VA works to save nurses’ backs

By ThinkReliability Staff

More than 35,000 nursing employees suffer back and other injuries every year that impact their ability to perform their jobs.   Their rate of musculoskeletal injuries is about three times that of construction workers.

The commonly taught “proper” lifting techniques and sharing the lift with other employees doesn’t help.  Says William Marras, director of The Ohio State University’s Spine Research Institute, “The bottom line is, there’s no safe way to lift a patient manually.  The magnitude of these forces that are on your spine are so large that the best body mechanics in the world are not going to keep you from getting a back problem.”

Armed with these findings, and some studies of their own, the Department of Veterans Affairs (VA) is leading the way in preventing these types of injuries.  The VA discovered that at least $22M (believed to be underestimated) was spent treating employees’ injuries every year.  There are other indirect costs – patient care suffers when nurses are unable to perform their jobs.  At least 2,400 nursing employees at the 153 hospitals operated by the VA suffer injuries every  year that interfere with their ability to work.

Says the VA, “In recent years, a patient body weight of 35 pounds was established as the maximum weight that providers can safely lift when lifting and moving patients without the risk of injury.  This limit requires a new approach to lifting and moving patients.”

To determine what that new approach should be, the VA looked at what was causing the injuries, and why.  (To see the cause-and-effect relationships leading to the nurse injuries at the VA in the Cause Mapping format, click on “Download PDF” above.)  As part of their routine tasks, nurses regularly lift more than 35 pounds.  (The weight of a 200-pound patient’s leg is about 40 pounds.)  Not only moving patients, but repositioning them was a problem.

The availability of equipment that provides lifting (or repositioning) assistance to nurses was a big issue.  Many hospitals purchase just a few pieces, which are frequently unavailable (or incredibly inconvenient) when needed.  The VA is working to install ceiling lifts in all patient rooms and everywhere else patients need to go (clinics, imaging departments, etc.).  They’re also using “floating” mattresses, which use an air stream to “float” patient mattresses from bed to gurney.

Even having readily available equipment didn’t completely solve the problem.  The VA is working to ensure that staff, who were accustomed to manually handling patients, would actually use the equipment.  Rather than minimal and occasional training, the VA trains on lifting constantly.  At least one employee on duty at all times is responsible for ensuring safe lifting technology is used.  Injuries that can be sustained from manual lifting are emphasized.  Additionally, each hospital has a “safety champion”.  This is a full-time position that ensures that other employees have what they need to ensure safe lifting and that the hospital as a whole puts in the time and money to protect worker’s backs.

These programs come at a cost, but appear to be very successful in reducing injury rates (and associated costs) at these hospitals.  The VA as a whole has spent more than $200 million since 2008 on its “safe patient handling program” and has reduced nursing injuries from moving patients 40%.  One California VA hospital has spent $2 million to install lifts across the hospital.  Before the program, it spent $1 million over four years hiring replacements for injured employees.  Last year, nobody got hurt badly enough to miss work.  Says Tony Hilton, the hospital’s safe patient handling and mobility coordinator (“safety champion”), “Remember, I’m your guardian angel.  You know I’ve got your back.”

Click on “Download PDF” to see an overview of the cause-and-effect relationships for which the VA is implementing solutions to reduce nursing injuries.  Or, click here to learn more about the VA’s program.