A new safe patient handling forum is now online for employee professionals to ask questions or share ideas and policies with colleagues and industry. Guy Fragala, PhD, PE, CSP, CSPHP, is the master moderator of the newly minted National Mobility Forum, which can be found at: https://mim.vbulletin.net/.
An editorial board member of Hospital Employee Health, Fragala has decades of experience in occupational safety and health. He is the Senior Advisor for Ergonomics at the Patient Safety Center of Inquiry in Tampa, FL. HEH recently asked him to describe this new venture, which is in conjunction with industry and other safe lifting professionals.
HEH: Can you tell us a little about what drew you to this new endeavor?
Fragala: The whole issue of musculoskeletal injuries among healthcare workers has been a longstanding, ongoing problem. We’ve made some progress, but it still remains a problem. Currently in the the practice of medicine, the whole concept of [patient] mobility is becoming more important. If we look at early mobilization in the ICU, the literature is showing us that if we get these patients up early and often, the outcomes that we achieve are so much better. We’re reducing adverse events, and there have been studies documenting that we are reducing the number of days in the ICU. As we move forward with this mobilization, patient handling is going to become even more critical because we are going to be asked to move these patients, reposition them in bed, get them out of bed, and get them ambulating. They are sicker, more dependent patients and these are going to be very difficult patient handling tasks. As this demand grows, we really need to think about how we are going to effectively do safe patient handling.
HEH: Tying the health benefits of patient mobility to safe handling seems to be a way to finally empower programs to get resources and equipment.
Fragala: Yes, for a number of years we have been talking about how we relate safe patient handling to wound care and falls management. The evidence is there, also, that if we put sick patients in beds and we don’t move them, they are going to develop pressure ulcers. Pressure ulcers have become a never event that we don’t want to ever see occur in a hospital. We need to move people while they are in the bed, and again, that is placing more demands on the caregivers. If we look at the patient handling tasks involved, repositioning is probably the task that presents the most risk to the caregiver. If we are going to be effective at minimizing and reducing these hospital-acquired pressure ulcers, we need to figure out good solutions to move patients.
HEH: Why the forum model? This seems like kind of a “wiki” approach to share ideas.
Fragala: I’ve been doing this for a long time. I’ve probably been involved with safe patient handling as long as anyone in the country now, and as we progress I’m meeting a lot of young, energetic people — the millennials. Someone came to me with this concept of a forum. He introduced me to the internet forum and the way it works. I said this would be a great idea because patient handling is a complex, multidimensional area where you need input from a lot of different people. We are trying to figure out best practices and the best way to approach solutions. I thought that a forum would be a very effective tool for us to share ideas and learn about successes, to really move forward in this area of making information available through open access. I’m seeing a trend toward open-access journals, making it easier for people to receive information.
I have a lot of content material and if I can make it open access on the forum, hopefully it can help some people with the development and implementation of programs. It can also give them ideas [on] how to continuously improve their programs. This forum concept is really something that made a lot of sense to me. These young people are very tech savvy and have the skills and the technology to do this. It allows me to take the knowledge that I have gained and share it.
HEH: Employee health professionals can just visit the site and join?
Fragala: I would encourage them to. There is no cost involved. I just recently uploaded three reference articles, and one is something on a five-step process to structure a safe patient handling program. That is available on the forum right now for them to download and use. If they have a question, there is a specific area to post that under one of the topics. We can get a dialogue going to help people out and really connect them to people all over the world.
HEH: We have reported successful safe patient handling programs, but it wasn’t that long ago when NPR produced a series on the devastating, career-ending injuries nurses have suffered trying to move patients. Is the glass half-full or half-empty?
Fragala: It’s not full yet — we are still seeing nurses injured. [Many] nurses still do these tasks manually. That’s kind of amazing when we know that these tasks are beyond the physical capabilities of a person; it’s beyond what we can expect them to do. I have been doing some work now in ambulatory care, which is a growing area. Just think of the person that comes into the clinic and needs to get up on an examination table. It is 32 inches high — a fixed-height table. If they have limited mobility and they need help, how is a healthcare worker in that clinic going to get them up on that table? There are still a lot of risks out there, but there are a variety of different groups who may have different approaches and are trying to have some impact.