Occupational injuries in health care: Injury rates and causes

It’s more dangerous to work in a hospital than to construct one.

That’s according to the Bureau of Labor Statistics data on non-fatal injuries by occupation.

Although construction has a reputation as a high-risk industry, workers in hospitals and nursing homes have higher injury rates than workers in manufacturing, construction or logging.

See the chart below for the comparison of injury rates by occupation.

Who is being injured?

Injury rates by occupation, showing hospitals and nursing homes have higher injury rates than manufacturing, logging and construction

Source: Bureau of Labor Statistics 2017 incident rates for non-fatal injuries per 10,000 full-time workers.

 

How are health care workers being injured?

In its February 2018 Work Comp newsletter , the Minnesota Department of Labor and Industry reported on the sources of injuries in Minnesota hospitals in 2016:

  • Nearly 60 percent due to overexertion
  • Nearly 20 percent due to slips, trips and falls
  • Nearly 10 percent due to violence

Thirty percent of the injuries directly involved a hospital patient. Of those injuries involving a patient, the majority were due to overexertion while lifting or moving a patient.

The second most common cause was intentional or unintentional violence by the patient. Health care workers face some of the greatest risk for workplace violence. See our De-escalation Team Training – health care resource for information on de-escalation tactics in health care settings.

Strains and sprains account for more than half of all health care injuries reported to SFM. Many strain and sprain injuries occur while manually lifting and transferring patients. Fractures and contusions made up 19 percent of injuries, and punctures and lacerations were another 17 percent.

See the chart for the types of injuries sustained by health care workers.

How are health care workers being injured? Bar chart showing breakdown of injury types, with 52% sprains and strains, 19% fractures/contusions, 17% punctures/lacerations, and 12% other types of injuries

 

 

 

 

 

Source: SFM 2007-2016 health care policyholders claim data.

 

Some groups at more risk

Nursing home workers and other types of health care professionals have higher injury rates. Home health care workers face additional challenges due to their unique working environment.

Safety in health care faces another challenge due to an aging workforce. The U.S. Department of Labor reports that the average nurse is now older than 50 years old.

When health care workers over the age of 40 are injured, their claim is 76 percent more likely to be an expensive lost-time claim, where they are unable to return to work quickly. Older workers are at high risk for serious injuries due to lost muscle strength and other factors. Their more severe injuries and slower recovery times result in claim costs 2.4 times higher than for younger workers.

For more data and tips on how to reduce lifting injuries, download our occupational injuries in health care fact sheet .

What our safety pros keep in their winter emergency kits

We asked SFM’s loss prevention representatives what we’d find in the winter emergency kits they keep in their cars in case of roadside emergencies.

Their safety kits include:

  • Magnetized emergency flashers you can stick on the car
  • Fleece hats, scarves and mittens
  • Tow ropes
  • A blanket, such as a Mylar emergency blanket
  • First aid supplies
  • Hand and foot warmers
  • Matches and candles
  • A whistle
  • A flashlight and spare batteries
  • Warm boots
  • High visibility vest
  • Shovel
  • A lithium battery jump starter, which can also charge cell phones and provide light
  • Packaged snacks such as nuts and granola bars
  • A snow suit
  • Road flares and warning triangles
  • Chemical light sticks
  • Traction footwear

Follow these other winter driving safety tips for more advice.

Prevent litigation, stay in contact with injured employees

By Kathy Bray, Esq.

Based on our experience with workers’ compensation claims, many litigated cases could have been avoided if the employer had taken the time to show some concern for the employee’s welfare during the early stages of the claim.

It can be stressful for an employee to suffer an injury, and then hear nothing from his or her employer. The injured worker gets the impression that nobody cares.

Often, litigation is a reflection of feeling ignored. If the employer won’t make time to listen to an injured employee, an attorney will.

Show concern right away

As soon as you learn of an injury, have the claims coordinator, risk manager or the employee’s supervisor follow up right away. If the employee is off work, call the employee at home to see how he or she is doing or have someone see the employee in person, if appropriate.

