The California Nurses Association says new state regulations by the California Occupational Safety and Health Standards Board will result in improved safety for patients, registered nurses, and other staff in lifting and other handling of hospitalized patients.
“At a time when California leads the nation in the number of musculoskeletal injuries, nurses endure more work-related musculoskeletal injuries than truck drivers or construction workers, and patients are continually at risk in hospitals from preventable falls, these new regulations will be a safety model for the nation,” said Deborah Burger, RN.
Burger is co-president of the California Nurses Association/National Nurses United, which sponsored the bill, AB 1135, signed by Gov. Jerry Brown in 2011 that directed the state to establish the rules, now completed after hearings and a review process by the Cal-OSHA Board.
The new requirements
Under the new regulations, as of October 1 all general acute care hospitals in California must have a safe patient handling policy that requires the replacement of manual lifting and transferring of patients with powered transfer devices, lifting devices and lift teams that are appropriate for the specific patient, and is consistent with both the employer’s safety policies and the professional judgment and clinical assessment of the RN.
“These regulations will go a long way in California to prevent the most common injury for nurses and patients, falls that are the direct result of not having lift teams, policies, or equipment needed to stop accidents and reduce injuries,” said Bonnie Castillo, RN, CNA’s associate executive director who shepherded the 2011 bill through the legislature in the face of what the organization calls "stringent opposition" from the hospital industry.
Patient falls and accidents have been a growing problem in the nation’s hospitals, for a variety of reasons, including the importance of ambulating patients to prevent bed sores and the fact that patients on certain medications or treatment are often more susceptible to dizziness or other conditions that make them less stable.
Safe patient handling policies are equally critical for RNs and other healthcare workers. In 2008, Bureau of Labor Statistics documented that 36,000 healthcare workers were injured by lifting and transferring patients.
Back pain a major reason for leaving workforce
Nursing surveys have found that 83 percent of RNs work in spite of back pain, 52 percent report chronic back pain, and 12 percent who leave the profession say back injuries were the main, or a major, reason for leaving the RN workforce. Hospitals that have lift teams in place have seen a significant drop in such injuries.
With the new regulations, the hospitals are also directed to establish, implement and maintain written patient protection and healthcare worker back and musculoskeletal injury prevention plans at all time for all patient care units, along with records available for inspection by state occupational safety and health officials and employees and their representatives.
Additionally, the plans are expected to include patient mobility assessments based on the RN’s professional judgment, procedures for correcting hazards related to patient handling, and proper training programs for healthcare workers assigned for specially designated lift teams.
Castillo praised Cal-OSHA officials for “the very thorough, meticulous, detailed regulations” that, she said, “will have an immediate effect on protecting patients, nurses and other healthcare workers. They have more than met the spirit and intent of the law.”