WING USA Legislative Update on Safe Patient Handling


WING USA Legislative Update March 22, 2009
National Bill for Safe Patient Handling to be Reintroduced

Great news, Friends! The office of U.S. Representative John Conyers, Jr., (Democrat, Michigan District 14) reports that the national bill for the safe handling of healthcare patients and residents is to be re-introduced.

hondrocreamFormerly known as HR 378, “Nurse and Patient Safety and Protection Act,” the new bill will have a different number, and will likely have a different title. Following discussions among key stake holders on changes in wording from the previous bill, the new bill for safe patient handling is expected to be introduced within a matter of weeks.
Though wording of the new bill is not yet known, it is hoped that this new bill will help bring America into the modern era of safety with patient handling by transferring hazardous loads from the backs of healthcare workers to modern patient lifting equipment.

For more information, or to express support of the new bill for safe patient handling which is to be introduced, contact Representative Conyers’ Legislative Assistant on Health Policy, Mr. Joel Segal, at (202) 225-5126 or Joel.Segal@mail.house.gov.

Legislators who wish to co-sponsor the anticipated new bill for the safe handling of patients and residents should call Representative Conyers at (202) 225-5126. Representative Conyers’ email is John.Conyers@mail.house.gov.

Anne Hudson, RN, BSN
March 22, 2009
Founder, Work Injured Nurses’ Group USA (WING USA)
Coos Bay, Oregon
anne@wingusa.org
www.wingusa.org


October 4, 2008

Dear WING USA friends,

WING USA Legislative Update 10-4-08:
Governor Schwarzenegger Vetoes Safe Patient Handling for the Fifth Time

On September 28, 2008, for the fifth time in as many years, Governor Arnold Schwarzenegger vetoed legislation for the safe handling of healthcare patients in California. See within below for Governor Schwarzenegger’s veto message of Senate Bill 1151, Hospitals: lift teams, “Hospital Patient and Health Care Worker Injury Protection Act.” Every year since 2004, Governor Schwarzenegger has vetoed legislation which would protect hospital patients and nurses and other healthcare workers from needless injuries directly caused by manual lifting and moving.

CA SB 1151 cites U.S. Bureau of Labor Statistics 2006 data with California leading the nation in work-related musculoskeletal disorders. With nurses aging at the same time that patient acuity and obesity are rising, SB 1151 states, “It is imperative that we protect our registered nurses and other health care workers from injury, and provide patients with safe and appropriate care.”

SB 1151 continues to say, “At a cost of between forty thousand dollars ($40,000) and sixty thousand dollars ($60,000) to train and orient each new nurse, preventing turnover from injuries will save hospitals money.”

Though the nurse shortage continues, and preventing injuries is proven to save money, Governor Schwarzenegger’s veto means that California nurses and other healthcare workers may still be required to lift back-breaking loads which can lead to devastating injuries and disabilities. And, California patients remain vulnerable to needless injuries which sometimes occur with manual lifting and moving, including pain, bruising, skin tears and abrasions, dislodgement of tubes, dislocations, fractures, being dropped, and other injuries.

Where safe patient lifting equipment is not available, healthcare workers are obligated to lift manually if dependent patients are to be moved at all. Injuries from placing such hazardous loads on the backs of nursing staff cannot rightfully be called “accidents” but are the predictable outcome of lifting dangerous amounts of weight in awkward postures. Such lifting has been proven to cause microfractures by exceeding tolerance limits of spinal structures. “None of the [manual patient] lifting techniques would be considered safe.” (William S. Marras et al. 1999. “A Comprehensive Analysis of Low-Back Disorder Risk and Spinal Loading During the Transferring and Repositioning of Patients Using Different Techniques.” Ergonomics. 42(7), 915).

From SB 1151 Bill Analysis, Senate Committee on Labor and Industrial Relations, date of hearing March 26, 2008, at http://info.sen.ca.gov/pub/07-08/bill/sen/sb_1151-1200/sb_1151_cfa_20080325_110047_sen_comm.html:

SUPPORT for SB 1151:

California Nurses Association (CNA) - Sponsor

American Federation of State, County and Municipal Employees, AFL-CIO

California Applicants' Attorneys Association (CAAA)

California Labor Federation, AFL-CIO

United Nurses Association of California/Union of Health Care Professionals (UNAC/UHCP)

OPPOSITION against SB 1151:

California Hospital Association (CHA)

From the same website, wording from the governor’s veto messages over the past five years:

Governor Schwarzenegger’s SPH veto messages 2004 to 2008:

September 22, 2004, AB 2532 (Hancock) vetoed. AB 2532 would have required general acute care hospitals, except rural ones, to provide lift teams to assist healthcare workers with patient lifting. Governor Schwarzenegger’s veto message stated, "Because I am concerned about the financial burden hospitals are already under, I cannot support the costly mandate imposed on them by AB 2532."

September 29, 2005, SB 363 (Perata) vetoed. SB 363 would have required general acute care hospitals, except rural ones, to provide lift teams to assist healthcare workers with patient lifting. Governor Schwarzenegger’s veto message stated that the bill, "imposes a one-size-fits-all mandate on hospitals to establish a zero lift policy requiring teams and the use of equipment to lift patients.” And, “If hospitals do not initiate these measures on their own, I will consider legislation next year that imposes the mandate."

September 29, 2006, SB 1204 (Perata) vetoed. SB 1204 would have required general acute care hospitals to establish a health care worker back injury prevention plan. Governor Schwarzenegger’s veto message stated, "Since my veto message of last year, hospitals of all sizes from throughout the state have reported on progress made in implementing lift policies. I applaud their efforts and encourage the continued development of these policies. I believe this is proof that allowing hospitals the flexibility to implement lift policies that meet their individual needs is far more effective than imposing a rigid one-size-fits-all mandate on every hospital in California."

October 13, 2007, SB 171 (Perata) vetoed. SB 171 would have required acute care hospitals to establish a patient protection and health care worker back injury prevention plan. Governor Schwarzenegger’s veto message stated, "This bill, which imposes a one-size fits all mandate on hospitals to establish a ‘zero lift’ patient handling policy, is similar to measures I have vetoed the last three years. While I continue to support the goal of reducing workplace injuries, I remain convinced that this inflexible mandate is a poor alternative to giving hospitals the flexibility needed to achieve this goal in the manner that most efficiently addresses each hospital's needs and resources."

September 28, 2008, SB 1151 (Perata) vetoed. SB 115 would have required general acute care hospitals “to use lift teams or lift, repositioning, and transfer devices when there is a risk of injury to a patient or a health care worker, except in emergency situations.” “A safe patient handling policy does not require the use of patient lift, repositioning, or transfer devices if the individual hospital’s own needs assessment indicates that it is safe for the patient and the employee to utilize techniques not requiring the use of those devices.”

SB 1151 veto message:
http://gov.ca.gov/pdf/press/SB_1151_Perata_Veto_Message.pdf.

“To the Members of the California State Senate:

”I am returning Senate Bill 1151 without my signature.

“This bill would require all general acute care hospitals to adopt, as part of their Injury and Illness Prevention Programs, a patient protection and health care worker back injury prevention plan that includes a ‘safe patient handling policy.’

“SB 1151 is similar to measures that I have vetoed over the last four years. This bill is unnecessary as current laws and regulations are in place to address the workplace health and safety needs of health care workers. Existing statutes are flexible and allow employers to exercise discretion in determining what combination of lift teams and equipment is necessary to have an effective Injury and Illness Prevention Program.

“For these reasons, I am returning this bill without my signature.

“Sincerely,

“Arnold Schwarzenegger”

SB 1151: Links to wording and complete history. The veto message should also be added soon through the “Veto Message” link: http://www.leginfo.ca.gov/cgi-bin/postquery?bill_number=sb_1151&sess=CUR&house=B&search_type=email.

Governor Schwarzenegger says safe patient handling legislation is unnecessary, that current law and regulations address the safety needs of healthcare workers, and that flexible statutes allow employers to determine what they need for injury prevention.

With healthcare workers remaining among top occupations in the nation for work-related musculoskeletal injuries, it is clear that volunteerism by the healthcare industry to adequately protect against lifting injuries has not worked on a large scale.

Onward we go in the national struggle for nearly 18,000 nursing homes and 6,000 hospitals to implement effective protection for healthcare workers and patients and residents against preventable injuries caused by manual lifting and moving.

Best wishes to all…Anne

Anne Hudson, RN, BSN
October 4, 2008
Founder, Work Injured Nurses’ Group USA
Coos Bay, Oregon
anne@wingusa.org
www.wingusa.org


September 26, 2008

Dear WING USA friends,

Legislative Update on Safe Patient Handling September 26, 2008
HR 378 Nurse and Patient Safety and Protection Act Remains in Committee


The national bill HR 378 “Nurse and Patient Safety and Protection Act of 2007” remains in committee. The bill for safe patient handling was originally introduced two years ago on September 26, 2006, as HR 6182 “Nurse and Patient Safety and Protection Act of 2006,” by U.S. Representative John Conyers, Jr., Democrat, Michigan District 14, calling for an amendment of the Occupational Safety and Health Act of 1970 to reduce injuries to patients, nurses, and other health care providers with a safe patient handling standard.

Representative John Conyers, Jr., re-introduced the bill as HR 378 “Nurse and Patient Safety and Protection Act of 2007” on January 10, 2007. HR 378 would "direct the Secretary of Labor to issue an occupational safety and health standard to reduce injuries to patients, direct-care registered nurses, and other health care providers by establishing a safe patient handling standard."

If HR 378 is successful, a Federal Safe Patient Handling Standard, calling for “all health care facilities” to comply, will be enacted “to prevent musculoskeletal disorders for direct-care registered nurses and other health care providers working in health care facilities. This standard shall require the elimination of manual lifting of patients by direct-care registered nurses and other health care providers, through the use of mechanical devices, except during a declared state of emergency.”

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The last action on HR 378 was over a year ago. HR 378 was referred on May 9, 2007, by two House Committees, the Committee on Education and Labor and the Committee on Workforce Protections, to the House Subcommittee on Workforce Protections. As of this date, September 26, 2008, HR 378 remains in the Subcommittee on Workforce Protections where it has not yet had a hearing, and no hearing is scheduled.

There is one co-sponsor to date of the Nurse and Patient Safety and Protection Act. On June 3, 2008, U.S. Representative Joe Sestak, Democrat, Pennsylvania District 7, (202) 225-2011, joined Representative John Conyers, Jr., to co-sponsor HR 378 for the protection of healthcare workers and dependent persons in their care against devastating injuries directly caused by manual patient lifting..

From a call this date, September 26, 2008, to the House Education and Labor Committee office, (202) 225-3725, the Subcommittee on Workforce Protections has not acted on HR 378. And, with Congress looking to adjourn for this session, the Nurse and Patient Safety and Protection Act is not likely to be acted on this year. The date for Congress to re-convene will be per call of the Chair.

Legislators wanting to co-sponsor HR 378 Nurse and Patient Safety and Protection Act, or others wishing to express support, can contact Representative John Conyers, Jr., (202) 225-5126, John.Conyers@mail.house.gov, and Mr. Joel Segal, Legislative Assistant on Health Policy, (202) 225-5126, Joel.Segal@mail.house.gov.

For links to the status, complete history, and text of HR 378, go to http://thomas.loc.gov.

California Legislature Passes Safe Patient Handling Fifth Time –
Will Governor Schwarzenegger Sign or Veto, Again?


Legislation for the safe handling of patients in California is on the desk of Governor Arnold Schwarzenegger – again. For the fifth year in a row, the California State Legislature has passed legislation to protect patients and healthcare workers from painful injuries caused by lifting and moving dependent persons. But, every year, for the past four years, Governor Schwarzenegger has chosen to veto. The question is whether he will sign the fifth time around in 2008.

California Senate Bill 1151, Hospitals: lift teams, “Hospital Patient and Health Care Worker Injury Protection Act,” was introduced on February 6, 2008, by Senator Don Perata, Democrat, (510) 286-1333, Senator.Perata@sen.ca.gov. Senator Perata has introduced, and successfully carried a bill through the California Legislature, every year since 2004 to protect California healthcare workers and patients from injuries caused by manual lifting.
SB 1151 passed the California Assembly 45 to 29 on August 14, 2008, and passed the Senate 22 to 15 on August 30, 2008. The bill was enrolled and delivered to the Governor on September 17, 2008.

Per call this date, September 26, 2008, to Governor Schwarzenegger’s office, (916) 445-2841, the “Hospital Patient and Health Care Worker Injury Protection Act” is on the Governor’s desk. Per governor’s office staff, Governor Schwarzenegger has until September 30th to sign or veto; if he neither signs nor vetoes, SB 1151 will become law without his signature.

SB 1151 cites U.S. Bureau of Labor Statistics 2006 data showing California to lead the nation in musculoskeletal disorders suffered by workers. “California’s nursing workforce is aging at the same time patient acuity and obesity is rising. It is imperative that we protect our registered nurses and other health care workers from injury, and provide patients with safe and appropriate care. At a cost of between forty thousand dollars ($40,000) and sixty thousand dollars ($60,000) to train and orient each new nurse, preventing turnover from injuries will save hospitals money.”

SB 1151 cites California’s Occupational Safety and Health Act of 1973 which requires employers to provide safety devices or safeguards reasonably necessary to render employment safe. If signed into law, SB 1151 would require general acute care hospitals “to establish a patient protection and health care worker back injury prevention plan,” requiring hospitals to conduct a needs assessment to identify patients needing lift teams, and lift, repositioning, or transfer devices.

"The bill would require a general acute care hospital to use lift teams or lift, repositioning, and transfer devices when there is a risk of injury to a patient or a health care worker, except in emergency situations.” “A safe patient handling policy does not require the use of patient lift, repositioning, or transfer devices if

the individual hospital’s own needs assessment indicates that it is safe for the patient and the employee to utilize techniques not requiring the use of those devices.”

For links to the wording, complete history, and current status of CA SB 1151: http://www.leginfo.ca.gov/cgi-bin/postquery?bill_number=sb_1151&sess=CUR&house=B&search_type=email.

For notification of when Governor Schwarzenegger signs or vetoes, you can subscribe to receive email notification of legislative action on SB 1151 at www.leginfo.ca.gov.

With best wishes to all…Anne

Anne Hudson, RN, BSN
September 26, 2008
Founder, Work Injured Nurses’ Group USA
Coos Bay, Oregon
anne@wingusa.org
www.wingusa.org


WING USA SPH Legislative Update 4-29-08

April 29, 2008

Dear WING USA Friends,
 
To clarify differences among the nine states which have passed legislation related to safe patient handling, as reported in WING USA’s Legislative Update of March 31, 2008: 

 
Nine States with Laws Related to Safe Patient Handling: Three States Supportive, Six States Require Safe Patient Handling Policy, Program, or Lift Equipment

Yes, nine states have passed legislation pertaining in some way to safe patient and/or resident handling, with three states lending support to efforts for safe patient and/or resident handling, and six states directly requiring development of safe patient handling policies, and/or implementation of safe patient handling programs, and/or use of mechanical patient lifting equipment, with variations in the scope and strength of requirements imposed by each state.
 
Inclusion of all nine states in the previous update was not meant to confuse, or to detract from the importance of the six states with laws mandating safe patient and/or resident handling policies and/or programs and/or lift equipment, but was in celebration of each state’s contribution on our country’s journey to a national standard for the safe handling of all patients and residents. 
 
To differentiate among the nine states which have passed legislation:
 
Three states, Ohio, New York, and Hawaii, have passed legislation which does not directly require, but is supportive of, safe patient and/or resident handling – Ohio with interest-free loans to nursing homes wishing to implement lift equipment, New York with a demonstration project on safe patient handling, and Hawaii with adopting a resolution supporting American Nurses Association’s “Handle With Care” program (more details on each state below). 
 
Six states, Texas, Washington, Rhode Island, Maryland, Minnesota, and New Jersey, have passed legislation requiring safe patient and /or resident handling policies, and/or programs, and/or lifting equipment, with much variation in scope and strength among the different state laws (more details on each state below).   
 
Links to wording of legislation enacted by the nine states are provided below, so comparisons can be made among state laws providing support for, and state laws mandating implementation of, safe patient handling policies, and/or programs, and/or provision and use of patient lift equipment. 
 
Of keen interest is the difference among states in addressing the safe handling of either or both hospital patients and/or nursing home residents.  As more states draft legislation, ideally they will cover the safe handling of dependent persons across all settings by all healthcare workers. 
 
With nearly 6,000 hospitals and 18,000 nursing homes, there are three nursing homes for every hospital in America.  The US Bureau of Labor Statistics regularly reports three to four times as many work-related musculoskeletal injuries among nurse aides, orderlies, and attendants as among registered nurses.  Efforts must be ramped up for the safe handling of dependent persons across all healthcare settings, and to other settings as well including correctional facilities, schools, etc., and for insurance coverage of home lift equipment, including ceiling-mounted lifts, to allow dependent persons to remain in their own home.
 
Efforts also need to move forward to assure permanent light duty nursing positions, to allow nurses disabled by lifting to remain with their employer in other non-lifting nursing work.  Retaining back-disabled nurses, instead of continuing the widespread practice of terminating nurses when they can no longer lift, would help ease the nurse shortage by retaining some of our most experienced nurses. 
 
Workers’ compensation carriers could save greatly on time loss payments and retraining costs if they would develop programs to assist employers to retain their injured nurses.  It is time to move beyond the old paradigm of using nurses to lift until they’re broken and discarding them, and to acknowledge the contributions of nurses beyond lifting by continuing their employment.  Yet, helping nurses back-disabled by lifting people to remain with their employer is a strategy missing in most discussions by thought leaders on easing the nurse shortage. 
 
In addition to the nine states which have passed legislation related to safe patient handling, several other states have introduced (see the previous Update of 3-31-08), and others are reportedly considering introducing.  Pressing toward a national standard for safe patient handling, HR 378 “Nurse and Patient Safety and Protection Act of 2007,” apparently remains in committee. 
 
The importance of working to stop injuries to nursing staff and patients and residents caused by manual lifting cannot be overstated.  With every day’s delay in implementing modern lift equipment, supported by the strongest safe patient and resident handling policies and programs possible, more nursing staff and dependent patients and residents suffer needless pain and injuries. 
 
Research has proven that there are no safe methods of manual patient lifting.  Injuries from lifting patients and residents cannot rightfully be called accidents.  Nursing staff injuries from lifting, turning, and repositioning patients and residents are the predictable result of lifting and handling hazardous amounts of weight, compounded by forward bending in the awkward postures required to manually handle people. 
 
Fortunately, equipment exists today which even eliminates the manual turning previously required to place the sling under the patient to use lift equipment.  Other equipment eliminates lifting wheelchair patients from wheelchair up onto the exam table in the office.  Large economical slide sheets extending head to foot are available to slide the patient’s whole body, and could be incorporated into the budget of almost any facility.  When learning how slide sheets reduce friction to eliminate dragging the patient, I was instructed to stop saying “draw sheet” and to call the standard item what it is – a “drag sheet.”  Low tech hand blocks and spring-loaded seat cushions could eliminate manually lifting patients who need only a small boost up to their feet. 
 

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Equipment available for safely handling patients and residents ranges from low-tech to extremely sophisticated.  Yet, availability of such an array of modern equipment and devices has not convinced many facilities to remove dangerous loads from the backs of their nursing staff.  With nursing assistants and nurses combined far surpassing any other occupation year after year for work-related musculoskeletal injuries, volunteerism clearly has not worked in large measure to stop injuries directly caused by lifting people.      
 
Here’s a quick comparison of the nine states which have passed legislation, first the three supportive states, then the six states requiring safe patient and/or resident handling policies, and/or programs, and/or lift equipment.  See wording at the links provided for details on requirements of each state’s legislation. 
 
Three states which have passed legislation supportive of, but not requiring, safe patient and/or resident handling: 
 
1.  Ohio HB 67.  March 21, 2005.  First state to pass any kind of legislation in U.S.A. related to safe patient or resident handling.  Created a workers’ compensation fund for interest-free loans to nursing homes wishing to purchase lift equipment for implementation of “No Manual Lifting of Residents” policies.  Note:  Does not require nursing homes to purchase and implement lift equipment or to develop safe patient handling policies and programs.  Offers interest-free loans for lift equipment to nursing homes.  Does not offer same loans to hospitals.  Text:  Scroll down to Sec. 4121.48.  http://www.legislature.state.oh.us/bills.cfm?ID=126_HB_67_EN.    
 
2.  New York A 7641 and S 4929.  October 18, 2005.  Created a two-year “Safe Patient Handling Demonstration Program” to establish safe patient handling programs and collect data on nursing staff and patient injury with patient handling, manual versus lift equipment, in order to describe best practices for health and safety of healthcare workers and patients.  Note:  Does not require health care facilities to implement safe patient handling policies and programs.  See:  http://assembly.state.ny.us/  and http://www.senate.state.ny.us
 
New York A 7836.  July 3, 2007.  Extends demonstration program for two years to research the effect of safe patient handling programs, to build upon existing evidence-based data, with the goal of designing best practices for safe patient handling in health care facilities.  Also establishes specifications for safe patient handling programs.  Note:  Does not require implementation of safe patient handling policies and programs.  Summary text: http://assembly.state.ny.us/leg/?bn=A07836.
 
3.  Hawaii HCR 16.  April 24, 2006.  Resolution calls for safeguards in health care facilities to minimize musculoskeletal injuries by nurses and for the State Legislature to support policies in American Nurses Association’s “Handle With Care” Campaign.  HCR 16 states that in 2005, the Council of State Governments’ Health Capacity Task Force adopted and supported the policies contained in American Nurses Association’s “Handle With Care” campaign, and asked member states to also support the campaign.  Recognizing that musculoskeletal disorders are the leading occupational health problem plaguing nurses, HCR 16 says, “Be it resolved…that the Legislature of the State of Hawaii supports the policies contained in the American Nurses Association's “Handle With Care” campaign.” Note:  Does not require safe patient handling policy or program or use of patient lift equipment. Text: http://www.capitol.hawaii.gov/session2006/Bills/HCR16_.pdf
 
Six states which have passed legislation requiring safe patient and/or resident handling policies, and/or programs, and/or patient lifting equipment:
 
1.  Texas SB 1525.  June 17, 2005.  First state to require both hospitals and nursing homes to establish a policy for safe patient handling and movement, to control the risk of injury to patients and nurses; to evaluate alternative methods from manual lifting, including equipment and patient care environment; to restrict, to the extent feasible with existing equipment, manual handling of all or most of a patient’s weight to emergency, life-threatening, or exceptional circumstances; and provides for nurses to refuse to perform patient handling tasks believed in good faith to involve unacceptable risks of injury to a patient or nurse.  Note:  Covers both hospitals and nursing homes.  Requires safe patient handling policy only.  Does not require safe patient handling program or provision and use of lift equipment.  Specifies nurses.  Does not cover nurse assistants.  Enrolled text:
http://www.capitol.state.tx.us/tlodocs/79R/billtext/html/SB01525F.htm

2.  Washington HB 1672.  March 22, 2006.  First state to mandate provision of lift equipment by hospitals and to offer financial assistance with implementation by tax credits and reduced workers’ compensation premiums.  Hospitals must establish a safe patient handling committee with at least half of the members frontline non-managerial employees providing direct patient care, a safe patient handling program, and policy for all shifts and units.  Hospitals may choose either one readily-available lift per acute care unit on the same floor, one lift for every ten acute care inpatient beds, or lift equipment for use by specially-trained lift teams.  Employees may refuse without fear of reprisal patient handling activities believed in good faith to impose an unacceptable risk of injury to an employee or patient.  With hospital construction or remodeling, feasibility of incorporating patient handling equipment is to be considered, or of designing to incorporate at a later date.  Note:  Covers hospitals only.  Does not cover nursing homes.  Provides financial assistance to implement lift equipment and programs.  Covers “employees,” which would include nurse assistants and other healthcare workers, not limited to nurses only.  Enrolled text: http://www.leg.wa.gov/pub/billinfo/2005-06/Pdf/Bills/House%20Passed%20Legislature/1672-S.PL.pdf.
                                       
3.  Rhode Island H 7386 and S 2760.  July 7, 2006.  Requires hospitals and nursing facilities to achieve maximum reasonable reduction of manual lifting, transferring, and repositioning of patients and residents except in emergency, life-threatening, or exceptional circumstances.  As a condition of licensure, health care facilities shall establish a safe patient handling committee chaired by a professional nurse with at least half the members non-managerial employees providing direct patient care, a safe patient handling program, and policy for all shifts and units.  An employee may report, without fear of discipline or adverse consequences, being required to perform patient handling believed in good faith to expose the patient and/or employee to an unacceptable risk of injury.  These reportable incidents shall be included in the facility's annual performance evaluation.  Availability and use of safe patient handling equipment in new space or renovation is to be considered, with input from the community to be served.  Legislative findings include that safe patient handling can reduce patient skin tears threefold.  Note:  Covers both hospitals and nursing facilities.  Covers “employees,” not limited to nurses only.  RI H 7386 text: http://www.rilin.state.ri.us/Billtext/BillText06/HouseText06/H7386Aaa.pdf and RI S 2760 text: http://www.rilin.state.ri.us/Billtext/BillText06/SenateText06/S2760A.pdf.   
 
4.  Maryland HB 1137 and SB 879.  April 10, 2007.  Defines “safe patient lifting” as “use of mechanical lifting devices by hospital employees, instead of manual lifting, to lift, transfer, and reposition patients.”  Hospitals required to develop a safe patient lifting committee with an equal number of managers and employees, and a safe patient lifting policy to reduce employee injuries with patient lifting.  Consideration is to be given to patient handling hazard assessment; enhanced use of mechanical lifting devices; development of specialized lift teams; training programs for safe patient lifting; incorporating space and construction design for mechanical lifting devices in architectural plans; and evaluating effectiveness of the safe lifting policy.  Note:  Covers only hospitals.  Does not cover nursing homes.  Covers “hospital employees,” not limited to nurses only.  MD HB 1137 text: http://mlis.state.md.us/2007RS/chapters_noln/Ch_57_hb1137T.pdf.  MD SB 879 text: http://mlis.state.md.us/2007RS/chapters_noln/Ch_56_sb0879T.pdf.    

5.  Minnesota HF 712 and SF 828 passed within HF 122.  May 25, 2007.  Requires a safe patient handling program by every licensed health care facility, including hospitals, outpatient surgical centers, and nursing homes; a safe patient handling committee; and policy to minimize manual lifting of patients by nurses and other direct patient care workers by utilizing safe patient handling equipment, rather than people, to transfer, move, and reposition patients and residents in all health care facilities.  The program will address acquiring adequate, appropriate, safe patient handling equipment; training; remodeling and construction consistent with program goals; and evaluations of the program.  Financial assistance will include matching grants and development of on-going funding sources to acquire and train on safe patient handling equipment, including low interest loans, interest free loans, and federal, state, or county grants, plus a special workers' compensation fund of $500,000 for safe patient handling grants.  The MN State Council on Disability shall convene a work group to study use of safe patient handling equipment in unlicensed outpatient clinics, physician offices, and dental settings.  Note:  Covers hospitals, surgical centers, and nursing homes.  Covers nurses and “other direct patient care workers,” not limited to nurses only.  Link to text within MN HF 122:  http://www.leg.state.mn.us/leg/legis.asp.  Language in three areas:  1. Grant funding Art 1, Sec 6, Sub 3, pp 25-26;  2. main body of wording Art 2, Sec 23. 182.6551 to Sec 25. 182.6553, pp 48-51; and 3. study ways for workers' comp insurers to recognize compliance in premiums and for on-going funding Art 2, Sec 36, and work groups on safe patient handling and equipment Sec 37, pp 58-59. 

6.  New Jersey SB 1758 and AB 3028.  January 3, 2008.  Covers general and special hospitals, nursing homes, state developmental centers, and state and county psychiatric hospitals.  To establish a safe patient handling committee, with at least 50% of the members health care workers representing disciplines employed by the facility.  Requires a safe patient handling program and policy on all units and all shifts; a plan for prompt access to patient handling equipment; posting the policy in a location easily visible to staff, patients, and visitors, which minimizes unassisted patient handling, and includes a statement on the right of a patient to refuse assisted patient handling.  “Assisted patient handling” means use of mechanical patient handling equipment, including, but not limited to, electric beds, portable base and ceiling track-mounted full body sling lifts, stand assist lifts, and mechanized lateral transfer aids; and patient handling aids, including, but not limited to, gait belts with handles, sliding boards and surface friction-reducing devices.  There shall be no retaliatory action against any health care worker who refuses a patient handling task due to reasonable concern about worker or patient safety, or the lack of appropriate and available patient handling equipment.  Includes recommendations for a capital plan to purchase equipment necessary to carry out the policy, which takes into account financial constraints of the facility.  Note:  Covers hospitals, nursing homes, developmental centers, and psychiatric hospitals.  Covers “health care workers,” not limited to nurses only.  NJ SPH Act text: http://www.njleg.state.nj.us/2006/Bills/PL07/225_.PDF.
 
With best wishes to all,
 
Anne Hudson, RN, BSN
April 29, 2008
Founder, Work Injured Nurses’ Group USA
Coos Bay, Oregon
anne@wingusa.org
www.wingusa.org


March 31, 2008

Dear WING USA friends,

 
WING USA Legislative Update on Safe Patient Handling:
Nine States Passed, Nine Other States Introduced, National Bill Continues

As of March 31, 2008, nine states are known to have passed industry-specific legislation related to the safe handling of patients and residents including Ohio, New York, Texas, Washington, Hawaii, Rhode Island, Maryland, Minnesota, and New Jersey. 
 
Nine other states are known to have introduced or re-introduced legislation on safe patient handling including Massachusetts, California, Iowa, Nevada, Michigan, Florida, Vermont, Missouri, and Illinois, with seven of the nine continuing in their state legislature.  It is unknown if Iowa and Nevada are re-introducing after being unsuccessful (see below).  Information follows on legislative activity known at this time, though other state activity may have occurred.      
 
