Sprains & Strains: Preventing Back Injury in the Workplace

The vast majority of reported workers’ compensation claims within the healthcare community that I have personally investigated involve sprain and strain injuries. These injuries are caused by a variety of incidents, from moving or repositioning a patient to lifting equipment or supplies for storage. Couple the higher than average rate of strains and sprains in the healthcare industry with our state’s aging workforce and it becomes a recipe for escalating workers’ compensation claims in Louisiana.

Consider the case of a 58-year-old Certified Nurse Assistant, whose job description includes assisting and/or moving patients to and from a bed or transferring them to the shower. The employee is often faced with awkward positioning when handling a patient, despite proper body mechanics and detailed instructions provided by the employer.

Typically in this situation, the injured employee is initially treated for a strained muscle by a physician. The first line of treatment is usually a regimen of physical therapy and oral medication. If the patient fails to improve, an MRI is the next step.

The test results then show signs of “Degenerative Disc Disease.” Consider that this 58-year old has spent time standing upright, walking, running and other rigorous activity throughout their lifetime and that general wear and tear of everyday living may be reason enough for this diagnosis without the initial injury. However, long ago, cases were presented before the court to determine if a muscular strain injury is directly related to a degenerative spine. The general conclusion is that muscular strain aggravates existing spinal degeneration. As a result, many older employees with degenerative spines become candidates for spinal fusion surgeries when the original injury was a simple pulled muscle.

Combating the connecting interpretation of the court is often difficult unless an investigator has access to prior test results. If an investigator is able to obtain a medical opinion that the injured worker has “returned to pre-injury baseline”, then perhaps there is a chance to return the employee back to work in a pre-strain circumstance.

Preventing back injuries is one of the most difficult challenges in healthcare. The healthcare industry trails only the trucking industry in numbers of back injuries. Because of the uncertainty involved with moving patients (size, weight, impaired mobility, tight spaces), getting into the proper position can be a daunting task. Pair that uncertainty with the aging workforce, largely due to the “baby boomers” generation, and the situation becomes problematic.

In a five-year period in the LHA Trust Funds membership, the following statistics show the frequency and severity of injuries related to patient handling:

• 543 lifting strains
• $5,500,114.33 paid out
• $10,129.12 average paid per claim. Many of these claims are ongoing with monies continuing to be paid out

These injuries impact each organization in several ways:

• Increased e-mods leading to higher workers’ compensation premiums
• Debilitating injuries to staff members can prevent them from returning in full capacity to their duties
• Decreased morale among staff members due to a shortage of help
• Intangible costs due to the need for temporary help and the hiring/training of new staff

Continued heightened awareness is needed to combat the occurrence of back injuries. Training at orientation and in safety huddles, in-services and competency fairs can help train employees to exhibit awareness while performing their duties.

Here are some additional steps that can be taken to pro-actively prevent lifting injuries:

• A detailed assessment of the patient. Determining the size, weight and level of mobility a patient can assist in a transfer plan.
• Proper body mechanics training. Poor body mechanics are learned over time and can be reversed. It takes an ongoing effort to improve these habits. This training can be provided by LHA Trust Funds staff at no cost to the member. Contact us to schedule training.
• Team lifting. Immobile or large patients often require multiple staff members to assist in a transfer.
• Use of transfer equipment/lifting aids. Many devices exist to ease the transfer of patients. Lifts, transfer belts, slide sheets and other devices ease the process. Properly operating equipment and training on the use of such equipment are vital.
• Stretching and exercise. Proper stretching is critical to warm the muscles and keep them limber when they are put into an awkward position.

Job-related back injuries lead to lost workdays, high medical costs, individual pain and suffering and possibly long-term disability. Don’t allow your organization to become a statistic. Educate your employees about preventative measures to stop back injuries.