Three States Supportive, Six States Require Safe Patient Handling Policy, Program, or Lift Equipment
Most of the information below comes to us from Anne Hudson, RN, BSN April 29, 2008 Founder, Work Injured Nurses Group USA Coos Bay, Oregon www.wingusa.org
Nine states have passed legislation pertaining in some way to safe patient and/or resident handling, with three states lending support to efforts for safe patient and/or resident handling, and six states directly requiring development of safe patient handling policies, and/or implementation of safe patient handling programs, and/or use of mechanical patient lifting equipment, with variations in the scope and strength of requirements imposed by each state.
To differentiate among the nine states which have passed legislation:
Three states, Ohio, New York, and Hawaii, have passed legislation which does not directly require, but is supportive of, safe patient and/or resident handling Ohio with interest-free loans to nursing homes wishing to implement lift equipment, New York with a demonstration project on safe patient handling, and Hawaii with adopting a resolution supporting American Nurses Association’s Handle With Care program
Six states, Texas, Washington, Rhode Island, Maryland, Minnesota, and New Jersey, have passed legislation requiring safe patient and/or resident handling policies, and/or programs, and/or lifting equipment, with much variation in scope and strength among the different state laws.
Links to wording of legislation enacted by the nine states are provided below, so comparisons can be made among state laws providing support for, and state laws mandating implementation of, safe patient handling policies, and/or programs, and/or provision and use of patient lift equipment.
Of interest is the difference among states in addressing the safe handling of either or both hospital patients and/or nursing home residents. As more states draft legislation, ideally they will cover the safe handling of dependent persons across all settings by all healthcare workers.
Here’s a quick comparison of the nine states which have passed legislation, first the three supportive states, then the six states requiring safe patient and/or resident handling policies, and/or programs, and/or lift equipment. See wording at the links provided for details on requirements of each state’s legislation.
Three states which have passed legislation supportive of, but not requiring, safe patient and/or resident handling:
- Ohio HB 67. March 21, 2005. First state to pass any kind of legislation in U.S.A. related to safe patient or resident handling. Created a worker’s compensation fund for interest-free loans to nursing homes wishing to purchase lift equipment for implementation of No Manual Lifting of Residents policies. Note: Does not require nursing homes to purchase and implement lift equipment or to develop safe patient handling policies and programs. Offers interest-free loans for lift equipment to nursing homes. Does not offer same loans to hospitals. Text: Scroll down to Sec. 4121.48. http://www.legislature.state.oh.us/bills.cfm?ID=126_HB_67_EN
- New York A 7641 and S 4929. October 18, 2005. Created a two-year Safe Patient Handling Demonstration Program to establish safe patient handling programs and collect data on nursing staff and patient injury with patient handling, manual versus lift equipment, in order to describe best practices for health and safety of healthcare workers and patients. Note: Does not require health care facilities to implement safe patient handling policies and programs. See: http://assembly.state.ny.us and http://www.senate.state.ny.us
New York A 7836. July 3, 2007. Extends demonstration program for two years to research the effect of safe patient handling programs, to build upon existing evidence-based data, with the goal of designing best practices for safe patient handling in health care facilities. Also establishes specifications for safe patient handling programs. Note: Does not require implementation of safe patient handling policies and programs. Summary text: http://assembly.state.ny.us/leg/?bn=A07836
- Hawaii HCR 16. April 24, 2006. Resolution calls for safeguards in health care facilities to minimize musculoskeletal injuries by nurses and for the State Legislature to support policies in American Nurses Association’s Handle With Care Campaign. HCR 16 states that in 2005, the Council of State Governments Health Capacity Task Force adopted and supported the policies contained in American Nurses Association’s Handle With Care campaign, and asked member states to also support the campaign. Recognizing that musculoskeletal disorders are the leading occupational health problem plaguing nurses, HCR 16 says, Be it resolved that the Legislature of the State of Hawaii supports the policies contained in the American Nurses Association’s Handle With Care campaign. Note: Does not require safe patient handling policy or program or use of patient lift equipment. Text: http://www.capitol.hawaii.gov/session2006/Bills/HCR16_.pdf
Six states which have passed legislation requiring safe patient and/or resident handling policies, and/or programs, and/or patient lifting equipment:
- Texas SB 1525. June 17, 2005. First state to require both hospitals and nursing homes to establish a policy for safe patient handling and movement, to control the risk of injury to patients and nurses; to evaluate alternative methods from manual lifting, including equipment and patient care environment; to restrict, to the extent feasible with existing equipment, manual handling of all or most of a patient’s weight to emergency, life-threatening, or exceptional circumstances; and provides for nurses to refuse to perform patient handling tasks believed in good faith to involve unacceptable risks of injury to a patient or nurse.
