2005 Legislation: Safe Patient Movement and Handling (updated 12/05)

Background: Safe Patient Handling and Movement

Patient handing tasks are recognized as the primary cause for musculoskeletal disorders among the nursing workforce. A variety of patient handling tasks exist within the context of nursing care, such as lifting, transferring, and repositioning patients, and are typically performed manually. Continuous, repeated performance of these activities throughout a nurse’s working lifetime results in the development of musculoskeletal disorders. Of primary concern are back injuries and shoulder strains, which can both be severely debilitating for nurses.

Compared to other occupations, nursing personnel are among the highest at risk for musculoskeletal disorders. According to the Bureau of labor Statistics, nursing aides, orderlies, and attendants ranked first and RNs sixth in a list of at-risk occupations for strains and sprains that included truck drivers (second), laborers (third), stock handlers and baggers (seventh), and construction workers (eighth). Studies of back related worker’s compensation claims reveal that nursing personnel have the highest claim rates of any occupation or industry.

The extent of musculoskeletal disorders among the U.S. nursing workforce is particularly distressing when considered in the context of the current nursing shortage. It is estimated that 12% of nurses leave the profession annually due to back injuries and greater than 52% complain of chronic back pain. Specifically, injuries secondary to patient handling tasks compound factors driving the shortage such as the aging of the nursing workforce, declining retention and recruitment rates, and the lowering social value of nursing.

In response to a persistent outcry from advocates and the mounting scientific evidence, the U.S. Department of Labor — Occupational Safety and Health Administration (OSHA) promulgated a standard intended to protect workers from ergonomic hazards, such as patient handling. In March 2001, Congress repealed the OSHA standard and ordered the agency to cease all work related to that standard. In March 2003, Federal OSHA released its "Guidelines for Nursing Homes — Ergonomic for the Prevention of Musculoskeletal Disorders." In these "Guidelines", OSHA explicitly recommends that manual lifting of patients be minimized in all cases and eliminated when feasible.

As part of the American Nurses Association’s (ANAs) Nationwide State Legislative Agenda, ANA and its State Nurses Association’s are promoting legislation that would require hospitals and other health care institutions to develop programs to prevent work-related musculoskeletal disorders and eliminate manual patient handling.

In 2005, three states enacted safe patient handling and movement legislation. NY legislation will fund a safe patient handling demonstration program. The bill authorizes a two year study to establish safe patient handling programs throughout the state to build upon existing evidence-based data, with the ultimate goal of designing a "best" practice for safe patient handling in New York State health care facilities. The bill also establishes specifications for safe patient handling programs.

Enacted OH legislation requires the Administrator of Workers' Compensation to use funds in the Long-Term Care Loan Fund to make loans without interest to nursing home employers to pay for specified equipment and training for employers to implement a policy of no manual lifting of residents by employees.

Legislation enacted in TX requires the governing body of a hospital or the quality assurance committee of a nursing home to adopt and ensure implementation of a policy to identify, assess, and develop strategies to control risk of injury to patients and nurses associated with the lifting, transferring, repositioning, or movement of a patient.   In 1996, California enacted an ergonomics regulation referring to repetitive motion injuries. This rule requires the consideration of engineering controls to minimize exposures that cause repetitive motion injuries. In 2003, the Cal/OSHA Standards Board voted to create an Advisory Committee to study a proposal for a revised ergonomics standard that would require employers to identify ergonomics hazards as part of their Injury and Illness Prevention Program.

Search	Contact ANA	Join/Renew Membership	Members Only	Online CE
NursingInsiderSpecial Offersnursesbooks.org © 2008 The American Nurses Association, Inc. All Rights Reserved Copyright Policy | Privacy Statement