1. Issue Analysis: Patient Safety Nursing 450 Annie Cordova Ashley Cruz

2. Introduction In the field of nursing, back, shoulder and other musculoskeletal disorders persist to be the leading AND most costly U.S. occupational health problem (Safe Patient Handling, 2015).

3. Assessment of the Health Care Environment What happens when this is not effective? Nurses must perform in unfavorable conditions, in chaos and in unpredictable situations Each patient is different in: 1. Size 2. Have different physical disabilities 3. Different level of cooperation 4. Variations in stability What is in a Nurse’s job description? Manual lifting Proper body mechanics Proper use of back belts Able to lift and transfer at least 50 pounds Assist with ambulation and transportation of patient Apply and use special equipment as necessary

7. What has your hospital done to implement a safe strategy? Patient handling equipment Ergonomic assessment protocols No lift policies Training of proper use for patient handling devices Designated patient lift teams Even applying stockings in the morning puts the nurse at risk

8. THIS PUTS THE PATIENT AT RISK This is uncomfortable for the patient Decreases quality of care Adverse events that can stem from this are: fear, pain, bruising, shearing, possibility of dropping the patient and a loss of dignity for the patient Unstable equipment or operationally difficult to use Storage issues/equipment is located in an inconvenient place Poor maintenance and cleaning of equipment Time constraints Inadequate number of lifts No training on equipment Space restrictions Weight limitations

10. Recommendations and Interventions: A set standard of patient handling is not effective Improve hospital beds Schedule more rest breaks Rotate job duties or length of shift Proper training to all staff in proper body mechanics Proper training in the use of lift devices Height-adjustable and electric beds Ceiling mounted lifts (allows for vertical transfers of patients without ever lifting manually

11. Recommendations and Interventions Encourage patients to assist in their own transfers or use handling aids to help reduce the risk of injury Manual lifting may only be continued if it does not involve lifting most or all of the patient’s weight Implement an effective ergonomic process that provides management support, involves employees, identifies the problem and implements a solution

12. Conclusion Facilities need to teach that body mechanics can protect against injury while providing manual handling procedures Recognize high-risk, patient care activities Identify risks in patient care environments Interventions with the strongest level of evidence are being implemented by numerous facilities which are evidence-based solutions such as: patient handling equipment/devices, ergonomic assessment protocols, no lift policies, and patient lift teams

13. References