The European, Australian, and Canadian healthcare systems have led a revolutionary change in the way patients and residents are lifted and transferred within their facilities by successful implementation of a comprehensive patient-handling programs that includes ergonomic assessments, lifting equipment, and administrative controls (Nelson 2006). It has only been in recent years, the U.S. healthcare industry has openly begun to acknowledge that manually lifting, repositioning, and transferring dependent patients and long-term care residents are high-risk activities, both for the caregiver and the patient or resident.
Moving dependant people on a daily basis is identifiably dangerous work - the cumulative weight lifted by a single nurse in one typical eight hour shift has been estimated at 1.8 tons, or 9 tons for a 40-hour work week (Nelson 2006). It is not surprising the nursing occupation has one of the highest incidences of work-related injuries of all occupations. In 2007, there were 8.4 injury and illness cases per 100 full time workers in skilled nursing and personal care facilities compared to 4.4 per 100 for private industry. The lost workday injury and illness rate for skilled nursing and personal care facilities at 5.2 per 100 exceeded some of the traditionally more hazardous occupations such as construction 4.7 per 100 and agriculture 5.0 per 100 (BLS 2007).
Direct and indirect costs associated with back injuries are estimated to over $100 billion annually, with $30 billion attributed to the healthcare industry. Over three quarters of a million working days are lost annually as a result of back injuries in nursing, with an estimated 40,000 nurses reporting illnesses from back pain each year (Nelson 2006; BLS 2007).
Caregivers in hospitals and skilled care nursing facilities risk serious injury every time they help transfer, move, or reposition a patient or resident. Most of these injuries are strains and sprains caused by patient or resident handling care tasks, and 50 percent are related to the back. In a recent study, over 50 percent of nurses reported job related musculoskeletal pain (Nelson 2007).
Traditionally, the response to patient-handling injuries has been to provide training to caregivers on body mechanics and proper lifting techniques, and to identify patients or residents that would require a "two person" transfer or lift, thinking the two caregivers would share the weight equally thereby reducing the risk. These approaches do not reduce the risk of injury to caregivers. Evidence-based studies showed the shear forces on the spine during both one and two-person transfers and lifts measured above tolerance limits and concluded that patient-handling tasks are extremely high risk for injury (Marras 1999).
High risk tasks are defined as duties imposing, significant biomechanical and postural stresses on the care provider. In addition to patient transfers and lifts, other identified high risk tasks in healthcare include repositioning a patient in bed or chair, applying anti-embolism stockings, and transporting a patient in a bed or stretcher (Nelson 2006).
