Work-related injury among direct care occupations in British Columbia, Canada

Objectives: To examine how injury rates and injury types differ across direct care occupations in relation to the healthcare settings in British Columbia, Canada. Methods: Data were derived from a standardised operational database in three BC health regions. Injury rates were defined as the number of injuries per 100 full-time equivalent FTE positions. Poisson regression, with Generalised Estimating Equations, was used to determine injury risks associated with direct care occupations registered nurses RNs, licensed practical nurses LPNs and care aides CAs by healthcare setting acute care, nursing homes and community care. Results: CAs had higher injury rates in every setting, with the highest rate in nursing homes 37.0 injuries per 100 FTE. LPNs had higher injury rates 30.0 within acute care than within nursing homes. Few LPNs worked in community care. For RNs, the highest injury rates 21.9 occurred in acute care, but their highest 13.0 musculoskeletal injury MSI rate occurred in nursing homes. MSIs comprised the largest proportion of total injuries in all occupations. In both acute care and nursing homes, CAs had twice the MSI risk of RNs. Across all settings, puncture injuries were more predominant for RNs 21.3 of their total injuries compared with LPNs 14.4 and CAs 3.7. Skin, eye and respiratory irritation injuries comprised a larger proportion of total injuries for RNs 11.1 than for LPNs 7.2 and CAs 5.1. Conclusions: Direct care occupations have different risks of occupational injuries based on the particular tasks and roles they fulfil within each healthcare setting. CAs are the most vulnerable for sustaining MSIs since their job mostly entails transferring and repositioning tasks during patient/resident/client care. Strategies should focus on prevention of MSIs for all occupations as well as target puncture and irritation injuries for RNs and LPNs.