Every day, healthcare professionals lift patients, respond to emergencies, navigate busy hallways and make split-second decisions that protect the people in their care. Those demands can also create significant workplace risks. Building stronger healthcare workplaces begins with protecting the people who make exceptional care possible—through practical prevention, the right equipment and a safety culture that empowers employees to act.
Healthcare remains one of the nation’s most physically demanding industries. NIOSH notes that the U.S. healthcare industry employs more than 22 million workers and has one of the country’s highest rates of nonfatal work-related injury and illness. Patient handling is a particularly significant exposure, with lifting, moving and repositioning patients identified as major risks for work-related musculoskeletal disorders and overexertion injuries.
Behind every statistic is a caregiver sidelined from work, a team adjusting to the absence and patients who depend on experienced professionals. While every healthcare organization faces unique challenges, three loss sources consistently demand attention: strains; slips, trips and falls; and struck-by injuries, often associated with resident or patient behaviors.
“The safest healthcare organizations don’t simply respond well after an injury—they build systems that help prevent injuries from happening in the first place,” said Ed Sowers, Risk Management Service Specialist at Amerisure.
“When organizations invest in their people through training, equipment and a strong safety culture, they’re protecting more than employees. They’re protecting the continuity of care their residents and patients depend on every day.”
Strains
Moving, repositioning and assisting patients are among healthcare’s most physically demanding responsibilities. Reducing strain injuries takes a coordinated approach that combines training, ergonomic design, safe patient handling and employee engagement. This aligns with NIOSH Safe Patient Handling and Mobility guidance, which emphasizes assistive lifting devices, employee training and comprehensive safe patient handling programs.
- Build Confidence Through Training
Healthcare employees should receive ongoing training that reinforces:
- Proper Lifting and Transfer Techniques: Use safe patient handling techniques and sound body mechanics.
- Equipment Use: Train employees on mechanical lifts, transfer devices and other assistive equipment.
- Hazard Awareness: Recognize repetitive tasks, awkward postures and other ergonomic exposures before injuries occur.
- Reporting Procedures: Maintain clear processes for reporting injuries, near misses and workplace concerns so corrective action can begin promptly.
- Design Workspaces That Reduce Physical Demands
Adjustable beds and chairs, mechanical lifts, transfer devices and ergonomic tools can reduce pushing, pulling and lifting forces. Routine workstation assessments can also help identify hazards before they contribute to injury. OSHA’s Safe Patient Handling resources identify repeated manual patient handling, heavy lifting and awkward postures as major contributors to musculoskeletal injuries.
- Make Safe Patient Handling the Standard
Before a transfer, assess the patient’s mobility and assistance needs and determine the appropriate equipment or level of support. Use mechanical lifts when appropriate and permitted by applicable licensure or regulatory requirements, use team lifts for heavier or higher-risk transfers, avoid awkward positions and encourage regular stretching or recovery breaks to reduce fatigue.
- Strengthening Safety
Leadership commitment, open communication and employee participation help turn safe practices into everyday habits. Additional opportunities may include pre-shift stretching, wellness initiatives and admissions planning that evaluates each resident’s mobility, cognitive condition and equipment needs. Regularly reviewing individualized care plans can further reduce strain-related exposures.
“Equipment certainly matters, but culture is what determines whether those tools are used consistently,” Sowers said. “When employees feel empowered to speak up, coach one another and continuously improve, safety becomes part of everyday care instead of another item on a checklist.”
Struck-By Injuries
Many of the same resident assessments that help prevent strains also play an important role in reducing struck-by incidents. Residents experiencing cognitive impairment, pain, illness or emotional distress may respond unpredictably during routine care. Understanding what is driving the behavior can help caregivers intervene before a situation escalates. OSHA’s workplace violence resources for healthcare provide additional prevention guidance for healthcare and social service settings.
- Recognize the Root Causes
Medical Factors: Pain, infections, medication side effects and unmanaged medical conditions can contribute to aggressive behaviors.
Environmental Factors: Noise, glare, clutter, lack of personal space or sudden changes in routine can be triggering.
Communication Challenges: Difficulty communicating needs or wants can lead to frustration and agitation.
