Safe Patient Handling & Movement in High Risk Units

1. Safe Patient Handling & Movement in High Risk Units Audrey Nelson, Ph.D., RN, FAAN audrey.nelson@va.gov Director Patient Safety Research Center VAMC Tampa, FL Web: www.visn8.va.gov/patientsafetycenter/

2. Study Goals • Reduce the incidence and severity of musculoskeletal injuries in nursing staff. • Create a culture of safety and empower nurses to create safe working environments

3. Overview • Study Design: • Prospective Study over 2 years • Pre and Post Test Design • Qualitative and Quantitative Data • Study Sites: • 23 High Risk Units at 6 VA Hospitals

4. Program Elements • Ergonomic Assessment Protocol • Patient Assessment Criteria • Algorithms • Back Injury Resource Nurses • State-of-the-art equipment • No-Lift Policy

5. Results: Incidence of Injuries • Decreased 31% • From 144 injuries to 99 injuries • Significant at 0.003 level

6. Results: Modified Duty Days • Decreased 88%, from 2061 days to 256 days • Significant at 0.01 level

7. Results: Lost Work Days • Decreased 18%, from 256 to 209 days

8. Results: Self-Reported Unsafe Patient Handling • The # times/day nurses handled or moved patient in unsafe manner decreased from 3.63 to 3.18. • Significant at the 0.1 level

9. Results: Job Satisfaction • Pay • Professional Status** • Task Requirements** • Autonomy • Organization Policy • Interaction • Overall**

10. POST $46,464 $35,201 $18,657 $21,948 $202,971 Treatment Worker’s Comp Lost Work Days Restricted Days Total Cost Comparison Pre to Post PRE $93,531 $173,763 $24,048 $84,281 $480,797

11. Cost Benefit (Pre to Post) Year 1 only • Savings in medical costs and lost or restricted days: $277,826 • Minus annualized costs of equipment ($140,417.46) and training ($9,596.75) • Total Savings Year 1: $127,812

12. COST/BENEFIT • Over a 10 year period this translates to over $1.25 million dollars in cost savings, excluding the effect of inflation.

13. Conclusions • Significant reduction in incidence and severity of injuries. • Job satisfaction was significant increased. • There were significant monetary benefits, associated with decrease in lost/modified work days and lower medical and cash payments due to injuries.

14. Next Steps • Apply research to moderate risk units • Conduct ergonomic assessment in acute care settings • Identify high risk tasks in ICU, ER, OR, PACU • Identify technological solutions • Apply solutions deemed effective in high risk units (BIRN, algorithms, etc)