Musculoskeletal Disorders Safe Patient Handling Moving

Title: Safe Patient Handling/Moving
1. Problem/Challenge/Need Description
Nonfatal occupational injury and illness rates in healthcare institutions tend to be relatively high. Musculoskeletal disorders (MSDs) continue to be a major injury source for healthcare workers in the realm of patient handling. As a matter of fact, some of those most affected include, but they are not limited to, nursing aides, attendants, as well as orderlies. To bring this concern into perspective, it is important to note that according to the Centers for Disease Control and Prevention - CDC (2013), the incident rate of MSDs amongst healthcare workers happens to be one of the highest across all industries. In essence, in the year 2010, “there were 27,020 cases, which equates to an incidence rate (IR) of 249 per 10,000 workers, more than seven times the average for all industries” (United States Department of Labor, 2019). Construction laborers had a rate of 85.0. With this in mind, the relevance of reigning in this concern cannot be overstated.
Nonfatal occupational injuries and illnesses in healthcare institutions come at a significant cost. Some of these will be highlighted below:
Days away from work: When healthcare workers suffer MSDs, they are likely to seek absence on grounds of sickness. This is more so the case given that MSDs could present as pain in various body joints, numbness in fingers and hands, joint stiffness, inflammation, swelling, etc. (Gallaghler, 2013). These are serious symptoms that could render healthcare workers incapable of performing their roles. In some instances, the recovery period could be quite long.
Decline in the quality of care advanced to patients: Illnesses and injuries affect the productivity of healthcare workers. In turn, this affects the standard of care advanced to patients - and hence patient outcomes.
Higher employee turnover: Healthcare workers could opt to leave or abandon the healthcare profession as a consequence of sustained injuries in the course of executing their mandate. This also happens to be the case in those instances whereby MSDs result in a long-term disability. There are other numerous downsides of MSDs. These will not be highlighted in this context.
2. An Assessment of Risk Factors
In seeking to develop a definitive safe patient handling framework, it would be prudent to highlight some of the risk factors that are in one way or another linked to patient handling. These include, but they are not limited to, lack of equipment for safe patient handling (effectively meaning that healthcare workers have to engage in the manual lifting of patients), repetitive lifting tasks, and space limitations. When it comes to lack of lifting equipment, it should be noted that in essence, patients do not have handles. For this reason, with no access to the appropriate lifting gear, healthcare workers are prone strain as they engage in lifting, pulling, as well as pushing tasks. The situation could be further aggravated by failure to adhere to safe lifting rules and procedures.
Repetitive lifting tasks also significantly strain the body. Over time, this takes a toll on the body’s locomotor system. Space limitation is also another less appreciated risk factor. With limited space, healthcare workers could be forced to assume ridiculous and uncomfortable positions as they seek to engage in various patient lifting, pulling, as well as pushing tasks. These positions effectively strain the body. The situation could be worsened in scenarios involving bulky patients, and/or patients connected to any of the various medical equipment or catheter.
3. Proposed Solutions
It is clear that in addition to minimizing healthcare worker injuries, safe patient handling practices could also help improve patient outcomes – and hence bottom line. In basic terms, MSDs are in this context caused by the manual lifting of patients and failure to adhere to certain standards when engaging in patient lifting, pulling, as well as pushing tasks (Noble and Sweeney, 2017). It with this in mind that the safe patient handling program has been developed below:
3.1. The Development of a Safe Patient Handling Policy
The safe patient handling policy will minimize manual lifting (as recommended by the Joint Commission, 2012) and seek to promote staff adherence to a set of rules and standards of safe patient handling. The primary mandate of the policy is the creation of a culture of safe patient handling. Deliberate effort will be undertaken to ensure that all members of staff are involved in not only the development, but also the implementation of a safe patient handling policy. Further, patients will also be sensitized on the policy so as to, amongst other things, obtain their cooperation.
