Look beyond patient handling to tackle MSDs
Hazards lurk in food service, materials, laundry
Hospitals had a larger number of injuries from overexertion in 2008 than any other industry in the country, according to the U.S. Bureau of Labor Statistics. But even if you cut out most of the patient handling injuries, many back and neck strains and other musculoskeletal injuries would still occur.
The hazards exist beyond patient handling, especially in environmental services and facilities maintenance, says Rick Barker, MA, CPE, an ergonomic consultant with Humantech in Ann Arbor, MI. He will be speaking on the topic at the upcoming annual conference of the Association of Occupational Health Professionals in Healthcare (AOHP), Sept. 15-18 in Boston.
The risk comes from pushing, pulling, and lifting in materials handling, he says. "Patient handling is going to be your biggest issue and it has to be your starting point in the hospital [to reduce work-related musculoskeletal disorders]. Probably half of all your sprains and strains are coming from this one activity," he says. "Once you've got some good reductions in those injuries, your injury analyses are going to show some other things bubble up."
Lifting hospital supplies or hauling dirty linens can cause injury. But it's also inefficient to have processes that are unnecessarily physically exerting, he says. "These are things that interfere with how someone can do their job well," Barker says.
Employee health professionals should team up with safety officers and the hospital's workers' compensation insurer or third-party administrator to look for ways to reduce risks. Look for tasks that involve high forces or awkward postures, he says.
The lessons of safe patient handling can benefit other hospital areas. For example, at Deborah Heart and Lung Center, Brown's Mill, NJ, patient handling is now the least common cause of musculoskeletal injuries. The specialty hospital purchased beds that convert into chairs or can be used for transport. The hospital also uses lifts, lateral transfer devices, and powered devices to move wheelchairs and stretchers.
From October 2009 to May 2010, there had been only 13 workers compensation claims related to musculoskeletal injuries. The hospital has about 1,000 employees.
The hospital now also uses a motorized ERGOtug device, which attaches to linen and supply carts. "The supply carts can easily weight 500 pounds," says Liz Foy, RN, BSN, COHN, employee health and wellness coordinator. "We're trying to replace physical exertion with machine power wherever we can."
Foy tries to be proactive to prevent injuries. She has analyzed floor surfaces to see how they impact the movement of materials, and she adjusts computer work stations to make sure they are ergonomically correct.
"We try to take a comprehensive approach," says Foy. "Everything we've put in place has really made a big difference. Our injuries are really minimal."
Hospitals can learn lessons from other industries to reduce injuries in food services, warehouse, maintenance, and other areas, suggests Barker. The tasks are varied, yet mirror processes that take place in other businesses.
"A hospital is almost like a running a little city, with all the things it has to do to support the care of the patient," he says.
You can begin by benchmarking with another company to learn about injury prevention in a warehouse. "When you look at what goes on in a stock room of a hospital, it's very much like small warehouse operations are anywhere," he says.
"People are generally delighted to be seen as a benchmark and to share what they're doing, especially when it's outside their competitive industry," he says. "You start in your community with organizations that may be doing various types of warehousing and shipping."
Food service also mirrors a commercial operation, where employees face hazards ranging from slips and falls to sharp objects and noise. Food deliveries present similar challenges as materials management.
Haphazard work stations pose risk
Collaboration will be critical as you try to identify potential hazards, says Barker. Your best feedback comes from frontline workers. But you also should have some input into purchasing to make sure that safety concerns are included in the selection criteria, he says.
Watch out for the unexpected, he advises. For example, in computer workstations, the biggest ergonomic issues don't occur in offices where people have been working for years. The problems pop up in nursing stations or other areas where someone added a computer, Barker says.
"Oftentimes the work area isn't changed, but we try to put a computer in there and it doesn't really fit," he says.
Nurses or other employees may be forced into an awkward posture to use a computer or look at a monitor while providing patient care. Sometimes the solution is as simply as a pivoting arm that allows the nurse to tilt or move the monitor, he says.
The key is to discover the hazards that cause discomfort before they cause injury, he says. "You need to have a sense of where your problems are," he says.
Hospitals had a larger number of injuries from overexertion in 2008 than any other industry in the country, according to the U.S. Bureau of Labor Statistics.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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