The federal government recently introduced new guidelines for nursing homes aimed at reducing the high number of nurses and nursing aides who get hurt on the job.
The new ergonomics guidelines for the nursing home industry was introduced on March 13 by the U.S. Occupational Safety and Health Administration, the federal agency that regulates safety in the workplace. In the guidelines, nursing homes are instructed to develop new ways to lift and move patients and other activities that routinely cause injury.
“Nursing home workers are suffering too many ergonomics-related injuries. I’m pleased to announce that we have completed guidelines that will help the nursing home industry prevent ergonomic injuries to their employees,” said OSHA Administrator John Henshaw in a statement.
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The new guidelines allow nursing homes the latitude to create their own new measures to prevent injuries. Still, the agency provided a list of practical recommendations, based on an OSHA study of methods found to be successful in the nursing home environment.
Most important, the agency’s new guidelines recommend that all nursing homes find ways to minimize manual lifting of residents in all cases, and eliminate lifting patients whenever possible.
“I think [the new OSHA guidelines] are very helpful. They’re not going to be hard to implement. As a result, going forward we’re going to conduct more staff training and resident-safety training,” said Joan Hupf, director of quality improvement for Cedar Crest Sub-acute Rehabilitation Center, a 153-bed facility in Cranston. “We have the advantage here of having an in-house rehabilitation center, so we’re already doing ergonomic workshops on the use of electric lifts for transferring patients from bed to chair on a regular basis. We’re a little bit ahead of the game. When you contract your services out you don’t have that flexibility.”
Nursing aides, orderlies and attendants top the list of most dangerous jobs in Rhode Island, in terms of sheer numbers of workdays lost due to injury and illness.
Of 9,169 total workdays lost due to injury or illness in Rhode Island in 2000, 619 days out were recorded for nursing aides and others who work in nursing homes, according to OSHA data.
The danger of working in nursing homes doesn’t only exist in Rhode Island. Nationally, the rate of injury and illness in the nursing care industry is about two and a half times that of all other general industries.
A combination of factors makes working in a nursing home so dangerous, according to OSHA data: Nursing aides and other attendants most often hurt themselves lifting people. They routinely trip, slip or fall. And they get tuberculosis and HIV at higher rates than in any other occupation.
But the experience of many nursing homes suggests that using safer means to lift and move patients can have success in reducing injuries and associated workers’ compensation costs, according to OSHA. Providing a safer and more comfortable work environment has also resulted in additional benefits for some facilities, including reduced staff turnover and associated training and administrative costs, reduced absenteeism, increased productivity, improved employee morale and increased resident comfort.
To develop the new guidelines, OSHA visited nursing homes in every state to review existing ergonomics practices being used successfully, and studied scientific information about nursing home injuries.
As part of that process, last fall OSHA inspected Rhode Island nursing care facilities that had 14 or more injuries or illnesses resulting in lost work days for every 100 full-time workers. An OSHA spokesman would not release the names of the facilities on the program’s list. But 43 nursing homes here recorded at least eight workdays lost per 100 workers due to injuries or illnesses, according to OSHA.
Some in the industry say workplace conditions have actually improved in nursing homes in recent years, with an increased focus on safety. Today more than ever, nursing aides are using hydraulic lifts and pivot discs to move patients, and using safety needle systems and wearing disposable gloves and goggles when administering shots.
Still, the very low level of occupational health and safety in the nursing and home care industry is a problem that threatens the health of the entire industry, said Bruce Rosenthal, spokesman for the American Association of Homes and Services for the Aging, in Washington, D.C.
In recent years, the industry has experienced a decrease in staffing and an increase in the number of patients under nurse’s care. Lost workdays due to injury just compound a critical shortage of caregivers in nursing homes, he said.
The new ergonomic guidelines are available for downloading from OSHA’s Web
site at www.osha.gov. A printed copy of the guidelines is also available from
the OSHA Publications Office.
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