Bill Text: HI HB440 | 2010 | Regular Session | Introduced
Bill Title: Safe Patient Handling Protocol; Committee; Program
Spectrum: Partisan Bill (Democrat 9-0)
Status: (Introduced - Dead) 2009-05-11 - Carried over to 2010 Regular Session. [HB440 Detail]
Download: Hawaii-2010-HB440-Introduced.html
Report Title:
Safe Patient Handling Protocol; Committee; Program
Description:
Requires each private hospital in the State and each community hospital within the Hawaii health systems corporation to establish a safe patient handling committee by 01/01/2010 and a safe patient handling program by 10/01/2010.
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HOUSE OF REPRESENTATIVES |
H.B. NO. |
440 |
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TWENTY-FIFTH LEGISLATURE, 2009 |
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STATE OF HAWAII |
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A BILL FOR AN ACT
relating to safe patient handling protocol.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. The legislature finds that the safe handling of patients reduces injuries to both patients and health professionals. Handling patients is an arduous and physically demanding task for nurses and other clinical health professionals. Adult patients are difficult to physically manipulate, lift, or carry. Patients may also be heavy, combative, unable to cooperate, or have a physical disability that hinders physical handling. Studies have shown that the cumulative weight lifted by a single nurse during a typical eight-hour shift may reach almost two tons; and nineteen separate stressful physical tasks that nurses and other clinical health professionals need to perform have been identified. Despite frequent underreporting, nursing has consistently been ranked in the top ten occupations for work-related musculoskeletal disorders with incident rates of 8.8 per one hundred in hospital settings and 13.5 per one hundred in nursing home settings. Most of these injuries occur during a planned physical patient transfer, not during unplanned emergencies. It has been estimated that as many as twelve per cent of nurses are either terminated or leave the profession due to back injuries.
The legislature further finds that prevention of work-related injuries for nurses and other clinical health professionals who physically handle patients through a safe patient handling program will reduce work-related injury leave, provide more consistent staffing levels, increase job satisfactions, and generally reduce patient-handling injuries.
Unsafe patient handling techniques also cause injuries to patients including damage to joints, muscles, skin tears due to friction and shearing movements, and bruising. A limited range of motion due to old humeral head fractures, shoulder subluxation, or arthritis may also predispose patients to pain and further injury when being handled. Patients may also experience fear of being dropped or loss of dignity during awkward handling. A patient's lack of mobility may also cause pressure ulcers and thus the patient needs to be physically repositioned at least every two hours. Nurses and other clinical health professionals who physically handle patients may think twice about maintaining this rigorous and strenuous schedule for fear of personal injury to themselves.
The legislature also finds that the proper implementation of a safe patient handling program has the potential to reduce patient length of stay ‑‑ a major cost component ‑‑ costs of treating pressure ulcers, patient pain and suffering, work-related injuries for nurses and other clinical health professionals who physically handle patients, and legal actions for malpractice. The implementation of similar safe patient handling programs has resulted in a decrease in workers' compensation costs per full-time employee by twenty-nine to sixty-eight per cent.
The purpose of this Act is to require all public and private hospitals in the State to implement a safe patient handling program.
SECTION 2. Chapter 321, Hawaii Revised Statutes, is amended by adding a new part to be appropriately designated and to read as follows:
"Part . SAFE PATIENT HANDLING PROGRAM
§321‑A Findings. 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 per cent of whom have previous back injuries, can drop patients if their pain thresholds are triggered;
(2) 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 per cent and many nurses who suffer a back injury do not return to nursing. Considering the present nursing shortage in Hawaii, measures must be taken to protect nurses from disabling injury; and
(3) Hawaii private 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 part to place an undue financial burden on private hospitals.
§321‑B Definitions. As used in this part:
"Lift team" means hospital employees specially trained to conduct patient lifts, transfers, and repositioning using lifting equipment when appropriate.
"Musculoskeletal disorders" means conditions that involve the nerves, tendons, muscles, and supporting structures of the body.
"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 patients and hospital residents.
§321‑C Safe patient handling committee; program; equipment. (a) By January 1, 2010, each private hospital 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. The purpose of the committee shall be 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 membership will adversely affect patient care.
(b) By October 1, 2010, each private hospital in the State shall establish a safe patient handling program. As part of this program, each private hospital shall:
(1) 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 (c);
(2) Conduct a patient handling hazard assessment. The assessment shall consider such variables as patient-handling tasks, types of nursing units, patient populations, and the physical environment of patient care areas;
(3) 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;
(4) 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
(5) 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.
(c) By January 30, 2013, each private hospital in the State shall complete, at a minimum, acquisition of their choice of:
(1) 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;
(2) One lift for every ten acute care available inpatient beds; or
(3) Equipment for use by lift teams. Hospitals shall train staff on policies, equipment, and devices at least annually.
(d) Nothing in this section precludes lift team members from performing other duties as assigned during their shift.
(e) Each private 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. Each 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."
SECTION 3. Chapter 323F, Hawaii Revised Statutes, is amended by adding a new part to be appropriately designated and to read as follows:
"Part . SAFE PATIENT HANDLING PROGRAM
§323F‑A Findings. 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 per cent of whom have previous back injuries, can drop patients if their pain thresholds are triggered;
(2) 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 per cent and many nurses who suffer a back injury do not return to nursing. Considering the present nursing shortage in Hawaii, measures must be taken to protect nurses from disabling injury; and
(3) Hawaii health systems corporation 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 part to place an undue financial burden on Hawaii health systems corporation hospitals.
§323F‑B Definitions. As used in this part:
"Lift team" means hospital employees specially trained to conduct patient lifts, transfers, and repositioning using lifting equipment when appropriate.
"Musculoskeletal disorders" means conditions that involve the nerves, tendons, muscles, and supporting structures of the body.
"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 patients and hospital residents.
§323F‑C Safe patient handling committee; program; equipment. (a) By January 1, 2010, each hospital within the Hawaii health systems corporation 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. The purpose of the committee shall be 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 membership will adversely affect patient care.
(b) By October 1, 2010, each hospital within the Hawaii health systems corporation shall establish a safe patient handling program. As part of this program, each hospital shall:
(1) 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 (c);
(2) Conduct a patient handling hazard assessment. The assessment shall consider such variables as patient-handling tasks, types of nursing units, patient populations, and the physical environment of patient care areas;
(3) 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;
(4) 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
(5) 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.
(c) By January 30, 2013, each hospital within the Hawaii health systems corporation shall complete, at a minimum, acquisition of their choice of:
(1) 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;
(2) One lift for every ten acute care available inpatient beds; or
(3) Equipment for use by lift teams. Hospitals shall train staff on policies, equipment, and devices at least annually.
(d) Nothing in this section precludes lift team members from performing other duties as assigned during their shift.
(e) Each hospital within the Hawaii health systems corporation 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. Each 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."
SECTION 4. This Act shall take effect upon its approval.
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INTRODUCED BY: |
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