Amanda, an HCA working at a local personal care home, was on a unit that was short staffed.  Amanda got everything prepped to get Mrs. Smith out of bed and went to find a second worker to assist with the transfer.  Unfortunately, all the other workers on the unit were already busy with other residents.  Amanda made the decision to proceed with the lift without help.  While guiding the resident in the mechanical floor lift from bed to wheelchair, Amanda felt a sudden sharp pain in her shoulder.  She managed to safely complete the transfer but was unable to continue working her shift and left work to seek medical attention.

This type of incident in healthcare is all too common.  Statistics show that in healthcare in 2023 36.9% (1963) of incidents resulted from musculoskeletal (MSI) hazards such as patient handling.  As a result of safe patient handling incidents, MASH partnered with a Manitoba hospital to explore how improved workplace monitoring of safe patient handling tasks might assist with reducing workplace incidents.

The pilot project incorporated a few units from the hospital where MSI injuries due to patient handling tasks had previously been experienced.  Members from the units participated in training sessions to learn how to complete safe patient handling audits.  During the pilot project, units significantly increased their monitoring practices - from completing 4 audits per month to 12 audits per month with the intent to complete 4 audits per shift per month.  The site decided audits could be conducted by any worker (HCA, RN, CRN, manager etc.) if they completed the safe patient handling auditor training.  This change in process assisted in making it easier to increase the number of audits conducted in one month.  All completed audits are then submitted to the unit manager for review and sign-off. 

The pilot project results have demonstrated the importance that monitoring plays in ensuring safety program effectiveness and reducing incidents.  Increased monitoring of the patient handling program not only identified issues with worker compliance with safe work procedures, but it also assisted with identifying root causes for non-compliance and supported the development of effective corrective actions that reduced incidents related to patient handling for these units.  

This pilot project has highlighted the importance of the Plan-Do-Check- Act (PDCA) cycle for evaluating any component of a safety and health program’s effectiveness.

The PDCA cycle is a structured process used to ensure your safety program is successful at reducing incidents.  The approach involves four simple steps:

1. Plan: Begin by identifying the goal of the program.  For this pilot project, the aim was to reduce MSI incidents experienced because of patient handling tasks.  The plan included increasing the number of observations (audits) of workers completing patient handling tasks from 4 per month to 12 per month on each unit.  This provided supervisors (and other workers) with more opportunities to observe, talk with their workers, and evaluate safe patient handling techniques. 
   

2. Do: Put the plan into action.  During the pilot project, supervisors and trained workers carried out audits regularly, observing patient handling techniques and identifying any deficiencies.  During this phase, issues such as the need for worker retraining, lack of patient handling equipment, issues with communicating patient mobility changes (such as updating in room logos) or a need for patient reassessment were documented.
   

3. Check: This phase involves evaluating the outcomes and processes from the "Do" phase. It requires a systematic review of data and results to measure progress toward the established goals or objectives. Managers from the units were given regular data regarding patient handling and deficiencies identified to analyze and were able to identify recurring problems such as equipment or worker refresher training needs.
   

4. Act: Now it’s time to implement changes and improvements based on the findings from the "Check" phase. It focuses on addressing inefficiencies, resolving issues, and reinforcing successful practices. In this phase, corrective actions are put in place to eliminate barriers, refine processes, and enhance overall performance. Supervisors could then use the information and develop effective changes necessary to reduce risks, such as targeted training on the importance of slider sheet use for any dependent bed mobility tasks and ordering more slider sheets to ensure workers had access to the necessary equipment.

Through increased monitoring and the use of patient handling audits, managers can identify risks for their workers such as a lack of equipment or issues with communication and take actions to prevent incidents from occurring.  These proactive actions can significantly reduce the rate of incidents experienced by an organization related to patient handling.

Additionally, the pilot project has highlighted the importance of open communication regarding safety and health and promoted a positive safety culture in these units as workers feel empowered to bring forward safety concerns knowing the organization’s commitment to taking actions to reduce the risks for workers. "

References:

https://www.safemanitoba.com/topics/Pages/Injury-and-illness-statistics.aspx