CDC - Safe Patient Handling - NIOSH Workplace Safety and Health Topic

SAFE PATIENT HANDLING

Overexertion incidents are the leading source of workers’ compensation claims and costs in healthcare settings. The primary outcome associated with such incidents are musculoskeletal disorders (MSDs). MSD risks are found in housekeeping, food service and other areas where workers manually handle heavy, awkward loads or perform repetitive forceful hand work. The single greatest risk factor for MSDs in healthcare workers is the manual moving and repositioning of patients, residents or clients. Rising obesity rates in the United States¹ impact the physical demands on caregivers. The aging of the workforce likely contributes to the problem; the average age of a registered nurse in the U.S. is approximately 47 years. Also contributing to the negative health consequences of manual handling is the shortage of nurses—Peter Buerhaus, a researcher at Vanderbilt University Medical Center, has estimated that there will be a shortage of 250,000 nurses by the year 2025 in the US.²


Nursing staff have high rates of back and shoulder injuries. In 2009, more than 23,000 lost-time cases of work-related back pain, carpal tunnel syndrome, and tendonitis were reported in the Healthcare and Social Assistance sector (HCSA) by BLS; of these, more than 44% were among healthcare support occupations such as aides and assistants.³ In 2009, nursing aides and orderlies, registered nurses, and licensed practical nurses suffered the highest prevalence (16.6%) and reported the most annual cases (n=3,620) of work-related back pain involving days away from work in the HCSA sector.⁴

Sources:
1 Flegal, KM, Carroll, MD, Ogden, CL, Curtin, LR.[2010] Prevalence and Trends in Obesity Among US Adults, 1999-2008 JAMA. 2010;303(3):235-241

2 Buerhaus, PI, Auerbach, DI, Staiger, DO, [2009] The Recent Surge In Nurse Employment: Causes and Implications, Health Aff July/August 2009 vol. 28 no. 4 w657-w668.

3 BLS [2009]. Number of nonfatal occupational injuries and illnesses involving days away from work by industry and selected natures of injury or illness, private industry, 2009  [PDF - 198KB]. Table R1.

4 BLS [2009]. Number of nonfatal occupational injuries and illnesses involving days away from work by occupation and selected natures of injury or illness, private industry, 2009 . Table R9.

Featured ResourcesDeveloping Evidence-Based Interventions to Address the Leading Causes of Workers’ Compensation Among Healthcare Workers
Rehabil Nurs 2010 Nov; 35(6):225-235, 261.
Safe Lifting and Movement of Nursing Home Residents
DHHS (NIOSH) Publication Number 2006-117 (February 2006)
This guide is intended for nursing home owners, administrators, nurse managers, safety and health professionals, and workers who are interested in establishing a safe resident lifting program.
An Evaluation of a Best Practices, Back Injury Prevention Program in Nursing Homes
Inj Prev 2004; 10:206-211.
NIOSH Healthcare and Social Assistance Program
The mission of this NIOSH research program is to eliminate occupational diseases, injuries, and fatalities among individuals working in this sector through a focused program of research and prevention.
Veteran’s  Health Administration - Key Safe Patient Handling and Movement Publications
Patient Care Ergonomics Resource Guide: Safe Patient Handling and Movement
http://www.nursingworld.org/safepatienthandling/resourceguide1.pdf  [PDF - 414KB]
http://www.nursingworld.org/safepatienthandling/resourceguide2.pdf  [PDF - 311KB]
The American Journal of Safe Patient Handling & Movement (SPHM) is the first journal of its kind in the USA devoted to the subject of safe patient handling and movement and provides a forum for the latest research and evidence on the how, why, and what in this area of practice. http://www.americanjournalofsphm.com/

NIOSH Blogs: Safe Patient Handling

Prevention of Back Injuries in Healthcare Settings
Healthcare workers often experience musculoskeletal disorders (MSDs) at a rate exceeding that of workers in construction, mining, and manufacturing...
Strains, Sprains and Pains in Home Healthcare
Working in an Uncontrolled Environment



