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ICN appeals for safe staffing ratios
Noting that inadequate staffing in health care settings is reaching crisis proportions in all regions of the globe, the president of the International Council of Nurses (ICN) used the occasion of International Nurses Day (May 12) to appeal to legislators and policy-makers to address the urgent need.

Evidence indicates that inadequate staffing is resulting in a critical increase of hospital stays, patient morbidity and mortality, and preventable adverse events. One study found that raising a nurse’s workload from four surgical patients to six resulted in a 14 percent increase in the likelihood of one of those patients dying within 30 days of admission. In reality, many nurses are challenged with much greater patient workloads on a daily basis.

“The evidence is in,” stated Hiroko Minami, president of the International Council of Nurses. “Safe staffing leads to lower incidences of medication errors, post-intervention urinary tract infections, upper gastrointestinal bleeding, falls, pneumonia and shock. The global nursing shortage experienced today clearly threatens reaching the Millennium Development Goals.” [For more information about the Millennium Development Goals, visit http://www.un.org/millenniumgoals/.]

A is for AHRQ and audio
Find it difficult to stay informed of the latest in health care research? The Agency for Healthcare Research and Quality (AHRQ), part of the U.S. Department of Health and Human Services, recently inaugurated audio newscasts to help keep nurses and other health care providers informed of the agency’s latest research findings, news and information. The mission of AHRQ is to improve the quality, safety, efficiency and effectiveness of health care for all Americans, and it is the lead federal agency in the effort to improve patient safety and reduce medical errors. For more information, to hear the newscast via computer or to download a newscast to a portable digital player such as an iPod, go to http://www.healthcare411.org.

NIH-funded research facility one of first in U.S. to serve nursing scientists
The University of North Dakota College of Nursing has received $4 million in federal funding to construct and operate the Northern Plains Center for Behavioral Research. The center, to be built adjacent to the existing nursing building, will house an integrated program of behavioral and mental health research and research training in nursing, psychology and counseling. The program will benefit vulnerable and underserved groups across the life span in the Dakotas, Minnesota, Wyoming, Montana and Idaho.

According to Chandice Covington, RN, PhD, FAAN, dean of the College of Nursing: “This building will be one of the first in the nation built with NIH funding to serve nursing scientists and interdisciplinary colleagues in the behavioral sciences. The plan includes state-of-the-art behavioral research space, offices for funded researchers and our federally funded RAIN (Recruitment and Retention of American Indians in Nursing) and INSYDE (Indians into Psychology) programs. We are anticipating exciting new research initiatives built on our strong history of research on vulnerable populations in the state and region.”

The Behavioral Research Center, funded by the National Institutes of Health National Center for Research Resources (NCRR), will be used by nursing and psychology faculty to explore conditions such as Alzheimer’s disease, alcoholism, diabetes, nutritional disorders and other conditions by helping patients alter their behaviors.

Members of Miami Valley Hospital’s lift-team prepare to move a patient.

Ohio nurses get a lift and reduce injuries
The nursing profession consistently ranks in the top 10 occupations in the United States for work-related musculoskeletal injuries, according to the Bureau of Labor Statistics, and data from more than 80 studies indicate that anywhere from 35 to 80 percent of nurses sustain back injuries during their career. Administrators of a hospital in Dayton, Ohio, are out to change those statistics with a patient lift-team program that has proven to be a resounding success.

The program began in April 2004, and first-year results are in. Lower-back injuries among nurses decreased 93 percent after the first six months and 50 percent after one year. In addition, more than 800 hours of nursing staff time was gained in that year, since nurses no longer were required to assist others in moving, lifting or holding patients.

How it works: The lift-team program presently employs about six physically fit men—women can apply—teamed in pairs, working overlapping shifts and covering a total of 800-plus beds. When they arrive for work, team members begin scheduling lifts for the day, with first priority given to medical-surgical units and critical care units, the primary users of the service. The team can be accessed any time for emergency lifts, helicopter off-loads and assistance in positioning patients for dressing changes or other procedures.

“Once this program launched at Miami Valley Hospital, we became 100 percent committed to ensure the safety of our nurses and the lift team staff,” said Mary Boosalis, president and CEO of Miami Valley Hospital. “To date, we have documented zero injuries among our lift team, and that is a total testament to the rigorous fitness and training standards we demand prior to getting hired and during employment.” To keep the lifters in shape, all have in-depth training in moving patients with and without mechanical assistance in a variety of environments. In addition, an ergonomics expert makes quarterly observations, and yearly competency reviews on patient handling are conducted to ensure that skills are maintained.

“We recruit staff from other professions such as trainers, security personnel and the military,” said Steve Roark, lift-team supervisor in the Centran Department of Miami Valley Hospital. “Everyone who works with us must demonstrate a level of fitness and experience rigorous training to ensure they don’t become injured on the job.”

To minimize risk of injury, lift-team members must successfully complete the Firefighters’ Fitness Test, along with an evaluation by the hospital’s medical director of employee health. These tests are completed prior to employment and also annually.

Patient satisfaction ranks high as a measurement tool for the lift team, and marks thus far have indicated that these men have become care ambassadors for the hospital. Not only is physical prowess important—people skills, empathy and compassion are also critical ingredients to program success.

The nursing staff is educated about and encouraged to effectively use the lift team. Guidelines on how to access the team and schedule lifts are posted in all hospital units. To improve communication between the lift team and the nursing staff, lift-team members are equipped with a wireless phone, which significantly reduces delays in team response and allows the lift team to prioritize lifts based on demand.

Initially, the lift team program was deployed on critical care and step-down units in the hospital (those with a higher proportion of injuries), and it operated during day shifts when most nurse injuries were sustained. Because of the success of the pilot program, Miami Valley Hospital Foundation is now expanding the program to second shift, hospital-wide.

“This program was developed at Miami Valley Hospital in answer to an aging workforce, something every hospital is addressing in this country,” said Pat O’Malley, RN, PhD, CCRN, CNS, nurse researcher in the Center of Nursing Excellence. “We’re a Magnet hospital, and there’s a reason for that. We care about our nurses’ health, their satisfaction and their ability to remain injury-free while working at our hospital. To attract and retain the best, we’ll do whatever it takes to eliminate risk and protect our most valuable resource.”

“People have a misconception that nurses get back injuries from lifting heavy patients,” said O’Malley. “That’s not the reason at all; patient handling and movement are physically demanding and are generally performed in unfavorable and stressful conditions. There’s an astonishing statistic we call the ‘gasp number,’ because the jaws dropping are palpable when we reveal that in a typical eight-hour shift, a nurse lifts cumulative weight of 1.8 tons.”