The Employee Health Director of a large 600 bed Medical Center recently observed a 30% increase in nursing injuries from FY15 to FY16. He identified data which revealed increases in injuries in the facility’s Intensive Care Unit, Emergency Room and the Spinal Rehabilitation Units. Staff who reported these injuries acknowledged that they had participated in the hospital’s patient-lift classes as part of the facility’s annual competency assessment while openly praising the information provided by the instructor who happened to be one of the hospital’s Physical Therapists. The Employee Health Director remained unsettled as for why patient handling injuries were consistently increasing and decided to take action.

Interventions:

1. The director first met with Nursing Leadership in search of information for why patient handling injuries were increasing.
2. Patient care staff were questioned regarding the use of the hospital’s patient-lift devices.
3. The Physical Therapy Department explained the training curriculum used to train nurses on how to properly lift patients by applying “body-mechanics” in hospital settings.
4. The director visited the facility’s Intensive Care, Emergency Room, and Spinal Rehabilitation units to observe patient care particularly patient-lift practices.

Considerations:

Increases in patient-handling injuries are a good indication that manual lifting practices are the norm amongst staff within the hospital organization. Unless it’s reasonable to believe that all staff injuries because of manually lifting patients are in some way a reflection of staff’s inability to perform proper manual lifting techniques, it must be concluded that teaching proper body-mechanics does not provide the necessary solutions for preventing these type injuries. Injury Data Analysis is important for determining a proper course of action to take towards developing a potential solution. From understanding the description of the lifting event, the consistency for which injuries related to patient handling events occur, to noting any steps or measures taken to avoid such injuries in the areas where incidents have taken place, information gathered assists in deciding best practices to prevent injuries. This level of information must be appropriately understood if it is to be used to decide what type of patient-lift equipment should be chosen to address injuries to employees in each patient-care area.

Outcomes:

Having observed the various areas watching caregivers perform manual patient care tasks, the Employee Health Director recommended that staff be required to use patient-lift equipment assigned to their areas. Nurse Management and staff expressed many concerns. Amongst those included: insufficient quantities of equipment, accessories or “lift pads” were never available, equipment remained broken and unrepaired most of the time, and equipment is necessary only for the “heavy” patients. The Employee Health Director did observe a slight decrease in injury rates over the next 6 months post his recommendations. His belief however was that results were more likely coincidental. There also was the feeling that staff were underreporting injuries. He was doubtful that significant changes in practice had been made.