Position Statement on Elimination of Manual Patient Handling to Prevent Work-Related Musculoskeletal Disorders

Alabama Nurse,  Dec 2003-Feb 2004  

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The degree of effectiveness of using patient handling equipment and devices to prevent musculoskelel disorders is significantly dependent on factors related to availability, maintenance, and sufficient space. Equipment and devices must be readily available to staff in order to encourage their use. Availability incorporates quantify, location, and access of equipment commensurate with staff and patient needs. Further, equipment and devices must be maintained utility. Disrepair and dilapidation unnecessarily subjects both caregiver and patient to preventable risk for injury. Also, adequate space within patient care settings that accommodates use of patient handling equipment and devices is essential. Barriers and obstacles within the physical patient care environment, such as, but not limited to furniture, walls, or other treatment equipment, may be prohibitive aspects to patient handling situations. The extent to which any of these factors are limited can strongly influence the risk for musculoskeletal injury.

Exceptional Situations

There may be occasions when manual patient handling cannot be avoided. Nurses may be presented with exceptional or life-threatening situations prohibiting the use of assistive patient handling equipment. In addition, manual patient handling may be performed if the action does not involve lifting most or all of a patient's weight. Other exceptions include the care of pediatric infant or small child) or other small patients and the use of sprapeutic touch. In any and all cases, effort toward patient handling should be minimized wherever possible without compromising patient care or exceeding the abilities and skills of the nurse.

Quality Patient Care

The use of assistive equipment for patient handling tasks also benefits patients. Patient adverse events related to patient handling and movement include pain (i.e., when lifting patients under their arms) and injury (e.g., falls, contusions, and skin tears). The use of assistive equipment directly contributes to preventing such adverse events and improving patient safety, comfort, and dignity - reflecting ANA's commitment to Patient Safety/Advocacy. Through the elimination of manual patient handling, patients are afforded more secure and stable means to progress through their care. Also, assistive equipment can be designed to incorporate patient comfort and dignity considerations as a way to respect patients' rights and to improve the overall quality of care.

Employer/Management Commitment

Employers and managers should adopt a policy that commits the institution to the safest approach to handling and moving patients. The safest approach prioritizes the use of assistive equipment and discourages the performance of manual patient handling. Organizational actions must support the use of assistive equipment for patient handling tasks by investing in an adequate supply of appropriate assistive equipment, ensuring that equipment is readily available to staff, assuring that staff are well-trained in the use of equipment, and designating resource specialists skilled in the assessment and evaluation of patient handling. Additionally, any policy related to the elimination of manual patient handling must be non-punitive. Nursing staff should be encouraged to participate in effectively implementing requirements for safe patient handling and not made fearful of reporting incidents of work-related injury. These elements are necessary to ensure that a policy restricting manual patient handling successfully serves to reduce the risk of musculoskeletal disorders.