Implementing Zero Lift Discussion Forum
Provided to facilitate communication and collaboration among those working toward safe patient handling.
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The U.S. Bureau of Labor Statistics identified “health care patient” as the source of 59,002 musculoskeletal disorders (MSD’s) in 1999 with the trunk and back most often affected. In 2000, “health care patient” was the cause of time away from work for 10,983 RN’s and 44,854 nursing aides, orderlies, and attendants with “overexertion” and “overexertion in lifting” the leading events. Also in 2000, of 129 occupations with time lost from MSD’s, nursing aides, orderlies, and attendants ranked 2nd with 44,660 MSD’s; RN’s ranked 6th with 12,074 MSD’s; and LPN’s ranked 18th with 5,598 MSD’s (http://www.bls.gov). Sprains, strains, tears, back pain, etc., are included while herniated spinal discs are classified elsewhere. One survey found that 57% of nurses’ back injuries were to spinal discs (see Buried But Not Dead by Elizabeth Langford). It appears that healthcare workers may suffer far more injuries than reflected by available data and that the injuries are often very serious.
Healthcare workers remain at the top of the charts for disabling back injuries while studies have repeatedly shown over many years that safe patient handling is possible. Over 60,000 patient transfers were accomplished in one study without injury to the transfer team or to the nursing staff working with the team (see “The effect of focusing ergonomic risk factors on a patient transfer team to reduce incidents among nurses associated with patient care" by Eric J. Meittunen et al.).
Lift Teams, specially trained in the use of mechanical lift equipment, and Zero Lift policies banning manual patient lifting, have shown dramatic reductions in injuries, lost and restricted duty days, and related costs (see "Reducing back injury in nursing: A case study using mechanical equipment and a hospital transport team as a lift team" by William Charney and "Long-Term Effectiveness of 'Zero-Lift Program' in Seven Nursing Homes and One Hospital" by Arun Garg). A variety of other approaches are being utilized as well including Team Lifting with availability of trained leaders for guidance in assessing lift/transfer needs of patients, selection of appropriate lift equipment, etc. The Back Injury Resource Nurse (BIRN) is a trained peer leader who supports a “culture of safety” around patient care and the work environment, acting as a resource, coach, and team leader (see Patient Care Ergonomics Resource Guide: Safe Patient Handling and Movement, developed by the Patient Safety Center of Inquiry.) Overhead patient lifts, said to be required with hospital construction in some European countries, have proven very successful with injury reduction (see "The ceiling lift: An efficient way to prevent injuries to nursing staff" by Jocelyn Villeneuve).
Though progress is slow, a growing number of healthcare facilities are increasing efforts to reduce injuries with patient handling activities. Some workers’ compensation carriers are helping facilities establish programs to reduce patient handling injuries and control the staggering medical and compensation costs related to these largely preventable injuries.
A number from around the U.S., Canada, England, Australia, and, most recently, Ireland, who are working toward safe patient handling, have been in touch. Some have had programs going for years; others are just starting. This forum is offered as one way to share experiences, practical tips, success stories, etc., with the hope that sharing this information will reach many others and will be helpful with establishing safe patient handling practices for nursing staff and patients alike.
A common concern with implementing a new patient handling program is how to enhance buy-in from nurses. From one person: “Some problems we are experiencing are with nurses. They are reluctant to agree to having lift teams as they feel it takes away from the total care that their profession provides. Any advice???” Perhaps someone will share from their experience successful methods of fostering nurses’ acceptance of their safe patient handling program.
Best wishes to all with efforts toward injury reduction and safe patient handling…Anne Hudson, RN
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