S' A' F' E' Lifting Program Safe Accident Free Environment

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S. A. F. E.Lifting Program(Safe Accident Free
Environment)

• Mary Doherty, RN, BSN
• Tabitha Sheen,RN, MSN, APRN-BC

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Work-related musculo-skeletal disordersare the
most prevalent, most expensive, and most
preventable workplace injuries in the country.
Alexis Herman
Secretary of Labor
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Injuries on the jobhow RNs get hurt
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How much do Nurses lift?

• Restas reported (2000) that in an 8 hour
  shift, the cummulative weight that clinical
  staff lift is equal to an average of 1.8 tons per
  day!

(Journal of Nursing)
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Nursing Injury and the Nursing Shortage

• In an ANA survey (2001), 87.9 of nurses said
  that health and safety concerns influenced
  decisions to stay in nursing.
• In a poll conducted by New Jersey local of 1199,
  18 of CNAs leave the profession due to back
  injuries
• 2001 rate of nursing injury of 8.5 in hospitals
  and 13.2 in LTC far exceeds private industrys
  rate of 6.3

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A Nurse speaks

• Four of my colleagues-good critical care
  nurses-can no longer work in critical care
  because of back injuries. We miss them we need
  them
• -Nurse Practitioner at a large medical center,
  2002.

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The Hidden Costs of Back Shoulder Injuries

• Visible Portion of Iceberg Direct Costs
• Medical
• Compensation
• Larger portion hidden below the waters surface
  Indirect Costs
• Wage on Modified Duty
• Wage of Replacement / OT
• Training of New Employee
• Morale
• Loss of Efficiency to HC team

Direct Cost
Indirect Cost
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Mission

• To decrease the cost, incidence, and optimize
  the treatment associated with low back pain for
  Aurora employees.

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Phase I Activities

• Pre-placement testing for all physically
  demanding positions to assess physical ability to
  perform essential job functions
• Education at time of hire, orientation, on-going
• Supervisor training for early reporting of
  injuries
• Case Management of injuries
• ED Physician/Staff training about early return to
  work philosophy

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Phase II

• Prevention from an engineering perspective
  needed to be addressed!

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A gap analysis of lifting equipment was conducted

• Arjo assessed the hospitals for
• Types of lifts currently available
• Types of lifts needed
• Location of lifts and storage issues
• Types of patients cared for on each unit
• Costs/potential savings

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Costs and potential savings were presented to
Management, including finance, for their approval
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Analyzing direct and indirect costs for savings
projections and investment return
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Before the final decision was made to use
Arjo/Diligent as our vendor

• Comparison was made to another company
  specializing in lifting equipment
• Site visit to a large medical center to actually
  see the equipment in use, talk to staff and
  review their outcomes
• Equipment fair was held by both vendors for
  clinical staff to check out the equipment and
  provide feedback

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Overwhelming theme on the evaluations was that
employees were glad to be getting some equipment
to aid them and didnt have a strong preference
for either vendor.

• Aurora choose Arjo for several reasons
• The equipment seemed to be more user-friendly
• Arjo offers the Diligent Clinical Services which
  guarantees the 60 reduction in number of patient
  handling injuries.

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Implementing a Minimal Lift/Transfer Program
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For a 600 bed hospital, we had
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The purchase of equipment is the easy part, the
fun has just begun . . .
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(No Transcript)
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Implementation Plan
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Requires a Team Effort

• Leadership
• Employee Health
• Infection Control
• Clinical Engineering
• Maintenance
• Central Supply
• Laundry

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Initial Strategy

• Trained approximately 1800 employees nursing
  staff, transporters, therapists
• Phased in equipment over 3 month period which
  coincided with training
• Training
• Transfer Mobility Coaches received 8 hours of
  training
• General staff received 3 hours of training,
  which included return demonstration of equipment
  use
• Classes were held Monday thru Friday 0730 2300
  sometimes with concurrent sessions

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Ongoing Coaching

• Learn by experience
• Monthly visits by Diligent consultant
• Continuing Education of TMCs
• TMCs train new employees

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Lessons Learned

• Need a core group to assume responsibility for
  implementing and addressing ongoing issues
• Importance of having good working relationship
  with consultants
• Will require gentle pressure relentlessly
  applied
• Celebrate your successes

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Outcomes

• Pre-implementation data
• 7 months after implementation
• Does not include injuries that occurred from
  failure to use equipment.

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Indirect Outcomes

• Improved staffing
• Improved morale
• Assists in maintaining Magnet status
• Retention of staff who may have been injured or
  may not have been able to keep up with the
  physical demands of the profession (aging
  population)
• Recruitment tool
• Pt satisfaction