Emotional Factors: Fear, anxiety, depression and loss of control can also contribute to challenging behaviors.
- Move from Reaction to Prevention
Individualized Care Plans (ICPs) should address each resident’s medical needs, preferences, communication style and potential behavioral triggers. A calmer physical environment, familiar routines and consistent staffing can help reduce uncertainty, while meaningful activities and regular attention to pain, hunger, thirst, fatigue and toileting needs can prevent physical discomfort from becoming a behavioral challenge. AHRQ patient safety resources provide additional guidance on safer healthcare delivery.
- Equip Employees to De-escalate with Confidence
Training should prepare caregivers to remain calm, use clear and simple language, listen actively, maintain non-threatening body language and appropriate personal space, and redirect attention when appropriate. Teams should also share information about resident triggers and effective interventions and debrief after incidents to identify lessons learned. OSHA’s workplace violence prevention guidance reinforces the importance of training, communication and post-incident evaluation.
- Use Observation as a Safety Tool
Some organizations use Observational Safety Programs to evaluate associate-resident interactions through both strain and struck-by injury prevention lenses. Peer observations can recognize what went well, identify opportunities for improvement and suggest practical next steps. Over time, observational data may also reveal trends that help organizations identify emerging risks before injuries occur.
- Respond Safely and Learn from Incidents
When aggressive behavior occurs, prioritize immediate safety: move nearby residents and staff away from danger, remove potential hazards, maintain appropriate supervision, use verbal de-escalation and request trained assistance when needed. Physical restraints should remain a last resort and be used only when necessary to protect immediate safety, consistent with applicable requirements. Regular medication reviews may also help identify side effects or interactions that contribute to behavioral changes.
After an incident, robust reporting and root cause analysis can help teams understand contributing factors, evaluate interventions and strengthen future practices. Sharing those lessons turns individual incidents into opportunities for continuous improvement.
Slips, Trips and Falls
Busy hallways, changing floor conditions, medical equipment, electrical cords and the fast pace of patient care can Busy hallways, changing floor surfaces, equipment, cords and the pace of care can create opportunities for slips, trips and falls. In fact, healthcare and social assistance are among the industries with the highest numbers of nonfatal fall injuries, with many involving slips and falls on the same level. Reducing those risks requires attention not only to the environment, but also to the everyday practices that help employees move safely through it.
Steps to a Stronger Safety Culture
- Identify and Correct Hazards
Regularly inspect for uneven flooring, wet or slippery surfaces, clutter and other hazards. Clean spills promptly and maintain clear walkways, aisles and stairways.
- Strengthen the Environment
Use slip-resistant flooring and appropriate mats in high-risk areas, maintain adequate lighting and handrails, and manage cords and equipment properly. Footwear is another important part of that equation. Clear dress-code expectations around appropriate slip-resistant footwear—and consistent reinforcement of those expectations—can help address a common source of preventable risk.
- Reinforce Safe Practices
Train employees on hazard recognition, fall prevention, incident reporting and safe lifting or carrying practices that preserve visibility. Educate patients and families about fall risks and provide mobility assistance when needed.
- Encourage a “See Something, Say Something” Mindset
Empower employees to identify and address hazards before they lead to an incident. Routine inspections, prompt reporting and shared accountability can make prevention part of the way work gets done.
- Pre-Shift Stretching and Flexing
Consider incorporating brief stretching and flexing before a shift or physically demanding work. Regular stretching can provide movement breaks and may help reduce or lessen ergonomic issues, and recent government data also identifies stretching as an option during rest breaks for nurses.
“Every healthcare organization has unique challenges, but the organizations that consistently outperform in safety share something in common: they’re always learning,” Sowers said.
“They look beyond the incident itself, ask what can be improved and make small changes every day that help protect both caregivers and residents over the long term.”
Looking Ahead in Healthcare
There is no single solution to healthcare’s top workplace injury risks. Safer, stronger workplaces are built through consistent investment in people, training, equipment, communication and leadership commitment—and by identifying risks early rather than waiting for an injury to reveal where improvement is needed.
Amerisure Risk Management professionals work alongside policyholders to help identify real-world exposures and strengthen practical prevention strategies. For more information, visit our Risk Management page.
