Safe Patient Handling Program: Applied Ergonomics for Nurses and Health Care Workers - PowerPoint PPT Presentation

Loading...

PPT – Safe Patient Handling Program: Applied Ergonomics for Nurses and Health Care Workers PowerPoint presentation | free to download - id: 6baa59-N2NmY



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Safe Patient Handling Program: Applied Ergonomics for Nurses and Health Care Workers

Description:

Safe Patient Handling Program: Applied Ergonomics for Nurses and Health Care Workers This material has been possible by a grant from Oregon Occupational Safety and ... – PowerPoint PPT presentation

Number of Views:1255
Avg rating:3.0/5.0
Slides: 81
Provided by: Lynda53
Learn more at: http://www.cbs.state.or.us
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Safe Patient Handling Program: Applied Ergonomics for Nurses and Health Care Workers


1
Safe Patient Handling Program Applied
Ergonomics for Nurses and Health Care Workers
This material has been possible by a grant from
Oregon Occupational Safety and Health Division,
Department of Consumer and Business Services 2004.
2
Session Objectives
  • Identify activities at work or away from work
    that could put you at risk of Musculoskeletal
    Disorders (MSDs).
  • Identify the primary risk factors that can
    contribute to the development of work related
    MSDs.
  • Define why manual patient handling tasks are
    unsafe.
  • Define health care ergonomics.
  • Define engineering, work practice and
    administrative controls.
  • Identify examples of work practice controls that
    can help reduce your risk of injury when
    performing patient handling and care tasks.
  • Describe the four action steps that can reduce
    your risk of injury.

3
Session Agenda
  • Background
  • The ABC Hospital Safe Patient Handling Program
  • Applied Ergonomics for Nurses and Health Care
    Workers Video Section 1
  • Review Key Points from Video
  • Applied Ergonomics for Nurses and Health Care
    Workers Video Section 2 Case Studies
  • Case Studies Discussion and Group Work
  • Quiz and Evaluations

4
  • Brand names mentioned or seen in the training
    video do not constitute endorsement of the
    device, equipment or product by the Oregon
    Occupational Safety and Health Division, Oregon
    Nurses Association, Bay Area Hospital,
  • the University of Oregon's Labor Education and
    Research Center or other organizations who
    support this grant.
  • Equipment shown in this video may vary from the
    equipment used by your health care facility. Not
    all patient handling equipment available is shown
    in the video.
  • This training session is not a substitute for
    specific training on safe use of patient handling
    equipment.
  • Always follow the patient handling policy at your
    facility.

5
Background
Safe Patient Handling Program Applied
Ergonomics for Nurses and Health Care Workers
6
The Incidence of MSDs in Health Care
  • The most common MSDs reported by nurses and
    nursing aides are strains or sprains and injuries
    due to overexertion (lifting, pushing or pulling)
    associated with patient handling tasks.
  • At risk Occupations for Strains and Sprains, 2000
  • 1 Truck Drivers
  • 2 Nursing aides, orderlies attendants
  • 3 Laborers
  • 6 RNs
  • 18 LPNs

Source U.S. DOL, 2002
7
Why is Manual Patient Handling So Hazardous?
  • The Physical Demands of Work
  • Patient
  • Weight (heavy load)
  • Shape (bulky and awkward)
  • Behavior (unpredictable, confused, fragile, in
    pain)
  • High repetition of tasks
  • Equipment and Facilities Design
  • Constricted work space
  • Poorly maintained equipment

8
Why is Manual Patient Handling So Hazardous?
  • Poor Work Practices
  • Adjustments on equipment (e.g., bed) not used
  • Personal Factors
  • Off the job activities e.g., Lifting and handling
    children trash shopping, or performing yard
    work, etc
  • Previous Injury

Remember Using good bodymechanics is not enough
to prevent back injuries and other MSDs caused by
manual patient handling.
9
Why is Manual Patient Handling So Hazardous?
  • The physical effort required
  • to repeatedly lift and move
  • patients manually is greater
  • than your musculoskeletal
  • system can tolerate.

The bottom line. There is No Safe method to
lift and transfer patients manually
10
Risk Factors for MSDs
Safe Patient Handling Program Applied
Ergonomics for Nurses and Health Care Workers
11
What are Musculoskeletal Disorders (MSDs)?
Acute A sudden or one-time traumatic event or
incident, e.g., slip, trip, fall or car wreck
Chronic or Cumulative Injuries that occur over a
period of time (months/years) are caused by a
combination of risk factors
MSDs affect ligaments, muscles, tendons,
cartilage, blood vessels nerves spinal discs
12
Some Common MSDs
  • Tendinitis Tenosynivitis (upper extremities)
  • Epicondylitis (Tennis Elbow/Golfers elbow)
  • Rotator Cuff Tear (shoulder)
  • Bursitis (shoulder or knees)
  • Strains and Sprains
  • (neck, back, shoulder)
  • Low Back Pain Sciatica
  • Bulging or Herniated Spinal Discs
  • Carpal Tunnel Syndrome

