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Occupational and Safety Health Administration (OSHA)—Safety and Health Topics—Safe Patient Handling

Occupational and Safety Health Administration (OSHA)—Safety and Health Topics—Safe Patient Handling

Nov 27th 2020

The healthcare industry has recognized for some time that healthcare workers are at great risk for musculoskeletal injury from lifting and managing patients. Safe Patient Handling programs have been in place for some time now and the hospitality industry is just catching up to these known risks.

Safe Patient Handling

One major source of injury to healthcare workers is musculoskeletal disorders (MSDs). In 2017, nursing assistants had the second highest number of cases of MSDs. There were 18,090 days away from work cases, which equates to an incidence rate (IR) of 166.3 per 10,000 workers, more than five times the average for all industries. This compares to the all-worker days-away from work rate of 30.5 per 10,000 workers.


These injuries are due in large part to overexertion related to repeated manual patient handling activities, often involving heavy manual lifting associated with transferring, and repositioning patients and working in extremely awkward postures. Some examples of patient handling tasks that may be identified as high-risk include: transferring from toilet to chair, transferring from chair to bed, transferring from bathtub to chair, repositioning from side to side in bed, lifting a patient in bed, repositioning a patient in chair, or making a bed with a patient in it.

Sprains and strains are the most often reported nature of injuries, and the shoulders and low back are the most affected body parts. The problem of lifting patients is compounded by the increasing weight of patients to be lifted due to the obesity epidemic in the United States and the rapidly increasing number of older people who require assistance with the activities of daily living.

The consequences of work-related musculoskeletal injuries among nurses are substantial. Along with higher employer costs due to medical expenses, disability compensation, and litigation, nurse injuries also are costly in terms of chronic pain and functional disability, absenteeism, and turnover. As many as 20% of nurses who leave direct patient care positions do so because of risks associated with the work. Direct and indirect costs associated with only back injuries in the healthcare industry are estimated to be $20 billion annually. In addition, healthcare employees, who experience pain and fatigue, may be less productive, less attentive, more susceptible to further injury, and may be more likely to affect the health and safety of others.

Industries where patient handling tasks are performed include:
  • Long-Term Care (includes facilities that provide skilled or non-skilled nursing care);
  • Acute Care - (includes hospitals, out-patient surgical centers, and clinics);
  • Home Healthcare workers; and
  • Others - such as physical therapists, radiologists, sonographers, etc.

Some examples of areas of a facility that may be identified as high-risk include: bathing rooms, extended care wings, and diagnostic units (e.g., radiology, emergency department, spinal unit, orthopedics department).

Given the increasingly hazardous biomechanical demands on caregivers today, it is clear the healthcare industry must rely on technology to make patient handling and movement safe. Patient transfer and lifting devices are key components of an effective program to control the risk of injury to patients and staff associated with lifting, transferring, repositioning or movement of patients. Essential elements of such a program include management commitment to implement a safe patient handling program and to provide workers with appropriate measures to avoid manual handling; worker participation in the assessment and implementation processes and the evaluation and selection of patient handling devices; a thorough hazard assessment that addresses high risk units or areas; investment in equipment; care planning for patient handling and movement; training for staff; and program review and evaluation processes. The education and training of healthcare employees should be geared towards assessment of hazards in the healthcare work setting, selection and use of the appropriate patient lifting equipment and devices, and review of research-based practices of safe patient handling.

The use of assistive patient handling equipment and devices is beneficial not only for healthcare staff, but also for patients. Explaining planned lifting procedures to patients prior to lifting and enlisting their cooperation and engagement can increase patient safety and comfort, and enhance their sense of dignity.

Hazards and Solutions (Transfer, Repositioning, and Lifting Devices)

Mechanical wheelchair helps patients from a sitting position to a standing position

Acute Care and Long Term Healthcare Workers
The OSHA Hospital e-Tool specific modules that address safe patient handling include:
Home Healthcare Workers
  • Home Healthcare Workers: How to Prevent Musculoskeletal Disorders. U.S. Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 2012-120, (February 2012). This is one in a series of six fast fact cards developed to provide practical advice for home healthcare workers and is based on NIOSH Hazard Review: Occupational Hazards in Home Healthcare, NIOSH Pub No. 2010–125. Lifting and moving clients create a high risk for back injury and other musculoskeletal disorders for home healthcare workers.
  • NIOSH Hazard Review; Occupational Hazards in Home Healthcare; Department of Health and Human Services, Center for Disease Control and Prevention.National Institute for Occupational Safety and Health (NIOSH). The document aims to raise awareness and increase understanding of the safety and health risks involved in home healthcare and suggests prevention strategies to reduce the number of injuries, illnesses, and fatalities that too frequently occur among wor kers in this industry.
Physical Therapists
  • The Ergonomics Module of the OSHA Hospital e-Tool is relevant to safe patient handling concepts in the field of physical therapy.
  • The Radiology Module of the OSHA Hospital e-Tool is relevant to patient handling concepts in the field of radiology.
  • The Sonography module of the OSHA Hospital e-Tool is relevant to safe patient handling concepts in the field of sonography.
  • Preventing Work-Related Musculoskeletal Disorders in Sonography.U.S. Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication, No. 2006-148, (November 2006). NIOSH recommends appropriate engineering controls, work practices, hazard communication, and training to prevent these work-related musculoskeletal disorders in healthcare workers giving sonograms.
Training Resources

Training Resources

State Legislation
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