The Frequency and Force of Manual Boosting: 9 Facts that Beg the Question, “Why are Nurses Manually Boosting at All?
By Sarah J Storer, BS, MS, BSN, RN
As the legend goes, Sisyphus, as punishment for defying death and attempting to outsmart the gods, was doomed to push a rock up a hill only to have it tumble down again over and over again for all eternity.
If there is one task that any nurse would quickly draw as a comparison to this story, it’s manual patient boosting.
No sooner have you found a partner in crime to boost your patient in bed, get said patient comfortable and leave the room, the call light goes off.
Your patient (or a different patient) is scrunched down bed again. How did it happen so fast?
You find another partner in crime (the first one is of course busy with another patient), boost your patient with a draw sheet (your patient hates this, it hurts), feel like this time will certainly be THE time, leave the room…
Call light.
Lather, rinse, repeat. All shift, every shift, for maybe just one of your patients, but maybe all of them.
In one scenario of a nurse in a 1:4 patient assignment where two patients are ambulatory and two are not:
- The nurse and a partner (likely a tech or another nurse) will boost each patient 10-12 times per shift for a total of 20 times
- Each boost will take an average of 7 minutes as the nurse looks for help, for a total of 77 minutes per shift
- All boosts, in total will equal 1,898 pounds lifted during that shift (*IF the patients are an average weight of 175 lbs)
That’s just a few of the facts about manual boosting that begs the question, “Why are nurses manually boosting at all?”
Here are 8 other boosting facts that should lay that question to rest forever.
- Boosting is a high force, high frequency task1, far outpacing Turns (≈2:1)2, lateral transfers (≈5:1)2, stand-and-pivots (≈5:1)2 and ground to bed/post fall transfers (≈2,400:1)3,4,5.
- The amount of force on the spinal column in Newtons (N) when manually boosting an average size patient of 170 lbs using the draw sheet method is 2,665 N1 or 666.25 lbs of force. (1 lb of force=4.4 N)
- The maximum allowable force per lift threshold to the spinal column (not per shift threshold) according to National Institute for Occupational Safety and Health (NIOSH) is 3,400 N. 1
- This maximum allowable spinal force threshold does not count the additional force to wrists, shoulders and necks, which typically far exceeds threshold, even with friction reducing tools6.
- The musculoskeletal injury or musculoskeletal disorder (MSD) rate for nurses, techs and other high-touch bedside caregiver roles is 7x the national average for all occupations.7
- UP to 90% of nurses will experience low back pain from their career8, and in one study, 52% reported chronic back pain, and 42% had been injured on the job at least once in the past year of the survey.9
- The direct and indirect costs associated with back injuries in the U.S. healthcare industry are estimated to exceed $7 billion annually, with some estimates placing the total direct and indirect costs for all related back-injury expenses as high as $20 billion annually.10
- When it comes to traditional “all-purpose” equipment like ceiling lifts, hover mats, lift sheets, etc., only 50% of nurses report using them regularly11 (many cite missing parts or equipment, or needing to find a second caregiver to operate) and 58% report still having pain at work.12
From a sheer frequency and force perspective, manual boosting is not only painful for the patient and painful for the nurse, it’s Sisyphean in nature. It’s an endless task that steals time from top-of-license activities and it never, ever stops.
It also begs the question, if it’s such a high-touch, high frequency task that far outpaces any other patient handling task, why is a first line purchase a ceiling lift, which still often requires two people to operate? Or also requires a specialized lift sheet (which are precious commodities…one of our techs had a special hiding place so other floors wouldn’t steal ours).
There is a better way, and it’s a way that makes nurses, patients and hospitals happier. Every time I see nurses with Hercules in their hospitals, I wish I’d had it for myself.
But that’s why I work here. Not one more nurse. Not one more Sisyphus. Because nursing shouldn’t hurt and it absolutely shouldn’t be a punishment.
Want to learn more about how to automate boosting at your hospital? Request a demo today! We’ll come to you!
References:
1 https://pmc.ncbi.nlm.nih.gov/articles/PMC8114440/
3 https://pmc.ncbi.nlm.nih.gov/articles/PMC3572247/
4 https://flbog.sip.ufl.edu/risk-rx-article/falls-in-the-acute-care-setting/
5 https://www.performancehealth.com/articles/the-role-of-nurses-in-fall-prevention
7 https://asphp.org/wp-content/uploads/2014/04/Patient-Handling-Fact-vs-Fiction.pdf
8 https://www.ncbi.nlm.nih.gov/books/NBK519066/
9 https://www.nursingworld.org/globalassets/docs/ana/health-safetysurvey_mediabackgrounder_2011.pdf
10 https://www.osha.gov/healthcare/safe-patient-handling
11 https://www.myamericannurse.com/wp-content/uploads/2016/05/Patient-Handling-Safety-426b.pdf
12 https://rehabnurse.org/about/position-statements/safe-patient-handling
Additional Resources:
https://scholars.fhsu.edu/cgi/viewcontent.cgi?article=1189&context=theses
https://pmc.ncbi.nlm.nih.gov/articles/PMC7949701
https://pmc.ncbi.nlm.nih.gov/articles/PMC6371290
https://www.asphp.org/wp-content/uploads/2011/05/When_Is_It_Safe_To_Manually_Lift_A_Patient.pdf
https://ijtech.eng.ui.ac.id/article/view/1332
About the Author:
Sarah J Storer, BS, MS, BSN, RN is the Creative Director for Hercules. As a career change nurse, Sarah spent the first part of her career in agency marketing, helping B2B companies tell better brand stories. She earned her BSN during the pandemic, made her way to the ICU, then came to Hercules to fulfill her dream of combining both her career passions into one. Her goal: that #notonemorenurse suffer injury from manual boosting.