Ergonomics: Nursing Home Case Study - Employee Training

Ergonomics: Guidelines for Nursing Homes

Appendix - A Nursing Home Case Study: Continued

Providing Training
As Wyandot purchased and installed new equipment, workers received training on how to use it, and guidelines for equipment use were put into place. An LPN in-service director did the training. New employees learn how to use the devices and know where to go for further instruction or help. Eventually, most of the nursing assistants adapted to the mechanical lifts and refused to use any other lifting techniques.

Providing Management Support
Wyandot's administrator took a personal interest in ergonomic issues. To address high injury and turnover rates at Wyandot, he remained committed to identifying and solving problems. For example, on one occasion the staff said that the lifts were not easy to roll on the floors in the B- and C-Wings. To solve the problem, he experimented with different wheels that would roll more easily and turn in tight places with less effort. Finally, he worked with a manufacturer to find and buy better casters to suit the home's flooring.

Evaluating Efforts
To start with, Wyandot's administrator spent $150,000 to buy equipment. He later set aside another $130,000 to continue his efforts, for a total of $280,000. Wyandot has saved $55,000 annually in payroll costs, according to Wyandot's administrator, because of reduced overtime and absenteeism. The home estimates savings of more than $125,000 in turnover costs. Meanwhile, workers' compensation costs also have fallen drastically. For example, Wyandot reports that, after the program was implemented workers' compensation costs declined from an average of $140,000 per year to began to average less than $4,000 per year.

From the time workers began to use the sit-to-stand lifts, which were among the first to be introduced at Wyandot, the incidence of back injuries stopped. Once the fast beds were introduced only six new hires were needed in the following year.

Worker satisfaction has increased greatly. One nursing assistant, who has spent most of her career working in nursing homes, confessed to being sore and unhappy at Wyandot before the lifts were introduced. After the innovations at the nursing home, she reported that she is no longer hurting. She concluded that "I think my career is right here in the Wyandot County Nursing Home till my time is due to retire comfortable. And you know if my time comes to be in a nursing home I do hope I get one like ours."

Mechanical lifts have also helped return a sense of dignity to Wyandot's residents. As one nursing assistant put it, through the use of the mechanical lifts, the residents are able to wear normal clothing again, which "improves their self-esteem and keeps them warmer."

The wife of one totally dependent resident who has been at Wyandot for eight years reports that because of her husband's size, he cannot help the nurses and nursing assistants in moving him from place to place. Before the overhead electric lifts and electric beds were installed in his room, it took three and sometimes four nursing assistants to move him from the bed to his cart or to the toilet. He had numerous bruises from falling and dreaded being moved. With the lifts in place, the resident's wife reports that the staff "can easily move him about to his chair and to the toilet. He cannot sit without help but the sling gives him comfortable support and makes it possible to have some dignity."

Occupational Safety & Health Administration (OSHA)
200 Constitution Avenue, NW
Washington, DC 20210

Updated on: 12/10/09
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Ergonomics: Guidelines for Nursing Homes
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Ergonomics: Guidelines for Nursing Homes

Recommendations for nursing home employers to help reduce the number and severity of work-related musculoskeletal disorders (MSDs) in their facilities.
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