The health care industry is under siege with muscular skeletal disorders (MSD), the vast majority of which are directly related to the manual repetitive transfer or repositioning of residents/patients from one position to another. Two purposive sample groups were selected from over 200 nursing home facilities and identified as the “high” injury rate sample group and the “low” injury rate sample group. The research study used a mixed method analysis with a causal-comparative methodology for examining the differences between the sample groups. The first research question explored: Did skilled nursing facilities with a high injury rate compare to low injury rate facilities on the number of mechanical transfer devices? The data analysis indicated that contrary to accept ed theory, there was a demonstrated inverse relationship between injury rate and number of lifts available for use by caregivers. The second question explored: Did the low injury rate sample group differ significantly from the high injury rate sample group when comparing them on the following variables: transfer training, morale, age, turnover, TIPS safety score, and individual efficacy? The data analysis of the six variables indicated that four of the six variables revealed a significant difference between the two sample groups. The third question analyzed: Did caregivers (LPN, RN, and nurses’ aides) compare proportionally between subgroup resident injury rates? The data analysis indicated a confounding of the job subgroup variables due to company staffing policies and the lack of definitive tracking requirements between licensed caregivers (LPN and RN) job exposures. The final research question examined: Did nursing facilities with a high transfer injury rate compare with nursing facilities with a low transfer injury rate on caregiver dignity concerns for utilizing mechanical transfer equipment? The qualitative analysis using comparative cataloging techniques indicated the high injury rate sample group expressed proportionally more caregiver dignity concerns about mechanically transferring residents. The research highlighted the complexity of issues that need to be addressed for solving the resident transfer injuries experienced by nursing facility caregivers. Therefore, the key to reducing these caregiver injuries is far more complex than just simply having additional mechanical transfer devices available for use
