Study Links Safe Patient Handling with Decline in Hospital Worker Injuries

Hospitals that implement safe patient handling and moving policies may find these practices associated with fewer injuries among healthcare workers, a small study suggests.

Researchers analyzed data on 1,832 patient care providers at two U.S. hospitals – one that started a safety program and one without these policies in place.

At the hospital that implemented safe patient handling policies, the risk of neck and shoulder injuries declined 32 percent in the year after these polices took effect. Over that same period, the odds of lifting and exertion injuries dropped 27 percent and the chances of pain and inflammation decreased 22 percent, the study found.

For the hospital that didn’t implement these safety programs, however, there were no significant changes in injury risk over the study period.

“Integrating safe patient equipment and procedures into the plan of care for each patient . . . aligns the goal of caring for the patient with the prevention of worker injury,” said lead study author Dr. Jack Dennerlein of Northeastern University in Boston.

“This approach can easily be transferred to other hospitals,” Dennerlein added by email.

For the current study, researchers evaluated a hospital-wide safe patient handling and mobilization program initiated at one academic medical center in the Boston area. The “control” hospital in the study was similar in size, patient complexity and payer mix but didn’t implement a safety program.

Before the teaching hospital started its safety program, both hospitals had limited success in improving safe patient handling and mobilization practices despite investing in things like lifting devices and swings, researchers note in the journal Occupational and Environmental Medicine.

Researchers surveyed workers with direct patient-care responsibilities at both facilities before these policies were put in place and again one year later.

In the first survey about 80 percent reported experiencing some kind of pain related to their jobs in the previous three months. More than half had lower back pain and about 43 percent had neck or shoulder pain. About a third said the pain interfered with their work.

At the hospital with new safety practices, more equipment was added to many inpatient care areas and rooms to facilitate moving patients – this included ceiling lifts, slings, sit-to-stand devices and air-assisted lateral transfer devices.

This equipment was designed to help minimize the risk of injuries when workers move extremely obese patients. Ceiling lifts, for example, could hoist patients weighing up to 625 pounds, while bed-repositioning slings could accommodate patients weighing up to 1,000 pounds.

All nurses, nurse directors and patient care assistants received training on how to use the new equipment and the best ways to safely move patients in different situations.

These efforts were part of a larger program designed to increase patient mobility. Plenty of previous research has found that patients can have a faster recovery and fewer complications when they are able to get out of bed and move around.

To some extent, however, efforts to get patients moving have clashed with the need to protect workers from injuries on the job, particularly as a growing number of U.S. adults are overweight and obese.

One limitation of the study is that researchers relied on hospital employees to accurately recall and report how well they followed new patient handling policies.

Even when policies aren’t in place or are practically hard to follow, workers can still take steps to be safer when moving patients, said Alexander Dewey, a physical therapist at Sutter Medical Center in Sacramento, California who wasn’t involved in the study.

“Use proper body mechanics at all times whether using a safety equipment or not,” Dewey said by email. “Ask for assistance when needed.”

This is crucial in healthcare because lifting patients is very different from other types of manual labor involving heavy loads, said Kermit Davis, a researcher at the University of Cincinnati in Ohio who wasn’t involved in the study.

“The loads are usually much higher than those in industry, even where loads are as high as 75 pounds like warehousing, baggage handlers and parcel delivery,” Davis said by email.

“Patients are four to five times as heavy,” Davis added. “Weights above 75 pounds or even 35 pounds are not safe to routinely lift manually.”