National Bill for Safe Patient Handling Continues: 
 
HR 378, “Nurse and Patient Safety and Protection Act of 2007,” was re-introduced on January 10, 2007, by Representative John Conyers (D-MI), phone 202-225-5126, email John.Conyers@mail.house.gov.  Legislative Assistant on Health Policy is Joel Segal, phone 202-225-5126, email Joel.Segal@mail.house.gov
 
HR 378 is currently in two House subcommittees.  On February 2, 2007, the House Committee on Energy and Commerce referred HR 378 to the Subcommittee on Health.  The last action was on May 9, 2007, when the House Committee on Education and Labor referred HR 378 to the Subcommittee on Workforce Protections.
 
If HR 378 is passed into law: "Nurse and Patient Safety and Protection Act of 2007 requires the Secretary of Labor, acting through the Director of Occupational Safety and Health Administration, to establish a Federal Safe Patient Handling Standard to prevent musculoskeletal disorders for direct-care registered nurses and other health care providers working in health care facilities by requiring the elimination of manual lifting of patients through the use of mechanical devices, except during a declared state of emergency.”        
 
HR 378 links to text, status, actions: http://thomas.loc.gov/cgi-bin/bdquery/z?d110:h378:
 
Nine States which have Introduced or Re-introduced Legislation related to Safe Patient Handling:  Massachusetts, California, Iowa, Nevada, Michigan, Florida, Vermont, Missouri, and Illinois. 
 
1.  Massachusetts has pursued legislation for safe patient handling since first introducing in December 2004 and continues with re-introduction of companion bills.    
 
Senate Number 1294, “An Act to Require the Use of Evidence-Based Practices for Safe Patient Handling and Movement,” was introduced on January 10, 2007, by Senator Richard T. Moore (D), phone 617-722-1420, email Richard.Moore@state.ma.us. 
 
House Number 2052, “An Act Relating to Safe Patient Handling in Certain Health Care Facilities,” was introduced on February 19, 2007, by Representative Jennifer M. Callahan (D), phone 617-722-2130, email Rep.JenniferCallahan@hou.state.ma.us, and 33 co-sponsors.    
 
On February 28, 2008, SN 1294 was attached to HB 2052.  The two bills were referred to the Joint Committee on Health Care Financing with further action pending. 
 
MA SN 1294 history:  http://www.mass.gov/legis/185history/s01294.htm.
MA SN 1294 text:  http://www.mass.gov/legis/bills/senate/185/st01/st01294.htm.
 
MA HN 2052 history: http://www.mass.gov/legis/185history/h02052.htm
MA HN 2052 text: http://www.mass.gov/legis/bills/house/185/ht02pdf/ht02052.pdf.
 
2.  California has re-introduced legislation for the fifth time on the safe handling of patients, following passage by the legislature, and vetoes by Governor Arnold Schwarzenegger (R), for the past four years running. 
 
Senate Bill 1151, Hospitals: Lift Teams, “Hospital Patient and Health Care Worker Injury Protection Act,” was introduced on February 6, 2008, by Senator Don Perata (D), phone 510-286-1333, email Senator.Perata@sen.ca.gov.  SB 1151 was heard by the Senate Committee on Labor and Industrial Relations on March 26, 2008, and was referred to the Senate Appropriations Committee with a hearing date set for April 14, 2008.    
 
Assembly Bill 371, Health Facilities, “An Act Relating to Health Facility Financing and Making an Appropriation Therefor,” was introduced by Assemblyman Jared Huffman (D), phone 916-319-2006, and Assemblywoman Sally Lieber (D), phone 916-319-2022, on February 14, 2007.  A two-year bill, AB 371 was amended and passed by the Senate on September 7, 2007, and was returned to the Assembly on January 7, 2008.  With concurrence, AB 371 is waiting to be heard and voted on for passage by the Assembly. 
 
CA SB 1151 links to wording, history, and status: www.leginfo.ca.gov.   
CA AB 371 links to wording, history, and status: www.leginfo.ca.gov.      
 
3.  Iowa introduced House File 635, “An Act Relating to Manual Patient Handling by Nurses in a Hospital Setting,” on March 8, 2005, by Representative Mary J. Mascher (D), phone 319-351-2826, email Mary.Mascher@legis.state.ia.us
 
HF 635 passed the first reading and was referred to the House Committee on Human Resources where the bill was apparently unsuccessful.  It is unknown if Iowa has re-introduced or has plans to re-introduce. 
 
IA HF 635, in Archives, link to history and summary:  http://coolice.legis.state.ia.us/Cool-ICE/default.asp?Category=BillInfo&Service=DspHistory&key=0671C&ga=81
 
4.  Nevada introduced Assembly Bill 577, “Requires Certain Medical Facilities to Establish a Program for Safe Handling of Patients,” on March 26, 2007.  AB 577 was introduced by Health and Human Services with no individual Assemblyperson’s name listed at the Nevada Legislature website as the bill’s sponsor.
 
On April 23, 2007, AB 577 was amended by the Assembly Committee on Health and Human Services, was declared an emergency measure under the Constitution, and passed the Assembly 34 to 8.  AB 577 was read the first time in the Senate, and passed the Senate Committee on Human Resources and Education, but was unsuccessful after the second reading in the Senate. 
 
Nevada’s two-year legislature is scheduled to reconvene in February 2009.  It is unknown if there are plans to re-introduce a bill for safe patient handling in Nevada.  Assemblywoman Sheila Leslie, Chair of the Committee on Health, may be able to provide more info, phone 775-333-6564, or email sleslie@asm.state.nv.us
 
NV AB 577 history: https://www.leg.state.nv.us/74th/Reports/history.cfm?DocumentType=1&BillNo=577.
NV AB 577 text with amendments April 23, 2007:  https://www.leg.state.nv.us/74th/Bills/AB/AB577_R1.pdf
 
5.  Michigan introduced Senate Bill 377 on March 27, 2007, to amend “Public Health Code” regarding each hospital’s establishment of a safe patient handling committee and implementation of a safe patient handling program. 
 
SB 377 was introduced by Senator Dennis Olshove (D), phone 517-373-8360; with co-sponsor Senator Gilda Jacobs (D), phone 517-373-7888; and four other co-sponsors: Senators Raymond Basham (D), Liz Brater (D), Deborah Cherry (D), and Bruce Patterson (R).  SB 377 is currently in the Senate Health Policy Committee.  
 
MI SB 377 history:  http://www.legislature.mi.gov/(S(bj3n1c2yhuxae3b5wvdzer45))/mileg.aspx?page=getObject&objectName=2007-SB-0377
MI SB 377 text http://www.legislature.mi.gov/documents/2007-2008/billintroduced/Senate/pdf/2007-SIB-0377.pdf
 
6.  Florida re-introduced companion bills “Relating to Hospitalized Patients/Safe Lifting Policies.” 
 
Senate Bill 508, “An Act Relating to the Safe Lifting of Hospitalized Patients,” was introduced on October 15, 2007, by Senator Mike Fasano (R), phone 727-848-5885; and co-sponsors Senator J. Alex Villalobos (R), phone 850-487-5130, email villalobos.alex.web@flsenate.gov; and Senator Evelyn J. Lynn (R), phone 850-487-5033, email lynn.evelyn.web@flsenate.gov
 
Significantly, SB 508 passed the Senate as amended 39 to 0 on March 13, 2008, with announcement of the Senate passing SB 508 made during the 8th Annual Safe Patient Handling and Movement Conference in Orlando, Florida (see http://www.cme.hsc.usf.edu/sphm/).  Following passage by the Senate, SB 508 was sent to the House and was referred to the House Joint Healthcare Council and the Policy and Budget Council with further action pending. 
 
House Bill 471, “Patient Lifting and Handling Practices,” was introduced on January 7, 2008, by Representative Jimmy Patronis (R), phone 850-914-6300; and co-sponsors Representative Yolly Roberson (D), phone 850-488-7088; and Representative Juan C. Zapata (R), phone 850-488-9550.  HB 471 passed the first reading, has been amended in committee, and is presently in the House Joint Healthcare Council pending further action. 

FL SB 508 links to history and text: http://www.flsenate.gov
FL HB 471 links to history and text: http://www.myfloridahouse.gov
 
7.  Vermont introduced companion bills in February 2007, both titled “An Act Relating to Safe Patient Handling.”  
 
Senate Bill 141 was introduced on February 27, 2007, by Senator Virginia V. “Ginny” Lyons (D), email vlyons@leg.state.vt.us; and Senator Richard T. Mazza (D), phone 802-863-1067.  SB 141 was referred to the Senate Committee on Health and Welfare with further action pending. 
 
House Bill 421 was introduced on February 28, 2007, by Representative Johannah Leddy Donovan (D), email jdonovan@leg.state.vt.us; co-sponsored by Representative Sarah R. Edwards (Progressive), phone 802-828-2231, email sedwards@leg.state.vt.us; and seven other co-sponsors: Representatives Peter Hunt, Tim Jerman, Patricia McDonald, Alice Miller, Betty Nuovo, Christopher Pearson, and Kathy Pellett.  HB 421 was referred to the House Committee on Human Services with further action pending.  
 
VT SB 141 status:  http://www.leg.state.vt.us/database/status/summary.cfm.  VT VT SB 141 text: http://www.leg.state.vt.us/docs/legdoc.cfm?URL=/docs/2008/bills/intro/S-141.HTM
 
VT HB 421 status:  http://www.leg.state.vt.us/database/status/summary.cfm.  
VT HB 421 text:  http://www.leg.state.vt.us/docs/legdoc.cfm?URL=/docs/2008/bills/intro/H-421.HTM.
 
8.  Missouri introduced House Bill 1940, “Hospital Patient Safety,” on January 31, 2008, by Representative Sam Page (D), phone 573-751-9762, email Sam.Page@house.mo.gov; co-sponsored by Representative Robert Schaaf (R), phone 573-751-2183, email rob.schaaf@house.mo.gov; and 14 other co-sponsors: Representatives Meadows, Frame, Komo, Talboy, McClanahan, Norr, Onder, Cooper, Threlkeld, Baker, Bland, Hughes, Skaggs, and Holsman.  HB 1940 was heard in the House Special Committee on Healthcare Transformation on March 26, 2008, and is pending further action. 
 
MO HB 1940 status and link to actions: http://house.mo.gov/billtracking/bills081/bills/hb1940.htm.
MO HB 1940 text:  http://www.house.mo.gov/billtracking/bills081/biltxt/intro/HB1940I.htm.
 
9.  Illinois re-introduced House Bill 5274, “Safe Patient Handling Act,” on February 14, 2008, by Representative Elizabeth Coulson (R), phone 217-782-4194.  HB 5274 was read for the first time and was referred to the House Rules Committee on February 14, 2008, with further action pending. 
 
Links to status, history, and text which contains only a short title provision:  http://www.ilga.gov/legislation/BillStatus.asp?DocNum=5274&GAID=9&DocTypeID=HB&LegId=36524&SessionID=51&GA=95.
 
Nine States which have Passed Legislation related to Safe Patient Handling:  Ohio, New York, Texas, Washington, Hawaii, Rhode Island, Maryland, Minnesota, and New Jersey. 
 
1.  Ohio House Bill 67 was signed into law on March 21, 2005, by Governor Bob Taft (R), with Section 4121.48 creating a workers’ compensation fund for interest-free loans to nursing homes for lift equipment and for implementation of “No Manual Lifting of Residents” policies. 
 
The law stipulates creation in the state treasury of the long-term care loan fund to be operated by the bureau of workers’ compensation “to make loans without interest to employers that are nursing homes for the purpose of allowing those employers to purchase, improve, install, or erect sit-to-stand floor lifts, ceiling lifts, other lifts, and fast electric beds, and to pay for the education and training of personnel, in order to implement a facility policy of no manual lifting of residents by employees.” 
 
OH HB 67 text as enrolled, scroll down to Section 4121.48:  http://www.legislature.state.oh.us/bills.cfm?ID=126_HB_67_EN
 
2.  New York companion bills, Assembly Bill 7641 and Senate Bill 4929, were introduced in April 2005, and were signed into law on October 18, 2005, by Governor George Pataki (R).  The law created a two-year “Safe Patient Handling Demonstration Program” to establish safe patient handling programs and collect data on the incidence of nursing staff and patient injury with patient handling, manual versus lift equipment, with results used to describe best practices for improving health and safety of healthcare workers and patients during patient handling.
 
NY AB 7641 links to history and text: http://assembly.state.ny.us/
NY SB 4929 links to history and text: http://www.senate.state.ny.us.
           
In April 2007, New York introduced identical bills, A 7836 by Assembly Member Richard N. Gottfried (D) and S 5116 by Senator Kemp Hannon (R), “An act to amend chapter 738 of the laws of 2005, relating to establishing a safe patient handling demonstration program, in relation to the effectiveness thereof.”  In June 2007, S 5116 was substituted by A 7836 which was signed into law on July 3, 2007, by Governor Eliot Spitzer (D), extending the safe patient handling demonstration program for two years to research the effect of safe patient handling programs in health care facilities, to build upon existing evidence-based data, with the ultimate goal of designing "best practices" for safe patient handling in New York State health care facilities. The bill also establishes specifications for safe patient handling programs. 
 
NY A 7836 summary text: http://assembly.state.ny.us/leg/?bn=A07836.
 
3.  Texas Senate Bill 1525, “An Act Relating to Safe Patient Handling and Movement Practices of Nurses in Hospitals and Nursing Homes,” introduced March 10, 2005, by author Senator Judith Zaffirini (D) and Sponsor Representative Dianne Delisi (R), was signed into law by Governor Rick Perry (R) on June 17, 2005, and became effective January 1, 2006. 
 
With passage of SB 1525, Texas became the first state to mandate implementation of policy for safe patient handling and movement programs by hospitals and nursing homes (“Texas Passes First Law for Safe Patient Handling in America: Landmark Legislation Protects Healthcare Workers and Patients from Injury Related to Manual Patient Lifting.”  Mary Anne Hudson.  September/October 2005.  Journal of Long-Term Effects of Medical Implants.  15(5): 559-566).
 
The Texas law requires hospitals and nursing homes to establish a policy to identify, assess, and develop methods of controlling the risk of injury to patients and nurses associated with lifting, transferring, repositioning, and movement of patients; to evaluate alternative methods from manual lifting to reduce the risk of injury from patient lifting, including equipment and patient care environment; to restrict, to the extent feasible with existing equipment, manual handling of all or most of a patient’s weight to emergency, life-threatening, or exceptional circumstances; and to provide for refusal to perform patient handling tasks believed in good faith to involve unacceptable risks of injury to a patient or nurse. 
 
TX SB 1525 enrolled text: http://www.capitol.state.tx.us/tlodocs/79R/billtext/html/SB01525F.htm
 
4.  Washington House Bill 1672, “An Act Relating to Reducing Injuries among Patients and Health Care Workers,” was initially introduced on February 1, 2005, sponsored by Representatives Steve Conway (D), Zack Hudgins (D), Tami Green (D), Eileen Cody (D), Sherry Appleton (D), Dawn Morrell (D), Alex Wood (D), John McCoy (D), Phyllis Kenney (D), Jim Moeller (D), and Maralyn Chase (D).  After being stalled in the House Committee on Commerce and Labor in 2005, HB 1672 was reintroduced on January 8, 2006.  HB 1672 passed the House 85 to 13 on March 7, 2006, and passed the Senate 48 to zero on March 8, 2006.  Washington State’s safe patient handling law was signed by Governor Christine Gregoire (D) on March 22, 2006, and went into effect June 7, 2006.
 
With passage of HB 1672, Washington became the first state to require hospitals to provide mechanical patient lift equipment as part of their policy for safe patient handling, and to offer financial assistance, with tax credits and reduced workers’ compensation premiums, for implementation of lift equipment to reduce injuries related to lifting and moving patients (“The Need to Legislate the Healthcare Industry in the State of Washington to Protect Healthcare Workers from Back Injury.”  William Charney.  September/October 2005.  Journal of Long-Term Effects of Medical Implants.  15(5): 567-571). 
 
On a timeline, Washington hospitals must establish a safe patient handling committee, a safe patient handling program, and implement a safe patient handling policy for all shifts and units.  Hospitals may choose among three options for implementation of lift equipment, either one readily-available lift per acute care unit on the same floor, one lift for every ten acute care inpatient beds, or lift equipment for use by specially-trained lift teams.  Provision is made for employees to refuse without fear of reprisal patient handling activities believed in good faith to impose an unacceptable risk of injury to an employee or patient.  With hospital construction or remodeling, feasibility is to be considered of incorporating patient handling equipment, or of designing to incorporate at a later date.

Significantly, Washington State’s safe patient handling law was passed during National Patient Safety Awareness Week, March 5-11, 2006.  HB 1672 states, “Patients are not at optimum levels of safety while being lifted, transferred, or repositioned manually.  Mechanical lift programs can reduce skin tears suffered by patients by threefold.  Nurses, thirty-eight percent of whom have previous back injuries, can drop patients if their pain thresholds are triggered.”  The Bureau of Labor Statistics reports that the injury rate of hospital employees in Washington State exceeds that of construction, agriculture, manufacturing, and transportation.  With passage of HB 1672, Washington hospital patients and healthcare workers will be protected from unintentional pain and injuries related to manual patient lifting and moving.
 
WA HB 1672 enrolled text: http://www.leg.wa.gov/pub/billinfo/2005-06/Pdf/Bills/House%20Passed%20Legislature/1672-S.PL.pdf.
      
5.  Hawaii House Concurrent Resolution Number 16, “Requesting Appropriate Safeguards be Instituted in Health Care Facilities to Minimize the Occurrence of Musculoskeletal Injuries Suffered by Nurses,” was introduced on February 3, 2006, by Representatives Marilyn B. Lee (D), Rida Cabanilla (D), Cindy Evans (D), Maile S. L. Shimabukuro (D), Roy M. Takumi (D), Clift Tsuji (D), Kirk Caldwell (D), Josh Green, MD (D), Robert N. Herkes (D), Ezra Kanoho (D), Bertha C. Kawakami (D), Bob Nakasone (D), Brian Schatz (D), Joseph M. Souki (D), Dwight Y. Takamine (D), and Kameo Tanaka (D).  HCR 16 was adopted on April 24, 2006, calling for safeguards in health care facilities to minimize musculoskeletal injuries by nurses and for the State Legislature to support policies in American Nurses Association’s “Handle With Care” Campaign. 
 
The report associated with HCR 16 is titled “American Nurses Association's ‘Handle With Care’ Campaign Support.”  HCR 16 recognizes that musculoskeletal disorders are the leading occupational health problem plaguing nurses; that of primary concern are back injuries, which can be severely debilitating to nurses; that nursing personnel are among the highest at risk for musculoskeletal disorders; that work days lost to back injuries are twice as great for nursing home workers as for truck drivers; that nursing home and hospital workers incur more lost work days due to back injuries than construction workers, miners, and agriculture workers.                  
                                                                    
HCR 16 recognizes that musculoskeletal injury to nurses is particularly distressing in context of the current nurse shortage; and that injuries to nurses from patient handling compound factors such as the aging nurse workforce, declining retention and recruitment rates, and lowering the social value of nursing to worsen the shortage. 
 
Hawaii’s resolution states that in 2005 the Council of State Governments’ Health Capacity Task Force adopted and supported the policies contained in American Nurses Association’s “Handle With Care” campaign, and asked member states to also support the campaign.  With adoption of HCR 16, Hawaii says, “Be it resolved…that the Legislature of the State of Hawaii supports the policies contained in the American Nurses Association's “Handle With Care” campaign” (see ANA “Handle With Care brochure: http://nursingworld.org/MainMenuCategories/OccupationalandEnvironmental/occupationalhealth/handlewithcare/Resources/hwc.aspx.)
 
HI HCR 16 text:  http://www.capitol.hawaii.gov/session2006/Bills/HCR16_.pdf
 
6.  Rhode Island’s “Safe Patient Handling Act of 2006” became law on July 7, 2006, “To Promote the Safe Handling of Patients in Health Care Facilities.”  Companion bills, Senate Bill 2760 and House Bill 7386, both entitled “An Act Relating to Health and Safety – Safe Patient Handling Legislation,” were introduced in February 2006.  SB 2760 was introduced on February 14, 2006, by Senators V. Susan Sosnowski (D), Beatrice A. Lanzi (D), Rhoda E. Perry (D), M. Teresa Paiva-Weed (D), and Juan M. Pichardo (D).  HB 7386 was introduced on February 16, 2006, by Representatives Grace Diaz (D), Paul E. Moura (D), Amy G. Rice (D), Edith H. Ajello (D), and Raymond J. Sullivan, Jr. (D). 
 
The bills were transmitted on June 29, 2006, to Governor Donald L. Carcieri (R), and became law on July 7, 2006, without Governor Carcieri’s signature.  Rhode Island’s Safe Patient Handling Act took effect on January 1, 2007, requiring hospitals and nursing facilities to achieve maximum reasonable reduction of manual lifting, transferring, and repositioning of patients and residents except in emergency, life-threatening, or exceptional circumstances. 
 
As a condition of licensure, health care facilities shall establish a safe patient handling committee, and a safe patient handling program, including implementation of a safe patient handling policy for all shifts and units by July 1, 2008.  Protocols shall be established for an employee to report, without fear of discipline or adverse consequences, to the committee being required to perform patient handling believed in good faith to expose the patient and/or employee to an unacceptable risk of injury.  These reportable incidents shall be included in the facility's annual performance evaluation.

The health services council shall consider the proposed availability and use of safe patient handling equipment in new or renovated space to be constructed, and input from the community to be served by the proposed equipment and services.  Legislative findings listed in the law include greater risk of patient injury with manual lifting and moving, and that safe patient handling can reduce skin tears suffered by patients by threefold and can significantly reduce other injuries to patients as well. 
 
RI H 7386 text:  http://www.rilin.state.ri.us/Billtext/BillText06/HouseText06/H7386Aaa.pdf 
RI S 2760 text:  http://www.rilin.state.ri.us/Billtext/BillText06/SenateText06/S2760A.pdf.   
 
7.  Maryland passed identical companion bills for safe patient handling, House Bill 1137 and Senate Bill 879, on April 10, 2007, with Maryland’s “Act concerning Hospitals – Safe Patient Lifting” taking effect on October 1, 2007.   
 
HB 1137, “Health Care Facilities and Regulation,” was introduced on February 19, 2007, by Delegates Joseline Pena-Melnyk (D), Aisha N. Braveboy (D), Melony G. Griffith (D), Jolene Ivey (E), and Kris Valderrama (D).  SB 879, “Hospitals – Safe Patient Lifting,” was introduced on February 21, 2007, by Senator Paul G. Pinsky (D).  HB 1137 and SB 879 were approved by Governor Martin O’Malley (D) on April 10, 2007. 
 
HB 1137 and SB 879 define “safe patient lifting” as “use of mechanical lifting devices by hospital employees, instead of manual lifting, to lift, transfer, and reposition patients.”  The new laws require Maryland hospitals to develop a safe patient lifting committee, with equal numbers of managers and employees by December 1, 2007, and a safe patient lifting policy to reduce employee injuries with patient lifting by July 1, 2008. 
 
Consideration is to be given to patient handling hazard assessment; enhanced use of mechanical lifting devices; development of specialized lift teams; training programs for safe patient lifting; incorporating space and construction design for mechanical lifting devices in architectural plans; and evaluating effectiveness of the safe lifting policy.       
 
MD HB 1137 history: http://mlis.state.md.us/2007rs/billfile/HB1137.htm.
MD HB 1137 text: http://mlis.state.md.us/2007RS/chapters_noln/Ch_57_hb1137T.pdf.
 
MD SB 879 history: http://mlis.state.md.us/2007rs/billfile/SB0879.htm.
MD SB 879 text: http://mlis.state.md.us/2007RS/chapters_noln/Ch_56_sb0879T.pdf.  

8.  Minnesota’s “Safe Patient Handling Act” was passed by inclusion of companion bills on safe patient handling, House File 712 and Senate File 828, within the second engrossment of a large omnibus bill, House File No. 122. 
HF 712, “Safe Patient Handling Act,” introduced on February 8, 2007, by Representatives Patti Fritz (D), Erin Murphy (D), Maria Ruud (D), Karen Clark (D), Jim Abeler (R), and David Bly (D); and SF 828, “Safe Patient Handling Act,” introduced on February 15, 2007, by Senators Linda Higgins (D), Sharon L. Erickson Ropes (D), Kathy Sheran (D), Paul E. Koering (R), and John Marty (D), passed within HF 122 which was approved by Governor Tim Pawlenty (R) on May 25, 2007. 

Minnesota’s Safe Patient Handling Act requires implementation of a safe patient handling program by every licensed health care facility in the state, including hospitals, outpatient surgical centers, and nursing homes.  On a timeline, a safe patient handling committee will be established; and a safe patient handling policy will be adopted to minimize manual lifting of patients by nurses and other direct patient care workers by utilizing safe patient handling equipment, rather than people, to transfer, move, and reposition patients and residents in all health care facilities. 

The safe patient handling program will address the assessment of hazards with patient handling, acquisition of an adequate supply of appropriate safe patient handling equipment, initial and ongoing training on use of the equipment, procedures to ensure that remodeling and construction are consistent with program goals, and periodic evaluations of the safe patient handling program.
Provisions are included for financial assistance with matching grants and development of on-going funding sources for health care facilities to acquire and train on safe patient handling equipment.  Such sources may include low interest loans, interest free loans, and federal, state, or county grants.  A special workers' compensation fund provided $500,000 for safe patient handling grants. 
The Minnesota State Council on Disability shall convene a work group representing clinics, disability advocates, and direct care workers, to study issues around use of safe patient handling equipment in unlicensed outpatient clinics, physician offices, and dental settings. 

On passage of Minnesota’s Safe Patient Handling Statute, Elizabeth (Bettye) Shogren, RN, Health and Safety Specialist, Minnesota Nurses Association, stated, “We had many supporters in the community and a comprehensive strategic plan to advance the bill.  Over-preparation and realistic expectations made this a success.” 

On January 17, 2008, the Minnesota Department of Labor and Industry announced awarding 67 grants totaling $500,000 to health care facilities to help purchase patient-lifting equipment in complying with the new state patient-handling regulations.  For a list of the facilities in Minnesota receiving patient-handling grants see http://www.doli.state.mn.us/pdf/sph_approv_grants.pdf. 
Omnibus bill HF 122 is over 130 pages, with language on safe patient handling in three separate areas:  1. Initial grant funding in Article 1, Section 6, Subdivision 3, on pages 25-26;  2. Main body of wording for safe patient handling in Article 2, Section 23. 182.6551 to Section 25. 182.6553, on pages 48-51; and 3. Study of ways to require workers' compensation insurers to recognize compliance in premiums and for on-going funding in Article 2, Section 36, and work groups on safe patient handling and equipment in Section 37 on pages 58-59. 
MN HF 122 text:  http://www.leg.state.mn.us/leg/legis.asp.
MN SF 828 and MN HF 712 links to history and text: http://www.leg.state.mn.us/leg/legis.asp.

9.  New Jersey appears to be the most recent state to pass legislation.  The “Safe Patient Handling Act” was signed into law by Governor Jon Corzine (D) on January 3, 2008, following passage of identical bills titled “Safe Patient Handling Act”:  Senate Bill 1758, introduced on March 21, 2006, by primary sponsors Senators Joseph F. Vitale (D) and Loretta Weinberg (D) and co-sponsors Senators John H. Adler (D), Fred H. Madden, Jr. (D), Ronald L. Rice (D), and Barbara Buono (D); and Assembly Bill 3028, introduced on May 15, 2006, by primary sponsors Assemblymen Herb Conaway, Jr. (D), Vincent Prieto (D), and Gary S. Schaer (D), and Assemblywoman Joan M. Voss (D), with co-sponsors Assemblywomen Linda R. Greenstein (D) and Valerie Vainieri Huttle (D), and Assemblymen Patrick J. Diegnan, Jr. (D), Robert M. Gordon (D), and Thomas P. Giblin (D). 
 
On December 13, 2007, A 3028 was substituted by S 1758 which passed the New Jersey Senate 37 to 0 and the Assembly 77 to 3.  The Safe Patient Handling Act went into effect immediately upon signing on January 3, 2008, covering general and special hospitals, nursing homes, state developmental centers, and state and county psychiatric hospitals. 
 
Covered facilities are to establish a safe patient handling committee for development and implementation of a safe patient handling program and a safe patient handling policy on all units and for all shifts.  Assessment of the handling requirements of each patient are to be Included, with a plan for prompt access to patient handling equipment and handling aids.  The safe patient handling policy shall be posted in a location easily visible to staff, patients, and visitors, which minimizes unassisted patient handling, and includes a statement concerning the right of a patient to refuse the use of assisted patient handling. 
           
“Assisted patient handling” means use of mechanical patient handling equipment, including, but not limited to, electric beds, portable base and ceiling track-mounted full body sling lifts, stand assist lifts, and mechanized lateral transfer aids; and patient handling aids, including, but not limited to, gait belts with handles, sliding boards and surface friction-reducing devices. 
           
There shall be no retaliatory action against any health care worker who refuses a patient handling task due to reasonable concern about worker or patient safety, or the lack of appropriate and available patient handling equipment. 
           
Recommendations shall be included for a three-year capital plan to purchase safe patient handling equipment and patient handling aids necessary to carry out the safe patient handling policy, which is to take into account the financial constraints of the facility. 
 
NJ Safe Patient Handling Act text: http://www.njleg.state.nj.us/2006/Bills/PL07/225_.PDF.

 
With best wishes to all,
 
Anne Hudson, RN, BSN
Founder, Work Injured Nurses’ Group USA
March 31, 2008
anne@wingusa.org
www.wingusa.org
 


October 21, 2007
Dear WING USA:



Fourth Veto on Safe Patient Handling for California


For the fourth year running, California Governor Arnold Schwarzenegger (R) has once more vetoed legislation to protect patients and healthcare workers from painful injuries with lifting and moving dependent persons.

