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Gary Evans writes Hospital Infection Control & Prevention (HIC), Hospital Employee Health (HEH) and contributes to IRB Advisor (IRB). As senior writer at AHC, Evans has written numerous articles on infectious disease threats to both patients and health care workers, including pandemic influenza, MERS and Ebola. He has been honored for excellence in analytical reporting five times by the National Press Club in Washington, DC.
As we reported in the July 2015 issue of Hospital Employee Health, OSHA launched a major new enforcement program today to protect an oft-injured group doing one of the most dangerous jobs in the nation: health care workers.
The agency is expanding its use of enforcement resources in hospitals and nursing homes to focus on musculoskeletal disorders (MSD) related to patient or resident handling; worker slips, trips and falls, bloodborne pathogens, workplace violence, and tuberculosis. U.S. hospitals recorded nearly 58,000 work-related injuries and illnesses in 2013, amounting to 6.4 work-related injuries and illnesses for every 100 full-time employees -- almost twice as high as the overall rate for private industry, OSHA said in announcing the new enforcement program.
While the other issues are critical areas of occupational safety, the issue of patient handling injuries is the primary driver of the OSHA action. Scathing reports of nurses with chronic back pain and permanent disabilities caused by patient handling incidents raised the inevitable question: Why doesn’t OSHA do something about this? The mismatch between enforcement and injuries has been most glaring in patient handling. About 11,000 nurses have musculoskeletal disorder injuries each year that are serious enough to cause them to miss work -- a number that has budged little in the past three years. OSHA has never issued a general duty clause citation related to patient handling injuries in a hospital, but that seems likely to change with the new inspection program. What can hospitals expect? A previous enforcement plan aimed at nursing homes resulted in 1,100 inspections and about $4 million in fines in three years.
OSHA issued a memorandum instructing that all inspections of hospitals and nursing home facilities, including those prompted by complaints, referrals or severe injury reports, should include the review of potential hazards involving MSD related to patient handling; bloodborne pathogens; workplace violence; tuberculosis; and slips, trips and falls.
In an era of heavier patients, safe patient handling equipment is still not used in many hospitals. For example, the federal Occupational Health Safety Network recently reported that of all patient handling injury reports collected, 62% included data on the use of lifting equipment. Of those, 82% of the injuries occurred when lifting equipment was not used.
1. Centers for Disease Control and Prevention. Occupational Traumatic Injuries Among Workers in Health Care Facilities — United States, 2012–2014. MMWR 2015:64(15);405- 410.