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February 27, 2015

This hospital prohibits nurses from lifting patients. Here's how the work gets done.

Daily Briefing

Hospitals across the country are following the example set by one California VA facility and focusing on clinician safety by implementing technology that could help prevent workplace injuries, Daniel Zwerdling writes for NPR.

Even with proper techniques, there is no safe way to lift a patient

Background on nursing injuries

The story comes as part of an investigative series conducted by NPR describing how, more than a decade after a study found nurses risk serious injury even when using proper "body mechanics," many hospitals still do not have equipment in place to reduce the risk of injury.

The investigation found that nurses suffer more debilitating back injuries than any other occupation, simply by doing their job of lifting and moving patients.

VA's commitment to reducing workplace injuries

Since the 1990s, the Department of Veterans Affairs (VA) has been working to alleviate nurses' on-the-job injuries. Records showed that more than 2,400 VA nurses sustained debilitated injuries each year from lifting patients.

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Michael Hodgson, a researcher at the agency, said nurses, physicians, and hospital administrators knew about the epidemic of back injuries and how they "were interfering with their lives at work" and "interfering with productivity." In addition, the VA was spending nearly $22 million per year treating injuries sustained by nursing staff, and an agency report called that figure likely a "substantial underestimate."

VA researchers began studying how nurses—following the traditional techniques they had been taught in school—lifted patients from beds to wheelchairs, wheelchairs to showers, etc.  The researchers found that the amount of force exerted on nurses' backs was more than that experienced by workers on assembly lines.

So in 2008, the VA announced a $200 million initiative known as "the safe patient handling program" to transform its current protocols to prevent further injury to clinicians at all 153 of its hospitals nationwide.

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How VA is preventing injuries

According to VA, Loma Linda VA Medical Center has embraced the program more than any other.

For instance, the hospital installed lifts in all 207 of its patient rooms—which cost about $2 million—as well as in other places throughout the hospital where patients might need to go, such as clinics and imaging centers.

The patient lifts include a hook on a metal track which attaches to a fabric sling that wraps around a patient's body and lifts him or her. Administrators at some private hospitals across the U.S. have also installed such tools, according to NPR, but Loma Linda is unique because its entire facility is fully outfitted.

According to Tony Hilton, Loma Linda's safe patient handling and mobility coordinator, no one at the hospital is permitted to move patients the traditional way. She says, "The guideline is, you're not manually moving or handling patients. You're using technology." 

The hospital has also invested in power-operated gurneys and HoverMatt floating mattresses, which are connected to an air pump that allows the mattress to levitate from bed to gurney.

How hospitals make it work

Hilton says training staff to use the equipment remains the most important agent of change.

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Six years ago, most rooms at Loma Linda were equipped with lifts, but many nurses failed to use them. Hilton explains that nurses "were used to their old ways. They wouldn't use it." She adds, "We have been taught for years that we manually handle patients, so to undo that in your brain is a cultural change."

To make that change, she says nurses had to be trained repeatedly. At Loma Linda, nurses are constantly trained on how to properly use lift equipment, matched with a "peer" trainer, and required to attend workshops on workplace safety. In addition, at least one person in every unit for every shift must be available to train colleagues on lifting techniques.

The hospital has also benefitted from the presence of Hilton, the hospital's full-time safety "champion." Hospital administrators say her lobbying for improved safety protocols caused the hospital to fund initiatives and clinicians to use the equipment properly.

According to federal data, VA hospitals nationwide have reduced nursing injuries by nearly 40% since the initiative took hold. And Loma Linda this year spent "zero" dollars to hire replacements for employees forced out of a job because of an injury, down from $1 million during a recent four-year period (Zwerdling, NPR, 2/25).

The takeaway: Investments in technology that helps nurses lift patients without sustaining debilitating injuries could help keep nurses healthy and reduce staff turnover.

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