Safe Patient Handling: Impact on Patient Care and Outcomes

According to the American Nurses Association, 89% of back injuries to staff members in healthcare facilities are related to patient handling activities. This statistic alone illustrates the vital need for healthcare facilities to have a safe patient handling and mobility program in place — and to follow these rules and operating procedures at all times.

The fact is that safe patient handling — and other ergonomic programs that help prevent injuries — can provide a great many benefits to your healthcare facility. These include reduced lost time, reduced Workers’ Compensation costs, and reduced employee turnover. Just as importantly, it can result in improved quality of care, patient satisfaction, employee satisfaction, and better outcomes for patients.

While safe patient handling practices are important, there is also a need for ergonomic programs to help reduce injuries to other staff members in departments including housekeeping, laundry, and dietary. Remember, it’s just as easy for an employee to injure their back by lifting a heavy box in the kitchen as it is for a nurse to suffer an injury while lifting a patient from a wheelchair.

The key to safe patient handling and other ergonomic issues is to develop a comprehensive written plan while also providing employees with proper training and education, according to Aileen Wilson, who serves as a Senior Risk Control Manager with Safety National.

“Strains and sprains are prevalent in the healthcare industry and are commonly caused by patient handling activities,” Aileen says. “Many people are surprised to learn that nurses actually suffer from these types of injuries more often than people working in the high rise construction and manufacturing industries.”

In order to help prevent injuries caused by patient handling activities, it’s important to first understand how and why these injuries happen. Patient handling involves trying to move, lift or reposition a human being. Unfortunately, conditions are not always ideal to accomplish this. For instance, you may need to lean over in order to move the patient, which prevents using the proper technique of using your legs to lift. Or there may be equipment in the way (such as a wheelchair) that prevents you from using the proper body mechanics. Factors such as these can put extra stress on your back, causing an injury.

Another factor that often contributes to injuries is overexertion. There are a number of high force tasks involved with patient handling – and these tasks put staff members at serious risk of injuries. The most common such high force tasks include lifting a patient, shifting a patient by pulling or pushing, and having to move a patient over a significant distance. Having to maintain control of your equipment at the same time also increases the risks. In addition, the risk of injury increases if the patient is uncooperative, confused, or woozy.

So how can we avoid these high-force tasks to help prevent injury? One solution is to limit the lifting of patients by utilizing available equipment. There are a variety of devices to help lift patients. For example, there is an inflatable device used to help lift patients who have fallen on the floor. The device is placed under the patient and then slowly inflated, which lifts the patient to a sitting position. A gait belt can then be placed on the patient to help bring them to a standing position. There is also specific equipment for geriatric patients, ergonomic bath and shower equipment, transfer chairs, and other mechanical devices to help hold patients up while working on mobility. With many healthcare facilities working to eliminate the lifting of patients manually, investing in such equipment is an effective way to reduce injuries and improve the quality of patient care.

Another way to help reduce risk when performing patient handling activities is to avoid having an awkward posture. For example, bending over to feed a patient, lowering yourself to bathe a patient, or leaning over to lift a patient. It’s important to avoid these awkward postures by keeping your body in a neutral position as much as possible. This can be accomplished through continual training of staff, as well as performing an ergonomic assessment of the work area.

“Another important factor in reducing risk is to do a thorough assessment regarding how much assistance the patient will need beforehand,” says Aileen. “You need to determine if the activity can be safely performed by one staff member or whether two or even three people will be needed to complete the task safely.”

As mentioned previously, in addition to safe patient handling it’s important to learn how to reduce the risk of injury for other departments including housekeeping, laundry, and dietary. One of the most effective solutions in the areas of housekeeping and laundry is to utilize spring-loaded laundry and linen carts. When linens are removed from these types of carts, a spring mechanism actually pushes the remaining linens up near the top of the cart. This greatly reduces the need for employees to bend over to get to the bottom of large carts and bins.

Another effective solution is the use of side bags on linen and laundry carts. These bags allow employees to place soiled linens into a bag on the side of the cart — and also to remove bags of soiled linens from the side, rather than having to reach into the cart and pull the bags up and out. This reduces repetitive bending and lifting — which in turn reduces the risk of injury.

Touching on a few solutions in the dietary department, one simple but effective method is to avoid storing heavy items such as large pots or big containers of food on overhead shelves or on the floor. By keeping such items stored at waist level, you avoid the risks involved with lifting heavy objects or having to reach up to grab such items from high shelves.

Yet another great solution here is the use of adjustable table feet in kitchens and storage areas. This allows you to increase or decrease the height of a table in order to fit the individual employees who work in certain areas. Remember, one of the basic principles of ergonomics is to fit the job to the worker and not the other way around. Having a work surface at the correct height for each employee greatly reduces the risk of injury.

“When it comes to reducing risks in both patient handling and performing everyday tasks throughout the facility, it’s vital to have a written plan,” says Aileen. “It’s also important that management is involved in developing written procedures and that your staff is qualified and well trained.”

Your facility’s plan should include standard operating procedures, the assessment of patients and a plan for their individual needs, and a clear statement of the responsibilities of everyone involved. Remember that safety is a team effort — having an effective program requires everyone to do their part.