March 12, 2004

Campaign to reduce work-related injuries among nurses at VUMC underway; addresses bariatric patients’ needs

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Vanderbilt University Medical Center now leases larger wheelchairs, right, to accommodate bariatric patients. A standard-size wheelchair is pictured on the left. Photo by Dana Johnson

Campaign to reduce work-related injuries among nurses at VUMC underway; addresses bariatric patients’ needs

Several new initiatives are in the works to address the safety and wellness of nurses working at Vanderbilt University Medical Center, in an effort to reduce the increasing number of work-related injuries from lifting patients.

Melanie Swift, M.D., medical director of Vanderbilt’s Occupational Health Clinic said the Medical Center sees the greatest number of work-related injuries with the most significant impact from back injuries suffered by nurses who are lifting and physically moving patients.

“A back injury can take them out of the job and put them on work restrictions,” said Swift. “Back injuries are the single most devastating in terms of suffering, lost time and lost productivity of any injury we have,” she added.

Swift said that last year, the Medical Center saw 172 nursing musculoskeletal injuries, up from 130 cases the previous year — about three new cases a week. She said the vast majority of those injuries were from lifting patients. For this reason, the Bureau of Labor has found nursing to be among the most dangerous of professions —more dangerous than both construction and farming.

The increase in nursing work-related injuries comes just as the profession is struggling with a nationwide shortage and an aging workforce.

“They get older and more skilled, but physically they become more vulnerable,” said Swift.

Yet nurses are facing more physical demands as the patient population changes. Kelly Wright, M.D., associate professor of Surgery, said there has been a steady increase in morbidly obese patients, also called bariatric patients, over the years.

“There is an epidemic as a nation; it’s been growing significantly since post World War II era. Currently, more than half of the population in the U.S. is obese and the incidence of morbid obesity population is rising as well,” Wright said. “As the general population develops a problem, we in health care need to be able to address it,” Wright said.

Swift said that is exactly what several groups within the Medical Center are trying to do. The Occupational Health Clinic, with the support of Nursing Administration, has spearheaded a campaign called Smooth Moves, to help provide the nursing staff with the tools they need to lift patients safely and help prevent injuries among nurses and patients.

“The growth in bariatric patients combined with an aging nurse workforce has brought forth this issue of how we can better meet bariatric patients’ needs,” Swift said. But she’s quick to point out that work-related injuries stem from lifting all patients, not just bariatric patients. “They occur from handling every kind of patient. Even a 120-pound elderly woman is difficult to lift,” Swift said.

The campaign involves members of Nursing Administration, Occupational Health, an ergonomic specialist, Health Plus, Risk Management, The Learning Center, the Nurse Wellness Task Force, Finance, Purchasing, Safety, and several other areas within the Medical Center. The group has been meeting every month for the last year to learn what the various nursing units are currently doing to address the issue and begin to focus on how they can make improvements. The first goal is to purchase new equipment to help nurses and care partners lift patients safely.

“Every unit’s needs are a little different, so we proposed to select vendors with a variety of equipment and allow units to select what they need based on a set equipment budget,” said Swift.

The items being considered for purchase include inflatable mats that can help move patients to and from beds and operating tables, electronic portable lifts, friction reducing devices like special sliding sheets and mats to help move a patient in the desired direction, and a gait belt that is strapped around the waist of a patient. One type of belt is designed with two handles that allow the nurse to grab the belt if a patient loses his or her balance and begins to fall.

Swift said hospital administration is currently reviewing budgets for the next fiscal year to determine how much will be spent on purchasing some of this new equipment, but she hopes to have some new tools in some of the units and begin a training program by this summer.

Bariatric patients’ needs addressed

In the meantime, another group within the Medical Center has formed to address current equipment needs to provide the best care for bariatric patients at VUMC.

Recently, the Bariatric Steering Committee, spearheaded by Robin Mutz, Administrative Director, Women’s and General Surgery Patient Care Centers, and Carolyn Watts, clinical nurse specialist, organized the leasing of equipment designed for bariatric patients that will accommodate two rooms in the Medical Center. The equipment includes a bariatric bed, a bedside commode that doubles as a shower chair, a larger wheelchair, walker, and lifting device.

“We store the equipment to accommodate two rooms at all times, and can order additional equipment as needed, and when a bariatric patient checks into the hospital the equipment can be immediately ordered,” said Mutz.

Susan Williams, who is a certified registered nurse and manager of Patient Care Services, General Surgery, Adult Step-down, Adult IV Therapy on 9 North, said the new equipment is constantly in use and is making a difference.

“It’s wonderful for our patients and our staff. It’s sometimes difficult to get, and we’re quickly realizing that two suites might not be enough, but it’s such a wonderful support,” Williams said.

Currently the equipment to accommodate the two rooms is rented by VUMC from an outside source. Mutz says the decision was made to rent the equipment for one year to get a better idea exactly what they need to order based on the number of patients treated each year. She says until the recent implementation of Star Panel, a patient’s weight was not recorded and a true database of how many bariatric patients VUMC serves did not exist.

The members of the Smooth Moves campaign and the Bariatric Steering Committee say they plan to work together over the coming months to decide what each unit needs and how best to meet the needs of patients.