Safe patient handling and mobility programs benefit healthcare workers and patients

Susan Salsbury OTR/L, CDMS, CSPHP 

Healthcare workers and musculoskeletal disorders 

Nurses (RNs) continue to suffer a higher rate of musculoskeletal disorders than workers in all other industries.¹ Musculoskeletal disorders are soft-tissue injuries or disorders to one or more of the following: muscles, nerves, tendons, joints, cartilage and spinal discs. Work-related musculoskeletal disorders (WMSDs) often result in days away from work for healthcare workers.² Nurses suffer high rates of WMSDs because of overexertion when performing manual transferring, repositioning, lifting and mobilizing patients.

Overexertion is a leading cause of healthcare worker injury. The greatest risk factors for WMSDs are patient handling, manually moving, repositioning and lifting of patients.² Additional ergonomic risk factors from manual patient handling include:

• duration of exposure (working long shifts)
• exertion (force required to manually move a patient)
• working in awkward postures
• repetitive movements in specific postures³

Research has repeatedly demonstrated that it is inherently unsafe to manually move patients. Maximum recommended weight limits for patient handling conditions have been identified by the National Institute of Occupational Safety and Health (NIOSH), Occupational Safety and Health Administration (OSHA) and Centers for Disease Control (CDC).⁴

Injury statistics and costs

In 2016, more than half of all injuries and illnesses to RNs resulted from sprains, strains or tears that averaged seven days away from work and occurred at a rate significantly greater than the rate for all occupations.¹ Consider these averages:

• compensation claim for a patient handling injury - $14,1005
• cost range for replacing a nurse - $27,000 to $103,0006

The American Association of Colleges of Nursing workforce fact sheet reported that the median age of registered nurses is 46, and more than one-quarter of registered nurses plan to leave nursing or retire in the next five years.⁷ We need to improve the ergonomics of our healthcare environments to keep our wisdom workers at the bedside and decrease the musculoskeletal injuries to our healthcare workers.

Safe patient handling and mobility programs

Safe Patient Handling and Mobility (SPHM) programs use an evidence-based approach to reduce risk to HCWs. Early work performed by Tampa VA to identify components for a comprehensive SPHM program included risk assessment of the environment, use of equipment, patient assessment, development of algorithms, peer safety leaders and after-action reviews.⁸

The American Nurses Association subsequently published its Safe Patient Handling and Mobility Interprofessional National Standards Across the Care Continuum.⁹ This benchmark publication contains eight standards to identify procedures that employers and healthcare workers can utilize to create and sustain an SPHM program. The standards are:

1. Establish a culture of safety
2. Implement and sustain a SPHM program
3. Incorporate ergonomic design principles to provide a safe environment of care
4. Select, install, and maintain SPHM technology
5. Establish a system for education, training and maintaining competence
6. Integrate patient-centered SPHM assessment, plan of care and use of safe patient handling and technology
7. Include SPHM in reasonable accommodation and post-occupational injury return to work
8. Establish a comprehensive evaluation system

The following are other resources available to healthcare organizations to establish SPHM programs. This is not an all-inclusive list.

• Susan Gallagher PhD, RN, authored the Implementation Guide to the SPHM Interprofessional National Standards,¹⁰ which outlines step-by-step recommendations for implementing the standards with sample policies and procedures.
• The Association of Occupational Health Professionals in Healthcare (AOHP) collaborated with OSHA to develop a free resource guide for implementing a comprehensive SPHM program.¹¹ The fourth edition was revised in the spring of 2020.
• The Facility Guidelines Institute (FGI) published its second edition of Patient Handling and Mobility Assessments in 2019,¹² which includes information on developing a business plan for SPHM programs plus facilitating and implementing such programs.
• The Association of Safe Patient Handling Professionals, Inc. (ASPHP)¹³ is a non-profit corporation for individuals interested in the science of safe patient handling to share experiences and access education and information. The membership of the ASPHP works together to build a credentialed profession dedicated to the safety and comfort of caregivers and their patients worldwide.
• Additionally, NIOSH, OSHA, CDC, BLS, and the Veterans Administration have SPHM resources on their respective websites.

A successful SPHM program¹⁴

The recent publication by Ericka Newkirk MSN, RN, AGNSC-BC, GERO-BC, CMSRN of Decreasing Nurse Injuries Outcomes of Safe Patient Handling and Mobility Program in Clinical Nurse Specialist is an example of one Midwest community hospital’s results from implementing an SPHM program. The Clinical Nurse Specialist team analyzed their employee injury data and determined that most injuries were from mobilizing patients without assistive devices. They completed an assessment of each unit in the hospital and then identified which SPHM technologies could decrease the risk of injury. Their team presented their findings, equipment recommendations and budget to the hospital’s executive team.

After procuring the Sage Prevalon® Turn and Positioning (TAP) System and a floor-based lift with disposable sling, they provided education to all staff. SPHM education was also added to their new employee orientation. When additional units were added they recommended ceiling lifts for the ICU and additional SPHM equipment for their progressive care unit. After a 5-year period, they evaluated their injury data. The data showed a 73% decrease in employee injuries and a cost avoidance of $171,000, once again illustrating that implementation of a comprehensive SPHM program can reduce injuries and create a safe work environment.

The Journey to Zero healthcare worker injuries 

We’re committed to actively partnering with your facility to reduce the risk of patient handling injuries and improving outcomes. Let’s start the journey to zero – together. If you’re interested in discovering how your facility can partner with Stryker to help reduce the risk of patient handling injuries click here.