JOB SAFETY: BACK CARE

By: Stephanie Olson

Angie Robl

LEARNER OBJECTIVES:
By the conclusion of this presentation on job safety: back
care, the learner will:
Be able to identify risk factors of back injuries.
Be able to identify equipment that should be used to
help reduce back injuries.
Understand how to reduce back pain and able to
educate fellow co-workers on the exercises listed.

INTRODUCTION:
Back injuries due to manual patient handling remain the #1 injury
reported in health care (Enos, 2009).

Healthcare worker back injuries alone excluding other

musculoskeletal disorders are estimated to cost $20 billion annually in
direct and indirect costs (Enos, 2009).

INTRODUCTION CONTINUE:
Work place safety is a right that is protected by law:
The OSHA ACT of 1970 outlines the responsibility of employers to
identify and prevent work place injuries and deaths.
Section 5 duties of the OSHA Act of 1970 states, Each employer
shall furnish to each of his employees employment and a
place of employment which are free from recognized hazards
that are causing or are likely to cause death or serious physical
harm to his employees (OSHA)

DEFINITION:
The U.S. Department of Labor defines a musculoskeletal disorder (MSD) as
the following:
An injury or disorder of the muscles, nerves, tendons, joints, cartilage, or spinal
discs (Enos, 2009).
They represent a wide range of disorders, which can differ in severity from mild
periodic symptoms to severe chronic and debilitating conditions (Enos, 2009).
Examples of MSDs can include, carpal tunnel syndrome, tension neck syndrome, low
back pain, bulging discs, and fracture vertebra.

ASSESSMENT OF BACK
CARE:

STATISTICS:
According to Martinez (2013), a study conducted in Grand Rapids, Michigan
stated, The 2013 Nurture by Steelcases State of Clinicians & Nurses Report
shows 35 percent of clinicians and nurses report being injured at least once
on the job (Nurture by Steelcase, para. 3).
24 percent had to modify activity or movement during their shifts and 17
percent had to miss at least one shift as a result of injury (Martinez, 2013, para.
3).

STATISTICS CONTINUED:
31% of nurses reported having personally experienced a back or
musculoskeletal injury while working as a nurse.
52% complain of chronic back pain.
12% of nurses leaving for good because of back pain as main contributory
factor.
20% transferred to a different unit, position, or employment because of lower
back pain.
12% considering leaving profession because of lower back pain.
38% suffered occupational-related back pain severe enough to require
leave from work; and 6%, 8% and 11% of RNs reported even changing jobs
for neck, shoulder, and back problems, respectively.
(Enos, 2009).

POLICIES:
The American Nurses Association (ANA) initiated a campaign that
began in 2003, called ANAs Handle with Care Campaign:
Since starting this campaign ten states, (California, Illinois,
Maryland, Minnesota, Missouri, New Jersey, New York, Ohio, Rhode
Island, Texas, and Washington) have enacted the safe patient
handling laws or regulations,
In these states there are established policies, and guidelines for
securing appropriate equipment and training, collection of
data, and evaluation (ANA, 2014, para. 2).

RISK FACTORS:
Back injuries can result from repeated manual lifting, pushing, pulling,
holding, carrying, transferring, and repositioning of a patient (Enos, 2009).
Having insufficient staffing.
Rising obesity rates in the United States increase the physical demands on
caregivers (CDC, 2014, para. 3).
Older nurses

ROOT CAUSE ANALYSIS:

Ferris State University NURS 450. (2014). Root cause analysis fish bone diagram example. Retrieved from: https://fsulearn.ferris.edu/webapps/portal/frameset.jsp?tab_tab_group_id=_2_1&url=%2F).

ROOT CAUSE ANALYSIS

CONTINUE:
Problem: Job Safety: Back Care
Largest Cause:
Manually Lifting Patients

Second Largest Cause:

Staffing Matrix

Third Largest Cause:

Environment

Least Influence:
Money

IMPLICATIONS AND
CONSEQUENCES:
Unsafe patient handling can contribute to patient injury such as falls during
transfers and skin tears and damage when pushing and pulling a patient
from bed to chair or repositioning in bed (Enos, 2009).
Data from 80 different studies have that every year, 40 to 50 percent of
nurses will experience back injuries (Enos, 2009).
Worldwide 17 percent of nurses will be injured at any point (Enos, 2009).

Shortage of nurses is increasing Why?

Because the impact of seeing nurses injured is not cost effective for health care
organizations but will negatively impact the recruitment of health care workers in
the long run.

EXERCISES TO REDUCE BACK PAIN:

Stretching everyday before work will reduce tension and stress in ones
back
Strengthening and stretching the muscles in your back can ultimately
reduce and or help prevent problems with back pain (Inverarity,
2014).
Examples of exercises:
Wall slides
Prone leg raises
Supine leg raises
Standing back stretch

RECOMMENDATIONS:
Federal and Government Legislation need to take action
Healthcare facilities need to initiate a No lift policy
Healthcare facilities need to invest in proper equipment and training cost to
use such equipment such as the following:

Height-adjustable electric beds

Mobile mechanical patient lifts
Ceiling-mounted lifts
Friction-reducing devices/lateral transfer aids
Bed repositioning devices

CONCLUSION:
Research has shown that there is not enough evidence to conclude that
only proper body mechanics will protect healthcare workers from injuries
when manually lifting a patient.
Policies need to be put into place, whether that is from the government
stand point or individual health care facilities.
Having proper equipment available to all nurses/units is a must.
Patient safety cannot be adequately addressed if employee safety is not
being adequately addressed (Enos, 2009).

REFERENCES:
American Nurses Association (ANA). (2014). Safe patient handling and mobility (SPHM). Retrieved September 15,
2014, http://nursingworld.org/Safe-Patient-Handling-and-Mobility
Centers for Disease Control and Prevention (CDC). (2014). Safe patient handling. Retrieved September 21, 2014,
http://www.cdc.gov/niosh/topics/safepatient/
Enos, L. (2009). Safe patient handling. A summary of the issue and solutions: The evidence base. Retrieved
September 15, 2014, http://www.hcergo.org/SPH%20Aug%2009%20Facts%20and%20References.pdf
Inverarity, L. (2014). Exercises to minimize or prevent back pain. Retrieved September 21, 2014,
http://physicaltherapy.about.com/od/backpain/a/BackPainEx.htm
Martinez, S. (2013). Nurture by Steelcase study shows 35 percent of nurses, clinicians injured on the job. Retrieved
September 21, 20214,
http://www.mlive.com/business/westmichigan/index.ssf/2013/12/nurture_by_steelcase_study_sho.html
Occupational Safety & Health Administration (OSHA). OSH Act of 1970 table of contents, section 5 duties.
Retrieved September 21, 2014,
https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=OSHACT&p_id=3359