Injury Reduction in the Nursing Home Industry
CAPP-Final Report Year 1
Georgia Tech Safety and Health Consultation Program
The intent of the Consultation Activity Performance Project for nursing homes is to identify problems in these workplaces that result in lost time or restricted time injuries and illnesses. Once the major causes of these injuries and illnesses can be identified solutions will be sought out that will help reduce or eliminate these situations in nursing homes.
It is still fairly early in this particular project to make any major conclusions because the analysis phase of the injury and illness data has not yet been completed. That being said, here are some initial observations. There were many shoulder, back, and arm injuries that appeared to be the direct result of patient handling issues. This is consistent with the literature and injury data for this industry. What is not known at this point is what common activities are responsible for these injuries and illnesses.
Visit Information Hazard Summary
Types of Program Hazards Discovered
- Incomplete or no lockout/tagout program
- Incomplete or no lockout/tagout training
- Incomplete or no bloodborne pathogens exposure control plan
- Incomplete or no bloodborne pathogens training
- Incomplete or no hazard communication program
- Incomplete or no hazard communication training
- No personal protective equipment evaluation
Types of Physical Hazards Discovered
- Unsecured gas cylinders
- Improperly guarded abrasive grinders
- Improperly guarded table saws
- Open electrical boxes with exposed wiring and con
- Electrical cords with no ground conductor
- Unguarded fan blades
- Exposed belt and pulley drives
Due to the patient handling problems observed in the facilities, it is recommended that each nursing home facility develop a formal ergonomics program. Reducing injuries is just one reason to begin a program. The recent promulgation of the OSHA ergonomics standard is another. The following information will assist you with the development of the ergonomics standard.
The OSHA Ergonomics Program Standard spells out exactly what is reqired to develop a program for each facility. It is primarily intended for companies with manual handling and manufacturing jobs, but can cover other industries like nursing homes if they have work-related MSDs. The requirements of the standard can be summarized as followed:
- Basic program required for companies with manual and manufacturing jobs including:
- Management leadership and employee participation;
- Hazards information and reporting.
- Full program required for companies with one workplace MSD including:
- Job hazard analysis and control;
- MSD management;
- Program evaluation;
Additional Ergonomics References
OSHA's "Ergonomics Program Management Guidelines for Meatpacking Plants"
Although it was intended for the meatpacking industry, this document gives an excellent overview of the elements of the ergonomics program.
WISHA's "Fitting the Job to the Worker: An Ergonomics Program Guideline"
An excellent resource for developing an ergonomic program, including some good information in the appendix materials such as checklists for various types of tasks.
This is document from WISHA compares several types of lifting devices for the nursing home industry and compiles the differences in tabular format.
Here are several vendor contacts for lifting devices. They are located on the West Coast but give you the names of many manufacturers that you cosuld most likely locate in your own area.
Other Formal Programs
Because so many facilities had problems with the requirements of existing OSHA standards, it is recommended that each facility develop its own formal written and training programs for each of the following:
- Control of Hazardous Energy (Lockout/Tagout)
- Bloodborne Pathogens
- Hazard Communication
- Personal Protective Equipment
The OSHA Technical Links page has pages on each of the above mentioned topics with links to other pages that have some good information that will assist in the development of each formal program. There is also a page specifically dedicated to nursing homes that can be reached from the OSHA Technical Links page.