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Re: Musculo-skeletal Injuries, Safe Patient Handling Research
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The following I copied from ANA's website I did a lot of the bolding:

http://www.nursingworld.org/MainMenu...enda/SPHM.aspx


Safe Patient Handling and Movement


Background
As part of the American Nurses Association's (ANA's) Nationwide State Legislative Agenda, ANA and its State Nurses Association's are promoting legislation that would require hospitals and other health care institutions to develop programs to prevent work-related musculoskeletal disorders and eliminate manual patient lifting.
The National Institute for Occupational Safety and Health identifies back injury as the second leading occupational injury in the US, with back pain as the most common reason for filing workers' compensation claims. In 1990, estimates of the annual cost of back injury ranged from $50 to $100 billion in the United States. (1) Studies of back related worker's compensation claims reveal that nursing personnel have the highest claim rates of any occupation or industry.
Compared to other occupations, nursing personnel are among the highest at risk for musculoskeletal disorders. According to the Bureau of labor Statistics (2006), nursing aides, orderlies, and attendants ranked second, immediately following laborers (first) and RNs fifth in a list of at-risk occupations for strains and sprains. More than one third of back injuries among nursing personnel have been associated with the handling of patients and the frequency with which nurses are required to manually move patients. (2)
The extent of musculoskeletal disorders among the U.S. nursing workforce is particularly distressing when considered in the context of the current nursing shortage. It is estimated that 12% of nurses leave the profession annually due to back injuries and greater than 52% complain of chronic back pain. Injuries secondary to patient handling tasks exacerbate the shortage and are of particular concern with the aging of the nursing workforce.

In spite of initiatives in other nations such as the United Kingdom and Australia, the concept of a no lift policy has been slow to be accepted in the US. In 2004, ANA developed a program, "Handle with Care" that supports safer practices with regards to patient handling. Approaches to addressing this issue include recommended changes in nursing school curriculums as well as legislation. Safe patient movement and handling benefits patients. The potential for patient injury (such as falls and skin tears) as a consequence of a manual handling mishap is reduced by using assistive equipment and devices. Equipment and devices provide a more secure process for lifting, transferring or repositioning patients. Patients are afforded a safer means to progress through their care, have less anxiety, are more comfortable and maintain their dignity and privacy. Assistive patient-handling equipment can be selected to match a patient's ability to assist in his or her own movement, thereby promoting patient autonomy and rehabilitation.
Safe patient movement and handling benefits the nursing workforce. Patient handing tasks are recognized as the primary cause for musculoskeletal disorders among the nursing workforce. A variety of patient handling tasks exist within the context of nursing care, such as lifting, transferring, and repositioning patients, and are typically performed manually. Continuous, repeated performance of these activities throughout a nurse's working lifetime results in the development of musculoskeletal disorders. Of primary concern are back injuries and shoulder strains, which can both be severely debilitating for nurses.
For more information, visit ANA's Handle with Care Program.
Enacted to Date
Prompted by ANA's Handle With Care Campaign which began in 2004, nine states have enacted "safe patient handling" legislation: Maryland, Minnesota, Missouri, New Jersey, New York, Ohio, Rhode Island, Texas, and Washington, with a resolution from Hawaii.

In 2008, ten states introduced legislation seeking health care worker protections through programs restricting or eliminating manual lifting of patients. They include: California, Connecticut, Florida, Hawaii, Illinois, Kansas, Maryland, Minnesota, Missouri, and New York; two of which passed legislation: Maryland and Missouri. Related bills died in Florida, Kansas, Minnesota, and Vermont.

Summary of states having passed legislation

(2008)
Missouri will provide tax credits for hospitals for the cost of purchasing lifting and other devices intended to minimize patient lifting following enactment of safe patient handling legislation. By January 1, 2009, each hospital will establish a safe patient handling committee or assign required functions to an existing committee. Functions of the committee, of which membership is to be at least half non managerial employees who provide direct care, will be responsible for design of a safe patient handling program and recommendations for the process for implementation. The implementation process considers: development of associated policy, including methods for addressing all units and shifts; conducting a patient handling hazard assessment; acquisition of equipment, with minimum requirements defined in statute; staff training; and provisions for conducting an annual evaluation of the program.

Maryland extended safe patient handling practices to residents and employees in nursing homes. 2007 legislation applied to hospitals only. On or before December 1, 2008, each nursing home will establish a safe patient handling workgroup with equal membership between management and employees. On or before July 1, 2009, the workgroup shall have developed policy, the goals of which are to reduce employee injuries associated with lifting; develop or enhance the use of patient handling hazard assessment processes; enhance the use of lifting devices with the incorporation of lift teams (role not defined); and determine the process for evaluating the program.
(2007)

