Patchwork of safe lift laws evolving state by state

Minnesota is the latest of eight states

A patchwork of safe patient handling state laws is evolving around the country, presenting a wide range of requirements for hospitals.

The mildest measures encourage safe patient handling or set up study committees. The toughest require employers to assess risks and purchase the appropriate equipment to reduce them.

Only one thing is certain: More patient handling laws are likely to emerge with each legislative season, typically beginning in January.

"The drum roll continues," says Bill Borwegen, MPH, occupational health and safety director at the Service Employees International Union (SEIU) in Washington, DC." We're continuing to follow the model that we used to put safer needles in the hands of health care workers, which resulted in a dramatic reduction in needlesticks."

As an increasing number of states passed sharps safety laws, pressure grew to develop a national law that would create a uniform standard. So far, the state laws on safe patient handling have not provided much momentum behind a national bill, which has not even been the focus of a hearing.

In California, which led the way for sharps safety, Gov. Arnold Schwarzenegger recently vetoed a safe patient handling bill for the fourth time.

"It is frustrating that stopping injuries to nurses and patients from manual lifting, as critical as it is, has not been elevated to the level of importance it deserves," says Anne Hudson, RN, a back-injured nurse from Coos Bay, OR, who formed the Work Injured Nurses Group (WING USA) to advocate for safe patient handling and co-edited the book Back Injury Among Healthcare Workers: Causes, Solutions, and Impacts (CRC Press/Lewis Publishers, 2003). "Even though there are literally thousands of people now working on this around the country, it seems that halting preventable injuries from lifting people is still not at the very top of the priority list."

Minnesota was the most recent state to enact safe patient handling legislation. By the summer of 2008, all licensed health care facilities must have a safe patient handling committee that includes frontline workers and a safe patient handling policy. They must conduct audits to determine how best to reduce the patient handling hazards and purchase equipment by 2011. The Minnesota legislature provided a $500,000 fund for "hardship grants" to help facilities purchase equipment.

The Minnesota Nurses Association worked on the bill with the state's hospital association, and had an added advantage in the legislature, says Carrie Mortrud, RN, governmental affairs and public policy specialist and lobbyist for the nurses association in St. Paul. "It helps to have six nurse-legislators in the legislature to speak about how difficult it is for nurses to move patients with dignity and safety," she says.

Meanwhile, some states are trying to beef up weaker laws. The Texas law, for example, specifically addresses nurses; its backers touted the legislation as an important measure to preserve the nursing work force in the midst of a shortage. However, certified nursing assistants (CNAs) are still at risk of injury at nursing homes, which are not required to create safe patient handling programs.

"Everybody who does lifting should be included in a safety program," says Sam Perlin, a Houston retiree who has become a vocal and effective advocate for nursing home residents.

Nursing homes may have a lifting policy that requires CNAs to ask for assistance, but in reality, the aides often try to perform the lifts on their own — sometimes with dire consequences for themselves and for the frail residents.

"They're shorthanded. There's no supervision [to make sure the policy is followed],"says Perlin. "If the aide wants help, she can't find anyone."

Perlin and others are pushing for changes to the Texas safe patient handling law. The Texas legislature meets every two years, and the next session isn't until 2009. "It's not just in Houston that there's a problem, or in Texas," says Perlin. "It's all over the country."

State Laws on Safe Patient Handling

  • Texas SB1525, enacted July 17, 2005: The first state to mandate implementation of a policy for safe patient handling and establishment of programs by hospitals and nursing homes. However, the law does not require the purchase of equipment and applies only to nurses.
  • Washington HB1672, enacted March 22, 2006: The first state to require hospitals to provide lift equipment as part of their policy for safe patient handling. The law provides financial assistance through tax credits and reduced workers' compensation premiums.
  • Hawaii House Concurrent Resolution No. 16, passed April 24, 2006: Calls for health care facilities to provide safeguards to minimize musculoskeletal injuries by nurses and calls for the legislature to support policies in the American Nurses Association's "Handle With Care" campaign.
  • Rhode Island H7386 and S2760, enacted July 7, 2006: Requires hospitals and nursing facilities to achieve the maximum reduction of manual lifting except in emergency situations.
  • Ohio HB 67, enacted March 21, 2005: Created a workers' compensation loan fund for interest-free loans to nursing homes to purchase lift equipment and implement a "No Manual Lifting" policy.
  • New York A07641 and S04929, enacted Oct. 18, 2005: Created a two-year "Safe Patient Handling Demonstration Program" to collect data on injuries and describe best practices.
  • Maryland HB 1137, enacted April 10, 2007: Requires hospitals to establish a safe patient lifting committee with equal representation from managers and employees and to develop safe patient lifting policies.
  • Minnesota HF 122, enacted May 25, 2007: All health care facilities must minimize manual lifting using safe patient handling equipment. A $500,000 fund enables facilities to apply for a hardship grant for assistance in purchasing safe patient handling equipment.

Source: Anne Hudson, WING USA (Work Injured Nurses Group), Coos Bay, OR.