Saving Healthcare Workers From Back Injuries

Healthcare Ergonomics

Part I – A Case for Implementation

Massachusetts Care Self-Insurance Group, Inc.

Safety Awareness For Everyone from Cove Risk Services

Healthcare

A growing industry in need of effective injury prevention programs.

The Practice of Nursing...Difficult and

Demanding

How can we make improvements?

AgendaMaking Improvements

• Where we have been

• Where we are

• Where we are going

• Sharing my thoughts

• Sharing your thoughts

What is your opinion on back injuries?

What are the major causes?

What are the major impacts?

Impact of Back Injuries

• Pain

• Lost time

• Disability

• Expense

• Inconvenience

The Financial Impact to the Healthcare Industry and to Individual Facilities

Who is at risk for back injuries?

What has been tried to prevent back injuries?

What should be done to prevent back injuries?

Occupations at Risk for Strains and Sprains

Number (in 1,000s) of work related musculoskeletal disorders involving

time away from work by occupation. BLS

Total Musculoskeletal Disorders 592.5Nursing aids, orderlies and attendants 49.1

Truck drivers 43.9

Laborers, non-construction 36.6

Assemblers 19.7

Janitors and cleaners 14.0

Registered nurses 12.4

Stock handlers and baggers 11.3

Construction laborers 10.8

BLS Statistics (U.S. injury data)

How many musculoskeletal disorder (MSD) casesinvolved health care patient handling?

• Almost all (97%) of the MSD cases involving patient handling occurred within the health care and social assistance industry, composing 58 percent of the 67,700 total MSD cases in that industry.

• For MSD cases involving patient handling, almost all (99%) were the result of overexertion. Sprain, strain, or tear was the type of injury incurred in 83% of the MSD cases involving patient handling.

• Nursing aides, orderlies and attendants incurred occupational injuries or illnesses in 49% of the MSD cases involving health care patients. Registered nurses accounted for 17% and home health aides for another 6%. Other occupations with MSD cases involving health care patients included licensed practical and licensed vocational nurses; emergency medical technicians and paramedics; personal and home care aides; health care support workers; radiologic technologists and technicians; and medical and health services managers.

Today Nurses are Very Concerned

• Believe quality of care has deteriorated• Time for patients has declined• Place patient safety ahead of their own• Feel discouraged and powerless• One third under thirty are thinking of leaving• Strikes and walk-outs increasing

The Aging Nursing Work Force

The average age of nurses isclose to 46 years old.

The largest portion of nursesare in their 50’s.

What are the impacts?

Impact of Nursing Crisis

• As Baby Boomer’s age = increased need for nurses• Nurses are burning out• Severe shortages• Increased risk of injury

- Insufficient staff- Higher stress levels- Risk increases with age

Work Conditions = Caregiver Shortage

• Root cause of nursing and nursing aide shortage – poor working conditions

• Improving methods for lifting, transferring, and repositioning can contribute much to improving working conditions

The Problem of Back Injuries in Healthcare is Well Recognized

What Have Been Traditional Approaches

for Prevention?

The Comprehensive Approach

• Anatomy and function of the back• Knowledge of physical fitness• General nutrition• Functional evaluations• Stress reduction• Pre-placement screening• Body mechanic and lifting technique• Ergonomics and job design

…The Back School Concept

Can you train staff how to eat?

Can you make them exercise?

Does a bad x-ray predict future injury?

Does Traditional Training Reduce Back Injuries

Several studies have been unable to demonstrate the effectiveness of

training in lifting techniques in preventing back injuries.

Why Have Traditional Training Programs Failed?

• Difficult to modify behavior and habits

• Lack of follow-up competency checks

• Difficult to apply optimum principles in real work environment (everyone has different natural abilities)

• Does use of proper technique remove the risk to the healthcare worker?

Notice the handles?

No handles here

Understanding Causation and Investigating Limits

for Manual Lifting

NIOSH Lifting EquationRWL = LC x HM x VM x DM x AM x FM x CM

LC = Load ConstantHM = Horizontal MultiplierVM = Vertical MultiplierDM = Distance MultiplierAM = Asymmetric MultiplierFM = Frequency MultiplierCM = Coupling Multiplier

Ergonomics or Human Factors Engineering

• Design job tasks to fit the person

• Do not expect the person to adapt to poor design

What is the engineering control in this picture?

Ergonomics

Move beyond the office environment and into the patient

care environment

Single Most Important Factor to Reduce Exposure to Back Injury

ELIMINATE THE LIFT!

Problems with Patient Handing Equipment in Years Past

• Poor design• Not available• Not maintained• Improper use• Time

OUCH!

• Review Current Practices

• Has this ever happened in your organization?

Play Catch Lately?

Proactive vs. Reactive

What is your next step?

Direction for the Future

Massachusetts Care Self-Insurance Group, Inc.

Safety Awareness For Everyone from Cove Risk Services