Lifting and exertion injuries decrease after implementation of an integrated hospital-wide safe patient handling and mobilisation programme

Abstract

Objective With increasing emphasis on early and frequent mobilisation of patients in acute care, safe patient handling and mobilisation practices need to be integrated into these quality initiatives. We completed a programme evaluation of a safe patient handling and mobilisation programme within the context of a hospitalwide patient care improvement initiative that utilised a systems approach and integrated safe patient equipment and practices into patient care plans. Methods Baseline and 12-month follow-up surveys of 1832 direct patient care workers assessed work practices and self-reported pain while an integrated employee payroll and injury database provided recordable injury rates collected concurrently at 2 hospitals: the study hospital with the programme and a comparison hospital. Results Safe and unsafe patient handling practice scales at the study hospital improved significantly ( p<0.0001 and p=0.0031, respectively), with no differences observed at the comparison hospital. We observed significant decreases in recordable neck and shoulder (Relative Risk (RR)=0.68, 95% CI 0.46 to 1.00), lifting and exertion (RR=0.73, 95% CI 0.60 to 0.89) and pain and inflammation (RR=0.78, 95% CI 0.62 to 1.00) injury rates at the study hospital. Changes in rates at the comparison hospital were not statistically significant. Conclusions Within the context of a patient mobilisation initiative, a safe patient handling and mobilisation programme was associated with improved work practices and a reduction in recordable worker injuries. This study demonstrates the potential impact of utilising a systems approach based on recommended best practices, including integration of these practices into the patient's plan for care.

Impact of California's safe patient handling legislation on musculoskeletal injury prevention among nurses

“…Musculoskeletal injury risk also showed a decreasing pattern although the finding was not significant. Many institutional‐level intervention studies have reported positive effects of SPH programs on musculoskeletal injury reduction . In our study, risk reduction was not observed for minor symptom parameters.…”

“…Following the implementation of these standards, evaluation research is needed to assess the impact and effectiveness of the SPH law on hospital programs and practices and musculoskeletal injury prevention. While there are reports of positive outcomes of SPH programs at a single hospital or health systems level, limited data exist on the statewide impact of SPH legislation. Only Washington State evaluated the impact of SPH legislation and reported reduction of workers’ compensation claim rates from musculoskeletal disorders …”

Do Technical Aids for Patient Handling Prevent Musculoskeletal Complaints in Health Care Workers?—A Systematic Review of Intervention Studies

“…The systematic search for literature resulted in 11 included studies from 12 articles published in 1999 to 2017 [ 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 ]. Ten of these studies were CBA studies [ 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 55 , 56 ] and one was an RCT [ 57 ]. Four of the studies were conducted in Canada, four in the USA, and one each in Italy, The Netherlands, and Great Britain.…”

Research Methodologies for Total Worker Health ®

“…Quasi-experimental studies may include evaluations of interventions initiated by employers, such as comparisons of change between intervention sites and comparison sites not randomly assigned to the intervention condition. 16 Because of the nonrandom selection, sophisticated statistical techniques like multivariate analysis, propensity score matching/weighting, coarsened exact matching, instrumental variable analysis, and other adjustment methods are used to control for confounders. 17–19 …”