1. Section Editor(s): Rodts, Mary Faut DNP, CNP, ONC, FAAN
  2. Editor

Article Content

Recently I was visiting a friend's mother in the hospital across town who had undergone surgery for a fractured hip. Of course I needed to go be sure that all was going well. She was not on an orthopedic nursing floor, which is becoming increasingly common. Although the nurse who was caring for her was very nice, it was clear that she was afraid of the situation, as were her colleagues. And no, they were not aware of who I was or what my profession was. I was just a family friend and an observer.

Mary Faut Rodts, Edi... - Click to enlarge in new windowMary Faut Rodts, Editor, DNP, CNP, ONC, FAAN

Throughout my evening on that floor, I saw several incidents that I thought might not possibly end well for the patient or the nurse. All too often, we as nurses say the job must get done and go ahead and do it. But at what cost? Significant injury to the nurse or patient? Graham in her article, Oh, Their Aching Backs! Occupational Injuries in Nursing Assistants (page 218) is yet another discussion of injuries sustained by nursing personnel while providing patient care.


In 2006, National Association of Orthopaedic Nurses (NAON) began its work in the area of Safe Patient Handling.1 Since that time many articles and a supplement devoted to this topic have been published in Orthopaedic Nursing that documents the use of evidence based practice. If you have not read these, go to the journal website at and search Safe Patient Handling. There you will find a tremendous amount of information on how NAON has led the way in preventing musculoskeletal injuries in the workplace. Algorithms are included for moving patients in high-risk orthopedic tasks (also located on the NAON website


In addition, as I was reviewing information for this editorial, I came across a site that I had never seen before. Oh, the power of search engines! I am glad I found it. It has a myriad of links to information about the health and safety needs, responsibilities, assessment, and suggestions for solutions that are worth exploring.


Dr. Carol Sedlak, who has been influential in leading the national response for NAON with Dr. Audrey Nelson to this significant problem, compiled a list of references that may also be useful as you and your organization look for ways to prevent injury to staff. She has given permission to reprint it here for your use.


As an orthopedic nurse, the last thing that anyone of us wants to become is a statistic as it relates to a disability sustained in the workplace. I often reflect about a patient and now friend of mine who was an orthopedic nurse who injured herself at the age of 22 on the job, lifting a patient and has been disabled from that incident for more than 35 years. Her life has been fraught with health problems: back pain, weight gain, obesity, diabetes, leg ulcers. I think you probably get the picture. I wonder what her life would have been like if not for that lifting injury. It behooves each of us to constantly think about what activities we are doing that may be unsafe and be determined to find alternative ways to improve the environment in which we work.


Safe Patient Handling Bibliography list compiled by Carol Sedlak, PhD, RN, CNS, ONC, FAAN,, 2011




Collins J.W., Nelson A., Sublet V. 2006. Safe lifting and movement of nursing home residents. Department Of Health And Human Services (Dhhs), Centers For Disease Control And Prevention National Institute For Occupational Safety And Health (Niosh), Pub # 2006-117, Telephone 800-356-4674,


de Castro A. B. 2006. Handle with Care: The American Nurses Association's campaign to address work-related musculoskeletal disorders (updated reprint from The Online Journal of Issues in Nursing, September 2004). Orthopaedic Nursing, 25(6), 356-365.


Gonzalez C. M., Howe C. M., Waters T.R., Nelson A., Hughes N. 2009. Recommendations for vertical transfer of a postoperative total hip replacement patient (bed to chair, chair to toilet, chair to chair, or car to chair). Orthopaedic Nursing, 28(2S), S9-S12.


Lavelle C., Sedlak C., Jones S., Doheny M. (2009, ). An evidence based and a safer workplace. futureAge, 22-24.


Menzel N.N., Hughes N.L., Waters T., Shores L.S., Nelson A. 2007. Preventing musculoskeletal disorders in nurses: A safe patient handling curriculum module for nursing schools. Nurse Educator, 32(3), 130-135.


