Preventing back injuries in nursing homes

Back injury is a common problem in the health care industry. A company that owned and managed five nursing homes decided to do something about it:

After reviewing employee injury records for the previous three years, the nursing home managers and safety personnel determined that most back injuries occurred while transferring residents – such as from their beds into chairs. These injuries were the most common (50 per year on average) and cost the most in workers’ compensation (about $165,000 per year). The records also showed that nursing aides and orderlies were the employees most likely to be injured.

A team of workers and managers developed an employee survey to help identify the most physically demanding tasks. Workers identified three types of resident transfers as “very heavy”:

• Transferring residents on and off the toilet
• Transferring residents in and out of beds and chairs
• Bathing and weighing residents

The managers of the nursing homes were aware of several types of lifting equipment that could assist in resident transfers. They asked three manufacturers of lifting equipment to provide samples for a 30-day trial. The managers included the employees from the beginning. They asked the nursing aides and orderlies to test the various types of lifts. They selected one type, which was purchased for permanent use. The cost to equip all five nursing homes was $143,000. By allowing staff to evaluate and select the equipment, the managers demonstrated confidence in staff judgment, encouraged teamwork, and increased use of the lifting equipment.

After using the equipment for 3 months, the original survey was given to the staff again. The tasks previously identified as “very heavy” were now identified as “not at all heavy.” During the next 2 years, an average of 25 injuries occurred per year, half as many as before the lifts were introduced. The cost of these injuries was about $60,000 per year, cutting workers’ compensation costs by almost two-thirds. Managers estimated that the original investment in the equipment (including training costs) was recovered within the first 2 years of use.

Three measures suggested that the change was successful: employees rated transfers as less stressful than before the equipment purchase, fewer injuries occurred, and workers’ compensation costs declined. Although this evaluation did not rule out other possible reasons for these improvements, it provided strong evidence that the introduction of lifting equipment prevented back injuries at the nursing homes.

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[Source for Case 1: Collins J, Wolf L [2001]. Intervention program for transferring residents in nursing homes. Washington, D.C.: Presentation to the 2001 National Occupational Research Agenda Symposium.]

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