Musculoskeletal injuries continue to be the leading cause of injury in healthcare. Nursing-related professions are consistently listed as one of the top ten occupations for work-related musculoskeletal disorders, with an incidence rate of 8.1 per 100 full-time equivalent (FTE) employees in hospitals, and 9.1 per 100 FTE in nursing and residential care facilities (Bureau of Labor Statistics, 2005). While other work-related injuries in and outside of healthcare have decreased over the past few years, nursing musculoskeletal injuries have been on the rise (Nelson and Baptiste, 2006). Studies have shown that every day in the United States, 9,000 healthcare workers sustain a disabling injury while performing work-related tasks (Brown, 2003). Due to the risk in this occupation, an estimated 12–18% of nurses will leave the profession due to chronic back pain, and another 12% will consider leaving the profession (Nelson and Baptiste, 2006). This statistic could be devastating to a profession that is already facing an stimated shortage of one million nurses by the year 2012 (Waters et al., 2006).

The unique and complex nature of healthcare makes implementing solutions challenging. There is rarely a single intervention that results in widespread success across multiple patient care units. According to Nelson (2006), comprehensive programs addressing specific risks and tasks within each setting are finding more success. Important pieces to these programs include technical systems such as patient handling equipment, no lift policies, and fundamental management skills and practices that provide management support by encouraging staff participation, monitoring processes and practices, and adjusting systems as needed. Research is becoming available that supports the use of both patient handling equipment and a no lift policy in effectively reducing risk and subsequent injuries (Nelson, 2006). Despite this evidence, implementing successful injury reduction programs continues to be a struggle for many healthcare institutions due to the multitude of challenges involved in providing safe, quality care for patie nts in a physical environment where barriers and obstacles exist. This paper identifies some of the barriers and obstacles associated with administrative systems, the physical environment, and the use of patienthandling equipment within a diverse patient population. Solutions to overcome these challenges are discussed along with strategies to assist facilities with a successful implementation of a minimal lift environment.

Administrative Barriers

Overcoming barriers in implementing a successful safe patient handling and minimal lift environment requires evaluating administrative systems to determine areas of improvement. Further evaluation of these areas will provide a baseline understanding of the variables involved and their potential impact on the use of patient handing equipment within your facility. Administrative systems may include reviewing and evaluating some of the following areas:

  • Level of administrative or managerial support

  • Level of financial support or pressure to reduce financial spending

  • Level of resistance by staff to change work practices

  • Level of desire to reduce injuries and workers' compensation costs

  • Organizational strategic priorities

  • Patient safety priorities

  • Regulatory requirements

  • Organizational pressures to meet goals

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