Hospital gives patients a lift

by Carren Bersch

While healthcare workers are the backbone of healthcare, nursing remains one of its highest risk occupations. For instance, an American healthcare worker suffers a back injury every 30 minutes. Somewhat surprisingly, the Bureau of Labor Statistics classifies healthcare patients as a direct cause of on-the-job injury. With nearly 55 percent of the U.S. population, or approximately 97 million adults, designated as overweight or obese, patient weight has become a contributing factor in these injuries, along with the accompanying cost. Morbid obesity (defined as 100 pounds or more overweight) grew 50 percent in men and 67 percent in women between 1996 and 2000.

“Workers’ compensation statistics clearly showed that our employees were being injured far too often lifting and transferring patients,” says Lynn Runyan, director of risk management at 300-bed North Colorado Medical Center (NCMC). The hospital is part of Banner Health, said to be the nation’s largest nonchurch-affiliated, not-for-profit healthcare system.

“In the year 2000, NCMC had 60 injury claims with developed costs of $350,000. Then, one year after beginning our ‘no-lift’ program, we had only seven claims with costs of $8,227,” says Runyan. Not only did NCMC face rapidly growing costs associated with the increasing severity of lift/transfer incidents, but also experienced rising turnover, low employee morale and a cast of injured employees reluctant to report the problem due to fear of job loss.

Although the hospital owned lift equipment, Runyan says, the challenge was that none of it was multipurpose, and what little equipment existed was rarely located where it was needed. “We had the ‘Cadillac’ of lifts but it was specifically designed for certain kinds of transfers,” she says. “Another piece of equipment was simply never used. Some of it was old-fashioned, not designed for acute care needs. Our resources were limited, so that nurses had to go find the equipment when they had to use it. We needed to saturate the hospital.

"We were discovering that recruiting certified nurses aids, who do much of the lifting and transferring of patients, was impeded because we didn’t have an appropriate lift/transfer program. We were competing for CNAs with long-term care facilities and nursing homes, which used lift equipment regularly.”

The carrier for Banner Health’s worker’s compensation plan suggested that the hospital consult with Prevent Inc., Hickory, NC, which offers patient lift and transfer equipment and processes to support the NCMC healthcare staff — a suggestion that the hospital implemented immediately.

According to Betty Bogue, Prevent’s president, her “Get A Lift” and other ergonomics programs that include the use of mechanical lifts improves worker and patient safety levels while reducing related injury costs. She says that when facilities combine mechanical lifts with the necessary processes, lift/transfer injuries have been reduced by more than 90 percent.

The Department of Labor points out that hospitals can save an average of $27,700 each time a severe musculoskeletal disorder (SMD) is prevented. An argument can be made that money already being spent on SMDs in the form of workers’ compensation costs can be shifted to pay for the implementation of a no-lift program to prevent such injuries. 

NCMC’s ergonomics committee and risk management team met with Prevent’s representatives, and determined that the combination of the comprehensive Get A Lift! program and Liko patient-lifting systems offered the best approach. Prevent, in fact, was engaged to bring the equipment, training and support necessary to provide a safe lift environment, and the NCMC program began in 2001 at the Greeley and Loveland facilities. 

Runyan says the initial training by Prevent included the entire NCMC staff for such components as assessing patients to find the proper Liko sling, how to use the slings and how to change batteries in the Liko equipment. “The training was easy and safe. Now, we can call Prevent any time for support, but we’ve had no problems in almost two years. Our ongoing training for new hires is done by an NCMC employee, and once a year everyone has a refresher class.”

In setting up the “Get A Lift” program at NCMC, Prevent also determined the number of lifts the hospital needed. Today, instead of searching the facility for scattered and outdated lift equipment, mechanical lifts are readily available for immediate use throughout the hospital. There are two or three lifts on each unit for use with each 16 to 20 beds. The hospital also now identifies patients entering its care as lift candidates upon admission and has the appropriate sling stationed in that patient’s room. NCMC had long-term care slings on its previous equipment, but it needed other types, such as supine slings, for its acute care patients. Liko supplies more than 200 standard slings for every lift/transfer need — from bed to chair/commode/toilet; to and from bath/shower/pool; for children, obese adults, amputees; to and from horizontal positions, including the floor and for ICU, surgery, back and burn units; and for standing or gait training. On rare occasions, customers need special slings, which Liko can provide. NCMC has purchased only standard slings to date.

Preparing for heavier patients is hospital-wide; the American Society for Bariatric Surgery estimated there were 57,200 bariatric procedures in 2001, a 29 percent increase from 2000. It takes several people to lift a bariatric patient — Tampa (FL) General Hospital hired a six-man “lift team” last summer for its surgical weight-loss patients. Liko, a Swedish-based concern, designed and produced specialty slings and lifts for NCMC. For example, the Viking aluminum lift and the appropriate sling manage up to 600 to 1,000 pounds. “We have a growing need for these types of lifts and slings for our bariatric (stomach stapling and gastric bypasses) surgery patients,” says Runyan.

With the lift system from Liko, Runyan says, one nurse can lift or transfer a patient alone. “Now that every nurse has more patients than ever before, she can do the lift or transfer without having to waste time rounding up other employees to help her. She can safely move her patient at her convenience. Nurses have changed their practice because of these systems.”

With NCMC’s current new construction plans, overhead lifts are being installed in certain patient rooms within the master plan’s pods. The equipment will allow nurses to move patients from their beds into adjoining bathrooms. In the new emergency department, to be fully completed this summer, there are overhead lifts to assist the emergency medical technicians in moving patients out of the ambulance. Patients are placed on supine sling, then moved into the ED with lifts.

In its 2001 Nursing World Health and Safety Survey of 4,826 nurses, the American Nursing Association reported 75.8 percent believed unsafe working conditions interfere with their ability to deliver quality care, and 87.9 percent stated that health and safety concerns influence their decision to continue nursing.

“Staff retention and morale at NCMC have improved,” says Runyan, “and we now use the no-lift program as an attractive recruitment tool, particularly for CNAs. It’s a win-win-win situation. Improved worker safety, better patient care and significant cost savings. All in all, it’s a solid ROI,” says Runyan. HPN

HPN

April