Identifying Workplace Hazards in Nursing Homes

January 9, 2023

There are several workplace hazards faced by staff at nursing homes and other facilities. Following is an overview of some of the risks workers face along with recommendations and resources you can share with your insureds to help mitigate workplace exposures.

Musculoskeletal Disorders

One primary source of injury to health care workers is musculoskeletal disorders (MSDs) due to repeated patient-handling activities such as lifting and repositioning patients. This includes, for example, transferring a patient from the toilet to a chair or from the chair to bed, lifting a patient in bed, or even making a bed with a patient in it. As a result of these activities, sprains and strains are very common, with the shoulders and lower back the most affected parts of the body. According to the Occupational Safety and Health Administration (OSHA), direct and indirect costs associated with back injuries in the health care industry are estimated at $20 billion.

To help mitigate the risk of MSDs, patient transfer and lifting devices and equipment are integral to an effective safety program. According to OSHA’s recommendations, management should also commit to the following:

  • Providing workers with appropriate measures to avoid manual handling
  • Having worker participation in the assessment and implementation processes and the evaluation and selection of patient-handling devices
  • Performing a thorough hazard assessment that addresses high-risk units or areas
  • Investing in care planning for patient handling and movement, training for staff, and a program review and evaluation process

Infectious Diseases

Infectious disease transmission occurs primarily through contact, droplet, and airborne routes in a nursing home setting. According to OSHA, contact transmission can be divided into two types: direct contact and indirect contact. The transfer of infectious agents to an individual via physical contact with an infected individual is referred to as direct contact transmission (e.g., direct skin-to-skin contact). When an infectious agent is transferred to an individual through physical contact with contaminated items and surfaces, this is called indirect contact transmission (e.g., via doorknobs, patient-care instruments or equipment, bed rails, and examination tables). Methicillin-resistant Staphylococcus aureus (MRSA) and Vancomycin-resistant enterococcus (VRE) are two examples of contact-transmissible infectious agents.

Droplets containing infectious agents are produced when an infected person coughs, sneezes, or talks or during specific medical procedures such as suctioning or endotracheal intubation. Transmission occurs when droplets produced in this manner come into direct contact with the mucosal surfaces of a susceptible individual’s eyes, nose, or mouth. The influenza virus, which causes seasonal flu, is an example of a droplet-transmissible infectious agent.

Airborne transmission occurs via tiny particles containing infectious agents that can float in the air for extended periods. They enter the respiratory tract and can cause infection when inhaled by an individual. Airborne transmission does not require face-to-face contact with an infected individual, because air currents can disperse these particles or droplet nuclei long distances. Only a few diseases can be transmitted via the airborne route, including tuberculosis (TB) and measles.

Both OSHA and the Centers for Disease Control and Prevention (CDC) provide resources and guidelines to reduce the risk of occupational exposure to infectious diseases, including the need to provide personal protection equipment (PPE) for workers exposed to contact, droplet, and airborne transmissible infectious agents. In addition, the CDC provides resources on the latest technological advances in hand hygiene adherence and links to promotional and educational tools published by the World Health Organization (WHO), universities, and health departments. The CDC also offers guidelines on preferred methods for sterilizing patient-care medical devices and cleaning and disinfecting the health care environment.

Workplace Violence

Health care workers face acts of workplace violence that range from the threat of physical violence to harassment, intimidation, or other disruptive behavior. A zero-tolerance policy for workplace violence is one of the best safeguards health care employers can provide for their employees. The policy should cover all employees, patients, clients, visitors, contractors, and anyone else who may come into contact with facility workers.

Employers in the health care industry can reduce the likelihood of incidents by assessing their work sites. OSHA recommends having a well-written and implemented workplace-violence prevention program, in conjunction with engineering controls, administrative controls, and training, to reduce workplace violence. In addition, it is critical to ensure that all employees are aware of the policy and understand that all claims of workplace violence will be investigated and resolved as soon as possible.

Other workplace hazards in nursing homes and other health care facilities include potential chemical and drug exposures, waste anesthetic gas exposures, contamination risks associated with laboratories, and radioactive material and X-ray exposure.

About Manchester Specialty Programs

Manchester Specialty Programs provides agents and brokers with totally integrated business insurance solutions, including Workers’ Compensation coverage, to meet the needs of Home Care, Allied Health, and Human/Social Services organizations. Our carrier partners provide payment plan options to meet clients’ budgetary needs. For more information about how our products and services can help protect your insureds and how we recognize accredited firms, please contact us at 855.972.9399.