Ergo Blitz! How To Establish A Zero Lift Policy That Works

Lessons BLITZ! Nursing home ergonomic problems can be addressed QUICKLY Payback is fast Management commitment/employee involvement is the key to success

OSHA Intervention? Nursing Home Administrator attended OSHA Outreach Activity Thereby motivated to avoid OSHA Nursing Home Programmed Inspection State of Illinois OSHA On Site Consultants were used No inspection by Federal OSHA

The Facility 207 bed long term care skilled nursing facility in Aurora, IL 160 employees (65-70 aides) 2002 injury/illness rate was high ! Many lifting injuries Beds Chairs Toileting

The Process, Step By Step Evaluate Injuries and Costs Obtain Approval For Funding Establish A Lifting Committee Evaluate and Select Equipment Resident/Family Notification Receive and Prep Equipment Training Resident Assessment Coordination with Other Staff Enforcement Performance Measurement Evaluate Efforts Regularly

Evaluate Injuries and Costs OSHA recordables and non-recordables Cost data from workman’s comp carrier Resident injuries such as skin tears Employee turnover rate and costs of turnover

Obtain Approval For Funding Present injury/cost data to owner Ballpark estimate for buying lifting equipment Note other expected results Reduced risk of OSHA inspections/penalties Reduced employee turnover, better morale Injury reduction from dropping residents Increased admissions from improved PR Overall better resident care

Establish A Lifting Committee CNA based committee Select outgoing CNAs 45 minute meeting per week Food, fun, praise Leader has budget authority, is committed to project, and is a motivator

Evaluate Equipment Hold open house for several different vendors Demo equipment never seen before CNAs test equipment in the facility/provide feedback Four inch extenders added to bed legs so lift will fit under lowboy bed.

Equipment Selection Equipment feedback list from CNAs Identify all different accessories needed for lifts such as scales and extra slings Decision meeting with lifting committee Final budget approval and purchase Set date for zero lifting policy

Resident/Family Notification Send letter to families advising of change Advise Resident’s Council

Equipment Prep Copy manufacturer instructions, laminate, and attach to equipment Attach a warning sign that each lift must be checked prior to use Charge battery operated equipment Develop competency checklist on use of equipment

Equipment Location Right number of lifts in the appropriate locations Lifts need to be available to aides, NOT the residents moved to be accessible to the equipment!

Training CNA one-on-one training for each employee Employees competency checked on each piece of equipment Competency check signed off by aide Not use equipment until competency checked 3 day suspension for not using lift

Resident Assessment Needs to identify the type of equipment needed for each resident Develop assessment sheet Review assessment sheet with staff

Coordination Maintenance staff – new equipment maintenance info Laundry staff – sling cleaning information (some slings can’t be laundered). Rehab staff – info on lift type(s) used with each resident (because lifts require use of muscles)

5 Sit to Stand Lifts 4 Hoyer Lifts 3 Pivot Disks Equipment Selection by this Nursing Home

Sit To Stand Lift Equip one sit-to-stand lift with a scale for weighing residents

Hoyer Lift Decision: Electric or Hydraulic Purchase extra slings Equip one lift with weigh scales to eliminate extra handling for resident weighing

Pivot Disk Like a Lazy Susan with handles Great for bathrooms, can be rotated using little space

Enforcement 3 day suspension for not using lift Policed by Lifting Committee members, empowered to recommend suspensions Nine suspensions were levied here Pick suspension days for best use of facility resources and less impact on employee’s paycheck at one time

Results: Costs and Savings Costs at this facility $24K for lifting devices and slings Time: 45 minutes weekly X approx 10 aides Team leader time of approx 1 hour/week in addition to above meeting Claims paid by comp carrier 1/1/02 - 8/15/02 $67.5K paid 31 recordables 1/1/03 - 8/15/03 $1215 paid 3 recordables

Employee Testimonials “I have much more energy at the end of the day. My quality of life is so much better when I am home.” “If interviewing at another nursing home, I would ask them about the equipment they have and their lifting policies.”

Performance Measurement Worker’s comp costs OSHA recordable and nonrecordable injuries Employee satisfaction Number of resident transfer injuries

Evaluation Continue regular committee meetings and solicit feedback Make changes in equipment, procedures, or training where necessary

Lessons Learned Hazard Resolved: nursing home ergonomic problems addressed in less than 3 months! Payback: almost immediate from a comp payout standpoint Safety Management: Administrator involvement and employee lifting committee were the key to success.

Contact October 2003 Charles J. Shields, MS, CIH, CSP U.S. Department of Labor – OSHA 365 Smoke Tree Plaza North Aurora, IL Six Year Anniversary of Aurora Area Office Electronic Mail Newsletters