This article will appear in the upcoming July-August print issue of Surgical Products.
It's impossible to provide quality care to patients if hospitals fail to provide a safe environment for their caregivers.
That’s what Kent Wilson tells hospital administrators who voice a desire to improve patient and staff safety, increase efficiency, and prevent unnecessary injuries through more effective patient handling practices. The safety programs director at HoverTech International never doubts their intentions to adopt best practices, but he does wonder why many facilities do not take a programmatic approach toward achieving that goal.
“A lot of hospitals are motivated to do the right thing,” he says. “But the natural reaction is to go out and purchase equipment. These hospitals fail to understand that they must establish detailed, sophisticated programs that need to be managed appropriately by people with the right skill set.”
Statistics indicate Wilson is right. They also suggest that hospitals should take great pains to establish effective and enforceable guidelines to protect personnel tasked with patient handling responsibilities, because whatever measures facilities are currently taking aren’t working all that well. According to data from the Bureau of Labor Statistics, the rate of overexertion injuries averaged across all industries was 38 per 10,000 full-time workers. However, the rate of injury for hospital workers is twice that amount – 76 per 10,000. Those numbers shed light on the unsettling fact that hospital staff members are unable to adequately prevent injuries while handling and moving patients in and around the operating room.
Why is the rate of injury so high? It turns out there are many contributing factors. Rising obesity rates in the United States mean hospital patients are larger and heavier than ever before. The average age of a nurse tasked with attending to them is now 44 years age, substantially higher than in past decades. To make matters worse, these nurses are in short supply and in high demand. According to the CDC, the burgeoning nursing shortage in this country is expected to result in 260,000 unfulfilled positions by 2025.
Rochelle Froloff, R.N., Medical Sales Specialist, Medical Products Group, Action Products Inc., says this ever-growing shortage has led facilities to not have enough people to properly move patients into proper positions on the operating room table or transferring them onto and off of tables via stretchers, especially given the rise in the obesity rate. That leads those staff on hand to embrace unsafe behaviors.
“In many facilities and in speaking with nurses, they are in a rush to get the next case going even though there is supposed to be a time-out procedure in place,” he adds.
Rushing and cutting corners can result in preventable injuries, some of which are serious enough (such as strained backs, knee injuries, among others) to land personnel on medical leave. Considering staff members are already in great demand, facilities cannot afford to lose additional help. Even healthy and productive staff members aren’t always adequately trained on equipment or even fully aware of their responsibilities as caregivers. Despite having access to tools that should serve as patient handling solutions, staff members are dealing with critical problems that go unaddressed.
Froloff advocates a proactive approach to combatting the problem.
“The best way to protect yourself (and the patient) is to make sure that there is the proper amount of personnel available,” she says. “Hospitals also can put guidelines in place for transporting patients and positioning.”
So why don’t more facilities create these guidelines and implement them? According to Wilson, it’s because many hospitals tend to view patient handling as a capital investment. Rarely, he says, do they approach patient handling as a means to avoid cost.
“When hospitals do a risk analysis and determine what it costs them to continue to pay for injuries, by being proactive and eliminating or reducing those, it becomes cost avoidance,” says Wilson. “And the payoff can be quite large.”
Characterizing patient handling as a capital investment is especially problematic in today’s modern healthcare landscape, where budgets are tight and adequate funds for investment are in short supply. Many hospitals are willing and able to purchase equipment to help handle patients, but a significant number of them fail to take a programmatic approach toward utilizing that equipment.
“Oftentimes, that equipment migrates to the closet and everyone’s frustrated,” says Wilson. “The administration is frustrated because they did spend the money, and now they aren’t seeing any results.”
No two hospitals are the same, and what works for one facility may not necessarily work for another. But every programmatic approach toward achieving patient handling goals involves effectively assessing patient handling problems or opportunities within the facility and determining how to address them before resources are deployed. This can lead to immediate and substantial results, most notably enhanced productivity and improved safety.
“When you look at the overall issue of ergonomics, it’s all about enhancing human performance or productivity,” says Wilson. “When you do that correctly, when you enhance that overall productivity and efficiency, you’ll sometimes overcome some of those staffing issues appropriately. Then you can have one or possibly two people moving a patient, as opposed to four or five.”
Yet, many facilities opt to purchase equipment first and ask the necessary questions second.
“Sadly, the vast majorities of hospitals that go down this pathway fail,” says Wilson.
Will hospitals no longer characterize patient handling as a capital investment? Will they begin to realize a sophisticated, detailed approach is what’s needed to achieve desired operational outcomes? Or will many facilities continue to remain steadfast in their efforts to address issues and chase goals by throwing money at them? Wilson isn’t so sure the healthcare industry as a whole is adequately prepared to leverage patient handling as a means to avoid cost, and he offers no guarantees as to when that fact may change.
“We’re going to head in one of two ways,” he says. “And I don’t know which way it will go."
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