Link Between Safe Patient Handling and Patient Outcomes in Long-Term Care

Abstract

This study examined the relationship between safe patient handling and quality of care measures. A comprehensive patient care ergonomics program included six elements. Using a retrospective observational design, 10 quality domains were compared before and after implementation of the program for 111 residents living on 24 units in six Veterans Administration nursing homes using a general linear regression model with repeated measures clustered within time and adjusted for age. After implementation, we found lower levels of depression, improved urinary continence, higher engagement in activities, lower fall risk, and higher levels of alertness during the day. Additionally, four areas showed a decline in function: pain, combativeness, locomotion, and cognition. Findings from this study may be useful in enhancing organizational support for safe patient-handling programs and could be used to build a business case for improving caregiver safety.

The Importance of Safe Patient Handling to Create a Culture of Safety: An Evidential Review

“…In general, however, a reduction in lost workdays due to injury was also found with ergonomic programme implementation [15,16,18,51], as were reductions in injury-related costs [16,51]. The quality of the study evidence overall is not high; some are small [13,14,41], not randomised [4,16,42,46,49,52], or lacking appropriate controls [4,12,16,17,45,49,50], or include other factors which may have an influence on the study result [44,48,51]. Table 1.…”

“…No significant improvement was shown in mood or behaviour indicators, however, or cognition. This study relied on secondary data, had no control group, and was also a retrospective analysis [4], so it would be interesting to see what outcomes were achieved from a better-powered study. Owen et al described a self-reported improvement in patient comfort and feeling secure when an ergonomic device was used [6], while Garg & Kapellusch assessed patient ratings of lifting devices, reporting that the majority of patients found the devices to be comfortable and safe [18].…”

“…A number of these studies are also underpowered -being either small [13,14,41,44,56], not randomised [4,16,46,42,49,52], or lacking appropriate controls [4,12,16,17,45,49,50]. Several studies are also based on self-reported data [6,14,42,44].…”

“…[ Manual patient handling can expose the musculoskeletal (MS) system of nurses and other healthcare workers to stress, leading to MSDs. Repeatedly and continuously performing manual patient handling tasks, such as lifting, transferring and repositioning throughout working life increases the risk of MSDs; this risk runs across all areas of nursing [4,24] (see Table 1). MSDs are a major source of injury to healthcare workers, and are especially prevalent in physical therapists [25,26].…”

“…This has an important causal effect on healthcare systems, as anything that takes staff away from patient care (be it injury, work limitations, or other factors) creates cost issues in a system (national or private healthcare), and has the potential for reducing the overall safety of the unit, including that of the patient. Manual patient handling is considered by many to be the single greatest risk factor for overexertion injuries in healthcare workers, while growing obesity rates and the increasing age of the nursing workforce are also contributory factors [1,4,11].…”