Injuries in Nursing Homes
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Transcript Injuries in Nursing Homes
Injuries in Nursing Homes
Nursing
Homes are ranked fifth among all
industries for low back injuries
17 Injuries For Every 100 Full Time
Workers
Nursing Home Workers Have the Most
Injuries Related to Overexertion of Any
Industry (no. 1 for overexertion)
Injuries Rose 55% in the Last Decade
Why Injuries Are Increasing
Pressure
in the Industry to Drive Down the
Price of Health Care
Nursing Home Sector Seeing More Acutely
Ill Patients - Hospitals Move Patients Out
Faster
More Acutely Ill Patients Means More
Dependant Patients who Requires More
Handling
Other Injury Risks
Nursing
(in general) has the highest rate of
Falls to the Floor on the Same Level of any
Group of Workers
96 Cases per 10,000 workers
Lack of Adequate Housekeeping Staff
Contributes to Slipping/Falling Problem
Risks for Injury: Patient
Handling Tasks
Frequent
Manual Lifting of Patients is the
Primary Risk
Two-person Manual Lift is the most
common patient transfer method
Average Nursing Home Worker Lifts More
Than 10,000 Human Pounds Per Day
Other Stressful Tasks
Lifting
Patient Up in Bed
Weighing Patient
Repositioning Patient
Making Bed With Patient In It
Making Bed Without Patient In It
Lifting Carrying Equipment or Supplies
Hoists Have Not Worked
One
study found that mechanical hoists
were used for only 2% of patient transfers
The reasons for not using hoists:
hoist not available
takes too much time
lack of staffing
the physical effort required to use hoist
For Dependant Weight
Bearing Patients
For
patient transfers, the two-person
walking belt was found to be least
physically stressful among several methods
Using a pulling technique (not lifting) was
important to minimize stress to the worker
Training of workers to use the pulling
technique with walking belts was required
Lifting Devices Differ Widely
Several
Mechanical Lifting Devices were
compared
Arjo-Century’s Ambulift Device was found
to be least physically stressful to workers
Hoyer Lifts were found to be as physically
stressful as manual lifting of patients
Comparing Three Lifting
Devices
Using
Hoyer lifts is more physically
stressful than most manual methods
Trans-Aid lifts reduced physical stress
compared to manual methods
Arjo-Century lift was least stressful
mechanical device, and patients preferred
this device (felt more secure)
Staff to Patient Ratio
Inadequate
staffing is a major obstacle to
injury prevention efforts
Many transfers require two workers, but are
performed by one worker
Lifting Teams have been used successfully
in hospital settings to dramatically reduce
workers compensation losses
Adequate Equipment
Adequate
equipment includes:
Walking Belts
Shower Chairs
Shower Chairs fit over toilet
Shower Chair fits easily into shower
Adaptive Clothing as needed
Ergonomics Efforts Do Work
In
one study losses were reduced by 50% by
making ergonomic improvements
Classifying patients and applying consistent
transfer methods per category was
important
Compliance Required Adequate Staff to
Patient Ratio
Classifying Patients
dependent/non-weight
bearing
dependent/weight bearing
independent
Patient Handling Per
Classification
non-weight
bearing: Use Mechanical
Device
weight bearing dependant: Use Two-Person
Walking Belt with Pulling Technique
independant: Patient Moves on Their Own
Lifting Team Approach
Also
relies on classifying patients into
categories
Lifting Team specially trained in each
method or patient category
Lifting Team adheres strictly to prescribed
methods per category
Adequate staffing ensured by Lifting Team
approach
Lifting Team Approach
Team
members selected for strength, ability
Nurses and Nurses Aids free to perform
other tasks
May increase number of Full Time
Equivalents (FTE) required
Has been cost-effective in hospital settings
due to reductions in injuries and costs
Administrative Issue
Handling
of Patients By Prescribed Method
Per Patient Classification Required
Compliance Must Be Monitored and
Enforced/Reinforced
Adequate Staffing is Required for
Compliance
Other Equipment
Adjustable
height beds
Slings attached to beds
Adequate number of mechanical lifts
Adequate type of mechanical lift
Most Stressful Tasks
Ratings
of Perceived Exertion has been
useful in job/task evaluations of nursing
home tasks
Transfers from wheelchair to toilet was
most stressful task
Transfers from chair to bed also stressful
Two-person manual lifting method most
stressful of several methods examined
Walking Belts and Gait Belts
Walking
belts differ from gait belts in that
they have handles and better secure the
patient
For best results with walking belt method,
nurses were instructed “Pull with your hand,
not your back. Do not lift”
Many nurses have old habit of lifting when
transferring - which must be “unlearned”
Improving Ergonomic
Conditions
Consistent
Use of Lifting Devices for NonWeight Bearing Patients
Easily Adjustable Chair and Bed Heights
Adequate Staff to Patient Ratio - Increase
Staff if Necessary
Training in Proper Techniques
Walking-Belts With Pulling Method
Standards and Regulatory
OSHA Launced
an Initiative To Improve
Conditions for Nursing Home Workers in
1996
Unions Pushing for Enforceable Staffing
Standards
OSHA’s Proposed Regulation on
Ergonomics Could Stimulate Dramatic
Improvement - If Made Into Law