Ergo Blitz!

1. Ergo Blitz! How To Establish A Zero Lift Policy That Works

2. Lessons • BLITZ! Nursing home ergonomic problems can be addressed QUICKLY • Payback is fast • Management commitment/employee involvement is the key to success

3. OSHA Intervention? • Nursing Home Administrator attended OSHA Outreach Activity • Thereby motivated to avoid OSHA Nursing Home Programmed Inspection • State of Illinois OSHA On Site Consultants were used • No inspection by Federal OSHA

4. The Facility • 207 bed long term care skilled nursing facility in Aurora, IL • 160 employees (65-70 aides) • 2002 injury/illness rate was high - 24.0! • Many lifting injuries • Beds • Chairs • Toileting

5. 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

6. Evaluate Injuries and Costs • OSHA recordables and non-recordables • Cost data from workman’s comp carrier • Resident injuries such as skin tears • Employee turnover rate and costs of turnover

7. Obtain Approval For Funding • Present injury/cost data to owner • Ballpark estimate for buying lifting equipment • Note other expected results • Reduced risk of OSHA inspections/penalties • Reduced employee turnover, better morale • Injury reduction from dropping residents • Increased admissions from improved PR • Overall better resident care

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

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

10. Equipment Selection • Equipment feedback list from CNAs • 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

11. Resident/Family Notification • Send letter to families advising of change • Advise Resident’s Council

12. Equipment Prep • Copy manufacturer instructions, laminate, and attach to equipment • Attach a warning sign that each lift must be checked prior to use • Charge battery operated equipment • Develop competency checklist on use of equipment

13. Equipment Location • Right number of lifts in the appropriate locations • Lifts need to be available to aides, NOT the residents moved to be accessible to the equipment!

14. Training • CNA one-on-one training for each employee • Employees competency checked on each piece of equipment • Competency check signed off by aide • Not use equipment until competency checked • 3 day suspension for not using lift

15. Resident Assessment • Needs to identify the type of equipment needed for each resident • Develop assessment sheet • Review assessment sheet with staff

16. Coordination • Maintenance staff – new equipment maintenance info • Laundry staff – sling cleaning information (some slings can’t be laundered). • Rehab staff – info on lift type(s) used with each resident (because lifts require use of muscles)

17. Equipment Selection by this Nursing Home • 5 Sit to Stand Lifts • 4Hoyer Lifts • 3 Pivot Disks

18. Sit To Stand Lift • Equip one sit-to-stand lift with a scale for weighing residents

19. Hoyer Lift • Decision: Electric or Hydraulic • Purchase extra slings • Equip one lift with weigh scales to eliminate extra handling for resident weighing

20. Pivot Disk • Like a Lazy Susan with handles • Great for bathrooms, can be rotated using little space

21. Enforcement • 3 day suspension for not using lift • Policed by Lifting Committee members, empowered to recommend suspensions • Nine suspensions were levied here • Pick suspension days for best use of facility resources and less impact on employee’s paycheck at one time

22. Results: Costs and Savings • Costs at this facility • $24K for lifting devices and slings • Time: 45 minutes weekly X approx 10 aides • Team leader time of approx 1 hour/week in addition to above meeting • Claims paid by comp carrier • 1/1/02 - 8/15/02 $67.5K paid 31 recordables • 1/1/03 - 8/15/03 $1215 paid 3 recordables

23. Employee Testimonials • “I have much more energy at the end of the day. My quality of life is so much better when I am home.” • “If interviewing at another nursing home, I would ask them about the equipment they have and their lifting policies.”

24. Performance Measurement • Worker’s comp costs • OSHA recordable and nonrecordable injuries • Employee satisfaction • Number of resident transfer injuries

25. Evaluation • Continue regular committee meetings and solicit feedback • Make changes in equipment, procedures, or training where necessary

26. Lessons Learned • Hazard Resolved: nursing home ergonomic problems addressed in less than 3 months! • Payback: almost immediate from a comp payout standpoint • Safety Management: Administrator involvement and employee lifting committee were the key to success.

27. Contact October 2003 shields.charlie@dol.gov Charles J. Shields, MS, CIH, CSP U.S. Department of Labor – OSHA 365 Smoke Tree Plaza North Aurora, IL 60542 630-896-8700 • Six Year Anniversary of Aurora Area Office Electronic Mail Newsletters