Senate Bill 171 "Hospital Patient and Health Care Worker Injury Protection Act," introduced by Senator Don Perata (D), passed the California Senate June 4, 2007, and the Assembly September 6, 2007, but was vetoed on October 13, 2007, by Governor Schwarzenegger.  The bill would have become effective on July 1, 2008, providing legal protection against preventable injuries from manual patient handling.

Citing California's Occupational Safety and Health Act of 1973, which requires employers to provide safety devices or safeguards for safe employment, SB 171 would have required all acute care hospitals to establish a "patient protection and health care worker back injury prevention plan," requiring "hospitals to use lift teams, and lift, repositioning, and transfer devices, and to train health care workers on the appropriate use of lift, repositioning, and transfer devices."

SB 171 cites Bureau of Labor Statistics (BLS) data showing that certified nurse assistants, registered nurses, and licensed practical nurses together, 95% of whom are women, consistently lead the nation in work-related musculoskeletal disorders (MSD's).

SB 171 further cites 2006 BLS data showing that California leads the nation in MSD's suffered by its workers, and points out that the risk of patient handling injury escalates with an aging nursing workforce and with rising patient acuity and obesity.

With the cost of replacing a single registered nurse between $40,000 and $60,000, SB 171 shows that preventing turnover of nurses due to patient handling injuries would save hospitals money, and states, "It is imperative that we protect our registered nurses and other health care workers from injury, and provide patients with safe and appropriate care."

Yet, it appears that Governor Schwarzenegger and most state governments to date lack the resolve to take measures necessary to protect healthcare workers and dependent persons from preventable lifting injuries.

With MSD's from the manual lifting of patients and residents possibly the single-largest cause of disabling work injury in America, and possibly the single-largest cause of the nurse shortage, injuries from lifting people is clearly a national healthcare crisis which deserves, but has not yet achieved, top priority.  One can only wonder why. B
eing lifted or moved by others will touch each one of us, literally, physically, at some point, either ourselves or a loved one.  With each passing moment, more patients, residents, and healthcare workers are unnecessarily injured by manual lifting.

A recent example of injury to a dependent person being moved is "Ms. Maggy," who finds herself in a nursing home following a hip fracture. Six weeks after successful hip pinning surgery, during a wheelchair-to-bed pivot transfer, Ms. Maggy was apparently rapidly turned on her operated leg, wrenching her knee.  When she refused to have the same nurse aide for the next transfer, another nurse aide apparently again performed a rapid pivot transfer on her operated leg, wrenching the same knee again.

X-rays showed no fracture to Ms. Maggy's knee, but weeks later, she still has much pain in that knee, further limiting her mobility.  If a "sit-stand" lift had been available, the wrenching injury to Ms. Maggy's knee could have been avoided.  Directives for use of safe lift and transfer equipment could avoid many such painful debilitating injuries.  It has been stated that safe patient-lift equipment should be considered just as essential as hospital and nursing home beds, for prevention of injuries to healthcare workers, patients, and residents alike.

In fact, "With availability of gentle repositioning, lift, and transfer equipment, which reduces risk of pain and injury to patients, manual handling without assistive equipment may become considered malpractice" ("Devastating Injuries in Healthcare Workers: Description of the Crisis and Legislative Solution to the Epidemic of Back Injury from Patient Lifting."  Richard F. Edlich, MD, PhD, Mary Anne Hudson, RN, BSN, Ralph M. Buschbacher, MD, et al.  March/April 2005.  Journal of Long-Term Effects of Medical Implants.  15(2): 225-241).

Volunteerism to protect healthcare workers, patients, and residents against lifting injuries, within the massive system of nearly 6,000 hospitals and 18,000 nursing homes, is not realistic and clearly is not working.  Thus far, about one quarter of the states have passed legislation for, or related to, safe patient handling.  Governor Schwarzenegger's fourth veto of protection against patient handling injuries for Californians underscores the profound need for a national standard to unify the states on safe patient handling.

The national bill, HR 378 Nurse and Patient Safety and Protection Act of 2007, re-introduced January 10, 2007, by US Representative John Conyers (D-MI), remains in committee.  HR 378 would "direct the Secretary of Labor to issue an occupational safety and health standard to reduce injuries to patients, direct-care registered nurses, and other health care providers by establishing a safe patient handling standard."  If HR 378 passes, a federal standard for safe patient handling will be established in our country, covering nurses, other healthcare workers, and dependent persons in their care.

To express support of HR 378 Nurse and Patient Safety and Protection Act of 2007, contact Representative John Conyers, John.Conyers@mail.house.gov, (202) 225-5126, and Mr. Joel Segal, Legislative Assistant on Health Policy, Joel.Segal@mail.house.gov, (202) 225-5126.  For links to the history and text of HR 378, go to http://thomas.loc.gov.

For the complete history of SB 171, California's "Hospital Patient and Health Care Worker Injury Protection Act," the fourth legislation for safe patient handling vetoed by Governor Schwarzenegger, go to http://www.leginfo.ca.gov/.  Click the "Bill Information" box.  Select "Bill Number" and enter "SB 171" in the box and click "Search."  Click "SB 171" where you can select "Status," "History," "Bill Text," etc., or scroll to the bottom and select "Veto Message" for Governor Schwarzenegger's statement, which follows.

Best wishes to all…Anne

Anne Hudson, RN, BSN
October 21, 2007
Founder, Work Injured Nurses' Group USA
anne@wingusa.org
www.wingusa.org



Governor Schwarzenegger's Veto Message:
Hospital Patient and Health Care Worker Injury Protection Act

http://www.leginfo.ca.gov/pub/07-08/bill/sen/sb_0151-0200/sb_171_vt_20071013.html

"BILL NUMBER:  SB 171
"VETOED DATE: 10/13/2007

"To the Members of the California State Senate:

"I am returning Senate Bill 171 without my signature.

"This bill, which imposes a one-size fits all mandate on hospitals to establish a "zero lift" patient handling policy, is similar to measures I have vetoed the last three years.  While I continue to support the goal of reducing workplace injuries, I remain convinced that this inflexible mandate is a poor alternative to giving hospitals the flexibility needed to achieve this goal in the manner that most efficiently addresses each hospital's needs and resources.

"For this reason, I am returning this bill without my signature.

"Sincerely,
"Arnold Schwarzenegger"




Reprinted with permission from: XtraWise: a publication for the medical community.  
Summer 2007.  Vol 9.2.  Sizewise Rentals, LLC.  www.sizewise.net.

Back Injured Nurses: 1st Person Account
Anne Hudson, RN, BSN


"Research has shown for many years that there is no safe way to manually lift patients."

I always thought of an injured nurse as someone who was put in a difficult situation where an accident occurred and caused the injury. I never realized that injuries are occurring on a daily basis from our basic patient handling tasks.  And then the pain went stabbing through my back and the doctor announced "cumulative trauma injury to the lumbar discs."  In my case, this cumulative injury resulted in more than just pain; ultimately nursing as I knew it was taken from me.

Many nurses do not know how the workers' compensation system operates or what to expect if they get injured while lifting patients.  At my
hospital, patient handling injury was never discussed at any unit meeting, hospital employee meeting, or nurses' union meeting.  Injury from lifting patients was simply never addressed as an issue among nurses but was left up to the hospital to handle.  Sadly, through my experience, I learned that hospitals generally deny workers' compensation claims, requiring the injured nurse to appeal the denial and appear in court to prove they were injured at work.  I also learned that many hospitals do not retain injured nurses in other non-lifting nursing work if they are unable to return to lifting patients.

Nurses need to educate themselves on how and why patient lifting causes spinal injury.  It has long been said that for nurses "back injury is part of the job" without clearly defining "back injury." Nurses need to know that manually lifting patients places them at tremendous risk of permanent spinal disability, not just at risk of muscle strain which would be expected to heal in a matter of days or weeks.

Learning how degenerative disc disease develops from repetitive micro-fractures to spinal structures with lifting hazardous amounts of weight often creates "champions" for a no lifting policy.  Due to the fact that there are no pain receptors in the center of discs and vertebral endplates where injury typically begins, much insidious damage can occur to the spine without pain; knowing this is a powerful motivator for use of lift equipment.

I would tell other nurses to learn about the great variety of lifting, transferring, and turning equipment and friction-reducing devices available, and to then campaign for their hospital to provide the equipment.  Hospital administrators need to recognize that preventing injuries with appropriate lift equipment and friction-reducing devices is always less costly than allowing injuries and replacing nurses. Research has shown for many years that there is no safe way to manually lift patients.  Forces are exerted which exceed tolerance limits of the spine, so that injuries from patient lifting cannot rightly be called "accidents."  Injury is the predictable outcome from performing such hazardous lifting.              

Anne Hudson, RN, BSN, of Coos Bay, Oregon, is a Public Health Nurse with the Coos County Public Health Department.  Since losing her
previous hospital nursing career to a spinal injury from lifting patients, she has become a voice for back-injured nurses and an activist for preventing injuries to nurses and patients related to manual patient lifting.  Anne Hudson founded Work Injured Nurses' Group USA (WING USA) at www.wingusa.org for information, mutual support, and advocacy for back-injured nurses. She has spoken around the country and in Australia on the high cost of avoidable injuries from patient lifting, and endorses "Safe Patient Handling – No Manual Lift" legislation to mandate use of safe lift equipment for dependent persons across all healthcare settings.  Anne Hudson has published articles and co-edited with William Charney the book Back Injury Among Healthcare Workers: Causes, Solutions, and Impacts.

Read full issue (pdf) XtraWise: a publication for the medical community. Summer 2007 Volume 9.2


September 8, 2007
 
Dear WING USA Friends,

Legislative Update September 2007
Minnesota Latest to Pass Legislation for Safe Patient Handling

Minnesota appears to be the most recent state to pass legislation for the safe handling of dependent health care patients and residents.  Legislative activity in other states may have occurred of which I am unaware. 
 
Minnesota’s "Safe Patient Handling Act," introduced as companion bills Senate File 828 and House File 712 in February 2007, was passed on May 20, 2007, within the second engrossment of a large omnibus bill, House File No. 122.  HF 122 was approved by Governor Tim Pawlenty (R) on May 25, 2007.  
 
Minnesota’s new Safe Patient Handling law requires all licensed health care facilities, including hospitals, outpatient surgical centers, and nursing homes, to establish a safe patient handling committee and a safe patient handling program, to minimize manual lifting by nurses and other direct patient care workers, by utilizing safe patient handling equipment rather than people, to transfer, move, and reposition patients and residents in all health care facilities. 
 
A special workers' compensation fund was to provide $500,000 the first year and $500,000 the second year for safe patient handling grants, but a line item veto reduced funding to $500,000 one time.  Provisions for development of on-going funding for safe patient handling programs and equipment are included in Minnesota’s Safe Patient Handling Act.   
 
Omnibus bill HF 122 is very large, over 130 pages, with language pertinent to safe patient handling in three separate areas of the bill regarding 1. Initial grant funding, 2. The main body of wording for safe patient handling, and 3. Study of ways to require workers' compensation insurers to recognize compliance in premiums and for on-going funding, and work groups on safe patient handling and equipment.      
 
Funding for safe patient handling grants is outlined in HF 122 Article 1 “Jobs, Economic Development, Housing and Minnesota Heritage Appropriations Summary,” Section 6 “Labor and Industry,” Subdivision 3 “Safety Codes and Services” on pages 25-26 (see below).      
 
Provisions for studying ways to require workers' compensation insurers to recognize compliance in premiums of health care facilities, and for on-going funding sources, are in HF 122 Article 2 “Employment and Development-Related Provisions,” Section 36 “Study; Safe Patient Handling," with requirements for work groups on safe patient handling and equipment in Section 37 “Work Group; Safe Patient Handling” on pages 58-59 (see below).
 
Wording of Minnesota's Safe Patient Handling Act is in HF 122 Article 2 “Employment and Development-Related Provisions,” Section 23. 182.6551 to Section 25. 182.6553, on pages 48-51. 
 
Wording of Minnesota's Safe Patient Handling Act follows below and may also be read online at the Minnesota State Legislature website.  Go to http://www.leg.state.mn.us/leg/legis.asp.  Enter "HF 122" in the House of Representatives “Enter Bill number” search box and click “go.”  Click "Status of Bill in the House" for the bill's history.  Under “Bill Name: HF 122,” click "Bill Text.”  Under “Bill Engrossments,” click "H.F.122, 2nd Engrossment" posted on May 21, 2007.
 
Elizabeth (Bettye) Shogren, RN, Health and Safety Specialist, Minnesota Nurses Association, email Bettye.Shogren@mnnurses.org, gave the following report June 11, 2007, on Minnesota’s new Safe Patient Handling Statute: 
 
“The language is pretty much what we had proposed initially, but the grant funding is significantly reduced.  The legislature was a hard sell on that and the governor exercised a line item veto on the funding except for $500,000, but there is a requirement to get back to the legislature with some funding ideas especially for Long Term Care.  In Minnesota, that group of employers has significant restrictions on what they can get as far as reimbursement.  There is one other state that has a similar problem so there will be continued work on that issue.  We really need that federal law so we don't have so much difference state to state.
 
“We are all so pleased that the bill got through largely intact.  The Minnesota Hospital Association testified in support of the bill.  The Long Term Care Associations opposed the bill due to financial issues not principle issues.
 
“We had many supporters in the community and a comprehensive strategic plan to advance the bill that has worked better than we had anticipated.  Over-preparation and realistic expectations made this a success.
 
“If you are among the supporters, please accept my deepest thanks in helping Minnesota Nurses Association (MNA) achieve a victory for direct patient care staff.  We will definitely be celebrating and hope you will be able to join us when we do--in spirit if not by being present.  Bettye”
 
Congratulations to Minnesota on their new Safe Patient Handling Act for the safe handling of patients and residents!  (See wording following.)  Other states and the nation press on to secure legislation for the safe lifting and moving of dependent persons across all health care settings.   
 
Best wishes to all…Anne
 
Anne Hudson, RN, BSN
September 8, 2007
Founder, Work Injured Nurses’ Group USA
Coos Bay, Oregon
anne@wingusa.org
www.wingusa.org
 
 
Note:  Funding outlined in Article 1, Section 6, Subdivision 3 (immediately following) was reduced by a line item veto to $500,000 one time.     
 
http://www.leg.state.mn.us/leg/legis.asp
 

MINNESOTA HOUSE FILE No. 122, 2nd ENGROSSMENT –  85th LEGISLATIVE SESSION (2007-2008)  Posted on May 21, 2007
 
Article 1
JOBS, ECONOMIC DEVELOPMENT, HOUSING AND MINNESOTA HERITAGE APPROPRIATIONS SUMMARY

 
Section 6.  LABOR AND INDUSTRY
Subdivision 3. Safety Codes and Services
 
This appropriation is from the workers' compensation fund.  $500,000 the first year and $500,000 the second year are from the workers' compensation fund for patient safe handling grants under Minnesota Statutes, section 182.6553.  This is a onetime appropriation and is available until expended.”
 

 
ARTICLE 2
EMPLOYMENT AND DEVELOPMENT-RELATED PROVISIONS
 
MINNESOTA SAFE PATIENT HANDLING ACT

 
    Section 23.  [182.6551] CITATION.
 
    Sections 182.6551 to 182.6553 may be cited as the "Safe Patient Handling Act."

    Section 24.  [182.6552] DEFINITIONS.

    Subdivision 1.  Direct patient care worker.  "Direct patient care worker" means an individual doing the job of directly providing physical care to patients including nurses, as defined by section 148.171, who provide physical care to patients.

    Subd. 2.  Health care facility.  "Health care facility" means a hospital as defined in section 144.50, subdivision 2; an outpatient surgical center as defined in section 144.55, subdivision 2; and a nursing home as defined in section 144A.01, subdivision 5.

    Subd. 3.  Safe patient handling.  "Safe patient handling" means a process, based on scientific evidence on causes of injuries, that uses safe patient handling equipment rather than people to transfer, move, and reposition patients in all health care facilities to reduce workplace injuries.  This process also reduces the risk of injury to patients.

    Subd. 4.  Safe patient handling equipment.  "Safe patient handling equipment" means engineering controls, lifting and transfer aids, or mechanical assistive devices used by nurses and other direct patient care workers instead of manual lifting to perform the acts of lifting, transferring, and repositioning health care facility patients and residents.


    Section 25.  [182.6553] SAFE PATIENT HANDLING PROGRAM.

    Subdivision 1.  Safe patient handling program required
    (a)  By July 1, 2008, every licensed health care facility in the state shall adopt a written safe patient handling policy establishing the facility's plan to achieve by January 1, 2011, the goal of minimizing manual lifting of patients by nurses and other direct patient care workers by utilizing safe patient handling equipment.
    (b)  The program shall address:
    (1)  assessment of hazards with regard to patient handling;
    (2)  the acquisition of an adequate supply of appropriate safe patient handling
equipment;
    (3)  initial and ongoing training of nurses and other direct patient care workers on the use of this equipment;
    (4)  procedures to ensure that physical plant modifications and major construction projects are consistent with program goals; and
    (5)  periodic evaluations of the safe patient handling program.

    Subd. 2.  Safe patient handling committee
    (a)  By July 1, 2008, every licensed health care facility in the state shall establish a safe patient handling committee either by creating a new committee or assigning the functions of a safe patient handling committee to an existing committee.
    (b)  Membership of a safe patient handling committee or an existing committee must meet the following requirements:
    (1)  at least half the members shall be non-managerial nurses and other direct patient care workers; and
    (2)  in a health care facility where nurses and other direct patient care workers
are covered by a collective bargaining agreement, the union shall select the committee members proportionate to its representation of non-managerial workers, nurses, and other direct patient care workers.
    (c)  A health care organization with more than one covered health care facility may establish a committee at each facility or one committee to serve this function for all the facilities.  If the organization chooses to have one overall committee for multiple facilities, at least half of the members of the overall committee must be non-managerial nurses and other direct patient care workers and each facility must be represented on the committee.
    (d)  Employees who serve on a safe patient handling committee must be compensated by their employer for all hours spent on committee business.

    Subd. 3.  Facilities with existing programs.  A facility that has already adopted a safe patient handling policy that satisfies the requirements of subdivision 1, and established a safe patient handling committee by July 1, 2008, is considered to be in compliance with those requirements.  The committee must continue to satisfy the requirements of subdivision 2, paragraph (b), on an ongoing basis.

    Subd. 4.  Committee duties.  A safe patient handling committee shall:
    (1)  complete a patient handling hazard assessment that:
    (i)  considers patient handling tasks, types of nursing units, patient populations, and the physical environment of patient care areas;
    (ii)  identifies problems and solutions;
    (iii)  identifies areas of highest risk for lifting injuries; and
    (iv)  recommends a mechanism to report, track, and analyze injury trends;
    (2)  make recommendations on the purchase, use, and maintenance of an adequate supply of appropriate safe patient handling equipment;
    (3)  make recommendations on training of nurses and other direct patient care
workers on use of safe patient handling equipment, initially when the equipment arrives at the facility and periodically afterwards;
    (4)  conduct annual evaluations of the safe patient handling implementation plan and progress toward goals established in the safe patient handling policy; and
    (5)  recommend procedures to ensure that, when remodeling of patient care areas occurs, the plans incorporate safe patient handling equipment or the physical space and construction design needed to accommodate safe patient handling equipment at a later date.

    Subd. 5.  Training materials.  The commissioner shall make training materials on implementation of this section available to all health care facilities at no cost as part of the training and education duties of the commissioner under section 182.673.

    Subd. 6.  Enforcement.  This section shall be enforced by the commissioner under section 182.661.  A violation of this section is subject to the penalties provided under section 182.666.

    Subd. 7.  Grant program.  The commissioner may make grants to health care
facilities to acquire safe patient handling equipment and for training on safe patient handling and safe patient handling equipment.  Grants to any one facility may not exceed $40,000.  A grant must be matched on a dollar-for-dollar basis by the grantee.  The commissioner shall establish a grant application process.  The commissioner may give priority for grants to facilities that demonstrate that acquiring safe patient handling equipment will impose a financial hardship on the facility.  For health care facilities that provide evidence of hardship, the commissioner may waive the 50 percent match requirement and may grant such a facility more than $40,000.  Health care facilities that the commissioner determines are experiencing hardship shall not be required to meet the safe patient handling requirements until July 1, 2012.
 
 
    Section 36.  STUDY; SAFE PATIENT HANDLING.   
    (a)  The commissioner of labor and industry shall study ways to require workers' compensation insurers to recognize compliance with Minnesota Statutes, section 182.6553, in the workers' compensation premiums of health care and long-term care facilities.  The commissioner shall report by January 15, 2008, the results of the study to the chairs of the policy committees of the legislature with primary jurisdiction over workers' compensation issues.
    (b)  By January 15, 2008, the commissioner must make recommendations to the legislature regarding funding sources available to health care facilities for safe patient handling programs and equipment, including, but not limited to, low interest loans, interest free loans, and federal, state, or county grants.
 
    Section 37.  WORK GROUP; SAFE PATIENT HANDLING.   
     The Minnesota State Council on Disability shall convene a work group comprised of representatives from the Minnesota Medical Association and other organizations representing clinics, disability advocates, and direct care workers, to do the following:
     (1)  Assess the current options for and use of safe patient handling equipment in unlicensed outpatient clinics, physician offices, and dental settings;
     (2)  Identify barriers to the use of safe patient handling equipment in these settings; and
     (3)  Define clinical settings that move patients to determine applicability of the Safe Patient Handling Act.
     The work group must report to the legislature by January 15, 2008, including reports to the chairs of the Senate and House of Representatives Committees on Workforce Development.


May 13, 2007

Dear WING USA Friends,
 
Safe Patient Handling Legislative Update May 2007
 
Legislative activity continues for the safe handling of patients and residents in America.  Maryland has most recently passed legislation and several more states have introduced legislation calling for the use of modern technology rather than the backs of healthcare workers for lifting and moving dependent persons. 
 
At this writing, at least 15 states have passed or introduced legislation for or related to safe patient handling.  With passage of companion bills in April 2007, Maryland joined the growing list of states which are acting to curtail the epidemic of injuries caused by the unsafe manual lifting of people by other people.  This report includes a summary of known state activity.  Other states besides those listed may have passed or introduced, while certain other states are reported to be considering introducing. 
 
Notably, the national bill, HR 378 Nurse and Patient Safety and Protection Act of 2007, introduced January 10, 2007, by Representative John Conyers, Jr, (D MI-14), continues in the US House of Representatives.  HR 378 was referred to the Committee on Education and Labor and, also, to the Committee on Energy and Commerce where it was subsequently referred, on February 2, 2007, to the Subcommittee on Health.  If HR 378 passes, the United States will have a federal standard for the safe handling of patients in our country.     
 
To express support of HR 378 Nurse and Patient Safety and Protection Act of 2007, contact Representative John Conyers, John.Conyers@mail.house.gov, (202) 225-5126, and Mr. Joel Segal, Legislative Assistant on Health Policy, Joel.Segal@mail.house.gov, (202) 225-5126.  For links to the history and text of HR 378, go to http://thomas.loc.gov
 
The following summarizes state activity for safe patient handling which is known at this time.
 
Maryland passed identical companion bills HB 1137 and SB 879 for safe patient handling on April 10, 2007. 
 
HB 1137 “Health Care Facilities and Regulation,” sponsored by Delegates Joseline Pena-Melnyk (D), Aisha N. Braveboy (D), Melony G. Griffith (D), Jolene Ivey (E), and Kris Valderrama (D), was introduced February 19, 2007.  After passing the House and Senate on March 21, 2007, and April 1, 2007, respectively, HB 1137 was approved by Democratic Governor Marin O’Malley on April 10, 2007. 
 
SB 879 “Hospitals - Safe Patient Lifting,” sponsored by Senator Paul G. Pinsky (D), was introduced on February 21, 2007.  SB 879 passed the Senate on March 24, 2007, the House on March 29, 2007, and was approved by Democratic Governor Martin O’Malley on April 10, 2007. 
 
HB 1137 and SB 879 define “safe patient lifting” as “use of mechanical lifting devices by hospital employees, instead of manual lifting, to lift, transfer, and reposition patients.”  The new laws require Maryland hospitals to develop a safe patient lifting committee, with equal numbers of managers and employees by December 1, 2007, and a safe patient lifting policy to reduce employee injuries with patient lifting by July 1, 2008.  Consideration is to be given to patient handling hazard assessment; enhanced use of mechanical lifting devices; development of specialized lift teams; training programs for safe patient lifting; incorporating space and construction design for mechanical lifting devices in architectural plans; and evaluating effectiveness of the safe lifting policy which is to take effect October 1, 2007.       
 
MD HB 1137 history and text:  http://mlis.state.md.us/2007rs/billfile/HB1137.htm.
MD SB 879 history and text:  http://mlis.state.md.us/2007rs/billfile/SB0879.htm.
 
Maryland joins these six states which have enacted legislation for or related to safe patient handling:  Texas, Washington, Hawaii, Rhode Island, Ohio, and New York. 
 
Texas, with passage of SB 1525 on June 17, 2005, became the first state to mandate implementation of policy for safe patient handling and movement programs by hospitals and nursing homes.  Enrolled text: http://www.capitol.state.tx.us/tlodocs/79R/billtext/html/SB01525F.htm
                                                     
Washington, with passage of HB 1672 on March 22, 2006, became the first state to mandate provision of lift equipment by hospitals as part of their policy for safe patient handling and to offer financial assistance with implementation by tax credits and reduced workers’ compensation premiums.  Enrolled text: http://www.leg.wa.gov/pub/billinfo/2005-06/Pdf/Bills/House%20Passed%20Legislature/1672-S.PL.pdf.
 
Hawaii House Concurrent Resolution No 16, passed on April 24, 2006, calls for safeguards in health care facilities to minimize musculoskeletal injuries by nurses and for the State Legislature to support policies in American Nurses Association’s “Handle With Care” Campaign.  Text:  http://www.capitol.hawaii.gov/session2006/Bills/HCR16_.pdf
 
Rhode Island passed H 7386 and S 2760 on July 7, 2006, requiring hospitals and nursing facilities to achieve maximum reasonable reduction of manual lifting, transferring, and repositioning of patients and residents except in emergency, life-threatening, or exceptional circumstances.  Text: http://www.rilin.state.ri.us/Billtext/BillText06/HouseText06/H7386Aaa.pdf and
http://www.rilin.state.ri.us/Billtext/BillText06/SenateText06/S2760A.pdf.   
 
Ohio passed HB 67 on March 21, 2005, to create a workers’ compensation fund for interest-free loans to nursing homes for lift equipment and for implementation of “No Manual Lifting of Residents” policies.  Text:  Scroll down to Sec. 4121.48.  http://www.legislature.state.oh.us/bills.cfm?ID=126_HB_67_EN
 
New York A 7641 and S 4929, passed on October 18, 2005, created a two-year “Safe Patient Handling Demonstration Program” for collection of data on injuries in order to describe best practices.  See:  http://assembly.state.ny.us/  and http://www.senate.state.ny.us
 
The following nine states have introduced, or re-introduced, legislation for safe patient handling:  Illinois, New Jersey, Massachusetts, California, Florida, Minnesota, Nevada, Michigan, and New York. 
 
Illinois companion bills with identical wording HB 4558 and SB 2692, to amend the Nursing Home Care Act and the Hospital Licensing Act, were introduced in January 2006 but were not successful.  HB 4558 was introduced by Representative Angelo Saviano (R) on January 11, 2006.  SB 2692 was introduced by Senator Donne E. Trotter (D) on January 20, 2006.  Both bills apparently died on January 9, 2007. 
HB 4558 and SB 2692 would have required Illinois nursing homes and hospitals to implement a policy to control the risk of injury to residents, patients, and nurses with lifting, transferring, repositioning, or movement of residents and patients, and “restriction to the extent feasible with existing equipment and aids, of manual resident [or patient] handling or movement of all or most of a resident’s [or patient's] weight to emergency, life-threatening, or otherwise exceptional circumstances.”  Analysis of the risk of injury to residents, patients, and nurses with handling; education of nurses to identify, assess, and control the risk of injury with handling; and procedures for a nurse to refuse to perform patient or resident handling believed in good faith to expose the patient, resident, or nurse to an unacceptable risk of injury would have also been required. 
 
IL HB 4558 text: 
http://www.ilga.gov/legislation/94/HB/PDF/09400HB4558lv.pdf
IL HB 4558 history:  http://www.ilga.gov/legislation/billstatus.asp?DocNum=4558&GAID=8&GA=94&DocTypeID=HB&LegID=22851&SessionID=50.

IL SB 2692 text: http://www.ilga.gov/legislation/94/SB/PDF/09400SB2692lv.pdf.
IL SB 2692 history:  http://www.ilga.gov/legislation/BillStatus.asp?DocNum=2692&GAID=8&DocTypeID=SB&LegId=23638&SessionID=50&GA=94
 

New Jersey introduced identical bills S1758 and A3028 in March and May of 2006. 
 
S 1758 was introduced on March 21, 2006, by primary sponsors Senators Joseph F. Vitale (D) and Loretta Weinberg (D) and co-sponsors Senators John H. Adler (D), Fred H. Madden, Jr. (D), Ronald L. Rice (D), and Barbara Buono (D).   On December 14, 2006, S1758 was reported favorably with amendments by the Senate Health, Human Services and Senior Citizens Committee and was referred to the Senate Budget and Appropriations Committee with no hearing scheduled.
 
A 3028 "Safe Patient Handling Act" was introduced on May 15, 2006, by primary sponsors Assemblymen Herb Conaway, Jr. (D), Vincent Prieto (D), and Gary S. Schaer (D), and Assemblywoman Joan M. Voss (D), with co-sponsors Assemblywomen Linda R. Greenstein (D) and Valerie Vainieri Huttle (D), and Assemblymen Patrick J. Diegnan, Jr. (D), Robert M. Gordon (D), and Thomas P. Giblin (D).  A3028 was reported favorably by the Assembly Health and Senior Services Committee as an Assembly Committee Substitute on January 18, 2007, and was referred to the Assembly Appropriations Committee with a hearing scheduled May 10, 2007.  If passed, licensed health care facilities will be required to establish a safe patient handling program and policy including availability and prompt access to mechanical patient handling equipment and patient handling aids.
 
