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When staff at Southern Ohio Medical Center Home Health Services reported a total of 777 days lost due to work-related injuries in one year, managers knew something had to change. By tapping into the expertise of an occupational therapist and developing a well-defined policy that limits employees’ risk of injury when handling patients, the number of lost workdays due to injury dropped to just 80 the following year.
"We are self-insured for workers’ compensation injuries, so finding a way to decrease injuries was a real financial incentive," says Karen L. Marshall, MS, RN, administrator of the home health agency in Portsmouth, OH. "We asked for help from a staff occupational therapist with a focus on work hardening and return-to-work patients," she says. Along with continuing the agency’s inservices on injury prevention, proper transfer of patients, and proper lifting techniques, the occupational therapist developed a set of guidelines to determine which patients require extra assistance, she explains.
"We titled the policy Client Safety Classification,’ since weight classification is a sensitive term," says Marshall. There are four classifications that are defined by patient description and type of assistance needed for transfer. The classifications are:
•The Class 1 client is independent with all movement and transfers and does not require any assistance to move from one posture to another.
•The Class 2 client weighs less than 300 pounds and requires minimal assistance for transfer from posture to another. Once in a standing position, the Class 2 patient is able to ambulate independently.
•The Class 3 client weighs less than 300 pounds, needs moderate assistance to move from one posture to another, and requires a walking device or assistance to ambulate.
•The Class 4 client weighs more than 300 pounds and requires moderate assistance, or weighs more than 50 pounds and requires maximum assistance. This patient requires a minimum of two people for assistance.