NURSING HOME ERGONOMICS

The Wyandot County Nursing Home in Upper Sandusky, Ohio, is a 100-bed, county-run home which employs 90 workers, 45 of whom are nursing assistants. The Wyandot facility crafted a program that is similar to voluntary guidelines issued by the Occupational Safety and Health Administration for nursing homes.

(See guidelines at www.osha.gov/ergonomics/guidelines/nursinghome/index.html)

Before Wyandot implemented its ergonomics program, annual workers’ compensation costs averaged nearly $140,000. In addition, the turnover rate among the nursing assistants averaged above 55%. This meant that an average of 25 new nursing assistants had to be hired each year.

A worker’s back injury that cost the facility more than $240,000 provided significant motivation to find effective ways to address injuries and the turnover rate. In examining injuries, they learned that resident-transfer and re-position tasks presented the highest risk for workers. An ergonomic analyst found that there was an unrealistic expectation about the nursing staff’s ability to manually lift and re-position residents.

After looking into a “no lift” policy and mechanical lifts to aid transfer, the facility decided to launch a full-scale ergonomic program. When employees were asked about the lifting issue, more than 30 workers volunteered to examine the tasks of moving and re-positioning patients. The group decided that better body mechanics was not the answer. They determined that there was no safe way to lift a patient other than with mechanical lifts.

With recommendations from employees, the facility purchased several portable mechanical lifts for residents who required extensive-to-total care. The lifts included portable sit-to-stand lifts, walk / ambulating lifts and total lifts. Employees could move each of the lifts from room to room as they worked with individuals. However, many of the employees remained unconvinced of the value of using the equipment. In fact, it was only the workers who had evaluated the lifts who were using them. Many workers said it took too long to use the lifts.

One of the nurses conducted a time study to test how long it took to lift a resident manually, compared to using a lift. The manual lift took about five minutes, but to perform the lift, the nurse had to find someone to help, which took about 15 minutes.

In addition, new beds were designed to replace the old hand-crank beds. The new models lifted from the floor to a height of about 30 inches in nearly 20 seconds. The new beds were also designed so that residents would be less likely to slide to the foot of the bed as they were raised to sitting positions. This also meant that the residents did not need to be re-positioned as frequently.

The keys to success at Wyandot were training and management support.

As they purchased and installed new equipment, workers were trained how to use each piece. Also, guidelines were established for using the equipment. Wyandot’s administrator took a personal interest in the ergonomics issue. To address high injury and turnover rates, he participated in identifying and solving problems. For example, the staff had problems rolling the lifting devices to the different wings in the facility. To solve the problem, they tried different wheels until they found some that rolled more easily and turned with less effort.

Wyandot spent $150,000 to buy equipment and has saved $55,000 annually in payroll costs because of reduced overtime and absenteeism. Workers’ compensation costs declined from an average of $140,000 a year to less than $4,000 a year. From the time the sit-to-stand lifts were introduced, the incidence of back injuries stopped and only six new hires were needed the following year.

Sections revised from CTDNEWS, “ Workplace Solutions for Repetitive Stress Injuries” April 2003; Vol. 12, No. 4