KELLY MCEVERS, HOST:
NPR's investigation's unit has been exposing an epidemic in U.S. hospitals. Nursing employees suffer more debilitating back and other injuries than almost any other occupation. They get hurt from lifting and moving patients. Today, we're going to hear how one of the nation's largest healthcare systems is proving many of these injuries can be prevented. And the name of that system may be surprising. As NPR's Daniel Zwerdling reports, it's the VA.
DANIEL ZWERDLING, BYLINE: You've probably heard negative stories recently about the Department of Veterans Affairs - long wait times and all that. But when it comes to nursing employees wrecking their backs, researchers say the VA has done more to prevent those injuries than any hospital system in America. And Bernard Valencia's room shows how.
PATIENCE UMOFFIA: Mr. Valencia, right now - I'm going to lift you up right now.
ZWERDLING: Valencia is a patient in the VA hospital in Loma Linda, Calif. His nurse has just walked into the room on one south to give him a shower. Valencia is 65 years old. His body's all twisted. He can barely move his hands or legs.
BERNARD VALENCIA: I have rheumatoid arthritis. I'm stiff as a board.
ZWERDLING: That poses a potentially dangerous challenge for his nurse, Patience Umoffia. How will she move Valencia from his bed to the shower? If this were a typical hospital, she'd cradle her arms around him and drag him to the edge of the bed. Then she'd lift him like a life-sized doll into a wheelchair. Umoffia says she used to move patients that way. That's what hospitals and nursing schools have been teaching for 100 years.
Did you ever have any back issues?
UMOFFIA: Yes. We get so sore, we barely can even take care of them the following day.
ZWERDLING: In fact, the VA's records show that more 2,400 workers at their hospitals used to get injured every year just from lifting patients. But since then, the VA has transformed the way that employees handle patients.
Umoffia grabs a hook that's dangling from the ceiling, and she attaches it to a sling around Valencia's body. She pushes a button and now a machine that's mounted in the ceiling lifts Valencia out of his bed and it raises him a few feet up in the air. Then it ferries him until he dangles over the wheelchair.
VALENCIA: I'm comfortable. I feel like a baby in a stork.
ZWERDLING: You look kind of like a baby hanging from a stork's beak.
VALENCIA: That's what it feels like. I feel like a little baby.
ZWERDLING: And then, the machine gently lowers him into the chair. Tony Hilton has been watching all this. She runs the hospital's campaign to prevent their staff from getting injured. Hilton says nobody at this VA is allowed to move patients the traditional way anymore.
TONY HILTON: The guideline is you're not manually moving or handling patients. You're using technology.
ZWERDLING: So you're saying your edict here - the edict in the whole VA is you do not manually handle patients?
HILTON: That's correct, not for lifting and moving them.
ZWERDLING: It doesn't sound possible.
HILTON: Well, we're doing it. (Laughter).
ZWERDLING: The VA's campaign to protect nursing staff started in the late 1990s. VA studies showed they were spending at least $22 million per year just on injuries that nursing employees got from lifting.
MICHAEL HODGSON: They were interfering with their lives at work. They were interfering with productivity.
ZWERDLING: Michael Hudgson was one of the VA's top researchers.
HODGSON: They were putting patients at risk, because, you know, if somebody gets hurt at work and has to go home, you're down a nurse on that shift.
ZWERDLING: So the VA's top officials decided we have to transform all 153 hospitals in our system to help prevent nursing staff from getting hurt. They called the campaign safe patient handling. Over the past six years, the VA has spent more than $200 million reinventing how nursing employees move patients. The most visible sign is the machines, like the one that moved Bernard Valencia.
OK, so we're in 1A 627B. Does this have a lift?
HILTON: Yes, it has a lift?
ZWERDLING: Now, a lot of hospitals around the country have bought some equipment to help the staff move patients. But Hilton says here at the Loma Linda VA, they ripped up the ceilings and installed motorized lifts in every patient room. I keep checking to see if she's exaggerating. The room across the hall - 1A 625?
HILTON: Every room has a lift. It's ever-present.
ZWERDLING: And the hospital's trying to prevent injuries with more than lifts. For instance, they move some patients on floating mattresses.
UNIDENTIFIED NURSE: Ready? One, two, three - I'm going to inflate.
ZWERDLING: And a pump shoots air streams through thousands of tiny holes under the mattress until it almost levitates so workers don't have to lift a patient from a bed to a gurney. They can pretty much float the mattress over with one hand. Still, the VA has discovered that all the equipment in the world does not prevent injuries on its own. When they started buying the equipment, most employees ignored it.
HILTON: It was actually a laughing matter in the beginning. They said oh no, lifts? They don't work. It takes too much time. They're used to their old ways. They wouldn't use it.
ZWERDLING: But here's what I don't get totally - it seems like management should be able to just say to the staff, look, this is what you - you're already shaking your head no. (Laughter).
HILTON: No. It's not as easy as the management telling the staff to do it. We have been taught for years that we manually handle patients. So to undo that in your brain is a culture of change. They have to buy into it.
ZWERDLING: Tony Hilton says to get employees to buy into it, you have to train them.
HILTON: Good morning, everyone.
UNIDENTIFIED CROWD: Good morning.
HILTON: So all about safe patient handling - anybody here knows what in the world is safe patient handling all about?
ZWERDLING: On a recent morning, Hilton stands at the podium in the hospital's auditorium. A batch of new employees has come for orientation.
HILTON: For a 200-pound man, how much do you think that leg weighs? Anybody wants to guess? It can go up to 45 pounds.
ZWERDLING: Officials at other hospitals around the country have told me we train our employees to move patients safely, too. We send them to an hour-long class every year, to which Tony Hilton says no, no, no, that won't work. We're constantly training here at the VA.
For instance, there's at least one employee on every unit 24 hours a day who coaches colleagues how to use the equipment. And we drop by a room where nurses in the ICU are learning how to use a brand-new machine that takes over the job of turning patients onto their stomachs.
HOSPITAL TRAINER: Use that yellow tab, swing it down.
ZWERDLING: Tiffany Gratton is taking this class. She says she was a substitute nurse at roughly 20 hospitals before she came to the VA a few years ago. And nobody had a program like this.
TIFFANY GRATTON: Zero.
GRATTON: Zero. In my 12 years of experience, I've not experienced this type of system for safe patient handling. They never stressed the injuries that could be sustained.
ZWERDLING: Researchers in the VA have discovered that there's one more ingredient hospitals need if they really want to prevent injuries. They need what they call a safety champion. They need a Tony Hilton who's constantly in your face.
HILTON: Can I grab you for a minute?
ZWERDLING: During the day I spent with her, Hilton speed walks from one unit to the next. At this moment, she's in the emergency room, and she's nudging people. Use that equipment. Don't hurt your back.
HILTON: Any issues here we need to take care of with safe patient handling today?
Do you have what you need to do your job?
UNIDENTIFIED MAN: Yes.
ZWERDLING: Government researchers have been studying the results. They show that VA hospitals across the country have reduced nursing injuries from moving patients by an average of 40 percent. And Hilton says here at Loma Linda, the injuries they do get are less serious than they used to be. This hospital spent almost a million dollars during a recent four-year period just to hire replacements for employees who got hurt so badly they had to go home. But last year, the hospital spent...
ZWERDLING: Hilton says nobody got hurt badly enough to miss work. Daniel Zwerdling, NPR News.
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