Nonfatal Injuries Among Skilled Nursing and Residential Care Facility Workers Treated in U.S. Emergency Departments, 2015-2022.

Abstract

Skilled nursing and residential care facilities report among the highest nonfatal occupational injury rates compared to the overall working population. This cross-sectional study reports nonfatal emergency department -treated injury national estimates among U.S. skilled nursing and residential care facility workers. Nonfatal ED-treated occupational injury data were analyzed (2015-2022) from the National Electronic Injury Surveillance System, Occupational Supplement, a national probability sample of approximately 67 U.S. emergency departments. Occupational injuries in skilled nursing and residential care facilities were selected using relevant U.S. Census Bureau industry codes. National estimates and rates per 10,000 worker full-time equivalents were calculated using the U.S. Current Population Survey. Piecewise linear regression models examined temporal trends in biannual injury rates. An estimated 569,800 (95% CI = 420,400; 719,200) injuries occurred from 2015 to 2022, a rate of 302 (223, 382) per 10,000 full-time equivalents. Most injuries occurred among females (81%). The most prevalent injury events were overexertion and bodily reaction (38%; 116 [85, 147] per 10,000 full-time equivalents), violence (24%; 73 [46, 100] per 10,000 full-time equivalents), and falls, slips, and trips (16%; 49 [35, 63] per 10,000 full-time equivalents). Skilled nursing and residential care facility injury rates were higher than the rest of the healthcare industry and all industries. Skilled nursing and residential care facility injury rates declined from 2015-2021 (average biannual change -9.6% [-13.3%, -5.9%], p<0.001]). Following a 2021 trend change, there was a non-significant increase in injury rates. Among the working population, skilled nursing and residential care facility workers experience a high rate of nonfatal emergency department-treated occupational injuries. Future research should confirm trends and study effectiveness and uptake of evidence-based injury prevention interventions across settings.