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Safe Patient Handling & Movement in High Risk Units . Audrey Nelson, Ph.D., RN, FAAN audrey.nelson@va.gov Director Patient Safety Research Center VAMC Tampa, FL Web: www.visn8.va.gov/patientsafetycenter/. Study Goals.

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safe patient handling movement in high risk units

Safe Patient Handling & Movement in High Risk Units

Audrey Nelson, Ph.D., RN, FAAN

audrey.nelson@va.gov

Director

Patient Safety Research Center

VAMC Tampa, FL

Web: www.visn8.va.gov/patientsafetycenter/

study goals
Study Goals
  • Reduce the incidence and severity of musculoskeletal injuries in nursing staff.
  • Create a culture of safety and empower nurses to create safe working environments
overview
Overview
  • Study Design:
    • Prospective Study over 2 years
    • Pre and Post Test Design
    • Qualitative and Quantitative Data
  • Study Sites:
    • 23 High Risk Units at 6 VA Hospitals
program elements
Program Elements
  • Ergonomic Assessment Protocol
  • Patient Assessment Criteria
  • Algorithms
  • Back Injury Resource Nurses
  • State-of-the-art equipment
  • No-Lift Policy
results incidence of injuries
Results: Incidence of Injuries
  • Decreased 31%
  • From 144 injuries to 99 injuries
  • Significant at 0.003 level
results modified duty days
Results: Modified Duty Days
  • Decreased 88%, from 2061 days to 256 days
  • Significant at 0.01 level
results lost work days
Results: Lost Work Days
  • Decreased 18%, from 256 to 209 days
results self reported unsafe patient handling
Results: Self-Reported Unsafe Patient Handling
  • The # times/day nurses handled or moved patient in unsafe manner decreased from 3.63 to 3.18.
  • Significant at the 0.1 level
results job satisfaction
Results: Job Satisfaction
  • Pay
  • Professional Status**
  • Task Requirements**
  • Autonomy
  • Organization Policy
  • Interaction
  • Overall**
cost comparison pre to post
POST

$46,464

$35,201

$18,657

$21,948

$202,971

Treatment

Worker’s Comp

Lost Work Days

Restricted Days

Total

Cost Comparison Pre to Post

PRE

$93,531

$173,763

$24,048

$84,281

$480,797

cost benefit pre to post year 1 only
Cost Benefit (Pre to Post) Year 1 only
  • Savings in medical costs and lost or restricted days: $277,826
  • Minus annualized costs of equipment ($140,417.46) and training ($9,596.75)
  • Total Savings Year 1: $127,812
cost benefit
COST/BENEFIT
  • Over a 10 year period this translates to over $1.25 million dollars in cost savings, excluding the effect of inflation.
conclusions
Conclusions
  • Significant reduction in incidence and severity of injuries.
  • Job satisfaction was significant increased.
  • There were significant monetary benefits, associated with decrease in lost/modified work days and lower medical and cash payments due to injuries.
next steps
Next Steps
  • Apply research to moderate risk units
    • Conduct ergonomic assessment in acute care settings
    • Identify high risk tasks in ICU, ER, OR, PACU
    • Identify technological solutions
    • Apply solutions deemed effective in high risk units (BIRN, algorithms, etc)