Now, while the nation’s attention is fixed on a fluctuating health care industry, is a worthy time to remind the public of some staggering facts that should be making more headlines for the impact they have on any person paying into or benefitting from the health care system.
The Occupational Safety and Health Administration (OSHA) estimates that the health care industry spends about $20 billion annually on costs related to occupational back injuries. OSHA also found that the occurrence of musculoskeletal disorders for health care workers in the U.S. is seven times the average for all other industries. Nursing staff, including nurses’ aides and orderlies, reports the most missed workdays due to work-related back pain. The culprit? An average of 1.8 tons of cumulative weight lifted by a single nurse during a regular eight-hour shift at the hospital. For reference, the National Institute for Occupational Safety and Health (NIOSH) recommends lifting no more than 35 pounds (the size of a small child) under the best ergonomic conditions.
The numbers are mind-boggling and the majority of hospital and medical centers nationwide have yet to convert their facilities into safe patient-handling environments, despite data that proves the effectiveness of such technology.
Some examples of patient-handling tasks that may be identified as high risk include transferring a patient from toilet to chair; from chair to bed or from bathtub to chair; repositioning patients from side to side in bed; lifting a patient in bed; and repositioning a patient in a chair or making a bed with a patient in it.
Sprains and strains are the most often reported types of injuries and the shoulders and low back are the body parts most affected by patient handling, but other types of pain and fatigue are also common. These injuries and the wearing down of health care workers lead to lower productivity, not to mention they can become less attentive and more susceptible to further injuries that can affect the safety of patients and fellow coworkers. Often, chronic injuries arise after years of patient care.
There is another less scientific and more humane side to safe patient-handling equipment. Patient-transfer and lifting devices have been proven to enhance patients’ sense of dignity and comfort, sparing them the discomfort of being lifted by one or more people.
A Veteran Affairs hospital in Tampa, Florida, has been one of the pioneering facilities to embrace safe patient-handling regulations and equipment. The hospital installed ceiling lift equipment in practically every room and a no-manual-lift policy was adopted and enforced. Within five years, the savings in lost workdays offset the cost of the equipment, its installation and administering the program. Most European countries have mandated no-manual-lifting policies in their health centers as well.
Some in Alaska’s health care industry also recognize the cost benefits of investing in a safe patient-handling program. Several years ago, the Alaska Veterans Affairs health care system in Anchorage received federal funding to implement the program and now has a state-of-the-art program and equipment. Norton Sound Regional Hospital in Nome, Providence Extended Care Center in Anchorage and Providence’s long-term care facility in Seward have also installed ceiling lifts in patient rooms. Most new facilities that were recently completed or are currently under construction do include this critical equipment. The challenge is presented primarily when existing facilities need to take rooms out of service to retrofit the patient-handling equipment.
More than 10 states have enacted safe patient-handling and movement laws or promulgated rules and regulations. In 2013, U.S. Rep. John Conyers of Michigan introduced a bill, the Nurse and Health Care Worker Protection Act of 2013 (H.R. 2480) that would set a safe patient-handling, mobility and injury prevention standard that ultimately eliminates manual patient handling and requires health care employers to develop a safe patient-handling and mobility program.
Unfortunately, there is no Alaska state legislation pending at this time. The Alaska Nurses Association is conducting surveys to determine how prevalent the chronic injury rate is among Alaska nurses with the full knowledge that more often than not, problems go unreported. While many nurses have come to expect back, leg, neck and shoulder pain as just “part of the job,” this does not have to be the case any longer.
Engineers and manufacturers have caught up with the need to supply necessary equipment to the health care industry. Now the real challenge is getting health care facilities and the government to recognize how the absence of such equipment brings great cost to the workers’ compensation system, adding to the overall cost of health care delivery in this country. This is bad for the public and bad for the individuals who have chosen to dedicate their lives to helping others and end up with a life-altering injury that can possibly lead to years of chronic pain.
Donna Phillips has 33 years of experience as an RN and currently serves as labor council chair of the Alaska Nurses Association Board of Directors.