Some supervisors avoid reaching out because they worry that they might say the wrong thing, but saying nothing is a sure way to deliver the wrong message.

Arrange with the employee to maintain contact. For example, maybe you agree to check in weekly.

What to say when you reach out to injured workers

Injured workers might be worried about their jobs and livelihood, so it’s really important to reassure injured workers that you’re looking forward to their return and you’ll have a job for them when they’ve recovered enough to return to work.

Make sure employees know you’ll provide light-duty work or needed accommodations so they can return to work as soon as medically possible. Help them understand that they might end up doing an entirely different job than what they’re used to depending on their medical restrictions.

Knowing that you’re committed to bringing them back to work can help quell any anxiety or uncertainty injured workers face over what will happen financially to them or their families. SFM’s experience is that the number one reason injured employees seek representation from an attorney is fear of losing their jobs and incomes.

Maintain good relationships, even if there’s a dispute

If representatives of the employer attend hearings or other proceedings related to a disputed benefit, they should remain civil and respectful to the employee even if relations are strained. If the employee remains actively employed, walking over to the employee and his or her spouse at a hearing to greet them is a nice gesture, and lets them know the dispute is a separate matter — “just business” — rather than something the employer is taking personally.

Educate your supervisors and help them separate personal feelings from any disputes that arise along the way.

Anticipate questions from the injured employee

Injured employees will likely have questions about workers’ compensation benefits and employee benefits. Be ready to review the company’s policies regarding workers’ compensation benefits and direct them to their workers’ compensation claims representative for more detailed questions. If the injury is denied, or there is some dispute related to the availability of workers’ compensation benefits, talk with them about other benefits they may be eligible for such as short-term disability, long-term disability, or paid or unpaid leave benefits.

Explain whether any FMLA (Family and Medical Leave Act) benefits will run concurrently with workers’ compensation leave, or separate from it if the workers’ compensation claim is denied.

Also review policies regarding continuation of health insurance benefits. Reassure the employee that you are there to answer any questions regarding employment or benefits, again minimizing the need for the employee to unnecessarily or prematurely consult outside sources.

Take concerns about work restrictions and retaliation seriously

Staying in contact with the injured employee remains important even after he or she is back at work.

If the employee or coworkers raise concerns about return-to-work issues, take them seriously. Be on alert if an injured employee feels like he or she is experiencing retaliation or being discriminated against in some way. Respond promptly to the concerns. Don’t ignore them.

If the supervisor or coworkers express concerns about the employee working outside of medical restrictions, talk with the employee right away. Emphasize the need to work safely and within restrictions. If the employee disregards that instruction, and continues to work beyond restrictions (for example, not asking for assistance with moving or lifting heavy objects despite the employer instructing him or her to do so), the employer may want to consider treating the disregard for restrictions as a performance issue or safety violation, and write up the employee or discipline the employee accordingly. While an employer cannot punish or retaliate against an employee for having a work injury, an employer can enforce reasonable performance and safety expectations such as working safely within restrictions.

If the employee complains that the supervisors or coworkers require the employee to work outside of restrictions, or retaliate when he or she declines to perform duties outside of restrictions, investigate those concerns. If the investigation suggests this is occurring, discipline or write up the supervisor or coworker if the behavior continues.

Work injuries can open up a host of opportunities for bad feelings, as well as goodwill. Your care, concern and attention throughout your injured worker’s recovery can play a big role in preventing unnecessary conflict.

For more information on what to do after an employee is injured, see these additional SFM resources:

This is not intended to serve as legal advice for individual fact-specific legal cases or as a legal basis for your employment practices.

Keeping problem employees on staff can increase workers’ compensation costs

Employees with poor performance often have more costly and challenging workers’ compensation claims than the average employee.

These typically are employees with:

  • Histories of attendance problems
  • Low productivity
  • Quality issues
  • Difficulty relating to others.

Many times, these employees should have been disciplined or even fired before they reported work injuries. But once a workers’ compensation claim has been filed, disciplining or firing an employee can become much more complicated, and costly.

For example, you may still be required to pay injured workers benefits for lost wages, even if you fire them. These wage-replacement benefits get expensive fast, ultimately impacting your workers’ compensation premium. If you’ve fired the employee, you no longer have access to an important tool to control these costs — offering light-duty transitional work.

In addition, it is not uncommon for an injured employee who is fired to sue an employer for retaliatory discharge.

What employers can do to prevent problems with poor performers

There are a number of things employers can do to avoid these types of challenges, including:

  • Deal with performance issues early. 
    This is the first and most important step you can take. This helps you avoid a situation where an employee has both ongoing performance problems and a workers’ compensation injury. The workers’ compensation claim undoubtedly will complicate your ability to manage this employee. Work with your supervisors to address performance situations. If termination is necessary, do it without delay to lessen the risk that it becomes entwined in the legalities of a workers’ compensation case.
  • Follow written policies and procedures. 
    Have a written and well-documented performance management plan that includes disciplinary steps to be taken in cases of misconduct. Follow your policy to the letter.
  • Document everything. 
    It can save you from expensive litigation. For example, document contacts with the employee, employee performance issues and remedial actions taken.
  • Think before you fire, especially when workers’ comp is involved. 
    You may be faced with a frustrating situation, but an impulsive decision could make the problem drag out longer and become more costly in the end. Discuss your options with your claims representative and your employment law attorney for assistance making the best business decision possible.

More information on dealing with problem employees

For more information on dealing with problem employees, see our:

This is not intended to serve as legal advice for individual fact-specific legal cases or as a legal basis for your employment practices.

Help your employees achieve the four elements of financial well-being

Money concerns aren’t usually something people like to talk about, especially at work.

So it may not be apparent to an employer when their employees experience financial stress. Yet recent data suggests financial stress is widespread. Employers can make an effort to recognize when money concerns affect their employees, so they can offer resources to help them move toward financial well-being.

The 2018 Employee Financial Wellness Survey by PwC reported that 53 percent of survey respondents feel financial stress.

The stress takes a toll on their focus and productivity at work. The same survey found that half of financially stressed workers took three or more hours of work time each week to deal with financial issues. Another 30 percent admit their productivity has suffered, and 16 percent occasionally miss work because of financial issues.

Financial stress could even lead to stress-related health issues, according to the Philadelphia Business Journal .

Signs of financial stress to look out for:

  • Requesting an advance on a paycheck
  • Being mentally distracted during work
  • Spending more time on phone calls
  • Showing up late or other attendance issues
  • Avoiding social occasions with co-workers, such as going out to lunch
  • Withdrawing money from a 401(k) early
  • Choosing not to participate in a retirement plan

Four elements of personal financial well-being

The opposite of financial stress, financial well-being, comes when people feel both secure about money and that they have the freedom to spend their money how they’d like.

The Consumer Financial Protection Bureau recommends that individuals review their financial well-being from four distinct perspectives.

People with high levels of financial well-being:

  1. Feel in control of daily and monthly finances
  2. Have the capacity to absorb a financial shock and have a safety net
  3. Have the flexibility to make choices about their finances
  4. Are on track to meet goals

 

Together, these four elements from the CFPB address someone’s financial security and freedom in the present and future.

 

In the present
In the future
Financial security
Feeling in control of daily and monthly finances
Capacity to absorb a financial shock, having a safety net
Financial freedom
Flexibility to make choices that represent their values and make them happy
On track to meet goals, setting and working toward goals that matter to them

Resources for your workplace financial wellness program

Developing resources to address financial stress requires knowing what stressors exist for your employees.

Jody Rogers, SFM Senior Vice President, Human Resources, recommends surveying employees about their needs and benefits.

“Even a small employer can put a survey together and hear what employees are asking for and what they need,” she says. “If you are tapped into and know what’s bothering your employees, and if financial stress is one of them, look into resources you can offer.”

