2. Issue Analysis: Handling Patient’s Safely Nursing 450 Annie Cordova Ashley Cruz

3. Introduction According to a study conducted by the U.S. Bureau of Labor Statistics, RN’s are the 5 th most likely field to develop musculoskeletal disorders 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).

4. 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 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

5. Factors impacting safe patient handling Each patient is different in: 1. Size 2. Physical disabilities 3. Level of cooperation 4. Stability Insufficient resources Improper maintenance of equipment

6. Factors impacting safe patient handling Lack of training Poor staff buy-in Accessibility

7. 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 lack of clean equipment Time constraints Space restrictions Weight limitations

8. What does this mean for hospitals? Increased costs due to: Hiring of temporary personnel Increased recruiting and training costs Patient injuries Legal fees Workman's compensation

9. 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)

10. 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. 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

13. What needs to be done 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

14. Conclusion The implementation of safe patient handing programs in healthcare organizations creates a safer, more positive experience for all involved. Risk of injury for patients and staff is decreased, patient outcomes are improved and dignity is maintained. Costs are decreased as are injury rates. Staff, especially nurses, benefit from working in an environment where there health and safety are priorities and experienced nurses are able to remain in the field longer.

15. References Elnitsky, C., Lind, J., Rugs, D., & Powell-Cope, G. (2014). Implications for patient safety in the use of safe patient handling equipment: A national survey. International Journal of Nursing Studies. Murphy-Dawson, J., & Harrington, S. (2012). Embracing safe patient handling. Nursing Management, 43(10). Public Health, Safe Patient Handling. (April 13, 2014). U.S. Department of Veterans Affairs. Retrieved March 7, 2015 from http://www.publichealth.va.gov/employeehealth/clinical_occhealth/safe_patient_handling.asp http://www.publichealth.va.gov/employeehealth/clinical_occhealth/safe_patient_handling.asp Safe Patient Handling - Worker Safety in Hospitals. (2015). United States Department of Labor. Retrieved March 9, 2015 from https://www.osha.gov/dsg/hospitals/patient_handling.htmlhttps://www.osha.gov/dsg/hospitals/patient_handling.html Workplace Safety and Health Topics: Safe Patient Handling. (2013) Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/niosh/topics/safepatient/default.htmlhttp://www.cdc.gov/niosh/topics/safepatient/default.html