NJ A 3028 and NJ S 1758 links to history and text: http://www.njleg.state.nj.us
 
NJ A 3028 text of Assembly Committee Substitute dated January 18, 2007:  http://www.njleg.state.nj.us/2006/Bills/A3500/3028_S1.PDF.
NJ S 1758 text with amendments dated December 14, 2006: 
http://www.njleg.state.nj.us/2006/Bills/S2000/1758_R1.PDF
 
Massachusetts Senator Richard T. Moore (D) introduced Senate Number 1294 on January 10, 2007, “An act to require the use of evidence-based practices for safe patient handling and movement.”  Massachusetts has pursued legislation for safe patient handling since the first introduction in December 2004. 
 
If passed, SN 1294 would require every licensed health care facility to implement an evidence-based policy for safe handling and movement of patients; and to provide training on use of patient handling equipment and devices, patient care ergonomic assessment protocols, no lift policies, and patient lift teams.  The intent of the “No Lift Policy” is the elimination of manual handling in virtually every patient care situation, apart from all but exceptional or life threatening situations.  Constituting a pledge from administrators that proper equipment, adequately maintained and in sufficient numbers, will be available to care providers, the “No Lift Policy” is an integral part of a comprehensive safe patient handling and movement program in acute care hospitals and long-term care facilities.
 
MA SN 1294 history:  http://www.mass.gov/legis/185history/s01294.htm.
MA SN 1294 text:  http://www.mass.gov/legis/bills/senate/185/st01/st01294.htm.
 
California has introduced safe patient handling legislation for the fourth year running, following vetoes by Governor Arnold Schwarzenegger (R) in 2004 of AB 2532 by Assembly Member Loni Hancock (D), in 2005 of SB 363 by Senator Don Perata (D), and in 2006 of SB 1204 by Senator Don Perata (D). 
 
On February 5, 2007, Senator Don Perata (D) introduced SB 171 “Hospital Patient and Health Care Worker Injury Protection Act” which would require general acute care hospitals to establish a patient protection and health care worker back injury prevention plan; to conduct needs assessments to identify patients needing lift teams, and lift, repositioning, or transfer devices; to use lift teams, and lift, repositioning, and transfer devices; and to train health care workers on the appropriate use of lift, repositioning, and transfer devices.  SB 171 was amended on April 23, 2007, and was referred to the Senate Appropriations Committee. 
 
Companion bill AB 371 “An act…relating to health facility financing…” was introduced February 14, 2007, by Assembly Member Jared Huffman (D).  AB 371 would require hospitals applying for financing from issuance of tax-exempt bonds to provide a copy of the hospital's injury and illness prevention program (IIPP) specifying how they have implemented or plan to implement a hospital patient and health care worker injury prevention program, including a "zero lift policy” for substituting manual lifting and transferring of patients with powered patient transfer devices, lifting devices, or lift teams.  AB 371 was amended on April 23, 2007, and was referred to the Assembly Committee on Appropriations. 
 
CA SB 171 links to history and text:  http://www.leginfo.ca.gov/.
CA SB 171 amended text:  http://www.leginfo.ca.gov/pub/07-08/bill/sen/sb_0151-0200/sb_171_bill_20070423_amended_sen_v98.pdf.
 
CA AB 371 links to history and text: http://info.sen.ca.gov. 
CA AB 371 amended text:  http://info.sen.ca.gov/pub/07-08/bill/asm/ab_0351-0400/ab_371_bill_20070423_amended_asm_v97.pdf.
 
Florida reintroduced companion bills for safe patient handling in February 2007 which would have created a new Florida statute for Safe Patient Handling and Movement Practices, but both bills died in committee on May 4, 2007. 
 
SB 2208 “Patient Handling/Safe Movement/Hospitals” was filed February 26, 2007, by Senator J. Alex Villalobos (R).  SB 2208 died in Committee on Finance and Tax on May 4, 2007.  SB 2208 would have required hospitals to adopt a policy for safe movement of patients and would have prohibited hospitals from retaliating or discriminating against employees who, in good faith, reported violations of the act. 
 
HB 1193 “Patient Handling and Moving Practices” was filed February 27, 2007, by Representative Yolly Roberson (D) and co-sponsors Representatives Susan Bucher (D); Edward D. “Ed” Bullard (D); Bill Heller (D); Evan Jenne (D); John Legg (R); Julio Robaina (R); Michael Scionti (D); James W. “Jim” Waldman (D); and Juan C. Zapata (R).  HB 1193 died in Committee on Health Innovation on May 4, 2007.  HB 1193 would have required hospitals and nursing homes to adopt a safe patient handling and moving policy and to provide for incorporation of patient handling equipment into construction or remodeling of hospitals or nursing homes; for protection for employees who report violations; for rulemaking authority; and for credit to cover cost of equipment. 
 
FL SB 2208 links to history and text: http://www.flsenate.gov
FL HB 1193 links to history and text: http://www.myfloridahouse.gov
 
Minnesota introduced companion bills SF 828 and HF 712 for safe patient handling in February 2007.  SF 828 "Safe Patient Handling Act" was introduced February 15, 2007, by Senators Linda Higgins (D); Sharon L. Erickson Ropes (D); Kathy Sheran (D); Paul E. Koering (R); and John Marty (D).  On March 12, 2007, the amended bill was referred to Finance - Economic Development Budget Division. 
 
HF 712 “Sate Patient Handling Act” was introduced February 8, 2007, by Representatives Patti Fritz (D); Erin Murphy (D); Maria Ruud (D); Karen Clark (D); Jim Abeler (R); David Bly (D).  On March 22, 2007, the amended bill was referred to the Higher Education and Work Force Development Policy and Finance Division. 
 
If passed, SF 828 and HF 712 would require all licensed health care facilities to establish a safe patient handling committee and a safe patient handling program to minimize manual lifting by nurses and other direct patient care workers by utilizing safe patient handling equipment rather than people to transfer, move, and reposition patients in all health care facilities.  The bill would require the Commissioner of Labor and Industry to enforce the Safe Patient Handling Act and would appropriate $2 million for grants to health care facilities for safe patient handling equipment.
 
MN SF 828 and MN HF 712 history and text: http://www.leg.state.mn.us/leg/legis.asp.  
 
Nevada AB 577 was introduced on March 26, 2007, by Health and Human Services.  If passed AB 577 would require hospitals and skilled nursing facilities to establish a program and policy for safe handling of patients, including a committee on safe handling of patients, annual training for employees on safe handling of patients, annual evaluation of the policy, consideration of incorporation of lifting equipment during construction or remodeling, and annual reports to the Nevada Legislature concerning the safe handling of patients.  On April 23, 2007, AB 577 passed the Assembly 34 to 8 and is currently in the Senate.   
 
NV AB 577 history: https://www.leg.state.nv.us/74th/Reports/history.cfm?DocumentType=1&BillNo=577.
 
NV AB 577 text with amendments adopted April 23, 2007:  
https://www.leg.state.nv.us/74th/Bills/AB/AB577_R1.pdf
 
Michigan Senator Dennis Olshove (D) introduced Senate Bill 377 on March 27, 2007, with co-sponsors Senators Gilda Jacobs (D), Raymond Basham (D), Liz Brater (D), Deborah Cherry (D), and Bruce Patterson (R).  If passed, SB 377 would amend 1978 PA 368 "Public health code" by adding section 21525 which would require hospitals to establish a safe patient handling committee by January 1, 2008, and a safe patient handling program by September 1, 2008.  Hospitals could choose one of three options for acquisition of lift equipment by December 31, 2011. 
 
SB 377 includes provision for employees refusing, without reprisal, to perform patient handling believed in good faith to be unsafe and specifies that "safe patient handling" means the use of engineering controls, lifting and transfer aids, or assistive devices, by lift teams or other staff, instead of manual lifting for lifting, transferring, and repositioning health care patients and residents. 
 
MI SB 377 history:  http://www.legislature.mi.gov/(S(bj3n1c2yhuxae3b5wvdzer45))/mileg.aspx?page=getObject&objectName=2007-SB-0377. 
MI SB 377 text http://www.legislature.mi.gov/documents/2007-2008/billintroduced/Senate/pdf/2007-SIB-0377.pdf

 
New York introduced identical bills A 7836 and S 5116 in April 2007.  “An act to amend chapter 738 of the laws of 2005, relating to establishing a safe patient handling demonstration program, in relation to the effectiveness thereof” would extend for two years the demonstration program to research the effect of safe patient handling programs in health care facilities in New York State, and would build upon existing evidence-based data in order to design "best practices" for safe patient handling in health care facilities in New York State.  Specifications for safe patient handling programs would also be established.    
 
NY S 5116 was introduced by Senator Kemp Hannon (R) on April 25, 2007.  History and text: http://assembly.state.ny.us/leg/?bn=S05116
 
NY A 7836 was introduced by Assembly Member Richard N. Gottfried (D) on April 26, 2007.  History and text: http://assembly.state.ny.us/leg/?bn=A07836.   
 
Anne Hudson, RN, BSN
May 13, 2007
Founder Work Injured Nurses' Group USA
Coos Bay, Oregon
anne@wingusa.org


March 9, 2007

Dear WING USA,
 
UAN was asked if only UAN nurses should fill out the Survey "Unsafe Handling -- Not on My Back!" in support of HR 378 Nurse and Patient Safety and Protection Act of 2007.  UAN's answer is no:  they want as many surveys as possible. 
 
So, surveys from nurses from other unions, nurses with no union, retired nurses, or nurses no longer able to work in the field of nursing due to their injuries are welcome.  All nurses are impacted by this problem. 
 
Many thanks to all for help circulating the survey and for directing nurses to the survey online at www.UANNurse.org.   
 
For questions, contact Suzanne Martin with UAN at 301-628-5133 or suzanne.martin@uannurse.org
 
Best wishes to all...Anne
 
Anne Hudson
March 9, 2007
Founder Work Injured Nurses' Group USA
Coos Bay, Oregon
anne@wingusa.org


 
Unsafe Handling — Not on My Back!
 
Return this form to United American Nurses, AFL-CIO:
 
Complete the form online at  www@UANNurse.org   OR
Email your responses to  UANInfo@UANNurse.org   OR 
Mail the form to:  
        UAN
        United American Nurses, AFL-CIO
        8515 Georgia Ave.
        Silver Spring, MD 20910
 
PLEASE RESPOND BY APRIL 20, 2007.
 
Too many nurses are injured through the simple act of repositioning a patient.  UAN is working with Rep. John Conyers (D-MI) to pass a federal law (H.R. 378) mandating safe patient handling for RNs in hospitals.
 
Help UAN put a face to the statistics—tell us your story.  Your responses will be confidential unless you give us permission to share them. 
 
(Fields #'s 1, 2, and 3, name, complete address, and home phone, are required.)
 
1)  First Name:  
     Last Name:  
 
2)  Address: 
     City, ST ZIP: 
 
3)  Home phone: 
     Cell Phone: 
 
4)  Email:  
 
5)  Best time to contact you: 
 
6)  Do we have your permission to publicly use your information? ___Yes  ___No
 
7)  Are you willing to talk to the media or testify before Congress about your injury? ___Yes  ___No
 
 
Tell us about your injury
 
8)  Is your injury a
     ___ One-time musculoskeletal injury
     ___ Cumulative injury from repetitive physical motion
     ___ Both
    
     Describe your injury: 
 
 
9)   What one-time or repetitive motion caused the injury? 
 
 
10)  How might the injury have been prevented? 
 
 
11)  Did you miss work due to the injury?   ___ Yes  How Long? ____________   ___ No
 
12)  Did you require surgery?   ___ Yes  ___ No
 
13)  Did you require physical therapy?  ___ Yes  ___ No
 
14)  Do you suffer from chronic pain or other long-term effects from the injury?  ___Yes ___No
        If yes, describe them:
 
 
15)  Did you change positions or clinical areas after the injury?  ___ Yes  ___ No
 
16)  What type of unit do you work in? 
 
 
Tell us about your workplace
 
17)  Are you a union member?  ___ Yes  ___ No
        If yes, what union?
 
18)  What was your employer’s response to your injury? 
 
 
19)  Did you file a workers’ compensation claim?  ___ Yes  ___ No 
        If no, why not? 
 
 
20)  Does your facility have patient lifting or other devices?  ___ Yes  ___ No
        If yes, what kind of devices?
 
 
21)  Do they work?  ___ Yes  ___ No
 
22)  Are they accessible to you at work?   ___ Yes  ___ No
 
23)  Do you use the lifting devices?    ___ Yes  ___ No 
        If no, why not?
 
 
24)  Does your facility have a no-manual lift policy?   ___ Yes  ___ No
 
25)  Does your facility have an ergonomics/safe patient handling committee?   ___ Yes  ___ No
 
 
PLEASE RESPOND BY APRIL 20, 2007. 
 
Mail to:   UAN
                United American Nurses, AFL-CIO
                8515 Georgia Ave.
                Silver Spring, MD 20910



March 2, 2007
Dear WING USA,
 
United American Nurses, AFL-CIO, is conducting a survey called "Unsafe Handling -- Not on My Back!" 
at http://www.uannurse.org/lift/index.html.    
 
UAN needs stories of injured nurses to "put a face to the statistics" in their work with US Representative John Conyers (D-MI) for passage of HR 378, Nurse and Patient Safety and Protection Act of 2007.   
 
Your survey responses are confidential unless you grant permission to use your information publicly.  You may also indicate if you are willing to talk to the media or to testify before Congress. 
 
UAN NEEDS THE SURVEYS BY APRIL 20, 2007.   
 
For any questions about the survey, please contact Suzanne Martin at 301-628-5133 or suzanne.martin@uannurse.org
 
Thank you for considering sharing information about your injury in the quest for safe patient handling in America. 
 
Best wishes to all...Anne
 
Anne Hudson, RN, BSN
March 2, 2007
Founder Work Injured Nurses' Group USA
Coos Bay, Oregon
anne@wingusa.org    
      


2/7/07
Dear WING USA,
 

Express Your Support 
Nurse and Patient Safety and Protection Act of 2007

To express support of HR 378 Nurse and Patient Safety and Protection Act of 2007, introduced January 10, 2007, by Representative John Conyers, Jr, (D MI-14), you may contact Representative Conyers and Mr. Joel Segal, Legislative Assistant on Health Policy: 
 
        The Honorable John Conyers, Jr
        U.S. House of Representatives
        2426 Rayburn Building
        Washington, DC 20515
       John.Conyers@mail.house.gov
        (202) 225-5126
 
        Mr. Joel Segal, Legislative Assistant on Health Policy
        Office of the Honorable John Conyers, Jr
        2426 Rayburn Building
        Washington, DC 20515
      Joel.Segal@mail.house.gov
        (202) 225-5126
 
Following is a summary of HR 378, status of the bill at this writing 2/7/07, and instructions to track progress of HR 378.  All best wishes to each of you...Anne   
 
Anne Hudson, RN, BSN
Coos Bay, Oregon
Work Injured Nurses' Group USA
anne@wingusa.org
www.wingusa.org 
 


 
HR 378 Summary as of 1/10/2007 -- Introduced.  From http://thomas.loc.gov/:
 
"Nurse and Patient Safety & Protection Act of 2007 - Requires the Secretary of Labor, acting through the Director of Occupational Safety and Health Administration, to establish a Federal Safe Patient Handling Standard to prevent musculoskeletal disorders for direct-care registered nurses and other health care providers working in health care facilities by requiring the elimination of manual lifting of patients through the use of mechanical devices, except during a declared state of emergency.
 
"Requires health care facilities to: (1) develop and implement a safe patient handling plan consistent with such standard; and (2) post a uniform notice that explains the standard and the procedures to report patient handling-related injuries.  Requires the Secretary to direct the Occupational Safety and Health Administration to conduct audits of plan implementation and compliance.
 
"Authorizes health care providers to: (1) refuse to accept an assignment in a health care facility if the assignment would violate the standard or if such provider is not prepared to fulfill the assignment without compromising the patient safety or jeopardizing the provider's license; and (2) file complaints against facilities that violate this Act. Requires the Secretary to investigate complaints and to prohibit retaliation if violations occur.  Prohibits health care facilities from retaliating with respect to employment against providers for such refusal or against any individual who in good faith reports a violation, participates in an investigation or proceeding, or discusses violations.
 
"Authorizes health care providers who have been retaliated against in violation of this Act to bring a cause of action in a U.S. district court.  Entitles providers that prevail to reinstatement, reimbursement of lost compensation, attorneys' fees, court costs, and/or other damages.
 
"Requires the Secretary of Health and Human Services to establish a grant program for purchasing safe patient handling equipment for health care facilities."
 
 
Status and Summary, as of February 7, 2007, from http://thomas.loc.gov:
HR 378 Nurse and Patient Safety & Protection Act of 2007
 
"Title:  To direct the Secretary of Labor to issue an occupational safety and health standard to reduce injuries to patients, direct-care registered nurses, and other health care providers by establishing a safe patient handling standard.

"Sponsor:  Rep Conyers, John, Jr. [MI-14] (introduced 1/10/2007)      Cosponsors (None)

"Latest Major Action:  1/10/2007 Referred to House committee. 
 
"Status:  Referred to the Committee on Education and Labor, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned."
 
 
To track progress of HR 378:   
Go to http://thomas.loc.gov
At the "Search Bill Text" box, select "Bill Number," enter "HR 378" in the box, and click Search.
This takes you to the page with the text of HR 378.  Select "Bill Summary and Status."
See "Latest Major Action."  Click "All Information" for Summary, All Actions, etc.


January 17, 2007
Dear WING USA,
 
Following below is wording of HR 378, the newly introduced Nurse and Patient Safety & Protection Act of 2007, posted online at Library of Congress Thomas:  http://thomas.loc.gov
 
Anne Hudson, RN, BSN
Work Injured Nurses' Group USA
Coos Bay, Oregon
anne@wingusa.org
www.wingusa.org
 

 
Nurse and Patient Safety & Protection Act of 2007 (Introduced in House)
 
HR 378 IH

110th CONGRESS

1st Session
H. R. 378

To direct the Secretary of Labor to issue an occupational safety and health standard to reduce injuries to patients, direct-care registered nurses, and other health care providers by establishing a safe patient handling standard.

IN THE HOUSE OF REPRESENTATIVES

January 10, 2007

Mr. CONYERS introduced the following bill; which was referred to the Committee on Education and Labor, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned

A BILL

To direct the Secretary of Labor to issue an occupational safety and health standard to reduce injuries to patients, direct-care registered nurses, and other health care providers by establishing a safe patient handling standard.

• Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,


SECTION 1. SHORT TITLE; FINDINGS.

• (a) Short Title- This Act may be cited as the `Nurse and Patient Safety & Protection Act of 2007'.

• (b) Findings- Congress finds the following:

• (1) Direct-care registered nurses rank 10th among all occupations for musculoskeletal disorders, sustaining injuries at a higher rate than laborers, movers, and truck drivers. In 2004, nurses sustained 8,800 musculoskeletal disorders, most of which (over 7,000) were back injuries. The leading cause of these injuries in health care are the result of patient lifting, transferring, and repositioning injuries.

• (2) The physical demands of the nursing profession lead many nurses to leave the profession. Fifty-two percent of nurses complain of chronic back pain and 38 percent suffer from pain severe enough to require leave from work. Many nurses and other health care providers suffering back injury do not return to work.

• (3) Patients are not at optimum levels of safety while being lifted, transferred, or repositioned manually. Mechanical lift programs can substantially reduce skin tears suffered by patients, allowing patients a safer means to progress through their care.

• (4) The development of assistive patient handling equipment and devices has essentially rendered the act of strict manual patient handling unnecessary as a function of nursing care.

• (5) Application of assistive patient handling technology fulfills an ergonomic approach within the nursing practice by designing and fitting the job or workplace to match the capabilities and limitations of the human body.

• (6) A growing number of health care facilities have incorporated patient handling technology and have reported positive results. Injuries among nursing staff have dramatically declined since implementing patient handling equipment and devices. As a result, the number of lost work days due to injury and staff turnover has declined. Cost-benefit analyses have also shown that assistive patient handling technology successfully reduces workers' compensation costs for musculoskeletal disorders.

• (7) Establishing a safe patient handling standard for direct-care registered nurses and other health care providers is a critical component in increasing patient safety, protecting nurses, and addressing the nursing shortage.


SEC. 2. FEDERAL SAFE PATIENT HANDLING STANDARD.


• Not later than 1 year after the date of the enactment of this Act, the Secretary of Labor, acting through the Director of Occupational Safety and Health Administration, shall establish a Federal Safe Patient Handling Standard under section 6 of the Occupational Safety and Health Act of 1970 (29 U.S.C. 655) to prevent musculoskeletal disorders for direct-care registered nurses and other health care providers working in health care facilities. This standard shall require the elimination of manual lifting of patients by direct-care registered nurses and other health care providers, through the use of mechanical devices, except during a declared state of emergency. The standard shall include a musculoskeletal injury prevention plan, which will include hazard identification and risk assessments in relation to patient care duties and patient handling. The standard shall require:

• (1) all health care facilities comply with the standard;

• (2) health care facilities to purchase, use, and maintain safe lift mechanical devices;

• (3) input from direct-care registered nurses and organizations representing direct-care registered nurses in implementing the standard;

• (4) a program to identify problems and solutions regarding safe patient handling;

• (5) a system to report, track, and analyze trends in injuries, as well as make injury data available to the public;

• (6) training for staff on safe patient handling policies, equipment, and devices at least on an annual basis. Training will also include hazard identification, assessment, and control of musculoskeletal hazards in patient care areas, which would include interactive classroom-based and hands-on training by a knowledgeable person or staff; and

• (7) annual evaluations of safe patient handling efforts, as well as new technology, handling procedures, and engineering controls. Documentation of this process shall include equipment selection and evaluation.


SEC. 3. REQUIREMENT FOR HEALTH CARE FACILITIES.


• (a) Safe Patient Handling Plan- In accordance with the standard required under section 2, and not later than 6 months after such standard is published, health care facilities shall develop and implement a safe patient handling plan that--

• (1) provides adequate, appropriate, and quality delivery of health care services that protects patient safety and prevents musculoskeletal disorders for direct-care registered nurses and other health care providers;

• (2) is consistent with the requirements of the Federal Safe Patient Handling Standard (as established in section 2);

• (3) provides for input by direct-care registered nurses and organizations representing direct-care registered nurses in implementing the plan; and

• (4) ensures that safe lifting mechanical devices shall only be used by direct care registered nurses and other health care providers.

• (b) Posting, Records, and Auditing-

• (1) POSTING REQUIREMENTS- Not later than 6 months after the standard required under section 2 is published, a health care facility shall post, in each unit of the facility, a uniform notice in a form specified by the Secretary in regulation that--

• (A) explains the Federal Safe Patient Handling Standard issued under section 2;

• (B) includes information regarding safe patient handling polices and training; and

• (c) explains procedure to report patient handling-related injuries.

• (2) AUDITS- The Secretary of Labor shall require the Occupational Safety and Health Administration to conduct unscheduled audits to ensure--

• (A) implementation of the safe patient handling plan in accordance with this Act and the standard established under section 2; and

• (B) compliance with reporting and reviewing findings for continual improvements to the safe patient handling plan.


SEC. 4. PROTECTION OF DIRECT-CARE REGISTERED NURSES AND OTHER INDIVIDUALS.


• (a) Refusal of Assignment- A direct-care registered nurse or other health care provider may refuse to accept an assignment in a health care facility if--

• (1) the assignment would violate the standard establish under section 2; or

• (2) the direct-care registered nurse or other health care provider is not prepared by education, training, or experience to fulfill the assignment without compromising the safety of any patient or jeopardizing the license of the nurse.

• (b) Retaliation for Refusal of Assignment Barred-

• (1) NO DISCHARGE, DISCRIMINATION, OR RETALIATION- No health care facility shall discharge, discriminate, or retaliate in any manner with respect to any aspect of employment, including discharge, promotion, compensation, or terms, conditions, or privileges of employment, against a direct-care registered nurse or other health care provider based on his or her refusal of a work assignment under subsection (a).

• (2) NO FILING OF COMPLAINT- No health care facility shall file a complaint or a report against a direct-care registered nurse or other health care provider with the appropriate State professional disciplinary agency because of his or her refusal of a work assignment under subsection (a).

• (c) Complaint to Secretary- A direct-care registered nurse, health care provider, or other individual may file a complaint with the Secretary of Labor against a health care facility that violates this Act or a standard established under this Act. For any complaint filed, the Secretary shall--

• (1) receive and investigate the complaint;

• (2) determine whether a violation of this Act as alleged in the complaint has occurred; and

• (3) if such a violation has occurred, issue an order that the complaining direct-care registered nurse, health care provider, or other individual shall not suffer any retaliation under subsection (b) or under subsection (d).

• (d) Whistleblower Protection-

• (1) RETALIATION BARRED- A health care facility shall not discriminate or retaliate in any manner with respect to any aspect of employment, including hiring, discharge, promotion, compensation, or terms, conditions, or privileges of employment against any individual who in good faith, individually or in conjunction with another person or persons--

• (A) reports a violation or a suspected violation of this Act or the standard established under this Act to the Secretary of Labor, a public regulatory agency, a private accreditation body, or the management personnel of the health care facility;

• (B) initiates, cooperates, or otherwise participates in an investigation or proceeding brought by the Secretary, a public regulatory agency, or a private accreditation body concerning matters covered by this Act; or

• (C) informs or discusses with other individuals or with representatives of health care facility employees a violation or suspected violation of this Act.

• (2) GOOD FAITH DEFINED- For purposes of this subsection, an individual shall be deemed to be acting in good faith if the individual reasonably believes--

• (A) the information reported or disclosed is true; and

• (B) a violation of this Act or the standard established under this Act has occurred or may occur.

• (e) Cause of Action- Any direct-care registered nurse or other health care provider who has been discharged, discriminated, or retaliated against in violation of subsection (b)(1) or (d), or against whom a complaint has been filed in violation of subsection (b)(2), may bring a cause of action in a United States district court. A direct-care registered nurse or other health care provider who prevails on the cause of action shall be entitled to one or more of the following:

• (1) Reinstatement.

• (2) Reimbursement of lost wages, compensation, and benefits.

• (3) Attorneys' fees.

• (4) Court costs.

• (5) Other damages.

• (f) Notice- A health care facility shall include in the notice required under section 3(b) an explanation of the rights of direct-care registered nurses, health care providers, and other individuals under this section and a statement that a direct-care registered nurse, health care provider, or other individual may file a complaint with the Secretary against a health care facility that violates the standard issued under section 2, including instructions for how to file such a complaint.


SEC. 5. DEFINITIONS.


• For purposes of this Act:

• (1) DIRECT-CARE REGISTERED NURSE- The term `direct care registered nurse' means an individual who has been granted a license by at least 1 State to practice as a registered nurse and who provides bedside care or outpatient services for 1 or more patients.

• (2) HEALTH CARE PROVIDER- The term `health care provider' means any person required by State or Federal laws or regulations to be licensed, registered, or certified to provide health care services, and being either so licensed, registered, or certified, or exempted from such requirement by other statute or regulation.

• (3) EMPLOYMENT- The term `employment' includes the provision of services under a contract or other arrangement.

• (3) HEALTH CARE FACILITY- The term `health care facility' means an outpatient health care facility, hospital, nursing home, home health care agency, hospice, federally qualified health center, nurse managed health center, rural health clinic, or any similar healthcare facility that employs direct-care registered nurses.

• (4) DECLARED STATE OF EMERGENCY- The term `declared state of emergency' means an officially designated state of emergency that has been declared by the Federal Government or the head of the appropriate State or local governmental agency having authority to declare that the State, county, municipality, or locality is in a state of emergency, but does not include a state of emergency that results from a labor dispute in the health care industry or consistent under staffing.


SEC. 6. FINANCIAL ASSISTANCE TO NEEDY HEALTH CARE FACILITIES IN THE PURCHASE OF SAFE PATIENT HANDLING EQUIPMENT.


• (a) In General- The Secretary of Health and Human Services shall establish a grant program that provides financial assistance to cover some or all of the costs of purchasing safe patient handling equipment for health care facilities, such as hospitals, nursing facilities, and outpatient facilities, that--

• (1) require the use of such equipment in order to comply with the standards established under section 2; but

• (2) demonstrate the financial inability to otherwise afford the purchase of such equipment are provided grants for some or all of the cost of purchasing such equipment.

• (b) Application- No financial assistance shall be provided under this section except pursuant to an application made to the Secretary of Health and Human Services in such form and manner as the Secretary shall specify. The Secretary shall establish a fair standard whereby the facility must clearly demonstrate true financial need in order to establish eligibility for the grant program.

• (c) Authorization of Appropriations- There are authorized to be appropriated for financial assistance under this section $50,000,000, which shall remain available until expended.
END


January 16, 2007
Dear WING USA friends:
 
HR 378:  National Safe Patient Handling Legislation Re-Introduced
 
US Representative John Conyers, Jr, Democrat, Michigan District 14, has re-introduced legislation for a national Safe Patient Handling law.  Originally introduced on September 26, 2006, as HR 6182, the new bill HR 378 was introduced into the US House of Representatives on January 10, 2007, by Representative Conyers “To direct the Secretary of Labor to issue an occupational safety and health standard to reduce injuries to patients, direct-care registered nurses, and other health care providers by establishing a safe patient handling standard.”  HR 378 was referred to the Committee on Education and Labor and to the Committee on Energy and Commerce “for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned” [http://thomas.loc.gov/cgi-bin/bdquery].   
 
When categories of healthcare workers are combined, including nurse aides, registered nurses, licensed practical nurses, and other healthcare workers who are required to lift people, they consistently suffer more musculoskeletal disorders than any other worker in the country [Table 12. Number of nonfatal occupational injuries and illnesses involving days away from work involving musculoskeletal disorders by selected occupations, 2004.  Bureau of Labor Statistics. U.S. Dept of Labor.  Dec 2005.  http://stats.bls.gov/iif/oshwc/osh/case/ostb1510.pdf.]  
 
