Development of Evidence-Based Algorithms for Safe Patient Handling of Orthopaedic Patients
Carol A. Sedlak, PhD, RN, CNS, ONC, CNE1, Margaret A. Doheny, PhD, RN, CNS, ONC, CNE1, Cynthia Gonzalez, MSN, RN, OCNS-C, APN2, Cynthia Howe, MSN, RN, ONC3, Miki Patterson, PhD, NP, ONC4, Audrey Nelson, PhD, RN, FAAN5, Thomas Waters, PhD, CPE6, Mary Matz, MSPH5, Andrea Baptiste, MA, (OT, ), CIE7, Stephanie Radawiec, MHS, PT8, Patricia Mechan, PT, MPH, CCS9, Valerie Kelleher, AA7, John Lloyd, PhD, CPE10, and Nancy Hughes, MS, RN11. (1) Nursing, Kent State University, Kent, OH, USA, (2) Weiss Memorial Hospital, Skokie, IL, USA, (3) City Hospital Martinsburg, Martinsburg, WV, USA, (4) UMass Memorial Trauma Center, Worcester, MA, USA, (5) Patient Safety Center of Inquiry, Tampa, FL, USA, (6) Division of Applied Research and Technology, Cincinnati, OH, USA, (7) Patient Safety Center (118M), James A. Haley Veterans Hospital, Tampa, FL, USA, (8) Diligent Services, Roselle, IL, USA, (9) Guldmann Inc, Guldmann Inc, Brookline, MA, USA, (10) James A Haley Veterans' Hospital, Patient Safety Research Center, Tampa, FL, USA, (11) Center for Occupational and environmental health American Nurses Association, Silver Spring, MD, USA
Patient transfers and lifting are well documented as causes of nurse injuries, however, protection of nurses from musculoskeletal injuries incurred from lifting and patient transfers have not kept up with the evidence and technology to prevent injury. The work of the National Association of Orthopaedic Nurses (NAON) Safe Patient Handling and Movement taskforce initiative using evidenced based ergonomic principles and patient handling technology to develop algorithms is discussed. This initiative addresses how NAON is working with the American Nurses Association (ANA) and with the James A. Haley Veterans Hospital Patient Safety Center of Inquiry to prevent work related musculoskeletal injuries from orthopaedic high risk tasks. NAON's work provides evidenced based and practical ergonomic methods for safe patient handling of orthopaedic patients to prevent injuries for nurses, patients, and healthcare workers. Input from the NAON membership was sought on specific tasks that orthopaedic nurses perform that could be considered high risk for job related musculoskeletal injury. A list of high risk tasks was identified and five algorithms were developed to promote standardization for decision making in conducting each task. These high risk tasks include: Turning Patient in Bed side to side (Patient with Orthopaedic Impairments);Vertical Transfer of a post-operative Total Hip Replacement Patient; Vertical Transfer of a Patient with a Cast/ Splint on Upper Extremity: Immobilized Arm; Vertical Transfer of a Patient with a Cast/Splint on Lower Extremity : Immobilized Leg; and Ambulation. An explanation of how these tasks can affect orthopaedic nursing and improve practice will be discussed.