35

section 2

Contents

• Injuriesfrommovingandhandlingpeople:Prevalenceandcosts

• Thebenefitsofmovingandhandlingprogrammes

• Preventinginjuriestocarersandclients

• InjurypreventioninNew Zealand

• PreventinginjuriesinNew Zealandworkplaces

• Referencesandresources.

Why moving and handling programmes are needed

36

2.1 Injuries from moving and handling people: Prevalence and costs

Movingandhandlingpeoplecanpotentiallybeaserioushazard.Manycountries,includingNew Zealand,havehighinjuryratesamonghealthcarestaffcomparedwithotheroccupationalgroups.Healthcareworkershaveoneofthehighestratesofmusculoskeletaldisordersamongalloccupationalgroups.1

• Healthcareworkersleadallotheroccupationsfortheriskofbackinjuriesrequiringhospitalisationinwomen

• Hospitals,nursingandresidentialcarefacilitiesleadallindustriesforworkplaceinjuryandillness

• Carersandhealthassistantshavethehighestriskofinjuries,astheirjobsrequirefrequentclienttransferringandrepositioning

• Musculoskeletalinjuriesmakeupthelargestproportionoftotalinjuries.

Carersperforminghighratesofclientmovingandhandlingeachdayaremuchmorelikelytoreportbackpain.Thedailynumberofclientmovingandhandlingtasksisakeymeasureforassessingtheriskofbackpain.

Carersareatriskofmusculoskeletalinjurywhentheirworkinvolvesmovingandhandlingclients.Repositioningclientsinbedandtransferringclientsfrombedtostretcherarethemostphysicallydemandingtasksperformedbycarers.Eventhoughrepositioningclientscanappeartobeastraightforwardormundaneactivity,itcanleadtoinjuriestostaff(seeBox2.1forexamples).

Carerswhodothemostclientmovingandhandlingtaskseachdayaremorelikelytoexperiencelowerbackpain.Theuseofappropriateequipmentgreatlyreducesmusculoskeletalstrainandtheriskofinjuryamongstaff.

1. Thomasetal,2009.

box 2.1

Examples of reasons given for staff injuries resulting from moving clients (quotes from ACC claim forms)

• Liftedpatient[anddeveloped]acutecervicalneckpainandradiationto shoulder

• Transferringpatientwhofellback,gotpulledforwardandhurtback

• Transferringpatientatwork,injuredlower back

• Workingataresthome,helpinganelderlyladyup,pulledbackmuscle

• Liftingpatient,patientslipped,pulledrightshoulder

• Whileputtingaresidenttobed,sherolledontomyhand

• Whileliftingandtransferringpatientsnoticedincreasedpaininlowback.

Source:ACCclaimsdata,June2010(forpeopleawayfromworkfor30daysor longer)

37

Section 2: Why moving and handling programmes are needed

Otherfactors,besidesthephysicalworkload,contributetoinjuriesandleadtostafftakingsickleave.Theseinclude:

• Irregularandlongshifts

• Lackingadequatesleepandbeinglessalertwhilemovingandhandlingclients

• Staffwhofeeltheyhavelittlecontrolovertheirworkandanunsupportiveworkenvironmentaremorelikelytoreportbackproblems.2

Moving and handling injury costs in New Zealand

InNew Zealand,theestimatedannualsocialandeconomiccostofworkplaceinjuriesis$1.347billion,andtheseinjuriesaccountforaround14%ofallinjurycostsinNew Zealand.3WorkplaceinjuriesareoneofthesixpriorityareasforinjurypreventionintheNew Zealand Injury Prevention Strategy(NZIPS).

AccidentCompensationCorporation(ACC)claimdataforbackinjuriesprovideanindicationofsomeofthecostsofinjuriesinhealthcarefacilitiesinNew Zealand.Claimssuchastheseresultindirectcoststohealthcareproviders.

