Safe Patient Handling and Mobility

According to the U.S. Bureau of Labor Statistics, nurses experience some of the highest back injury rates of all professions in the U.S. Patient handling-related injuries affect an enormous number of nurses, leaving many of them so incapacitated that they are forced to leave the profession.

Effective SPHM programs have been proven to:

Significantly reduce healthcare worker injuries.
Decrease healthcare worker absenteeism.
Decrease patient falls and pressure injuries.
Improve patient mobility.

Many hospitals have implemented highly successful SPHM programs. New York’s Safe Patient Handling (SPH) law requires all New York State hospitals, nursing homes and mental health facilities to gather input from frontline nurses and develop comprehensive SPHM programs. Contact healthandsafety@nysna.org for more information on facility SPH law requirements as well as other information on moving patients safely. NYSNA can also provide on-site assessments and training on SPH free of charge.

Elements of an Effective SPHM Program

For SPHM programs to be successful, the following elements are key:

Risk assessment — All areas of the healthcare facility must be assessed to determine what type of assisted patient movement is necessary based on patient mobility levels and healthcare activities conducted. A review of all staff injuries due to patient handling as well as patient falls and pressure injuries should be included in the risk assessment. Frontline staff members who are involved in patient care activities must be included in the assessment process.

Patient mobility tool — Each patient must be assessed using a patient mobility assessment tool to determine their level of functional mobility, their need for assistance and the appropriate SPH equipment necessary to move them safely. The Bedside Mobility Assessment Tool (BMAT) is one commonly used tool. Find more information about the bmat. Please note that a falls assessment tool is not an adequate substitute for a mobility assessment tool.

SPHM equipment assessment — A determination must be made, based on the results of the risk assessment, as to the type and amount of SPHM equipment that should be made available. Examples of SPHM equipment include but are not limited to:

Floor lifts.
Ceiling lifts.
Sit-to-stand devices.
Inflatable transfer and repositioning devices.
Friction-reducing sheets.
Electric bed and wheelchair movers.
Motorized hygiene chairs.

Ease of access to equipment — If the right equipment is not readily available where and when needed, the program will not be successful.

Training — All staff who handle patients, regardless of job title, must be trained on the patient mobility assessment tool and proper use of SPHM equipment with hands-on training. Competency assessments must be developed.

On-going recordkeeping and analysis — Patient handling-related injuries to both staff and patients must be recorded and reviewed on an ongoing basis. Root cause analyses of the conditions that cause these injuries must be identified and addressed to prevent future injuries.

SPHM committee — As required by the New York State SPH law, each covered facility must have a labor-management SPH committee that conducts each of these activities. The committee is required to be composed of both managerial staff and frontline, direct care nonmanagerial staff. At least one of the nonmanagerial committee members must be a direct care RN. The committee must have management and nonmanagerial frontline healthcare staff co-chairs. The more varied the representation on the committee, the more effective it will be. Nursing, physical therapy, occupational therapy, patient transport, radiology, education, purchasing, laundry, facilities and other units all play key roles in effective SPH programs.

Include falls, early mobilization and pressure injury committees in the SPHM committee’s work to better coordinate compatible programs.

Success Stories

Working closely with unions, some facilities have already implemented SPH programs. The results are impressive:

Erie County Medical Center experienced a 50% decrease in workers’ compensation claims, a 79% reduction in workers’ compensation costs, a 73% reduction in lost work days and an 83% reduction in restricted work days pertaining to patient handling injuries 3 years into SPHM program implementation.
Northwell Health/Staten Island University Hospital experienced a 65% decrease in lost workdays 2.5 years after implementation.
Kaleida Health experienced a 77% decrease in lost workdays two years after implementation.
New York State Veterans Home at Batavia experienced a 93% reduction in lost workdays three years after implementation.
Glen Falls Hospital experienced a 56% decrease in injuries related to patient handling and a 25% decrease in total workers’ compensation costs five years after implementation.

Backed by Research

According to nine studies that the National Institute for Occupational Safety and Health conducted, healthcare facilities that instituted comprehensive SPH programs saw:

60% to 95% reduction in injuries.
95% reduction in workers’ compensation costs.
92% reduction in medical/indemnity costs.
As much as a 100% reduction in lost workdays (absence due to injury).
98% reduction in absenteeism (absence due to unreported injury).

Read more about the benefits of comprehensive SPHM programs in this meta-analysis.