Reduced musculoskeletal injuries among direct carers is the key justification. Back injuries and other musculoskeletal issues are becoming more common due to the physical demands and strains of caring for patients in nursing homes and hospitals. Muscles, ligaments, tendons, nerves, bursae, joints, and cartilage, including intervertebral discs, can all sustain musculoskeletal injuries. Damage signs may include: swelling or discomfort. Feelings of numbness, burning, or tingling. a reduction in movement near a certain joint or joints. Both the immediate consequences of accidents during transfers and the cumulative long-term physical effort of patient transfers are typically to blame for these injuries. Additionally, they might result from a ""peak load."" Peak loads happen when a one-time task or event that pushes the body beyond its limits is done. Musculoskeletal injuries cause injury and disability in registered nurses, registered practical nurses, and health care assistants. Both caregivers and employers can gain from a patient handling ergonomic strategy that is a part of a larger program to decrease musculoskeletal injuries.
How do you begin creating a program for safe patient handling that is ergonomic?
The employer's promise to create and maintain a safe workplace is expressed in the health and safety policy.
The terms of reference that define how the workplace will operate in approaching this problem and achieving its aim of fewer injuries will be developed when the parties from the workplace sit down to design an ergonomic approach to patient management.
A safe patient handling program will typically include the following actions: approval from management and a commitment to create and carry out a patient handling program. creation of a collaborative plan by the management, staff, union (if applicable), health and safety committee, etc. Analyze your needs. Establish and standardized patient evaluation standards. To create standardized actions, create decision trees. Identify the controls required to carry out particular tasks or meet patient needs. Introduce a ""no-lift"" policy wherever it is practical.
What factors should go into a requirements analysis?
The causes of injuries sustained while handling patients should be reviewed and recorded regularly as part of the needs analysis. Analyzing the effects of caring for combative patients and residents is also necessary. It should record the number of injuries as well as all the pertinent information required to remove hazards and create working procedures that will assure prevention. The facility should do the needs analysis. All departments, shifts, and groups of workers who have endured musculoskeletal injuries or who are expected to be working with patients should be represented on the committee doing the needs analysis. A survey to get the opinions of the employees is a crucial instrument in doing the needs analysis. Details on risks and suggested remedies can be requested in a written, anonymous questionnaire. Workload, tasks, and work conditions that employees view as high risk are all possible topics for discussion. These surveys frequently bring to light issues that are not typically discovered by conventional means. The committee should examine the survey results along with their own research and knowledge. In order to identify high risk activities and produce baseline injury data against which future injury data can be compared, this information is required (e.g., compare injury frequency after a mechanical lift is installed versus before).
How may the office climate be evaluated?
Visit the location and look around each workspace or area. The objective is to analyze injury data and correlate it with concerns about personnel, physical layout, storage accessibility, equipment and space challenges, and maintenance and repair problems.
Does the committee need to take the workload into account as well?
In order to accurately assess workload, the committee will need to carefully examine the number of patients or residents assigned to staff members, the quantity and length of tasks necessary for these particular clients, and the time allotted to caregivers. Both the clients and the caregivers are in danger when there is an excessive workload.
What distinguishes patient lifts from patient transfers?
The distinction between a patient or resident transfer and a lift is an important consideration in ergonomic patient handling.
A dynamic effort is a transfer where the client participates and can support weight on at least one leg.
A lift is used to move a client who is unable to support their weight on at least one leg. There should always be mechanical lifting equipment used in lifts. When a patient transfer abruptly changes into a patient lift, injuries to caregivers during patient and resident transfers typically happen. Any ergonomic patient-handling program must consequently include an evaluation of the client's capabilities. To decide if a transfer requires two carers or a mechanical device, it is vital to identify clients who suddenly lose their equilibrium. When deciding whether a transfer requires more workers or a motorized lift, one must take into account the relative sizes of the caregiver and the client. The need for mechanical help might be determined by the disparities in height and weight.
Why is the patient handling policy's client assessment a crucial component?
It is necessary to do an assessment of each client to establish the best transfer technique and precisely define the client's level of mobility and physical handicap.
A patient's assessment criteria could include: How much help is the patient going to need? What is the patient's ability to support their own weight? Does the patient have enough upper body strength to support their weight during the transfer? Is the patient co-operative, and can they understand instructions? Is the patient able to cooperate with each lift, or does this change each time (e.g., time of day)? Are there physical characteristics that should be noted (height, weight, age)? Are there special circumstances such as injuries, presence of tubes, history of falls, osteoporosis, fractures, pressure ulcers, splints, history of spasms, etc.? This information must be clearly communicated to all staff that may care for the client including staff that may be filling in for workers that are ill or on vacation. Appropriate symbols and codes can communicate whether the client is capable of an unassisted transfer, can bear his or her weight on at least one leg during an assisted transfer, or requires a mechanical lift. The ability of the client to communicate with the caregiver to either identify physical limitations or to aid in the transfer will also determine the need for a mechanical lift. Mechanical lifts should be available in all situations where the patient or resident cannot bear weight on at least one leg. The adequate number, variety, and placement of mechanical lifts will need to be determined by the committee undertaking an ergonomic analysis of the workplace. Training needs should also be assessed by the committee. Are new employees receiving proper training and orientation regarding safe transfer techniques, patient or resident assessment, and the proper use of mechanical lifts? Are current staff receiving on-going in-service training and refresher training? Employees should also be informed about the importance of appropriate footwear and clothing. Proper footwear that is slip resistant and clothing that allows unrestricted movement can significantly reduce the chance of injury in transfers. Jewellery such as necklaces or bracelets can become a hazard if the patient grabs at these objects during a fall.
What are some features that make a care facility ergonomically well-designed?
The design and layout of a facility is critical in reducing risk factors for caregivers and clients.
The space and design of the patient or resident's room (including the bathroom) must allow for the free movement of the caregiver, resident, lifting devices, walkers, and wheelchairs.
The layout and space must also enable the caregiver to use proper body mechanics and transfer techniques.
Furniture should be of sufficient height to safely effect transfers. Furniture and equipment, in particular beds, should be adjustable to best insure safe client handling. Arms and legs on wheelchairs should be adjustable and removable. Cushions on wheelchairs should be secured so they cannot slip. Grab bars should be sufficient in number and placement to aid transfers in the bathroom. Commode chairs should have removable arms and leg and foot rests. A well-designed chair should be stable with a lap belt for clients. Geriatric chairs should, as well, have removable arm and foot rests to effect transfers. Bed rails should be light to allow operation by the caregiver with only one hand to reduce physical exertion. Lighting should be adequate to accomplish necessary tasks. Lighting that is too bright however can cause optical strain and stress. Colours and black and white contrast that aide the visual perception of the elderly can reduce the chance of accidents during transfers or if the client is ambulatory. Wet, highly polished, or otherwise slippery floors can contribute to slip and fall hazards.
What is the proper approach to the patient transfer or lift?
In addition to the physical layout of the workplace, equipment, staffing, and workload, the approach to the transfer or lift is a key element to reducing caregiver injuries.
Proper documentation and communication should inform the caregiver of the client's abilities, transfer needs, physical stability, and tendency if any, towards aggressive acts.
The caregiver should anticipate what actions would be necessary if the client loses balance or falls.
The procedure for the transfer should be clearly communicated and understood by any other staff assisting and the patient or resident.
The caregiver should assess the client, even briefly, before every transfer.
The client should be transported the shortest possible distance by the lifting device. The mechanical lifting device should not be used to transport the patient or resident outside the room. In transfers, tighten your abdominal muscles, keep your back straight, and use your leg muscles to avoid injury. Do not rotate or twist the spine. Move your entire body in the direction of the transfer. Never grab the client under his or her armpits as this could injure the client. Position yourself close to the client and assure footing is stable. Try to maintain eye contact with the client and communicate while the transfer is in progress. Never allow the client to grasp you around the neck as this could result in injury. Agree on the timing of the transfer with the client and other caregiver(s) and count together. Assure that the path of the transfer or lift is clear from obstructions and that furniture and aids that the client is being transferred to are properly placed and secure.
Are there some additional things you should know when transferring aggressive clients?
Injury to the caregiver and client can occur when transferring aggressive clients.
Caregivers have a legal right to know if the client they are caring for has a history of aggressive behaviour.
Caregivers must receive proper training and have the assistance of other properly trained staff when dealing with potentially violent clients. The reasons for client anger and hostility can be complex. Staff should be trained to identify the signs of potential aggressive behaviour, the triggers that can lead to violent outburst, means of deescalating an aggressive encounter, and emergency procedures to follow if retreat from an aggressive client is not possible or an attack occurs. Emergency communication and security procedures and systems need to be in place before they are needed. All aggressive incidents should be documented and reported to the supervisor and/or the health and safety committee.
What is a no-lift policy?
A no-lift policy would state that all manual handling tasks are to be avoided where ever possible. No-lift policies successfully reduce the risk only if the organization has the infrastructure in place (e.g., technical solutions, lifts, equipment) to support the initiative. Training is also necessary for caregivers to recognize the risk in activities, and how to follow appropriate steps to move or transfer a patient safely.
Are there examples or assessment charts that can assist with these decisions?
Yes.*No Unsafe Lift Workbook, Alberta Government
Patient Handling for Healthcare Workers, Occupational Health Clinic for Ontario Workers Inc.
Safe Patient Handling and Mobility, National Institute for Occupational Health and Safety
(*We have mentioned these organizations as a means of providing a potentially useful referral. You should contact the organization(s) directly for more information about their services. Please note that mention of these organizations does not represent a recommendation or endorsement by CCOHS of these organizations over others of which you may be aware.)""" - https://www.affordablecebu.com/