• Therewere4,800newworkplaceclaimsforbackinjuriesforthe12‑monthperiodJuly2009–June2010

• ACCpaid$126.4millioninclaimpaymentsinthat12‑monthperiodfornewandongoingbackclaims

• Ofthe4,800newclaims,301claimswereinthehealthsector,withnewclaimcostsof$6.5millionover12months.4

Withinthehealthsector,ACCdatashoweda28%increaseininjuryclaimcostsfortheNew Zealandresidentialcare(orretirementvillage)sectorinafive‑yearperiod(2004‑2008).In2009,theentitlementclaimcost(forinjuriesthatcausedtheemployeestobeawayfromworkformorethanaweek)was$6millionperannumfortheresidentialcaresector.Bycomparison,thehospitalsectorexperiencedan11%increaseininjurycostsinthesamefive‑yearperiod,withentitlementclaimsbeingaround$8millionperannum.5

Figure2.1showsthecostsofwork‑relatedentitlementclaimsrecordedbyACCforemployeesinhealthservices(hospitalsandaged‑careresidentialservices)inthefive‑yearperiodtoJune2010.Theseclaims,whichcostACCaround$8millionperyear,werefordiscomfort,painandinjury(DPI),includingsofttissuepainandinjuriestothehead,neck,upperandlowerback,armsandlegs.

Ananalysisoflong‑termclaims(claimspaidfor60daysormore)fromresidentialcareemployees(2007‑2009)showedthatlong‑termclaimsaccountedfor38%ofallclaimsand84%ofthecostofclaims.Amongtheseclaims,63%wereforinjuriestothelower

2. Thomasetal,20093. NewZealandGovernment,20104. Source:ACCclaimsdata,June20105. Ludcke&Kahler,2009.

38

backorshoulders,and26%wereforupperorlowerlimbinjuries.Fiftypercentoftheinjuriesoccurredduringclientmovingandhandling,16%duringequipmentmovingandhandling,4%whileusingequipmentduringclientmovingandhandling,and17%fromfallsoccurringatthesamelevel(mostlyslipsonwetsurfacesandtripfalls).4

Amonghealthcarestaff,fallsarethesecondmostcommontypeofinjuryafterinjuriesoccurringwhenmovingandhandlingclients.Fallsamonghealthcarestaffoccurbothwhileattendingtoclientsandduringotheraspectsoftheirwork(seeBox2.2).

Box 2.2

Examples of fall injuries among healthcare staff

• Helpingapatient,trippedandfellbackwardsonoutstretchedhand,injuredleftwrist

• Showeringresident,slippedandinjuredleftknee

• Fellwhileputtingshoesonresident,toppledandpulledabdominal muscles

• Trippedoverequipmentlandingheavily

• Walkingonkitchenfloorandslippedontoknee

• Servinglunchtoresidents,trippedoverperson’shandbagonfloorbesidetheirchair.

Source:ACCclaimsdata,June2010

InjuriestohealthcarestaffandtheirassociatedcostsaresubstantialinNew Zealand.Industryinitiativestoreduceinjuriesneedtoincludebothhospitalsandresidentialcareservices,andespeciallyinjury‑reductionstrategiesforemployeesinaged‑careresidentialservicesandretirementvillages.

figure 2.1 Acc work‑releated entitlement claims in the health services sector (source: Acc data, july 2011)

$ m

illio

ns

0

2

4

6

8

10

12

2005/2006 2009/20102006/2007 2007/2008 2008/2009

Hospitals (except psychiatric hospitals) Aged care residential services Total health services

Estimating the cost of workplace injuries to employers and staff

Themostcommonlyreportedcostsforworkplaceinjuries,includingmovingandhandlinginjuries,aretheclaimcostsincurredbyACC.However,theseareonlyonepartoftheoverallcost.Expensestoemployersandinjuredindividualsandtheirfamiliesarealsosignificantandneedtobeincludedincostestimates.

