Development of Evidence-Based Algorithms for Safe Patient Handling of Orthopaedic Patients

Monday, 7 July 2008: 1:15 PM
Carol A. Sedlak, PhD, RN, CNS, ONC, CNE , Nursing, Kent State University, Kent, OH
Margaret A. Doheny, PhD, RN, CNS, ONC, CNE , Nursing, Kent State University, Kent, OH
Cynthia Gonzalez, MSN, RN, OCNS-C, APN , Weiss Memorial Hospital, Skokie, IL
Cynthia Howe, MSN, RN, ONC , City Hospital Martinsburg, Martinsburg, WV
Miki Patterson, PhD, NP, ONC , UMass Memorial Trauma Center, Worcester, MA
Audrey Nelson, PhD, RN, FAAN , Patient Safety Center of Inquiry, Tampa, FL
Thomas Waters, PhD, CPE , Division of Applied Research and Technology, Cincinnati, OH
Mary Matz, MSPH , Patient Safety Center of Inquiry, Tampa, FL
Andrea Baptiste, MA, (OT, ), CIE , Patient Safety Center (118M), James A. Haley Veterans Hospital, Tampa, FL
Stephanie Radawiec, MHS, PT , Diligent Services, Roselle, IL
Patricia Mechan, PT, MPH, CCS , Guldmann Inc, Guldmann Inc, Brookline, MA
Valerie Kelleher, AA , James A. Haley Veterans Hospital, Tampa, FL
John Lloyd, PhD, CPE , James A Haley Veterans' Hospital, Patient Safety Research Center, Tampa, FL
Nancy Hughes, MS, RN , Center for Occupational and environmental health American Nurses Association, Silver Spring, MD

Learning Objective 1: describe key components of evidence based algorithms for safe patient handling of orthopaedic patients

Learning Objective 2: explain how the use of the safe patient handling algorithms can improve orthopaedic nursing care and improve practice

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.