Lawmakers Endorse New Nursing Home Ergonomic Guidelines

State lawmakers involved in insurance issues have endorsed proposed federal rules designed to reduce workers’ compensation claims and employee injuries in nursing homes.

A resolution supporting ergonomics guidelines for nursing homes and encouraging such facilities to use alternative mechanical lifting methods was unanimously approved by the Workers’ Compensation Committee at the spring National Conference of Insurance Legislators in Hilton Head, S.C.

The ergonomics measure was proposed by the U.S. Department of Labor’s Occupational Safety and Health Administration. Sen. Ann Cummings (D-Vt.), sponsor of the NCOIL resolution, also chaired the committee meeting.

The goals of OSHA’s ergonomics guidelines are to reduce ergonomic-related injuries and workers’ compensation claims in the nursing home industry. The guidelines are designed specifically for the nursing home industry, but OSHA hopes employers with similar work environments, such as assisted living centers, homes for the disabled, homes for the aged and hospitals will also find the information useful.

Cummings emphasized that the guidelines are a set of recommendations, not standards or laws, aimed at reducing the number and severity of work-related injuries and associated workers’ compensation insurance costs, by using methods that have proven successful in nursing homes.

OSHA says that specific measures or guideline implementations may differ from site to site. Still, it recommends that all facilities minimize manual lifting of residents in all cases and eliminate such lifting when feasible. Further, OSHA encourages employers to implement a basic ergonomic process that provides management support while involving workers, identifying problems and implementing solutions, addressing reports of injuries, provide training and evaluating ergonomics efforts.

The committee voted on its recommendation after a presentation on promoting by David Askew, a registered nurse with Ethica Healthcare, a non-profit organization that manages 42 nursing homes and two assisted-living facilities that takes care of 3,500 patients and has 5,000 employees. Yolanda Pence, a professional therapist with Integra Rehabilitation, Ethica’s primary rehabilitation provider, operates 61 sites and 150 associates.

Askew described Ethica’s safety improvement team as encompassing all allied disciplines from certified nursing assistant to regional vice presidents. Every two months these employees participate in an evaluation process to assess the success of a no-lift program that has eliminated manual lifting and relies totally on mechanical lifts.

Pense illustrated three different types of mechanical equipment used to lift patients and described how employee resistance to using such equipment was overcome. She stressed the importance of having lifts readily available.

“At first we encountered resistance, but in four to six weeks the employees thought it was the best thing since sliced bread,” Pense said. “Patients also endorsed it, saying they felt much more secure.”

Pense said statistics show that after six months of implementation the number of patients lifted increased, while patient injuries and their severity decreased.

She said the program kicked off in July of 2003 and the occurrence of employee claims for light duty have been reduced dramatically.

The program was phased-in to two nursing homes and due to its success it will now be implemented in all facilities. They estimated that the costs for new equipment would be recouped within two years after a program’s implementation.

Ethica has partnered with Emory University to develop and trial the fall-prevention program.

Askew described Ethica’s safety audits and annual examinations of each center using a 350-item checklist which includes OSHA recommendations, fire drill records and basic practices. Askew said OSHA has helped implement the program and attends the meetings.

Ethica implemented an incentive program to prevent lost time, including a drawing at the end of each month to present awards and prizes to employees who have no lost time.

They have also developed a return to work or transitional work program to try to get people back into the workforce as soon as possible.