Presented by Kelly Moed, MSN, RN-BC Nursing Logic LLC

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1 Presented by Kelly Moed, MSN, RN-BC Nursing Logic LLC November 10,2011 Quality Care Community Conference Transforming Nursing Homes for Generations---Let s Make It Happen

2

3 Identify healthcare workers who are at risk for musculoskeletal disorders. Describe the key components of a safe resident handling program. State the direct and indirect benefits of reduction of staff and resident injuries through elimination of manual lifting.

4 Not to become injured

5 Early in My Career (1982) High touch Low Tech Culture Use of gloves considered an insult to the patient Blood on the uniform was cool Mid to late 1980 s Blood and Body Fluid Precautions for fever of unknown origin (FUO) Universal/Standard Precautions (PPE) Needlestick Safety and Prevention

6

7 Illustrations by K. Rinker, WNYCOSH

8 Include conditions such as: low back pain sciatica rotator cuff injuries epicondylitis carpal tunnel syndrome

9 Nursing aides, orderlies and attendants are listed in the top 10 occupations for work-related musculoskeletal disorders (MSDs) according to the Bureau of Labor Statistics (2009). The MSD rate for nursing aides, orderlies and nursing attendants is 7 times higher than the average of ALL occupations. American Nurses Association (2004) says that over 52% of nurses complain of chronic back pain.

10

11 Incidence rate of nonfatal occupational injuries and illnesses per 100 full time workers by industry, State governments, Nursing and residential care facilities (NAICS 623) 12.5 Hospitals (NAICS 622) 11.9 Correctional institutions (NAICS 92214) 7.9 Construction (NAICS 23) 6.9 Police protection (NAICS 92212) 5.9 Colleges and Universities (NAICS 6113) 2.6 Source: Bureau of Labor Statistics, U.S. Department of Labor, October 2009

12 Since 1980 s Proper Body Mechanics Education (Orientation and Annual Mandatory Training) Select use of Hoyer lifts for heavy patients Staff accepts that an aching back is part of the job Early 1990 s Battery operated patient lifts introduced Back Injury Prevention Program- BIPP

13 The average healthcare worker manually lifts 1.8 tons per 8 hour shift. That is equal to lifting one sedan per shift! Zeroliftforny.org/slidebyCathyGillingham

14 In one year, healthcare workers lift the equivalent of an airplane that is at 50% capacity. *Zeroliftforny.com/slidebyCathyGillingham

15 The number of manual lifting injuries to healthcare workers in one year exceeds the number of attendees at a sold-out game in the new Yankee Stadium*. Photo courtesy of *ZeroliftforNY.org

16 Manual Patient Handling Is broadly defined as the transporting or supporting of a patient by hand or bodily force, including: Pushing Pulling Carrying Holding Supporting of the patient or a body part Manual Handling Operations Regulations (MHOR),1992

17 Situations which may cause staff or resident injury: Manual lifting Repositioning Bedpan placement Confined Workspaces Awkward postures Ambulation Lack of Assessment CDC,NIOSH slidebycathygillingham 17

18 People: Are getting larger. Have no handles! Can be unpredictable. Cannot be held close to your body.

19 The amount of weight manually handled by workers in other industries is limited to 50 pounds under IDEAL conditions. (NIOSH Lifting Equation,1993) Resident handling is NOT an ideal condition! Researchers have reported that no caregiver should lift more than 35 pounds of a patient s weight. (Waters T, When is it safe to manually lift a patient, American Journal of Nursing, 107(8), , 2007)

20 Position statement supporting actions and policies that result in elimination of manual patient lifting to promote a safe work environment of care for nurses and patients (ANA, 2003)

21 Illinois Maryland Minnesota New Jersey New York* Ohio* Rhode Island Texas Washington with a resolution from Hawaii*

22 Federal Policy regarding Safe Patient Handling Federal Legislation : H.R and S Nurse and Health Care Worker Protection Act (introduced May 2009) American Nurses Association Handle With Care Campaign

23 Handling Residents Safely Slide created by Cathy Gillingham, North Shore LIJ-SIUH

24 No Manual Lift Policy (non-punitive) Ergonomic Hazard Assessment Investment in Equipment Staff training Care planning for resident handling and movement Review and Evaluation Process

25 Frontline Employers? Residents? workers? WNYCOSH,2010

26 Improved quality of care Improved resident safety More comfortable/secure patient transfers Early mobility efforts enhanced Skin integrity improvement More skilled staff retained at the bedside

27 Safe workplace without a threat of injury Decreased fatigue Increased job satisfaction Not working in pain Sustainability of professional careers Retention of staff Recruitment of staff to the facility ANA, 2004

28 Direct Cost Savings: $ Workers compensation $ Medical treatment costs for musculoskeletal disorders Indirect Cost Savings: $ Lost work days $ Modified duty time $ Investigation time $ Replacement of injured employee $ Education & training $ Liability costs $ Overtime pay ANA, 2004

29 Equipment Availability Staff Training Caregiver Participation 29

30 What do you have? What do you need?

31 WNYCOSH,2010

32 Equipment Lateral Transfer Devices Friction-reducing devices Gel filled pads/mats Roller boards or mats Nylon slippery sheets Transfer boards Friction reducing device Slide Boards Slide sheets and turning discs WNYCOSH, 2010

33 WNYCOSH, 2010

34 WNYCOSH, 2010

35 Bathtub, Shower and Toileting Activities Equipment Height adjustable and easy entry bath tubs Height adjustable shower gurney Bath lift Shower/toileting chairs Toilet Seat Risers Grab bars/stand Long handled tools for hygiene Weighing Beds and lifts with scales Recessed floor scales WNYCOSH, 2010

36 Listed in your handout

37

38

39 Because the people who are crazy enough to think they can change the world are the ones who do. RIP Steve Jobs

40 Questions? Kelly Moed, MSN, (Twitter)

41 American Nurses Association Safe Patient Handling Website NIOSH Web-based Training for nursing students NYS Zero Lift Task Force Patient Safety Center of Inquiry of the Veteran s Health Administration. Preventing Back Injuries: Safe Patient Handling and Movement Brochure BackInjuries.aspx United States Department of Labor. Healthcare Ergonomics: Waters T, When is it safe to manually lift a patient, American Journal of Nursing, 107(8), , 2007 Western New York Council on Occupational Safety & Health-WNYCOSH Workplace Safety through SRH and Ergonomics Programs (2010)

Guidelines for Nursing. Homes. Ergonomics for the Prevention. Musculoskeletal Disorders OSHA 3182-3R 2009

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