39

Section 2: Why moving and handling programmes are needed

Foremployers,thecostsofinjuriestostaffincludenotonlyadditionalsalaryexpensesforreplacementstaff(partofwhichmaybemetbyACCunderentitlementclaims)butalsoothercosts.Theseadditionalcostsinclude:

• Providinginductiontrainingfornewstaff(andtemporaryreplacementstaff)

• Payingovertimetootherstafftocoverforinjuredstaff

• Costsrelatedtoincreasedstaffturnover

• Costofinjuryinvestigation,recordingdetailsoftheinjuryandnotifyingACC,andabsenteeismandsickleavedays(whicharenotcoveredbyACC)

• Difficultiesforemployeesreturningtoworkfollowinginjuries.

Takingstaffturnoverasanexample,theestimatedaveragecostofreplacingaregisterednurseintheUnitedStates,includingproductivitylosses,is1.3timestheannualsalaryofanurse.6ANew Zealandstudyreportedthatfouroutoftenstaffnursesinhospitalgeneralwardsmovejobseachyear,costinghospitalsonaveragearound$25,000toreplaceeachnurse7(afigurethatdoesnotincludethelossofproductivity).Thesecostswillvarydependingontheeducation,experienceandtenureofthenursewholeaves,whetherornotthereisanurseshortage,andotherorganisationalandenvironmentalfactors.

Replacementcostsmayincludethecostsof:

• Advertisingandrecruitment

• Vacancies(e.g.payingforagencynurses,overtime,closedbedsandhospital diversions)

• Hiring(e.g.paperwork,backgroundchecksandmovingandtravelexpenses)

• Orientationandtrainingfornewstaff

• Decreasedproductivity(thedifferencebetweenfullproductivityandproductivityduringtheinductionandlearningperiod)

• Terminationforlong‑termstaffwholeave

• Potentialclienterrors,compromisedqualityofcare

• Poorworkenvironmentandculture,dissatisfactionanddistrust

• Lossoforganisationalknowledge

• Additionalturnover.8

Thecoststoindividualswhoareinjuredandtheirfamiliescanbesubstantial.TheywilloftenincludemedicalandspecialistfeesnotcoveredbyACC,transportcostsandprescriptioncosts.Theywillalsoincludecoststhataremoredifficulttoestimate,suchasincreasedstressandworkloadforotherfamilymembers,lossofleisuretimeandactivities,andpotentiallossoffutureincome.Table2.1showsahypotheticalexampleofthecostofaninjuredhealthcareemployeebeingawayfromworkfor

6. Jones,2005.7. Northetal,2006.8. Jones,2007.

40

threemonths.Examplesofsimilarcostestimatesforinjuredemployeesinotheroccupationsaredescribedinthe2002reportpublishedbytheDepartmentofLabour:Aftermath: The Social and Economic Consequences of Workplace Injury and Illness(Adamsetal,2002).

table 2.1 Example of costs for an injured employee away from work for three months

Cost source Total costCost to ACC & Dept of Labour

Cost to employer

Cost to individual and family

Salary/wagesforinjuredpersonwhileawayfrom work

$15,000 $15,000paidtoemployerbyACC

Replacementstaffforinjured person

$5,000 $5,000

($20,000fortempstaffless$15,000from ACC)

Assessmentbymedicalspecialist

$800 $800ACC

Visitstogeneralpractitionerandphysiotherapist

$600 $600

Prescriptions $200 $200

Transportforhealthvisits

$300 $300

Incidentreportcosts(stafftime)

$800 $800

Healthandsafetyvisitsandcompliancecosts

$900 $600(DoL) $300

Totalcostestimates

$23,600 $16,400 $6,100 $1,100

Intangiblecosts Increasedstaffturnover,inductiontrainingfortemporarystaff

Possiblelossof futureincome,lossofleisuretime,increasedworkloadon family

41

Section 2: Why moving and handling programmes are needed

2.2 The benefits of moving and handling programmesMovingandhandlingprogrammessignificantlyreducetheratesofinjuryresultingfromclientmovingandhandling,aswellastheassociatedcosts.Programmesthataresuccessfulinreducinginjuriestohealthcarestaffneedmultiplecomponents,suchassupportfrommanagement,anappropriatepolicy,training,riskassessments,equipment,facilitydesign,auditingandreviews.Therearealsofinancialsavingsthroughlowercostsfrominjuries,andreducedstaffabsenteeismandturnover.

