Introduction
Mr. Chairman and Members of the Committee
Thank you for granting me this great opportunity to testify before you at this important hearing concerning the legislation H.R. 2381. In this era of advanced technology and patient awareness, patient safety continues to play an important role in the overall performance of healthcare organizations. The H.R. 2381 is a bill that will ensure that:
- Patients are provided safer healthcare by minimizing injuries and death arising from improper handling during transfer, repositioning or lifting
- The injuries suffered by direct-care nurses and other health workers during the manual handling of patients are minimized
- Total protection of direct-care nurses and other health workers from their employers of provided to ensure the upholding of the patient safety standards
- Health care facilities that are in need of safe handling equipment and devices receive them through appropriations of funds
Legislation Background
Background information
The H.R. 2381 is a proposed bill that seeks to direct the Secretary of Labor to issue a standard for occupational safety and health that will minimize the injuries suffered by patients and healthcare workers. This objective can only be achieved through the establishment of a safe patient handling and injury prevention standard (H.R. 2381, 2009). The need for the safe patient handling and injury prevention standard arose when the Congress conducted a research on patient safety and found that:
- Direct-care registered nurses and other healthcare workers suffer from numerous musculoskeletal disorders majority of which arise during the handling of patients.
- Healthcare organizations suffer from a severe shortage of nurses as a result of the physically demanding nature of the profession which discourage many nurses from continuing with it
- Patients do not enjoy optimal safety when handling them either by lifting, transferring or repositioning them. Lack of safety during the handling process causes patients to suffer from injuries that could easily be prevented
- The use of handling technologies, equipment and devices has made the manual handling irrelevant
- An increasing number of healthcare organizations continue to adopt technologies for handling patients and the use of these technologies has significantly reduced the number of injuries suffered by patients and nurses
- The establishment of a safe patient handling and injury prevention standard would protect patients as well as health care workers from injuries. The standard would also help to tackle the severe nursing shortage that is currently faced by many healthcare facilities
The Need for the Safe Patient Handling and Injury Prevention Standard
Based on the Congress’ findings, the H.R. 2381 was introduced by Mr. Conyers and Ms. Woolsey on May 13, 2009. The successful passage of the bill would ensure that:
- Patients are provided safer healthcare by minimizing injuries and death arising from improper handling during transfer, repositioning or lifting and that the injuries suffered by direct-care nurses and other health workers during the manual handling of patients are minimized
These two objectives will be achieved through several ways. First, through the development and implementation of a safe patient handling and injury prevention plan by health care organizations within a span of 6 months. The plan will address the identification of hazards, the evaluation of risks, and control measures concerning patient care. The second means is through the purchase, utilization, maintenance and accessibility of sufficient number of patient handling equipment by healthcare organizations. Third, healthcare organizations will be required to involve the registered nurses and other health workers in the design and implementation of the safe patient handling and injury prevention plans. Fourth, the bill will mandate healthcare facilities to institute data management systems which will track and assess trends in the injuries suffered by patients or health workers during patient handling. The data and analysis will be made available to all health workers so as to minimize future similar incidents.
According to a research study conducted by Nelson, Matz, Chen, Siddharthan, Lloyd and Fragala (2006), it was reported that nurses suffer one of the highest rates of work-related injuries. Efforts to minimize the frequency of work-related injuries by healthcare organizations over the last three decades have mostly been futile. However, the adoption of technical lifting devices by healthcare organizations can have a significant impact on: the reduction of injuries suffered by patients during transfer, lifting or repositioning; the reduction of the frequency of injuries suffered by direct-care registered nurses and other health workers during the lifting and movement of patients; the reduction of the number of days spent away from work as a result of work-related injuries; and on the overall increase in the level of job satisfaction among direct-care registered nurses and other health workers (Nelson et al., 2006).
- Total protection of direct-care nurses and other health workers from their employers of provided to ensure the upholding of the patient safety standards.
The bill will grant direct-care registered nurses and other health workers protection from their employers in cases that involve:
Refusal of work – health workers will be protected if they refuse to undertake a work assignment that is likely to violate the safe patient handling and injury prevention standard or if the health worker lacks training in the work assigned to him/her.
Retaliation for refusal of lifting assignment barred – health workers will be protected from grave actions by the employers if they refuse to act in a manner that would compromise the safety of the patients.
Report of violation of the Act – health workers will be protected from their employers when they report any actual or potential violation of the Act by the healthcare facility (H.R. 2381).
- Health care facilities that are in need of safe handling equipment and devices receive them through appropriations of funds.
The Act will ensure the establishment of a grant program which will offer financial assistance to healthcare facilities that need to buy safe patient handling equipment but lack the financial resources to do so. Nevertheless, healthcare facilities will be required to demonstrate the requirement of such equipment as well as the financial need.
Implications of the Legislation for Nursing Practice
The passing of the Nurse and Health Care Worker Protection Act (2009) will have several implications for nursing practice.
Safer healthcare for patients
The legislation will ensure that patients are handled in a safe manner and thus the care received is of high quality. This will be achieved by the utilization of lifting devices that will replace the manual method that is currently used in most healthcare facilities.
Safer working environment for direct-care registered nurses and other health workers
The use of technical lifting devices as mandated by the legislation will reduce the burden placed on nurses and other health workers during the manual lifting, transfer or repositioning of patients. As a result, the number and severity of injuries suffered by the health workers during the process will be minimized. Secondly, a safer working environment for health workers will be ensured through the protection provided to them from any adverse action taken against them by the employers in their faithful course of duty.
Efficient provision of safe patient care
The legislation will guarantee that all healthcare facilities purchase and utilize patient handling equipment. The use of such equipment will reduce the number of health workers needed to lift, move, or reposition a patient. The equipment will also reduce the amount of time needed to move one patient. As a result, health workers will have more time to concentrate on other patients or tasks thus saving a lot of time currently spent on the handling patients (Nelson et al., 2006). Healthcare organizations will thus become more efficient in the provision of patient care.
Improved job satisfaction among health workers
The use of patient handling equipment will definitely reduce the burden and strain placed on direct-care registered nurses and other health workers. This, coupled with the protection guaranteed by the Act, will lead to enhanced job satisfaction among the health workers. In the long-term, the Act will to some extent help in addressing the problem of nursing shortages currently faced by healthcare facilities (Nelson et al., 2006).
Chairman and members of committee, after analyzing the facts and evidence presented in this hearing, I hope you will find it in your heart to act in support of the legislation so that patients can receive safer healthcare and health workers can be protected from injuries and adverse actions from their employers.
Conclusion
Once again I would like to thank you for the opportunity you have granted me to testify before you. If you have any questions please do not hesitate to ask. You can also contact me any time and any day. Be assured that all your issues and concerns will be addressed promptly.
References
Nelson, A., Matz, M., Chen, F., Siddharthan, K., Lloyd, J., & Fragala, G. (2006). Development and evaluation of a multifaceted ergonomics program to prevent injuries associated with patient handling tasks. International Journal of Nursing Studies, 43(6), 717-33.
Nurse and Health Care Worker Protection Act of 2009, H.R. 2381, 111th Cong., 1st Sess.