Ergo tools help you get a fix on injuries

Use assessments to build a business plan

You’ve heard the ergonomics horror story: Thousands of dollars of lift equipment gathering dust in a storage closet while nurses become disabled and rack up thousands of dollars more in workers’ compensation claims.

That doesn’t have to happen to you, says Lynda Enos, RN, MS, COHN-S, CPE, an ergonomist who is founder of HumanFit, a consulting firm based in Oregon City and nursing practice specialist/ergonomist with the Oregon Nurses Association.

Enos has teamed up with the American Association of Occupational Health Nurses in Atlanta to offer online tools and resources at www.ergoresources.org. Those tools should be part of a nurse-driven program to reduce patient handling injuries, she says. "I think everyone wants a quick fix, and the vendors are very keen to sell you a wide variety of equipment," says Enos, who also is past president of the Oregon State Association of Occupational Health Nurses.

But instead of buying first and then building your program around your equipment, you should develop a business plan for ergonomics that involves nurses from the start, she says. "We’re asking them to perform their job differently [in their patient handling]. If we don’t get them involved, the change to safer patient handling practices isn’t going to occur. They have to believe that the change is good for their patients as well as themselves."

First, you will need an ergonomics program coordinator (which may be you) and a multidisciplinary team that includes the employees you are trying to help. Together, you need to identify just what patient handling injuries are costing you and where you’ll get the most benefit for your investment. "You have to know what the problem is," she says. "Everyone jumps to the OSHA [Occupational Health and Safety Administration] logs and workers’ comp claims."

The highest risk units may jump out at you. They are usually those areas where patients are most dependent, such as intensive care or rehabilitation. But you need to look more closely at the numbers to understand your true costs.

Remember that the total number of injuries may not give you a full picture because staffing levels may vary. So to compare different units, calculate the incident rate. Multiply your OSHA recordable injuries for each unit by 200,000 and divide by the number of hours worked per unit.

Keeping a separate log of musculoskeletal injuries can help you assess trends. A sample log provided by www.ergoresources.org incorporates the nature of the injury, lost workdays, and workers’ comp costs. (See log.) You can break down the costs of some individual cases to better understand the indirect costs. (See sample form. All the materials are from www.ergoresources.org.)

Those numbers will help you make your case for an investment in ergonomics equipment and training, Enos explains. "You really want to target where your problems are. You want to know where the greatest risk for musculoskeletal disorders exists and show early successes," she says.

From these numbers, you can draft your business plan with a simple goal. For example, you may say, "I am going to reduce strains and sprains by 25% in the first year of this program," Enos adds. You should note how the ergonomics plan fits in with other goals of the organization, such as complying with standards of the Joint Commission on Accreditation of Healthcare Organizations.

Be sure your expectations are reasonable, she advises. While ergonomics programs can produce impressive savings, an emphasis on reporting of injuries could lead to a spike in injury rates, she cautions. You want employees to report their injuries so they can reduce their risk of disability through early medical treatment.

"The incident rate usually goes up the first year of a program [because of reporting] then goes down," Enos says. "But the injury severity and costs go down dramatically early on in the program partly due to careful case management by employee health nurses and others. You need to tell administration that’s going to happen."

Beyond the numbers, you’ll want to stress that ergonomics is best for patients, too. Being held under the armpits while being moved can be uncomfortable and embarrassing, and if a nurse loses her grip, the patient could fall.

"Sometimes, you can’t sell [ergonomics] on injury reduction alone," Enos adds. "You have to look at other benefits such as patient safety and quality of service."