Hospital battles back injuries with zero lift

New equipment allows for smoother transfers

Patient handling can have costly consequences. At the University of Kentucky Chandler Medical Center in Lexington, 21 back injuries in the intensive care unit led to $42,000 in medical expenses in one year alone.

When hospital safety officer Tomi Ross examined back injuries hospitalwide during 1998, she calculated medical costs of $119,000 — and much more for replacement staff.

Now, the hospital has a new policy: zero lift.

"In any patient move or transfer for which there is an established protocol, you must follow that. You must not lift," says Ross.

The medical center backed that policy up with an investment in state-of-the-art patient-handling equipment. For example, On3 by Ergodyne in St. Paul, MN, is a lateral transfer device that uses draw sheets, poles, and belts to move a patient from a bed to a stretcher. One worker guides the transfer, and another stands by in case there is need for assistance.

Neither worker carries any weight, even if the patient weighs as much as 400 pounds. "It actually pulls the patient from one surface to the other, so there is no lifting by staff," says Ross.

"It’s a smoother transfer from a bed to a stretcher with the On3 device," she says. "We think it will increase patient satisfaction, too."

New beds reduce need for transfers

The hospital also purchased sling lifts and stand-assist devices, which help patients move from a sitting to a standing position.

In fact, the back injury project began with the purchase of new beds throughout the medical center. These beds actually fold into a sitting position, allowing incapacitated patients to sit up with greater ease and somewhat ambulatory patients to exit the bed from a sitting position.

"If the reason for a bed-to-chair move is to reduce the risk of pneumonia and increase respiration, all they have to do is fold the bed and they’re sitting up," she says.

Ross placed ergonomics equipment in the ICU and its ancillary areas. If the study project proves successful in reducing injuries, she plans to expand it hospitalwide.

Ross also designed her program to comply with the new ergonomics standard proposed by the U.S. Occupational Safety and Health Admi nistration. That doesn’t mean employees will never lift; there may still be some occasions in which there is no alternative to manually assisting a patient, says Ross. But the policy specifies that "if there is an accepted or established alternative, you have to use that," she says.

Program complies with OSHA regulations

Today’s ergonomics fixes are more likely to be successful than earlier approaches, says Guy Fragala, PhD, PE, CSP, director, environmental health and safety at the University of Massachusetts Medical Center in Worcester.

"It’s been difficult to find good ergonomic solutions for health care," says Fragala, who is consulting with the University of Kentucky Chandler Medical Center. "We haven’t had a lot of options in the past. But now many options are becoming available."

Some devices require a substantial investment, such as the On3, which costs about $10,000. Ross estimates she would need 30 of them to cover the entire hospital. But other devices, such as friction-reducing devices to assist in lateral transfers, are low-tech, inexpensive solutions.

Ease of use is important to ensure employee compliance. "This is not the first time we bought equipment," says Ross. "When we do inspections, we find the lifts in the back of the storage closet. We find a high incidence of back injury in those units."

Ross has told managers they are responsible for monitoring safety in their areas. Employ ees also have been trained in the zero-lift techniques and told of the policy that they must use these alternative methods of patient handling as long as they’re available.

"If you make it a condition of employment to comply with safe work practices and you’re unequivocal about it, that becomes the standard," she says.