OBJECTIVES: To examine how injury rates and injury types differ across direct care occupations in relation to the healthcare settings in British Columbia (BC). METHODS Data were derived from a standardized operational database in three BC health regions. Injury rates were defined as the number of injuries per 100 Full-Time Equivalent (FTE) positions. Poisson regression, with Generalized Estimating Equations, was used to determine injury risks associated with direct care occupations (registered nurses, licensed practical nurses, and care aides) by healthcare setting (acute care, nursing homes, and community care). RESULTS: Care Aides (CAs) had higher injury rates in every setting with the highest rate in nursing homes (37.0 injuries per 100 FTE). Licensed practical nurses (LPNs) had higher injury rates (30.0) within acute care than within nursing homes. Few LPNs worked in community care. The registered nurse (RN) highest injury rates (21.9) occurred in acute care, but their highest (13.0) musculoskeletal injury (MSI) rate occurred in nursing homes. MSIs comprised the largest proportion of total injuries in all occupations. In both acute care and nursing homes, CAs had twice the MSI risk compared to RNs. Across all settings, puncture injuries were more predominant for RNs (21.3% of their total injuries) compared to LPNs (14.4%) and CAs (3.7%). Skin, eye and respiratory irritation injuries comprised a larger proportion of total injuries for RNs (11.1%) compared to LPNs (7.2%) and CAs (5.1%). CONCLUSIONS: Direct care occupations have different risks of occupational injuries based on the particular tasks and roles they fulfill within each healthcare settings. CAs are the most vulnerable for sustaining MSIs since their job entails mostly of transferring and repositioning tasks during patient/resident/client care. Strategies should focus on prevention of MSIs for all occupations as well as target puncture and irritation injuries for RNs and LPNs.
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