale for ANA to work with its’ partners, the National Institute of Occupational Safety and Health (NIOSH), Department of Veterans Affairs, and others, to promote funding for research and innovative solutions to reduce these numbers.

Table 1. Number, incidence rate, and median days away from work of occupational injuries and illnesses involving days away from work to registered nurses with musculoskeletal disorders by ownership for All United States, 2003 – 2009

Year Ownership ;Occupation Total
Cases
Incidence
Rate
Medial Days Away
From Work
2009 private industry
local government
state government
RNs
RNs
RNs
8,760
1,060
660
51.6
55.0
56.1
8
7
14
           
2008 private industry
local government
state government
RNs
RNs
RNs
8,120
960
540
48.4
-
-
6
5
9
           
2007
2006
2005
2004
2003
private industry
private industry
private industry
private industry
private industry
RNs
RNs
RNs
RNs
RNs
8,580
9,200
9,060
8,810
10,050
53.4
59.1
-
-
-
6
6
7
7
6

SOURCE: Bureau of Labor Statistics, U.S. Department of Labor, February 14, 2011. Numbers for local and state government Unavailable prior to 2008.For more information see Resources below.


Table 1. Number, incidence rate, and median days away from work2 of occupational injuries and illnesses involving days away from work to registered nurses with musculoskeletal disorders by ownership for All United States, 2000-2002.

Year Ownership ;Occupation Total
Cases
Incidence
Rate
Medial Days Away
From Work
2002
2001
2000
private industry
private industry
private industry
RNs
RNs
RNs
10,815
11,759
12,074
-
-
-
6
5
4

SOURCE: Bureau of Labor Statistics, U.S. Department of Labor, February 14, 2011. Data is unavailable for state and local government industry prior to 2008. For more information see Resources below.

The extent of musculoskeletal disorders among the U.S. nursing workforce is particularly distressing when considered in the context of the current nursing shortage. The nation – now facing a serious nursing shortage can no longer afford to lose the nurses who leave the profession annually due to musculoskeletal injuries and pain. Injuries secondary to patient handling tasks compound the factors driving the nursing shortage.

Safe patient handling benefits patients as well as health care workers. The potential for patient injury(such as falls and skin tears) as a consequence of a manual handling mishap is reduced with equipment specially designed to move patients safely. SPH equipment provides a more secure process for lifting, transferring, or repositioning patients. Patients are afforded a safer means to progress through their care, have less anxiety, are more comfortable and maintain their dignity and privacy. SPH equipment is designed to match a patients’ ability to assist in his or her own movement.

Another benefit to patients when SPH equipment is readily available is more frequent use by healthcare workers and family caregivers to reposition dependent patients or move them out of bed. Preventing poor patient outcomes associated with immobility such as urinary tract infections, decubitus ulcers, and pneumonia are known benefits of patients with lifts and sliding sheets at home or in use at long-term care facilities.

In addition to safety for both health care worker and patient, a business case can be made for implementing a safe patient handling program.

  • Reduction in workers compensation claims 2003 - 2010. Franklin Square Center Hospital, MD Hinton, M.V. (2010). Establishing a safe patient handling/minimal lift program. Orthopedic Nursing. 29(5) 325-330.
  • The payback period for a safe patient handling program was 4.3 years in direct costs. Siddharthan et al. (2005). A business case for patient care ergonomic interventions. Nursing Administration Quarterly.29:1, 63-71
  • SPH programs are cost effective due to reduction in workers compensation claims and indirect costs. BLS. 2007. USDL 07-1741. www.bls.gov/iif/oschwc/osh/case/osnr0029.pdf
  • Workers compensation injury rates reduced by 61%. Collins, J.W. et al. (2004). An evaluation of “best practices” musculoskeletal injury prevention in nursing homes. Injury Prevention. 10, 206-211.
  • Initial investment in both lifting equipment and employee training can be recovered in two to three years through reductions in workers compensation costs. Collins et al., 2004; Tiesman et al., 2003; Garg, 1999.
Join ANA’s Safe Patient Handling Team and play a part in helping to improve the safety of nurses and their patients!

Resources

For more information about the above referenced statistical tables and reprints, contact Roberta Capewell, PhD, RN, CRNP, Senior Policy Fellow, Center for Occupational and Environmental Health, 301-628-5130 or e-mail roberta.capewell@ana.org.

For more information about ANA’s efforts related to ergonomics, work-related musculoskeletal disorders, and safe patient handling, visit the Handle with Care website or contact Nancy Hughes, MS, RN, Director, Center for Occupational and Environmental Health, 301-628-5021, or e-mail nancy.hughes@ana.org.



Resources

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