Ergonomic Guidelines for the Nursing Home Industry

1. Ergonomic Guidelines for the Nursing Home Industry

2. THE PROBLEM • Musculoskeletal injuries account for more than 50% of all lost times injuries in the Healthcare Industry • Greater than 750,000 work days are lost annually due to back injuries in Healthcare Sector

3. OTHER FACTS • In one 8-hr. shift the cumulative weight a Nurse/Aide, etc., lifts is…. 1.8 Tons

4. What Can You Do to Reduce Your Risk of MSDs? • Conduct a hazard or risk assessment • Assess the patient • Assess & prepare the environment • Get necessary equipment & help • Perform the patient care task, lift or movement safely Plan and Prepare – It only takes a minute but can save a career

5. NIOSH Lifting Equation Applied toPatient Handling Activities • Even using the NIOSH Lifting Equation, the threshold limits for injury are exceeded when performing patient handling tasks.

6. NIOSH • Determined that ½ day of training was not effective in minimizing MSD’s associated with patient lifting. • 1 to 1.5 days of training better

7. OTHER FACTS • American Nurses Association is currently pushing for a national law governing safe lifting practices and standards at the National level. • Gait belts have been banned from use several European countries

8. LIFTS NOT ALLOWED • UK, Austria, Ireland, Netherlands, Sweden, Denmark, S Africa, British Columbia do not allow… Under the axilla lift; hook and toss; lift with patients’ arms around nurse’s neck, etc.

9. Goal of Ergonomic Evaluation, Design, and Intervention • Increase Efficiency • Increase Productivity • Increase Quality • Decrease Cost WHILE.....

10. Goal of Ergonomic Evaluation, Design, and Intervention • Decrease Injury/Illness • Lost work day rates • Restricted work day rates • OSHA reportable rates • Workers’ compensation costs • Decrease Fatigue • Decrease Absenteeism • Decrease Turnover

11. Ergonomic Guidelines for the Nursing Home Industry • Why are we doing this: • OSHA’s Ergonomics for the Prevention of Musculoskeletal Disorders – Recommendations to help reduce number and severity • SB 1525 – Safe Patient Handling and Movement Practices • Promote and achieve as much as possible, a “ZERO” lift attitude in the work place dealing with “PEOPLE”

12. Senate Bill - 1525 • Effective January 1, 2006 • Governing body/Assurance Committee shall adopt and ensure implementation of a policy to identify, assess, and develop strategies to control risk of injury to patients and nurses associated with lifting, transferring, repositioning, or movement of a patient. • Analysis of risk of injury to both parties posed by patient handling • Education of nurses in the identification, assessment and control of risks

13. Senate Bill – 1525 (cont.) • Evaluation of alternative ways to reduce risks associated with patient handling • Restriction, to the extent feasible with existing equipment and aids, of manual patient handling or movement of all or moist of a patients weight • Collaboration with and annual report to the nurse staffing committee • Procedures for nurses to refuse to perform or be involved in patient handling or movement that the nurse believes in good faith will expose a patient or nurse to an unacceptable risk of injury…

14. Senate Bill – 1525 (cont.) • Submission of an annual report related to the identification, assessment, and development of strategies to control risk of injury associated with lifting, transferring, repositioning, or movement of a patient • In developing architectural plans for constructing or remodeling a hospital or nursing home in which patient handling and movement occurs, consideration of the feasibility of incorporating patient handling equipment, etc.

15. American Nurses Association survey found 83% worked in spite of back pain 60% fear a disabling back injury 38% require time off during their career due to back pain In 2000 resulted in time away from work for 10,983 RN’s 44,854 in nursing aides, orderlies, etc., experienced overexertion in lifting related incidents BLS STATISTICS (2004)

16. We need to address a “no lift” process in Nursing Homes when it comes to lifting/moving/transferring of residents/clients, etc. This can be accomplished by use of any of the following: Hoyer Lifts Sit/Stand Hoist Use of shower chairs Ceiling mounted lift devices Ambulation assist device Geri or Cardiac Chairs Stand Assist Devices Lift Chairs Transfer Boards NO LIFT Technology

17. The Process, Step By Step • Evaluate Injuries and Costs • Obtain Approval For Funding • Establish A Lifting Committee • Evaluate and Select Equipment • Resident/Family Notification • Receive and Prep Equipment • Training • Resident Assessment • Coordination with Other Staff • Enforcement • Performance Measurement • Evaluate Efforts Regularly

18. Establish A Lifting Committee • CNA based committee • Select outgoing CNA’s • 45 minute meeting per week • Food, fun, praise • Leader has budget authority, is committed to project, and is a motivator

19. Evaluate Equipment • Hold open house for several different vendors • Demo equipment never seen before • Can's test equipment in the facility/provide feedback Four inch extenders added to bed legs so lift will fit under lowboy bed.

20. Equipment Selection • Equipment feedback list from CNA’s • Identify all different accessories needed for lifts such as scales and extra slings • Decision meeting with lifting committee • Final budget approval and purchase • Set date for zero lifting policy

21. Nursing Home Departments Primarily At Risk • Nursing Care Services • Housekeeping • Laundry • Maintenance • Dietary/Food Service • Office, Volunteer Services, etc.

22. Risk Factors Pulling/Pushing Forces Heavy Lifting Awkward Postures Inappropriate Equipment Lack of or no Training Body Segment Affected Back Neck Shoulders Lower Limbs Arms Wrists Knees Nursing Care Services Risk Factors

23. Lifting and Moving of Patients/Clients/Residents Possible Solutions • Hoyer Lift • Good Body Mechanics • Team Lifting • Powered sit-to-stand or standing assist devices • Ceiling mounted lift devices