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Lifting and exertion injuries decrease after implementation of an integrated hospital-wide safe patient handling and mobilisation programme
  1. Jack T Dennerlein1,2,
  2. Elizabeth (Tucker) O'Day3,
  3. Deborah F Mulloy4,
  4. Jackie Somerville5,
  5. Anne M Stoddard6,
  6. Christopher Kenwood7,
  7. Erin Teeple2,8,
  8. Leslie I Boden9,
  9. Glorian Sorensen6,10,
  10. Dean Hashimoto3,11,12
  1. 1Department of Physical Therapy, Movement, and Rehabilitation Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts, USA
  2. 2Department of Environmental Health and The Center for Work, Health, and Wellbeing, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
  3. 3Department of Occupational Health Services, Partners HealthCare System, Boston, Massachusetts, USA
  4. 4Center for Nursing Excellence, Brigham and Women's Hospital, Boston, Massachusetts, USA
  5. 5Patient Care Services Center for Nursing Excellence, Brigham and Women's Hospital, Boston, Massachusetts, USA
  6. 6Center of Community Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
  7. 7New England Research Institutes, Watertown, Massachusetts, USA
  8. 8Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
  9. 9Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
  10. 10Department of Social and Behavioral Sciences Health and The Center for Work, Health, and Wellbeing, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
  11. 11Boston College Law School, Newton Centre, Massachusetts, USA
  12. 12Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Dr Jack T Dennerlein, Department of Physical Therapy, Movement, and Rehabilitation Sciences, Bouvé College of Health Sciences, Northeastern University, Robinson Hall 301, 360 Huntington Avenue, Boston, MA 02215, USA; j.dennerlein{at}neu.edu

Abstract

Objective With increasing emphasis on early and frequent mobilisation of patients in acute care, safe patient handling and mobilisation practices need to be integrated into these quality initiatives. We completed a programme evaluation of a safe patient handling and mobilisation programme within the context of a hospital-wide patient care improvement initiative that utilised a systems approach and integrated safe patient equipment and practices into patient care plans.

Methods Baseline and 12-month follow-up surveys of 1832 direct patient care workers assessed work practices and self-reported pain while an integrated employee payroll and injury database provided recordable injury rates collected concurrently at 2 hospitals: the study hospital with the programme and a comparison hospital.

Results Safe and unsafe patient handling practice scales at the study hospital improved significantly (p<0.0001 and p=0.0031, respectively), with no differences observed at the comparison hospital. We observed significant decreases in recordable neck and shoulder (Relative Risk (RR)=0.68, 95% CI 0.46 to 1.00), lifting and exertion (RR=0.73, 95% CI 0.60 to 0.89) and pain and inflammation (RR=0.78, 95% CI 0.62 to 1.00) injury rates at the study hospital. Changes in rates at the comparison hospital were not statistically significant.

Conclusions Within the context of a patient mobilisation initiative, a safe patient handling and mobilisation programme was associated with improved work practices and a reduction in recordable worker injuries. This study demonstrates the potential impact of utilising a systems approach based on recommended best practices, including integration of these practices into the patient's plan for care.

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Footnotes

  • Funding The programme evaluation was supported by a grant from the National Occupational for Safety and Health (U19 OH008861) for the Harvard T.H. Chan School of Public Health Center for Work, Health and Well-being. Additional support was provided by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under award number T32AR055885. The programme itself was funded by Partners HealthCare.

  • Competing interests None declared.

  • Ethics approval Harvard T.H. Chan School of Public Health.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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