Predictors of shoulder and back injuries in nursing home workers: A prospective study

Background: Nursing assistants (NAs) working in nursing homes have among the highest back and shoulder injury rates in the US. Incidence, severity, and cost of non-traumatic soft tissue musculoskeletal disorders in the nursing home industry in Washington State are quite high. Methods: To determine whether resident characteristics data reported on the Health Care Financing Administration Minimum Data Set (MDS) could be used as a surrogate measure of cumulative exposure to physical loads, we conducted an 18-month prospective study in one nursing home. Results: The combined NA injury incidence rate (IR) was 45.8 self-reported back and shoulder injuries per 100 [FTE] workers per year. In general, MDS reported resident characteristics failed to predict risk with the exception of exposure to loss of voluntary leg mobility (OR = 1.11 perperson-shifts of exposure, 95% CI [0.97-1.27]), with the highest risk on the day shift (OR = 1.15, 95% CI [0.95-1.40]). Conclusions: These findings suggest social integration and work organization issues may be more important predictors of back and shoulder injuries in nursing assistants than reported resident characteristics as measured by the MDS.