The phrase “culture of safety” is a common buzzword in healthcare these days—but it is focused on keeping patients safe from errors and injury, while workplace safety for nurses has largely been ignored. That is expected to change quickly now, because of an OSHA initiative announced in June that is going to crack down on hospitals that don’t take steps to protect nurses from back and shoulder injuries. Hospitals that do not adopt safe practices will be fined.
The fact is, a failure to keep nurses safe from injury can have direct consequences on patient care. When large numbers of nurses either suffer from or fear a debilitating back injury, they are likely to retire early, which can contribute to a predicted nursing shortage in the years ahead. Those who stay on the job may experience job dissatisfaction and burnout, which research has linked to higher rates of poor outcomes, like hospital-acquired infections.
A recent series of investigative reports on NPR examined the issue. (If you missed it, you can listen or read transcripts of the five-part series online.) NPR cited Bureau of Labor statistics that state there are more than 35,000 musculoskeletal injuries among nurses, nursing assistants, and orderlies every year. As a whole, this group of healthcare workers is injured on the job more often than construction workers. The number one cause of injury? Moving and lifting patients.
While the problem is not new, recent trends may be increasing the frequency of injuries that stem from moving patients. Surging obesity rates mean patients are heavier and harder to move. And our healthcare system is sending hospitalized patients home earlier and sicker, meaning nurses have to get them up and moving sooner.
What’s more, research shows that the “proper body mechanics” catchphrase nurses are taught about moving patients is not accurate– it is demonstrably not true that keeping the back straight and bending the knees can prevent a back injury when there is too much force on the spine. And no technique can compensate for repetition, as small injuries accumulate over time. The same goes for “team lifting,” which refers to the practice of having two to four nurses move a patient. Experts say this does not reduce stress on the spine to safe levels and can actually cause more stress from bending.
The bottom line? Experts have determined there is no safe way to lift and move a patient manually. The answer, they say, is to follow the lead of the manufacturing industry and use machines and specialized equipment to do the heavy lifting. The NPR series reported that a handful of hospital systems, including some managed by the Department of Veterans Affairs, have adopted motorized hoists to lift patients and have conducted intensive training to make sure nurses know how to use them – but these hospitals remain the exception rather than the rule.
The recent OSHA initiative may change all that that, as hospitals look for ways to be in compliance and avoid fines. The good news is, OSHA has created a website full of resources about safe patient handling, including downloadable documents, posters, and checklists.
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