title: Devastating injuries in healthcare workers: description of the crisis and legislative solution to the epidemic of back injury from patient lifting.
abstract: The purpose of this report is to describe a crisis in healthcare, disabling back injuries in US healthcare workers. In addition, outlined is the proven solution of safe, mechanized, patient lifting, which has been shown to prevent these injuries. A "Safe Patient Handling--No Manual Lift" policy must be immediately instituted throughout this country. Such a policy is essential to halt hazardous manual patient lifting, which promotes needless disability and loss of healthcare workers, pain and risk of severe injury to patients, and tremendous waste of financial resources to employers and workers' compensation insurance carriers. Healthcare workers consistently rank among top occupations with disabling back injuries, primarily from manually lifting patients. Back injury may be the single largest contributor to the nursing shortage. Reported injuries to certified nursing assistants are three to four times that of registered nurses. A national healthcare policy for "Safe Patient Handling--No Manual Lift" is urgently needed to address this crisis. Body mechanics training is ineffective in prevention of back injury with patient lifting. Mandated use of mechanical patient lift equipment has proven to prevent most back injury to nursing personnel and reduce pain and injury to patients associated with manual lifting. With the national epidemic of morbid obesity in our country, innovative devices are available for use in emergency medical systems and hospitals for patient lifting and transfer without injury to hospital personnel. The US healthcare industry has not voluntarily taken measures necessary to reduce patient handling injury by use of mechanical lift devices. US healthcare workers who suffer disabling work-related back injuries are limited to the fixed, and often inadequate, relief which they may obtain from workers' compensation. Under workers' compensation law, healthcare workers injured lifting patients may not sue their employer for not providing mechanical lift equipment. Discarding healthcare workers disabled by preventable back injuries is an abuse which legislators must remedy. In addition, Medicare reimbursement policies must also be updated to allow the disabled community to purchase electrically operated overhead ceiling lifts. The US lags far behind countries with legislated manual handling regulations and "No Lifting" nursing policies. England and Australia have had "No Lifting" nursing policies in place since 1996 and 1998, respectively. The National Occupational Research Agenda (NORA) recognized a model in 2003 for reduction of back injuries to nursing staff in US healthcare facilities. Also in 2003, the American Nurses Association called for elimination of manual patient handling because it is unsafe and causes musculoskeletal injuries to nurses. The first state legislation for safe patient handling passed both houses in California but was vetoed by the Governor in September 2004. California and other states are preparing to (re)introduce legislation in January 2005. A national, industry-specific policy is essential to quell the outflow of nursing personnel to disability from manual patient lifting.
authors.affiliation: Plastic Surgery and Biomedical Engineering, University of Virginia Health System,Virginia, USA. redlich9@comcast.net
authors.forename: Richard F
authors.initials: RF
authors.lastname: Edlich
authors.forename: Mary Anne
authors.initials: MA
authors.lastname: Hudson
authors.forename: Ralph M
authors.initials: RM
authors.lastname: Buschbacher
authors.forename: Kathryne L
authors.initials: KL
authors.lastname: Winters
authors.forename: L D
authors.initials: LD
authors.lastname: Britt
authors.forename: Mary Jude
authors.initials: MJ
authors.lastname: Cox
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Becker
authors.forename: Joseph K
authors.initials: JK
authors.lastname: McLaughlin
authors.forename: K Dean
authors.initials: KD
authors.lastname: Gubler
authors.forename: Thomas S P
authors.initials: TS
authors.lastname: Zomerschoe
authors.forename: Mary F
authors.initials: MF
authors.lastname: Latimer
authors.forename: Robert D
authors.initials: RD
authors.lastname: Zura
authors.forename: Nona S
authors.initials: NS
authors.lastname: Paulsen
authors.forename: William B
authors.initials: WB
authors.lastname: Long
authors.forename: Barbara M
authors.initials: BM
authors.lastname: Brodie
authors.forename: Susan
authors.initials: S
authors.lastname: Berenson
authors.forename: Scott E
authors.initials: SE
authors.lastname: Langenburg
authors.forename: Lise
authors.initials: L
authors.lastname: Borel
authors.forename: Danielle B
authors.initials: DB
authors.lastname: Jenson
authors.forename: Dillon E
authors.initials: DE
authors.lastname: Chang
authors.forename: W Randolph
authors.initials: WR
authors.lastname: Chitwood
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Roberts
authors.forename: Mara J
authors.initials: MJ
authors.lastname: Martin
authors.forename: Anna
authors.initials: A
authors.lastname: Miller
authors.forename: Charles L
authors.initials: CL
authors.lastname: Werner
authors.forename: Peyton T
authors.initials: PT
authors.lastname: Taylor
authors.forename: Jeanette
authors.initials: J
authors.lastname: Lancaster
authors.forename: Marina S
authors.initials: MS
authors.lastname: Kurian
authors.forename: Jerry L
authors.initials: JL
authors.lastname: Falwell
authors.forename: Reverend Jerry
authors.initials: RJ
authors.lastname: Falwell
mesh_terms: D000328:Adult; D001315:Australia; D019567:Back Injuries / Q000191:economics / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D017770:Lifting / Q000009:adverse effects*; D006278:Medicare / Q000191:economics / Q000706:statistics & numerical data; D009741:Nursing Staff, Hospital; D009784:Occupational Diseases / Q000191:economics / Q000209:etiology* / Q000517:prevention & control; D006113:United Kingdom / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014942:Workers' Compensation / Q000191:economics / Q000706:statistics & numerical data