# Presentation: 697549

## Audrey Nelson, Ph.D., RN, FAAN
audrey.nelson@med.va.gov
Director
Patient Safety Research Center  
VAMC Tampa, FL
Web: patientsafetycenter.com

_**audrey.nelson@med.va.gov**_
**Director**
**Patient Safety Research Center  **
**VAMC Tampa, FL**
**Web: **_**patientsafetycenter.com**_

***Safe Patient Handling & ******Movement in High Risk Units ***

**Notes:**
Safe Patient Handling & Movement in High Risk Units
Audrey Nelson, Ph.D., RN, FAAN
audrey.nelson@med.va.gov
Director
Patient Safety Research Center  
VAMC Tampa, FL
Web: patientsafetycenter.com

## Study Goals 

- Reduce the incidence and severity of musculoskeletal injuries in nursing staff.
- Create a culture of safety and empower nurses to create safe working environments

**Notes:**
Study Goals
Reduce the incidence and severity of musculoskeletal injuries in nursing staff. 

Create a culture of safety and empower nurses to create safe working environments

## Overview  

- Study Design:
- Prospective Study over 2 years
- Pre and Post Test Design
- Qualitative and Quantitative Data
- Study Sites:
- 23 High Risk Units at 6 VA Hospitals

**Notes:**
Overview
Study Design: 
Prospective Study over 2 years 
Pre and Post Test Design 
Qualitative and Quantitative Data 

Study Sites:
23 High Risk Units at 6 VA Hospitals 

## Program Elements

- Ergonomic Assessment Protocol
- Patient Assessment Criteria
- Algorithms
- Back Injury Resource Nurses
- State-of-the-art equipment
- No-Lift Policy

**Notes:**
Program Elements
Ergonomic Assessment Protocol
Patient Assessment Criteria 
Algorithms
Back Injury Resource Nurses
State-of-the-art equipment
No-Lift Policy 

## Results: Incidence of Injuries

** ****Decreased 31%**
**From 144 injuries   to 99 injuries**
** ****Significant at 0.003 level**

**Notes:**
Results: Incidence of Injuries
Decreased 31%

From 144 injuries   to 99 injuries

 Significant at 0.003 level

## Results: Modified Duty Days 

**Decreased 88%,  from 2061 days to 256 days**
** ****Significant at 0.01 level **

**Notes:**
Results: Modified Duty Days
Decreased 88%,  from 2061 days to 256 days
 Significant at 0.01 level 

## Results: Lost Work Days 

**Decreased 18%, from 256 to 209 days**

**Notes:**
Results: Lost Work Days
Decreased 18%, from 256 to 209 days 

## Results: Self-Reported Unsafe Patient Handling 

** ****The # times/day nurses handled or moved patient in unsafe manner decreased from 3.63 to 3.18. **
**Significant at the 0.1 level **

**Notes:**
Results: Self-Reported Unsafe Patient Handling
The # times/day nurses handled or moved patient in unsafe manner decreased from 3.63 to 3.18. 
Significant at the 0.1 level

## Results: Job Satisfaction

**Pay**
**Professional Status********
**Task Requirements********
**Autonomy**
**Organization Policy**
**Interaction**
**Overall********

**Notes:**
Results: Job Satisfaction
Pay
Professional Status**
Task Requirements**
Autonomy
Organization Policy
Interaction

Overall**

## Cost Comparison Pre to Post 

**POST **
- $46,464
- $35,201
- $18,657
- $21,948
- $202,971

**PRE**
- $93,531
- $173,763
- $24,048
- $84,281
- $480,797

- Treatment
- Worker’s Comp
- Lost Work Days
- Restricted Days
- Total

**Notes:**
Cost Comparison Pre to Post
Treatment  Pre $93,531 Post $46,464
Worker’s Comp  Pre 173,763 Post 35,201
Lost Work Days Pre 24,048 Post 18,657
Restricted Days Pre 84,281 Post 21,948
Total Pre 480,797 Post 202,971

## Cost Benefit (Pre to Post) Year 1 only

- Savings in medical costs and lost or restricted days:  $277,826
- Minus annualized costs of equipment ($140,417.46) and training ($9,596.75)
- Total Savings Year 1: $127,812

**Notes:**
Cost Benefit (Pre to Post) Year 1 only
Savings in medical costs and lost or restricted days:  $277,826

Minus annualized costs of equipment ($140,417.46) and training ($9,596.75)

Total Savings Year 1: $127,812

## COST/BENEFIT

- Over a 10 year period this translates to over $1.25 million dollars in cost savings, excluding the effect of inflation.

**Notes:**
COST/BENEFIT
Over a 10 year period this translates to over $1.25 million dollars in cost savings, excluding the effect of inflation.

## Conclusions

- Significant reduction in incidence and severity of injuries.
- Job satisfaction was significant increased.
- There were significant monetary benefits, associated with decrease in lost/modified work days and lower medical and cash payments due to injuries.** **

**Notes:**
Conclusions
Significant reduction in incidence and severity of injuries. 
Job satisfaction was significant increased. 
There were significant monetary benefits, associated with decrease in lost/modified work days and lower medical and cash payments due to injuries.

## Next Steps 

- Apply research to moderate risk units
- Conduct ergonomic assessment in acute care settings
- Identify high risk tasks in ICU, ER, OR, PACU
- Identify technological solutions
-  Apply solutions deemed effective in high risk units (BIRN, algorithms, etc)

**Notes:**
Next Steps
Apply research to moderate risk units  
Conduct ergonomic assessment in acute care settings
Identify high risk tasks in ICU, ER, OR, PACU 
Identify technological solutions
 Apply solutions deemed effective in high risk units (BIRN, algorithms, etc)