NIOSH Publications
NIOSH Hazard Review: Occupational Hazards in Home Healthcare
DHHS (NIOSH) Publication No. 2010-125 (January 2010)
Chapter 2: Musculoskeletal Disorders and Ergonomic Interventions: Home healthcare provides vital medical assistance to ill, elderly, convalescent, or disabled persons who live in their own homes instead of a healthcare facility, and is one of the most rapidly expanding industries in this country.
State of the Sector Healthcare and Social Assistance Identification of Research Opportunities for the Next Decade of NORA
DHHS (NIOSH) Publication No. 2009-139 (June 2009)
Chapter 11: Musculoskeletal Disorder and Ergonomic Issues: Work-related musculoskeletal disorders (MSD) are defined as an injury of the muscles, tendons, ligaments, nerves, joints, cartilage, bones, or blood vessels in the extremities or back that is caused or aggravated by manual-handling work tasks such as lifting, pushing and pulling, and carrying; as well as working in awkward postures with very repetitive or static forceful exertions.
Safe Patient Handling Training for Schools of Nursing
DHHS (NIOSH) Publication No. 2009-127 (March 2010)
Training program focused on student learning, faculty development in effective teaching and student assessment.

Patient Lifting Legislation in the USA

While safe patient legislation continues to be introduced in numerous states and at the federal level, the following safe patient handling legislation has been passed:

• Ohio House Bill 67 was signed into law on March 21, 2006, Section 4121.48 [State of Ohio 2006].
• New York companion bills A11484 and A07836 and S05116 and S08358 were signed into law on October 18, 2005 [State of New York 2006].
• Texas Senate Bill 1525 was signed into law on June 17, 2005 [State of Texas 2005].
• Washington House Bill 1672 was signed into law on March 22, 2006 [State of Washington 2006].
• Hawaii House Concurrent Resolution No. 16 passed on April 24, 2006 [State of Hawaii 2006].
• Rhode Island House 7386 and Senate 2760, passed on July 7, 2006 [State of Rhode Island 2006].
• Minnesota HB 712.2 safe patient handling legislation signed into law May 2007 [State of Minnesota 2007a,b].
• Maryland SB 879 safe patient handling legislation signed into law April 2007 [State of Maryland 2007a,b].
• New Jersey S-1758/A-3028 safe patient handling practice act signed into law January 2008 [State of New Jersey 2008].

Additional Resources

American Nurses Association’s (ANA) Handle with Care Program
The Handle with Care Program of the American Nurses Association is an industry-wide effort designed to prevent back and other musculoskeletal injuries among the Nation’s nurses. The campaign is helping reshape nursing education and federal and state ergonomics policy by highlighting safe patient-lifting research that shows technology-oriented safe patient-handling benefits both patients and the nursing workforce. Similar efforts are underway by other healthcare unions and employee organizations.
U.S. Department of Veterans Affairs Safe Patient Handling Program
Key Objective: To develop and test innovations and decrease risk related to patient handling and movement.
Work Injured Nurses Group (WING USA)
Implementation of Safe Patient Handling in Washington State Hospitals  [PDF - 1.4MB]
Washington State Department of Labor and Industries’ SHARP program evaluation of impact of legislation report.
Safe Lifting Portal
This pro-bono healthcare site is designed to support safe lifting and caregiver injury prevention programs.

Conferences

The conferences listed below are designed to meet the needs of direct healthcare providers, managers, administrators, risk managers, educators, industrial hygienists/safety professionals and researchers of any discipline who are interested in advancing safety for patients and caregivers.
12th Annual Safe Patient Handling and Movement Conference
March 19-23, 2012, Orlando, Florida
2011 West Coast Safe Patient Handling and Movement Conference  [PDF - 414KB]
September 12-15, 2011, San Diego, California









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CDC - Safe Patient Handling - NIOSH Workplace Safety and Health Topic