Georgia Tech Occupational Safety & Health Program

Injury Reduction in the Nursing Home Industry

CAPP-Final Report Year 1

Georgia Tech Safety and Health Consultation Program
Bryan Black

Introduction

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.

Initial Findings

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

Companies visited	12
Interventions	3

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

Recommendations

Ergonomics Program

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;
- Training;
- MSD management;
- Program evaluation;
- Recordkeeping.

For more specifics, refer to the OSHA web site and retrieve a full copy of the standard at the following address:

http://www.osha-slc.gov/ergonomics-standard/index.html

Additional Ergonomics References

http://www.osha-slc.gov/Publications/Osha3123.pdf
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.

http://www.www.lni.wa.gv/wisha/ergo/veg/vegtoc.htm
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.

http://www.wa.gov/Ini/hip/lifefaq.html
This is another document from WISHA. It compares several types of lifting devices for the nursing home industry and compiles the differences in tabular format.

http://www.wa.gov/Ini/hip/vendor_information.htm
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 could 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 (http://www.osha-slc.gov/SLTC/ ) 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.