Lifting, transferring and repositioning patients manually is dangerous work. It leaves health care professionals vulnerable to disabling musculoskeletal disorders (MSDs) and patients at risk of injuries that can complicate their underlying health problems. A recent bill in the United States House of Representatives aims at reducing the risks. It’s not the first safe patient handling bill in the nation, but if passed, it will have the most far-reaching benefits.

The Ergonomics Report™, a publication for professionals in ergonomics-related disciplines, noted in an article in June that many circumstances can be counted on to complicate the work of handling a patient. They can be very frail, very heavy, combative, uncooperative, unconscious, and loaded down with tubes and devices. The presence of wounds and fractures complicates any move.

The risks can be reduced with the use of safe, secure, mechanical lift equipment and gentle friction-reducing devices for patient maneuvering.

The article pointed out that health care personnel who do not have the benefit of assistive equipment and devices when they are moving patients are often forced by circumstances into the awkward postures and positions that invite back injury. It has been widely observed that this type of injury may be the single largest contributor to the nursing shortage in the United States, with some 12 percent of nurses leaving the profession because of the problem.

On September 26 US Representative John Conyers (D) introduced HR 6182, a bill to amend the Occupational Safety and Health Act of 1970 that aims to establish safer patient handling programs across the United States.

The congressman’s bill is the latest of a string of legislative efforts with the same aim.

On June 17, 2005, Texas Governor Rick Perry (R) signed a law that made Texas the first state in the nation to require hospitals and nursing homes to implement safe patient handling and movement programs. In language similar to Congressman Conyers’ bill, it requires the establishment of policy to identify and develop methods of controlling the risks associated with moving patients, the evaluation of manual lifting alternatives, and the restriction of manual handling to emergency, life-threatening or exceptional circumstances.

In March 2006, Washington State Governor Christine Gregoire (D) signed new legislation, ESHB 1672, requiring hospitals to implement a safe patient handling program. This law became effective June 7, 2006. In addition to mandating the implementation of a safe patient-handling program, the law prescribes a reasonable and well-defined set of equipment requirements.

Anne Hudson, Director of the Work Injured Nurses' Group (WING USA), sends out regular updates on legislative efforts to "halt needless injuries to nursing staff, patients, and residents from hazardous manual patient lifting." She alerts readers to legislation as it passes and as it progresses through legislatures.

In a recent update she reported that Hawaii, Rhode Island, Ohio and New York have also passed legislation pertaining to safe patient handling.

Related legislation was introduced in 2004 in Massachusetts. The bill was defeated, but there are plans to re-introduce safe patient handling legislation into the Massachusetts legislature.

Similar legislation in California was vetoed twice by Governor Arnold Schwarzenegger in 2004 and 2005. Senate Bill 1204 "Patient Safety and Health Care Worker Protection Act" was introduced into the California Senate on January 25, 2006, for a third time. SB 1204 passed the Assembly on August 28, 2006, and passed the Senate on August 31, 2006. The WING USA director reported on October 9 that on September 29 the Governor vetoed it again. He argued that hospitals throughout California have reported progress in implementing lift policies and "that allowing hospitals the flexibility to implement lift policies that meet their individual needs is far more effective than imposing a rigid one-size-fits-all mandate on every hospital in California."

New Jersey, Illinois and Florida have all introduced related legislation this year, but the issue appears to be dead for the moment in Florida.

The WING USA director notes that a key element of the Texas and Washington laws provide for health care workers to refuse to move patients without fear of reprisal if they believe in good faith that the activity would expose themselves or patients to an unacceptable risk of injury. This protection is also included in legislation introduced by several other states and in the Conyers bill.

Sources: WING USA Director Anne Hudson; The Ergonomics Report™