We propose to evaluate the effectiveness of lift equipment in the prevention of patient-handling injuries at a large tertiary care medical center. The placement of the equipment represents an institutional policy shift to a minimal manual-lift environment supported by training of inpatient nursing staff, including nurses and nurse's aides, in the appropriate use of equipment and reinforcement through nurse trainers and occupational safety and health ergonomics staff. The institution is supporting the collection of data for process evaluation and surveillance of unintended patient-related incidents such as falls or skin tears, as well as monitoring the adoption of the equipment on each unit as it is introduced. By combining surveillance data we are able to identify the dynamic cohort of nursing staff at this medical center over a 12-year period (1997-2008), their hours worked, their workers' compensation claims, and their health care claims through their private employer-provided health insurance; all are linked on an individual basis. These data provide the opportunity to evaluate the effectiveness of lift equipment placed on all in- patient units through changes in injury rates, lost work days, and workers' compensation costs taking into account temporal trends. We also have the ability to evaluate changes in private health care utilization for selected conditions that may fail to be appropriately attributed to work conditions. The placement of the equipment institution-wide will allow us to compare the relative effectiveness among units with patients that place different levels of physical demand on staff such as orthopaedics, general medicine and intensive care, for example. In addition, through collection of questionnaire data from staff at the time of equipment training and at several points in follow-up, we will be able to explore high risk groups for musculoskeletal symptoms and work-related injuries related to patient handling based on time in the profession, age, job, work unit characteristics, and elements of job control, demand, and satisfaction. The information collected prospectively combined with the retrospective data will allow a very comprehensive evaluation of the effectiveness of this equipment designed to decrease injuries among nursing staff at high risk of occupational injury from patient handling. The proposed work addresses several NIOSH priority areas including health care workers, back injuries, and intervention effectiveness research.
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