Safe patient handling and mobility

Safe handling can help prevent injuries to patients and providers.

The Department of Labor enacted the Nurse and Health Care Worker Protection Act of 2015 to establish standards regarding safe patient handling, mobility, and injury prevention to prevent musculoskeletal disorders for healthcare workers. The act requires healthcare employers to:

  1. Develop and implement a safe patient handling, mobility, and injury prevention program
  2. Train workers on safe patient handling, mobility, and injury prevention
  3. Post a notice that explains the standard, procedures to report patient handling-related injuries, and workers' rights under this Act.
  4. Conduct unscheduled inspections to ensure compliance with the standard. (H.R.4266 — 114th Congress) (2015-2016)

Findings included:

  • In 2014, registered nurses ranked sixth among all occupations for the number of cases of musculoskeletal disorders resulting in days away from work, with 11,360 total cases.5
  • Nursing assistants reported 20,020 cases in 2014, the second highest of any profession.5
  • The leading cause of these healthcare employees' injuries is patient lifting, transferring, and repositioning injuries, which constitute a significant risk to the health and welfare of those employees under the Occupational Safety and Health Act of 1970.2
  • Patients are not at optimum levels of safety while being lifted, transferred, or repositioned manually.5
  • Appropriate mechanical lifts can substantially reduce skin tears and pressure ulcers suffered by patients and the frequency of patients being dropped, thus allowing patients a safer means to progress through their care and avoid disabling injuries due to unsafe practices.1
  • The development of assistive patient handling technology, equipment, and devices has essentially rendered the act of strict manual patient handling outdated and typically unnecessary as a function of nursing care.5
  • Establishing a safe patient handling, mobility, and injury prevention standard for direct-care registered nurses and other healthcare workers is a critical component reasonably necessary for protecting the health and safety of nurses and other healthcare workers, addressing the nursing shortage, and increasing patient safety. (H.R. 4266. Introduced 12/16/2015)5

Occupational Safety and Health Administration (OSHA) recommendations:

  • Minimize or eliminate manual lifting as feasible.
  • Establish a process to systematically assess ergonomic issues to prevent occupational safety and health hazards.
  • Effective solutions usually require modifications to eliminate hazards and promote safer environment.
  • Solutions usually will include the use of equipment or modifications to practices.

Patients should be assessed prior to attempting any transfer for:

  • Level of assistance required to complete transfer.
  • Size and weight of patient.
  • Ability of patient to understand and assist with transfer.
  • Any medical conditions that need to be considered when transferring.

Evaluation of caregiver skills and capabilities:

  • Increased level of skill and experience of caregiver usually equates to less injury.
  • Matching caregiver size and experience level to patient needs.
  • Education and training of caregiver to specific tasks and equipment reduces likelihood of injury.
  • Document annually verification of competencies.
  • Establish metrics to measure: appropriate use of equipment, setting up of equipment, utilization of proper body mechanics, and utilization of risk assessment.

Equipment and aids: (not inclusive)

  • Medical beds, wheelchairs, lifting devices, sit-to-stand devices, turning aids.
  • Shower chairs, height-adjusted toilet seats, sliding sheets/boards, limb lifters, stand aids, walkers, and canes.

Should the unexpected occur, it is crucial to have the right insurance protection. The Hanover offers tailored coverages that address the unique risks faced by healthcare providers and facilities. In addition our risk solutions team provides an array of tools and resources to help you minimize risk and create a culture of safety.


  1. BxHealthcare: Safe Patient Handling and Mobility-Successful Implementation Techniques. Prepared by Amber Perez, MHA AND CSPHP. 2017 Briotix Limited Partnership.
  2. Fitzpatrick MSN, RN FAAN, Melissa A. Safe Patient Handling and Mobility: A call to action much more must be done to enhance safety for patients and caregivers. Supplement to American Nurse Today- Curent Topics in Safe Patient Handling and Mobility. Sept. 2014

The recommendation(s), advice and contents of this material are provided for informational purposes only and do not purport to address every possible legal obligation, hazard, code violation, loss potential or exception to good practice. The Hanover Insurance Company and its affiliates and subsidiaries ("The Hanover") specifically disclaim any warranty or representation that acceptance of any recommendations or advice contained herein will make any premises, property or operation safe or in compliance with any law or regulation. Under no circumstances should this material or your acceptance of any recommendations or advice contained herein be construed as establishing the existence or availability of any insurance coverage with The Hanover. By providing this information to you. The Hanover does not assume (and specifically disclaims) any duty, undertaking or responsibility to you. The decision to accept or implement any recommendation(s) or advice contained in this material must be made by you.

LC 2018-004