Differential effectiveness of the Minnesota Safe Patient Handling Act by health care setting: An exploratory study.

BACKGROUND: The Minnesota Safe Patient Handling (MN SPH) Act requires health care facilities to implement comprehensive programs to protect their workers from musculoskeletal injuries caused by lifting and transferring patients. Nursing homes, hospitals, and outpatient facilities each face unique challenges implementing and maintaining SPH programs. The objective of the study was to compare patient handling injuries in these three health care settings and determine whether change in injury rate over time differed by setting following enactment of the law. METHODS: Workers' compensation data from a Minnesota-based insurer were used to describe worker and claim characteristics in nursing homes, hospitals, and outpatient facilities. Negative binomial models were used to compare claims and estimate mean annual patient handling claim rates by health care setting and time period following enactment of the law. RESULTS: Consistent with national data, the patient handling claim rate was highest in Minnesota nursing homes (168 claims/$100 million payroll [95% confidence interval: 163-174]) followed by hospitals (35/$100 million payroll [34-37]) and outpatient facilities (2/$100 million payroll [1.8-2.2]). Patient handling claims declined by 38% over 10 years following enactment of the law (vs. 27% for all other claims). The change in claims over time did not differ by health care setting. CONCLUSIONS: In this single-insurer sample, declines in workers' compensation claims for patient handling injuries were consistent across health care settings following enactment of a state SPH law. Though nursing homes experienced elevated claim rates overall, results suggest they are not lagging hospitals and outpatient facilities in reducing patient handling injuries.

Evaluation of the Minnesota Safe Patient Handling Act: trends in workers' compensation indemnity claims in nursing home workers before and after enactment of the law.

OBJECTIVES: The 2007 Minnesota Safe Patient Handling Act aims to protect healthcare workers from injuries caused by lifting and transferring patients. The effectiveness of the law in nursing homes is unknown. This policy evaluation measured changes in patient handling injuries before and after the law was enacted. Additionally, it assessed whether effects of the law were modified by facility levels of staffing and retention. METHODS: Workers' compensation indemnity claims for years 2005-2016 were matched to annual direct care productive hours and facility characteristics (eg, profit status, hospital affiliation and region) for all Medicaid-certified nursing homes in Minnesota. Trends in patient handling claims were analysed using negative binomial regression with generalised estimating equations. The primary predictors were time period, staff hours per resident day and staff retention. RESULTS: The patient handling indemnity claim rate declined by 25% in years 4-6 and 38% in years 7-9 following enactment of the law. Claims for all other injuries and illnesses declined by 20% in years 7-9 only. Associations between time period and patient handling claims did not vary by levels of staffing or retention. However, independent of time, facilities with annual retention ≥75% (vs <65%) had a 17% lower patient handling claim rate. CONCLUSIONS: Results suggest the law reduced patient handling claims in nursing homes. However, claim rates were elevated in facilities with low worker retention and those that were non-profit, not hospital-affiliated or in a non-metro area. Facilities with these characteristics may benefit from targeted state grants and consultation efforts.

Occupational differences in workers' compensation indemnity claims among direct care workers in Minnesota nursing homes, 2005-2016.

BACKGROUND: Nursing assistants have one of the highest injury rates in the U.S., but few population-based studies assess differential injury risk by occupation in nursing homes. This statewide study assessed differences in musculoskeletal disorders (MSDs) and patient handling injuries among direct care workers in Minnesota nursing homes. METHODS: Indemnity claims from the Minnesota workers' compensation database were matched to time at risk from the Minnesota Nursing Home Report Card to estimate 2005 to 2016 injury and illness claim rates for certified nursing assistants (CNAs), licensed practical nurses (LPNs), and registered nurses (RNs). Associations between occupation and claim characteristics were assessed using multivariable regression modeling. RESULTS: Indemnity claim rates were 3.68, 1.38, and 0.69 per 100 full-time equivalent workers for CNAs, LPNs, and RNs, respectively. Patient handling injuries comprised 62% of claims. Compared to RNs, CNAs had higher odds of an indemnity claim resulting from an MSD (odds ratio [OR] = 1.67; 95% confidence interval [CI], 1.31-2.14) or patient handling injury (OR = 1.89; 95% CI, 1.47-2.45) as opposed to another type of injury or illness. CNAs had lower odds of receiving temporary and permanent partial disability benefits and higher odds of receiving a stipulation settlement. CONCLUSIONS: CNAs in Minnesota nursing homes are at heightened risk for lost time MSDs and patient handling injuries. Claims filed by CNAs are more frequently settled outside the regular workers' compensation benefit structure, an indication that the workers' compensation system is not providing adequate and timely benefits to these workers.

Myths and facts about Minnesota's new safe patient handling statute and your dental practice.

With the passage of a safe patient handling statute in 2009, Minnesota became one of a growing number of states requiring health care providers to become more aware and accountable about providing appropriate assistance during the movement of patients in clinical care settings. The Minnesota Department of Labor and Industry and the Minnesota Dental Association have been working together to ensure that Minnesota's SPH regulations are as practical as possible for dental providers while still achieving the objectives of the statute. A template Safe Patient Handling Program for Clinics has been developed with substantial input from MDA's ESNA Committee and is now available on the DLI website: www.dli.mn.gov/WSC/SPHlegislation.asp. All Minnesota dental practices should use this template to develop their own safe patient handling program as soon as possible. Additional background information and resources related to Minnesota's SPH regulations are also available on the DLI website. MDA and DLI are currently also developing a hazard assessment tool for dental practices to assess their specific risks associated with patient movement. This hazard assessment will, in turn, guide decisions about what type of safe patient handling equipment and staff training will be necessary for total compliance with the new statute. MDA, in cooperation with DLI, will continue to keep dental professionals informed about when these materials will be available. Additionally, MDA is working to ensure appropriate training options will be available for compliance with SPH regulations. The University of Minnesota's School of Dentistry's Oral Health Services for Older Adults Program and Department of Continuing Dental Education have been regularly providing such training in conjunction with the school's "Miniresidency in Nursing Home and Long-term Care for the Dental Team," and efforts are now underway at the dental school to create stand-alone training options for Minnesota's dental professionals. Further information about SPH training may also be found on the DLI website (www.dli.mn.gov/WSC/SPHlegislation.asp). MDA members can also contact MDA's Elderly and Special Needs Adults Committee via the MDA central office.