(1) Direct-care registered nurses rank 10th 
among all occupations for musculoskeletal disorders, 
sustaining injuries at a higher rate than laborers, 
movers, and truck drivers. In 2004, nurses sustained 
8,800 musculoskeletal disorders, most of which (over 
7,000) were back injuries. The leading cause of 
these injuries in health care are the result of patient 
lifting, transferring, and repositioning injuries. 
(2) The physical demands of the nursing pro-
fession lead many nurses to leave the profession. 
Fifty-two percent of nurses complain of chronic back 
pain and 38 percent suffer from pain severe enough 
to require leave from work. Many nurses and other 
health care providers suffering back injury do not 
return to work. 
(3) Patients are not at optimum levels of safety 
while being lifted, transferred, or repositioned manu-
ally. Mechanical lift programs can substantially re-
duce skin tears suffered by patients, allowing pa-
tients a safer means to progress through their care. 
(4) The development of assistive patient han-
dling equipment and devices has essentially rendered 
the act of strict manual patient handling unneces-
sary as a function of nursing care. 
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(5) Application of assistive patient handling 
technology fulfills an ergonomic approach within the 
nursing practice by designing and fitting the job or 
workplace to match the capabilities and limitations 
of the human body. 
(6) A growing number of health care facilities 
have incorporated patient handling technology and 
have reported positive results. Injuries among nurs-
ing staff have dramatically declined since imple-
menting patient handling equipment and devices. As 
a result, the number of lost work days due to injury 
and staff turnover has declined. Cost-benefit anal-
yses have also shown that assistive patient handling 
technology successfully reduces workers’ compensa-
tion costs for musculoskeletal disorders. 
(7) Establishing a safe patient handling stand-
ard for direct-care registered nurses and other 
health care providers is a critical component in in-
creasing patient safety, protecting nurses, and ad-
dressing the nursing shortage. 
SEC. 2. FEDERAL SAFE PATIENT HANDLING STANDARD. 
Not later than 1 year after the date of the enactment 
of this Act, the Secretary of Labor, acting through the 
Director of Occupational Safety and Health Administra-
tion, shall establish a Federal Safe Patient Handling 
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Standard under section 6 of the Occupational Safety and 
Health Act of 1970 (29 U.S.C. 655) to prevent musculo-
skeletal disorders for direct-care registered nurses and 
other health care providers working in health care facili-
ties. This standard shall require the elimination of manual 
lifting of patients by direct-care registered nurses and 
other health care providers, through the use of mechanical 
devices, except during a declared state of emergency. The 
standard shall include a musculoskeletal injury prevention 
plan, which will include hazard identification and risk as-
sessments in relation to patient care duties and patient 
handling. The standard shall require: 
(1) all health care facilities comply with the 
standard; 
(2) health care facilities to purchase, use, and 
maintain safe lift mechanical devices; 
(3) input from direct-care registered nurses and 
organizations representing direct-care registered 
nurses in implementing the standard; 
(4) a program to identify problems and solu-
tions regarding safe patient handling; 
(5) a system to report, track, and analyze 
trends in injuries, as well as make injury data avail-
able to the public; 
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(6) training for staff on safe patient handling 
policies, equipment, and devices at least on an an-
nual basis. Training will also include hazard identi-
fication, assessment, and control of musculoskeletal 
hazards in patient care areas, which would include 
interactive classroom-based and hands-on training 
by a knowledgeable person or staff; and 
(7) annual evaluations of safe patient handling 
efforts, as well as new technology, handling proce-
dures, and engineering controls. Documentation of 
this process shall include equipment selection and 
evaluation. 
SEC. 3. REQUIREMENT FOR HEALTH CARE FACILITIES. 
(a) SAFE PATIENT HANDLING PLAN.—In accordance 
with the standard required under section 2, and not later 
than 6 months after such standard is published, health 
care facilities shall develop and implement a safe patient 
handling plan that— 
(1) provides adequate, appropriate, and quality 
delivery of health care services that protects patient 
safety and prevents musculoskeletal disorders for di-
rect-care registered nurses and other health care 
providers; 
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(2) is consistent with the requirements of the 
Federal Safe Patient Handling Standard (as estab-
lished in section 2); 
(3) provides for input by direct-care registered 
nurses and organizations representing direct-care 
registered nurses in implementing the plan; and 
(4) ensures that safe lifting mechanical devices 
shall only be used by direct care registered nurses 
and other health care providers. 
(b) POSTING, RECORDS, AND AUDITING.— 
(1) POSTING REQUIREMENTS.—Not later than 
6 months after the standard required under section 
2 is published, a health care facility shall post, in 
each unit of the facility, a uniform notice in a form 
specified by the Secretary in regulation that— 
(A) explains the Federal Safe Patient 
Handling Standard issued under section 2; 
(B) includes information regarding safe 
patient handling polices and training; and 
(c) explains procedure to report patient 
handling-related injuries. 
(2) AUDITS.—The Secretary of Labor shall re-
quire the Occupational Safety and Health Adminis-
tration to conduct unscheduled audits to ensure— 
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