MDS Alert

These facility-wide tips can help nursing home staff avoid some workplace injuries, regardless of their role.

Workplace injuries, especially injuries caused by the strain of repetitive motion, are common across industries, and healthcare is no exception. Nursing homes and other inpatient facilities are consistent sources for workplace injury, from issues caused by helping manipulate residents’ bodies to wrist injuries due to computer use. Luckily, technology like lifts has made moving residents easier and safer, but nursing facilities are still rife with opportunities for injury for staff.

Knowing what responsibilities management have, as well as what individuals can do to stay safe and healthy, are both important ways of preventing workplace injury.

Workplace Injury can Affect Facility Bottom Line

Work-related musculoskeletal disorders are the most common reported reason for missing work, says the Occupational Safety and Health Administration (OSHA). OSHA lists both healthcare and office work as “high-risk” industries for causing musculoskeletal disorders (MSD), which suggests that basically all staff positions in nursing facilities come with risk of injury. OSHA’s longstanding recommendations for nursing facilities have included minimizing manual resident lifts and eliminating them entirely where possible, recommending that facilities invest in technology.

The risk to staff health and safety is real: “Nurses and nursing assistants each accounted for a substantial share of this total. In 2013, orderlies, nursing assistants, and personal care aides continued to have some of the highest MSD rates of all occupations. MSD cases accounted for 53 percent of total reported cases that occurred to nursing assistants in 2013,” said Dorothy Dougherty, deputy assistant secretary for OSHA in 2015 (the last year for which nursing-facility-specific OSHA data is available). Overall, nursing homes and personal care facilities have some of the highest rates of work loss due to injury across industries, Dougherty said.

Know the Risks

Repetitive stress injuries (RSIs), also called repetitive motion injuries, are one of the most common workplace injuries and can affect people of many differing work environments. RSIs are of particular concern to people who sit in front of a computer all day. These injuries are not caused by one-time events, like a bad resident lift that immediately makes one’s back hurt, but by cumulative hours in the same position, be it an awkward posture or uncomfortable placement of one’s hands on the keyboard. RSIs can involve sprains, strains, tears, back pain, carpal tunnel, or even hernias, says the Centers for Disease Control and Prevention (CDC).

RSIs are so insidious because they develop gradually, so staff may not be aware that they’re injuring themselves until the issue is quite serious. Pursuing preventative measures, from employee training on safe resident lifts to ergonomic workstations for computer-bound staff to informative posters detailing helpful wrist stretches, can collectively help stave off some repetitive stressors. However, staff should be aware that some exercises can exacerbate an injury if one has already occurred, so it’s important to seek treatment as early as possible.

Implement These Strategies

OSHA considers managerial support one of the most crucial ways of preventing workplace injuries — having a top-down workplace culture that prioritizes an ergonomic environment, with clear, defined goals and consistent, open communication with staff. Staff should feel empowered to pursue ergonomic solutions to their work and workspaces and to report injuries.

Once management and staff are united in their goal to address potential and current workplace injuries, figure out where to start by conducting an analysis of the work environment, OSHA says. Make sure employees of all roles are involved in this analysis and brainstorming; management may miss practices that occur regularly on the floor, and staff may not realize what their colleagues in other roles face. Nursing facilities involve many potential hazards for employees due to the myriad roles: Hands-on resident care, nutrition and kitchen services, laundry, building maintenance, janitorial duties, and office-type work all present individual and sometimes unique hazards for repetitive stress issues or other workplace injuries.

Once staff have come together to identify issues and brainstorm about potential problems, conduct an analysis of accident records.

Note: OSHA recommends careful and accurate documentation of workplace injuries within facilities (and within corporations, generally), so if you don’t already have such recordkeeping practices in place, prioritize creating some such policies and train staff on how and when to report workplace injuries or incidents.

This practice is a useful opportunity for employers and workers to “identify hazards in their operations and shortcomings in their safety and health programs. Most importantly, it enables employers and workers to identify and implement the corrective actions necessary to prevent future incidents,” OSHA says.

When conducting such analyses, focus on finding the root cause instead of apportioning blame, OSHA says. This approach will more effectively target the problem that needs correction, as well as boost morale and show a facility administration’s commitment to making a facility a safe place to work.

Incorporate employee training about how to provide hands-on resident care safely, including lifts and other maneuvers, into onboarding procedures for new staff, as well as providing continual education for current staff.

Even if injuries aren’t completely preventable all of the time, demonstrating a real, long-term commitment to employee safety can go a long way in boosting morale and reducing turnover.

Facilities can be Held Liable

Repetitive stress injuries can qualify as eligible for workers’ compensation, and many personal injury lawyers have information available online for nursing facility staff who are injured on the job.

It can be difficult to prove that a repetitive stress injury is directly tied to a workplace; employees can have trouble getting workers’ compensation benefits for such injuries, says Ron Meyers, attorney at Ron Meyers & Associates LLPC, in Olympia, Washington. Soft-tissue injuries, especially, can be tough to prove because physicians rely on reports of injury and symptoms for diagnosis and treatment; there’s more gray area surrounding repetitive stress injury claims than, say, an injury that has evidence of being caused by a particular incident.

See sidebar, page 128, on what information nursing facility employees should know about their rights.

Resource: For more information, including training on record keeping, ergonomics, and back injury prevention educational materials specific to nursing facilities, visit  www.osha.gov/SLTC/nursinghome/additional_info.html.