Anoutlayontherighttrainingandequipmentcansavemoneythroughreducedinjuriestostaffandclients.Forexample,incorporatingceilinghoistsintothedesignofnewfacilitiesorduringrenovationsisacost‑effectiveoption.Thepaybacktime(the timewhenthesavingsfromreducedinjurycostsexceedsthecostsofinstallingceilinghoists)fromtheinstallationofceilinghoistshasbeenreportedasbeingaroundthreeyears9–whentheceilinghoistswereinstalledsothattheycouldbeusedeffectivelyformovingandhandling.Section12hasexamplesofhowpaybackcostscanbecalculated.

9. SeeChhokaretal,2005;Milleretal,2006.

Box 2.3

Benefits of including ceiling lifts in intervention strategies

Therapideconomicgainsandreductioninthefrequencyandcostofpatienthandlinginjuriesmakeastrongcaseforceilingliftprogrammesaspartofaninterventionstrategy.Incorporatingceilingliftsintothedesignofnewfacilitiesorduringrenovationsismostcosteffective.Themosteffectiveinterventionsincludetheinstallationofceilingliftsandtrainingstaffhowtousethem.

Source:Chhokaretal,2005

42

2.3 Preventing injuries to carers and clientsInjurypreventionresearchandprogrammesplayavitalroleinreducinginjuriesandtheirassociatedcosts.InNew Zealandseveralgovernmentagencies,includingACC,haveongoinginjurypreventionprogrammes.Researchonthecausesofinjuries,andthemosteffectivewaysofpreventinginjuries,isessentialtoavoidanongoingescalationinthecostsofinjuries,bothtostateagenciessuchasACCandtoindividualsandtheirfamilies.

Therearesignificantreductionsininjuries,backproblemsandabsenteeismratesamonghealthcarestafffollowingtheintroductionofliftingandtransferequipmentsuchashoists(mobileandceilinghoists).Followingtheinstallationofceilinghoists,therearesignificantreductionsinthreetofiveyearsintheriskofinjury,andsustaineddecreasesindayslost,workers’compensationclaimsandotherdirectcostsassociatedwithclientmovingandhandlinginjuries.10

Trainingstaffinpeoplemovingandhandlingtechniquesaloneisineffectiveinreducinginjuries.Onlyamovingandhandlingprogrammewithmultiplecomponentsiseffectiveinreducingbackproblemsandotherinjuriesamonghealthcarestaff.Coreprogrammecomponentstypicallyinclude:

• Apolicyonmovingandhandlingclients

• Atrainingprogrammeforstaffinmovingandhandlingpeople

• Riskassessmentprotocols,documentationandanincidentreportingsystem

• Theprovisionofmovingandhandlingequipment

• Facilitiesthataredesignedormodifiedformovingandhandlingpeople.11

Installingceilinghoistsisoneofthemostcost‑effectiveinterventionstrategies,evenaftertakingintoaccounttheinitialcosts.Incorporatingceilinghoistsintothedesignofnewfacilitiesandduringrenovationsreducesinjuryratestostaffandclients,andprovidesforfutureproofingoffacilities.

Thecostsofprovidingequipment,improvingthedesignofbuildingsformovingandhandlingpeopleandprovidingstafftrainingaregenerallyrecoveredafterthree years.12

10. Thomasetal,2009.11. ComponentsidentifiedintheliteraturereviewbyThomasetal,2009.12. See,forexample,anAustralianstudybyBird,2009.

