According to the National Safety Council, 3.7 million American workers suffered disabling injuries on the job in the year 2002. Work-related injuries cost Americans $146.6 billion in 2002, amounting to $1,060 per worker (National Safety Council). A survey conducted by the Bureau of Labor Statistics (BLS) indicated a total of 4.7 million nonfatal injuries and illnesses were reported in private industry in 2002. Further evaluation of the BLS data indicates that the services industry, of which healthcare is a part, led the percent of nonfatal injuries by industry division with 27.3% of the injuries. A more in-depth breakdown of the nonfatal injuries and illnesses within the services industry shows health services-Standard Industrial Classification (SIC) code 80-as the primary contributor, with 13% of the total reported, equating to more than 623,000 recordable cases. Hospitals (SIC code 806) lead the total number of cases and incidence rates of nonfatal occupational injuries and illnesses for industries with over 321,000 cases and an incidence rate of 9.7. Nursing homes are third (SIC code 805) with 187,000 cases and an incidence rate of 12.6 (United States Department of Labor).
For nurses, nursing aides and orderlies, patient care activities were identified as the most frequent cause of injuries (Bureau of Labor Statistics). In particular, back injuries have been identified as the leading injury associated with healthcare incidents.
Determining the factors that contribute to the high volume of incidents in the nursing profession has been a challenge. In 1990, Jensen identified the specific criteria that led to the risk of injury and then defined the health outcomes associated with the exposure. The study used Meta analysis to determine that a larger number of injuries occurred among patient care personnel who frequently performed physically strenuous patient handling tasks. An additional study concluded that the amount of risk factors to those involved in patient care was directly correlated with the frequency of patient transfers (Meittunen, Matzke, Sobczak).
Tasks related to patient care and transfers are intrinsically risky. Some of the risk factors include lifting loads far from the body, twisting, unexpected changes in load demand during a lift, and reaches outside the recommended ranges. Patients can be unpredictable, vary in ability to assist caregivers, and may present with additional challenges such as tubes, monitors, and wounds. The facility and environment can add additional risk factors due to lack of space, poor room design, inadequate equipment, and poor working surfaces. Because of these factors, typical lifting guidelines do not accurately apply and most tasks exceed the recommended limits. One study found the majority of transfer tasks produce extreme compressive forces on the spine (Marras, Davis, Kirking, Bertsche) and other research concludes that there is no safe way to manually perform most patient handling tasks.