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Safe patient handling and movement in a pediatric setting.

Article Excerpt
According to the American Nurses Association (ANA) (2006), up to 38% of all nurses experience back injuries. Musculoskeletal disorders (MSDs), more than any other work-related injury or illness, are responsible for lost work time, the need for protracted medical care, and permanent disability among health care workers. It is estimated that 12% of nurses leave the profession annually due to back injuries, and 52% complain of chronic back pain (ANA, 2009a).

In September 2003, ANA (2008) developed the American Nurses Association Ergonomics Handle with Care Campaign to mount a profession-wide effort to prevent back and other musculoskeletal injuries in health care facilities. The campaign addressed issues that included greater education and training, the use of equipment technology when moving and transferring patients, and a need for a paradigm shift in the schools of nursing curriculum.

ANA called for a collaboration of nursing organizations, the Occupational Safety and Health Administration (OSHA), and the National Institute for Occupational Safety and Health (NIOSH) to work together to develop a plan to promote these new strategies. The VISN 8 Patient Safety Center of Inquiry (PSCI), located at the James A. Haley Veterans' Hospital in Tampa, FL, in collaboration with these other organizations, performed a school of nursing study with nursing schools throughout the United States (Nelson et al., 2007). NIOSH, the American Nurses Association, and the Veterans Health Administration developed and evaluated an evidence-based training program on safe patient handling for educators at schools of nursing. Because the outcome of the study was positive, the Patient Safety Center developed a school of nursing curriculum under the direction of Dr. Audrey Nelson, which can be found on the center's Web site (U.S. Department of Veterans Affairs, 2009). The study found that when using the curriculum, nurse educator and student knowledge improved significantly, as did the intention to use mechanical lifting devices in the near future (Menzel, 2007; Nelson et al., 2007). The curriculum module won the 2008 National Occupational Research Agenda (NORA) Partnership Award and can be accessed on the Internet for use by all nursing schools to reduce the risk of musculoskeletal disorders among nurses (U.S. Department of Veterans Affairs, 2009).

The VISN Patient Safety Center also developed evidence-based practice algorithms for safe patient handling and movement. Prior to the use of the generic algorithms, a patient assessment is conducted; based on the assessment, an algorithm is used for a specific patient handling task. Because the patient's health needs change as the patient's condition changes, new assessments must be performed at the different states of a patient's health status. For example, patients' needs will differ pre-operatively and post-operatively. The patient assessment tool is used whenever there is a change in the patient status or health condition.

The Use of Lifting Technology in Pediatric Settings

The development of assistive patient handling equipment and devices has rendered the act of strict manual patient handling an unnecessary function of nursing care. Further, the use of mechanical lifts can substantially reduce patient skin tears and the frequency of patients being dropped.

The NIOSH equation for...

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