43

Section 2: Why moving and handling programmes are needed

2.4 Injury prevention in New ZealandThereareseveralnationalinjurypreventioninitiativesinNew Zealand.Theseinitiativesprovideacontextforpreventinginjuriestocarersinvolvedinmovingandhandlingpeople.Figure2.2showsthemaininjurypreventionstrategies.

Figure 2.2 Injury prevention initiatives in New Zealand

NZIPS

(MinistryofHealth)

National Falls Prevention Strategy

(ACC)

Workplaceinjuryprevention strategies

(ACC)

DPIProgramme

(ACC)

Moving and Handling People: The New Zealand Guidelines

(ACC)

Healthandsafetyinalllocations,includingworkplaces,transportandleisureactivities

Preventingfallsinmultiplelocations

AllworkplacesinNew Zealand.Aimstoraiseawarenessandcoordinateprevention

strategiestoimproveworkplacehealthand safety

Strategy,actionplansandresourcesforpreventingmusculoskeletalinjuries

in workplaces

Guidelinesforhealthcareservices,residentialcareservicesandotheroccupationsinvolvingmovingand

handling people

applies

applies

applies

applies

applies

Moving and Handling People: The New Zealand Guidelinesisdesignedasaresourceforpreventingmovingandhandlinginjuriesinworkplacesandotherlocations.Thepreventionofmanualhandlinginjuriesisanintegralpartofthreenationalstrategies:workplaceinjuryprevention,fallspreventionandtheNZIPS.Thesestrategiesaredescribedbelow.

New Zealand Injury Prevention Strategy

TheNZIPSwasestablishedin2003.Itprovidesaframeworkfortheinjurypreventionactivitiesofgovernmentagencies,localgovernment,non‑governmentorganisations,communitiesandindividuals.Thestrategyisintendedtofocusnationalinjurypreventioneffortsandresourcesbyprovidingacleardirectiontoagencies,organisationsandcommunitiesthathaveeitheradirectinvolvementorcontributoryroletoplayininjurypreventioninNew Zealand.Thesixnationalpriorityareasinthestrategyaremotorvehicletrafficcrashes,suicideanddeliberateself‑harm,falls,

44

workplaceinjuries(includingoccupationaldiseases),assault,anddrowningandnear‑drowning.Thesixareasaccountforatleast80%ofinjurydeathsandseriousinjuriesinNew Zealand.13

National Falls Prevention Strategy

Fallsaretheleadingcauseofhospitalisationastheresultofinjury,andoneofthetopthreecausesofinjury‑relateddeathsinNew Zealand.Between1993and2002,morethan160,000peoplewerehospitalisedforfall‑relatedinjuries,accountingfor43%ofallunintentionalinjury‑relatedhospitaladmissions.14ComplementingtheNational Falls Prevention Strategy,preventingslips,tripsandfallsinworkplacesisoneofthepriorityareasintheWorkplace Health and Safety Strategy for New Zealand to 2015.Facilitatingsafeclientmovingandhandlingcanreducefallsforbothclientsandstaff.

Workforce injury prevention programmes

Twogovernmentagencieshaveongoingworkplaceinjurypreventionprogrammes.In2005,theDepartmentofLabourinitiatedtheWorkplace Health and Safety Strategy for New Zealand to 2015,whichaimstoenhanceNew Zealand’sworkplacehealthandsafetyperformanceandreduceworkplaceinjuries.TheACCWorkSafeCycleprovidesaguideonhowtosetupandsupportthecomprehensivesystemsandproceduresrequiredforeffectiveworkplacehealthandsafety,toreduceinjuryandillnessintheworkplace.AmajorinjurypreventionprogrammepromotedbyACCwithinworkplacesisPreventing and Managing Discomfort, Pain and Injury(theDPIProgramme).

