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Ergonomic Guidelines for the Nursing Home Industry

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In one 8-hr. shift the cumulative weight a Nurse/Aide, etc., lifts is.... 1.8 Tons ... Even using the NIOSH Lifting Equation, the threshold limits for injury are ... – PowerPoint PPT presentation

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Title: Ergonomic Guidelines for the Nursing Home Industry


1
Ergonomic Guidelines for the Nursing Home Industry
2
THE PROBLEM
  • Musculoskeletal injuries account for more than
    50 of all lost times injuries in the Healthcare
    Industry
  • Greater than 750,000 work days are lost annually
    due to back injuries in Healthcare Sector

3
OTHER FACTS
  • In one 8-hr. shift the cumulative weight a
    Nurse/Aide, etc., lifts is….
  • 1.8 Tons

4
What Can You Do to Reduce Your Risk of MSDs?
  • Conduct a hazard or risk assessment
  • Assess the patient
  • Assess prepare the environment
  • Get necessary equipment help
  • Perform the patient care task, lift or movement
    safely
  • Plan and Prepare It only takes a minute but can
    save a career

5
NIOSH Lifting Equation Applied to Patient
Handling Activities
  • Even using the NIOSH Lifting Equation, the
    threshold limits for injury are exceeded when
    performing patient handling tasks.

6
NIOSH
  • Determined that ½ day of training was not
    effective in minimizing MSDs associated with
    patient lifting.
  • 1 to 1.5 days of training better

7
OTHER FACTS
  • American Nurses Association is currently pushing
    for a national law governing safe lifting
    practices and standards at the National level.
  • Gait belts have been banned from use several
    European countries

8
LIFTS NOT ALLOWED
  • UK, Austria, Ireland, Netherlands, Sweden,
    Denmark, S Africa, British Columbia do not allow…
  • Under the axilla lift hook and toss lift with
    patients arms around nurses neck, etc.

9
Goal of Ergonomic Evaluation, Design, and
Intervention
  • Increase Efficiency
  • Increase Productivity
  • Increase Quality
  • Decrease Cost
  • WHILE.....

10
Goal of Ergonomic Evaluation, Design, and
Intervention
  • Decrease Injury/Illness
  • Lost work day rates
  • Restricted work day rates
  • OSHA reportable rates
  • Workers compensation costs
  • Decrease Fatigue
  • Decrease Absenteeism
  • Decrease Turnover

11
Ergonomic Guidelines for the Nursing Home Industry
  • Why are we doing this
  • OSHAs Ergonomics for the Prevention of
    Musculoskeletal Disorders Recommendations to
    help reduce number and severity
  • SB 1525 Safe Patient Handling and Movement
    Practices
  • Promote and achieve as much as possible, a ZERO
    lift attitude in the work place dealing with
    PEOPLE

12
Senate Bill - 1525
  • Effective January 1, 2006
  • Governing body/Assurance Committee shall adopt
    and ensure implementation of a policy to
    identify, assess, and develop strategies to
    control risk of injury to patients and nurses
    associated with lifting, transferring,
    repositioning, or movement of a patient.
  • Analysis of risk of injury to both parties posed
    by patient handling
  • Education of nurses in the identification,
    assessment and control of risks

13
Senate Bill 1525 (cont.)
  • Evaluation of alternative ways to reduce risks
    associated with patient handling
  • Restriction, to the extent feasible with existing
    equipment and aids, of manual patient handling or
    movement of all or moist of a patients weight
  • Collaboration with and annual report to the nurse
    staffing committee
  • Procedures for nurses to refuse to perform or be
    involved in patient handling or movement that the
    nurse believes in good faith will expose a
    patient or nurse to an unacceptable risk of
    injury…

14
Senate Bill 1525 (cont.)
  • Submission of an annual report related to the
    identification, assessment, and development of
    strategies to control risk of injury associated
    with lifting, transferring, repositioning, or
    movement of a patient
  • In developing architectural plans for
    constructing or remodeling a hospital or nursing
    home in which patient handling and movement
    occurs, consideration of the feasibility of
    incorporating patient handling equipment, etc.

15
BLS STATISTICS (2004)
  • American Nurses Association survey found 83
    worked in spite of back pain
  • 60 fear a disabling back injury
  • 38 require time off during their career due to
    back pain
  • In 2000 resulted in time away from work for
    10,983 RNs
  • 44,854 in nursing aides, orderlies, etc.,
    experienced overexertion in lifting related
    incidents

16
NO LIFT Technology
  • We need to address a no lift process in Nursing
    Homes when it comes to lifting/moving/transferring
    of residents/clients, etc.
  • This can be accomplished
  • by use of any of the
  • following
  • Hoyer Lifts
  • Sit/Stand Hoist
  • Use of shower chairs
  • Ceiling mounted lift devices
  • Ambulation assist device
  • Geri or Cardiac Chairs
  • Stand Assist Devices
  • Lift Chairs
  • Transfer Boards

17
The Process, Step By Step
  • Evaluate Injuries and Costs
  • Obtain Approval For Funding
  • Establish A Lifting Committee
  • Evaluate and Select Equipment
  • Resident/Family Notification
  • Receive and Prep Equipment
  • Training
  • Resident Assessment
  • Coordination with Other Staff
  • Enforcement
  • Performance Measurement
  • Evaluate Efforts Regularly

18
Establish A Lifting Committee
  • CNA based committee
  • Select outgoing CNAs
  • 45 minute meeting
  • per week
  • Food, fun, praise
  • Leader has budget authority, is committed to
    project, and is a motivator

19
Evaluate Equipment
  • Hold open house for several different vendors
  • Demo equipment never seen before
  • Can's test equipment in the facility/provide
    feedback
  • Four inch
  • extenders
  • added to
  • bed legs
  • so lift will
  • fit under
  • lowboy
  • bed.

20
Equipment Selection
  • Equipment feedback list from CNAs
  • Identify all different accessories needed for
    lifts such as scales and extra slings
  • Decision meeting with lifting committee
  • Final budget approval and purchase
  • Set date for zero lifting policy

21
Nursing Home Departments Primarily At Risk
  • Nursing Care Services
  • Housekeeping
  • Laundry
  • Maintenance
  • Dietary/Food Service
  • Office, Volunteer Services, etc.

22
Nursing Care Services Risk Factors
  • Risk Factors
  • Pulling/Pushing Forces
  • Heavy Lifting
  • Awkward Postures
  • Inappropriate Equipment
  • Lack of or no Training
  • Body Segment Affected
  • Back
  • Neck
  • Shoulders
  • Lower Limbs
  • Arms
  • Wrists
  • Knees

23
Lifting and Moving of Patients/Clients/Residents
  • Possible Solutions
  • Hoyer Lift
  • Good Body Mechanics
  • Team Lifting
  • Powered sit-to-stand or standing assist devices
  • Ceiling mounted lift devices
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