Safety intervention less effective for low-wage workers

A safe patient-handling intervention decreased injuries among nurses, but not among lower-wage workers employed as patient care associates, according to a recent study in the American Journal of Public Health.

This study at the Harvard T.H. Chan School of Public Health compared self-reports of safe patient-handling practices and hospital injury rates at two large Boston area hospitals from 2012 to 2014. The purpose of the study, which was funded by the National Institute for Occupational Safety and Health (NIOSH) was to investigate how results at the population level may not show the full picture.

In 2013, nurses and patient care associates at one hospital received the same safe patient-handling intervention while workers at the other hospital did not. The intervention included initial and ongoing training on using new equipment, including slings and special devices, to help move patients safely. Study participants included 482 nurses and 96 patient care associates at the intervention hospital and 915 nurses and 94 patient care associates at the comparison hospital.

After the intervention, lifting and exertion injuries among nurses decreased by about a third, but no decrease in injuries occurred among patient care associates. At the same time, both groups reported similar improvements in their own safe handling of patients. These findings are an example of the “inequality paradox,” which is the tendency of some interventions to unintentionally widen the gap between less and more advantaged workers. As such, the results highlight the importance of accounting for differences among workers when designing and evaluating health and safety interventions.