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By the numbers
The Indiana Department of Labor reports injuries and illness incident rates per 100 workers. The most dangerous jobs in 2011, the most recent data available, were in the following industries:
1. Agriculture, forestry, fishing and hunting – 9.5
2. Health care and social assistance – 6.3
3. Manufacturing – 5.2
4. Transportation and warehousing – 4.6
4. State and local government – 4.6
6. Accommodation and food services – 4.5
7. Construction – 3.9
8. Retail trade – 3.7
9. Wholesale trade – 3.6
10. Administrative and (various) services – 3.0
Source: Indiana Department of Labor
At a glance
The injuries and illnesses reported most often by health care workers are:
•Musculoskeletal disorders – sprains, strains and tears most commonly affecting the back, neck and shoulder
•Slip, trip and fall hazards – most often occurring during the handling of patients and during facility cleaning and maintenance
•Workplace violence
•Exposure to blood-borne pathogens and other potentially infectious materials
•Exposure to drug-resistant diseases
•Exposure to tuberculosis
•Exposure to potentially hazardous materials and chemicals
Source: Indiana Department of Labor
Photos by Samuel Hoffman | The Journal Gazette
Physical therapist Zach Beiswanger, left, shows nurses Jodi Romano, right, and Ann Marie Klopsch, on the bed, how to properly move a patient to a sitting position in bed at Lutheran Hospital.

Caregivers most in danger

Health care workers report second-highest rate of workplace injury

Beiswanger shows Romano and Klopsch how to properly lift a patient from bed.

The same people who take care of us when we’re sick are among the workers most in danger of getting hurt on the job.

Health care industry employees reported the second-highest rate of workplace injury and illness – a total of more than 22,000 incidents in 2011 – in the most recent data collected by the Indiana Department of Labor.

Statistics show 6.3 incidents for every 100 health care workers in 2011. Looking back at the decade leading up to that year, the rate has been as high as 8 per 100 workers in 2001 and as low as 5.9 per 100 in 2010.

Health care industry workers are more likely to get hurt on the job than factory or construction workers, according to the data. Among health care workers, the injury and illness rate is highest for those based in hospitals (7.2 per 100 workers) and nursing homes (9.5 per 100).

State officials last month launched a safety initiative aimed at Indiana’s 350,000 health care workers, who sometimes strain their backs trying to lift patients, slip on wet floors or stick themselves with used needles.

Union Hospital in Terre Haute was the first to collaborate with the state on the safety program. The facility has adopted measures that reduced workplace lifting injuries by 43 percent and falls by 38 percent. Work time lost to injuries was decreased by 84 percent, according to hospital officials.

Dr. William VanNess II, Indiana’s health commissioner, said supporting the health and safety of hospital and nursing home workers benefits everyone.

“Health care workers are extremely important to Hoosiers,” he said in a written statement. “Continuing to support safe and healthy working environments for those workers allows Hoosiers to have access to the most qualified health care professionals available, improving the overall health of our state.”

Local health care leaders say they already stress safety with staff but are always willing to learn new tips and tricks to keep their people healthy.

Preaching prevention

Lutheran Hospital hopes its nurses and other caregivers focus on training – rather than straining – when they move patients.

Zachary Beiswanger, a physical therapist, guides new hires at Lutheran Hospital and The Orthopedic Hospital on the proper ways to assist patients. He leads one-hour orientation sessions that staff must attend and pass before working one-on-one with patients.

Parkview Health requires similar training for new staff.

Beiswanger’s message: Don’t put your back into it.

When hospital staff relies on lifting equipment, both workers and patients are better protected from injury, he said.

If a caregiver allows a patient to clasp his hands around her neck for support when getting out of bed, the added weight could strain the caregiver’s neck, shoulders or back, Beiswanger said. Or – possibly worse – the added weight could be too much for the caregiver, sending the patient sprawling onto the hospital bed with the nurse on top of the pile.

Beiswanger trains nurses and other caregivers to help patients succeed in standing from their beds by making sure their feet are directly under them before attempting the feat and pushing off from the bed itself for that extra boost. “Employee safety goes hand-in-hand with patient safety,” he said.

Beiswanger, who also works directly with patients, holds a doctorate in physical therapy. He offers Lutheran staff continuing education on various safety topics, especially ergonomics, the science of designing and arranging things so people interact most efficiently and safely with them.

Reviewing injuries

Parkview Health officials have adopted some simple safety strategies that have paid off, said Diane Casey, operations director for Operational Health, the department that manages employee health for Parkview.

They include investing in mechanical lifts to move patients and slippery sheets to make it easier for staff to help patients sit up higher in bed.

Casey considers staff musculoskeletal strains the hardest to eliminate. Sometimes, she said, patients suddenly lose strength and caregivers don’t have time to use lift equipment to keep the patient from falling.

Parkview’s safety program has addressed issues from head to toe.

Workers – including those in housekeeping and food service – are now required to wear slip-resistant shoes. Crocs – the comfortable slip-ons that gained a loyal following among hospital workers – are strongly discouraged. The clunky plastic shoes are considered trip hazards, Casey said.

Despite those efforts, injuries still happen. When they do, Parkview officials review the incidents and try to identify whether the person, behavior, environment or tool was to blame.

When education is needed to avert a repeat of the incident, workers throughout the health care system receive training, Casey said.

Parkview leaders started using that weekly injury review process in 2009. Since then, Parkview Health’s injury incidence rate has fallen below the state average.

Parkview Hospital Randallia reported 9.5 injuries and illnesses per 100 full-time-equivalent workers for 2011 and 6.2 last year. Parkview Regional Medical Center, which opened March 17, reported 8.5 per 100.Lutheran Hospital in 2011 reported 11.2 injuries and illnesses per 100, an unusually high number for the hospital that typically reports rates between 8.6 and 9.5 per 100. Lutheran’s rate dropped back to 7.7 in 2012.

State assistance

The Indiana Department of Labor is offering health care employers free help that can be divided into three categories, spokeswoman Chetrice Mosley said.

The first focus is providing information, such as posters and signs that can be placed throughout a health care facility. The Labor Department also offers articles that can be printed in workplace newsletters. For those who prefer to go online, there are blog posts and podcasts.

The second state effort is online education and training.

And the third is consultations to help smaller organizations develop safety training, Mosley said. INSafe, a division of the state’s Labor Department, will visit worksites to consult on training plans and follow up to make sure the program is on track.

State officials assure employers that such visits don’t trigger a federal or state Occupational Safety and Health Administration citations or inspections.

Employers who agree to correct serious violations aren’t reported to enforcement agencies.

Looking at the bottom line, workplaces that focus on employee health and safety save money, Mosley said.

Statistics show, she said, that safer workplaces have:

•Less employee turnover

•Fewer OSHA fines

•Fewer workers’ compensation payouts

•Fewer work days lost

•Higher employee morale

•Better community relations

Although Parkview Health already has a safety program in place, Casey said the organization is “absolutely” interested in looking at what the state has to offer to supplement efforts.

“I don’t think there can ever be too many reminders” about safety, she said.

Lutheran Health Network and Parkview Health are committed to becoming High Reliability Organizations.

The method – used by the airline and nuclear energy industries – calls for zero errors as its standard.

Lutheran CEO Joe Dorko uses an unconventional illustration to make his point.

Imagine, he said, that in the space between patient and caregiver are five slices of Swiss cheese. Any time holes in all the slices line up, an accident happens. So staff needs to do everything it can to minimize the size and number of holes, Dorko said.

“We really want to manage the Swiss cheese between the provider and the patient,” he said.

Discussing safety daily, Dorko said, makes it part of corporate culture.