Poorly Supported Jobs Linked to Higher CNA Injury Rates

Work-related injuries are extremely prevalent among certified nursing assistants (CNAs) working in U.S. nursing homes, with 60 percent of CNAs suffering an injury in the previous year, according to a study (pdf) by the Research Triangle Institute.

Common injuries included scratches, open wounds, back injuries, black eyes and other bruising, human bites, and strained or pulled muscles. Of those injured, nearly one quarter (24 percent) were left unable to work.

The report, which uses data from the 2004 National Nursing Home Survey and National Nursing Assistant Survey, found that:

• CNAs who were new to a facility, or to the field of direct-care work entirely, were more likely to suffer on-the-job injuries.
• CNAs who had two or more jobs in the prior five years were more likely to be injured. Due to the high turnover rates in direct-care work, three-fourths of CNAs fit that description.
• Poor training and job preparation are strongly linked to higher injury rates among CNAs. More than one-third of CNAs felt that their initial training was inadequate.
• Higher wages are associated with lower CNA injury rates.
• CNAs who said they felt rushed at work were more likely to be hurt on the job. One out of every three CNAs reported not having enough time to help consumers perform activities of daily living (ADLs).
• CNAs working mandatory overtime were more likely to be injured on the job during overtime hours. More than one out of five (22 percent) of CNAs are required to work overtime.

An unexpected finding of the study was that, although assistive equipment was readily available and often used, it was not associated with lower injury rates.

For example, lifting equipment may be too cumbersome to use properly or may require the help of additional staff who may not be available.

Additionally, the study found that positive and supportive organizational cultures in nursing homes promote safer work environments. “The odds of being injured decreased for CNAs who felt respected and rewarded for their work and for CNAs who felt that [their workplace] values CNA work,” the authors wrote.

They suggest that, in order to reduce injury rates even further, facilities should concentrate on providing robust initial and ongoing training, reducing mandatory overtime, and working to lower turnover.

— by Matthew Ozga