The single greatest risk factor for musculoskeletal injuries in nurses and healthcare workers is the manual lifting, moving and repositioning of patients.
The most common types of injuries sustained due to lifting patients include:
- disc degradation or prolapse.
- herniated discs with associated nerve damage.
- lower back pain caused by soft tissue injury.
- pulled or torn ligaments.
- sprained muscles.
This inherent work-related hazard, which has always been present, is poised to become more prevalent as rising obesity rates in the general population increase the physical demands on caregivers, coupled with the fact that the average age for retirement for nurses and care assistants is on the increase. In addition to this, the manner in which hospitals are now treating patients has evolved, with as many people as possible being dealt with in outpatient clinics, meaning that the inpatient population has become more immobile and in need of assistance with movement.
While the risk of injury can never be completely eliminated, there is a large body of research that has shown that safe patient handling interventions can significantly reduce musculoskeletal injuries. This is done by replacing conventional manual patient handling with safer ergonomically-inspired methods, including the use of mechanical equipment and safety procedures to lift and move patients so that health carers can avoid using manual exertion (or where this is not possible, they can minimize the level of exertion required), thereby reducing the likelihood of sustaining an injury.
The use of “lifting teams”, where a group of workers perform patient handling using appropriate lifting equipment, may also be used to reduce the risk. But of course, while all very well in theory, the use of lifting teams can only be really effective if the unit in which you are working has appropriate staffing levels so that co-workers will be readily available to assist you at short notice if the need to handle a patient arises suddenly.
One of the most basic requirements of employers is to ensure that all health carers who are required to participate in patient lifting activities are provided with proper health and safety training in the use of proper body mechanics, including lifting and moving techniques. This is an ongoing requirement. It’s not good enough to be provided with a crash course on the first day on the job – health carers should be provided with the facility to attend regularly at refresher courses to ensure that they are using all appropriate techniques to minimize their risk of injury.
Although good lifting techniques can help to reduce the likelihood of back injury, they are not sufficient on their own and should be complemented with the appropriate equipment, adequate staffing levels, and other measures that effectively reduce the risk factors that are associated with musculoskeletal injuries.
Where possible, lifting should be eliminated altogether and replaced with a mechanical solution, using equipment such as:
- devices for lateral transfer.
- inflatable mattresses.
- overhead track lifts.
- portable total lifts.
- reduced friction sheeting.
- sit-to-stand lifts.
- transfer boards.
It will not be a good defence for an employer to state that they had the most state-of-the-art lifting equipment on the premises when your accident occurred. If the day-to-day reality is that when you needed a lifting machine to move a patient you would routinely discover that some other unit had borrowed it, or that it was not properly cleaned and maintained, or that there were not sufficient staff to assist you in its use, or that there was some other legitimate reason for not relying on it, your employer will be liable if you suffer musculoskeletal injuries from handling the patient manually.
If employers are serious about identifying the risks in your work environment with a view to minimizing them, they should constantly be maintaining records including worker surveys, health and safety assessments, injury logs, and incident report forms so that recurring issues may be identified and addressed. A failure to do so would amount to a breach in the duty of care owed to health care workers.
Because the types of musculoskeletal disorders associated with patient handling can develop gradually, as the lifting behaviour which is causing the injury is repeated over time, it can be difficult to pinpoint precisely when you will be deemed to have sustained a “significant” injury such that the two-year period within which you are entitled to make a claim will begin to run. For this reason, if you are experiencing any kind of back pain or discomfort and if you believe that it is in any way associated with your work activities you should not delay in seeking legal advice to determine whether anything requires to be done to ensure that your entitlement to secure compensation is preserved.
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