Construction workers, warehouse
personnel, delivery goods drivers, nurses, shopkeepers and farm workers, if you
had to choose, which of these occupations suffers the highest incidence of back
injury? You might think that construction workers or delivery goods drivers
might be the riskiest occupations for back injuries, because the work involves
a lot of bending and lifting, but you'd be wrong! Many people are surprised to
learn the Nursing is the riskiest occupation for back injuries! In fact,
nursing has the second highest incidence of all types of non-fatal work-related
injuries.
What
are the risk factors for Back Injury?
There are two main risk factors for
back injury among nurses: lifting and transferring patients, and bed- making.
During a typical shift, on average a hospital staff nurse will lift 20 patients
into bed, and transfer 5-10 patients from bed to a chair. Patients typically
weight in excess of 100lbs, which puts this load well above the weight that
would be considered 'safe' for industrial workers for this frequency of
lifting. As with many hospitality workers, bed- making also increases the risks
of back injury because of the bending and stretching involved in putting sheets
onto a bed.
Ways
to Reduce Injury Risks
There are several ways that
hospitals, care facilities and nursing professionals can reduce injury risks.
These include:
Using lifting assistance devices - a variety of devices is available to help lift and move
patients from bed to seat, such as:
- Gait belt - this is a specialized belt that fits snugly
around the patient's waist and has hand straps for the nurse or caregiver
to grasp while assisting during transfers or walking.
- Walkers - lightweight metal frame devices with rails
that can be gripped by the patient to help to support their body weight
during transfer and rising from sitting.
- Rails - wooden or metal rails that are fixed to walls
or equipment, such as beds, to allow the patient to help to support their
body weight during transfer.
- 'Hoyer' lifts - a hydraulic lift that consists of a
metal frame and a heavy canvas swing. It is capable of lifting and
suspending a patient for transfer.
- Sliding boards - a smooth board with tapered ends made
of either wood or plastic that is used to help someone get from one
sitting surface to another.
- Draw/lift sheets - a regular flat sheet placed under a
person in bed can be used to move them. If the sheet is strong enough it
can also be used to lift and transfer the patient.
Using appropriate equipment - there is a choice of powered equipment available to reduce
patient handling activities, such as powered beds to change a patient's
posture, height adjustable chairs, and powered wheelchairs.
- Use appropriate beds - the height of the bed determines
how much bending and reaching a nurse has to do. Nurses are different
heights, so a simple-to-operate, height-adjustable bed is important to
allow bed height to be appropriately adjusted to the nurse.
- Use back belts - the general use of back belts in the
distribution industry has been questioned. However, in a study of 47
employees over a 6-month period, the use of back belts significantly
reduced injury risks. The test group with back belts worked 22,243 hours
and had no injuries, whereas the control group worked 23,109 hours and
lost 80 hours due to back injuries.
- Implement regular equipment maintenance procedures -
equipment must be kept in good working order.
- Ergonomic design of workplaces - use architectural and
design features, such as rails or ramps, to minimize awkward movements.
- Providing better ergonomics training - train nurses and
and health aides in good work postures and ways of minimizing twisting,
bending and/or lifting items from the floor. Also train them in safe
lifting practices, and in the correct use of appropriate equipment.
Provide ways of refreshing and reinforcing the training.
- Provide adequate staffing - injury risks can be reduced
by increasing the number of people available to assist with lifting
patients.
- Systematic record-keeping - implement processes that
facilitate more detailed statistics on manual handling activities and
outcomes so that this can help to identify injury trends before more
serious incidents occur.
