Patient Care Unit » Work-related Musculoskeletal Disorders

Hazards

Patient Care Unit staff that frequently lift and reposition patients and equipment during patient care and/or patient transfers may experience work-related musculoskeletal disorders (MSDs) (e.g., strain and sprain injuries to back and shoulder areas).

Risk factors include:

  • Overexertion (e.g., trying to stop a patient from falling or picking a patient up from the floor or bed).
  • Lifting uncooperative and/or confused patients.
  • Lifting patients who cannot support their own weight.
  • Lifting and/or repositioning very heavy patients (bariatric patients).
  • Distance the patient is being moved, and the distance the patient is from the employee, (e.g., it is more stressful to reach away from the body to lift or pull a patient).
  • Focusing on body mechanics and lifting techniques instead of providing mechanical lifting devices.

Recognized Controls and Work Practices

Safe Patient Handling Programs and policies that limit or prohibit manual lifting have been shown to be effective in reducing MSDs in hospital and nursing staff. Research has shown that the use of mechanical lifting equipment and a Safe Patient Handling Program can significantly reduce injuries to hospital staff.

Minimize manual lifting of patients in all cases and eliminate manual lifting when possible. Focusing solely on “proper body mechanics" during lifting is not sufficient to prevent MSDs.

Additional Information

Provide employees with proper assistive devices and equipment to reduce lifting hazards.

  • Proper equipment selection depends on the specific needs of the facility.
Examples of Patient Handling Assistive Devices
  • Devices such as toilet chairs that fit over the toilet: Eliminate the need for multiple transfers and save healthcare workers multiple lifts. For example, a patient can be moved to a toilet chair from a wheelchair, then toileted and showered, and finally transferred back to the wheelchair.
  • Shower stalls that allow for shower chairs to be pushed in and out on level floor surfaces. This is a standard shower without a front lip, which allows for easy access.
  • Toilet seat risers: Use toilet seat risers on toilets to equalize the height of wheelchair and toilet seat. This allows for a lateral transfer rather than a lift up and out of or back into the wheelchair.
  • Lateral transfer devices: Devices used to laterally transfer a patient, for example, from bed to gurney. These devices usually require multiple staff members to help do the lifting. Lifting is often done with the help of a draw sheet, or similar device. Some new lateral transfer systems do not require any lifting by staff, and are totally mechanical. Lateral transfer devices help prevent staff back injuries.
  • Sliding boards: A slick board used under patients/residents to help reduce the need for lifting during transfer of patients from bed to chair, or chair to car. Patients are slid rather than lifted.
  • Slip sheets/Roller sheets: Help to reduce friction while laterally transferring patients or repositioning patients in bed. Also help to reduce the force workers need to exert to move the patient.
  • Repositioning Devices: Mechanically pull patients up in bed, thus eliminating manual maneuvering by staff.
  • Height-adjustable electric beds: The use of height-adjustable electric beds allows for easy transfers from bed height to wheelchair height. These beds can be kept low to the ground for patients’ safety and then raised up for interaction with staff.
  • Trapeze lifts: A bar device suspended above the bed that allows patients with upper muscle strength to help reposition themselves. This device is particularly useful with adjustable beds and armless wheelchairs.
  • Walking belts or gait belts (with handles): Provide stabilization for ambulatory patients by allowing workers to hold onto the belt handles and thereby support patients/residents when they are walking. Not designed for lifting patients/residents.
  • Wheelchairs with removable arms: Allow for easier lateral transfers. Especially useful with height adjustable beds.
  • Sitting-standing Wheelchairs: Wheelchairs that provide sitting to standing options for patients.
  • Mechanical lift equipment: Helps lift patients who cannot support their own weight or can bear only some body weight. Choose a lift that does not require manual pumping to avoid possible repetitive motion disorders to workers' arms or shoulders. Mechanical lift equipment falls into two main categories:
  • Sit-to-Stand Device: Designed to help patients who have some mobility but lack the strength or muscle control to rise to a standing position from a bed, wheelchair, chair, or commode. A sit-to-stand device can only be used by patients who are able to bear some body weight. Depending on how much weight-bearing capacity the patient has, a sit-to-stand device can raise the patient either just high enough for short distance transfers, such as bed to wheelchair or wheelchair to commode, or to a fully standing posture for longer distance transfers. Use of a sit-to-stand device requires patients to be able to sit up on the edge of a bed with or without assistance, and to be able to bend their hips, knees, and ankles. A sit-to-stand device does not work from a prone position.
    • Sling-Type Full Lift: Used to transfer patient from a bed to a wheelchair, toilet chair, bathtub or commode. A full-body lift is used for non-weight bearing patients who have physical limitations (i.e., quadriplegic or amputee). A full-body lift supports the entire weight of the patient with a sling that is attached to a swivel bar on the boom of the lift. There are two types of sling-type full lifts:
      • Overhead track mounted patient lifts: The sling attaches to a track system built into the ceiling. This system provides patient mobility from room to room without manual lifting.
      • Portable lift: Can be moved to the location where it is needed.

Additional Information