DPI Programme

TheDPIProgrammeisACC’sapproachtothepreventionandmanagementofworkplacemusculoskeletalconditions.Thismultifacetedapproachencouragesworkplacestofocusonboththepreventionandmanagementoftheseproblems.15

TheDPIProgrammeamalgamatesthreeseparateinjury‑relatedprogrammesfor the workplace:

1. Occupationaloverusesyndrome(OOS)preventionprogramme

2. Acutelowbackpainprogramme

3. Serious(specific)backinjuriespreventionprogramme,whichincludedtheearlypatienthandlingguidelines.

DPIcanbepreventedormanagedifthepainanditscontributoryfactorsareaddressedintheearlystages.Wherefeasible,workersshouldbeabletostayatwork,providingchangesaremadetoaddressfactorscontributingtotheirconditions.The

13. New ZealandGovernment,2003.14. ACC,2005.15. InformationabouttheDPIProgrammeisavailablefromtheACCwebsiteat:www.acc.co.nz.

45

Section 2: Why moving and handling programmes are needed

sevengroupsoffactorsthatcombinetocontributetoDPIareshowninFigure2.3anddescribedbelow.

figure 2.3: the dpi framework

Individual factors–thingsapersoncanandcan’tchangeaboutthewaytheyare,suchastheirstrength,physicalfitness,skillsandtraining.

Psychosocial factors–thewayapersoninteractswiththeirsocialenvironmentandtheinfluencesontheirbehaviour,includingthedevelopmentofacultureofsafety.

Workplace layout/awkward postures–thewaytheworkplaceissetupandtheworkingpositionsworkersadopt,includingthefacilitydesignandspaceavailable.

Work organisation–howworkisarranged,delegatedandcarriedout.Formovingandhandlingpeoplethisincludespolicies,managementsupportandtraining.

Task invariability–howmuchataskchangesovertime.

Load/forceful movements–whatapersonhandlesandtheforcestheyhavetoapplytousethem,includingtheuseofspecificclienthandlingtechniquesandequipment.

Environmental issues–wheretheworktakesplaceandtheconditionsinwhichapersonworks,includingworkplacesize,resourcesandstaffskilllevels.

Manual handling

ManualhandlingisapriorityareaintheWorkplace Health and Safety Strategy for New Zealand to 2015(DepartmentofLabour,2005)andisasignificanthazardforthehealthcareworkforce.Broadly,manualhandlingworkrequiresapersontolift,lower,push,pull,carryorotherwisehandleanobject.Examplesincludeliftingboxes,packinginasupermarket,undertakingcleaningtasks,operatingmachinery,using

46

handtoolsandmovingandhandlingpeople.Poormanualhandlingpracticescanleadtomusculoskeletalinjuries,includingsprainsandstrainsandoverusedisorders.TheDepartmentofLabourisresponsiblefortheongoingdevelopmentofthestrategyandactionplansrelatedtoworkplacehealthandsafety.Italsocoordinatesthepromotionandevaluationofthestrategy,monitorsimplementation,producesaccountabilityreports,andcollectsanddisseminatesinformationthroughthestrategy’swebsite(www.whss.govt.nz).

47

Section 2: Why moving and handling programmes are needed

2.5 Preventing injuries in New Zealand workplacesAkeyprincipleinthepreventionofinjuriesisthatprimarypreventionwithmultiplestrategiesworksbest(Box2.3).Itisbettertoallocateresourcestopreventinjuriesratherthanonlyprovidetreatmentforinjuriesoncetheyhaveoccurred.Primarypreventioninvolvestacklingthecausesofinjuriesthataremostamenabletochange.Oneviewisthattherearethreegeneralstrategiesforisolating,eliminatingorminimisingthelikelihoodofinjuries(sometimesreferredtoasthethreeEs):

• Education–persuadingpeopletoaltertheirbehaviour,forexamplethroughtraining

• Engineering–designingtheworkenvironmentandprovidingequipmentformovingandhandling people

• Enforcement–requiringchangesthatreduceinjuriesbylaworadministrativerules,suchasorganisationalpoliciesandprogrammes.

