2005 News

Safe patient handling: it’s all been said, now here’s what needs to happen

10.15.2005

From the Massachusetts Nurse Newsletter
October 2005 Edition

By Chris Pontus, MS, RN, COHN-S
Associate Director, Health & Safety

Many nurses wonder what can be said about back injury reduction programs that has not been said already. We understand why many nurses think and feel this way, but nurses also recognize that it is not what we know or what has not been said already, it is what needs to happen.

But it calls for a change in the way we think about nursing, as well as the culture of the organizations we work in before this paradigm shift can occur to make it happen.

Do you remember the term “body mechanics?” Body mechanics was part of the nurses’ training and education very early on in most nursing programs. In fact it was one of the first behavioral objectives taught to nursing students before going on into the clinical setting. This approach ensured that the newly acquired skill was practiced throughout all the nursing clinical rotations the nursing student would be exposed to.

 
  Chris Pontus (back right), from the MNA’s health and safety program, with Gladeen Jackson (back left), BSN, RN; Christopher Young, an EMT; and Sarah Larry, BSN, RN and a BIRN nurse at the Safe Patient Handling Convention in Florida. Jackson, Young and Larry all practice at the James A. Haley VA Medical Center in Tampa.

Body mechanics was also one of the first concepts and actions a nursing student thought they were practicing in order to take better care of themselves in addition to delivering excellent patient care. Now the new found truth is that body mechanics does not work.

What? How can that be?

That is the general reaction most nurses have when hearing this news. But the rationale is simple: injuries involving work-related musculoskeletal disorders show us that body mechanics does not work. This has become so evident that it has led to some countries in Europe to restrict nurses, doctors and other emergency and medical personnel from manually lifting patients.

Six months ago, Beth Piknick, chairperson of the MNA’s Safe Patient Handling Task Force and the newly elected president of the MNA, and I attended a four-day safe patient handling convention. Aside from the fact that we learned much and met many people, we also came back with very specific information to share with our
Safe Patient Handling Task Force.

The task force is made up of MNA members who attend monthly meetings to discuss and develop legislation, educational, training and nursing initiatives to get the word out about safe patient handling methods, ergonomics and lifting devices.

One of the specific points we were able to clarify after coming back from the conference was that “lift teams” were not something we wanted to convey as a panacea. In fact, we found the protocol and concept of the back injury resource nurse (BIRN) much more conducive for a long-term effective approach.

We now understand the value of a safe patient handling and movement program. This program works best as a team. Members of the team are nursing staff (CCNAs,LPNs, RNs), nursing services-safety representatives, peer leaders (BIRN), nursing administrator, risk managers, nurse educators, therapy staff members (OTs, PTs), engineering, employee health representatives, union members, and others who are committed to making this work.

A real benefit to attending the conference was that Beth and I actually meet and spoke to certified BIRN nurses. These frontline staff nurses from the Florida Veterans Administration were trained and certified in the basic education model. Their current practice with the peer review model of instruction is a testimony to the success of the program when practiced in a supportive environment.

We also met other interested professionals from various backgrounds who are all contributing to what has historically been a nursing issue when it comes to patient care. Clearly the challenge in the nursing profession has been the fact that patients themselves do not come in one size or predictable loads. The requirements for safe patient handling are often more varied and unpredictable than many manufacturing facilities where the problem can often be engineered out in a more direct and planned approach.

This reality puts the nurse and her profession at a disadvantage in that equipment, time, and nursing personnel are often resources not readily available at most given times while delivering patient care. Therefore, unless there is a program in place in each facility to ensure compliance for objectives of safe patient handling, equipment and personnel can not be properly utilized.

The Massachusetts Nurses Association has submitted to the Legislature a related bill for consideration entitled, An Act Relating to Safe Patient Handling in Certain Health Care Facilities (H.2662). Filed last December, it was referred by the House to the Joint Committee on Public Health in April. The bill is sponsored by Rep. Jennifer Callahan, D-Sutton.

If you are interested in supporting this legislation contact the Safe Patient Handling Task Force at 781.830.5754.

FPO