The injuries continue because healthcare workers, 95% of whom are female, are required to lift hazardous amounts of weight which are not tolerated in many male-dominated industries.  Though the Occupational Safety and Health Act of 1970 states that all work places are to be “free from recognized hazards,” there is inadequate enforcement to curtail manual patient lifting shown by research to be a high risk of serious spinal injury [William S Marras et al. 1999.  “A Comprehensive Analysis of Low-Back Disorder Risk and Spinal Loading During the Transferring and Repositioning of Patients Using Different Techniques.”  Ergonomics.  42(7), 915]. 
 
With apparent lack of enforcement of the OSH Act related to dangerous lifting of people by other people, often in a forward leaning position with the spine in its most vulnerable position, and with much of the healthcare industry apparently unable to regulate itself, the US must have industry-specific legislation to protect and preserve our country’s precious supply of nurses and other healthcare workers.  In light of our most critical nurse shortage ever, it is obscene for healthcare employers to require unsafe lifting, essentially causing serious, sometimes disabling, injuries to nurses and other healthcare workers who want to work! 
 
With nearly 6,000 hospitals and 18,000 nursing homes in America, it would seem impossible to go one-by-one expecting to convince every facility to please voluntarily comply with implementation of “Safe Patient Handling--No Manual Lift,” with enforced policy, thorough training, and adequate amounts of appropriate well-maintained equipment.  Because the healthcare industry is apparently unable to self-regulate to stop preventable injuries to their workers, legislation mandating the safe handling of patients is imperative. 
 
The progress of HR 378 can be tracked at http://thomas.loc.gov.   At this writing on Januarly 16, 2007, the bill text had not yet been received from the Government Printing Office by the Library of Congress for posting.  Watch the site http://thomas.loc.gov as the wording of HR 378 should be posted soon.  Sincere best wishes to each of you...Anne  
 
Anne Hudson, RN, BSN 
January 16, 2007
Work Injured Nurses' Group USA
anne@wingusa.org
www.wingusa.org 


Dear WING USA,
 
Governor Schwarzenegger Vetoes Legislation for Safe Patient Handling Again, and Again, and Again
 
For the third time, in three consecutive years, Governor Arnold Schwarzenegger has vetoed legislation for safe patient handling in California.  Senate Bill 1204 "Patient Safety and Health Care Worker Protection Act" passed the California Assembly on August 28, 2006, and passed the Senate on August 31, 2006. 
 
On September 29, 2006, Governor Schwarzenegger vetoed SB 1204, which would have become effective on July 1, 2007.  Reiterating his concern over "inflexible requirements," Governor Schwarzenegger's Veto Message states that hospitals throughout California have reported progress in implementing lift policies and "that allowing hospitals the flexibility to implement lift policies that meet their individual needs is far more effective than imposing a rigid one-size-fits-all mandate on every hospital in California."
 
To read Governor Schwarzenegger's Veto Message:
 
At http://www.leginfo.ca.gov/bilinfo.html, select "Senate" and enter "1204" in the Search box.  This takes you to the page with links to SB 1204's Status, History, and Enrolled Bill Text.  At the bottom of the page is a link to the Veto Message.  
 
Best wishes to each of you...Anne
 
Anne Hudson, RN
October 8, 2006
anne@wingusa.org
www.wingusa.org


Dear WING USA:
 
To let you know of the momentous move of our country toward national legislation for safe patient handling. 
 
Yesterday, on 9-26-06, U.S. Representative John Conyers (MI-14) introduced HR 6182, the long-awaited bill to amend the OSH Act of 1970 with establishment of a safe patient handling standard for the United States of America. 
 
A query at http://thomas.loc.gov/  in "Browse Bills by Sponsor" for "Conyers, John, Jr [D-MI-14] gives the site http://thomas.loc.gov/cgi-bin/bdquery with Item # 45: 
 
"H.R.6182 : To amend the Occupational Safety and Health Act of 1970 to reduce injuries to patients, direct-care registered nurses, and other health care providers by establishing a safe patient handling standard.
 
"Sponsor:  Rep Conyers, John, Jr. [MI-14] (introduced 9/26/2006).   Cosponsors (None).
"Committees:  House Education and the Workforce; House Energy and Commerce.
"Latest Major Action:  9/26/2006 Referred to House committee.  Status: Referred to the Committee on Education and the Workforce, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned."  
 
The link from H.R.6182 explains that the text of HR 6182 is not yet available online because "The text of H.R.6182 has not yet been received from GPO [Government Printing Office].  Bills are generally sent to the Library of Congress from the Government Printing Office a day or two after they are introduced on the floor of the House or Senate.  Delays can occur when there are a large number of bills to prepare or when a very large bill has to be printed."
 
The text of HR 6182 as introduced should be available soon online.
 
Best wishes to all as we celebrate this historic step toward national protection for healthcare workers and patients from preventable injuries with patient handling...Anne
 
Anne Hudson, RN
September 27, 2006
anne@wingusa.org
www.wingusa.org  Work Injured Nurses' Group USA


Nurse And Patient Safety & Protection Act of 2006 (Introduced in House)
 
HR 6182 IH

109th CONGRESS

2d Session
H. R. 6182
To amend the Occupational Safety and Health Act of 1970 to reduce injuries to patients, direct-care registered nurses, and other health care providers by establishing a safe patient handling standard.
IN THE HOUSE OF REPRESENTATIVES

September 26, 2006
Mr. CONYERS introduced the following bill; which was referred to the Committee on Education and the Workforce, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned
A BILL
To amend the Occupational Safety and Health Act of 1970 to reduce injuries to patients, direct-care registered nurses, and other health care providers by establishing a safe patient handling standard.

• Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE; FINDINGS.

• (a) Short Title- This Act may be cited as the `Nurse And Patient Safety & Protection Act of 2006'.

• (b) Findings- Congress finds the following:

• (1) Direct-care registered nurses rank 10th among all occupations for musculoskeletal disorders, sustaining injuries at a higher rate than laborers, movers, and truck drivers. In 2004, nurses sustained 8,800 musculoskeletal disorders, most of which (over 7,000) were back injuries. The leading cause of these injuries in health care are the result of patient lifting, transferring, and repositioning injuries.

• (2) The physical demands of the nursing profession lead many nurses to leave the profession. Fifty two percent of nurses complain of chronic back pain and 38 percent suffer from pain severe enough to require leave from work. Many nurses and other health care providers suffering back injury do not return to work.

• (3) Patients are not at optimum levels of safety while being lifted, transferred, or repositioned manually. Mechanical lift programs can substantially reduce skin tears suffered by patients, allowing patients a safer means to progress through their care.

• (4) The development of assistive patient handling equipment and devices has essentially rendered the act of strict manual patient handling unnecessary as a function of nursing care.

• (5) Application of assistive patient handling technology fulfills an ergonomic approach within the nursing practice by designing and fitting the job or workplace to match the capabilities and limitations of the human body.

• (6) A growing number of health care facilities have incorporated patient handling technology and have reported positive results. Injuries among nursing staff have dramatically declined since implementing patient handling equipment and devices. As a result, the number of lost work days due to injury and staff turnover has declined. Cost-benefit analyses have also shown that assistive patient handling technology successfully reduces workers' compensation costs for musculoskeletal disorders.

• (7) Establishing a safe patient handling standard for direct-care registered nurses and other health care providers is a critical component in increasing patient safety, protecting nurses, and addressing the nursing shortage.

SEC. 2. FEDERAL SAFE PATIENT HANDLING STANDARD.

• Not later than 1 year after the date of the enactment of this title, the Secretary of Labor, acting through the Director of Occupational Safety and Health Administration, shall establish a Federal Safe Patient Handling Standard to prevent musculoskeletal disorders for direct-care registered nurses and other health care providers working in health care facilities. This standard shall require the elimination of manual lifting of patients by direct-care registered nurses and other health care providers, through the use of mechanical devices, except during a declared state of emergency. The standard shall include a musculoskeletal injury prevention plan, which will include hazard identification and risk assessments in relation to patient care duties and patient handling. The standard shall require:

• (1) all health care facilities comply with the standard;

• (2) health care facilities to purchase, use, and maintain safe lift mechanical devices;

• (3) input from direct-care registered nurses and organizations representing direct-care registered nurses in implementing the standard;

• (4) a program to identify problems and solutions regarding safe patient handling;

• (5) a system to report, track, and analyze trends in injuries, as well as make injury data available to the public;

• (6) training for staff on safe patient handling policies, equipment, and devices at least on an annual basis. Training will also include hazard identification, assessment and control of musculoskeletal hazards in patient care areas, this would include interactive classroom based and hands on training by a knowledgeable person or staff; and

• (7) annual evaluations of safe patient handling efforts, as well as new technology, handling procedures, and engineering controls. Documentation of this process shall include equipment selection and evaluation.

SEC. 3. REQUIREMENT FOR HEALTH CARE FACILITIES.

• (a) Safe Patient Handling Plan- In accordance with the standard required under section 2, and not later than 6 months after such standard is published, health care facilities shall develop and implement a safe patient handling plan that--

• (1) provides adequate, appropriate, and quality delivery of health care services that protects patient safety and prevents musculoskeletal disorders for direct-care registered nurses and other health care providers;

• (2) is consistent with the requirements of the Federal Safe Patient Handling Standard (as established in section 2);

• (3) provides for input by direct-care registered nurses and organizations representing direct-care registered nurses in implementing the plan; and

• (4) ensures that safe lifting mechanical devices shall only be used by direct care registered nurses and other health care providers.

• (b) Posting, Records, and Auditing-

• (1) POSTING REQUIREMENTS- Not later than 6 months after the standard required under section 2 is published, a health care facility shall post, in each unit of the facility, a uniform notice in a form specified by the Secretary in regulation that--

• (A) explains the Federal Safe Patient Handling Standard issued under section 2;

• (B) includes information regarding safe patient handling polices and training; and

• (C) explains procedure to report patient handling-related injuries.

• (2) AUDITS- The Secretary shall require the Occupational Safety and Health Administration to conduct unscheduled audits to ensure--

• (A) implementation of the safe patient handling plan in accordance with this title; and

• (B) compliance with reporting and reviewing findings for continual improvements to the safe patient handling plan.

SEC. 4. PROTECTION OF DIRECT-CARE REGISTERED NURSES AND OTHER INDIVIDUALS.

• (a) Refusal of Assignment- A direct-care registered nurse or other health care provider may refuse to accept an assignment in a health care facility if--

• (1) the assignment would violate the standard establish under section 2; or

• (2) the direct-care registered nurse or other health care provider is not prepared by education, training, or experience to fulfill the assignment without compromising the safety of any patient or jeopardizing the license of the nurse.

• (b) Retaliation for Refusal of Assignment Barred-

• (1) NO DISCHARGE, DISCRIMINATION, OR RETALIATION- No health care facility shall discharge, discriminate, or retaliate in any manner with respect to any aspect of employment, including discharge, promotion, compensation, or terms, conditions, or privileges of employment, against a direct-care registered nurse or other health care provider based on his or her refusal of a work assignment under subsection (a).

• (2) NO FILING OF COMPLAINT- No health care facility shall file a complaint or a report against a direct-care registered nurse or other health care provider with the appropriate State professional disciplinary agency because of his or her refusal of a work assignment under subsection (a).

• (c) Complaint to Secretary- A direct-care registered nurse, health care provider, or other individual may file a complaint with the Secretary against a health care facility that violates this Act or a standard established under this Act. For any complaint filed, the Secretary shall--

• (1) receive and investigate the complaint;

• (2) determine whether a violation of this Act as alleged in the complaint has occurred; and

• (3) if such a violation has occurred, issue an order that the complaining direct-care registered nurse, health care provider, or other individual shall not suffer any retaliation under subsection (b) or under subsection (d).

• (d) Whistleblower Protection-

• (1) RETALIATION BARRED- A health care facility shall not discriminate or retaliate in any manner with respect to any aspect of employment, including hiring, discharge, promotion, compensation, or terms, conditions, or privileges of employment against any individual who in good faith, individually or in conjunction with another person or persons--

• (A) reports a violation or a suspected violation of this Act or the standard established under this Act to the Secretary, a public regulatory agency, a private accreditation body, or the management personnel of the health care facility;

• (B) initiates, cooperates, or otherwise participates in an investigation or proceeding brought by the Secretary, a public regulatory agency, or a private accreditation body concerning matters covered by this Act; or

• (C) informs or discusses with other individuals or with representatives of health care facility employees a violation or suspected violation of this Act.

• (2) GOOD FAITH DEFINED- For purposes of this subsection, an individual shall be deemed to be acting in good faith if the individual reasonably believes--

• (A) the information reported or disclosed is true; and

• (B) a violation of this Act or the standard established under this Act has occurred or may occur.

• (e) Cause of Action- Any direct-care registered nurse or other health care provider who has been discharged, discriminated, or retaliated against in violation of subsection (b)(1) or (d), or against whom a complaint has been filed in violation of subsection (b)(2), may bring a cause of action in a United States district court. A direct-care registered nurse or other health care provider who prevails on the cause of action shall be entitled to one or more of the following:

• (1) Reinstatement.

• (2) Reimbursement of lost wages, compensation, and benefits.

• (3) Attorneys' fees.

• (4) Court costs.

• (5) Other damages.

• (f) Notice- A health care facility shall include in the notice required under section 3(b) an explanation of the rights of direct-care registered nurses, health care providers, and other individuals under this section and a statement that a direct-care registered nurse, health care provider, or other individual may file a complaint with the Secretary against a health care facility that violates the standard issued under section 2, including instructions for how to file such a complaint.

SEC. 5. DEFINITIONS.

• For purposes of this Act:

• (1) DIRECT-CARE REGISTERED NURSE- The term `direct care registered nurse' means an individual who has been granted a license by at least 1 State to practice as a registered nurse and who provides bedside care or outpatient services for 1 or more patients.

• (2) HEALTH CARE PROVIDER- The term `health care provider' means any person required by State or Federal laws or regulations to be licensed, registered, or certified to provide health care services, and being either so licensed, registered, or certified, or exempted from such requirement by other statute or regulation.

• (3) EMPLOYMENT- The term `employment' includes the provision of services under a contract or other arrangement.

• (4) HEALTH CARE FACILITY- The term `health care facility' means an outpatient health care facility, hospital, nursing home, home health care agency, hospice, federally qualified health center, nurse managed health center, rural health clinic, or any similar healthcare facility that employs direct-care registered nurses.

• (5) DECLARED STATE OF EMERGENCY- The term `declared state of emergency' means an officially designated state of emergency that has been declared by the Federal Government or the head of the appropriate State or local governmental agency having authority to declare that the State, county, municipality, or locality is in a state of emergency, but does not include a state of emergency that results from a labor dispute in the health care industry or consistent under staffing.

SEC. 6. FINANCIAL ASSISTANCE TO NEEDY HEALTH CARE FACILITIES IN THE PURCHASE OF SAFE PATIENT HANDLING EQUIPMENT.

• (a) In General- The Secretary of Health and Human Services shall establish a grant program that provides financial assistance to cover some or all of the costs of purchasing safe patient handling equipment for health care facilities, such as hospitals, nursing facilities, and outpatient facilities, that--

• (1) require the use of such equipment in order to comply with the standards established under section 2; but

• (2) demonstrate the financial inability to otherwise afford the purchase of such equipment are provided grants for some or all of the cost of purchasing such equipment.

• (b) Application- No financial assistance shall be provided under this section except pursuant to an application made to the Secretary in such form and manner as the Secretary shall specify. The Secretary shall establish a fair standard whereby the facility must clearly demonstrate true financial need in order to establish eligibility for the grant program.

• (c) Authorization of Appropriations- There are authorized to be appropriated for financial assistance under this section $50,000,000, which shall remain available until expended.
END


Greetings WING USA,   
 
NurseWeek has graciously granted permission to forward their "Five Minutes With" interview by Don Vaughan, June 19, 2006, titled "Anne Hudson, RN, On 'No Lift' Legislation" (following below) with the link to NurseWeek's website. 
 
The website is http://www.nurseweek.com/ and the article can be accessed by clicking on "Read current NurseWeek magazine articles"  Then click "California Edition" or "Mountain West Edition."  Then scroll down and click the article title (as more recent editions are published, you will need to click the "older" button and then click the article title) which links to this page: http://www2.nurseweek.com/Articles/article.cfm?AID=22082 (NurseWeek California Edition). 
 
NurseWeek California and NurseWeek Mountain West Editions both carried the interview article, as well as the "Up Front" editorial "Backing Up Nurses" by Judith Berg, RN, MS, CHE, Vice President of Professional and Editorial Services of NurseWeek Mountain West, and also the cover story "Watching Our Backs" by Phil McPeck which features nurses passionate about successful programs for preventing nurse injury caused by patient lifting. 
 
NurseWeek California's cover story, "Watching Our Backs - RNs Get a Lift from 'No Lift' Policies," features Washington State's new law mandating patient lift equipment in all hospitals.  "['No Lift'] is where all of nursing is headed, says Kim Armstrong, RN, president of the Washington State Nurses Association.  'It has to go to no lift because so many people in the health profession - aides, orderlies and RNs included - are receiving lifetime injuries,' she says."
 
In the editorial "Backing Up Nurses," Judith Berg reports that 35 years of research have proven that training in body mechanics, safe lifting techniques, and back belts are not effective in reducing injuries with patient lifting.  She says, "...health care facilities need to stop using outdated approaches and replace them with evidence-based strategies." 
 
Much gratitude to NurseWeek for extensive coverage of the ready solutions to devastating musculoskeletal injuries caused by manual patient lifting and for publishing Don Vaughan's interview of myself highlighting the need for federal legislation requiring the healthcare industry to practice safe patient handling with mechanical lift equipment instead of with the backs of nurses and other healthcare workers.  
 
A note about the photo in the article:  Credit to Elizabeth Langford, AM, RN, RM, BN, Grad. Dip. (Adv. Nsg), Coordinator of the Injured Nurses Support Group in Melbourne, Victoria, Australia, who took the photo when I spoke at the Australian Nursing Federation Victorian Branch "No Lifting Expo," on November 23, 2005.  Elizabeth Langford and I are international counterparts in working toward nurse injury prevention and as advocates for injured nurses. 
 
Please see Don Vaughan's interview, "Anne Hudson, RN - On 'No Lift' Legislation," following and at http://www.nurseweek.com
 
Best wishes to each of you...Anne
 
Anne Hudson, RN, BSN
anne@wingusa.org
www.wingusa.org  Work Injured Nurses' Group USA
July 4, 2006
 
 
"Anne Hudson, RN - On 'No Lift' Legislation."  Don Vaughn.  June 19, 2006.  Five Minutes With.  NurseWeek Mountain West Edition.  7(13), 12.  Online: http://www.nurseweek.com/.  Then, http://www2.nurseweek.com/Articles/article.cfm?AID=22150 (Mt W) and http://www2.nurseweek.com/Articles/article.cfm?AID=22082 (CA).
 

Anne Hudson, RN — On “No Lift” Legislation
By Don Vaughan
June 19, 2006

Photo by Elizabeth Langford

Anne Hudson, RN, BSN, of Coos Bay, Ore., knows firsthand the debilitating musculoskeletal injuries that can afflict nurses who are required to manually lift patients. Following a painful back injury in 2000, she started a website called B.I.N. There – Back-Injured Nurses, which was later renamed the Work Injured Nurses’ Group USA.
 
In the years since, Hudson, who is now a public health nurse, has become a vocal proponent of state and federal “safe patient handling – no manual lift” legislation, and lectures often on the hazards of manual lifting and the financial/workforce rewards that can result from the use of patient-lift equipment.                        
                                                                                                                
Q How did you become involved with the issue of “no lift” legislation?
 
All health care workers combined suffer more musculoskeletal injuries than any other occupation in America — with back injury from lifting patients removing more nurses from the bedside than any other kind of injury.  I discovered that even though research shows that manual patient lifting cannot be done safely, and that modern patient-lift equipment prevents injuries, many nursing schools still teach manual lifting and many hospitals and nursing homes do not provide safe lift equipment.
 
Even though the Occupational Safety and Health Act (OSHA) of 1970 General Duty clause states that all workplaces are to be “ … free from recognized hazards that are causing or likely to cause death or serious physical harm,” many facilities still [require nurses to manually lift patients.]
 
Q What exactly is “no lift” legislation?  What is your organization trying to achieve nationally and worldwide?
 
A comprehensive national “safe patient handling – no manual lift” law would require mechanical lifting equipment and friction-reducing devices for all health care workers, patients, and residents across all health care settings.  There simply is no such thing as safe manual patient lifting, for either nursing staff or for patients, who may suffer pain, skin tears, abrasions, bruising, dislocations, fractures, tube dislodgement, and being dropped.
 
Q Tell us about your own experiences with patient-lift issues.
 
As a hospital floor nurse, I felt strong and healthy.  I lifted and moved patients manually throughout every shift as I had been taught in nursing school and as practiced throughout the hospital.  I was happy to assist other nurses with their patients, as well.  I naively believed that hospitals would help nurses injured in their service to remain with them.  Because the handling of injured employees was never discussed at any nurse bargaining unit meetings or hospital employee meetings, nurses were generally unaware of what to expect from the workers’ compensation system if they became disabled by lifting.
 
Additionally, nurses were never taught how microfractures occur to spinal discs and vertebral endplates over time from repetitively lifting hazardous amounts of weight.  Because there are no pain receptors in the center of discs and in the vertebral endplates, microfractures may occur without pain until sudden extreme pain announces a severe spinal injury and the potential end of a nurse’s career.
 
Q How close are we to the passage of national “no lift” legislation?
 
I believe that as more states introduce and pass legislation for safe patient handling, momentum will build, leading quickly to a national “no manual lift for health care” standard.  With many dedicated people working toward this end, with the safety of patients and residents at risk, and with the country’s limited supply of nurses and other health care workers jeopardized by current dangerous manual lifting practices, I believe there are no barriers which cannot be overcome to achieve national legislation.
 
Q What is your organization doing to make nurses and others aware of this issue?
 
I continue speaking and writing about the danger of manual patient lifting to help get the word out.  I believe it is especially important to teach nurses how and why insidious damage occurs to spinal structures from repetitively lifting hazardous amounts of weight.  Nurses who understand how spinal damage may occur over time without pain until the injury is severe often become champions for “no lift” policies with use of lift equipment.
 
Q What can nurses do to promote the passage of “no lift” legislation in their states?
 
They need to lobby their state legislators to introduce a “safe patient handling – no manual lift” bill. Wording for draft legislation may be patterned after states that have passed and that have introduced legislation, building upon the best language from each state.
 
Additionally, lobbying insurance companies for coverage of lift equipment for home use, including overhead ceiling lift systems, is essential to help dependent persons remain in their homes and to prevent injuries to family members and home care workers who assist with lifting and movement. The primary reason people move to long-term care facilities is inability of family membe. Insurance companies should assist dependent pe


Greetings All,
 
For the text of HR 6182 "Nurse And Patient Safety and Protection Act of 2006" which was introduced by U.S. Representative John Conyers (D-MI) into the U.S. House of Representatives on September 26, 2006:
 
Go here http://thomas.loc.gov/home/bills_res.html and click "Search Bill Text."  Then, under "Enter Search," select "Bill Number" and type "HR 6182" in the blank box, which takes you to the wording, which also follows below. 
 
Best to all...Anne
 
Anne Hudson, RN
September 29, 2006
anne@wingusa.org
www.wingusa.org  Work Injured Nurses' Group USA


  
Nurse And Patient Safety & Protection Act of 2006 (Introduced in House)
 
HR 6182 IH

109th CONGRESS

2d Session
H. R. 6182
To amend the Occupational Safety and Health Act of 1970 to reduce injuries to patients, direct-care registered nurses, and other health care providers by establishing a safe patient handling standard.
IN THE HOUSE OF REPRESENTATIVES

September 26, 2006
Mr. CONYERS introduced the following bill; which was referred to the Committee on Education and the Workforce, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned
A BILL
To amend the Occupational Safety and Health Act of 1970 to reduce injuries to patients, direct-care registered nurses, and other health care providers by establishing a safe patient handling standard.

• Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE; FINDINGS.

• (a) Short Title- This Act may be cited as the `Nurse And Patient Safety & Protection Act of 2006'.

• (b) Findings- Congress finds the following:

• (1) Direct-care registered nurses rank 10th among all occupations for musculoskeletal disorders, sustaining injuries at a higher rate than laborers, movers, and truck drivers. In 2004, nurses sustained 8,800 musculoskeletal disorders, most of which (over 7,000) were back injuries. The leading cause of these injuries in health care are the result of patient lifting, transferring, and repositioning injuries.

• (2) The physical demands of the nursing profession lead many nurses to leave the profession. Fifty two percent of nurses complain of chronic back pain and 38 percent suffer from pain severe enough to require leave from work. Many nurses and other health care providers suffering back injury do not return to work.

• (3) Patients are not at optimum levels of safety while being lifted, transferred, or repositioned manually. Mechanical lift programs can substantially reduce skin tears suffered by patients, allowing patients a safer means to progress through their care.

• (4) The development of assistive patient handling equipment and devices has essentially rendered the act of strict manual patient handling unnecessary as a function of nursing care.

• (5) Application of assistive patient handling technology fulfills an ergonomic approach within the nursing practice by designing and fitting the job or workplace to match the capabilities and limitations of the human body.

• (6) A growing number of health care facilities have incorporated patient handling technology and have reported positive results. Injuries among nursing staff have dramatically declined since implementing patient handling equipment and devices. As a result, the number of lost work days due to injury and staff turnover has declined. Cost-benefit analyses have also shown that assistive patient handling technology successfully reduces workers' compensation costs for musculoskeletal disorders.

• (7) Establishing a safe patient handling standard for direct-care registered nurses and other health care providers is a critical component in increasing patient safety, protecting nurses, and addressing the nursing shortage.

SEC. 2. FEDERAL SAFE PATIENT HANDLING STANDARD.

• Not later than 1 year after the date of the enactment of this title, the Secretary of Labor, acting through the Director of Occupational Safety and Health Administration, shall establish a Federal Safe Patient Handling Standard to prevent musculoskeletal disorders for direct-care registered nurses and other health care providers working in health care facilities. This standard shall require the elimination of manual lifting of patients by direct-care registered nurses and other health care providers, through the use of mechanical devices, except during a declared state of emergency. The standard shall include a musculoskeletal injury prevention plan, which will include hazard identification and risk assessments in relation to patient care duties and patient handling. The standard shall require:

• (1) all health care facilities comply with the standard;

• (2) health care facilities to purchase, use, and maintain safe lift mechanical devices;

• (3) input from direct-care registered nurses and organizations representing direct-care registered nurses in implementing the standard;

• (4) a program to identify problems and solutions regarding safe patient handling;

• (5) a system to report, track, and analyze trends in injuries, as well as make injury data available to the public;

• (6) training for staff on safe patient handling policies, equipment, and devices at least on an annual basis. Training will also include hazard identification, assessment and control of musculoskeletal hazards in patient care areas, this would include interactive classroom based and hands on training by a knowledgeable person or staff; and

• (7) annual evaluations of safe patient handling efforts, as well as new technology, handling procedures, and engineering controls. Documentation of this process shall include equipment selection and evaluation.

SEC. 3. REQUIREMENT FOR HEALTH CARE FACILITIES.

• (a) Safe Patient Handling Plan- In accordance with the standard required under section 2, and not later than 6 months after such standard is published, health care facilities shall develop and implement a safe patient handling plan that--

• (1) provides adequate, appropriate, and quality delivery of health care services that protects patient safety and prevents musculoskeletal disorders for direct-care registered nurses and other health care providers;

• (2) is consistent with the requirements of the Federal Safe Patient Handling Standard (as established in section 2);

• (3) provides for input by direct-care registered nurses and organizations representing direct-care registered nurses in implementing the plan; and

• (4) ensures that safe lifting mechanical devices shall only be used by direct care registered nurses and other health care providers.

• (b) Posting, Records, and Auditing-

• (1) POSTING REQUIREMENTS- Not later than 6 months after the standard required under section 2 is published, a health care facility shall post, in each unit of the facility, a uniform notice in a form specified by the Secretary in regulation that--

• (A) explains the Federal Safe Patient Handling Standard issued under section 2;

• (B) includes information regarding safe patient handling polices and training; and

• (C) explains procedure to report patient handling-related injuries.

• (2) AUDITS- The Secretary shall require the Occupational Safety and Health Administration to conduct unscheduled audits to ensure--

• (A) implementation of the safe patient handling plan in accordance with this title; and

• (B) compliance with reporting and reviewing findings for continual improvements to the safe patient handling plan.

SEC. 4. PROTECTION OF DIRECT-CARE REGISTERED NURSES AND OTHER INDIVIDUALS.

• (a) Refusal of Assignment- A direct-care registered nurse or other health care provider may refuse to accept an assignment in a health care facility if--

• (1) the assignment would violate the standard establish under section 2; or

• (2) the direct-care registered nurse or other health care provider is not prepared by education, training, or experience to fulfill the assignment without compromising the safety of any patient or jeopardizing the license of the nurse.

• (b) Retaliation for Refusal of Assignment Barred-

• (1) NO DISCHARGE, DISCRIMINATION, OR RETALIATION- No health care facility shall discharge, discriminate, or retaliate in any manner with respect to any aspect of employment, including discharge, promotion, compensation, or terms, conditions, or privileges of employment, against a direct-care registered nurse or other health care provider based on his or her refusal of a work assignment under subsection (a).

• (2) NO FILING OF COMPLAINT- No health care facility shall file a complaint or a report against a direct-care registered nurse or other health care provider with the appropriate State professional disciplinary agency because of his or her refusal of a work assignment under subsection (a).

• (c) Complaint to Secretary- A direct-care registered nurse, health care provider, or other individual may file a complaint with the Secretary against a health care facility that violates this Act or a standard established under this Act. For any complaint filed, the Secretary shall--

• (1) receive and investigate the complaint;

• (2) determine whether a violation of this Act as alleged in the complaint has occurred; and

• (3) if such a violation has occurred, issue an order that the complaining direct-care registered nurse, health care provider, or other individual shall not suffer any retaliation under subsection (b) or under subsection (d).

