A New York state law now in effect requires healthcare facilities to establish safe patient lifting programs that include the formation of committees, risk assessments and purchase of devices. As it becomes increasingly unlikely that any federal action on the issue will be forthcoming, the New York law could serve as a template for other states as the push continues to reduce the chronic, potentially career-ending injuries caused by manual lifting of heavy patients with high acuity.
The CDC reports that patient-handling injuries accounted for 44% of OSHA-reportable injuries at 112 hospitals in 19 states from Jan. 1, 2012, to Sept. 30, 2014.1 Of all patient handling injury reports, 62% included data on the use of lifting equipment. Of those, 82% occurred when patient lifting and handling equipment was not used.
The Nurse and Health Care Worker Protection Act (H.R. 4266/S. 2408) is languishing in Congress, and prospects for passage are not favorable. In the absence of a federal law, the New York state model could be considered by other states. The New York law required hospitals to form safe lifting committees by January 2016 and implement programs in January 2017.
“Although we have had a safe patient handling committee here for 8 to 10 years and are very familiar with safe patient handling, it was a huge undertaking to roll out a program according to the requirements of the law,” says Carol L. Cohan, RN, BSN, MHA, director of the Employee Health Department at Winthrop University Hospital in Mineola, NY. “We had a committee and small program here and we really wanted to expand it, and the law has empowered us to do that. Fortunately, the administration here is very supportive, very safety culture-oriented, and we have safety infused throughout our facility.”
To comply with the law, the hospital contracted the services of a safety consulting firm that embeds “lift coaches” into facilities to assess risks and train workers at the bedside.
“We looked at several companies that could help us to roll out our program and introduce the equipment, lifts, and the training into the facility,” Cohan tells HEH. The company the hospital chose is “equipment [neutral], which means they don’t recommend any specific company for equipment. We are allowed to choose the company that we would like to use for equipment. They will make recommendations on equipment type, and we can follow what they recommend or look at other companies for a similar device. We liked that we wouldn’t be committed to one company.”
Having the lift coaches available by pager 24/7 was also a key factor, as they are available to train workers at the bedside as questions arise.
“They train at the bedside at the point of care,” Cohan says. “To backtrack, first they came in and did a full assessment of our facility and made recommendations to our administration on what equipment they think we would need, and their proposal for the cost of the program.”
In accordance with the state law, Winthrop has a multidisciplinary committee that is comprised of 50% front-line staff and 50% management or administration.
“The law really doesn’t define what the program is and it is up to interpretation, but you have to have the committee start assessing your needs and start purchasing equipment and educating workers,” she says. “We are looking at the [consultant] assessments and recommendations and working on a prioritization system. And we have actually started bringing in equipment in some areas based on their assessments. As we are doing that, other areas are asking for equipment so we have the opportunity to send those coaches in to those areas to assess them. They evaluate all of your statistics when they come in and they assess front line staff in how they lift and move patients.”
Part of the initial assessment includes whether the hospital’s safe patient handling equipment was functioning properly, what needed to be repaired, and what was outdated, she adds.
“They looked at our patient fall data and our work injuries, and then came up with their proposal for us,” she says.
The primary causes of worker injuries and strains at Winthrop are repositioning patients in bed, and lateral transfers, Cohan says.
“We have recommendations in certain areas for wall-mounted equipment, and we have ordered some portable lifts, transfer sheets and boards, and now we are looking at hover mats, which are air mattresses that inflate and lift the patient for easy repositioning in bed and lateral transfer,” she says. “Our intensive care unit has a good amount of injuries due to the type of patients they take care of — they have a lot of challenges with patients that really are not ambulatory.”
The hospital is looking at devices that can improve early mobility in patients, which can aid healing and prevent complications like bed sores.
“The entire program that is ongoing addresses the quality of care for the patients, and hopefully will improve the time that it takes to get them well and discharged,” she says. “It will decrease length of stay and decrease complications for the patient, and it will provide a safer environment for both the patient and the staff.”
The cost of consulting and equipment purchases should be weighed against improving the quality of care of patients and protecting workers from expensive, potentially debilitating, injuries.
“Injuries arising in connection with manual lifting are among the most frequent injuries in healthcare — and among the most expensive, with the most ‘lost time’ occurring as a result,” the New York law states.1
- 1. New York State Department of Health. Safe Patient Handling Work Group: Report to the Commissioner of Health. http://on.ny.gov/2jWJLFg.