Cost-Effective Strategies for Preventing Lift-Related Injuries among Health Care Workers

1. Cost-Effective Strategies for Preventing Lift-Related Injuries among Health Care Workers Marjorie C. McCullagh, PhD, RN,1 COHN-S,Melissa Foster Rietz, BSN, RN,1 Marge Calarco, RN, PhD2 1 University of Michigan School of Nursing2 University of Michigan Health System Background Nursing aides, orderlies, attendants, and registered nurses are in the top 10 job categories for work-related musculoskeletal disorders. The University of Michigan Health System (UMHS) employs thousands of nurses and assistive personnel. Over the past several years, UMHS has invested heavily in state-of-the-art strategies to reduce back injuries among nurses and assistive personnel. Despite these interventions, UMHS continued to experience unacceptable rates of back injuries related to patient handling. Institutional Assessment Lift Team and Equipment Assistive devices (i.e., 68 ceiling mounted mechanical lifts, slings, slide sheets, tubes, accessories) and training were pilot tested in 3 patient care units in 2005. Lifts and training were later expanded to all units. By 2007, unit-specific equipment needs were assessed, and selected devices were purchased, installed, and training offered based on individual unit needs. A specially trained 24-hour lift team began serving selected patient care areas in 2007. However, nurses and assistive personnel continue to be hesitant to utilize the available equipment or the on-call lift team. Lift-related Injuries • Review of Literature • There was support in the literature for use of the following strategies to reduce lift-related injuries among health care workers. • Specialized lifting equipment • No lift policies • Patient care assessment protocols/algorithms • Training in the proper use of lifting equipment and devices; annual refresher training • Unit-based peer leaders (or back injury RN specialists) • Gaps Analysis • The following strategy in use matched those in the literature. • Lift team and equipment • The following strategies recommended in the literature were lacking at the institution. • Agency policies (e. g, no lift policy, ongoing staff education, patient handling algorithms) • Unit-based peer leaders Patient Handling Policies As of 2012, a review of existing policies revealed policies requiring education of new nursing and assistive personnel hires, and a bariatric patient lifting algorithm. Objectives The purpose of this study was to evaluate the effectiveness of the UMHS back injury prevention program and its consistency with current best practices. Investments Equipment and personnel expenses related to the program totaled $1.5 million between 2004 and 2007. Conclusions UMHS has experienced modest improvement in lift-related injury rates in response to investment in patient handling equipment and a lift team. However, lift-related injury rates remain at unacceptable levels. Current policies regarding training and lifting may be limiting the effectiveness of investments in safe patient handling strategies. Recommendations for continuous quality improvement include development and implementation of a no-lift policy, patient care assessment protocols/algorithms, annual refresher training, and unit-based peer leaders. Program success will be evaluated by monitoring Injury rates. Nursing Lift–Related Injury (DART) Rate Methods A comprehensive literature review was conducted to identify state-of-the-art methods of back injury prevention among health care workers. A qualitative review of institutional policies and practices (e.g., patient lifting equipment, lift team) was used to identify gaps between state-of-the-science and current practice in the health system. A review of budget records and employee injury data was used to evaluate the effectiveness of current policies and practices. Frequency This study was supported by CDC/NIOSH grant number T42OH008455. Approved by University of Michigan IRB HUM00060704. Year