In a study of 13 years of worker compensation costs in a large tertiary hospital and affiliated community hospital setting, "patient-handling injuries (n=1543) were responsible for 72% of MS injuries and 53% of compensation costs among patient care staff. Mean costs per claim were 5 times higher for those over age 45 than those <25 years of age. Physical and occupational therapy aides had the highest cost rates ($578/FTE) followed by nursing aides ($347/FTE) and patient transporters ($185/FTE). There was an immediate, marked decline in mean costs per claim and costs per FTE following the policy change and delivery of lift equipment." Evaluation of direct workers' compensation costs for musculoskeletal injuries surrounding interventions to reduce patient lifting. Lipscomb HJ1, Schoenfisch AL, Myers DJ. http://www.ncbi.nlm.nih.gov/pubmed/22199366
A 2009 review of the published literature on use of lifting equipment found "16 individual and 45 environmental barriers and facilitators . . . The most important environmental categories were 'convenience and easy accessibility' (56%),'supportive management climate' (18%) and 'patient-related factors' (11%). An important individual category was motivation (63%)." Determinants of implementation of primary preventive interventions on patient handling in healthcare: a systematic review. Koppelaar E1, Knibbe JJ, Miedema HS. http://www.ncbi.nlm.nih.gov/pubmed/19228679
As reported in the Herald Sun, Melbourne, Australia: "A graduate nurse who says she injured her back moving an obese patient is suing the hospital amid a raft of similar complaints, [charging that the] injuries [were] triggered by trying to shift the “unco-operative” patient in a faulty commode have left her unable to work. The suit comes as the nursing union warned that nurses and midwives were at serious risk of injury if hospitals failed to follow safe handling guidelines for obese patients. The nurse says her injury from the December 2008 incident was exacerbated after she slipped on a wet floor, as well as through other heavy and repetitive duties during her time at *** Hospital, [alleging that] the hospital was negligent because [she] wasn’t given any help or instruction on how to heave the patient on her own and wasn’t warned the person was stubborn. http://www.heraldsun.com.au/news/victoria/nurses-sue-hospitals-for-injuries-from-moving-patients/story-fni0fit3-1227003459175
MAYBE IT IS TIME TO DESIGN DEVICES THAT CAN BE SELF-MANAGED BY MORE CARE RECIPIENTS, REDUCING THE NEED TO LIFT SOME PATIENTS AT ALL? As with many challenges in healthcare, the big toileting issues will be addressed only through targeted sub-population interventions.