• (d) Whistleblower Protection-

• (1) RETALIATION BARRED- A health care facility shall not discriminate or retaliate in any manner with respect to any aspect of employment, including hiring, discharge, promotion, compensation, or terms, conditions, or privileges of employment against any individual who in good faith, individually or in conjunction with another person or persons--

• (A) reports a violation or a suspected violation of this Act or the standard established under this Act to the Secretary, a public regulatory agency, a private accreditation body, or the management personnel of the health care facility;

• (B) initiates, cooperates, or otherwise participates in an investigation or proceeding brought by the Secretary, a public regulatory agency, or a private accreditation body concerning matters covered by this Act; or

• (C) informs or discusses with other individuals or with representatives of health care facility employees a violation or suspected violation of this Act.

• (2) GOOD FAITH DEFINED- For purposes of this subsection, an individual shall be deemed to be acting in good faith if the individual reasonably believes--

• (A) the information reported or disclosed is true; and

• (B) a violation of this Act or the standard established under this Act has occurred or may occur.

• (e) Cause of Action- Any direct-care registered nurse or other health care provider who has been discharged, discriminated, or retaliated against in violation of subsection (b)(1) or (d), or against whom a complaint has been filed in violation of subsection (b)(2), may bring a cause of action in a United States district court. A direct-care registered nurse or other health care provider who prevails on the cause of action shall be entitled to one or more of the following:

• (1) Reinstatement.

• (2) Reimbursement of lost wages, compensation, and benefits.

• (3) Attorneys' fees.

• (4) Court costs.

• (5) Other damages.

• (f) Notice- A health care facility shall include in the notice required under section 3(b) an explanation of the rights of direct-care registered nurses, health care providers, and other individuals under this section and a statement that a direct-care registered nurse, health care provider, or other individual may file a complaint with the Secretary against a health care facility that violates the standard issued under section 2, including instructions for how to file such a complaint.

SEC. 5. DEFINITIONS.

• For purposes of this Act:

• (1) DIRECT-CARE REGISTERED NURSE- The term `direct care registered nurse' means an individual who has been granted a license by at least 1 State to practice as a registered nurse and who provides bedside care or outpatient services for 1 or more patients.

• (2) HEALTH CARE PROVIDER- The term `health care provider' means any person required by State or Federal laws or regulations to be licensed, registered, or certified to provide health care services, and being either so licensed, registered, or certified, or exempted from such requirement by other statute or regulation.

• (3) EMPLOYMENT- The term `employment' includes the provision of services under a contract or other arrangement.

• (4) HEALTH CARE FACILITY- The term `health care facility' means an outpatient health care facility, hospital, nursing home, home health care agency, hospice, federally qualified health center, nurse managed health center, rural health clinic, or any similar healthcare facility that employs direct-care registered nurses.

• (5) DECLARED STATE OF EMERGENCY- The term `declared state of emergency' means an officially designated state of emergency that has been declared by the Federal Government or the head of the appropriate State or local governmental agency having authority to declare that the State, county, municipality, or locality is in a state of emergency, but does not include a state of emergency that results from a labor dispute in the health care industry or consistent under staffing.

SEC. 6. FINANCIAL ASSISTANCE TO NEEDY HEALTH CARE FACILITIES IN THE PURCHASE OF SAFE PATIENT HANDLING EQUIPMENT.

• (a) In General- The Secretary of Health and Human Services shall establish a grant program that provides financial assistance to cover some or all of the costs of purchasing safe patient handling equipment for health care facilities, such as hospitals, nursing facilities, and outpatient facilities, that--

• (1) require the use of such equipment in order to comply with the standards established under section 2; but

• (2) demonstrate the financial inability to otherwise afford the purchase of such equipment are provided grants for some or all of the cost of purchasing such equipment.

• (b) Application- No financial assistance shall be provided under this section except pursuant to an application made to the Secretary in such form and manner as the Secretary shall specify. The Secretary shall establish a fair standard whereby the facility must clearly demonstrate true financial need in order to establish eligibility for the grant program.

• (c) Authorization of Appropriations- There are authorized to be appropriated for financial assistance under this section $50,000,000, which shall remain available until expended.
END
_________________________________________________________________________________

Dear friends,
 

Exciting news as more states have introduced and have passed legislation for safe patient handling (SPH).  With my last report, I had missed that Illinois introduced SPH legislation in January 2006 and that Hawaii adopted a resolution in April 2006 supporting SPH policies in American Nurses Association’s “Handle With Care” Campaign.  More recently, Rhode Island passed SPH legislation in June 2006.  (See details following below on Illinois, Hawaii, and Rhode Island.)
 
And, after two vetoes by California Governor Arnold Schwarzenegger, for the third time, SPH has passed the California Legislature and was delivered to the governor on September 12, 2006, with action by the governor pending at this writing. 
 
As the number of states with legislative activity for safe patient handling continues to grow, on the way to a national mandate for “safe patient handling—no manual lift,” I will attempt to keep you informed.  However, there are many states, and I may be unaware of their progress.  So, please email info on initiatives for safe patient handling in your state and I will be glad to forward to all. 
 
Wording of legislation passed and introduced by the following states can be used as model language for drafting initiatives in remaining states. 
 
 

States Which Have Passed Laws for Safe Patient Handling and Pertaining to Safe Patient Handling
 

Texas SB 1525, 6-17-05:  First to mandate implementation of policy for safe patient handling and movement programs by hospitals and nursing homes. 
http://www.capitol.state.tx.us/tlo/79R/billtext/SB01525F.HTM.
                                            
Washington HB 1672, 3-22-06: First to mandate provision of lift equipment by hospitals as part of their policy for safe patient handling; financial assistance with implementation by tax credits and reduced workers’ compensation premiums.
http://www.leg.wa.gov/pub/billinfo/2005-06/Pdf/Bills/House%20Passed%20Legislature/1672-S.PL.pdf.    
 
Hawaii House Concurrent Resolution No. 16, 4-24-06: Safeguards to be instituted in health care facilities to minimize the occurrence of musculoskeletal injuries suffered by nurses; calls for the Legislature of Hawaii to support policies in ANA’s Handle With Care Campaign.
http://www.capitol.hawaii.gov/sessioncurrent/bills/HCR16_.pdf
 
Rhode Island H 7386 and S 2760, 7-7-06: Hospitals and nursing facilities to “achieve maximum reasonable reduction of manual lifting, transferring, and repositioning …except in emergency, life-threatening, or otherwise exceptional circumstances.”
http://www.rilin.state.ri.us/Billtext/BillText06/HouseText06/H7386Aaa.pdf and
http://www.rilin.state.ri.us/Billtext/BillText06/SenateText06/S2760A.pdf 
 
Ohio HB 67, 3-21-05: Created workers’ comp loan for interest-free loans to nursing homes for lift equipment and implementing “No Manual Lifting of Residents” policy.  http://www.legislature.state.oh.us/bills.cfm?ID=126_HB_67_EN
 
New York A07641 and S04929, 10-18-05:  Created two-year “Safe Patient Handling Demonstration Program” to collect data on injuries and describe best practices. 
http://assembly.state.ny.us/leg/?bn=A07641&sh=t  and  http://assembly.state.ny.us/leg/?bn=S04929&sh=t
 
 

States Which Have Introduced Safe Patient Handling Legislation

 
California introduced companion bills.   
SB 1204, 1-25-06:  “Patient Safety and Health Care Worker Protection Act.”  
Passed Legislature 8-31-06.  Delivered to Governor 9-12-06 with action pending as of 9-14-06. 
Wording:  http://www.leginfo.ca.gov/pub/bill/sen/sb_1201-1250/sb_1204_bill_20060125_introduced.pdf.
History: http://www.leginfo.ca.gov/bilinfo.html.  Enter SB1204
 
AB 2716, 2-24-06:  “Hospitals: Lift Policies.”  Died, hearing cancelled by author in April 2006.  http://www.leginfo.ca.gov/pub/bill/asm/ab_2701-2750/ab_2716_bill_20060224_introduced.pdf
 
Massachusetts introduced:   
HB 2662, 1-26-05:  “An Act Relating to Safe Patient Handling in Certain Health Facilities.”
Wording:  http://www.mass.gov/legis/bills/house/ht02pdf/ht02662.pdf
History:  http://www.mass.gov/legis/184history/h02662.htm.    
 
New Jersey introduced companion bills:   
SB 1758, 3-21-06:  “Safe Patient Handling Act.”
Wording:  http://www.njleg.state.nj.us/2006/Bills/S2000/1758_I1.PDF.
History:  http://www.njleg.state.nj.us/bills/BillsByNumber.asp.  Enter SB 1758.
 
A3028, 5-15-06:  “Safe Patient Handling Practices Act”;
Wording: http://www.njleg.state.nj.us/2006/Bills/A3500/3028_I1.HTM
History: http://www.njleg.state.nj.us/bills/BillsByNumber.asp.  Enter A3028. 
 
Illinois introduced companion bills with identical wording:
Amend Nursing Home Care Act and Hospital Licensing Act
HB 4558, 1-11-06:
Wording:  http://www.ilga.gov/legislation/94/HB/PDF/09400HB4558lv.pdf
History:  http://www.ilga.gov/legislation/billstatus.asp?DocNum=4558&GAID=8&GA=94&DocTypeID=HB&LegID=22851&SessionID=50
 
SB 2692, 1-20-06:
Wording:   http://www.ilga.gov/legislation/94/SB/PDF/09400SB2692lv.pdf  
History:  http://www.ilga.gov/legislation/BillStatus.asp?DocNum=2692&GAID=8&DocTypeID=SB&LegId=23638&SessionID=50&GA=94
 
Florida companion bills died in committee on 5-6-06.
HB 1177:  “Patient Handling and Movement Practices.” 
Wording:  http://www.myfloridahouse.gov/Sections/Documents/loaddoc.aspx?FileName=_h1177__.doc&DocumentType=Bill&BillNumber=1177&Session=2006.
History: http://www.myfloridahouse.gov/Sections/Bills/billsdetail.aspx?BillId=33345&.
 
SB 2244:  “Patient Handling / Safe Movement.”
Wording: 
http://www.myfloridahouse.gov/Sections/Documents/loaddoc.aspx?FileName=_s2244__.html&DocumentType=Bill&BillNumber=2244&Session=2006.
History: http://www.myfloridahouse.gov/Sections/Bills/billsdetail.aspx?BillId=33408&.
 
See following for more info on Illinois, Hawaii, and Rhode Island. 
 
 

Illinois Introduces Legislation for Safe Patient Handling

 
Companion bills for safe patient handling, "Nursing Home-Hospital-Handle Patients," were introduced into the House and the Senate of Illinois in January of this year.  On January 11, 2006, House Bill 4558 was introduced by Representative Angelo Saviano.  On January 20, 2006, Senate Bill 2692 was introduced by Senator Donne E. Trotter. 
 
If passed, IL HB 4558 and SB 2692, which have identical wording, will “Require every nursing home and hospital to adopt and ensure implementation of a policy to identify, assess, and develop strategies to control the risk of injury to residents, patients, and nurses associated with the lifting, transferring, repositioning, or movement of a resident or patient.”  The Illinois Nursing Home Care Act and the Hospital Licensing Act both would be amended, requiring “Restriction, to the extent feasible with existing equipment and aids, of manual resident [or patient] handling or movement of all or most of a resident’s [or patient's] weight to emergency, life-threatening, or otherwise exceptional circumstances.” 
 
Specifically required would be an analysis of the risk of injury to residents, patients, and nurses with handling needs, and education of nurses to identify, assess, and control the risk of injury to residents, patients, and nurses with resident or patient handling.  Procedures would be implemented for a nurse to refuse to perform patient or resident handling or movement which the nurse believes in good faith would expose the patient, resident, or nurse to an unacceptable risk of injury.
 
Wording of IL HB 4558:
http://www.ilga.gov/legislation/94/HB/PDF/09400HB4558lv.pdf
 
Wording of IL SB 2692:
http://www.ilga.gov/legislation/fulltext.asp?DocName=09400SB2692lv&SessionID=50&GA=94&DocTypeID=SB&DocNum=2692&print=true
 
Bill status:  http://www.ilga.gov/legislation/BillStatus.asp?DocNum=2692&GAID=8&DocTypeID=SB&LegID=23638&SessionID=50&SpecSess=&Session=&GA=94
 
 
 

Hawaii Adopts Resolution to Support ANA’s “Handle With Care” Campaign for Safe Patient Handling

 
On February 3, 2006, Hawaii House Concurrent Resolution No. 16, “Requesting appropriate safeguards be instituted in health care facilities to minimize the occurrence of musculoskeletal injuries suffered by nurses,” was introduced by Representatives Lee, Cabanilla, Evans, Shimabukuro, Takumi, Tsuji, Caldwell, Green, Herkes, Kanoho, Kawakami, Nakasone, Schatz, Souki, Takamine, and Tanaka.  The report associated with HCR 16 is titled “American Nurses Association's Handle With Care Campaign Support.”   
 
On April 24, 2006, Hawaii adopted HCR 16, recognizing that “work-related musculoskeletal disorders are the leading occupational health problem plaguing the nursing workforce; [that]…nursing personnel are among the highest at risk for musculoskeletal disorders; [that]…of primary concern are back injuries, which can be severely debilitating for nurses…[and that] compared to other occupations, nursing personnel are among the highest at risk for musculoskeletal disorders.”   
 
The resolution calls for the Legislature of Hawaii to support policies provided in American Nurses Association’s “Handle With Care” campaign for safe patient handling, “…to control ergonomic hazards in the health care workplace and prevent back injuries among the nation's nursing workforce.” 
 
On June 21, 2003, ANA’s “Position Statement on Elimination of Manual Patient Handling to Prevent Work-Related Musculoskeletal Disorders” became effective.  “In order to establish a safe environment of care for nurses and patients, the American Nurses Association (ANA) supports actions and policies that result in the elimination of manual patient handling.”  See http://www.nursingworld.org/readroom/position/workplac/pathand.htm
 
On September 17, 2003, the announcement “ANA Launches 'Handle with Care' Ergonomics Campaign” was released, “aimed at preventing work-related musculoskeletal disorders through greater use of assistive equipment and patient-handling devices.”  See http://nursingworld.org/pressrel/2003/pr0917.htm.  In early 2004, ANA’s "Handle with Care" brochure with accompanying CD was sent to every hospital in the United States.  See http://www.nursingworld.org/handlewithcare/hwc.pdf.    
 
HCR16 states: “In 2005, the Council of State Governments' Health Capacity Task Force adopted and supported the policies contained in the American Nurses Association's Handle With Care campaign and asked member states to also support the campaign.” 
 
With adoption of HCR 16, Hawaii says, “Be it resolved…that the Legislature of the State of Hawaii supports the policies contained in the American Nurses Association's Handle With Care campaign; and… that certified copies of this Concurrent Resolution be transmitted to the Council of State Governments' Health Capacity Task Force and the American Nurses Association.”
 
History of HI HCR 16:
http://www.capitol.hawaii.gov/site1/docs/getstatus2.asp?billno=HCR16.
 
Wording of HI HCR 16: 
http://www.capitol.hawaii.gov/sessioncurrent/bills/HCR16_.pdf   
 
 
 

Rhode Island Passes Safe Patient Handling Legislation

 
Rhode Island has joined other states in addressing musculoskeletal injuries to healthcare workers caused by manual patient lifting with legislation requiring healthcare facilities to practice safe patient handling. 
 
RI Senate Bill 2760 was introduced by Senators Sosnowski, Lanzi, Perry, Paiva-Weed, and Pichardo on February 14, 2006.  RI House Bill 7386 was introduced by Representatives Diaz, Moura, Rice, Ajello, and Sullivan on February 16, 2006. 
 
According to Rhode Island's "Legislative Status Report" at http://dirac.rilin.state.ri.us/BillStatus/WebClass1.ASP?WCI=BillStatus&WCE=ifrmBillStatus&WCU, companion bills SB 2760 and HB 7386, both entitled “An Act Relating to Health and Safety – Safe Patient Handling Legislation,” were transmitted on June 29, 2006, to Governor Donald L. Carcieri (R).  Rhode Island’s “Safe Patient Handling Act of 2006,” “to promote the safe handling of patients in health care facilities,” became law on July 7, 2006, without Governor Carcieri’s signature.
 
Rhode Island’s Safe Patient Handling Act of 2006, which will take effect on January 1, 2007, covers both hospitals and nursing facilities, calling for “use of engineering controls, transfer aids, or assistive devices whenever feasible and appropriate instead of manual lifting to perform the acts of lifting, transferring, and/or repositioning health care patients and residents.”
 
Following establishment of a safe patient handling committee, and development of a written safe patient handling program, by July 1, 2008, healthcare facilities shall “implement a safe patient handling policy for all shifts and units of the facility that will achieve the maximum reasonable reduction of manual lifting, transferring, and repositioning of all or most of a patient's weight, except in emergency, life-threatening, or otherwise exceptional circumstances.” 
 
Rhode Island’s new Safe Patient Handling Act of 2006 will increase healthcare safety by mandating use of modern technology to decrease injuries traditionally suffered by nursing staff, patients, and residents as the result of unsafe manual lifting and movement.   
 
Here are websites for wording of the two bills with complete wording of Rhode Island’s Safe Patient Handling Act of 2006 following below.

Wording of RI SB 2760:   http://www.rilin.state.ri.us/Billtext/BillText06/SenateText06/S2760A.pdf 
 
Wording of RI HB 7386:
http://www.rilin.state.ri.us/Billtext/BillText06/HouseText06/H7386Aaa.pdf
 
Anne Hudson, RN, BSN
Work Injured Nurses’ Group USA
anne@wingusa.org
September 14, 2006
 
 
 
 
2006 -- S 2760 SUBSTITUTE A, LC01138/SUB A/2
2006 -- H 7386 SUBSTITUTE A AS AMENDED, LC01442/SUB A/2
 
  

STATE OF RHODE ISLAND IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2006

 
AN ACT RELATING TO HEALTH AND SAFETY – SAFE PATIENT HANDLING LEGISLATION
 
S 2760 Introduced on February 14, 2006, by:  Senators Sosnowski, Lanzi, Perry, Paiva-Weed, and Pichardo
 
H 7386 Introduced on February 16, 2006, by:  Representatives Diaz, Moura, Rice, Ajello, and Sullivan
 
 
It is enacted by the General Assembly as follows:
 
SECTION 1.  Title 23 of the General Laws entitled "HEALTH AND SAFETY" is hereby amended by adding thereto the following chapter:
 
 

CHAPTER 80        SAFE PATIENT HANDLING ACT OF 2006

 
23-80-1.  Short title. –  (a) This chapter shall be known and may be cited as the "Safe Patient Handling Act of 2006."
 
23-80-2.  Legislative findings. –  
(a)  Patients are at greater risk of injury, including skin tears, falls, and musculoskeletal injuries, when being lifted, transferred, or repositioned manually.
 
(b)  Safe patient handling can reduce skin tears suffered by patients by threefold, and can significantly reduce other injuries to patients as well.
 
(c)  Health care workers lead the nation in work-related musculoskeletal disorders.  Between thirty-eight percent (38%) and fifty percent (50%) of nurses and other health care workers will suffer a work-related back injury during their career.  Forty-four percent (44%) of these workers will be unable to return to their pre-injury position.
 
(d)  Research indicates that nurses lift an estimated 1.8 tons per shift.  Eighty-three percent (83%) of nurses work in spite of back pain, and sixty percent (60%) of nurses fear a disabling back injury.  Twelve percent (12%) to thirty-nine percent (39%) of nurses not yet disabled are considering leaving nursing due to back paid and injuries.
 
(e)  Safe patient handling reduces injuries and costs.  In nine (9) case studies evaluating the impact of lifting equipment, injuries decreased sixty percent (60%) to ninety-five percent (95%).  Workers' Compensation costs dropped by ninety-five percent (95%), and absenteeism due to lifting and handling was reduced by ninety-eight percent (98%).
 
SECTION 2.  Chapter 23-17 of the General Laws entitled "Licensing of Health Care Facilities" is hereby amended by adding thereto the following section:
 
23-17-58.  Safe patient handling. –
 
(1)  Definitions. -  As used in this chapter:
 
(a)  "Safe patient handling" means the use of engineering controls, transfer aids, or assistive devices whenever feasible and appropriate instead of manual lifting to perform the acts of lifting, transferring, and/or repositioning health care patients and residents.
 
(b)  "Safe patient handling policy" means protocols established to implement safe patient handling.
 
(c)  "Health care facility" means a hospital or a nursing facility.
 
(d)  "Lift team" means health care facility employees specially trained to perform patient lifts, transfers, and repositioning in accordance with safe patient handling policy.
 
(e)  "Musculoskeletal disorders" means conditions that involve the nerves, tendons, muscles, and supporting structures of the body.
 
(2)  Licensure requirements. -  Each licensed health care facility shall comply with the following as a condition of licensure:
 
(a)  Each licensed health care facility shall establish a safe patient handling committee, which shall be chaired by a professional nurse or other appropriate licensed health care professional.  A health care facility may utilize any appropriately configured committee to perform the responsibilities of this section. At least half of the members of the committee shall be hourly, non-managerial employees who provide direct patient care.
 
(b)  By July 1, 2007, each licensed health care facility shall develop a written safe patient handling program, with input from the safe patient handling committee, to prevent musculoskeletal disorders among health care workers and injuries to patients.  As part of this program, each licensed health care facility shall:
 
(i)  By July 1, 2008, implement a safe patient handling policy for all shifts and units of the facility that will achieve the maximum reasonable reduction of manual lifting, transferring, and repositioning of all or most of a patient's weight, except in emergency, life-threatening, or otherwise exceptional circumstances;
 
(ii)  Conduct a patient handling hazard assessment.  This assessment should consider such variables as patient-handling tasks, types of nursing units, patient populations, and the physical environment of patient care areas;
 
(iii)  Develop a process to identify the appropriate use of the safe patient handling policy based on the patient's physical and mental condition, the patient's choice, and the availability of lifting equipment or lift teams.  The policy shall include a means to address circumstances under which it would be medically contraindicated to use lifting or transfer aids or assistive devices for particular patients;
 
(iv)  Designate and train a registered nurse or other appropriate licensed health care professional to serve as an expert resource, and train all clinical staff on safe patient handling policies, equipment, and devices before implementation, and at least annually or as changes are made to the safe patient handling policies, equipment and/or devices being used;
 
(v)  Conduct an annual performance evaluation of the safe patient handling with the results of the evaluation reported to the safe patient handling committee or other appropriately designated committee.  The evaluation shall determine the extent to which implementation of the program has resulted in a reduction in musculoskeletal disorder claims and days of lost work attributable to musculoskeletal disorder caused by patient handling, and include recommendations to increase the program's effectiveness; and
 
(vi)  Submit an annual report to the safe patient handling committee of the facility, which shall be made available to the public upon request, on activities related to the identification, assessment, development, and evaluation of strategies to control risk of injury to patients, nurses and other health care workers associated with the lifting, transferring, repositioning, or movement of a patient.
 
(c)  Nothing in this section precludes lift team members from performing other duties as assigned during their shift.
 
(d)  An employee may, in accordance with established facility protocols, report to the committee, as soon as possible, after being required to perform a patient handling activity that he/she believes in good faith exposed the patient and/or employee to an unacceptable risk of injury.  Such employee reporting shall not be cause for discipline or be subject to other adverse consequences by his/her employer.  These reportable incidents shall be included in the facility's annual performance evaluation.
 
SECTION 3.  Section 23-15-4 of the General Laws in Chapter 23-15 entitled  "Determination of Need for New Health Care Equipment and New Institutional Health Services" is hereby amended to read as follows:
 
23-15-4.  Review and approval of new health care equipment and new institutional health services. –
 
(a)  No health care provider or health care facility shall develop or offer new  health care equipment or new institutional health services in Rhode Island, the magnitude of which exceeds the limits defined by this chapter, without prior review by the health services council and approval by the state agency; except that review by the health services council may be waived in the case of expeditious reviews conducted in accordance with section 23-15-5, and except that health maintenance organizations which fulfill criteria to be established in rules and regulations promulgated by the state agency with the advice of the health services council shall be exempted from the review and approval requirement established in this section upon approval by the state agency of an application for exemption from the review and approval requirement established in this section which contain any information that the state agency may require to determine if the health maintenance organization meets the criteria.
 
(b)  No approval shall be made without an adequate demonstration of need by the applicant at the time and place and under the circumstances proposed, nor shall the approval be made without a determination that a proposal for which need has been demonstrated is also affordable by the people of the state.
 
(c) No approval of new institutional health services for the provision of health services to inpatients shall be granted unless the written findings required in accordance with section 23-15-16 6(b)(6) are made.
 
(d)  Applications for determination of need shall be filed with the state agency on a date fixed by the state agency together with plans and specifications and any other appropriate data and information that the state agency shall require by regulation, and shall be considered in relation to each other no less than once a year.  A duplicate copy of each application together with all supporting documentation shall be kept on file by the state agency as a public record.
 
(e)  The health services council shall consider, but shall not be limited to, the following in conducting reviews and determining need:
 
(1) The relationship of the proposal to state health plans that may be formulated by the state agency;
 
(2)  The impact of approval or denial of the proposal on the future viability of the applicant and of the providers of health services to a significant proportion of the population served or proposed to be served by the applicant;
 
(3)  The need that the population to be served by the proposed equipment or services has for the equipment or services;
 
(4)  The availability of alternative, less costly, or more effective methods of providing services or equipment, including economies or improvements in service that could be derived from feasible cooperative or shared services;
 
(5)  The immediate and long term financial feasibility of the proposal, as well as the probable impact of the proposal on the cost of, and charges for, health services of the applicant;
 
(6)  The relationship of the services proposed to be provided to the existing health care system of the state;
 
(7)  The impact of the proposal on the quality of health care in the state and in the population area to be served by the applicant;
 
(8)  The availability of funds for capital and operating needs for the provision of the services or equipment proposed to be offered;
 
(9)  The cost of financing the proposal including the reasonableness of the interest rate, the period of borrowing, and the equity of the applicant in the proposed new institutional health service or new equipment;
 
(10)  The relationship, including the organizational relationship of the services or equipment proposed, to ancillary or support services;
 
(11)  Special needs and circumstances of those entities which provide a substantial portion of their services or resources, or both, to individuals not residing within the state;
 
(12)  Special needs of entities such as medical and other health professional schools, multidisciplinary clinics, and specialty centers; also, the special needs for and availability of osteopathic facilities and services within the state;
 
(13)  In the case of a construction project:
 
(i)  The costs and methods of the proposed construction, and
 
(ii)  The probable impact of the construction project reviewed on the costs of providing health services by the person proposing the construction project; and
 
(iii)  The proposed availability and use of safe patient handling equipment in the new or renovated space to be constructed.
 
(14)  Those appropriate considerations that may be established in rules and regulations promulgated by the state agency with the advice of the health services council;
 
(15)  The potential of the proposal to demonstrate or provide one or more innovative approaches or methods for attaining a more cost effective and/or efficient health care system;
 
(16)  The relationship of the proposal to the need indicated in any requests for proposals issued by the state agency;
 
(17)  The input of the community to be served by the proposed equipment and services and the people of the neighborhoods close to the health care facility who are impacted by the proposal;
 
(18)  The relationship of the proposal to any long-range capital improvement plan of the health care facility applicant.
 
(f)  In conducting its review, the health services council shall perform the following:
 
(1)  Within one hundred and fifteen (115) days after initiating its review, which must be commenced no later than thirty-one (31) days after the filing of an application, the health services council shall determine as to each proposal whether the applicant has demonstrated need at the time and place and under the circumstances proposed, and in doing so may apply the criteria and standards set forth in subsection (e) of this section; provided however, that a determination of need shall not alone be sufficient to warrant a recommendation to the state agency that a proposal should be approved.  The director shall render his or her decision within five (5) days of the determination of the health services council.
 
(2)  Prior to the conclusion of its review in accordance with section 23-15-6(e), the health services council shall evaluate each proposal for which a determination of need has been established in relation to other proposals, comparing proposals with each other, whether similar or not, establishing priorities among the proposals for which need has been determined, and taking into consideration the criteria and standards relating to relative need and affordability as set forth in subsection (e) of this section and section 23-15-6(f).
 
(3)  At the conclusion of its review, the health services council shall make  recommendations to the state agency relative to approval or denial of the new institutional health services or new health care equipment proposed; provided that:
 
(i)  The health services council shall recommend approval of only those proposals found to be affordable in accordance with the provisions of section 23-15-6(f); and
 
(ii)  If the state agency proposes to render a decision that is contrary to the recommendation of the health services council, the state agency must render its reasons for doing so in writing.
 
(g)  Approval of new institutional health services or new health care equipment by the state agency shall be subject to conditions that may be prescribed by rules and regulations developed by the state agency with the advice of the health services council, but those conditions must relate to the considerations enumerated in subsection (e) and to considerations that may be established in regulations in accordance with subsection (e) (14).
 
(h)  The offering or developing of new institutional health services or health care equipment by a health care facility without prior review by the health services council and approval by the state agency shall be grounds for the imposition of licensure sanctions on the facility, including denial, suspension, revocation, or curtailment or for imposition of any monetary fines that may be statutorily permitted by virtue of individual health care facility licensing statutes.
 
(i)  No government agency and no hospital or medical service corporation organized under the laws of the state shall reimburse any health care facility or health care provider for the costs associated with offering or developing new institutional health services or new health care equipment unless the health care facility or health care provider has received the approval of the state agency in accordance with this chapter.  Government agencies and hospital and medical service corporations organized under the laws of the state shall, during budget negotiations, hold health care facilities and health care providers accountable to operating efficiencies claimed or projected in proposals which receive the approval of the state agency in accordance with this chapter.
 
(j)  In addition, the state agency shall not make grants to, enter into contracts with, or recommend approval of the use of federal or state funds by any health care facility or health care provider which proceeds with the offering or developing of new institutional health services or new health care equipment after disapproval by the state agency.
 
SECTION 4
.  This act shall take effect on January 1, 2007.


