Ergonomics in long-term care communities
By Toby Pearson | January 12, 2024 | SNF/NF providers
A new law effective January 1, 2024, requires healthcare facilities—including nursing homes with a North American Industrial Classification system code of 623110—to create and implement an effective written ergonomics program establishing the employer’s plan to minimize the risk of its employees developing or aggravating musculoskeletal disorders. See the “
2023 Legislative Update Book” for more information. The following is an article AHCA/NCAL recently published on ergonomics in long-term care communities: “
Safe Resident Handling and Prevention of Musculoskeletal Injuries: Ergonomics in Long Term Care Communities.”
OSHA regulations workforce
Musculoskeletal disorders (MSDs) are a significant concern in the health care industry, including long term care (LTC) centers. Common MSDs associated with resident handling include strains, sprains, and other injuries resulting from overexertion, awkward postures, and repetitive movements. MSDs are addressed, in OSHA terms, by implementing “ergonomic” practices and controls.
OSHA does not have a specific standard dedicated solely to ergonomics or MSDs. However, OSHA addresses ergonomic concerns through the General Duty Clause of the Occupational Safety and Health Act.
What is the General Duty Clause?
The General Duty Clause (Section 5(a)(1)) states that employers must provide a workplace free from recognized hazards that are causing or likely to cause death or serious physical harm to employees. As a result, if OSHA finds that an employer has failed to provide a safe workplace, it can issue a citation under the General Duty Clause even where no specific OSHA standard applies.
Ergonomics and safe resident handling in LTC centers are one of the areas that OSHA applies the General Duty Clause. To further their compliance efforts, employers can refer to OSHA's guidelines, publications and resources (see Guidelines for Nursing Homes) that provide recommendations for preventing MSDs and encouraging safe patient handling. State OSH Agencies may provide further guidance, and several states have regulations directly related to patient handling.
Understanding OSHA Expectations for Ergonomics and Safe Resident Handling
OSHA's guidelines aim to minimize the risk of injuries associated with patient handling and promote ergonomic practices to enhance workplace safety. These standards cover various aspects, including patient lifting, transferring, and repositioning, with the primary goal of reducing MSDs among health care workers.
Examples of Controls to Protect Employees
- Mechanical Lifts and Transfer Devices:
- Mechanical lifts and transfer devices, such as ceiling lifts and floor-based lifts, can significantly reduce the physical strain on healthcare workers during patient transfers.
- OSHA has indicated that mechanical lifting equipment reduces exposure to manual lifting injuries by up to 95% among health care workers.
- Training and Education Programs:
- Training programs for health care workers on proper lifting techniques, body mechanics, and the use of assistive devices are frequently offered in nursing and aid certification course curriculum (e.g., nursing school) and should also be part of the employer’s training regular regimen.
- According to a study published in the Journal of Occupational and Environmental Medicine, facilities with robust training programs experienced a notable decrease in work-related injuries.
- Ergonomic Equipment and Furniture:
- Investing in ergonomic furniture and equipment, such as adjustable beds and chairs, can contribute to a more comfortable and safer working environment.
Examples of Controls to Protect Residents and Employees
- Individualized Care Plans:
- Utilizing the information provided in individualized care plans for residents ensures that their specific needs and limitations are considered during transfers and movements.
- From an employee safety perspective, these care plans can serve as individualized hazard assessments to identify appropriate lifting and transfer methods.
- Assistive Devices for Residents:
- Providing residents with assistive devices, such as grab bars and mobility aids, enhances their independence and reduces the need for manual assistance, thereby promoting employee safety.
Conclusion
Incorporating OSHA guidelines for ergonomics and safe resident handling LTC centers can be beneficial for protecting both employees and residents. The implementation of controls such as mechanical lifts, training programs, ergonomic equipment, individualized care plans, and assistive devices can significantly contribute to a safer and more comfortable environment.
Toby Pearson | President/CEO |
tpearson@careproviders.org | 952-851-2480