Note: Covers both hospitals and nursing homes. Requires safe patient handling policy only. Does not require safe patient handling program or provision and use of lift equipment. Specifies nurses. Does not cover nurse assistants. Enrolled text: http://www.capitol.state.tx.us/tlodocs/79R/billtext/html/SB01525F.htm
- Washington HB 1672. March 22, 2006. First state to mandate provision of lift equipment by hospitals and to offer financial assistance with implementation by tax credits and reduced workers€™ compensation premiums. Hospitals must establish a safe patient handling committee with at least half of the members frontline non-managerial employees providing direct patient care, a safe patient handling program, and policy for all shifts and units. Hospitals may choose either one readily-available lift per acute care unit on the same floor, one lift for every ten acute care inpatient beds, or lift equipment for use by specially-trained lift teams. Employees may refuse without fear of reprisal patient handling activities believed in good faith to impose an unacceptable risk of injury to an employee or patient. With hospital construction or remodeling, feasibility of incorporating patient handling equipment is to be considered, or of designing to incorporate at a later date. Note: Covers hospitals only. Does not cover nursing homes. Provides financial assistance to implement lift equipment and programs. Covers employees, which would include nurse assistants and other healthcare workers, not limited to nurses only. Enrolled text: http://www.leg.wa.gov/pub/billinfo/2005-06/Pdf/Bills/House%20Passed% 20Legislature/1672-S.PL.pdf
- Rhode Island H 7386 and S 2760. July 7, 2006. Requires hospitals and nursing facilities to achieve maximum reasonable reduction of manual lifting, transferring, and repositioning of patients and residents except in emergency, life-threatening, or exceptional circumstances. As a condition of licensure, health care facilities shall establish a safe patient handling committee chaired by a professional nurse with at least half the members non-managerial employees providing direct patient care, a safe patient handling program, and policy for all shifts and units. An employee may report, without fear of discipline or adverse consequences, being required to perform patient handling believed in good faith to expose the patient and/or employee to an unacceptable risk of injury. These reportable incidents shall be included in the facility’s annual performance evaluation. Availability and use of safe patient handling equipment in new space or renovation is to be considered, with input from the community to be served. Legislative findings include that safe patient handling can reduce patient skin tears threefold. Note: Covers both hospitals and nursing facilities. Covers employees, not limited to nurses only. RI H 7386 text:
http://www.rilin.state.ri.us/Billtext/BillText06/HouseText06/H7386Aaa.pdf and RI S 2760 text: http://www.rilin.state.ri.us/Billtext/BillText06/SenateText06/S2760A.pdf
- Maryland HB 1137 and SB 879. April 10, 2007. Defines safe patient lifting as use of mechanical lifting devices by hospital employees, instead of manual lifting, to lift, transfer, and reposition patients. Hospitals required to develop a safe patient lifting committee with an equal number of managers and employees, and a safe patient lifting policy to reduce employee injuries with patient lifting. Consideration is to be given to patient handling hazard assessment; enhanced use of mechanical lifting devices; development of specialized lift teams; training programs for safe patient lifting; incorporating space and construction design for mechanical lifting devices in architectural plans; and evaluating effectiveness of the safe lifting policy. Note: Covers only hospitals. Does not cover nursing homes. Covers hospital employees, not limited to nurses only. MD HB 1137 text:
http://mlis.state.md.us/2007RS/chapters_noln/Ch_57_hb1137T.pdf MD SB 879 text: http://mlis.state.md.us/2007RS/chapters_noln/ Ch_56_sb0879T.pdf
- Minnesota HF 712 and SF 828 passed within HF 122. May 25, 2007. Requires a safe patient handling program by every licensed health care facility, including hospitals, outpatient surgical centers, and nursing homes; a safe patient handling committee; and policy to minimize manual lifting of patients by nurses and other direct patient care workers by utilizing safe patient handling equipment, rather than people, to transfer, move, and reposition patients and residents in all health care facilities. The program will address acquiring adequate, appropriate, safe patient handling equipment; training; remodeling and construction consistent with program goals; and evaluations of the program. Financial assistance will include matching grants and development of on-going funding sources to acquire and train on safe patient handling equipment, including low interest loans, interest free loans, and federal, state, or county grants, plus a special workers’ compensation fund of $500,000 for safe patient handling grants. The MN State Council on Disability shall convene a work group to study use of safe patient handling equipment in unlicensed outpatient clinics, physician offices, and dental settings. Note: Covers hospitals, surgical centers, and nursing homes. Covers nurses and other direct patient care workers, not limited to nurses only. Link to text within MN HF 122: http://www.leg.state.mn.us/leg/legis.asp
Language in three areas:
- Grant funding Art 1, Sec 6, Sub 3, pp 25-26;
- main body of wording Art 2, Sec 23. 182.6551 to Sec 25. 182.6553, pp 48-51; and
- study ways for workers’ comp insurers to recognize compliance in premiums and for on-going funding Art 2, Sec 36, and work groups on safe patient handling and equipment Sec 37, pp 58-59.
- New Jersey SB 1758 and AB 3028. January 3, 2008. Covers general and special hospitals, nursing homes, state developmental centers, and state and county psychiatric hospitals. To establish a safe patient handling committee, with at least 50% of the members health care workers representing disciplines employed by the facility. Requires a safe patient handling program and policy on all units and all shifts; a plan for prompt access to patient handling equipment; posting the policy in a location easily visible to staff, patients, and visitors, which minimizes unassisted patient handling, and includes a statement on the right of a patient to refuse assisted patient handling. Assisted patient handling means use of mechanical patient handling equipment, including, but not limited to, electric beds, portable base and ceiling track-mounted full body sling lifts, stand assist lifts, and mechanized lateral transfer aids; and patient handling aids, including, but not limited to, gait belts with handles, sliding boards and surface friction-reducing devices. There shall be no retaliatory action against any health care worker who refuses a patient handling task due to reasonable concern about worker or patient safety, or the lack of appropriate and available patient handling equipment. Includes recommendations for a capital plan to purchase equipment necessary to carry out the policy, which takes into account financial constraints of the facility. Note: Covers hospitals, nursing homes, developmental centers, and psychiatric hospitals. Covers health care workers, not limited to nurses only. NJ SPH Act text: http://www.njleg.state.nj.us/2006/Bills/PL07/225_.PDF
Resources related to facility design: