The clinical nurse specialist as change agent: reducing employee injury and related costs.

Purpose: The purpose of this study was, first, to examine the role of the clinical nurse specialist (CNS) as it relates to the implementation of a CNS-initiated Safe Movement Program and, second, to report findings from a CNS-initiated safe movement program (SMP) in reducing healthcare workers' injuries and related costs.

Design: A longitudinal preimplementation and postimplementation study design was used.

Setting: Healthcare workers in a 156-bed, extended-care facility (nursing home) participated in the study.

Sample: Participants at the onset of the study included 52 healthcare workers who participated in the study preimplementation and postimplementation of the SMP. Attrition resulted in a final sample of 46.

Methods: Data were collected on healthcare workers' perceptions of injuries as well as existing incident reports and workers' compensation records preimplementation and postimplementation of the study.

Findings: Outcomes included major reduction in healthcare worker injuries and related workers' compensation cost savings. The number of healthcare workers who thought an injury occurred as a result of lifting or transferring a resident was reduced by 75%, and perceptions of lifting and transfer injuries resulting in a back strain were reduced by 80%. The number of times in a month healthcare workers felt lifting or transferring a resident was "too much" for them was reduced by 73%. Workers' compensation insurance was reduced by 93%.

Conclusions: A CNS-initiated SMP reduces injuries and costs and may recoup the cost of the program in 5 years.

Implications: Job-related musculoskeletal injuries are a critical problem. As the healthcare workforce continues to age, a comprehensive SMP needs to be implemented to ensure safety of employees in the clinical practice setting. The program may pay for itself in 5 years.