Workers' compensation costs for healthcare caregivers: Home healthcare, long-term care, and hospital nurses and nursing aides

The Safe Home Care Intervention Study: Implementation Methods and Effectiveness Evaluation

Home care (HC) aides experience numerous safety hazards in clients' homes; many hazards also put clients at risk. We hypothesized that safety coaching led by nurse managers (NMs) during their initial HC needs assessment could prompt clients to improve safety conditions in their homes. Following a 2-arm proof-of-concept intervention study design, intervention NMs used motivational interviewing (MI), facilitated by a safety handbook and video, to coach clients on home safety improvements. Control arm NMs performed intake assessments with no changes to usual practices. Intervention effectiveness was assessed by NMs and aides. Three HC agencies and two elder services contributed 35 intervention and 23 control homes. NMs coached 97% of clients and reported that 94% were engaged; 63% implemented improvements. NMs' and aides' assessments were consistent; homes with clients reported by NMs as resistant to safety changes had higher aides' hazard scores. Client coaching can be effective for improving HC safety.

Using Digital Human Modelling to Evaluate the Risk of Musculoskeletal Injury for Workers in the Healthcare Industry

BACKGROUND

Hospital nurses and caregivers are reported to have the highest number of workplace injuries every year, which directly leads to missed days of work, a large amount of compensation costs, and staff shortage issues in the healthcare industry. Hence, this research study provides a new technique to evaluate the risk of injuries for healthcare workers using a combination of unobtrusive wearable devices and digital human technology. The seamless integration of JACK Siemens software and the Xsens motion tracking system was used to determine awkward postures adopted for patient transfer tasks. This technique allows for continuous monitoring of the healthcare worker's movement which can be obtained in the field.

METHODS

Thirty-three participants underwent two common tasks: moving a patient manikin from a lying position to a sitting position in bed and transferring the manikin from a bed to a wheelchair. By identifying, in these daily repetitive patient-transfer tasks, potential inappropriate postures that can be conducive to excessive load on the lumbar spine, a real-time monitoring process can be devised to adjust them, accounting for the effect of fatigue. Experimental Result: From the results, we identified a significant difference in spinal forces exerted on the lower back between genders at different operational heights. Additionally, we revealed the main anthropometric variables (e.g., trunk and hip motions) that are having a large impact on potential lower back injury.

CONCLUSIONS

These results will lead to implementation of training techniques and improvements in working environment design to effectively reduce the number of healthcare workers experiencing lower back pain, which can be conducive to fewer workers leaving the healthcare industry, better patient satisfaction and reduction of healthcare costs.

Healthcare worker choice and low back force between self-chosen and highest bed height when boosting a patient up in bed

Healthcare workers have a high rate of low back injury due to patient handling tasks. These workers receive training in patient handling methods such as adjusting bed height, but often ignore them. In this study, 35 healthcare workers completed patient boosts at a self-chosen bed height and again with the bed in a higher standardised position. Motion capture and force data were collected for analysis. Given the choice, less than half of participants adjusted the bed at all and none of them moved the bed to the highest position (99.1 cm). The self-chosen bed position yielded significantly higher low back force than the higher position at L4-L5 and L5-S1 (p = 0.02, p = 0.01 respectively). Low back forces can be reduced by raising the bed prior to engaging in patient handling tasks, which is a simple step that can reduce forces placed on healthcare workers' low backs. Practitioner summary: Healthcare workers experience high rates of low back pain secondary to patient handling tasks. In this cross-sectional crossover study, healthcare workers consistently chose a low bed height when boosting a patient, which resulted in higher low back loads compared to the highest bed height.

An Examination of Washington State Workers’ Compensation Claims for Home-Based Health Care Workers, 2006 to 2016: Part 2. Injury Rates and Trends

Research of home-based health care (HBHC) has shown that care providers suffer from a high rate of injuries. Analysis of workers’ compensation records, a reliable source for injury and illness data, enables the identification of trends within a specific working population. HBHC workers’ compensation compensable claims in Washington State from 2006 to 2016 were compared to clinical health care (CHC) claims. Injury event and source attributed to HBHC claims were also analyzed, with a focus on work-related musculoskeletal disorders (WMSDs). Though CHC had 5 times the number of full-time employees during the study period, HBHC grew by 61.1%, compared to 28.7% in CHC. Claim rates for all compensable claims and WMSD claims consistently decreased year-over-year for both HBHC and CHC. WMSD claims experienced a year-over-year decline of 5.3%; for all compensable claims the decline was 4.5%. Analysis of HBHC claim rates by injury event found WMSD had the highest rates, followed by falls from the same level. However, the largest annual change was for the injury event overexertion (−10.1%, 95%CI: −13.4, −6.8). HBHC injuries attributable to the health care patient were the most common. Claims with this injury source declined annually by 6.0%. Claim rates for injuries to the back region, and specifically back WMSDs, were consistently higher year-over-year compared to other body regions and WMSD types. Claims for injuries to the back declined by an annual rate of 6.6% (95% CI: −7.9, −5.3), while back WMSD claims decreased by 6.4% (94% CI: −7.8, −4.9).