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Safe Patient Handling & Mobility: What’s Standing in the Way?

Survey led by Dr. Neal Wiggermann, PhD, from Baxter’s Ergonomics Lab

Two clinicians help a patient stand using a ceiling lift

In the United States, more musculoskeletal disorders (MSDs) occur in healthcare than any other occupational sector.1 Safe patient handling & mobilization (SPHM) protocols have long been shown to reduce MSDs.2 Why, then, is compliance with these protocols often so poor?

That’s the question a research team led by Dr. Neal Wiggermann, PhD, from Baxter’s Ergonomics Lab in Batesville, IN, set out to answer in their recent study, “Individual and organizational factors associated with injury history and patient handling behaviors: results from a nationwide survey of professional caregivers.”

“Many of us who work in this area know — or at least strongly suspect based on our experience — that SPHM-related injuries among healthcare workers are often underreported,” comments Dr. Wiggermann. “We acknowledge there are many challenges to safely mobilizing patients, but those are not often reported in context with task demands and organizational factors. So, with the help of our colleagues at the American Nursing Association (ANA), we set out to draw connections between some of these issues.”

Survey Says: MSDs are Chronic — and Chronically Underreported

973 healthcare workers (HCWs) responded to the nationwide online survey.3 Among those respondents, ~60% reported past work-related MSDs or pain lasting more than one week3 — most frequently in the back (80.2%) and shoulder (36.6%).3 Among those reporting pain or injury:

Only ~30%

had filed workers’ compensation claims3

~33%

had changed roles in response3

~80%

had worked while injured3

Did these results surprise the research team? Yes and no.

“There were a few findings that we suspected were true, but weren’t sure would stand out as strongly as they did,” says Dr. Wiggermann. “One, of course, is the high rate of unclaimed injuries — about 70%.3 It’s important that we quantify this disparity in actual vs. reported injuries as clearly as possible if we hope to change it.”

How Much is Too Much for Manual Lifting?

While SPHM responsibilities and resources varied across respondents, several notable trends emerged across the group:

<50%

agreed SPHM equipment was readily available3

>50%

considered manually handling patients weighing over 200 lbs (91 kg) to be acceptable3

Interestingly, even respondents with SPHM equipment available tended not to use it. In fact, the most common response for the frequency of using SPHM equipment for any mobilization task was “never.”3

“It has been well established that repositioning a patient weighing as little as 110 lbs (50 kg) can easily pose injury risk,”4,5 points out Dr. Wiggermann. “Yet even though many participants in the survey recognized the high risk of injury, they still did not use lifts — presumably because of barriers like availability of equipment, time demands, etc.”

Setting Clinicians up for Success

Despite overall agreement that SPHM programs are beneficial, the survey highlights that common clinical practice remains insufficient to adequately protect HCWs from risk of injury.3 Fortunately, several factors were noted that made use of safe patient handling & mobilization equipment more likely. These included:

· Equipment availability (including ceiling lifts)3

· Supervisor encouragement3

· Annual training3

Ceiling lifts appear to be particularly effective interventions, as respondents were twice as likely to agree they “always use” SPHM equipment when ceiling lifts are present.3 Furthermore, the survey showed that SPHM equipment availability reduced the likelihood of injured nurses changing roles3  — an important consideration in an industry already plagued with staffing shortages.

A Path to Safe Patient Mobilization

“This research really drove home for me that we, as an industry, need to go beyond telling nurses to use lifts. We need to support working environments that set them up for success in terms of safely mobilizing patients,” urges Dr. Wiggermann. “That means supervisor support. That means having lifting equipment available. And it means following ANA safe patient handling standards and recommendations. Equipment is an important part of the equation, but we also need training, assessments and evaluation systems to make sure the equipment is used to its greatest benefit.”

Results from this survey were presented at the 2023 ASPHP National Education Event. The full study will appear in a print issue of Applied Ergonomics later this year. Complete the form to download a digital copy now.

SPHM equipment availability reduced the likelihood of injured nurses changing roles.3

When ceiling lifts were present, respondents were twice as likely to agree they “always use” SPHM equipment.3

 

References

  1. Bureau of Labor Statistics. https://www.bls.gov/iif/factsheets/msds.htm Accessed February 27, 2024.
  2. Teeple, E., Collins, J. E., Shrestha, S., Dennerlein, J. T., Losina, E., & Katz, J. N. (2017). Outcomes of safe patient handling and mobilization programs: a meta-analysis. Work, 58(2), 173-184.
  3. Wiggermann, N., Francis, R., & Solomon, A. (2024). Individual and organizational factors associated with injury history and patient handling behaviors: results from a nationwide survey of professional caregivers. Applied Ergonomics, July 2024. https://doi.org/10.1016/j.apergo.2024.104251
  4. Waters, T. R. (2007). When is it safe to manually lift a patient?. AJN The American Journal of Nursing, 107(8), 53-58.
  5. Wiggermann, N., Zhou, J., & McGann, N. (2021). Effect of repositioning aids and patient weight on biomechanical stresses when repositioning patients in bed. Human factors, 63(4), 565-577.