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A new National Emphasis Program (NEP) for Nursing and Residential Care Facilities was released on April 5 by the U.S. Department of Labor‘s (DOL) Occupational Safety and Health Administration (OSHA) in an effort to reduce occupational illnesses and injuries in these long-term care settings.

The NEP (pdf) provides guidance for a three-year effort to use OSHA outreach and inspections to reduce specific occupational hazards in nursing and residential care facilities.

In 2010, workers employed in these settings experienced “one of the highest rates of lost workdays due to injuries and illnesses of all major American industries,” a DOL press release states.

“The incidence rate for cases involving days away from work in the nursing and residential care sector was 2.3 times higher than that of all private industry as a whole, despite the availability of feasible controls to address hazards,” DOL explains.

Nearly two thirds of the cases (62.5 percent) that involved days away from work were attributed to injuries in two categories: 1) overexertion and 2) slips, trips, and falls.

DOL identified the following hazards associated with providing care in nursing and residential facilities:

• exposure to blood and other potentially infectious material;
• exposure to other communicable diseases such as tuberculosis;
• ergonomic stressors related to lifting patients;
• workplace violence;
• slips, trips, and falls; and
• exposure to hazardous chemicals and drugs.

“These are people who have dedicated their lives to caring for our loved ones when they are not well,” said David Michaels, assistant secretary of labor for occupational safety and health. “It is not acceptable that they continue to get hurt at such high rates. Our new emphasis program for inspecting these facilities will strengthen protections for society’s caretakers.”

Nursing Aides Rank among the Highest for Job Injury and Illnesses

According to analysis by PHI of 2010 data on nursing aides from the Bureau of Labor Statistics, Injuries, Illnesses and Fatalities Program:

• Nursing aides ranked second in the list of occupations with the highest numbers of injuries and illness (53,030), after hand laborers and freight, stock, and material movers (65,040), and far ahead of police and sheriff’s patrol officers (29,150).
• Nursing aides also had one of the highest incidence rates of work-related illness and injuries (489.4 per 10,000 workers), placing them third in the list of the top five. In 2010, they experienced injury at a rate four times that of all workers combined.
• Nursing aides had the highest incidence rate for musculoskeletal disorders of all occupations (or ergonomic injuries) at 249.4 per 10,000 full-time, or more than seven times the national average (34.3 per 10,000).

Visit the OSHA website for more information, including guidance on nursing and residential care facility ergonomics and workplace violence.

– by Deane Beebe

The newest additions to PHI’s National Clearinghouse on the Direct Care Workforce:

Improving Job Quality: Direct Care Workers in the US — This paper presents several strategies for improving the quality of direct-care jobs in the U.S. and the U.K. It argues that a “decent public sector investment” in caregivers’ wages, working conditions, career advancement opportunities, and training requirements is necessary to substantially improve job quality. The paper was published in September 2011 by the Center for Economic and Policy Research.

Nursing Home Survey on Patient Safety Culture: 2011 User Comparative Database Report — This August 2011 survey contains data compiled from 226 nursing homes throughout the U.S. The data presents the opinions of nursing home staff regarding resident safety, the incidence of medical errors, and event reporting. The survey was conducted by the federal Agency for Healthcare Research and Quality.

Cost of Turnover in the Direct Care Workforce — This June 2011 report by the Iowa Department of Public Health estimates that statewide turnover among the direct-care workforce cost Iowa $117 million in 2010 alone. That figure is expected to increase as the workforce grows larger; by 2015, turnover will cost $148 million.

The Influence of Nurse Staffing Levels on Quality of Care in Nursing Homes — This study examines the relationship between the certified nursing assistant (CNA) staffing levels and the Nursing Home Compare scores of Florida nursing homes. The authors demonstrate a correlation: For every six-minute increase in CNA hours per resident day, a nursing home sees a 3 percent reduction in its care-quality deficiency score. The authors therefore conclude that nursing home providers would benefit by hiring more CNA staff. The study was published on the website of the Gerontologist in May 2011.

PHI’s National Clearinghouse on the Direct Care Workforce is a national online library for people in search of solutions to the direct-care staffing crisis in long-term care. It houses over 1,000 articles, reports, issue briefs, and fact sheets on the direct-care workforce.

– by Matthew Ozga

Dr. Donald Berwick

Donald Berwick, the administrator of the Centers for Medicare and Medicaid Services (CMS), will conduct a conference call at 1:45 this afternoon to discuss a new program designed to improve patient safety, increase health care quality, and lower the costs of care.

The program is a public-private partnership called Partnership for Patients: Better Care, Lower Costs. Its two primary goals, according to a fact sheet issued by the Department of Health and Human Services, are:

• to keep patients from getting injured or sicker; and
• to help patients heal without complication.

Berwick will be joined by two other high-ranking CMS officials for the call.

The call-in number is 888-469-1561, and the passcode is HHS. The conference call is off the record and may not be used for press purposes.

Robyn Gershon

Robyn R. M. Gershon, MHS, DrPH, a professor of sociomedical sciences and associate dean at Columbia University’s Mailman School of Public Health, explores the occupational hazards faced by home care workers. Read the full story

Logo for 2010 Nursing Assistants Week

The National Network of Career Nursing Assistants (NNCNA) has announced that the 33rd Annual National Nursing Assistants Week will take place from June 10-17. Read the full story