Nursing grads may demand safer lifting  

New curriculum brings change to schools  

Future nursing graduates will come to their job interviews with new expectations and questions about safe patient handling.

A new curriculum has been introduced at some nursing schools emphasizing the use of lift and transfer devices, teaching nurses to use body mechanics only if a hospital fails to provide that equipment. Students are taught to ask about the hospital’s plans to buy equipment and establish a safe patient handling program.

A draft version of the curriculum is available on-line at the web site of the National Institute for Occupational Safety and Health (NIOSH) at http://www.cdc.gov/niosh/review/public/safe-patient through May 30. A final version will be available on the NIOSH web site when the review is complete. It was developed through the Handle With Care program of the American Nurses Association, with a NIOSH grant.

This curriculum provides important new information for nursing students. Textbooks have continued to teach body mechanics as the appropriate method for patient lift and transfer, although the curriculum notes that numerous studies have shown that proper body mechanics cannot prevent injury. The national licensing exam still includes questions about manual lifting, but also includes some about lifting with devices.

For nursing schools, this is a time of transition as they try to prepare students for a safer workplace but must acknowledge the current level of adoption at the nation’s hospitals.

“We gave them the new curriculum and said, ‘This is the latest information we have. We want you to know how to use the equipment. You have to follow your clinical instructor’s lead. If you have to move a patient to a wheelchair and there are no lifts, here is the safest way to do it,’” explains Lynne Shores, PhD, MSN, BSN, RN, associate professor of adult health nursing at the Belmont University School of Nursing in Nashville, TN.  

Teaching myths and facts on lifting  

Nursing education could be a vanguard for changes in hospital practice, predicts Nancy Menzel, PhD, RN, COHN-S, associate professor at the University of Florida College of Nursing in Gainesville and an author of the curriculum.

After all, nurses who have relied on manual lifting throughout their careers often find it difficult to change their habits. “Practicing nurses have all been taught body mechanics,” she says, and they are reluctant to dismiss it as ineffective.

Students have a chance for a fresh approach. The curriculum teaches nursing students some myths about lifting:

Myth: Staff in great physical shape are less likely to be injured. Fact: “Studies have shown that many patient handling tasks are risky regardless of the person’s strength and even those in great physical strength are at danger of being injured.”

Myth: Classes in body mechanics and lifting techniques keep nurses from getting hurt. Fact: “These approaches have not protected nurses from injury. You need more assistance than these techniques provide.”

Myth: Lifting equipment slows me down. Fact: “More modern equipment is designed with ease of use in mind.”

The program provides an algorithm to help students determine the dependency level of a patient and the correct patient handling device. It describes the types of devices that are available, including ceiling lifts, beds that convert into chairs, and the HoverMatt that can be used for lateral transfers instead of draw sheets.

But hands-on practice also is an important component. Vendors have loaned or donated equipment to the 29 pilot schools of nursing.

“We’re hoping vendors will see the advantage of training students on their equipment.  

A recruitment and retention tool  

Still, it will take time for nursing schools to make this shift. Although there are about 580 schools of nursing that offer a baccalaureate program and about 1,500 nursing education programs nationwide, only 29 nursing schools have participated in this project.

Those schools attended the Safe Patient Handling and Movement Conference, sponsored by the Patient Safety Center of the James A. Haley VA Medical Center in Tampa, FL. As part of the program, the schools agreed to work with the state nursing organizations, says Nancy Hughes, RN, MHA, director of the Center for Occupational and Environmental Health at the American Nurses Association.

“Once you have a few schools of nursing talking enthusiastically about it, it will spread,” she says.  

Hospitals recognize value of programs  

Meanwhile, hospitals have begun to recognize the value of safe patient handling programs not just for injury prevention, but for retention and recruitment, says Hughes.

“We’re finding that the nurses that have worked at facilities with safe patient handling and movement are looking for that in their next position,” she says. “They won’t go to a facility that doesn’t have it. There’s no reason to have the injuries when the equipment is available.”

Nursing students may have similar feelings after they’ve been exposed to safer methods of lifting and transferring patients. Shores encourages her students to ask about ergonomic equipment.

She tells them, “When you interview, I would encourage you to ask, ‘Do you have safe patient handling policies that include equipment? Is that on your short-range plan for the next few years?’ Use that as part of your decision making. Would you like to continue to pursue a job there?”

Wooing nursing graduates in the future may require something more than just body mechanics, Shores says.