335 Ergonomic interventions in nursing facilities: Long-term effectiveness of a comprehensive program

Abstract

Objective Determine long-term efficacy of a comprehensive, multi-facility ergonomic intervention, utilising patient handling devices and participatory approach, on patient handling injuries to nursing personnel and comfort and safety of patients. Background Musculoskeletal injuries (MSDs), in particular back and shoulder injuries, are a major problem for nursing personnel in patient care. In USA, nursing aides (NAs) have the highest incidence rate of days-away from-work injuries and illnesses (465/10,000 workers) from MSDs, a rate more than seven times the national MSD average for all occupations. The majority of injuries and illnesses (56%) among NAs involved contact with patients, with 86% of those injuries due to overexertion. Methods A pre-post design (pre: 38.9 months, post: 51.2 months) was used to evaluate the efficacy of an ergonomic intervention using patient handling devices in six long-term care facilities and one chronic care hospital. Each facility formed teams consisting of: worker representatives, management, and an ergonomic specialist. These teams developed comprehensive ergonomics programs using participatory approach to reduce patient handling injuries, primarily through implementation of “no-manual-lifting-policies”. Results Compared to pre-intervention, post-intervention data showed significant reductions in: injuries (59.8% reduction), lost workdays (86.7%), modified duty days (78.8%) and worker's compensation costs (WCC) (90.6%) associated with patient handling activities (p < 0.001). The mean of payback periods was 15 months. Patient handling devices were rated to be less stressful on the low back (p < 0.001), shoulders (p ≤ 0.008) and wrists (p ≤ 0.005). Patients rated these devices as more comfortable (p ≤ 0.007) and safe (p ≤ 0.010) than manual lifting methods. The programs had no effect on staffing levels. Conclusions This study demonstrates that comprehensive ergonomics programs, properly utilising patient handling devices, are effective in reducing patient handling injuries, lost workdays, modified duty days, and WCC as well as improving patient comfort and safety during patient transfers.