How to do it ... Mitigating worker injuries
1 First, identify your facility's most vulnerable workers.
The most serious and costly staff injuries typically entail repetitive motions, heavy lifting or exposure to aggressive resident behaviors, making nursing assistants the biggest target, says Betsy Hardy, vice president of business development for the American Association of Directors of Nursing Services.
The rate of injury among nursing assistants is similar to the rate among construction workers, police and firefighters, according to 2016 data from the U.S. Bureau of Labor Statistics. Two years ago, skilled nursing facilities became required to submit their workplace injury and illness data to OSHA.
Other positions high on the list for possible injury include dietary aides, housekeeping and laundry workers, says Trey Mullins, senior director, post-acute operations for HealthcareSource.
Peter Corless, executive vice president for OnShift, believes “injuries most often occur when employees ignore policies that require two-person transfers, the use of gait belts or the use of a mechanical lift because they are rushed, short-staffed or simply think that they are strong enough to move a resident on their own.”
2 Attractive safety programs are a major staff retention tool.
Some managers may be surprised to learn that, among all of the other perks that seem to bolster loyalty, showing employees attention and caring go a long way toward creating worker trust.
Gary Johnson, leadership development consultant for Monarch Risk Management, cites a recent Gallup Employee Engagement Survey that found “the leading reason employees call off, show up late, steal, quit or get injured is because they don't feel their supervisor listens to them or even cares about them.”
Efforts such as safe resident handling programs and equipment training clearly signal that the facility genuinely cares about their workers' safety, adds Mullins.
The more regular such efforts are, the better. Mary Madison, RN, a clinical consultant in long-term and senior care for Briggs Healthcare, supports frequent and repeated training on proper body mechanics and how to use assistive devices such as lifts.
Corless strongly urges facilities to adopt “no lift” policies and even market them as part of their staff recruitment program.
3 Establish and maintain a culture of safety.
“Education, accountability, equipment, always doing what's right even when no one is looking” are the key components, says Teresa Remy, DSc, LNHA, BSN, RN, director of consulting for LeaderStat.
A safety culture is high on the list of any worker advocate.
Based on conducting thousands of department safety audits for hospitals, nursing homes and CCRCs and interviewing many thousands of employees who were injured at these healthcare organizations, Joe Caracci, founder of Monarch Risk Management, is one of those advocates.
“I believe the root cause of the majority of preventable injuries in healthcare is the relationship between frontline supervisors and their staff,” he says.
Successful safety cultures are DNA-level ingredients in the best facilities and rooted at the highest level, says Robert Phelan, president and CEO of TriPoint.
4 Reinforce the concept of personal responsibility.
If the lift and the training to operate it are provided and a worker ignores both, that's a major problem.
“Start with a culture of safety on Day One of hire,” Madison says. “Counsel the employee and add that counseling session to their personnel file and follow up at a reasonable point to see if the improper behavior has been corrected. If it has not, reinforce again with consequences. If it happens again, terminate the employee. Facilities cannot risk allowing individuals to work in unsafe manners in their buildings.”
5 Positive reinforcements can go far in ensuring staff buy-in.
Remy and Madison offer a few ideas to keep employee enthusiasm and momentum headed in the right direction. They include a pizza or dessert party to mark injury-free periods; reminder notes about fundamental safety practices in paychecks; annual or quarterly “skill fairs” to brush up on safety; or even modest rewards to employees “caught” performing a task in an exemplary manner.
Most important: Make staff feel they are an integral part of the facility's safety efforts, says Hardy. “Let them be part of the solutions,” she says. “Most of the time I was amazed at the answers I got when I asked the staff for the solution to a safety problem.”
Make it a “personal” issue with everyone, as Corless says.
“Ask your staff, ‘What impact would it have on your family if you were injured?'” he says. “That can have a big impact on getting the message to resonate.”
Mistakes to avoid
Investing in basic safety equipment without proper training. All the high-tech equipment in the world is useless if staff don't know how to use it.
Creating a safety culture sounds like a lot of work, but a facility that makes safety ubiquitous will experience fewer injuries.
Ignoring personal responsibility. Staff must be constantly reminded of the role they play in ensuring a safe workplace.