[This article originally appeared under the title “More Evidence Supporting Ergonomics as a Business Improvement Strategy,” in The Ergonomics Report™, on March 20, 2012.]
A well formulated and executed patient handling ergonomics program is once again shown to be a significant contributor to the organizational bottom line. The latest evidence comes from research conducted by University of Wisconsin based researchers Garg and Kapellusch who tracked key business metrics at seven health care facilities with ergonomics programs that included patient handling equipment. Safe patient handling has become an important topic in many health care facilities, and regulators in at least twelve US states, at the time of this writing, have taken note and enacted related regulations.
In their scholarly article, the researchers share some recent industry statistics from the US BLS that show the burden of poor patient handling practices. For example, nursing aides:
experienced the highest musculoskeletal disorder (MSD) incidence rate of days-away-from-work (7 times the national average for all occupations in 2009; and
the majority of injuries and illnesses (56%) among nursing aides involved patients, and 86% of those injuries were linked to overexertion.
Though the exact causative relationship between patient handling and injuries remains debatable, according to a 1989 study, patient handling activities preceded injury in 89% of low-back injury reports filed by hospital nurses. Biomechanical, psychophysical and epidemiological studies have all linked manual patient handling activities to risk exposure and injury.
The authors note that historical approaches to this problem included education and training in body mechanics and lifting/transferring techniques, but “with a few exceptions, these approaches have not been effective in reducing MSDs in nursing personnel.” Instead, they point to numerous studies that focused on the benefits of engineering controls, particularly patient handling devices, that solve the root causes of injuries, as the most effective approaches to reducing injuries. Their review of the literature revealed gaps in the research base, including:
The authors provide additional background to this problem, as well as much more detail on methods, results and interpretation than can be summarized here, so interested readers are directed to the original research article, referenced below, for complete details.
In this study, Garg and Kapellusch cooperated with 7 patient care facilities (6 long-term care, 1 chronic care). The researchers assisted each facility to establish a participatory ergonomics program with a primary focus on “no manual lifting” procedures. Facility based teams consisted of management and volunteers from nursing, housekeeping, dietary, and maintenance departments. Each team invited vendors to demonstrate and leave equipment for further evaluation, and were later free to select and purchase equipment of their choice. Each team then:
Taking special care to address known barriers to safe patient handling equipment implementation, the authors included these key aspects in the programs (italicized text is quoted directly from the original article):