Exploring the impact of safe patient handling and mobility program compliance on patient handling injury rates

• Safe patient handling and mobility program compliance showed mixed relationship with patient handling injury rate. • Higher staffing was consistently linked to fewer patient handling injuries. • Ceiling lift availability alone did not enough to lower patient handling injuries. • Program managers play a key role in injury surveillance. Patient handling injuries (PHIs) from activities of turning, repositioning, and transferring patients are one of the leading causes of work-related injuries and musculoskeletal disorders (MSD) among healthcare workers. Safe Patient Handling and Mobilization (SPHM) programs aim to reduce PHIs. Differences in program design and implementation can impact program effectiveness, underscoring the importance of evaluating compliance rather than merely assessing program existence. This study examined the relationship between SPHM program compliance and direct care staff’s PHI rates in Veterans Health Administration (VHA) facilities. This cross-sectional study used data from the 2023 Annual SPHM Compliance Survey; 124 of 152 VHA facilities were included in the study. A SPHM program compliance index was created to measure each facility’s compliance with the SPHM program’s performance criteria. Data were analyzed using Kruskal-Wallis Test, Mann Whitney-U, and Negative binomial regression analysis. Facilities with higher SPHM Compliance Index showed higher PHI rates when adjusted for the staff-to-patient ratio, but their significant relationship did not remain after adding other facility characteristics. Facilities with higher staff-to-patient ratio and lower ceiling lift coverage had lower PHI rates. PHI rates were lower in facilities with ambulatory care services only compared to long-term care. Medium-sized facilities and large-sized facilities reported significantly lower PHI rates compared to small-sized facilities. This study found mixed results in different models between the relationship of SPHM program and PHI rate. The unexpected finding of a positive correlation between higher SPHM Compliance Index and higher PHI rates requires further research to validate the findings. This study can be used by healthcare organizations to evaluate their SPHM program compliance and strengthen the roles of the SPHM program managers in active surveillance. The findings provide guidance for identifying facility-level factors that influence injury risk and for implementing targeted strategies to improve staff safety.