Transcript IEEE-EMBS 2004 Poster

Cost-Effective Strategies for Preventing
Lift-Related Injuries among Health Care Workers
Marjorie C. McCullagh, PhD,
1 University
1
RN,
COHN-S, Melissa Foster Rietz, BSN,
of Michigan School of Nursing
Background
Institutional Assessment
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-ofthe-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.
Lift Team and Equipment
2 University
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, unitspecific 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.
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.
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.
Investments
Equipment and personnel expenses related to the
program totaled $1.5 million between 2004 and 2007.
Nursing Lift–Related Injury (DART) Rate
500
400
300
200
100
0
03
04
05
06
07
Year
08
of Michigan Health System
09
10
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
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.
Frequency
The purpose of this study was to evaluate the
effectiveness of the UMHS back injury
prevention program and its consistency with
current best practices.
Marge Calarco, RN,
2
PhD
Lift-related
Injuries
Review of Literature
Patient Handling Policies
Objectives
1
RN,
11
This study was supported by CDC/NIOSH grant number T42OH008455.
Approved by University of Michigan IRB HUM00060704.