Healthcare workers top injury and illnesses list
Healthcare more dangerous than mining, construction
Their jobs revolve around helping people recover from injuries and illnesses, yet healthcare workers have the highest risk for injury themselves, surpassing nearly every industry-including mining, manufacturing, and construction.
According to a report released by the U.S. Bureau of Labor and Statistics on workplace injuries and illnesses in 2010, healthcare workers experienced an injury/illness incidence rate of 5.2 out of every 100 full-time workers, a number well ahead of the private construction sector (4.0), manufacturing (4.4), and natural resources and mining (3.7).
Specifically, healthcare injuries were broken down into the following sectors-out of these, nursing homes led the way in injuries:
- Ambulatory healthcare services: 2.8
- Hospitals: 7.0
- Nursing and residential care facilities: 8.3
The reason for these elevated statistics is because in addition to some of the general musculoskeletal issues that almost every industry faces, healthcare also has to deal with unique hazards like needlesticks, says Bruce Cunha, RN, MS, COHN-S, manager of employee health and safety at Marshfield (WI) Clinic.
"We are as dangerous as any industry out there," Cunha says, "plus we have things they don't have. We have biological agents, we have bloodborne pathogens, we have radiation, and we have lasers. And then we have back injuries just like everyone else with lifting, pushing, and pulling."
Differentiating healthcare injuries
As Cunha points out, healthcare injures can be categorized into several distinct groups, including bloodborne pathogen exposures; chemical exposures; slips, trips, and falls; and back injuries. Below are some common issues safety officers face:
- Needlesticks. The Bureau of Labor and Statistics doesn't break down injuries according to type, but Cunha says injuries such as needlesticks are likely to elevate the healthcare worker injury rate above other industries. OSHA estimates there are roughly 800,000 needlestick injuries each year.
Although OSHA's Needlestick and Safety Prevention Act has helped drastically reduce the number of injuries, Cunha says operating rooms still face the biggest uphill battle. OSHA recommendations call for surgeons to use blunted suture needles, but they can only be used in certain situations, and safety scalpels don't always offer the precision of regular scalpels.
For general exposure protection measures, safety officers need to be involved with purchasing safety needles that are effective and easy to use. Employees should be trained on how to use safety needles to reduce the risk for a sharps injury.
- Back injuries. Musculoskeletal injuries are a big issue in healthcare facilities, especially among nurses and aides who frequently need to push, pull, or turn heavy patients. Cunha says many hospitals have instituted team lifting programs or purchased devices to help with lifting, but injuries still occur because employees are often too busy to employ proper methods.
Cunha says Marshfield has a high rate of knee and back injuries thanks to employees pushing heavy patients in wheelchairs. "Nobody worried about pushing 500-pound patients five or 10 years ago," Cunha says. "Now it's not unusual at all for hospitals to have patients that are over 300 pounds."
- Slips, trips, and falls. While there is always the risk that employees will be injured inside the facility by slipping on a wet surface or tripping over equipment, Cunha says most of the injuries at Marshfield Clinic occur while going to and from the parking lot. Outdoor areas are particularly precarious during the winter months in Wisconsin, which bring heavy snowfall and create icy sidewalks, entrances, and parking lots.
Hospitals in regions affected by ice and snow should have a plan for sufficiently clearing pathways during winter storms and have the appropriate equipment (salt, shovels, and plows) to prevent falls outside the building.
Make it easy
In general, healthcare workers are aware of the risks they face during their job every day. However, problems arise when competing interests take priority over safety.
To avoid the pitfalls of human nature and higher priorities, Cunha says safety officers need to incorporate safety measures seamlessly into everyday tasks. As an example of how not to do things, he points to the U.S. Postal Service, which required reeducation for injured workers on proper lifting techniques.
"A researcher came in and looked at the results of that training and found they had highly educated injured employees," Cunha says. "The retraining didn't necessarily reduce the amount of injuries."
The trick is to integrate safety measures into workers' routines so they don't need to take more time during a procedure to actively think about safety.
Putting safety on the shoulders of leadership
If there's one group to blame for the high rate of healthcare worker injuries, it's hospital leadership, says Paul O'Neill, non-executive chair of Value Capture, LLC, in Pittsburgh and former secretary of the U.S. Treasury and CEO of Alcoa.
After the statistics were released, O'Neill publicly singled out healthcare leadership, particularly at the University of Pittsburgh Medical Center (UPMC), which employs 54,000 workers.
Unfortunately, the leadership at UPMC is not unique, he says; in fact, it serves as a snapshot of most medical facilities in the country.
"For me, the reason the injury rates are so high in healthcare is because as a general matter, the people who are in charge of health and medical facilities don't really care about their people," O'Neill says. "Because if they did, they would learn from the activity of other organizations that it's possible to have an injury-free workplace, and they would make that a precondition for their work."
O'Neill says leaders need to set aggressive goals for their organization, starting with the objective that no one should get hurt on the job. Then they should back up those objectives with a systematic action plan that would improve and eliminate workplace injuries.
He points to Cincinnati Children's Hospital, which publishes its injury rates online-rates significantly lower than other hospitals. The hospital did this in part by teaming with Celanese, a chemical company with a history of excellent worker safety. Celanese was able to show the healthcare system ways to virtually eliminate injuries by adopting some of the safety principles from the chemical and manufacturing industry.
One issue O'Neill sees as a detriment to worker safety is that hospitals focus too much on small projects devoted to one particular area, rather than focusing on an overarching system of excellence.
"There has been an even more concentrated level of attention paid to certain kinds of hospital-acquired infections-for example, central line-associated bloodstream infections," he says. "That's all wonderful, but if those project efforts to concentrate on a particular activity exist in an institution that aside from those projects is not habitually excellent, then that will creep back into the project areas as soon as people stop paying attention."
The ultimate goal is to improve safety processes until they are second nature, O'Neill says. Worker safety should be an automatic focus rather than a small concentrated project.
"That's what's wrong with healthcare," he says. "[Leaders] don't really change the system. They just do projects and congratulate themselves and then revert back to where they were."
Safety initiatives have to come from the top down, O'Neill says-meaning healthcare leaders need to change the way they think about and approach safety in their institution.
"You cannot cause what needs to be done to happen from the bottom up," he says. "This needs to begin with leadership or it doesn't ever begin. If the leaders don't call out the need and facilitate the creation of systems of continuous learning and continuous improvement, then it's just a life of projects that have a shooting-star mentality; it gets results, but they don't last."