Whoshouldberesponsibleformakingthechangesthatcanreduceworkplaceinjuries?There arefourkeygroupsofchangeagents:

• State or government agenciesthatidentifythebroadstrategiesneededandthespecifichealthandsafetyrequirements,andhelpprovideresourcesfororganisationsandindividuals

• Organisations,suchascompaniesandemployerswherehealthcare,residentialcare,disabilitycareandotherstaffwork

• Professional associations and unions(e.g.theNew ZealandNursesOrganisation,TheNew ZealandPublicServicesAssociationandtheServiceandFoodWorkersUnion)

• Individuals in workplaces,suchasmanagersandemployees,forwhomtheinitiativesareintendedtoreducetheriskofinjuries.

Eachofthesefourgroupshaskeyrolesincreatingaculture of safetyinNew Zealandworkplaces(seeSection11Workplaceculture).Acultureofsafetyisonethatfostersandpromotesaworkingclimatewheresafetyisvaluedbyeverypersonworkinginanorganisation.Suchacultureensuresthatresponsibilityforsafetyisanintegralpartofeverymanager’sandemployee’sjob.

Box 2.3

Key points in the New Zealand Injury Prevention Strategy

Currentevidencesuggeststhatinjurypreventionwillworkbestwhenit:

• Addressesthemultiplefactorsthatcontributetoinjury

• Encouragesenvironmentalandbehaviouralchange

• Engagesthepeoplewhoaremostatrisk

• Involvesactionacrosssectors(e.g. health,police,education)

• Issustainedandreinforcedover time.

Source:New ZealandGovernment,2003,p.9

48

Thepurposeoffosteringasafetycultureinanorganisationistoguidehowemployeesbehaveintheworkplace.Safetycultureinvolvesafocusbothontheattitudesandbehaviourofemployeesandontheirworkactivities.Workplacebehaviourisshapedbywhatbehavioursareacceptableandrewardedbymanagementandcolleagues.Creatingasafetyculturerequiresanassessmentofrewardssystemstoensuretheyencouragesafebehavioursbybothmanagersandemployees.Onewayofthinkingaboutsafetycultureisaddinganemphasisonworkingsafelytotheexistingculturalpatternsinaworkplace,ratherthancreatingaseparatelayerofworkplacepatterns.

Anessentialpartofsustaininginjuryreductionsforthelongtermistosetupmonitoringsystemsthatallowassessmentsofongoingeffectivenessandensurethatthepreventionstrategiesusedarecosteffective.Thisrequiressettingupincidentreportingsystemswhereinjuriesandeventsthatcouldhaveledtoaninjury(‘nearmisses’)areroutinelyrecordedandreviewed.Thisismoreeffectivewhenincidentsarereportedanonymously.Activereviewsofincidents,followedbyappropriateactions,shouldoperateinallorganisationstoensurecontinuingimprovementinhealthandsafety systems.

AkeyfeatureofthedevelopmentofasafetycultureinNew Zealandhasbeenthegrowthofworkplacehealthandsafetyinitiatives,suchastheappointmentofoccupationalhealthandsafetymanagers(seeBox2.4).Manyworkplacesnowhavedesignatedmanagersorcoordinatorsforhealthandsafety.Largeorganisationsoftenhavehealthandsafetysectionswithseveralpeople,eachofwhomhasresponsibilityforaspecificaspectofhealthandsafety.Forexample,manyDistrictHealthBoardsinNew Zealandhaveoccupationalhealthandsafetymanagersresponsibleforstaffandclientsafety.Someunitshavedesignatedpeopleresponsibleforensuringthesafemovingandhandlingofclients.Insomecasesbusinessesuseexternalhealthandsafetyconsultantstoprovideadviceonthemosteffectivewaystosetupandimprovetheirhealthandsafetysystems.