Both Maryland (April) and New Jersey (passed December, 2007 enacted January, 2008) chose a comprehensive programmatic approach, requiring health care facilities to establish a safe patient handling programs comprised of committees to establish policy and monitor the program.
Maryland's "Safe Patient Lifting" law, requires hospitals to establish a safe patient lifting committee with an equal number of managers and employees on or before December 1, 2007; requiring the committee to establish a safe patient lifting policy on or before July 1, 2008; and requiring the committee to consider specified factors while developing a safe patient lifting policy and program.
New Jersey requires licensed health care facilities, state developmental centers, and state and county psychiatric hospitals to establish a safe patient handling program to reduce the risk of injury to both patients and health care workers at the facility within 18 months of the bill’s enactment. (July 2009) Each facility would be required to maintain a detailed written description of the program and its components and provide a copy to the Department of Health and Senior Services or Department of Human Services, as applicable, and make the description available to health care workers at the facility and to any collective bargaining agent representing health care workers at the facility. A facility would also be required to post its safe patient handling policy in a location easily visible to staff, patients, and visitors; and to designate a representative of management at the facility who will be responsible for overseeing all aspects of the program. Within 12 months following enactment, each facility must establish a safe patient handling committee, responsible for all aspects of the development, implementation, annual evaluation and revision of the facility’s safe patient handling program, including the evaluation and selection of patient handling equipment and aids and other appropriate engineering controls. At least one-half of the members of the committee shall be health care workers who provide direct patient care to patients at the facility or are otherwise involved in patient handling at the facility. The remaining members of the committee shall have experience, expertise, or responsibility relevant to the operation of a safe patient handling program. The law provides that a health care facility shall not retaliate against any health care worker because that worker refuses to perform a patient handling task due to a reasonable concern about worker or patient safety, or the lack of appropriate and available patient handling equipment or aids.

With a voluntary approach, Minnesota law, signed at the end of May, provides for grants to support safe patient handling programs and activities in health care facilities by transferring money ($500,000 per year for two years) from the workers compensation special fund to an assigned risk safety account.
(2006)
Rhode Island legislation requires each licensed health care facility to have a committee developed, by July 1, 2007, to develop a written safe patient handling program. By July 1, 2008, facilities must be prepared to implement a safe patient handling policy for all shifts and units that will achieve the maximum reasonable reduction of manual lifting, transferring, and repositioning of all or most of a patient's weight, except in emergency, life-threatening or otherwise exceptional circumstances. The statute also addresses completion of patient handling hazard assessments, staff training and the provision for reporting to a safe patient handling committee within each facility annually. Washington legislation promotes safe patient handling and reduction of injuries among health care workers by establishing a Safe Patient Handling Committee (with at least half of the committee comprised of direct care providers) and implementation of a safe patient handling policy to prevent musculoskeletal disorders among health care workers and injuries to patients. The law mandates hospitals to acquire the much needed lifting equipment and provide staff training. Hospitals will receive a tax credit when purchasing lifting equipment.
Hawaii passed a House Concurrent Resolution calling for the Legislature of the State of Hawaii to support the policies contained in the American Nurses Association's Handle with Care campaign.
(2005)
New York State (NYS) passed legislation that creates a two-year safe patient handling demonstration program and was extended by two additional years in 2007. The program will serve to collect evidence based data, reflecting the incidence of employee and patient injuries resulting from patient handling, comparing the use of manual and technology based techniques. Any type of licensed health care facility interested in participating in this program applies to the NYS Department of Health for funding. All participants must develop a risk identification and assessment plan, a comprehensive employee training program, be willing to commit to a culture which avoids manual patient handling to the greatest extent practicable, and provides ongoing reporting through the facility health and safety committee as well as the Department of Health. Appropriations were designated in the 2006 budget.
Ohio legislation resulted in the long term care loan fund program, to be operated by the bureau of workers' compensation. The administrator of the program shall use the program to make loans without interest to nursing homes for the purpose of purchasing, improving, installing lifts, as well as to support the cost of staff education and training in support of a policy of no manual lifting of residents.
Legislation enacted in Texas, effective 2006, requires the governing body of a hospital or the quality assurance committee of a nursing home to adopt and ensure implementation of a policy to identify, assess, and develop strategies to control risk of injury to patients and nurses associated with the lifting, transferring, repositioning, or movement of a patient. The code stipulates there be collaboration with and annual reporting to a nurse staffing committee, as well as reports to the governing body or quality assurance committee. There is also the provision that in developing architectural plans for constructing or remodeling a unit of a hospital or nursing home in which patient handling occurs, consideration of the feasibility of incorporating patient handling equipment must be considered.
2008 Summary of Proposed Legislation
California (SB 1151/AB 371) is the latest to join ranks in recognizing that musculoskeletal disorders (MSDs) in health care personnel far surpass that of other occupations and report that according to the 2006 Bureau of Labor Statistics, California leads the nation in the number of workers reporting musculoskeletal disorders. This factor, combined with an aging workforce has prompted the state to seek a legislative solution this year. The California bill, the “Hospital Patient and Healthcare Worker Injury Protection Act”, would establish a zero lift policy and lift teams within general hospitals. It would also require each hospital to establish a patient protection and health care worker injury prevention plan, based upon a needs assessment to determine the patients needing lift teams, and types of lifts and repositioning devices.

Florida (HB 471/SB 508), Hawaii (HB 2126), and Missouri (HB 1940) have each introduced legislation requiring hospitals to establish safe patient handling and movement policy and programs. Maryland (HB 585) would establish a work group to create policy for nursing homes. Kansas (HB 2846) would require safe patient handling policy and program to apply to all “medical” facilities.

Legislation was again introduced in New York (AB 8165/ SB 315) to require hospitals and nursing homes to install ceiling lifts. This is in addition to the extension of a demonstration project first enacted in 2005.

Illinois (HJR 61) reintroduced legislation that creates a Safe Patient Handling Task Force to study safe patient handling policies and create recommended policy guidelines for all health care facilities to eliminate the manual lifting of patients by direct-care registered nurses and other health care providers. Although legislation passed in 2007, Minnesota (HB3870/SB3559) introduced bills that would require every clinical setting that moves patients to develop a written safe patient handling plan with attention to identification of risks, establishment of policy, acquisition of resources, training, and evaluation of the plan.

Connecticut (SB470)’s bill is directed to addressing a number of different nurse retention issues, including a provision for purchasing lift equipment.


Last updated 7/03/08