Ergo Blitz!How To Establish A

Zero Lift Policy That Works

Lessons BLITZ! Nursing home ergonomic

problems can be addressed QUICKLY

Payback is fast

Management commitment/employee involvement is the key to success

OSHA Intervention?

Nursing Home Administrator attended OSHA Outreach Activity

Thereby motivated to avoid OSHA Nursing Home Programmed Inspection

State of Illinois OSHA On Site Consultants were used

No inspection by Federal OSHA

The Facility 207 bed long term care skilled nursing

facility in Aurora, IL 160 employees (65-70 aides)

2002 injury/illness rate was high - 24.0! Many lifting injuries

Beds Chairs Toileting

The Process, Step By Step Evaluate Injuries and Costs Obtain Approval For Funding Establish A Lifting Committee Evaluate and Select Equipment Resident/Family Notification Receive and Prep Equipment Training Resident Assessment Coordination with Other Staff Enforcement Performance Measurement Evaluate Efforts Regularly

Evaluate Injuries and Costs

OSHA recordables and non-recordables

Cost data from workman’s comp carrier

Resident injuries such as skin tears

Employee turnover rate and costs of turnover

Obtain Approval For Funding

Present injury/cost data to owner Ballpark estimate for buying lifting equipment Note other expected results

Reduced risk of OSHA inspections/penalties Reduced employee turnover, better morale Injury reduction from dropping residents Increased admissions from improved PR Overall better resident care

Establish A Lifting Committee

CNA based committee Select outgoing CNAs 45 minute meeting per week Food, fun, praise Leader has budget

authority, is committed to project, and is a motivator

Evaluate Equipment Hold open house for several different vendors Demo equipment never seen before CNAs test equipment in the facility/provide

feedback

Four inchextendersadded to bed legsso lift willfit underlowboybed.

Equipment Selection

Equipment feedback list from CNAs Identify all different accessories needed

for lifts such as scales and extra slings Decision meeting with lifting committee Final budget approval and purchase

Set date for zero lifting policy

Resident/Family Notification

Send letter to families advising of change

Advise Resident’s Council

Equipment Prep

Copy manufacturer instructions, laminate, and attach to equipment

Attach a warning sign that each lift must be checked prior to use

Charge battery operated equipment

Develop competency checklist on use of equipment

Equipment Location

Right number of lifts in the appropriate locations

Lifts need to be available to aides, NOT the residents moved to be accessible to the equipment!

Training

CNA one-on-one training for each employee

Employees competency checked on each piece of equipment

Competency check signed off by aide Not use equipment until competency

checked 3 day suspension for not using lift

Resident Assessment Needs to identify the type of

equipment needed for each resident Develop assessment sheet Review assessment sheet with staff

Coordination Maintenance staff – new equipment

maintenance info

Laundry staff – sling cleaning information (some slings can’t be laundered).

Rehab staff – info on lift type(s) used with each resident (because lifts require use of muscles)

5 Sit to Stand Lifts

4 Hoyer Lifts

3 Pivot Disks

Equipment Selection by this Nursing Home

Sit To Stand Lift

Equip one sit-to-stand lift with a scale for weighing residents

Hoyer Lift Decision: Electric or Hydraulic

Purchase extra slings

Equip one lift with weigh scales to eliminate extra handling for resident weighing

Pivot Disk Like a Lazy

Susan with handles

Great for bathrooms, can be rotated using little space

Enforcement 3 day suspension for not using lift

Policed by Lifting Committee members, empowered to recommend suspensions

Nine suspensions were levied here

Pick suspension days for best use of facility resources and less impact on employee’s paycheck at one time

Results: Costs and Savings

Costs at this facility $24K for lifting devices and slings Time: 45 minutes weekly X approx 10 aides Team leader time of approx 1 hour/week in

addition to above meeting

Claims paid by comp carrier 1/1/02 - 8/15/02 $67.5K paid 31 recordables 1/1/03 - 8/15/03 $1215 paid 3 recordables

Employee Testimonials

“I have much more energy at the end of the day. My quality of life is so much better when I am home.”

“If interviewing at another nursing home, I would ask them about the equipment they have and their lifting policies.”

Performance Measurement

Worker’s comp costs OSHA recordable

and nonrecordable injuries

Employee satisfaction

Number of resident transfer injuries

Evaluation

Continue regular committee meetings and solicit feedback

Make changes in equipment, procedures, or training where necessary

Lessons Learned Hazard Resolved: nursing home

ergonomic problems addressed in less than 3 months!

Payback: almost immediate from a comp payout standpoint

Safety Management: Administrator involvement and employee lifting committee were the key to success.

Contact October

2003

shields.charlie@dol.govCharles J. Shields, MS, CIH, CSPU.S. Department of Labor – OSHA 365 Smoke Tree PlazaNorth Aurora, IL 60542630-896-8700

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