Relatively little attention has been given to measuring and reducing the frequency of handling patients. Facility design and equipment selection can directly impact the frequency of patient handling and the efficiency of nursing staff. A new approach to care process design known as the Universal or Acuity Adaptable Room can be used to dramatically reduce this risk.

Background

The need for improved ergonomics is present in nearly every occupation, but this need is especially large in healthcare. Careers in providing direct patient care, such as nursing and related fields, have been particularly impacted by staffing shortages and an aging workforce. In 1996, the average practicing registered nurse in the U.S. was 42.3 years old, which is nearly 10 years older than the average age in the workforce in general. As a result, over 10% of all occupational back injuries in the U.S. are caused by moving and assisting healthcare patients. Not only does this make nursing one of the most dangerous of all U.S. professions in terms of risk of over-exertion injury, the majority of those injuries occur while handling and transferring patients. Estimates of the cost for each over-exertion injury caused by patient handling vary considerably, depending upon factors such as the definition of injuries (e.g. OSHA recordable cases compared to compensable cases), state compensation laws, and utilization of modified duty work assignments. Injury costs also vary between hospitals depending on each facilities practices regarding charge-backs for services provided to their own injured employees. Hospitals are in a unique position relative to most other employers in that the employer provides many, or all, of the medical treatment services that are paid through workers' compensation. Some hospitals, particularly those that are self-insured, write-off many of the internal charges for treating injured employees. When the hospital system is also the direct employer of the physician an even greater portion of the work-related injury costs may be hidden within the total system operating costs, rather than paid through workers' compensation. Furthermore, compensation costs are only one aspect of the total costs. These costs extend into myriad areas including:

  • Turnover. Many nurses leaving the direct care aspect of the profession cite safety concerns and back pain as key factors in their decision to leave. Most areas are experiencing shortages of qualified nursing staff, and as a result, the cost to recruit and replace a nurse is much higher than most typical positions

  • Absenteeism. Underreporting of actual injuries is a concern in many settings. It appears to be particularly so within healthcare. The people who choose to pursue nursing as a career often place the well-being of their patients before their own. Nurses also appear more likely to insist on a greater degree of control of their own healthcare; which can result in a tendency to self-treat work-related over-exertion injuries. This self-treatment can involve self-imposed rest, accomplished by calling in sick to work.

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