Ergo coaches prevent patient handling injury
Support staff in the use of lift equipment
Even the best ergonomics equipment has one potential drawback: It only works if employees use it properly and consistently. That human component — changing bad habits — may be the most challenging aspect of preventing injuries.
The Department of Veterans Affairs (VA) is testing a new way of addressing that weak link in musculoskeletal disorder prevention. By turning a highly motivated staff member into a "back-injury resource nurse [BIRN]," the VA created an in-house ergonomics coach.
"We looked for informal leaders, people whom others looked up to, who could motivate and lead and coach, and who had great interest in back injury prevention," explains Mary Matz, MSPH, project manager of the Safe Patient Handling and Movement Research Project at the James A. Haley VA Hospital in Tampa, FL.
"The units we’re targeting are high-risk units," she says. "They’re defined through injury data. We see a higher number and greater severity of injury on these units."
The VA is testing the BIRN concept in 23 units in eight facilities in Florida and Puerto Rico as a part of a large research study aimed at decreasing the risk for musculoskeletal injuries due to patient handling tasks. They also are tracking ergonomic-related injuries in control sites in California and Texas.
The BIRN program focuses on the highest-risk units — places where highly dependent patients must be moved frequently in and out of bed. That includes spinal cord injury units and long-term care units. Too often, health care workers reason that they have moved patients in the same manner before without injury. They may try to perform tasks that can’t be done safely even with proper posture or the assistance of a second worker.
"There’s a continuing increase in injuries to nursing staff due to patient handling and movement," Matz says. "The bottom line is that you need to use lifting equipment or some sort of patient handling aids to safely perform patient-handling and movement tasks. In terms of forces on the spine, [the tasks] are not within the norm."
High-risk units benefit from BIRN
At the Orlando (FL) VA Healthcare Center, the use of back-injury resource nurses has led to an increase in the use of ergonomic equipment, says Dawn Smith, PT, site coordinator for the VISN 8 Safe Handling and Movement Project.
The hospital identified two high-risk units — both of them long-term care centers. The BIRN nurses received four days of ergonomics training, and shared the information with their units during inservice training.
But being an ergonomics coach isn’t a full-time job. In fact, the duties are allotted just 0.1 full-time equivalent of the BIRN nurse’s job.
Nor are they expected to be the experts on purchasing and using ergonomic equipment.
"We’re not necessarily looking for them to train everyone on the equipment," Smith says. "The goal is for them to help change the culture to be more safety-conscious."
The BIRN nurse functions best as a role model, someone who promotes the use of ergonomic equipment.
"It’s mainly [a program designed] to help change attitudes," says Smith. "It’s important to have a co-worker there who really has an interest and believes in this. [He or she] can spread the belief that, although it may take a minute or two longer [to transfer patients], using these devices will reduce injuries."
If there’s an injury on the unit, the BIRN nurse meets with other nurses to review and analyze the incident. BIRN nurses also can pass along any staff concerns about the accessibility or ease of use of the equipment.
While the VA won’t know for a couple of years whether the BIRN nurses have had an impact on injury rates, Smith says the data will prove they are effective.
"They’re just a very enthusiastic group," she says. "I really think they’re needed just to help with the shift to a culture of safety and as a resource person."
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