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Safety first: How nurses can minimize risks on the job

This story was originally published in June 2018.

Nursing can be risky business.

Caring for sick patients has been found to make nurses and other healthcare workers vulnerable to physical injuries, blood-borne pathogens and tuberculosis.

They’re also more likely than workers in other professions to face violence in the workplace, as employees at some Georgia hospitals know first-hand.

But in recent years, there’s been a push to improve workplace safety for nurses and other healthcare workers, and there’s some evidence that it’s paying off.

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Piedmont Fayette Hospital, for instance, saw bedside injuries of staff drop from 50 to 25, and then down to 16, after purchasing — and then training employees to use — patient-lifting equipment.

“It’s forever a moving target, but our goal is zero,” said Jill Fenimore, the hospital’s director of rehabilitation and fitness.

Workplace safety for nurses and other healthcare workers has been a growing concern, with surveys showing that one in four nurses reports being physically assaulted by a patient or patient’s family member.

In 2015, the federal Occupational Safety and Health Administration set new safety inspection guidelines, based on data showing that hospitals have some of the highest rates of workplace injuries and illnesses in the country.

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U.S. hospitals recorded 244,800 work-related injuries and illnesses in 2013, according to Bureau of Labor Statistics data. That’s 6.4 work-related injuries and illnesses for every 100 full-time employees — nearly double the rate for all private industries (3.3 per 100 full-time employees.) Those same sick and injured hospital workers had 57,680 lost workdays.

OSHA’s safety memo identified five specific areas of potential danger: musculoskeletal disorders related to patient or resident handling; workplace violence; blood-borne pathogens; tuberculosis; and slips, trips, and falls.

Manual lifting of patients becomes more challenging

Musculoskeletal injuries accounted for 44 percent of all injuries reported by the health care industry in 2013. Those injuries are so pervasive and concerning that the American Nurses Association (ANA) takes the stance that, for the safety of the patient and the worker, there should be no manual lifting.

Hospitals across Georgia are on board with that thinking and are acquiring patient-lifting equipment, said Dr. Sherry Danello, vice president of patient care services and chief nurse officer at St. Joseph’s/Candler Health System in Savannah and a member of the board of directors of the Georgia Nurses Association.

“Safe patient handling and movement programs are not all at the same level of maturity,” Danello said. “But I am confident that every CNO (chief Nursing Officer) and vice president of Human Resources are working to decrease work-related injuries that at times are career-ending.”

These programs “are a win-win for nurses and organizations,” she said. “That’s a cost we all want to take out of the system.”

The St. Joseph/Candler Health System in Savannah tracks worker’s compensation claims for staff injuries related to lifting patients and has seen a dramatic drop in claims since launching a program in 2012 to put lifting equipment in most patient rooms, Danello said.

The hospital system had 78 of these worker’s compensation claims in 2011, the year before the program launched. By 2017, the number of claims had fallen to 15

Even more dramatic, Danello said, was the reduction in lost worker days from 2,018 to 137 in that same period.

At DeKalb Medical, lifting equipment has been provided to prevent musculoskeletal injuries of the staff related to patient handling, reducing risk for back, knees and shoulder injuries, said Cynthia Holbrook, the center’s executive director of WorksWell, Wellness on Wheels & Outpatient Wound Care Clinic. Daily safety briefings at the medical center keep the issue in the spotlight, Holbrook said. Staff also has access to computer-based learning on how to properly lift and carry patients, she said.

At Piedmont Fayette, where lifting-related injuries are down substantially, the hospital “has purchased a variety of safe patient handling equipment designed to lift, transfer and move patients from many different surfaces,” Fenimore said.

The focus, she said, has been: “How can we move patients of any size and keep our staff and patients safe?”

“It’s a lot about changing the culture,” Fenimore said. “We’re so used to going and grabbing a friend and co-workers to move a patient, and that’s not safe for the patients or employees.”

With ongoing training, employees at Piedmont have accepted the idea that they need to use equipment – not their backs – to move patients, she said.

Fear of violence exists for nurses

The nurses’ association’s Danello said nurses in Georgia and across the nation “just don’t feel equipped to respond” to workplace violence.

Violence, she said, is no longer just an issue in the emergency departments, it is occurring at all points of care.

The violence playing out in hospitals is “really a reflection of the greater society,” Danello said.

Several factors are likely at play, including the opioid epidemic and the closing of many of the country’s mental health facilities, she said.

More and more, hospitals are seeing patients who come in with an illness or injury and have mental health issues, Danello said.

Some hospitals are responding by establishing active shooter protocols, installing metal detectors and having security personnel in the emergency departments and across the hospital.

Data shows that, nationally, there’s been a 110 percent increase in violence against health care workers, and that’s come with a hefty price tag. Healthcare facilities are spending about $775,000 a year on security, according to a 2016 hospital security survey.

DeKalb Medical has revamped its workplace violence prevention program to deal with potentially volatile situations of patient vs. staff, staff vs. staff and staff vs. family, said Russell Richardson, the hospital’s security director.

The medical center offers work place violence classes, women’s self-defense training and teaches employees how to de-escalate potentially violent situations, he said

“OSHA requires organizations to establish programs to address workplace violence,” Richardson said.

Why does this matter?

For one reason, the healthcare industry in America employs more than 18 million workers, including more than 329,000 in Georgia. Women fill almost 80 percent of those jobs.

Georgia’s economic well-being also is dependent on the healthcare industry. For instance, data from 2017 shows Georgia hospitals pumped almost $50 billion into the state’s economy and were responsible for about 500,000 direct and indirect jobs.

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