Back Saver Program, Publishers of ADVANCE Newsmagazines

Times have changed. Not only are the patients heavier than ever, their acuity is up and the nursing workforce is aging. These are combined facts we can no longer deny. According to 2006 data from the Bureau of Labor Statistics, nurse's aides, orderlies and attendants ranked second after laborers as the most at-risk occupation for sprains and strains; nurses ranked fifth. "It is estimated 12 percent of nurses leave the profession annually due to back injuries, and greater than 52 percent complain of chronic back pain" (ANA, Safe Patient Handling Movement).

What is your organization doing to meet the everyday challenges to transfer your patients and minimize risk to your employees?

History

Smooth Move

The "slipper," an inexpensive slide sheet, was created at Gottlieb Memorial Hospital for moving patients up in bed, repositioning and cart-to-cart transfers. Since its implementation, there has been an 88 percent drop in injuries this year to date(Courtesy Gottlieb Memorial Hospital).
 
Gottlieb Memorial Hospital in Melrose Park, IL, began looking at back injuries in 1992 when the back injury rate comprised 25 percent of all employee injuries. A total lift device was bought and implemented on the transitional care unit. The staff underutilized this device. An education inservice was presented to the unit staff but was poorly attended due to staff workload.

By 1995, the percentage of back injuries was still at 20 percent. A task force reviewed the data and recommended adding a 4-hour lab with another demonstration using all equipment. Within the next 2 years, there was a decrease in back injuries by 15 percent. However, we were unable to sustain this improvement. The task force realized it was unrealistic to educate staff for 4 hours every year, providing limited hands-on experience and then expect full policy compliance with access to only one patient lifter for the entire facility.

By 2000, it was apparent employee lifting incidents were not limited to back injuries, but also included injuries to the neck and shoulders. This prompted us to expand monitoring to capture other injury trends related to lifting. This revealed lifting injuries had trended back up to 20 percent of all injuries.

Moving Toward Our Goal

In response to this data, funds were allocated to allow the purchase of additional lateral transfer equipment and sit-to-stand lift equipment. Administration support was the key to our success. Frontline managers were engaged to get their staff to attend and monitor compliance with the program.

By the fourth quarter of 2006, total lifts were available on all nursing units. This marked the first time in 20 years of data collection that not one lifting injury was reported for the quarter. Our lifting injury rate dropped to 10 percent of all injuries. The next year was even better with only 2 percent of caregivers reporting a lifting injury. Not only was there an 18 percent drop in total injuries, our dollars and lost work days decreased to an all-time low.

When the 2007 data was analyzed, we identified that pulling patients up in bed had to be addressed. I developed an inexpensive slide sheet we call the "slipper," which we trialed in several units in January 2008. By June, the slide sheet was implemented housewide. It has been used for moving patients up in bed, repositioning and cart-to-cart transfers. Radiology is also using it to slide cassettes under lying patients. We have had an 88 percent drop in injuries this year to date.

How Did We Do It?

The following are strategies we implemented to ensure our injury-prevention program was successful.

• Developed a proposal describing the organization's objectives, including statistics regarding present injuries and dollars spent, as well as details of the equipment needed.
• Determined how much manpower it would take to run the program. We dedicated one FTE to manage, educate, promote, develop, implement, report and continually evaluate the program.
• Developed a monitoring tool to log equipment usage to track compliance.
• Rounded on units at least weekly to develop face-to-face time with unit staff and support their efforts.
• Developed policy and protocols for storage, use, maintenance and cleaning of all equipment.
• Set realistic goals to include what we were trying to achieve.
• Developed unit champions named "Back Savers." All were provided scrubs and jackets with a themed logo to recognize their participation.
• Set up a budget allocating monies to include an educator, equipment, incentives and luncheons. Our program includes pizza parties for departments providing direct patient care with no lifting injuries. Quarterly massages are awarded to one department from a drawing of all departments that submit equipment log usage reports.
• Implemented floor rounds with giveaways for employees lifting properly.
• Created mandatory competencies yearly for patient caregivers.
• Educated leadership and physicians on the program, types of equipment and goals.
• Promoted safety, made rounds on units, created poster campaigns, advertised positive outcomes and rewarded those outcomes.
• Had designated reps promote the project philosophy on each unit and shift. Rewarded reps using different incentives, including lunch meetings at least twice a year. Motivated them to feel empowered to promote the program.
• Kept all employees informed with a regular newsletter. E-mailed staff on changes in the program and equipment as they occur.
• Followed up on all lifting injuries, identified if they were preventable in the future and took corrective action, if indicated.

The staff at Gottlieb has been instrumental in promoting the "minimal-lift culture" we strive for. This culture change has proved beneficial. Currently, staff injuries are the lowest to date since we have collected statistics, the dollars spent in claims for lifting injuries have plummeted from $445,426 in 2005 to $27,580 in 2008, and staff morale has improved as physical workloads have been easier to manage utilizing the equipment available to staff.

Mary Ann Shamoon is the wellness coordinator and Michelle Bookout is education coordinator, both at Gottlieb Memorial Hospital, Melrose Park, IL
 
 
Publishers of ADVANCE Newsmagazines