MDS Alert

Published on Mon Jan 08, 2018 PDF

Providing long-term care can be hard on a person's body; make sure you're staying safe.

You know from experience that delivering health care to other people is an intensely physical job. Working in long-term care, especially in a skilled nursing facility, only magnifies the toll your chosen healthcare career can take on your body. Make sure you and team members are providing the best possible care - in the safest possible manner.

Check out these statistics and tips from Renee Kinder, Ms, CCC-sLP, RaC-Ct, director of clinical education at encore Rehabilitation services in Louisville, Kentucky.

Know the risks

More than 52 percent of nurses complain of chronic back pain, and statistics show that 12 percent of nurses leave the profession annually due to back injuries, Kinder says.

If it seems like you and your colleagues are getting hurt or are in pain more than acquaintances pursing other careers, it's not just your imagination. In fact, the national institute for occupational safety and Health (NIOSH) suggests that workers should not have to lift manually any object weighing more than 51 pounds. Obviously, the average adult human weighs two to five times more than NIOSH's maximum lift recommendation, and healthcare staff injuries are common.

"Data from the Bureau of Labor Statistics (BLS) show that in 2014, the rate of overexertion injuries averaged across all industries was 33 per 10,000 full-time workers. By comparison, the overexertion injury rate for hospital workers was twice the average (68 per 10,000), the rate for nursing home workers was over three times the average (107 per 10,000) ....

"The single greatest risk factor for overexertion injuries in healthcare workers is the manual lifting, moving, and repositioning of patients, residents or clients, i.e., manual patient handling," NIOSH says.

What can you do to keep yourself healthy and safe?

More than one-third of back injuries among nursing personnel is associated with patient handling and the frequency with which nurses are required to manually move patients, Kinder says. (Ask yourself the questions at the top of this page to figure out whether you're moving residents as safely as possible.)

Moving or transferring residents manually is always risky, for everyone involved. The american nurses association (ANA) and the and Health Administration (OSHA) both offer many resources on how nurses can stay safe on the job, as well as advocating for legislation for more on-the-job protections. Both the ANA and OSHA take the official position of supporting actions and policies that eliminate manual patient handling.

If your facility isn't quite there, there are steps you can take to make sure staff and residents stay safe. If you need to move a patient manually, follow these general rules, Kinder suggests.

• Think through entire process before initiating any patient activity.
• Don't make a transfer or any movement of a resident more dangerous than necessary.
• Before you begin, make sure that all paths are clear and the floor is dry.
• If you're transferring the resident to a chair, make sure chair is properly positioned. If you're transferring a resident to a wheelchair, make sure all brakes are engaged.
• Have the resident help you as much as possible - know his transfer status and his ADL status before attempting the transfer.
• Have another colleague who has experience and knowledge about safe manual transfers help you whenever possible.
• If providing care alongside another colleague, commu-nicate your plan clearly before attempting the lift.
• If you're adjusting a resident's position on a bed, consider assistive equipment and techniques like using a draw sheet.
• Get as close to the resident as possible when manually assisting in moving him or her.
• Provide simple, clear directions for the resident, and calmly explain what you're doing as you do it.
• Whenever possible, use your body weight and momentum to move the patient, rather than relying just on your muscle strength.

Important: Always transfer the patient to their unaffected, stronger side unless instructed otherwise by a physical therapist.

Facilities need to ensure safe environments for their workers.

Employers have the responsibility to provide a safe, work-friendly environment, and employees have the responsibility to use good body mechanics and maintain their bodies through lifestyle choices to help prevent injury, Kinder says.

Remember: It's easier to prevent injuries than heal them.

OSHA provides suggestions for both management and individual employees to utilize to keep everyone safe.

OSHA suggests that management and other leadership should demonstrate their commitment to reducing - and ideally eliminating - resident-handling hazards by establishing a written program that addresses the many facets of potential issues.

Beyond investing in mechanical lift equipment, make sure to include these points:

• Train new hires in your facility's protocols for transfers and lifts, and emphasize injury prevention.
• Make injury prevention and safe resident-handling techniques part of your continued training for all staff.
• Incentivize and enforce team member compliance with transfer and lift procedures - every team member, every lift or transfer, every day.
• Establish and publicize procedures so staff can report early signs and symptoms of back pain and other musculoskeletal injuries without fear of retaliation.

All individual employees should feel empowered to report unsafe working conditions, as well as promptly recording and reporting any signs or symptoms of injuries.

If your facility is not responsive to your complaints and concerns about working conditions, you can file a complaint with OSHA.

"Workers can file a complaint with OSHA by calling 1-800-321-OSHA (6742), online via eComplaint Form, or by printing the complaint form and mailing or faxing it to the local OSHA area office. Complaints that are signed by a worker are more likely to result in an inspection," OSHA says.

For more information on best practices for keeping yourself self while completing work tasks, check out OSHA's handy e-tool for nursing homes: https://www.osha.gov/SLTC/etools/nursinghome/index.html.