“Nursing: A Profession in Peril,” a five-part series of reports by consumer watchdog group Public Citizen being released over the spring and summer 2015, explores injuries to healthcare workers, potential methods to reduce these injuries, the policy positions of stakeholders and potential solutions. Occupational Safety and Health Administration (OSHA) data show healthcare workers perennially suffer more injuries — requiring time away from work — than those of any other profession, and many of these injuries result from handling patients.
Public Citizen released part one, “The Health Care Industry’s Castoffs: Nurses Injured at Work Often Find Themselves Out of Work and Suffering from Chronic Pain,” on June 9 and part two, “Taking the Burden Off Their Backs,” a week later.
In 2013, the healthcare and social assistance industry reported 629,500 cases of injury and illness cases to the Bureau of Labor Statistics. That’s 152,000 more cases than in manufacturing, the next highest industry sector. Nearly half (48 percent) of injuries that resulted in days away from work were due to over-exertion or bodily reaction, which includes motions such as lifting, bending, or reaching. Musculoskeletal disorders (MSDs) accounted for 33 percent of all injury and illness cases in 2013, and workers who sustained MSDs required a median of 11 days to recuperate before returning to work, compared with 8 days for all types of cases.
Paying the price
When a healthcare employee gets hurt on the job, hospitals pay the price in many ways: workers’ compensation for lost wages and medical costs; temporary staffing, backfilling, and overtime when injured employees miss work; turnover costs when an injured employee quits; and decreased productivity and morale as employees become physically and emotionally fatigued. Workplace safety also affects patient care. Manual lifting can injure caregivers and also put patients at risk of falls, fractures, bruises, and skin tears. Caregiver fatigue, injury, and stress are tied other problems. Nationwide, workers’ compensation losses result in a total annual expense of $2 billion for hospitals.
“Taking the Burden Off Their Backs” outlines a number of recommended technologies and policies to reduce injuries to nurses and other caregivers. It describes devices that assist in lifting, transferring and repositioning patients. Because most musculoskeletal injuries in the hospital setting are cumulative, any steps to minimize risks during patient handling tasks will offer substantial benefits for hospital caregivers.
Even if patient handling equipment is available, experts concur that successful patient handling programs rely on management directives to succeed, such as written policies and committees governing patient handling practices, methods for employees to report concerns or incidents without fear of retribution, reliable systems to measure incidents and injuries, and the existence of policies that align physical stress demands with employees’ capabilities. According to the report, only a fraction (between 3 and 25 percent) of hospitals have comprehensive safe-patient handling programs.
The right support
“It’s unconscionable that so many caregivers on the front lines are relegated to using archaic technology to perform their jobs,” said Taylor Lincoln, research director for Public Citizen’s Congress Watch division and author of the report. “Hospitals should provide the necessary equipment and management support to ensure that caregivers are spared lifting requirements that jeopardize their health.”
When properly implemented, safe-patient handling programs work. For example, the New York State Department of Health Veterans Home at Batavia reports that it saw a reduction from having an average of nine FTE employees out of work per day due to patient handling injuries to just 0.5 employees after instituting a program that minimized manual lifting.