BILL REQ. #:  S-4979.1 

READ FIRST TIME 02/06/06.   

     AN ACT Relating to reducing injuries among patients and health care workers; and adding a new section to chapter 49.17 RCW.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION.  Sec. 1   A new section is added to chapter 49.17 RCW to read as follows:
     (1) The legislature finds that:
     (a) Patients are not at optimum levels of safety while being lifted, transferred, or repositioned manually. Mechanical lift programs can reduce skin tears suffered by patients by threefold. Nurses, thirty-eight percent of whom have previous back injuries, can drop patients if their pain thresholds are triggered.
     (b) Health care workers lead the nation in work-related musculoskeletal disorders. In 1999, the bureau of labor statistics identified "health care patient" as the source of fifty-nine thousand such injuries.
     (c) According to the bureau of labor statistics, hospitals in Washington have a nonfatal employee injury incidence rate that exceeds the rate of construction, agriculture, manufacturing, and transportation.
     (d) The physical demands of the nursing profession lead many nurses to leave the profession. Research shows that the annual prevalence rate for nursing back injury is over forty percent and many nurses who suffer a back injury do not return to nursing. Considering the present nursing shortage in Washington, measures must be taken to protect nurses from disabling injury.
     (e) Between 1993 and 2001, self-insured hospitals have led the state in compensable lost-time back injury claims and compensable lost-time back, neck, and upper extremity claims with four thousand three hundred fourteen and nine thousand seven hundred fifty-four, respectively.
     (2) The definitions in this subsection apply throughout this section unless the context clearly requires otherwise.
     (a) "Department" means the department of labor and industries.
     (b) "Hospital" means hospitals as defined in chapter 70.41 RCW and state hospitals as defined in RCW 72.23.010.
     (c) "Lift team" means hospital employees specially trained to conduct patient lifts, transfers, and repositioning.
     (d) "No manual lift policy" means hospital protocols to replace the manual lifting, transferring, and repositioning of patients identified by the process established in subsection (4)(c) of this section with lift teams using mechanical lifting devices, engineering controls, and equipment to accomplish these tasks.
     (e) "Safe patient handling" means the use of engineering controls, transfer aids, or assistive devices instead of manual lifting to perform the acts of lifting, transferring, and repositioning healthcare patients and residents.
     (f) "Musculoskeletal disorders" means conditions that involve the nerves, tendons, muscles, and supporting structures of the body.
     (3) By December 1, 2006, each hospital must establish a safe patient handling committee. At least half of the members of the safe patient handling committee shall be frontline nonmanagerial employees who provide direct care to patients involved in patient care handling activities.
     (4) By July 1, 2007, each hospital must establish a written patient care activities program that addresses patient handling with input from the safe patient handling committee to prevent musculoskeletal disorders among health care workers and injuries to patients. As part of this program, a hospital must:
     (a) Implement a no manual lift policy for all shifts and units of the hospital;
     (b) Conduct a patient handling hazard assessment. This assessment should consider such variables as patient-handling tasks, types of nursing units, patient populations, and the physical environment of patient care areas;
     (c) Develop a process to identify the appropriate use of the no manual lift policy based on the patient's physical and medical condition. However, in limited circumstances applying the no manual lift policy may be contraindicated for a particular patient. In such cases hospitals must document the reasons for the exemption. Such documents shall be retained by the hospital and made available for review by the safe patient handling committee and the department; and
     (d) Implement and conduct an annual performance evaluation of the program to prevent musculoskeletal disorders to determine the program's effectiveness according to the reduction of musculoskeletal disorder claims and days of lost work for musculoskeletal disorder purposes and make recommendations to increase the program's effectiveness.
     (5) By July 1, 2008, each hospital must acquire needed equipment and train staff on policies, equipment, and devices before implementation and at least annually or as changes are made to the patient care activities program or type or make of equipment being used.
     (6) Nothing in this section precludes lift team members from performing other duties as assigned during their shift.
     (7) A hospital employee who refuses a patient care activity due to concerns about either employee or patient safety or the lack of trained lift team personnel or equipment may not, based upon the refusal, be the subject of disciplinary action by the hospital or hospital managers or employees.