Safe patient handling in Oregon

In the last 150 years, machines have dramatically changed the nature of work by helping people work more efficiently, with less effort and risk of injury...except when it comes to jobs in healthcare and the job of handling patients.

“For all of the technological advances in healthcare, the vast majority of healthcare facilities still rely on antiquated, physicallychallenging techniques,” says SAIF Loss Control manager Chuck Easterly. “If you were a mason, or a carpenter, or a factory worker who had to move 150 or 250 or 300 pounds, you’d get a dolly or a lift of some kind. You wouldn’t try to do it by hand. But that’s what we do in healthcare when we move people.”

Nurses, aids, paramedics and other healthcare workers for years have been using their own muscles to lift and move patients. But research now shows that the cumulative effect and risk of injury of this activity is a serious and growing problem, one that America’s growing obesity problem doesn’t help, either.

What makes the problem greater here than in other developed countries is a different approach to healthcare. In Australia, Denmark, Canada and Sweden, healthcare facilities are often designed around safe patient handling equipment, such as ceiling tracks and other devices. In these countries as well, healthcare is largely government-funded, which allows long-term investments in equipment and training for safe patient handling.

Finding a SAIF solution

“We think the nursing shortage is a problem now, but lifting injuries are just going to compound it as the baby boomers start to retire and more nurses and caregivers are needed to meet the demand,” says Deb Fell-Carlson, RN, one of the SAIF loss control consultants who has helped spearhead the SAIF Safe Patient Handling/Zero-Lift Initiative. “Industry leaders are starting to see the costs, and the workers are starting to see the real risks to themselves as well. And that will affect recruitment and etention in the nursing field.”

Because the SAIF mission is to reduce injuries while reducing costs for employers, SAIF is working to help healthcare customers understand the benefits of investing in equipment and programs for safe patient handling. Decisions to make such investments can be difficult, because of rising healthcare costs and increasing focus on the bottom line.

In 2001, using research that showed the dramatic cost savings and decreased injuries other healthcare organizations had experienced from implementing safe patient handling, SAIF held a policyholder Comp Chat seminar on the topic. Loss Control Consultant Judi Croft helped lead that discussion.

“We told our customers that safe patient handling is becoming a big issue in healthcare, and we want to give them the resources they need to eliminate the risk in lifting and moving people. They can get involved in proactive measures today, or wait until their employees and consumers push the issue,” says Croft.

A pilot project for policyholders

In late 2001, SAIF launched a safe patient handling pilot project, helping 19 committed policyholders learn about and implement lift equipment as part of their new “safe patient handling” efforts. Today, those organizations are using lift equipment daily as part of their comprehensive safe patient handling programs, with impressive results: 65 percent fewer patient-handling injuries and 84 percent lower costs from those claims.

One policyholder in the pilot program is Gateway Living in Springfield, where Operations Director Mark Kinkade has installed eight patient lifts. He says the decision has immediate bottom line returns by reducing claims and injuries, and longterm benefits by making his organization more attractive for both employees and residents.

“This is safer for the caregivers and the residents, and that helps not only in terms of attracting employees, but to attract prospective residents,” says Kinkade. “Our residents’ families want to know that their loved one can live here for a long time without needing more intensive services, and the lift equipment extends the time they can be with us.”

Once Kinkade learned from SAIF what the potential for reducing injuries was, he made the commitment to bring his organization on board, working with Croft and Loss Control Consultant Don Hadley from SAIF to understand his workplace injury trends and to identify potential savings, efficiencies and benefits for his employees and residents. He included his employees in the lift equipment selection process and provided hands-on training. This meant personally ensuring that every staff member knew how to correctly lift residents with the equipment by having employees practice lifting and being lifted by one another, including himself. Today, this committment has led to a significant reduction in injury severity and corresponding claims.

Taking safety into group homes

At a group home in Eugene run by Oregon Supported Living Program, HR director Gus McKeithen has seen the benefits of the equipment, as well. OSLP provides 24-hour group home care for adults with developmental disabilities. With 17 time-loss injuries in 2001, the organization had become nearly uninsurable and was facing cancellation by SAIF. Gus began working with SAIF to learn about and install patient lifts, and the organization has dramatically improved its injury experience in the three years since.

“Using the lifts not only provides the resident more safety from being mishandled or hurt, but it allows more dignity as well,” says Gus. “Our caregivers and residents have fewer scratches, bruises and skin tears from using it, too.”

Starting systemic changes

In 2003, the Oregon Board of Nursing revised its curriculum for certified nursing assistants (CNAs), as it does every
two years. This time, based on research from Fell-Carlson at SAIF Corporation added a new section to the training curriculum on safe patient handling and lift equipment. Every CNA program in Oregon is now required to include specific patient handling and safety as part of the coursework.

At the Samaritan Health Career Center, located at Samaritan Lebanon Community Hospital, students from the Linn-Benton
Community College-credit CNA program learn this using patient lifts donated by Wy’East Medical of Clackamas. Over the course of 15 class sessions, Nursing Assistant Program Instructor Carol Egan, R.N., spends parts of several days teaching students about body mechanics and safety, including use of patient lifts.

“Once these students understand why to use the equipment, they want to use it,” says Egan. “Many of them will then ask potential employers about it, and it may be a deciding factor in where they choose to work.”

Stephen Kalb is the safety manager for Samaritan Lebanon Community Hospital and Albany General Hospital, working as part of a broader effort to implement patient handling equipment into all in-patient facilities in the Samaritan Health Systems network, from Lebanon to Lincoln City.

“We traditionally have had the mindset that it’s somehow - kinder’ to lift people manually, but it’s just the opposite - there is far more risk of injury to the patient and the caregiver lifting manually,” says Kalb. “On the other hand, once people start using lift equipment on a regular basis, they use it better, and it gets quicker and easier. It becomes natural.”