The ANA Handle with Care Recognition Program

The American Nurses Association (ANA) historically has had a strong commitment to safe work environments for registered nurses (RNs), including prevention of musculoskeletal disorders (MSDs). During an 8-hour shift, the cumulative weight a nurse lifts equals an average of 1.8 tons.

Fear of a disabling MSD has led some nurses to leave the profession. In 2003, alarm over unacceptably high MSD rates resulted in the launch of ANA’s Handle with Care® campaign. The goal—to establish a national no-manual-handling policy—would be achieved through partnerships, outreach, education and training, legislation, and regulation.

ANA increasingly became aware that numerous healthcare organizations were making a commitment to their workers and investing in establishing safe patient-handling programs. Such programs consist of policies and processes that enable nurses and other healthcare workers to move patients using equipment and other devices in a way that doesn’t cause strain or injury to them, other healthcare providers, or the patient, while preserving the patient’s dignity. A safe patient-handling program is comprehensive and consists not only of equipment but also education, training, procedures, policies, and other components to keep caregivers safe while creating a safe environment for patients.

To acknowledge the organizations committed to safe patient handling and enable them to serve as role models to others, ANA developed a program to highlight these admirable organizations. In 2009, it launched the ANA Handle with Care Recognition Program™. The main goal is to assist healthcare organizations to establish, implement, and monitor a comprehensive program to reduce or eliminate MSDs in clinical healthcare workers and patients. The program consists of nine key elements:

  • program planning and leadership
  • initial assessment
  • program development
  • equipment
  • education and training
  • program implementation
  • program evaluation
  • program sustainability
  • regulation.

For recognition award eligibility, the safe patient-handling program must be operational at the applicant facility for a minimum of 3 years. The program start date is the date the equipment is put in use after completion of education and training of healthcare workers. The program must have a dedicated facility coordinator responsible for management and oversight. The chief nursing officer must have a leadership role in the program. The program must have a multidisciplinary committee consisting of frontline nursing staff. High-risk tasks on individual units must be determined from hazard and walk-through assessments. Department-specific safe patient-handling plans must be developed. Equipment selection must involve frontline staff and include evaluation of at least two different manufacturers. Education and hands-on training must be conducted for all staff on participating units. Policies and procedures specific to safe patient handling must be developed and readily available to the staff. The program must be evaluated periodically, with changes communicated and implemented within the organization. Compliance with state and federal regulations is required.

The electronic application must be submitted to ANA and cannot exceed 50 pages. After review and determination, the organization must meet eligibility criteria. Then a site visit will be conducted. Two nurse reviewers will visit the facility to review the program and assess whether program elements are reflected, thereby meeting the ANA’s comprehensive criteria.


After the visit, the reviewers’ report will be evaluated by the review panel of the ANA Handle with Care Recognition Program™, which will decide whether to grant the award to the organization. The award will be granted for a 3-year term. Recipients will be permitted to use the program logo during the recognition term. During those 3 years, the organization will be required to submit annual update reports to ANA. Significant changes to the program may trigger additional update reports.

More information about the ANA Handle with Care Recognition Program™ and a program application are available at www.ANAHandleWithCare.org.

Nancy L. Hughes is the director of ANA’s Center for Occupational and Environmental Health.

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