Reader question

Tired of back injuries? Let technology do heavy lifting

Question: We have been trying to reduce back injuries among our nurses and other staff for years, but we’re not satisfied with the results. Despite extensive education and training for staff, we’re still spending a fortune on workers’ comp and lost work time. What are we doing wrong?

Answer: You might need to do some shopping. Increasingly, hospitals and other health care facilities are finding that they can’t seriously reduce back injuries without using machines to do the lifting, says Butch de Castro, PhD, MSN/MPH, RN, senior staff specialist for occupational health and safety with the American Nurses Association in Washington, DC.

"If you’re still seeing a high rate of musculoskeletal injuries among your staff, you might need to look at adopting more of the technology that can assist nurses with these high-risk tasks," he says. "Some of the lifting techniques and proper body mechanics are a little bit outdated now and not really proven to be that effective in the long run. There’s a change now in the way people are looking at this problem, and technology is really seen as the way to reduce the risk."

The idea of relying more on technology immediately raises the question of costs, but de Castro says there are a number of options ranging from the inexpensive to the very sophisticated and pricey. Simply using nonfriction transfer boards, for instance, can greatly reduce the effort and risk in moving a patient to or from a bed.

On the other end of the spectrum are built-in devices like the sling lifts that can raise a patient out of bed and, with a nurse using a remote control, move the patient across the room. Some facilities may adopt such devices for all patients, while others might reserve their use for high-risk transfers. De Castro says the ideal solution would be to adopt technological solutions to the greatest extent possible and keep manual lifting to an absolute minimum.

Exactly what devices you should adopt will be determined by your own patient population, your desire to reduce injuries, and your budget. No matter how much you can spend, the investment will be worthwhile, de Castro says.

"Technology is successful in reducing not just injuries but also costs. In the long run, the cost savings can be tremendous," he says. "The goal of the technology is to eliminate the risk of the ergonomic hazard to people and let the machines take it instead. You can reduce the staff person’s risk to zero from that task and let the technology carry that burden."

That reflects a change in how the experts now look at back injuries among nurses, de Castro says. There is more focus now on the lifetime risk of a nurse and the cumulative effect of lifting and handling patients over the years. Even if there is no acute injury, the daily effects of lifting add up over time and the risk of injury rises with the person’s age. Experts now say the advice followed for years, in which nurses were educated about proper lifting, is at best inadequate. It may be nearly useless, he says.

"We need to find a way to take that lifting burden off the nurse, as opposed to making sure the nurse does manual lifting in the correct way," he says. "Even with proper techniques, the burden is still there if the nurse is doing manual lifting."

Nurses also are getting savvy about the risk of musculoskeletal injuries at work and taking a hard look at the techniques employers use to reduce that risk. De Castro says he has heard reports of nursing staff being offered positions at other facilities and refusing to accept the position because they would have to use manual lifting. Similarly, he has heard of staff being lured away to facilities that use lifting devices instead of manual lifting techniques. Such differences can be important when health care providers are facing a shortage of nurses and other skilled staff, he says.

De Castro offers one important tip about how to choose the right lifting technology for your organization: Involve the frontline health care workers in the decision. You can waste a lot of money and not reduce back injuries by just flipping through a catalog and picking some equipment to order.

"Make sure your investment is fruitful by getting frontline workers’ input into choosing and purchasing the equipment. If your staff isn’t willing to use it or is uncomfortable with it, they’re going to use manual lifting or use the new equipment improperly," he says. "Getting them involved gives them a sense of ownership as well. They know their needs, what patients they will need to manage, and what devices might be useful."

For more information on what kind of lifting technology is available and how to decide what is right for you, de Castro recommends the web site www.patientsafetycenter.com.