Back Care for Nurses

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.