Implementing the Safe Patient Handling & Movement Rule
Introduction
A final rule, 19 CSR 30-20.097 Safe Patient Handling and Movement in Hospitals, was
published in the Missouri Code of State Regulations on Oct. 30 and is effective Nov. 30. To
assist hospitals with compliance with the rule, MHA has compiled the text of the rule, a brief
overview of the rule and recommendations for compliance, as well as references and resources to
assist with implementation. Wrenae Shabel Ph.D., R.N., of Phelps County Regional Medical
Center in Rolla chaired the Nursing Technical Advisory Committee, which developed the rule in
response to legislative proposals. She has graciously provided additional resources to assist with
implementation.
The Rule
19 CSR 30-20.097 Safe Patient Handling and Movement in Hospitals
PURPOSE: This rule specifies the requirements for safe patient handling and movement
practices in a hospital.
(1) There shall be an active multidisciplinary committee responsible for implementing and
monitoring the safe patient handling and movement program. At least one-half (1/2) of the
members of the committee shall be frontline non-managerial employees who are involved in
patient care handling activities.
(2) This program shall include:
(A) A safe patient handling policy for all shifts that will achieve elimination of manual lifting,
transferring, and repositioning of all or most of a patient’s weight, except in emergency, lifethreatening, or otherwise exceptional circumstances;
(B) A patient-handling hazard assessment that considers such variables as patient-handling
tasks, types of nursing units, patient populations, and the physical environment of patient care
areas;
(C) A process which assesses patient’s needs for safe patient handling and movement;
(D) Educational materials for patients and their families to help orient them to the hospital’s
safe patient handling program;
(E) An annual evaluation of the program utilizing measurable outcome measures including but
not limited to employee and patient injuries, lost work days, and workers’ compensation claims;
and
(F) Evidence of changes based on the program evaluation.
(3) All employees involved in patient care handling activities are to be trained and demonstrate
competence on safe patient handling policies, equipment, and devices before implementation,
annually, and as changes are made to the program.
AUTHORITY: section 197.080, RSMo 2000.* Original rule filed April 29, 2011, effective Nov.
30, 2011.
*Original authority: 197.080, RSMo 1953, amended 1993, 1995.
Overview and Recommendations
REGULATION
(1) There shall be an active multidisciplinary
committee responsible for implementing and
monitoring the safe patient handling and
movement program. At least one-half of the
committee members shall be frontline nonmanagerial employees who are involved in
patient care handling activities.




(A) a safe patient handling policy for all
shifts that will achieve elimination of
manual lifting, transferring and
repositioning of all or most of a patient’s
weight, except in emergency, lifethreatening or otherwise exceptional
circumstances

(B) a patient-handling hazard assessment that
considers such variables as patienthandling tasks, types of nursing units,
patient populations and the physical
environment of patient care areas

(C) a process which assesses patient’s needs
for safe patient handling and movement;


ACTION NEEDED AND
RECOMMENDATIONS
Establish a multidisciplinary committee with
at least half the members recruited from
frontline staff involved in patient care
handling activities.
Recommendation — Include representation
from nonnursing units, such as radiology,
rehab services, transport teams, risk
management and employee/occupational
health staff.
The primary responsibility of the committee
should be establishing, implementing and
monitoring the program.
Determine how the committee will
demonstrate that it is responsible
implementation and monitoring.
Develop a hospitalwide policy that applies to
all shifts that can be applied “facilitywide” or
be tailored to meet unit-specific needs.
In the policy, define exceptions to the rule for
your hospital. For example, exceptions could
include infants, children under a certain
weight and patients capable of transferring or
repositioning themselves.
Assess patient, staff and equipment needs.
This could be done through various means.
1. Review injury/illness logs, incident
reports and other reporting systems.
2. Perform a walk-through for all units
during all shifts to look for risk factors.
3. Survey employees.
4. Catalog safe patient handling and
movement equipment in use and
determine gaps.
5. Determine which tasks pose a risk for
injury on each unit, such as frequent lifts
of dependent patients, multiple transfers
for geriatric residents, repositioning
bariatric (obese) patients, etc.
Develop an assessment tool or process to
determine patients’ needs. See screen shots
from Phelps County Regional Medical
Center or consult the PHAMA white paper,
“Patient Handling and Movement
Assessments.”
REGULATION
(D) educational materials for patients and
their families to help orient them to the
hospital’s safe patient handling program

(E) an annual evaluation of the program
utilizing measurable outcome measures
including but not limited to employee
and patient injuries, lost work days and
workers’ compensation claims; and
(F) evidence of changes based on the
program evaluation

(3) All employees involved in patient care
handling activities are to be trained and
demonstrate competence on safe patient handling
policies, equipment and devices before
implementation, annually and as changes are
made to the program.


ACTION NEEDED AND
RECOMMENDATIONS
Revise information that is provided to
patients during admission to include
information about the hospital’s safe patient
handling program. See material taken from
the Phelps County Regional Medical
Center’s patient handbook for an example.
Develop outcome measures, regularly track
performance and document evaluation of
performance and changes made to program at
least annually.
As soon as safe patient handling and
movement policy is adopted, provide training
to applicable staff before implementation.
Make revisions to training and competency
verification required during orientation and
annually update to included new policies.
Resources and References
Nelson, A., Baptiste, A. (September 30, 2004). “Evidence-Based Practices for Safe Patient
Handling and Movement.” Online Journal of Issues in Nursing. Vol. 9 No. 3, Manuscript 3.
ANA Safe Patient Handling Campaign at www.anasafepatienthandling.org/default.aspx
PHAMA white paper, “Patient Handling and Movement Assessments,” written by the Specialty
Subcommittee on Patient Movement of the 2010 Health Guidelines Revision Committee.
Resources provided by Wrenae Shabel, Phelps County Regional Medical Center
 safe patient handling sample policy
 excerpt from patient admission handbook
 screen shots from electronic medical record of assessment tools for determining patient
needs