Consider using your benefits broker to conduct an anonymous survey. Based on survey results, employers can tailor their financial wellness program to address the issues most common to their workforce, whether that’s budgeting and debt reduction or longer-term retirement savings plans.

According to the PwC survey, two of the most desired benefits employees sought were “access to unbiased counselors” and “help understanding and using their employer benefits.”

Rogers offers several strategies for building financial education into your benefits program, based on her extensive experience and what’s worked for SFM’s benefits program.

Components of a financial wellness program

Financial benefits or a financial wellness program could include any of the following:

  • Financial education – Inform new employees of all of the benefits available to them. Education could include group trainings on planning for retirement or an introduction to investing. It could also mean providing access to 1:1 financial counseling.
  • Retirement savings plans – According to the U.S. Census Bureau and Bloomberg , “Two-thirds of Americans don’t invest in their company retirement plan at all.” Make participating the default to increase employees’ long-term savings.

    SFM has designed the 401(k) plan to make it easy for employees to participate. Employees are automatically enrolled in SFM’s 401(k) plan and would need to take action to opt out, making participation the default. Employees may choose to automatically increase their contributions by 1 percent each year. SFM matches a portion of the investment as a further incentive. Combined, these techniques lead to a very high participation rate and make reaching savings goals effortless.

  • Student loan forgiveness – If your employees or potential employees have student loan debt or attend school while working, a benefit increasing in popularity is student loan repayment or tuition reimbursement. This benefit may give you an edge in a competitive job market.
  • Employee Assistance Program – Your Employee Assistance Program (EAP) might offer multiple resources, including referrals to a financial planner, and it’s all anonymous.
  • Reputable resources – Provide links to trustworthy sites for further information. Government programs include MyMoney.gov and the Consumer Financial Protection Bureau . For more on designing your workplace financial wellness program, visit Prosperity Now . Local nonprofits may offer financial counseling services.

Making financial benefits available to employees based on their needs shows you care. Employees can choose the benefits they want to build their financial well-being, for the present and the future.

This is not intended to serve as legal advice for individual fact-specific legal cases or as a legal basis for your employment practices.

Inexpensive safety solution: Replace old utility knives

Looking for an easy, inexpensive way to prevent injuries in your workplace? Consider replacing old manually retractable and fixed-blade utility knives with a concealed blade version.

They typically cost less than $3 a piece, and can prevent serious lacerations. As a side benefit, they also help prevent damage to the contents of boxes.

You can purchase these types of knives through Martor , Uline and many other retailers.

Safety video: Moves you can use to avoid winter slips and falls

When it’s snowy and icy outside, it takes the right moves to avoid a winter slip-and-fall injury in a parking lot. Show your employees this lighthearted video to remind them how to walk safely in slippery conditions.

Avoid winter slips and falls: Icy parking lot safety

For more winter prevention resources and information, visit SFM’s winter slip and fall prevention page.

How to develop a workplace severe weather policy

What do Midwesterners dread most about nasty winter weather? Driving in it.

Getting across town during a snow or ice storm can be stressful, time-consuming and dangerous.

What can you as an employer do to keep your employees safe and your organization functioning when dangerously bad weather hits?

There’s not always an easy answer, but the first step is to have a plan.

Why you need a severe winter weather policy

A severe weather policy is a critical component of your business’s overall emergency preparedness and disaster recovery plan.

It’s not uncommon for state departments of transportation to advise against travel due to severe weather. Whether it’s poor visibility or ice, unsafe road conditions could keep your employees from the office.

Schools have decades of experience in communicating closures to keep staff and students out of treacherous weather conditions. They’ve established clear plans on who makes the decision to close, by what time, and how to notify people.

But calling a snow day isn’t just for schools.

It’s essential for employers of all types to be prepared for a disruption to normal business operations because of severe weather. Of course, not everyone can shut down during inclement weather. Hospitals, for example, need to be staffed 24/7. You may have critical operations to keep running.

How can you get prepared? With a snow day policy.

Before the snow flies: Develop a snow day policy

The time to plan for bad weather is before a storm hits. Employees will have many questions that should be addressed in an inclement weather policy, like in this example policy .