3.1.1. The Involvement of Management and Staff
Management Involvement: The management serves as a custodian of the various organizational resources. Although not resource intensive, this undertaking will call for the purchase of new equipment, employee training, as well as other related undertakings. For this reason, there is need to ensure that management is part and parcel of the entire undertaking. It is important to note that the nurse manager will be instrumental in this endeavor and in the absence of a safe employee handling implementation committee, he or she could serve as a link between the management and the team involved in implementation.
Staff Involvement: Those to be affected most by the changes involving the development of a culture of safety in the organization are employees. For this reason, they ought to be involved in every step of the way. Employee involvement will also serve to ensure that there is no resistance to change experienced along the way.
3.1.2. Equipment:
The most effective equipment in this endeavor will be identified. All the equipment identified will be selected on the basis of the needs of the relevant units. This is more so the case given that the needs of the various units vary with regard to their transfer and/or movement needs.
In seeking to further enhance the utility of the equipment selected, ease-of-use will be taken into consideration. This is more so the case given the need to shorten the time it takes for employees to familiarize themselves with the said equipment.
One other key consideration with regard to the equipment used is the vendor. This is more so the case given that they are often instrumental in maintenance, troubleshooting issues, replacement, etc.
The equipment will be utilized for three categories of patients, i.e.
· Patients who, as a consequence of a certain illness or medications, have impaired alertness
· Patients incapable of appropriately adhering to directions/instructions
· Patients in need of total physical assistance – i.e. disabled persons
In seeking to create a hospital environment that is mindful of the wellbeing as of its workforce, as well as that of its patients, the items and equipment listed below have been proposed:
· Sliding transfer boards
· Gait belts that are equipped with handles
· Transfer aids (mechanical)
· Lifts (mechanical) that are either fixed or portable
· Air lateral transfer systems
3.1.3. Remodeling of Premises
At Present: rooms, passages, and other spaces considered inadequate for efficient safe patient handling will be remodeled.
In the Future: Future construction undertakings will take into consideration the appropriate design models that promote safe patient handling.
4. Conclusion
In the final analysis, it is important to note that evidence-based standards for the safe handling of patients will be utilized throughout this entire undertaking. Other considerations that suffice are inclusive of:
1.1. In seeking to create a culture of safe patient handing, the relevance of ensuring an enabling environment cannot be overstated. This is particularly the case when it comes to the establishment of an environment that favors collaboration and effective communication. Towards this end, it should be noted that the creation of a culture of safe patient handling is largely a collaborative effort and calls for excellent coordination of efforts.
1.2. Encouraging continuous learning: Continuous learning enables all kinds of organizations to improve their processes and find solutions to emerging concerns. The need for a continuous improvement approach in this case has been identified. This will be the only way to ensure long-term success of the present undertaking.
1.3. Periodic Evaluation: The relevance of periodic evaluations cannot be overstated. This is more so the case given the need to assess whether or not there are any meaningful improvements and in those instances where there are none, identify the key concerns so that corrective action can be undertaken. One of the ways of evaluating the success of this particular undertaking is an assessment of staff injuries prior to the implementation of a patient handling policy, an thereafter.















References
Centers for Disease Control and Prevention - CDC (2013). Safe Patient Handling and Mobility (SPHM). Retrieved from https://www.cdc.gov/niosh/topics/safepatient/default.html
Gallaghler, S. (2013). Implementation Guide to the Safe Patient Handling and Mobility Inter-professional National Standards. New York, NY: American Nurses Association.
Letourneau, M. (2014). Safe Patient Handling and Movement: A Literature Review. Association of Rehabilitation Nurses, 39(3), 123-129.
Mayeda, J. (2014). Safe Patient Handling and Movement: A Literature Review. Rehabilitation Nursing: The Official Journal of the Association of Rehabilitation Nurses, 39(3), 123-129.
Noble, N. & Sweeney, N. (2017). Barriers to the Use of Assistive Devices in Patient Handling. Workplace Health and Safety, 66(1), 1-8.
The Joint Commission (2012). Improving Patient and Worker Safety. Retrieved from https://www.jointcommission.org/assets/1/18/TJC-ImprovingPatientAndWorkerSafety-Monograph.pdf