 

Retrieved from:  http://releases.usnewswire.com/printing.asp?id=73343 
 
U.S. Newswire - Medialink Worldwide

Michigan and Nation's Largest RN Unions Endorse Conyers Safe Patient Handling Bill

9/27/2006 5:37:00 PM

To:  National Desk

Contact:  Carol Feuss of Michigan Nurses Association, 517-349-5640 or 517-230-4086; Suzanne Martin of United American Nurses, 301-628-5133

SILVER SPRING, Md., Sept. 27 /U.S. Newswire/ -- A new federal bill introduced Monday by Rep. John Conyers (D-MI) will give direct care nurses the protection they need to safely treat and move patients without running the risk of debilitating musculoskeletal disorders, say leaders of the United American Nurses, AFL-CIO (UAN) and its Michigan affiliate, the Michigan Nurses Association (MNA).

UAN and MNA have worked closely with Rep. Conyers to provide nurses' input on this landmark legislation to protect RNs from lifting and handling injuries and ensure safer patient care.

Direct care RNs get injured at a higher rate than laborers, movers and truck drivers from repositioning, moving and lifting patients, according to the Bureau of Labor Statistics. Workrelated lifting injuries in turn lead many nurses to leave the profession, with more than half of all nurses complaining of chronic back pain and 38 percent of nurses suffering from pain severe enough to require leave from work.

"No nurse should have to sacrifice his or her own health to care for patients," said UAN President Cheryl L. Johnson, RN, who is also president of the Michigan Nurses Association. "If we hope to protect patients and address the current nurse staffing crisis, we must do a better job of protecting nurses at the bedside so that they will choose to stay at the bedside instead of pursuing other, less dangerous career paths. The bill introduced by Rep. Conyers will help accomplish that."
The Nurse and Patient Safety & Protection Act of 2006 (H.R. 6182) will protect nurses by:
-- Establishing a Federal Safe Patient Handling Standard to be administered by the Occupational Safety and Health Administration within one year of the bill's enactment. The standard will eliminate manual lifting of patients by nurses except in case of emergency and require all hospitals to purchase and use safe patient lift mechanical devices, with input from RNs and organizations representing RNs.
-- Requiring hospitals to implement a safe patient handling plan within one year of the bill's enactment that is consistent with the requirements of the federal standard and that provides quality delivery of health care services to protect patient safety and nurses' health;
-- Requiring the posting of information on the federal standard and unscheduled audits to ensure compliance;
-- Including strong whistleblower and refusal of assignment protections for nurses who speak out against non-compliance and penalties for hospitals which do not comply.
"We are pleased to work with Rep. Conyers on this important piece of legislation," added Johnson. "Nurses around the country are ready to fight for this measure, which not only protects nurses but helps patients get the care they need by making hospital nursing jobs more attractive.
We intend to let other Congress members know about the devastating effects of unsafe lifting on nurses and we expect they will agree that now, more than ever, patients need safe care from their registered nurses when they check into the hospital."
---
The Michigan Nurses Association, nurses' voice for 100 years, is the largest nurses' union in the State of Michigan. The Michigan Nurses Association (MNA) promotes the economic and general welfare of nurses in the workplace, fosters high standards of nursing practice, and lobbies the legislature and regulatory agencies on health care issues affecting nurses and recipients of nursing services. MNA is a constituent member of the American Nurses Association and the United American Nurses, as well as an affiliate of the AFL-CIO.
The United American Nurses, AFL-CIO, the collective bargaining affiliate of the American Nurses Association, is the nation's largest RN union, representing more than 100,000 nurses and including 27 state nurses associations or collective bargaining program affiliates.
http://www.usnewswire.com/
© 2006 U.S. Newswire 202-347-2770/


Dear WING USA:
 
To let you know of the momentous move of our country toward national legislation for safe patient handling. 
 
Yesterday, on 9-26-06, U.S. Representative John Conyers (MI-14) introduced HR 6182, the long-awaited bill to amend the OSH Act of 1970 with establishment of a safe patient handling standard for the United States of America. 
 
A query at http://thomas.loc.gov/  in "Browse Bills by Sponsor" for "Conyers, John, Jr [D-MI-14] gives the site http://thomas.loc.gov/cgi-bin/bdquery with Item # 45: 
 
"H.R.6182 : To amend the Occupational Safety and Health Act of 1970 to reduce injuries to patients, direct-care registered nurses, and other health care providers by establishing a safe patient handling standard.
 
"Sponsor:  Rep Conyers, John, Jr. [MI-14] (introduced 9/26/2006).   Cosponsors (None).
"Committees:  House Education and the Workforce; House Energy and Commerce.
"Latest Major Action:  9/26/2006 Referred to House committee.  Status: Referred to the Committee on Education and the Workforce, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned."  
 
The link from H.R.6182 explains that the text of HR 6182 is not yet available online because "The text of H.R.6182 has not yet been received from GPO [Government Printing Office].  Bills are generally sent to the Library of Congress from the Government Printing Office a day or two after they are introduced on the floor of the House or Senate.  Delays can occur when there are a large number of bills to prepare or when a very large bill has to be printed."
 
The text of HR 6182 as introduced should be available soon online.
 
Best wishes to all as we celebrate this historic step toward national protection for healthcare workers and patients from preventable injuries with patient handling...Anne
 
Anne Hudson, RN
September 27, 2006
anne@wingusa.org
www.wingusa.org  Work Injured Nurses' Group USA


Greetings WING USA,   
 
NurseWeek has graciously granted permission to forward their "Five Minutes With" interview by Don Vaughan, June 19, 2006, titled "Anne Hudson, RN, On 'No Lift' Legislation" (following below) with the link to NurseWeek's website. 
 
The website is http://www.nurseweek.com/ and the article can be accessed by clicking on "Read current NurseWeek magazine articles"  Then click "California Edition" or "Mountain West Edition."  Then scroll down and click the article title (as more recent editions are published, you will need to click the "older" button and then click the article title) which links to this page: http://www2.nurseweek.com/Articles/article.cfm?AID=22082 (NurseWeek California Edition). 
 
NurseWeek California and NurseWeek Mountain West Editions both carried the interview article, as well as the "Up Front" editorial "Backing Up Nurses" by Judith Berg, RN, MS, CHE, Vice President of Professional and Editorial Services of NurseWeek Mountain West, and also the cover story "Watching Our Backs" by Phil McPeck which features nurses passionate about successful programs for preventing nurse injury caused by patient lifting. 
 
NurseWeek California's cover story, "Watching Our Backs - RNs Get a Lift from 'No Lift' Policies," features Washington State's new law mandating patient lift equipment in all hospitals.  "['No Lift'] is where all of nursing is headed, says Kim Armstrong, RN, president of the Washington State Nurses Association.  'It has to go to no lift because so many people in the health profession - aides, orderlies and RNs included - are receiving lifetime injuries,' she says."
 
In the editorial "Backing Up Nurses," Judith Berg reports that 35 years of research have proven that training in body mechanics, safe lifting techniques, and back belts are not effective in reducing injuries with patient lifting.  She says, "...health care facilities need to stop using outdated approaches and replace them with evidence-based strategies." 
 
Much gratitude to NurseWeek for extensive coverage of the ready solutions to devastating musculoskeletal injuries caused by manual patient lifting and for publishing Don Vaughan's interview of myself highlighting the need for federal legislation requiring the healthcare industry to practice safe patient handling with mechanical lift equipment instead of with the backs of nurses and other healthcare workers.  
 
A note about the photo in the article:  Credit to Elizabeth Langford, AM, RN, RM, BN, Grad. Dip. (Adv. Nsg), Coordinator of the Injured Nurses Support Group in Melbourne, Victoria, Australia, who took the photo when I spoke at the Australian Nursing Federation Victorian Branch "No Lifting Expo," on November 23, 2005.  Elizabeth Langford and I are international counterparts in working toward nurse injury prevention and as advocates for injured nurses. 
 
Please see Don Vaughan's interview, "Anne Hudson, RN - On 'No Lift' Legislation," following and at http://www.nurseweek.com
 
Best wishes to each of you...Anne
 
Anne Hudson, RN, BSN
anne@wingusa.org
www.wingusa.org  Work Injured Nurses' Group USA
July 4, 2006
 
 
"Anne Hudson, RN - On 'No Lift' Legislation."  Don Vaughn.  June 19, 2006.  Five Minutes With.  NurseWeek Mountain West Edition.  7(13), 12.  Online: http://www.nurseweek.com/.  Then, http://www2.nurseweek.com/Articles/article.cfm?AID=22150 (Mt W) and http://www2.nurseweek.com/Articles/article.cfm?AID=22082 (CA).
 

Anne Hudson, RN — On “No Lift” Legislation
By Don Vaughan
June 19, 2006

Photo by Elizabeth Langford

Anne Hudson, RN, BSN, of Coos Bay, Ore., knows firsthand the debilitating musculoskeletal injuries that can afflict nurses who are required to manually lift patients. Following a painful back injury in 2000, she started a website called B.I.N. There – Back-Injured Nurses, which was later renamed the Work Injured Nurses’ Group USA.
 
In the years since, Hudson, who is now a public health nurse, has become a vocal proponent of state and federal “safe patient handling – no manual lift” legislation, and lectures often on the hazards of manual lifting and the financial/workforce rewards that can result from the use of patient-lift equipment.                        
                                                                                                                
Q How did you become involved with the issue of “no lift” legislation?
 
All health care workers combined suffer more musculoskeletal injuries than any other occupation in America — with back injury from lifting patients removing more nurses from the bedside than any other kind of injury.  I discovered that even though research shows that manual patient lifting cannot be done safely, and that modern patient-lift equipment prevents injuries, many nursing schools still teach manual lifting and many hospitals and nursing homes do not provide safe lift equipment.
 
Even though the Occupational Safety and Health Act (OSHA) of 1970 General Duty clause states that all workplaces are to be “ … free from recognized hazards that are causing or likely to cause death or serious physical harm,” many facilities still [require nurses to manually lift patients.]
 
Q What exactly is “no lift” legislation?  What is your organization trying to achieve nationally and worldwide?
 
A comprehensive national “safe patient handling – no manual lift” law would require mechanical lifting equipment and friction-reducing devices for all health care workers, patients, and residents across all health care settings.  There simply is no such thing as safe manual patient lifting, for either nursing staff or for patients, who may suffer pain, skin tears, abrasions, bruising, dislocations, fractures, tube dislodgement, and being dropped.
 
Q Tell us about your own experiences with patient-lift issues.
 
As a hospital floor nurse, I felt strong and healthy.  I lifted and moved patients manually throughout every shift as I had been taught in nursing school and as practiced throughout the hospital.  I was happy to assist other nurses with their patients, as well.  I naively believed that hospitals would help nurses injured in their service to remain with them.  Because the handling of injured employees was never discussed at any nurse bargaining unit meetings or hospital employee meetings, nurses were generally unaware of what to expect from the workers’ compensation system if they became disabled by lifting.
 
Additionally, nurses were never taught how microfractures occur to spinal discs and vertebral endplates over time from repetitively lifting hazardous amounts of weight.  Because there are no pain receptors in the center of discs and in the vertebral endplates, microfractures may occur without pain until sudden extreme pain announces a severe spinal injury and the potential end of a nurse’s career.
 
Q How close are we to the passage of national “no lift” legislation?
 
I believe that as more states introduce and pass legislation for safe patient handling, momentum will build, leading quickly to a national “no manual lift for health care” standard.  With many dedicated people working toward this end, with the safety of patients and residents at risk, and with the country’s limited supply of nurses and other health care workers jeopardized by current dangerous manual lifting practices, I believe there are no barriers which cannot be overcome to achieve national legislation.
 
Q What is your organization doing to make nurses and others aware of this issue?
 
I continue speaking and writing about the danger of manual patient lifting to help get the word out.  I believe it is especially important to teach nurses how and why insidious damage occurs to spinal structures from repetitively lifting hazardous amounts of weight.  Nurses who understand how spinal damage may occur over time without pain until the injury is severe often become champions for “no lift” policies with use of lift equipment.
 
Q What can nurses do to promote the passage of “no lift” legislation in their states?
 
They need to lobby their state legislators to introduce a “safe patient handling – no manual lift” bill. Wording for draft legislation may be patterned after states that have passed and that have introduced legislation, building upon the best language from each state.
 
Additionally, lobbying insurance companies for coverage of lift equipment for home use, including overhead ceiling lift systems, is essential to help dependent persons remain in their homes and to prevent injuries to family members and home care workers who assist with lifting and movement. The primary reason people move to long-term care facilities is inability of family members to lift and move them. Insurance companies should assist dependent persons to remain at home.
 

 
Don Vaughan is a freelance writer for NurseWeek. To comment on this story, send e-mail to editorca@nurseweek.com.
 
Copyright 2006. Nursing Spectrum Nurse Wire (www.nursingspectrum.com).  All rights reserved. Used with permission.
 


United American Nurses, AFL-CIO Announces Commitment to Federal Legislation
for Safe Patient Handling, Prevention of Nurse Injury from Patient Lifting


Following introduction of a resolution in March 2006, by Maggie Flanagan, RN, Washington State Nurses Association, calling for "the ban of manual movement of patients where safer technology has already been developed," United American Nurses (UAN) National Labor Assembly (NLA) unanimously passed the resolution and UAN has announced working with Representative John Conyers (D) of Michigan toward national legislation to prevent injuries to nurses caused by manual patient lifting.   

Legislation related to safe patient handling has already passed and has been introduced in several states.  Now, with involvement of United American Nurses, AFL-CIO, efforts are moving toward introduction of national legislation to stop devastating musculoskeletal injuries from physically lifting patients.  Such painful back, neck, and shoulder injuries have been permitted to take their toll on the health, lives, and careers of nurses and other healthcare workers for far too long.  It is welcome news that a national legislator has responded to the cry to stop disabling our country's limited supply of healthcare workers by requiring them to lift outrageous amounts of weight. 

Ideally, national legislation for safe patient handling would outlaw the manual lifting of patients and would require use of safe mechanical patient lift equipment by nurses, nursing assistants, lift teams, and all other healthcare workers, across all acute care, long-term care, and residential care settings, wherever dependent patients and residents require assistance with lifting and movement needs.  A national "no manual patient lifting" standard would also reduce pain and injuries to patients such as skin tears, abrasions, dislocations, tube dislodgement, and being dropped, which sometimes occur during attempts by nursing staff to manually lift.
    
Notably the resolution introduced by Maggie Flanagan calls for development by UAN of collective bargaining language for members including provisions for temporary and permanent light-duty assignments for work-injured nurses.  Inclusion of this language underscores the critical need to attend to the plight of nurses disabled by hazardous lifting who have been traditionally expected to just go away.  A two-part strategy, of both nurse injury prevention, and of retention of injured nurses by employers in non-lifting nursing positions, would lead to maximum savings to insurers and employers of financial and human resources, as well as saving our country's precious supply of nurses.  It is clearly time to quit squandering nurses to preventable disabling injuries. 

For complete wording of the resolution, see http://www.uannurse.org/who/resolution/2006/08.html.

See following below for UAN's announcement "UAN, Affiliates Tackle Safe Lifting and Moving" which is available online at  http://www.uannurse.org/read/index.html.

Anne Hudson, RN, BSN
anne@wingusa.org
www.wingusa.org
  Work Injured Nurses' Group USA
June 20, 2006

 
UAN, Affiliates Tackle Safe Lifting and Moving 

Bedside nursing is one of the most dangerous jobs there is.  Yet, some tasks performed by staff nurses are often more hazardous than they need to be.  One such task is lifting, moving and repositioning patients--who are increasingly heavier and more immobile.

In Washington State, WSNA [Washington State Nurses Association] and its allies are celebrating the passage of a new law that will reduce injuries to nurses who move patients by requiring the use of mechanical lift devices.  The new law, signed by Gov. Christine Gregoire (D) March 22, [2006] requires hospitals to buy lift equipment for use by lift teams [or by nurses] and protects from discipline any employees that refuse to perform heavy lifts.

Building on a call by the 2006 NLA [National Labor Assembly] to make safe handling legislation and activities a priority (see resolution 8-06 on www.UANNurse.org/who/resolution.html), UAN [United American Nurses, AFL-CIO] is tackling this issue from the national level as well.  UAN was asked by Rep. John Conyers (D-MI) to draft national legislation to create a federal safe patient handling standard.  The bill UAN wrote requires hospitals to establish such a standard and have a safe patient lifting plan, and protects nurses who refuse assignments that are unsafe.  UAN is seeking support for the bill from ANA [American Nurses Association] and other unions in the AFL-CIO and the Change to Win federation.

“Unsafe lifting, moving and handling is a growing concern for staff nurses,” said UAN Vice President Ann Converso, RN.  “We need a standard that protects nurses who are already on the job and makes bedside nursing safer for future nurses.  It’s a problem we’re prepared to address on every level—local contracts, state laws and now federal legislation.”  

"UAN, Affiliates Tackle Safe Lifting and Moving."  Spring 2006.  United American Nurses, AFL-CIO.  UAN Activist.  Vol. 1, No. 2.  Online:  http://www.uannurse.org/read/index.html.
 


Legislative Update on Safe Patient Handling

 
Greetings to All,
 
Following below is a rundown of legislative activity in the United States on safe patient handling, including states which have passed and states which have introduced legislation to halt needless injuries to nursing staff, patients, and residents from hazardous manual patient lifting.  
 
Healthcare workers remain among top occupations for work-related musculoskeletal injuries.  Safety with patient and resident lifting is a concern which will touch nearly all families at some point and is a bipartisan issue with solid support from both Democrats and Republicans.  Legislative initiatives to prevent injuries to nursing staff and to patients and residents across all healthcare settings should not need to wait for the “right” political climate.  More needless injuries, and untimely loss of nursing personnel, occur with every passing day. 
 
The states and nation need to intensify legislative efforts now to stop avoidable pain to patients and residents, and breaking the backs of nursing staff, from preventable lifting injuries.  Research has proven that no method of manual patient lifting is safe and that mechanical patient-lift equipment prevents injuries.  Much of the healthcare industry has not voluntarily provided modern patient-lift equipment and has not developed the workplace climate and culture to support its use.  Legislation is, therefore, essential to ensure provision of patient-lift equipment for the safety of healthcare workers and of dependent patients and residents. 
 
Changing from accepting nurse injury as “part of the job” and skin tears and other patient injuries with lifting as inevitable, to embracing safe patient handling with modern lift equipment, will occur as the fallacy of applying body mechanics for safety with patient lifting continues to be dismantled.  Additionally, beyond training on operation of mechanical patient-lift equipment, optimal nurse “buy-in” of no-manual-lift policies may be achieved by teaching nurses explicatively how the repetitive lifting of hazardous amounts of weight injures spinal structures over time, often without pain, until “too late” when nurses may find themselves with a severe spinal injury, in intense pain, and quite likely out of a job.  This crucial information has been sadly lacking from nursing education. 
 
From the following list of state activity, note that Texas and Washington passed legislation for safe patient handling in 2005 and 2006, respectively.  Massachusetts legislation for safe patient handling was introduced in 2004 and continues in the Massachusetts Legislature.  California legislation for safe patient handling, vetoed twice by Governor Arnold Schwarzenegger in 2004 and 2005, has been introduced for the third time, in January and February 2006, into the California Senate and Assembly.  Rhode Island and Florida each introduced safe patient handling legislation in February 2006 into both the House and the Senate.  New Jersey introduced safe patient handling legislation in March 2006. 
 
Importantly, the safe patient handling laws enacted by both Texas and Washington provide for healthcare workers to refuse to perform patient lifting or movement activities, without fear of reprisal, if they believe in good faith that the activity would expose the healthcare worker or patient to an unacceptable risk of injury.  This protection is also included in legislation introduced by several other states.
 
See the list below for more details and for websites for the complete wording of safe patient handling legislation passed and pending in the various states, which may be used as model language by other states in drafting their legislation. 
 
In addition to the states listed below, there may be other states working toward “safe patient handling-no manual lift” legislation which are not listed.  Please email me if you have corrections to the info below or information about other state activity. 
 
Thanks much and best wishes to each of you…Anne  
 
Anne Hudson, RN, BSN
Work Injured Nurses’ Group USA
anne@wingusa.org
May 6, 2006
 
 
Safe Patient Handling Legislation Passed:
 
Texas SB 1525 was signed into law by Governor Rick Perry (R) on June 17, 2005.  Texas is the first state in the nation to mandate that hospitals and nursing homes implement policy for safe patient handling and movement programs, restricting “to the extent feasible with existing equipment and aids, of manual patient handling or movement of all or most of a patient’s weight to emergency, life-threatening, or otherwise exceptional circumstances.”  
Wording:  http://www.capitol.state.tx.us/tlo/79R/billtext/SB01525F.HTM.
 
Washington HB 1672 was signed into law by Governor Christine Gregoire (D) on March 22, 2006.  Washington is the first state to mandate that hospitals provide lift equipment as part of their policy for safe patient handling, with the hospital’s choice of three options for implementation of equipment, and with financial assistance by tax credits for the cost of purchasing lifting equipment and reduced workers’ compensation premiums for hospitals implementing safe patient handling programs.  
Wording:  http://www.leg.wa.gov/pub/billinfo/2005-06/Pdf/Bills/House%20Passed%20Legislature/1672-S.PL.pdf
 
 
 
Safe Patient Handling Legislation Introduced: 
 
California has introduced for the third time.    
CA AB 2532, introduced in 2004, was vetoed on September 22, 2004, by Governor Arnold Schwarzenegger.  
Veto message:  http://www.leginfo.ca.gov/pub/03-04/bill/asm/ab_2501-2550/ab_2532_vt_20040922.html.
 
CA SB 363, introduced on February 17, 2005, was vetoed on September 29, 2005. 
Wording: http://www.leginfo.ca.gov/pub/bill/sen/sb_0351-0400/sb_363_bill_20050217_introduced.pdf.  
History:  http://www.leginfo.ca.gov/bilinfo.html
Veto message:  http://www.leginfo.ca.gov/pub/bill/sen/sb_0351-0400/sb_363_vt_20050929.html
 
CA SB 1204, “Hospitals: lift teams,” was introduced into the Senate on January 25, 2006.  If passed, CA SB 1204 will require all general acute care hospitals to adopt a patient protection and health care worker back and musculoskeletal injury prevention plan including a zero lift policy and lift teams trained on lift equipment. 
Wording: http://www.leginfo.ca.gov/pub/bill/sen/sb_1201-1250/sb_1204_bill_20060125_introduced.pdf.
History: http://www.leginfo.ca.gov/pub/bill/sen/sb_1201-1250/sb_1204_bill_20060424_history.html
 
CA AB 2716, “Hospitals: lift policies,” was introduced into the Assembly on February 24, 2006.  If passed, CA AB 2716 will require every general acute care hospital to include a patient lifting policy as a part of its injury prevention program, including a lifting and transferring process, identifying patients needing lift teams, lifting devices, and lifting equipment. 
History: http://www.leginfo.ca.gov/pub/bill/asm/ab_2701-2750/ab_2716_bill_20060417_history.html
Wording: http://www.leginfo.ca.gov/pub/bill/asm/ab_2701-2750/ab_2716_bill_20060224_introduced.pdf.
 
 
Massachusetts HB 2662, filed on December 1, 2004, covers private and public acute care hospitals, rehabilitation and psychiatric facilities, and nursing homes.  If passed into law, MA HB 2662 will require that "Each health care facility...shall develop and implement a health care worker back injury prevention plan so that manual lifting of patients be minimized in all cases and eliminated when feasible…[by] utilizing lift teams and lifting devices and equipment."   
Wording: http://www.mass.gov/legis/bills/house/ht02pdf/ht02662.pdf
History: http://www.mass.gov/legis/184history/h02662.htm.
 
 
Rhode Island introduced bills into the House and the Senate:
RI SB 2760 was introduced into the Senate on February 14, 2006.  If passed, RI SB 2760 will establish the "Safe Patient Handling Act of 2006" requiring licensed health care facilities to “Implement a safe patient handling policy for all shifts and units of the facility that will achieve elimination of manual lifting, transferring, and repositioning of all or most of a patient's weight, except in emergency, life-threatening, or otherwise exceptional circumstances.” 
Wording:  http://www.rilin.state.ri.us/Billtext/BillText06/SenateText06/S2760.pdf
History: http://dirac.rilin.state.ri.us/BillStatus/WebClass1.ASP?WCI=BillStatus&WCE=ifrmBillStatus&WCU.
 
RI HB 7386 was introduced into the House on February 16, 2006.  If passed, RI HB 7386 will establish the "Safe Patient Handling Act of 2006" requiring licensed health care facilities “to replace the manual lifting, transferring, and repositioning of patients with lift teams, mechanical lifting devices, engineering controls, and/or equipment to accomplish these tasks…for elimination of manual lifting, transferring, and repositioning of all or most of a patient's weight, except in emergency, life-threatening, or otherwise exceptional circumstances.” 
Wording:  http://www.rilin.state.ri.us/Billtext/BillText06/HouseText06/H7386.pdf.  
History: http://dirac.rilin.state.ri.us/BillStatus/WebClass1.ASP?WCI=BillStatus&WCE=ifrmBillStatus&WCU.
 
Florida introduced bills into the House and the Senate: 
FL HB 1177, “Patient Handling and Movement Practices,” was filed on February 20, 2006.  If passed, FL HB 1177 will require hospitals and nursing homes to implement “a minimal manual lift program…that will eliminate manual lifting, repositioning, and moving of patients…with acquisition of, training with, and deployment of sufficient equipment and aids so that manual lifting, repositioning, or moving all or most of a patient's weight is restricted to emergency, life-threatening, or otherwise exceptional circumstances.”  
Wording: http://www.myfloridahouse.gov/Sections/Documents/loaddoc.aspx?FileName=_h177__.doc&DocumentType=Bill&BillNumber=1177&Session=2006.  
History: http://www.myfloridahouse.gov/Sections/Bills/billsdetail.aspx?BillId=33345&.
 
FL SB 2244, “Patient Handling / Safe Movement,” was filed on February 22, 2006.   If passed, this legislation would have required hospitals and nursing homes to adopt policies for the safe movement of patients and residents.  FL SB 2244 died, however, in the Committee on Health Care on May 6, 2006. 
Wording: http://www.myfloridahouse.gov/Sections/Documents/loaddoc.aspx?FileName=_s2244__.html&DocumentType=Bill&BillNumber=2244&Session=2006. 
History: http://www.myfloridahouse.gov/Sections/Bills/billsdetail.aspx?BillId=33408&   
 

New Jersey S1758, "Safe Patient Handling Act," was introduced into the Senate on March 21, 2006, calling for licensed health care facilities, and State developmental centers and State and county psychiatric hospitals, to establish safe patient handling programs.  Health care facilities are to post their safe patient handling policy in a location easily visible to staff, patients, and visitors; and to “purchase safe patient handling equipment and patient handling aids necessary to carry out the safe patient handling policy.” 
Wording: http://www.njleg.state.nj.us/2006/Bills/S2000/1758_I1.PDF
History: http://www.njleg.state.nj.us/bills/BillView.asp
 
 Other legislation related to safe patient handling:
 
Ohio HB 67 was signed into law on March 21, 2005, by Governor Bob Taft (R), with Section 4121.48 creating a bureau of workers’ compensation long-term care loan fund “to make loans without interest to…nursing homes…to purchase, improve, install, or erect sit-to-stand floor lifts, ceiling lifts, other lifts, and fast electric beds, and to pay for the education and training of personnel, in order to implement a facility policy of no manual lifting of residents by employees.”   
Wording of OH HB 67, Sec. 4121.48:  http://www.legislature.state.oh.us/bills.cfm?ID=126_HB_67_EN.
 
 New York companion bills A07641 and S04929 were introduced in April 2005, and signed into law on October 18, 2005, by Governor George Pataki (R), calling for creation of a two-year study to establish safe-patient-handling programs and collect data on the incidence of nursing staff and patient injury with patient handling, manual versus lift equipment.  Results will be used to describe best practices for improving health and safety of healthcare workers and patients during patient handling. 
Wording of NY A07641 / 7641A: http://assembly.state.ny.us/leg/?bn=A07641&sh=t.  
History of NY A07641A, “Same as S 4929-A”:    http://assembly.state.ny.us/leg/?bn=A07641
 
Wording of NY S04929 / 4929A: http://assembly.state.ny.us/leg/?bn=S04929&sh=t.
History of S04929, “Same as A 7641-A”: http://assembly.state.ny.us/leg/?bn=S04929.   

 
Washington First State to Mandate Patient Lift Equipment: 
Revolutionary Legislation Protects Patients,
Removes Hazardous Lifting from Backs of Healthcare Workers

 Washington’s pioneering Safe Patient Handling law is the first legislation in the United States to require hospitals to provide mechanical lift equipment for the safe lifting and movement of patients.
 
Washington House Bill 1672, which passed the House of Representatives 85 to 13 on March 7, 2006, and the Senate 48 to 0 on March 8, 2006, was signed into law by Washington State Governor Christine Gregoire (D) on March 22, 2006.  See “Certification of Enrollment, Engrossed Substitute House Bill 1672” at the Washington State Legislature website: http://www.leg.wa.gov/pub/billinfo/2005-06/Pdf/Bills/House%20Passed%20Legislature/1672-S.PL.pdf.
 
Healthcare workers continually rank among top occupations for work-related musculoskeletal disorders.  Washington’s ground-breaking law provides a model for all of the states and the nation to mandate protection of nurses, nursing assistants, and other healthcare workers against injury related to manual patient lifting by the use of modern technology designed for the task. 
 
Significantly, passage of Washington’s Safe Patient Handling law occurred during National Patient Safety Awareness Week, which was March 5-11, 2006.  The new law will protect Washington patients from unintentional pain and injuries, such as skin tears, bruising, dislocations, and being dropped, which sometimes occur during attempts to lift and move patients manually. 
 
On a timeline between February 1, 2007, and January 30, 2010, Washington hospitals must take measures including implementation of a safe patient handling policy and acquisition of their choice of either one readily available lift per acute care unit on the same floor, one lift for every ten acute care inpatient beds, or lift equipment for use by specially trained lift teams. 
 
