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Miami Valley Hospital "Lift Team" Pilot a Success: Nurses Reduce Injury, Increase Productivity

First-Year Results: 70% Reduction Back/Shoulder Injuries

First-year results are in, after more than 10,000 lifts in one year, the Miami Valley Hospital's (MVH) patient lift-team program is a resounding success. The program, begun in April 2004 with funding provided by Miami Valley Hospital Foundation, found that lower-back injuries among nurses decreased 93 percent after the first six months and 50 percent after the first year. In addition, more than 800 hours of nursing staff time was gained in the first year since nurses no longer were required to assist others in moving, lifting or holding patients.

After funding an initial pilot program, Miami Valley Hospital Foundation is expanding the program to second shift hospital-wide. Initially, the lift team program was deployed on critical care and step down units in the hospital (those with a higher proportion of injuries), and it operated during day shift when most injuries were sustained by nurses.

"This program is a wonderful example of how MVH is working to improve services and patient care, as well as keep health and wellbeing of our nursing staff top of mind," said Mary Boosalis, president and CEO of MVH. "The growth of this pilot to a system-wide program is a win-win for everyone on the patient care team who seek to put patient safety and dignity first."

Nursing consistently ranks as one of the top 10 occupations for work-related musculoskeletal injuries, according to the Bureau of Labor Statistics, 2002. Data compiled from more than 80 studies internationally indicate 35 percent to 80 percent of all nurses sustain back injury during their career.

"This program was developed at Miami Valley Hospital in answer to an aging workforce, something every hospital is addressing in this country," said Pat O'Malley, PhD, RN, CCRN, CNS, nurse researcher in the Center of Nursing Excellence. "We're a Magnet hospital, and there's a reason for that. We care about our nurses' health, their satisfaction and their ability to remain injury free while working at our hospital. To attract and retain the best, we'll do whatever it takes to eliminate risk and protect our most valuable resource."

Hospitals must consistently seek new methods to ensure the handling of patients is safe for them, as well as anyone doing the lifting. Awkward patient handling can negatively impact the quality of care delivered, as well as comfort. It is estimated that 12 percent of nurses will consider a job transfer in a year to help reduce the risk of back injury, according to the U.S. Department of Labor, 2002.

"People have a misconception that nurses get back injuries from lifting heavy patients," said O'Malley. "That's not the reason at all; patient handling and movement are physically demanding and are generally performed in unfavorable and stressful conditions.

"There's an astonishing statistic we call the 'gasp number' because the jaws dropping are palpable when we reveal that in a typical eight-hour shift, a nurse lifts cumulative weight of 1.8 tons," added O'Malley.

Patients themselves add a dimension of challenges when it comes to being lifted — variations in size, physical disability, level of consciousness, need to cooperate and changes in physical condition each contribute to level of lift difficulty. In addition to the physical challenges, there are emotional difficulties, too. Some people are fearful being lifted; worry about pain; fractures; skin tears; or bruising.

How the Lift Team Works

Today, the lift-team program employs about six physically fit men (women can apply), teamed in pairs working overlapping shifts and covering a total of 800 plus beds. When they arrive for work, team members begin scheduling time lifts for the day, with their first priority being medical-surgical units and critical care units, the primary users of the service. The team can be accessed any time for emergency lifts, helicopter off loads, and assistance in positioning patients for dressing changes or other procedures.

"Once this program launched at Miami Valley Hospital, we became 100 percent committed to ensure the safety of our nurses AND the lift team staff," added Boosalis. "To date, we have documented zero injuries among our lift team, and that is a total testament to the rigorous fitness and training standards we demand prior to getting hired and during employment."

To keep them in shape, all have gone through in-depth training in moving patients with and without mechanical assistance in a variety of environments. Moreover, there are quarterly observations by an ergonomics expert and yearly competency reviews in patient handling in order to ensure skills are maintained.

"We recruit staff from other professions like trainers, security personnel and the military," said Steve Roark, lift team supervisor in the Centran Department of Miami Valley Hospital. "Everyone who works with us must demonstrate a level of fitness and experience rigorous training to ensure they don't become injured on the job."

To minimize the risk of injury, lift team members must successfully complete the Firefighters' Fitness Test, along with an evaluation by the hospital's medical director of employee health. These tests are completed prior to employment and annually.

Patient satisfaction ranks high as a measurement tool for the lift team, and marks thus far have indicated that these men have become care ambassadors for the hospital. Not only is physical prowess important, people skills, empathy and compassion are critical ingredients to program success.

The nursing staff is educated about and encouraged to effectively use the lift team. Guidelines on how to access the team and schedule lifts are posted in all hospital units. To improve communication between the lift team and the nursing staff, the lift team members are equipped with a wireless phone, which significantly reduces delays in team response and allows the lift team to prioritize lifts based on demand.

"It is a rare occasion when nurses are unable to use the lift team to help during critical periods," added O'Malley. "The communication and collaboration between nursing and the transportation department is high-level. When we need immediate assistance, they are a step away."