Impact of California Safe Patient Handling Legislation: Health Care Workers’ Perspectives

Abstract

Background: Musculoskeletal injuries from patient handling are significant problems among health care workers. In California, legislation requiring hospitals to implement safe patient handling (SPH) programs was enacted in 2011. This qualitative study explored workers’ experiences and perceptions about the law, their hospital’s SPH policies and programs, patient handling practices, and work environment. Methods: Three focus groups were conducted with 21 participants (19 nurses and 2 patient handling specialists) recruited from 12 hospitals located in the San Francisco Bay Area and San Joaquin Valley. Qualitative content analysis was used for data analysis. Results: Multiple themes emerged from diverse experiences and perceptions. Positive perceptions included empowerment to advocate for safety, increased awareness of SPH policies and programs, increased provision of patient handling equipment and training, increased lift use, and improvement in safety culture. Perceived concerns included continuing barriers to safe practices and lift use such as difficulty securing assistance, limited availability of lift teams, understaffing, limited nursing employee input in the safety committee, blaming of individuals for injury, increased workload, and continuing injury concerns. Participants indicated the need for effective training, sufficient staffing, and management support for injured workers. Conclusions/Application to Practice: This study identified improvements in hospitals’ SPH programs and practices since the passage of California’s SPH law, as well as continuing challenges and barriers to safe practices and injury prevention. The findings provide useful information to understanding the positive impacts of the SPH law but also notes the potential limitations of this legislation in the view of health care workers.

Safe patient handling legislation and musculoskeletal disorders among California healthcare workers: Analysis of workers' compensation data, 2007–2016

“…One possible reason for these findings may have to do with greater use of equipment. Specifically, a qualitative study reported that some nurses expressed concerns about shoulder and neck injuries related to more frequent use of ceiling lifts 36 . In the Minnesota study, 34 the PHI indemnity claims rate for shoulder injuries showed an initial increase during the first 3 years of postlegislation periods and then showed gradual decreases, which were statistically significant; however, the study observed little change for the PHI claim rate for neck injuries.…”

“…Specifically, a qualitative study reported that some nurses expressed concerns about shoulder and neck injuries related to more frequent use of ceiling lifts. 36 In the Minnesota study, 34 the PHI indemnity claims rate for shoulder injuries showed an initial increase during the first 3 years of postlegislation periods and then showed gradual decreases, which were statistically significant; however, the study observed little change for the PHI claim rate for neck injuries. In interpreting the study findings, our case definitions and limitations in case identification methods from the WC data system and data quality issues should be considered.…”

The integration of care ethics and nursing workload: A qualitative systematic review

“…Large patient ratios have notable negative impacts on nurses and patients. This is often due to inadequate staffing (Cengiz et al, 2021 ; Chua et al, 2019 ; Lee et al, 2021 ; Tamata et al, 2021 ), but also an overall higher number of patients admitted and lack of coverage of sick calls or annual leave (Tamata et al, 2021 ). Contributing to the large patient ratios is the current coronavirus pandemic.…”

Preserving the Bedside Nurse: Grip Strength and Orthopedic Problems Among Nurses and Nursing Students

“…Efforts have been made to reduce injuries among healthcare workers and some progress has been made. OSHA as well as the American Nurses Association (ANA) has campaigned for a safer work environment in hospitals through safe patient handling programs (American Nurses Association [ANA], 2021; Lee et al, 2021). The ANA has published the second edition of Interprofessional National Standards for safe patient handling and mobility signaling continued commitment to preventing injuries in the workplace (2021).…”

“…The average grip strength in the U.S. population has decreased dramatically since the 1980s normative data (Vanderbilt, 2017). Grip strength is an effective indicator of present and future health status (Bohannon, 2015(Bohannon, , 2019Carney & Benzeval, 2018;Lee et al, 2021;Leong et al, 2015;Wang et al, 2018). Decreased grip strength reflects lower overall strength and upper limb function, and is associated with increased risk for musculoskeletal injury, cardiac events, and other health problems (Bohannon, 2019).…”