Injuries in Maine’s Nursing Care Facilities (2010) Welcome to our presentation of data on Work-related injuries in the Health Care Industry. My name is Steve Laundrie – here for Kirk Duplessis – who has just become a new Dad. I will be going over some general information – primarily covering calendar year 2009 but also some historical data. CLICK TO NEXT PAGE Kirk Duplessis, Statistician II Maine Department of Labor Bureau of Labor standards

Agenda Injuries by Industry Injuries in Healthcare Injuries by Occupation Top 5 CNA Injuries The data that I will be presenting comes from reported disabling Maine Workers’ Comp. first reports. “Disabling” meaning the employee had to have lost at least one day away from work beyond the day of the injury. Each of these blocks pertains to the following slides. Again, I’m going to be presenting a very general overview of all disabling cases. If you’re interested in further information please see Kirk or myself or contact our office. Top 5 CNA Events Top 5 CNA Sources Top 5 CNA Body Parts

Top 5 Industries by First Report Of Injury (FROI), 2010 [Rough Injury Rate*] Much of this presentation is a ‘TOP 5’ list so think of me as David Letterman. In 2009, the top five industries in terms of the frequency of disabling claims are listed here. Health care businesses are two of the top 5 – highlighted in green. N=2817, represents 20.8% of FROI, Data from WCB *RIR = (FROI/Annual Employment)x100, Data from WCB

Top 5 Nursing Care Facilities (NAICS 623110) Occupations by FROI (2010) By far the most common occupation are “nursing aides, orderlies and attendants” i.e. CNAs. This is well over twice the frequency of the next highest occupation – R.N’s. Some 35% of all disabling cases within healthcare are CNA’S . Before I go on to the next slide I want to let you know that we have a set of rules for coding work-related injuries. Using the information from the Workers Comp. first report we code each disabling case by occupation, nature (which is the diagnosis), part (part of body), source (the object that directly caused the injury or illness), and perhaps the most relevant variable – the event which is a description of what happened to cause the injury. The first variable to look at would be the nature or diagnosis.

Proportionality of Employment and Injuries by FROI, 2010 (NAICS 623110)

Top 5 CNA Injuries, 2010 This slide shows the top 5 injuries or diagnoses of disabling cases regarding CNAs and RNs in healthcare. Sprains, strains, and tears are by far the most common injury for these occupations. This is not surprising since for all occupations in all industries this is the most common diagnosis. Of note, I have also highlighted , in a lighter shade of green, “back pain – hurt back.” For both of these occupations “sprains, strains, and tears” and “back pain” - indicators of a musculoskeletal disorder - account for about half of all cases. I have further data which shows the high frequency of MSDs for these occupations.

Top 5 CNA Injury Events, 2010 This slide shows the 5 most common identified events - in other words - what actually happened to cause or contribute to the injury. Looking at this slide what sticks out (highlighted in purple) is that over half of all CNA cases and over a quarter of RN injuries are overexertions: lifting, pulling , pushing, carrying objects or people. These are your MSD cases. Note: If someone asks about workplace violence – for CNA’s 33 cases coded or about 5% of all claims for their occupation.. For R.N.s the 24 cases coded or 8.6% of all claims for their occupation. Also, if someone asks about needlestick cases – for R.N.’s in 2009 only 3 disabling cases where the source was identified as a “needle or syringe.” No cases for CNAs.

Top 5 CNA Injury Sources, 2010 This slide presents the top 5 sources of injury or illness. A source is what object directly caused or contributed to the injury. For CNA’s and RN’s the number one source of injury is the health care patient or resident. The data indicates that over half of CNA cases and over a quarter of RN cases are a result of some sort of patient handling incident. I have also highlighted, in a lighter shade, the second most frequent source – bodily motion. These are cases where the employee is stretching, reaching, repetitive motion, or assuming some awkward position which could result in an MSD. Also, to mention briefly, the fourth highest source is listed as a “floor of the building.” You may wonder about that but we code that source for falls. If an employee falls to the floor the floor directly caused the injury – therefore it is the source.

Top 5 CNA Injured Body Parts, 2010 This last graph shows the top 5 most frequently identified part of body for disabling cases within these two occupations. I have highlighted in dark gray, the percentage of cases involving the back. I’ve also in lighter gray highlighted multiple body parts which could have involve the back. Back cases account for at least 30% of all CNA disabling cases and for at least 23% of all RN disabling cases. Looking at this and the previous slides on the types of injuries, the events, and the source the data shows that for CNAs the primary occurrence leading to a disabling involves some sort of patient handling putting some sort of strain on the back. This is true to a lesser degree for RNs. So – in summary:

Summary: In 2010, CNA’s had the highest frequency of disabling cases in Nursing Care Facilities. Ergonomics injuries (lifting, pushing, pulling, holding, wielding, etc.) are the most common types of injuries in healthcare The most common source of injury are health care patients i.e. the most common situation leading to a disabling case involves patient or resident handling.