Safe Work Environments for Nurses: Safe Patient

Handling

Audrey Nelson, Ph.D., RN, FAANaudrey.nelson@.va.gov

Every work environment has its own special challenges

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.

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)

The Ergonomic ChallengeThe Ergonomic Challenge

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

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.”

Outcomes Nursing Outcomes:

31% reduction in incidence of injuries 18% reduction in lost work days 88% reduction in modified duty days

Patient Outcomes:1. Lower depression 2. Improved urinary continence3. Increased engagement in activities4. Less likely to fall5. 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

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

Making the change is hard……but nurses deserve this!

Patients deserve this!

 

Wis

e w

ords

The End…..

Do one Do one brave brave thing thing

each dayeach day