Box 2.4

Development of occupational health and safety positions in New Zealand

• Occupationalhealthandsafetymanagersmonitorworkplacehazardsandrisksandadviseworkersandmanagersonhowtominimiseoreliminateorreduce hazards

• In2006therewere1035healthandsafetypositionsinNew Zealand

• InJune2009therewere590privateoccupationalhealthandsafetybusinesses. MostofthesewereinAuckland,Canterburyand Wellington.

Source:www.careers.govt.nz

49

Section 2: Why moving and handling programmes are needed

References and resourcesACC.(2005).Preventing Injury from Falls: The national strategy 2005‑2015.

Wellington: ACC.

ACC.(2010).Preventing and Managing Discomfort, Pain and Injury to Healthcare Workers.WellingtonACC.www.accdpi.org.nz.

Adams,M.,Burton,J.,Butcher,F.,Graham,S.,McLeod,A.,&Rajan,R.(2002).Aftermath: The Social and Economic Consequences of Workplace Injury and Illness.Wellington:DepartmentofLabour,New Zealand.Retrieved10August2010fromwww.dol.govt.nz.

Bird,P.(2009).Reducingmanualhandlingworkerscompensationclaimsinapublichealthfacility.Journal of Occupational Health and Safety: Australia and New Zealand,25(6),451‑459.

Chhokar,R.,Engst,C.,Miller,A.,Robinson,D.,Tate,R.B.,&Yassi,A.(2005).Thethree‑yeareconomicbenefitsofaceilingliftinterventionaimedtoreducehealthcareworkerinjuries.Applied Ergonomics,36(2),223‑239.

DepartmentofLabour.(2005).Workplace Health and Safety Strategy for New Zealand to 2015.Wellington:DepartmentofLabour.

DepartmentofLabourandACC.(2001).Code of Practice for Manual Handling.Wellington:DepartmentofLabour.

Jones,C.B.(2005).Thecostsofnursingturnover,part2:ApplicationoftheNursingTurnoverCostCalculationMethodology.Journal of Nursing Administration,35(1),41‑49.

Jones,C.B.(2007).Thecostsandbenefitsofnurseturnover:Abusinesscasefornurseretention.Online Journal of Issues in Nursing,12(3),1‑11.

Ludcke,J.,&Kahler,R.(2009).Taxonomy of Injuries in Residential Care.Brisbane:TheInterSafeGroupPtyLtd(researchonACCNew Zealandclaimdata).

Miller,A.,Engst,C.,Tate,R.B.,&Yassi,A.(2006).Evaluationoftheeffectivenessofportableceilingliftsinanewlong‑termcarefacility.Applied Ergonomics,37(3),377‑385.

New ZealandGovernment.(2003).New Zealand Injury Prevention Strategy.Wellington:Accident Compensation Corporation(ACC).Retrievedfromwww.nzips.govt.nz.

New ZealandGovernment.(2010).New Zealand Injury Prevention Strategy: Five‑year Evaluation – Final Report May 2010.Wellington:Accident Compensation Corporation(ACC).Retrievedfromwww.nzips.govt.nz.

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North,N.,Hughes,F.,Finlayson,M.,Rasmussen,E.,Ashton,T.,Campbell,T.,Tomkins,S.(2006).The Rates and Costs of Nursing Turnover and Impact on Nurse and Patient Outcomes in Public Hospital Medical and Surgical Units: Report of a national study 2004‑2006.Auckland:SchoolofNursing,UniversityofAuckland.

Thomas,D.R.,Thomas,Y‑L.,Borner,H.,Etherington,M.,McMahon,A.,Polaczuk,C.,&Wallaart,J.(2009).Patient Handling Guidelines: Literature review.Wellington:ACC.