“The inclement weather policy must set expectations, present a balanced approach to compensation, mitigate risks for both employers and employees, and present a fair solution for emergency situations,” writes Susan Heathfield .

Eight items to consider covering in your snow policy

Following are items you should think about covering in your inclement weather policy:

  • How you will communicate a closure to employees — phone call, text, email, broadcasting system, etc.
  • Your expectation that employees use caution while entering and leaving work in poor weather conditions
  • Your intention to monitor the weather forecast, as well as any specific conditions that will trigger a closure (snowfall amount, temperature, electrical outage, loss of heat, declaration of weather emergency, etc.)
  • Instructions that traveling employees are not to drive in unsafe conditions, as well as a reminder of your prohibition of cell phone use while driving
  • Expectations about what happens in the event of closure, such as whether employees should work from home
  • Compensation in the event of a severe weather scenario, keeping in mind local, state and federal laws
  • How you will notify customers, clients or vendors of a closure — notice on your website, voicemail message, email, etc.
  • The expectation in the event of a mid-day closure that employees are expected to leave immediately

Let’s look at a few of these items in more detail.

How to define a weather emergency

When developing your plan, consider setting specific criteria about the amount of snowfall, road conditions and temperatures that may trigger a closure. This will keep your employees from wondering about a snow day each time the snowplows come out.

Blizzards aren’t the only weather situation that may require closing. Below-freezing temperatures and wind chills as low as -60 degrees prompted the governor of Minnesota to close schools statewide in January of 2014.

Rely on an expert like the National Weather Service for weather conditions and to your state’s department of transportation for road conditions. You may look to your local school district as a guide. Know the terminology for different winter weather alerts, advisories and warnings.

Expectations for employees

If you’ve set up the ability for workers to telecommute or work remotely, do you still expect employees to work if your office is closed due to weather? What if the company does not close, but an employee would prefer to avoid traveling? Remote work options could allow them to avoid taking a personal day.

As with other parts of your snow day plan, communicate clear expectations with your employees if you expect them to work remotely if they cannot make it into the office. Prepare your IT infrastructure for a spike in activity if many more employees than normal try to access the remote work system.

Your weather emergency plan also needs to factor in maintaining any business-critical operations. If a vital employee cannot make it to work, do you have a backup plan?

Compensation

Keep in mind the business implications of voluntarily closing because of the weather. Even if your employees aren’t working, they may still be due a paycheck. Check your state and federal regulations for rules around paying exempt and non-exempt employees in various bad weather scenarios .

By developing a snow day policy ahead of time, you’ll be prepared to make a thoughtful decision before a storm hits, and you’ll help your employees stay safe.

Key: Be proactive and build a strong safety culture

An inclement weather policy can formalize your stance on employee safety during winter weather conditions, but ultimately, employees must also make decisions about their own safety and use their best judgment about whether they should be driving.

That’s why it’s important to foster a workplace culture where employees know you care about their health and safety and wouldn’t punish them for prioritizing their safety over work.

In the same vein, you can be proactive by starting to plan as soon as you hear a big storm is coming. You can encourage employees to rearrange their schedules in advance to avoid driving during the worst of it. This might mean leaving a day early to get to an out-of-town meeting, doing a delivery early or simply rescheduling an offsite meeting.

Strategies like this can keep your organization functioning while also keeping your employees safe.

This is not intended to serve as legal advice for individual fact-specific legal cases or as a legal basis for your employment practices.

This post was originally published on January 18, 2017 and updated on November 7, 2018.

The dangers of drowsy driving

Have you ever been driving home late at night and had to fight to keep your eyes open?

Or maybe you’ve felt your attention drift while driving to work in the morning?

It might seem commonplace, but driving in these situations can be dangerous. Even if you’re not falling asleep at the wheel, drowsy driving poses a risk to your life and others.

Driving while drowsy can cause drivers to pay less attention to the road, slows their reaction time and affects the ability to make good decisions. It also impairs information processing and short-term memory and decreases performance, vigilance and motivation.

