Safe Patient Handling and Transfer

The Issue:

Numerous studies have documented a high prevalence of back, knee, shoulder and other joint pain among healthcare workers. Based on workers’ compensation claims for back injuries, nursing aides and licensed practical nurses (LPNs) ranked fifth and ninth, respectively, among all occupations, as those most at risk for such injuries. Nursing aides are at a higher risk for back injuries than construction laborers, lumbermen, material handlers and laborers.

Lifting and transferring of patients are the most commonly reported causes of back pain and knee and shoulder injury among healthcare workers. Most programs for the prevention of back and joint injury to healthcare personnel tend to focus on proper lifting techniques, body mechanics and back care. But many researchers now recommend an ergonomics approach that focuses on workplace assessment of patient care areas, patient assessment criteria, algorithms for safe patient handling and movement, lifting and transfer equipment, peer-safety leaders, lifting teams, incident reviews and other similar policies. These ergonomic approaches to safe patient handling and transfer policies are often called “no-lift” or “zero-lift” policies.

Delegates to the 2004 convention of the American Federation of Teachers passed a resolution requiring the AFT Healthcare division to undertake a national campaign to establish safe lifting policies in all healthcare and educational settings. As part of that campaign, AFT Healthcare has developed or collected the following resources and materials.

Resources:

Safe Patient Handling: A Report—Based On Quantitative Research Among Nurses and Radiology Technicians, conducted on behalf of AFT Healthcare by Peter D. Hart Research Associates Inc., March 2006. This study of hospital nurses and radiology technicians reveals that their work has become extremely physically demanding, often resulting in job-related injury or chronic pain. Many nurses and radiology technicians report that they have considered leaving patient care because of the physical demands of the job, which would only exacerbate the current shortage in those professions.

Patient Handling Solutions —Directory of Equipment Solutions to Reduce the Strain and Stress of Patient Transfer and Repositioning Activities, 2nd Edition, 2003, compiled by the Occupational Safety and Health Department of the New York State Public Employees Federation. This is a guide to some of the equipment available for moving patients, and includes checklists of desired features and a directory of manufacturers.

Long-Term Effectiveness of “Zero-Lift Program” in Seven Nursing Homes and One Hospital, by Arun Garg, University of Wisconsin-Milwaukee, sponsored by the National Institute for Occupational Safety and Health. The primary objective of this study was to reduce injuries to healthcare workers resulting from manual lifting and transferring of patients. The “zero-lift” programs, using employee-management advisory teams, were implemented in seven nursing homes and one hospital. All eight facilities had a large number of acute-care patients. The “zero-lift” programs were implemented by replacing manual lifting and transferring of patients with battery-operated, portable hoists and other patient-transfer assistive devices. Injury statistics were collected and showed that the number of injuries from patient transfers decreased by 62 percent, lost workdays by 86 percent, restricted workdays by 64 percent, and workers’ compensation costs by 84 percent.