Karen Stenger

Karen Stenger

University of Iowa Hospitals and Clinics, Iowa City

and Karen Stenger, RN, MA, CCRNThe University of Iowa Hospital and Clinic

  with Karen Stenger
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with Karen Stenger RN, MA, CCRN
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According to Karen Stenger RN, MA, CCRN, Advanced Practice Nurse with the University of Iowa Hospitals and Clinics, in 2000, the facility initiated a multidisciplinary ergonomics committee to look at how to deal with both patient handling-exertion injuries and non-patient care injuries.

Stenger notes the initial focus was on the general patient population."At the time, there wasn't so much of an awareness of bariatrics," she said.
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"Then in 2005," said Stenger, "the focus began to shift much more towards bariatrics than it was in the beginning; and we started installing more ceiling lifts with a 600-lb. capacity, and we now have two ceiling lifts that have a 1,000-lb. capacity in our inpatient areas.
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It's important for recovery and rehab goals, not to limit the rehab but enhance the rehab," said Stenger.

She also notes that portable lifts are critical if ever a patient should fall or trip.

Stenger said that research conducted by Audrey Nelson, PhD, RN, FAAN, director of the Patient Safety Research Center at the Veterans Administration Medical Center in Tampa, FL, was integral in guiding their initial efforts. (See "Safe Patient Handling & Movement in High Risk Units" available at http:www.visn8.med.va.gov/patientsafetycenter/).
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Stenger and Dr. Montgomery also provide education assistance and consultation to other departments within the hospital.
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Stenger credits the success of the training program with the appointment of several "key coaches" - specially trained employees who helped to lead the culture of safety change and champion the use of patient handling equipment and safe lifting policies throughout the facility.
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Now people don't even question going to get that equipment," said Stenger.

"One important piece to mention is that a person can get injured just by one lift, or they can have an accumulation of injuries just by doing things over and over again in their career.So it's really important to look at the career of the nurse and trying to protect them.With those kinds of accumulative injuries, they may not realize that they are setting themselves up for injury, and then they might end up getting injured at home or elsewhere."

UIHC employs what they call a "minimal-lift policy" explained Stenger."We try very diligently to respond to any patient handling need that arises, and ask ‘do we have the right equipment in the hospital to perform that lift?' If we don't have the equipment, we question what we can do about that task in the short term and long term to make it as safe as possible."

She notes that most of the facilities' current construction projects, including an ambulatory surgery clinic and neurosurgery clinic, will all have ceiling lifts installed.
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I was surprised by that at first, but that's exactly what we're seeing," said Stenger."Nurses are also so aware of it they are reporting more if they are injured."

"I think that we've taken care of some of the easier things to take care of like transferring patients from bed to chair, and look at how much the worker's comp. costs dropped.What we spend the majority of our time with now is trying to have a plan for the harder tasks and one of those being a bariatric patient."

Stenger says that the multidisciplinary ergonomics committees continue to meet regularly and they are continually looking at purchasing new bariatric equipment as technology advances.

"I can't stress enough how important it is to assure this committee has the voice of disciplines involved in direct care giving.Hospitals need to look at the injuries they're having related to patient handling and know that there are really good solutions out there for that.But they can't just buy it and then put it on the floor."She adds, "Staff and patients need administrative support and education to make the change to safe patient handling."

Karen Stenger RN, MA, CCRN is an Advanced Practice Nurse, Intensive and Specialty Services, Department of Nursing Services and Patient Care, at The University of Iowa Hospitals and Clinics, Iowa City, IA.

"Acute Brain Injury: A Guide for Family and Friends" This guide, written by Michele Wagner, RN, CNRN, and Karen Stenger, RN, MA, CCRN of University of Iowa Health Care (UIHC), is now available.

Karen Stenger

University of Iowa Hospitals and Clinics , Iowa City

"To lose a nurse in a critical care unit because of an injury, who has 20 years of experience -- we just can't replace their knowledge," said Karen Stenger, an advanced practice nurse who has helped implement the new program.
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"Injuries to the backs and shoulders of nurses is fairly significant," Stenger said."Nursing is the only profession that thinks 100 pounds is light."

The nursing industry has remained one of the top 10 most injury-prone industries for years, she added.
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"Change champions are experts on how to use the different pieces of equipment in their units," Stenger said.