Accidents caused by drowsy driving are most common late at night and early in the morning, with early afternoon also being a peak time for drowsiness. Most crashes result from failure to brake or avoid an accident. It’s also common for drivers to veer off the road.

According to the National Highway Traffic Safety Administration, drowsy driving causes 100,000 crashes, 71,000 non-fatal injuries and 1,500 deaths per year. However, these are low estimates as drowsy driving can be difficult to track. It’s thought that up to 6,000 fatal crashes each year may be caused by drowsy drivers.

Underlying causes

Drowsy driving occurs when a driver is sleepy or fatigued. Excessive drowsiness is usually caused by sleep loss from restriction or too little sleep. This can result from interrupted or fragmented sleep or chronic sleep debt. Other factors include undiagnosed or untreated sleep disorders, the use of sedating medication and consumption of alcohol when already tired. These factors can compound on one another, and any combination of them increases the chances of causing a motor vehicle accident.

According to the National Sleep Foundation, people who sleep six hours a night are twice as likely to be involved in a drowsy driving crash than those sleeping eight hours or more, and people sleeping less than five hours increase the risk to four or five times.

Commercial drivers who operate vehicles such as tow trucks, tractor-trailers and buses have increased risk of drowsiness. Workers with long, rotating or night shifts, such as doctors, nurses, pilots and police officers, have a higher risk of drowsy driving, especially when driving home.

Warning signs

Warning signs include:

  • Yawning
  • Frequent blinking or rubbing your eyes
  • Blurry vision
  • Heavy eyelids or inability to keep eyes open
  • Nodding off or trouble keeping your head up
  • Difficulty remembering the past few miles or missing your exit
  • Drifting from your lane or hitting a rumble strip on the side of the road
  • Ending up too close to nearby cars or tailgating
  • Daydreaming, difficulty focusing or wondering and disconnected thoughts

If you experience these signs, pull over to rest or change drivers. It’s not enough to just roll down the windows or turn up the radio.

Prevention

There are many ways to prevent drowsy driving:

  • Get enough sleep

At least seven hours is the recommended amount of sleep for the average adult.

  • Develop good sleeping habits

Go to bed and get up at the same time every day and make sure your bedroom is dark, quiet, relaxing and at a comfortable temperature. Remove electronic devices from your room, avoid large meals, caffeine and alcohol before bed and get some exercise.

  • Talk to your physician about treatment options if you have a sleep disorder

Pay attention to potential symptoms, such as snoring or regularly feeling sleepy during the day. Many people with obstructive sleep apnea and narcolepsy go untreated.

  • Avoid drinking alcohol or taking medications that make you sleepy

Check the label on medications or talk to your pharmacist. Common sedating medications include antidepressants, cold tablets and antihistamines.

  • Avoid driving late at night or alone

Share driving with other passengers on long trips, pull over at rest stops and take a short nap or arrange for someone to give you a ride home after working a late shift. On long trips, schedule breaks or switch drivers every 100 miles or 2 hours.

Watch out for these top 10 OSHA violations

The Occupational Safety and Health Administration (OSHA) released its preliminary top 10 violations for 2018 in late October at the 2018 National Safety Council Congress & Expo .

These standards were the most frequently cited during OSHA’s fiscal year that ended September 30. According to OSHA, the list serves to “increase awareness of these standards so employers can take steps to find and fix the hazards to prevent injury or illness.”

The top 10 most frequently cited OSHA violations for 2018

Fall protection has topped the list of most-cited OSHA violations for eight years in a row, and many of the other standards continue to be in the top 10 year after year. The only new item in 2018 is eye and face protection at number 10.

Here’s the full list:

  1. Fall protection – general requirements
  2. Hazard communication
  3. Scaffolding
  4. Respiratory protection
  5. Lockout/tagout
  6. Ladders
  7. Powered industrial trucks
  8. Fall protection – training requirements
  9. Machine guarding
  10. Eye and face protection

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