The new law also provides for hospital employees to refuse to perform, without fear of reprisal, patient handling or movement which the employee believes in good faith would expose a patient or employee to an unacceptable risk of injury.
 
Hospitals will be assisted financially with implementation of safe patient handling programs by reduced workers’ compensation premiums and tax credits covering the cost of purchasing mechanical lifting or other patient handling devices. 
 
Complete wording of WA HB 1672 follows below.
 
Anne Hudson, RN, BSN
March 24, 2006
anne@wingusa.org
www.wingusa.org  Work Injured Nurses’ Group USA
  
http://www.leg.wa.gov/pub/billinfo/2005-06/Pdf/Bills/House%20Passed%20Legislature/1672-S.PL.pdf

ENGROSSED SUBSTITUTE HOUSE BILL 1672

Passed Legislature - 2006 Regular Session

State of Washington   59th Legislature   2006 Regular Session

By House Committee on Commerce & Labor (originally sponsored by Representatives Conway, Hudgins, Green, Cody, Appleton, Morrell,Wood, McCoy, Kenney, Moeller and Chase)

READ FIRST TIME 02/03/06.

     AN ACT Relating to reducing injuries among patients and health care workers; adding a new section to chapter 70.41 RCW; adding a new section to chapter 72.23 RCW; adding a new section to chapter 51.16 RCW; adding a new section to chapter 82.04 RCW; and creating a new section.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

     NEW SECTION. Sec. 1. The legislature finds that:
     (1)  Patients are not at optimum levels of safety while being lifted, transferred, or repositioned manually. Mechanical lift programs can reduce skin tears suffered by patients by threefold. Nurses, thirty-eight percent of whom have previous back injuries, can drop patients if their pain thresholds are triggered.

     (2)  According to the bureau of labor statistics, hospitals in Washington have a nonfatal employee injury incidence rate that exceeds the rate of construction, agriculture, manufacturing, and transportation.

     (3)  The physical demands of the nursing profession lead many nurses to leave the profession. Research shows that the annual prevalence rate for nursing back injury is over forty percent and many nurses who suffer a back injury do not return to nursing. Considering the present nursing shortage in Washington, measures must be taken to protect nurses from disabling injury.

     (4)  Washington hospitals have made progress toward implementation of safe patient handling programs that are effective in decreasing employee injuries. It is not the intent of this act to place an undue financial burden on hospitals.

     NEW SECTION. Sec. 2. A new section is added to chapter 70.41 RCW to read as follows:
     (1)  The definitions in this subsection apply throughout this section unless the context clearly requires otherwise.
     (a)  "Lift team" means hospital employees specially trained to conduct patient lifts, transfers, and repositioning using lifting equipment when appropriate.
     (b)  "Safe patient handling" means the use of engineering controls, lifting and transfer aids, or assistive devices, by lift teams or other staff, instead of manual lifting to perform the acts of lifting, transferring, and repositioning health care patients and residents.
     (c)  "Musculoskeletal disorders" means conditions that involve the nerves, tendons, muscles, and supporting structures of the body.
   
  (2)  By February 1, 2007, each hospital must establish a safe patient handling committee either by creating a new committee or assigning the functions of a safe patient handling committee to an existing committee. The purpose of the committee is to design and recommend the process for implementing a safe patient handling program. At least half of the members of the safe patient handling committee shall be frontline nonmanagerial employees who provide direct care to patients unless doing so will adversely affect patient care.

     (3)  By December 1, 2007, each hospital must establish a safe patient handling program. As part of this program, a hospital must:
  
   (a)  Implement a safe patient handling policy for all shifts and units of the hospital. Implementation of the safe patient handling policy may be phased-in with the acquisition of equipment under subsection (4) of this section;
     (b)  Conduct a patient handling hazard assessment. This assessment should consider such variables as patient-handling tasks, types of nursing units, patient populations, and the physical environment of patient care areas;
     (c)  Develop a process to identify the appropriate use of the safe patient handling policy based on the patient's physical and medical condition and the availability of lifting equipment or lift teams. The policy shall include a means to address circumstances under which it would be medically contraindicated to use lifting or transfer aids or assistive devices for particular patients;
     (d)  Conduct an annual performance evaluation of the program to determine its effectiveness, with the results of the evaluation reported to the safe patient handling committee. The evaluation shall determine the extent to which implementation of the program has resulted in a reduction in musculoskeletal disorder claims and days of lost work attributable to musculoskeletal disorder caused by patient handling, and include recommendations to increase the program's effectiveness; and
     (e)  When developing architectural plans for constructing or remodeling a hospital or a unit of a hospital in which patient handling and movement occurs, consider the feasibility of incorporating patient handling equipment or the physical space and construction design needed to incorporate that equipment at a later date.

     (4)  By January 30, 2010, each hospital must complete, at a minimum, acquisition of their choice of: (a) One readily available lift per acute care unit on the same floor unless the safe patient handling committee determines a lift is unnecessary in the unit; (b) one lift for every ten acute care available inpatient beds; or (c) equipment for use by lift teams. Hospitals must train staff on policies, equipment, and devices at least annually.
    
(5)  Nothing in this section precludes lift team members from performing other duties as assigned during their shift.
   
  (6)  A hospital shall develop procedures for hospital employees to refuse to perform or be involved in patient handling or movement that the hospital employee believes in good faith will expose a patient or a hospital employee to an unacceptable risk of injury. A hospital employee who in good faith follows the procedure developed by the hospital in accordance with this subsection shall not be the subject of disciplinary action by the hospital for the refusal to perform or be involved in the patient handling or movement.

     NEW SECTION. Sec. 3. A new section is added to chapter 72.23 RCW to read as follows:
     (1)  The definitions in this subsection apply throughout this section unless the context clearly requires otherwise.
     (a)  "Lift team" means hospital employees specially trained to conduct patient lifts, transfers, and repositioning using lifting equipment when appropriate.
     (b)  "Safe patient handling" means the use of engineering controls, lifting and transfer aids, or assistive devices, by lift teams or other staff, instead of manual lifting to perform the acts of lifting, transferring, and repositioning health care patients and residents.
     (c)  "Musculoskeletal disorders" means conditions that involve the nerves, tendons, muscles, and supporting structures of the body.
     (2)  By February 1, 2007, each hospital must establish a safe patient handling committee either by creating a new committee or assigning the functions of a safe patient handling committee to an existing committee. The purpose of the committee is to design and recommend the process for implementing a safe patient handling program.  At least half of the members of the safe patient handling committee shall be frontline nonmanagerial employees who provide direct care to patients unless doing so will adversely affect patient care.
     (3)  By December 1, 2007, each hospital must establish a safe patient handling program. As part of this program, a hospital must:
     (a)  Implement a safe patient handling policy for all shifts and units of the hospital. Implementation of the safe patient handling policy may be phased-in with the acquisition of equipment under subsection (4) of this section;
     (b)  Conduct a patient handling hazard assessment. This assessment should consider such variables as patient-handling tasks, types of nursing units, patient populations, and the physical environment of patient care areas;
     (c)  Develop a process to identify the appropriate use of the safe patient handling policy based on the patient's physical and medical condition and the availability of lifting equipment or lift teams;
     (d)  Conduct an annual performance evaluation of the program to determine its effectiveness, with the results of the evaluation reported to the safe patient handling committee.  The evaluation shall determine the extent to which implementation of the program has resulted in a reduction in musculoskeletal disorder claims and days of lost work attributable to musculoskeletal disorder caused by patient handling, and include recommendations to increase the program's effectiveness; and
     (e)  When developing architectural plans for constructing or remodeling a hospital or a unit of a hospital in which patient handling and movement occurs, consider the feasibility of incorporating patient handling equipment or the physical space and construction design needed to incorporate that equipment at a later date.

     (4)  By January 30, 2010, hospitals must complete acquisition of their choice of: (a) One readily available lift per acute care unit on the same floor, unless the safe patient handling committee determines a lift is unnecessary in the unit; (b) one lift for every ten acute care available inpatient beds; or (c) equipment for use by lift teams.  Hospitals must train staff on policies, equipment, and devices at least annually.

     (5)  Nothing in this section precludes lift team members from performing other duties as assigned during their shift.
   
  (6)  A hospital shall develop procedures for hospital employees to refuse to perform or be involved in patient handling or movement that the hospital employee believes in good faith will expose a patient or a hospital employee to an unacceptable risk of injury. A hospital employee who in good faith follows the procedure developed by the hospital in accordance with this subsection shall not be the subject of disciplinary action by the hospital for the refusal to perform or be involved in the patient handling or movement.

     NEW SECTION. Sec. 4. A new section is added to chapter 51.16 RCW to read as follows:
     (1)  By January 1, 2007, the department shall develop rules to provide a reduced workers' compensation premium for hospitals that implement a safe patient handling program. The rules shall include any requirements for obtaining the reduced premium that must be met by hospitals.  
    
(2)  The department shall complete an evaluation of the results of the reduced premium, including changes in claim frequency and costs, and shall report to the appropriate committees of the legislature by December 1, 2010, and 2012.

     NEW SECTION. Sec. 5. A new section is added to chapter 82.04 RCW to read as follows:
     (1)  In computing the tax imposed under this chapter, a hospital may take a credit for the cost of purchasing mechanical lifting devices and other equipment that are primarily used to minimize patient handling by health care providers, consistent with a safe patient handling program developed and implemented by the hospital in compliance with section 2 of this act. The credit is equal to one hundred percent of the cost of the mechanical lifting devices or other equipment.

     (2)  No application is necessary for the credit, however, a hospital taking a credit under this section must maintain records, as required by the department, necessary to verify eligibility for the credit under this section. The hospital is subject to all of the requirements of chapter 82.32 RCW. A credit earned during one calendar year may be carried over to be credited against taxes incurred in a subsequent calendar year. No refunds shall be granted for credits under this section.

     (3)  The maximum credit that may be earned under this section for each hospital is limited to one thousand dollars for each acute care available inpatient bed.

     (4)  Credits are available on a first in-time basis. The department shall disallow any credits, or portion thereof, that would cause the total amount of credits claimed statewide under this section to exceed ten million dollars. If the ten million dollar limitation is reached, the department shall notify hospitals that the annual statewide limit has been met. In addition, the department shall provide written notice to any hospital that has claimed tax credits after the ten million dollar limitation in this subsection has been met. The notice shall indicate the amount of tax due and shall provide that the tax be paid within thirty days from the date of such notice. The department shall not assess penalties and interest as provided in chapter 82.32 RCW on the amount due in the initial notice if the amount due is paid by the due date specified in the notice, or any extension thereof.

     (5)  Credit may not be claimed under this section for the acquisition of mechanical lifting devices and other equipment if the acquisition occurred before the effective date of this section.

     (6)  Credit may not be claimed under this section for any acquisition of mechanical lifting devices and other equipment that occurs after December 30, 2010.

     (7)  The department shall issue an annual report on the amount of credits claimed by hospitals under this section, with the first report due on July 1, 2008.

     (8)  For the purposes of this section, "hospital" has the meaning provided in RCW 70.41.020.
_________________________________________________________________

 


"I would like to increase awareness of the high risk of back injuries with manual patient lifting still required in many areas and of safe patient handling methods proven to prevent injuries. It is not necessary for nurses to risk disabling spinal injuries and loss of career every day on the job."

Speaking for injured nurses and
those who wish to avoid injury -
Anne Hudson, RN, BSN, BIN - Back Injured Nurse




Anne Hudson, RN, spoke at the National Service
Employees International Union (SEIU) Nurse Alliance
Conference in Washington, DC, September 26, 2005, on the 
need for state and national "safe patient handling - no manual lift"
legislation to protect healthcare workers and patients from the
epidemic of injuries related to manual lifting. 



"TX first state to adopt safe patient handling law for nurses"
Inside OSHA    07/11/05

Department of Health and Human Services
Centers for Disease Control and Prevention
Published by the Public Health Law Program, Public Health Practice Program Office, CDC
Wednesday, July 13, 2005
Online:  http://www2a.cdc.gov/phlp/Weeklynews.asp

 
Texas has enacted the first state law that requires nursing homes and hospitals to implement safe patient handling programs for nurses.  Facilities must create policies to control the risk of injuries to patients and nurses when patients are lifted, transferred, repositioned or moved.  
 
Under the law, a nurse can refuse to perform or be involved in an activity if he or she believes in good faith that the activity poses an unreasonable risk of injury to anyone involved. 
 
While some states are looking into requiring facilities to use lift teams or devices to move patients, Texas opted not to mandate those alternatives.  "We didn't think lift teams were the best way," said Jim Wellman, of the Texas Nurses Association, an organization that helped draft the legislation.  
 
In California, Governor Arnold Schwarzenegger vetoed a similar bill last year, stating that existing workplace injury standards are sufficient.  But several other states are currently working to pass legislation similar to the new Texas law.
 
Anne Hudson, of the Work Injured Nurses Group USA, said she expects rapid enactment of a national "Safe Patient Handling – No Manual Lift” mandate.  
 
The new Texas law goes into effect January 1, 2006.
 



 Texas passes first Safe Patient Handling legislation in U.S

The State of Texas has passed TX SB 1525, the first state legislation signed into law requiring hospitals and nursing homes to implement a safe patient handling and movement program.   
 
The Texas Nurses Association has worked long and hard on passage of this important legislation which was signed by Texas Governor Rick Perry June 17, 2005, and will take effect January 1, 2006. 
 
With Texas the first state to succeed with passage of legislation, a number of other states continue working toward legislative protection of healthcare workers against preventable injury from manual patient lifting.  
 
Eventually, all of the United States will mandate safe patient handling practices like those already in place in countries more advanced in protecting nurses and patients against injury from manual lifting.  
 
Anne Hudson, RN, BSN
6-24-05
anne@wingusa.org
www.wingusa.org  Work Injured Nurses Group USA



 
http://www.capitol.state.tx.us/tlo/79R/billtext/SB01525F.HTM

                                                                  Texas S.B. No. 1525  AN ACT

relating to safe patient handling and movement practices of nurses in hospitals and nursing homes.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:                       
SECTION 1.  Subtitle B, Title 4, Health and Safety Code, is amended by adding Chapter 256 to read as follows:

CHAPTER 256.  SAFE PATIENT HANDLING AND MOVEMENT PRACTICES

Sec. 256.001.  DEFINITIONS.  In this chapter:                          
(1)  "Hospital" means a general or special hospital, as defined by Section 241.003, a private mental hospital licensed under Chapter 577, or another hospital that is maintained or operated by the state.
(2)  "Nursing home" means an institution licensed under Chapter 242.  
 
Sec. 256.002.  REQUIRED SAFE PATIENT HANDLING AND MOVEMENT POLICY. 
(a)  The governing body of a hospital or the quality assurance committee of a nursing home shall adopt and ensure
implementation of a policy to identify, assess, and develop strategies to control risk of injury to patients and nurses
associated with the lifting, transferring, repositioning, or movement of a patient.
(b)  The policy shall establish a process that, at a minimum, includes:
(1)  analysis of the risk of injury to both patients and nurses posed by the patient handling needs of the patient
populations served by the hospital or nursing home and the physical environment in which patient handling and movement occurs;
(2)  education of nurses in the identification, assessment, and control of risks of injury to patients and nurses during patient handling;
(3)  evaluation of alternative ways to reduce risks associated with patient handling, including evaluation of equipment and the environment;
(4)  restriction, to the extent feasible with existing equipment and aids, of manual patient handling or movement of all or most of a patient's weight to emergency, life-threatening, or otherwise exceptional circumstances;
(5)  collaboration with and annual report to the nurse staffing committee;
(6)  procedures for nurses to refuse to perform or be involved in patient handling or movement that the nurse believes in good faith will expose a patient or a nurse to an unacceptable risk of injury;
(7)  submission of an annual report to the governing body or the quality assurance committee on activities related to
the identification, assessment, and development of strategies to control risk of injury to patients and nurses associated with the lifting, transferring, repositioning, or movement of a patient; and
(8)  in developing architectural plans for constructing or remodeling a hospital or nursing home or a unit of a hospital or nursing home in which patient handling and movement occurs, consideration of the feasibility of incorporating patient handling equipment or the physical space and construction design needed to incorporate that equipment at a later date.

 SECTION 2.  This Act takes effect January 1, 2006.                            

______________________________    ______________________________
President of the Senate             Speaker of the House

 
 
I hereby certify that S.B. No. 1525 passed the Senate on April 20, 2005, by the following vote: 
    Yeas 30, Nays 1;
and that the Senate concurred in House amendment on May 27, 2005, by the following vote: 
    Yeas 29, Nays 0.

______________________________
   Secretary of the Senate            
 
 
I hereby certify that S.B. No. 1525 passed the House, with amendment, on May 25, 2005, by a non-record vote.

______________________________
   Chief Clerk of the House           

Approved:

______________________________
            Date

______________________________
          Governor
 
 
For the chronology of actions taken on SB 1525, go to:  http://www.capitol.state.tx.us/cgi-bin/db2www/tlo/billhist/actions.d2w/report?LEG=79&SESS=R&CHAMBER=S&BILLTYPE=B&BILLSUFFIX=01525&SORT=Asc

Also see Confined Space: News and Commentary on Workplace Health & Safety, Labor and Politics, for an article, with quotes from Anne, about this legislation: http://spewingforth.blogspot.com/2005/06/texas-passes-safe-lifting-law-for.html

 


AJN, American Journal of Nursing
November, 2004
Volume 104 Number 11
Pages 81 - 81
 
More Letters:  Putting Patient Safety First Responses to the July Editorial, ‘That’s Nursing!’
 
With evidence mounting that proves mechanized patient lifting prevents injury to nurses and patients, and dramatically cuts medical and compensation costs to employers, many hospital administrators are still dragging their feet. 

Causing injury by requiring manual lifting, and then firing the injured, is an appalling exploitation of health care workers and an inexcusable waste of valuable nurses.  We have accepted back injury as “part of the territory” for far too long.

Anne Hudson, RN, BSN
Coos Bay, OR 

REFERENCE
1. Charney W. Prevention of back injury to healthcare workers using lift teams. 18 hospital data. In: William Charney and Anne Hudson, editors. Back Injury among Healthcare Workers: Causes, Solutions, and Impacts. Boca Raton, FL: Lewis Publishers; 2003. p. 99–112.



Patient Lifting and Back Injury: 
Disabling and Discarding Nurses Who Want to Work!

Though neglected by many of those reporting on the shortage, disabling spinal injuries from patient lifting looms as perhaps the single largest and most preventable contributor to the nursing shortage. 

Since suffering a spinal injury from years of lifting patients, I have learned, along with thousands of other nurses, that a back injury is not just part of the job -- it is often the end of the job, with most employers unwilling to provide permanent light duty for nurses unable to continue heavy lifting. 

Since losing my position because I could not keep lifting, I have learned much about back injuries to nurses and have become an activist, speaking and writing for injured nurses.  I hope to draw attention to the exploitation of predominantly female nursing professionals and the scandalous, unnecessary wastage of highly-skilled nurses during a critical nursing shortage.   

Research has repeatedly proven, since William Charney's pioneering work in 1991, that most back injuries to nurses could be prevented by use of safe, gentle, mechanical, lift equipment.  Still, administration and management opposition to "No-Lift Teams," trained to use patient lift equipment, and/or "Zero Lift Policy," requiring nursing staff to use lift equipment, keeps many nurses in the ironic position of being required to perform hazardous lifting in order to keep their job and of then being fired when disabled from the lifting. 

One after the other, the myths about back injury from patient lifting have been debunked and the arguments against using lift equipment defused: 

Myth:  There is no proof that patient lifting causes back injuries. 
Years of research have proven that patient lifting - whether with one or two lifters - exceeds tolerance limits of compressive forces to spinal structures.  The evidence is in - there simply is no safe way to manually lift adult patients.  Healthcare workers combined (CNA's, RN's, and LPN's together) suffer more disabling back injuries than any other category of worker in the country.

Myth:  If nurses used proper body mechanics, they wouldn't hurt themselves. 
This blames the victim, inferring that nurses are too stupid to remember body mechanics when, in reality, they are being required to perform repetitive hazardous lifting in awkward postures beyond the capability of the human spine.  

Myth:  It’s only a few. 
83% of nurses work in spite of back pain.  60% fear a disabling back injury.  39% are considering leaving nursing due to fear of a back injury.  38% or more will go off work with a back injury.  12% of nurses leaving nursing for good do so because of back injuries.  The data does not define “leaving.”  It is likely that most injured nurses do not voluntarily give up their position but are fired if unable to continue lifting. 

Myth:  Mechanical lift equipment costs too much. 
Translation: Nurses are disposable human lift equipment.
 
Studies show that lift equipment pays for itself by tremendous savings on medical and compensation costs with nurse injury prevention.  Do hospital beds cost too much?  Mechanical lift and transfer equipment should be viewed as essential medical equipment. 

Myth:  Patients won't like lift equipment. 
Patients report feeling more secure and more comfortable with equipment.  Manual turning is reported by critically-ill adult patients to be the most painful procedure - more painful than tracheal suctioning, tube advancement, and wound dressing changes!  Incredibly, the hands of nurses, which are dedicated to healing, may cause the greatest, most unnecessary, pain to patients.  The public should be educated to demand lift equipment and friction--reducing devices. 

Myth:  Lift equipment makes patients more dependent. 
The opposite has proven true.  It has been found that patients are more likely to regain mobility when equipment is used because the patients become participants, assisting in the lifts and moves, rather than passively submitting as they do when manually lifted. 

Myth:  It takes too long to use lift equipment. 
When readily available, after a learning period, using equipment scarcely takes more time, particularly with over-head ceiling lifts which are always available just overhead and with disposable, single patient use slings which remain with the patient throughout their stay.     

Myth:  Nurses won't use lift equipment. 
75% of nurses say they would use equipment if it was available.  However, as long as nursing schools keep teaching hazardous manual lifting, and hospitals do not provide "No-Lift Teams" or enforce "Zero Lift Policy," some nurses may keep lifting.  Just bringing in equipment will not change the decades-long practice of manual lifting or the well-established culture of injury acceptance within nursing. 

Last lame excuse:  We've always done it this way.    
From nursing schools up, and from top administration down, the culture must change from injury acceptance around patient handling into a culture of safety, protecting nurses from unnecessary disability and loss of career; preventing patients from experiencing needless skin tears, bruising, friction-burns, dislocated shoulders, and being dropped; and preserving the nation’s supply of experienced nurses who want to remain at the bedside.  It is NOT okay to educate, wreck, and can nurses. 

Every facility needs a champion whose sole responsibility is educating, promoting, and bedside coaching of mechanized safe patient handling, backed by strict no manual lift policy.  With abundant research, there are no excuses left for nursing schools and hospitals not putting the evidence into practice and teaching nurses that they do not have to sacrifice their back to be good nurses. 

Endorsing an evidence-based practice model, it is a puzzle why the nursing community has not demanded that the evidence on prevention of back injury to nurses be put into practice!  Even with the escalating shortage, nursing remains incredibly passive on the disabling and discarding of nurses who want to work!   It appears that legislation will be required to force provision of protection.   

Once more the front-runner with progressive healthcare legislation, California has introduced Assembly Bill 2532 (see http://www.leginfo.ca.gov/cgi-bin/postquery) calling for use of safe lift equipment by lift teams or nursing staff in every hospital in the state.  A number of other states are currently working toward introduction of similar legislation.  Hopefully, “Safe Patient Handling - No Manual Lift” legislation will soon be enacted and enforced in all the states so nurses can work without fear of losing their career to a disabling back injury. 

Anne Hudson, RN, BSN
anne@wingusa.org
www.wingusa.org  Work Injured Nurses’ Group USA
8-23-04



Hi, my name is Anne Hudson. I live in Coos Bay on the beautiful southern Oregon Coast. When I became an RN, I never dreamed I would one day have reason to make public comments on my personal life and health.

I went to work as a hospital floor nurse in 1990 with an Associate of Science in Nursing from Southwestern Oregon Community College. I later earned a Bachelor of Science in Nursing from Oregon Health Sciences University. I worked in medical/surgical, telemetry, and intermediate care units and planned to continue working as a nurse at the hospital until retirement. Since suffering a work-related spinal injury in June of 2000, and losing my position solely because I was unable to continue heavy lifting, I want to help increase awareness of what can and does happen to back-injured nurses across the country.

I knew that back injury with lifting patients was a risk but was unaware of the magnitude of the problem. American Nurses Association's Health and Safety Survey found that 83% of nurse respondents work in spite of having back pain and 60% fear a disabling back injury (see http://www.nursingworld.org/surveys/hssurvey.htm). An estimated 38% of nurses require time off work during their career due to back pain and injuries (see "Preventing Injuries Using an Ergonomic Approach" by Bernice Owen).

In 2000, the Bureau of Labor Statistics reported that "health care patient" was the cause of time away from work for 10,983 RN's and 44,854 nursing aides, orderlies, and attendants with "overexertion" and "overexertion in lifting" the leading events. Also in 2000, healthcare workers combined (nursing aides, orderlies, and attendants; RN's; and LPN's together) had more work-related musculoskeletal injuries than workers in any other industry (see http://www.bls.gov).

The ongoing epidemic of back injuries among healthcare workers is largely related to physically lifting and moving patients. I was unaware that back injury from lifting patients has been studied for many years. Had hospitals implemented readily-available technology and methodologies long proven to prevent injuries, it is likely that the disabling injuries of multiple thousands of healthcare workers would not have occurred; many of us would still be at the bedside. Body mechanics training was presented by my nursing school and hospital as the method of preventing injuries with patient handling, implying that nurses could safely lift patients if they lifted "correctly." Nurses were not told that lifting the weight of adult patients, regardless of how carefully the lift is performed, has been proven to generate compressive forces to spinal structures which far exceed established tolerance limits (see "A Comprehensive Analysis of Low-Back Disorder Risk and Spinal Loading During the Transferring and Repositioning of Patients Using Different Techniques" by W.S. Marras et al.).

I never considered that workers in other industries are protected from lifting such heavy loads through the use of mechanical lifts and hoists provided by employers. In the healthcare industry, nurses have been used as human lifts; and, when the "lifts" are broken from lifting excessive loads, if unable to be repaired and returned to lifting tasks, they are often discarded as no longer serviceable. Though the Occupational Health and Safety Administration's (OSHA) General Duty Clause states that all workplaces are to be "free from recognized hazards that are causing or likely to cause death or serious physical harm," it appears there are no enforced safeguards against hazardous manual lifting by healthcare workers - while feasible safe alternatives exist - or against disposal of the casualties.

The process of dealing with work-disabled nurses was never discussed in any hospital employee meeting or nurses' union meeting I ever attended. Disposal of back-injured nurses - many of whom, if permitted, could continue nursing duties apart from heavy lifting - appears to be largely ignored and goes unchallenged by the nursing community which is surprising during a critical nursing shortage and very disturbing considering the ethics of terminating experienced nurses following largely preventable injuries. Injured nurses continue to be exploited in this fashion and most of them have no advocate.

There does not yet appear to be an organized nationwide effort to protect nurses' bodies with Zero Lift for Healthcare legislation in the states or to protect injured nurses' careers by negotiating for Permanent Light Duty policies in the hospitals. It has been very troubling to discover the lack of support for nurses injured serving others in what has been called "America's most respected profession." It is possible, with nursing being 90 to 95% female, that exploitation of nurses is a gender issue. I doubt any male-dominated professional group would allow preventable injuries to permanently damage their bodies and destroy their careers; yet, the nursing community permits this to continue among its own.

Since looking into back injuries among nurses, I've heard from nurses around the U.S. and beyond. My English nurse friend, Maria Bryson, Safety Representative and Steward for the Royal College of Nursing and member of RCN Work Injured Nurses' Group (WING), has been invaluable in sharing patient handling practices in her country where nurses do not manually lift patients (see "The Role of the Steward and Safety Representative in Manual Handling," PowerPoint by Maria Bryson). Lifting patients was banned in the U.K. by reason of lifting limits imposed by introduction of the Manual Handling Operations Regulations 1992. Many safe, gentle, mechanical lifts, hoists, and friction-reducing devices are available; patients can be safely moved without manual lifting. Due to the recognized hazards to both nurses and patients, English nurses can be disciplined by their employers if they physically lift patients while many American nurses are still required to do so.

My Australian nurse friend, Elizabeth Langford, Coordinator of the Australian Nursing Federation (Victorian Branch) Injured Nurses' Support Group, has shared her research (see Buried But Not Dead by Elizabeth Langford), upon which the ANF (Vic Branch) based their No Lifting Policy in 1998, and reports much progress toward safe patient handling. (See "ANF's No Lifting Policy Wins Outstanding OH&S Leadership Award" [Click article title to go to ANF Victoria's Home Page. Enter "ANF's No Lifting Policy" into the "Search Our Site" box to go to the link to the article.] : "The ANF [Vic Branch] listened to nurses, we funded research and we have transformed a deeply entrenched culture of injury acceptance in an area no one thought we could change.")

After suffering painful, and often disabling, work-related back injuries, many of which could have been prevented, many injured nurses find themselves in pain, out of work, and without an advocate. It is believed that injured nurses must be brought together and galvanized to best be heard. If you would like to be added to WING USA's Database of Work-Injured Nurses, email me with your name and address. Your name will not be shown online by WING USA or provided to any other organization. Information received will be used only to keep you informed with potential mailings and for tracking by WING USA of numbers and geographical location of injured nurses.

It is hoped that WING USA's efforts will help increase awareness of the hazards of manual patient lifting to nurses' bodies and careers; will provide information helpful in establishing safe patient handling practices; will lead to practical assistance for work-injured nurses, including provision of Permanent Light Duty when necessary; and will facilitate enactment by the states of Zero Lift for Healthcare legislation. It is not necessary for nurses to risk disability and loss of career every day on the job from preventable injuries.

Speaking for injured nurses and those who wish to avoid injury,
Anne Hudson, RN, BSN, BIN - Back Injured Nurse
June 14, 2003

This site is under construction. More information will be added soon.
Please contact Anne at anne@wingusa.org with any questions
or suggestions you might have.