In an ideal world, healthcare facilities such as hospitals and nursing homes would evoke feelings of healing and comfort. However, for those at the forefront of patient care, these environments can pose significant hazards, particularly when manual patient lifting and repositioning are frequent tasks. With patients becoming older, heavier, and dealing with more complex conditions, manual handling has emerged as a significant risk.
Paradoxically, patient handling can be as hazardous as construction work. Data from the Bureau of Labor and Statistics reveals that injury rates for nurses’ aides, orderlies, and attendants were alarmingly high in 2007, with 44,930 days away from work due to injury, translating to an injury rate of 465 cases per 10,000 workers. In comparison, construction workers, traditionally seen as engaged in risky tasks, had a relatively lower injury rate of 394 cases per 10,000 workers. Moreover, the musculoskeletal disorder rate for healthcare workers exceeded the national average for all occupations by more than sevenfold, standing at 252 cases per 10,000 workers.
The documented physical hazards of manual patient handling notwithstanding, misinformation still circulates about safe handling techniques and the use of equipment like ceiling and floor lifts for patient movement. Disseminating accurate information becomes paramount in curbing these injuries.
Misconception: Injury can be prevented through proper biomechanics and lifting techniques during manual patient movement.
Numerous studies have debunked the idea that training caregivers in proper body mechanics significantly reduces injury rates. This is likely because the biomechanical demands of manual lifting often surpass the body’s capabilities. Moreover, caregivers question whether the existing biomechanics research, which informs their training, is truly applicable to patient care scenarios. Traditional studies focused on lifting static objects, not patients who are dynamic and often moved in different planes. Additionally, research doesn’t support many popular manual techniques, indicating that they are unsafe.
The National Institute for Occupational Safety and Health’s revised lifting equation, which calculates recommended weight limits for two-handed manual lifting tasks, found that under ideal conditions, a patient lift should not exceed 35 pounds. However, most patients weigh more than this limit, especially considering the rising obesity rates. This stark reality, along with factors such as patient agitation and the unpredictability of patient handling, highlights the impracticality of relying solely on “proper” techniques.
Misconception: Manual patient handling is faster than using equipment, but equipment usage is safer.
While manual handling might be quicker in some cases, the use of lift equipment is significantly safer. The perceived time difference often arises from the time spent searching for equipment, which wouldn’t be an issue if equipment were readily available. Manual handling could potentially take more time if additional staff are needed to assist. Research indicates that mechanical lift equipment not only requires fewer personnel but also saves around 5 minutes (even accounting for equipment setup) compared to manual transfers. Installing fixed ceiling lifts in patient rooms can further eliminate time lost in equipment search and retrieval.
Misconception: Mechanical equipment compromises patient comfort and safety during movement or repositioning.
Numerous studies have demonstrated that mechanical lift equipment enhances patient comfort and feelings of security compared to manual handling. Patients may even perceive the equipment as a means of reducing their impact on nursing staff. Although some patients may be initially wary of the equipment, patient education can address their concerns and emphasize safety.
Misconception: Lift equipment is costly, and many healthcare facilities cannot afford it.
While the initial investment in proper lift equipment might seem steep, the long-term benefits significantly outweigh the costs associated with injuries from manual patient handling. Hospitals with safe patient-handling programs have consistently witnessed a decrease in injuries, workers’ compensation claims, and costs, accompanied by improved worker satisfaction and retention.
The return on investment for program implementation (including equipment) is remarkably short. One hospital reported a payback period of around 4 years for direct costs and less than 2 years when factoring in indirect costs. In another case, the payback period was less than 1 year when indirect costs were considered. Certain states even offer tax rebates to healthcare facilities that implement safe patient handling programs.
Misconception: Being young, healthy, and strong eliminates the risk of patient-handling injuries.
Contrary to intuition, research suggests that even young, physically fit caregivers are susceptible to patient-handling injuries. The risk of back injury increases with age and years in the field, yet younger or healthier caregivers have also reported injuries. Their strength might lead colleagues to seek their assistance more often, inadvertently putting them at higher risk. Additionally, leisure, household, and exercise activities have been linked to lower back pain. Younger nursing students who engage in more physical activity are more likely to experience back pain.
Furthermore, physical conditioning doesn’t necessarily expedite the return to work for nurses with back injuries. Physical-conditioning programs aimed at facilitating employees’ return to work have shown limited effectiveness in reducing sick leave for workers with acute back pain.
Addressing the Problem
Patient-handling injuries continue to take a toll on healthcare workers, contributing to the already existing nursing shortage. To counteract this, healthcare institutions must prioritize safe patient-handling programs. These programs should incorporate risk assessment, effective risk control policies, adequate equipment, continuous training, and collaboration across all levels of the organization. By focusing on staff health and safety, these programs can contribute to improved patient care and staff retention.