Nelson A., Motacki K., Menzel N. 2009. The illustrated guide to safe patient handling and movement. New York: Springer.


Nelson A.L., Waters T. R., Menzel N., Hughes N., Hagan P.C., Powell-Cope G., Sedlak C., Thompson V. 2007. Effectiveness of an evidence-based curriculum module in nursing schools targeting safe patient handling and movement. International Journal of Nursing Education Scholarship, 410,


Nelson A. 2006. Safe patient handling and movement: A practical guide for health care professionals. New York, NY: Springer.


Nelson A., Baptiste A. 2004. Evidence-based practices for safe patient handling and movement. Online Journal of Issues in Nursing. 9(3) Available:


Nelson A. 2006. Evidence-based practices for safe patient handling and movement (updated reprint from The Online Journal of Issues in Nursing, September 2004). Orthopaedic Nursing, 25(6), 366-379.


Nelson A., Fragala G., Menzel N. 2003. Myths and facts about back injuries in nursing. AJN, 103(2), 32-41.


Nelson A., Owens B., Lloyd J.D., Fragala G., Matz M.W., Amato M., Bowers J., Moss-Cureton S., Ramsey G., Lentz K. 2003. Safe patient & handling movement. American Journal of Nursing, 103(3), 32-44.


Patterson M., Mechan P., Hughes N., Nelson A. 2009. Safe vertical transfer of patients with extremity cast or splint. Orthopaedic Nursing, 28(2S), S18-23.


Powell-Cope G., Hughes N., Sedlak C.A., Nelson A. 2008. Faculty perceptions of implementing an evidence-based safe patient handling nursing curriculum module. Online Journal of Issues in Nursing, 13(3).


Radawiec S. M., Howe C., Gonzalez C. M., Waters T. R., Nelson A. Safe ambulation of an orthopaedic patient. Orthopaedic Nursing, 28(2S), S24-S27.


Safe patient handling in orthopaedic nursing. 2009. Supplement to Orthopaedic Nursing, 28(2S).


Safe Patient Handling.


Sedlak C. A., Doheny M. O., Jones S. L. 2009. The clinical nurse specialist as change agent: Reducing employee injury and related costs. Clinical Nurse Specialist, 23(6), 309-313.


Sedlak C., Doheny M. 2009. Orthopaedics. In Nelson A., Motakci K., Menzel N. (Eds.), The illustrated guide to safe patient handling and movement (pp. 91-102). New York: Springer.


Sedlak C., Doheny M., Nelson A., Waters T. 2009. Development of the national association of orthopaedic nurses guidance statement on safe patient handling and movement in the orthopaedic setting. Orthopaedic Nursing, 28(2S), S2-S8.


Sedlak C.A. 2004. Guest Editorial. Nurse safety: Have we addressed the risks? The Online Journal of Issues in Nursing, 9(3).


Sedlak C. A. 2006. Guest Editorial. Nurse safety: NAON's role in preventing workplace musculoskeletal injury. Orthopaedic Nursing, 25(6), 354-355.


U.S. Department of Labor. Bureau of Labor Statistics. 2011. Table 17: Number, incidence rate, and median days away from work for nonfatal occupational injuries and illnesses involving days away from work by selected nature of injury or illness by selected event or exposure and part of body in private industry, state government, and local government, 2010.


Waters T., Sedlak C., Howe C., Gonzolez C., Doheny M., Patterson M., Nelson A. 2009. Recommended weight limits for lifting and holding limbs in the orthopeadic setting. Orthopaedic Nursing, 28(2S), S28-S32.


Waters T., Collins J., Galinsky T., Caruso C. 2006.NIOSH research efforts to prevent musculoskeletal disorders in the healthcare industry. Orthopaedic Nursing, 25(6), 380-389.


Waters T. 2007. When is it safe to manually lift a patient? American Journal of Nursing, 107(8), 53-59.