Lift-free policy can reduce workers’ comp claims
Involve staff in the selection of mechanical devices
More than a third of workers’ compensation losses at hospitals and nursing homes occur when staff members attempt to move patients. Most of these injuries involve the back. But they can be avoided with the use of mechanical lifting devices, which, though expensive, cost far less than workers’ compensation claims that result from lifting injuries, according to Lois Zangl, RN, BSN, COHN-S, CST, occupational health specialist at the Milwaukee office of Wausau Insurance Cos. Zangl and her colleagues at Wausau conduct seminars on how to minimize the need for manually lifting and moving patients.
"The lift-free idea uses mechanical devices when a resident is unable to bear weight, is unable to assist in his or her transfer, or has only partial weight-bearing ability," explains Zangl.
Devices geared for virtually any patient-lifting scenario are available to hospitals. For patients who cannot bear any weight at all, Zangl recommends total lift devices. For those who can bear some of their own weight and who have some capacity to control their muscles well enough to sit upright, she recommends using a sit-stand device, which allows a single staff member to bring the patient to an upright position and then pivot the patient to a bedside chair, toilet, or bathtub without risking back strain. Some patients may be able to use an apparatus that allows them to walk unassisted and will break a fall should the patient lose balance.
Zangl says one of the most common back injury scenarios in hospitals occurs when a patient collapses or falls and a staff member attempts to catch the patient on the way down. The sudden load can easily result in serious injury.
Sit-stand devices, which are becoming more common, are designed for patients who have some ability to swing into a sitting position at their bedside but are unable to bear their own weight completely. The devices work by using a sling under the patient’s arm and then hydraulically lifting the patient to a standing position, after which the patient can maneuver the device alone. Other lifting devices help reposition patients in bed.
While the notion of lift-free transference focuses primarily on patient movement, other employees who lift heavy objects in the hospital also should use mechanical lifting devices, such as food service workers who are required to lift heavy pots and pans, Zangl recommends. Lifting accidents caused by moving materials are the second most common cause of injury in hospitals, she adds.
Zangl acknowledges that patient lifting devices are expensive, often costing from $3,000 to $6,000 apiece. But compared to the financial and human cost of losses caused by patient-lifting injuries, the investment is minuscule.
"It’s not unusual for a back injury to a nurse to cost the hospital $50,000," says Zangl. "You can purchase a lot of mechanical lifting devices for that amount. Devices on the market are very versatile and available for a variety of different transfer situations. They’ll pay for themselves in not much time at all."
But even hospitals that have a stock room full of patient-lifting tools must promote a culture that supports their use, or the machines will go to waste, Zangl stresses. "Some hospitals purchase expensive devices but don’t encourage their use or educate staff on their benefits, so management gets frustrated," she says. "The administration needs to get the message out that using lifting devices is how we do business now. Don’t manually transfer patients when the assessment warrants otherwise."
Zangl advises that hospitals take the following steps for introducing lifting devices into the hospital and making sure they don’t collect dust:
• Assess the lifting needs of each unit before purchasing any mechanical devices. "An orthopedic unit, for instance, probably does more patient lifting than other unit, and so will likely need more lifting devices," Zangl says.
• Ask staff members what lifting devices they need and would use. Involving employees in the selection process will greatly increase the likelihood that staff will use the devices after delivery.
• If possible, allow staff to test out equipment under consideration before making a purchase.
• Once delivered, lifting devices should be kept physically accessible, or staff members will ignore them.
• Administration must support the use of lifting devices by committing to buy enough of them to cover staff needs and conduct training sessions.
"I’ve seen some facilities that have been very successful with lifting devices because management and employees were involved in the process from the beginning," says Zangl.