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Safe Patient Handling Legislation

In 2012, nursing homes were deemed the most dangerous workplaces in the country by the Bureau of Labor Statistics. Nursing assistants had the third highest rate of musculoskeletal injuries of all occupations in the US. This comes as no surprise when the realities of the nursing home context are considered. We previously reported that the prevalence of NH resident obesity has more than doubled in the past 20 years (~25% in 2008).  In a typical 8-hour workday, a nurse may manually lift an estimated cumulative weight of 1.8 tons. In other industries, guideline-concordant manual lifting of stable objects is limited to 50 pounds or less. NH residents—who may move or shift unexpectedly, have pain or wounds, be precariously attached to tubing, or even actively resist efforts to assist them—may weigh 250 pounds or more. The importance of this issue is highlighted by the Occupational Safety and Health Administration (OSHA) recent directive targeting “ergonomic stressors in patient lifting” as an important hazard to worker safety. 

To examine the extent to which state-level safe patient handling legislation reduces nursing home worker injury rates, Dr. Bill Jesdale has developed a novel national data source which spans from before to after enactment of safe patient handling legislation. He led the efforts to merge facility level worker injury rates collected in the OSHA Data Initiative, resident level information from the Minimum Data Set, and facility level information captured by the Certification and Survey Provider Enhanced Reporting system. Leveraging the “natural experiment” of states enacting legislation in different years with data collected before and after legislation implementation, Drs. Jesdale and Chrysanthopoulou are implementing advanced analytic techniques to estimate the effect of state-level safe patient handling legislation on nursing home worker injury rates and identify characteristics of those nursing homes which may require additional interventions beyond safe patient handling legislation to effectively reduce worker injury rates. 

This research is funded by a grant from the National Institute for Occupational Safety and Health (NIOSH)