Taking the Burden Off Their Backs

Technology and Sensible Systems Greatly Reduce Risk of Injuries to Caregivers While Improving Patient Safety

By Taylor Lincoln

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Introduction

Nurses are responsible for maneuvering and handling patients in all sorts of ways. For example, transferring patients to stretchers, turning them, lifting their limbs for wound care, positioning them to use toilets, showering them, and more.

The sheer weight of the human body renders these tasks challenging. The body’s irregular shape and the awkward nature of building quarters enhance the difficulty. The result is that health care workers suffer more injuries requiring time away from work than members of any other profession. As the first report in this series, “Nursing: A Profession in Peril,”showed, these injuries can end careers and leave their victims in permanent pain.

Not surprisingly, nurses have long suffered injuries from lifting and repositioning patients. Historically, these outcomes were blamed on the nurses, themselves. For instance, atextbook written in 1898 said: “Occasionally the complaint is made that a nurse has injuredher back or strained herself in some way in moving a patient. This will generally be because she has failed to do the lifting properly”

Gradually, a consensus has emerged among experts that proper mechanics, alone, cannot reliably prevent injuries. Guidelines published by the federal government’s National Institute for Occupational Safety and Health (NIOSH) in 1994 said that no worker should lift more than 51 pounds, and said that this was too much for health care workers because the loads they lift are apt to be unstable or pose other challenges.

A subsequent paper by a co-author of those NIOSH standards concluded that the limit in health care settings should be 35 pounds, and less for work conducted in restricted spaces.

Now, there is question about whether any substantial amount of lifting is safe over the long haul, especially when involving particularly heavy patients. “The magnitude of these forcesthat are on your spine are so large that the best ‘body mechanics’ in the world are not going to keep you from getting a back problem,” William Marras, director of the Spine Research Institute at Ohio State University, told National Public Radio. “There is no safe way to do it with body mechanics.” Similarly, the American Nurses Association has flatly opined:“Manual patient handling is unsafe and is directly responsible for musculoskeletal disorder suffered by nurses.”

Yet, as the first report in this series showed, nurses who are not able to fulfill significant lifting expectations can be at risk of losing their jobs.

Not surprisingly, technology exists to take the burden off of nurses’ backs. When implemented sensibly, safe patient handling programs reduce injuries to caregivers significantly. But, experts counsel, successful programs rely on numerous cultural factors, in addition to technology.

This report will review some of the technologies and policies recommended by experts to prevent injuries to caregivers.