Safe Work Environments for Nurses: Safe Patient Handling

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Safe Work Environments for Nurses Safe Patient
Handling

• Audrey Nelson, Ph.D., RN, FAAN
• audrey.nelson_at_.va.gov

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Every work environment has its own special
challenges
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Problem Statement

• Nursing is one of the Top 10 high risk
  occupations in USA, for over 3 decades, despite
  the fact that 50 of injuries remain unreported
• Highest risk task contributing to injury is
  manual patient handling
• In an eight hour shift, the cumulative weight
  that nurses lift equal to an average of 1.8 tons
  per day.
• Estimated costs in VHA are estimated at
  approximately 22 million/year

• Tuohy-Main, K. (1997). Why manual handling
  should be eliminated for resident and carer
  safety. Geriaction, 15, 10-14.

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The Ergonomic Challenge
The adult human form is an awkward burden to lift
or carry. Weighing 200 pounds or more, it has no
handles, it is not rigid, and it is susceptible
to severe damage if mishandled or dropped. (circa
1950)
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Link Between Nurse Safety and Patient Safety

• Nurse Occupational injury results in lost work
  days, absenteeism, staff turnover, decreased
  retention, discouraged recruitment
• Patient Unsafe patient handling leads to drops
  and drags, as well as increase in
  immobility-related adverse events

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VHA Program Core Elements

• Risk assessment identifying local needs, followed
  by monthly unit-based hazard evaluation
• Selection/purchase of equipment involved front
  line nursing staff (equipment fairs)
• Facility Champion
• Unit-based peer leader education model
• Minimal Lift Policy.

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Outcomes

• Nursing Outcomes
• 31 reduction in incidence of injuries
• 18 reduction in lost work days
• 88 reduction in modified duty days
• Patient Outcomes
• Lower depression
• Improved urinary continence
• Increased engagement in activities
• Less likely to fall
• Increase in Alertness/awake during day
• Business case (Cost 8,000/bed)
• pay-back of the capital investment in
  approximately 4.13 years with an internal rate of
  return between .19 and .37 depending on model
  assumptions.
• Basis of the OSHA Ergonomics Guidelines for
  Healthcare Facilities and ANA Handle with Care
  program.
• Basis of VA Initiative to Roll out nationwide

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Other Solutions

• Evidence-based facility programs
• Hospitals
• Nursing Homes
• Home Health Care
• Outpatient
• Change Curriculum in Schools of Nursing
• State Legislation (national proposed)
• VHA National Rollout

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Making the change is hardbut nurses deserve
this!
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Patients deserve this!
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Do one brave thing each day
 
Wise words
The End..