13
Primary Risk Factors For MSDs
At work and/or at home
14
(No Transcript)
15
Awkward Posture MSDs
  • Examples
  • Providing medical care or performing personal
    hygiene tasks when the patient is in a chair or
    bed that is too low
  • Accessing medical equipment such as in-wall
    oxygen or suction equipment
  • Manually repositioning or transferring patients

16
Static or Fixed Postures MSDs
17
Static or Fixed Postures MSDs
  • Examples
  • Prolonged standing or sitting
  • Performing patient care tasks or making a bed
    while bending forward at the waist for a few
    minutes or longer
  • Supporting a patients extremities or heavy
    instruments during a nursing task or medical
    procedure

18
Force and MSDs
Definition Amount of physical exertion or
muscular effort expended when performing a task
or activity such as lifting, pushing, pulling,
carrying or gripping tools or equipment The
greater the force exerted and/or sustained over
time accelerates muscle fatigue and increases
risk of injury

19
Force and MSDs
  • The amount of force exerted is influenced by
    the
  • Weight, shape and condition of the patient or
    equipment
  • Body posture used
  • Number of repetitions performed
  • Duration or length of time that task is performed
  • Examples
  • Load or patient shifts suddenly or unexpectedly
  • Lifting bariatric or obese patients
  • Pushing a stretcher with poorly maintained or
    incorrect casters

20
Repetitions and MSDs
  • Definition
  • Performing the same motion over and over again.
  • Example
  • Repeated positioning of patients in bed or
    transfers to chairs

21
The Cumulative Effect
  • Duration of Exposure to Risk Factors (Time)
  • Affected by
  • Working through breaks
  • Overtime
  • Task variability

When the musculoskeletal system is exposed to a
combination of these risk factors (too quickly,
too often and for too long) without sufficient
recovery or rest time, damage occurs
22
The Cumulative Effect
23
Patient HandlingHigher Risk Tasks
  • Transfer from/to bed to chair or stretcher
  • Manually moving patient in bed
  • Manually lifting from floor
  • Attempting to stop falls

(SourceHignett, 2003)
24
Prevention
  • Employee SafetyPatient Safety

Safe Patient Handling Program Applied
Ergonomics for Nurses and Health Care Workers
25
Defining Health Care Ergonomics
  • The science of fitting the physical and cognitive
    demands of the
  • job to the worker to prevent injury, human error
    and improve
  • worker and patient comfort
  • or

Fitting the Job to the Worker NOT Fitting The
Person To The Job
Capabilities of People
Demands of the Job
26
Preventing MSDS
  • First Choice (or Method) Engineering Controls
  • Eliminate or reduce primary risk factors
  • e.g., Use patient handling equipment, such as,
  • ceiling and portable floor lifts, air
    assist transfer devices and mechanical sit to
    stand lifts
  • Must match equipment with
  • patient dependency
  • (physical and cognitive abilities),
  • the type of lift, transfer or movement
  • the number of staff available

27
Preventing MSDS
  • Second Choice Work Practice Controls
  • Reduce employee exposure to primary risk factors
    by using best work methods, e.g.,
  • Plan work organization
  • Use good housekeeping practices
  • Use adjustments on equipment
  • Get help
  • Eliminate unnecessary movements
  • Dont use broken equipment

Remember its the employees responsibility to
use good work practices and follow the
organizations safe patient handling policy and
procedures
28
Preventing MSDS
  • Second Choice - Work Practice Controls
  • Use neutral or good body postures
  • Neutral postures reduce physical stress on
  • musculoskeletal structures and enable optimum
    blood flow to the musculoskeletal system.
  • Your body is in the strongest and most balanced
    position.
  • Example
  • Work at proper heights keep everything in easy
    reach

Using good body mechanics or postures is still
important when using patient handling equipment
and devices
29
(No Transcript)
30
Optimal Work Height Reach Envelopes
31
Preventing MSDS
  • Second Choice Administrative Controls
  • Reduce employee exposure to primary risk
    factors, e.g.,
  • Ergonomics training
  • Policy procedures that define good work
    practices
  • Job rotation
  • Staffing and overtime practices

32
Preventing MSDS
  • Engineering
  • Work Practice
  • Administrative
  • Controls
  • Reduce the Risk of Injury for
  • Employees Patients

Remember - back belts are ineffective in
preventing back injuries
33
What Can You Do to Reduce Your Risk of MSDs?
34
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
35
Assess the Patient
  • Goal
  • To assess if patient status (physical and
    cognitive abilities) has changed and to determine
    the safest method to transfer or move the
    patient.
  • Compare assessment with patient handling orders
    or instructions in the Patient's Care Plan and
    ensure that staff are alerted to changes in
    patient status.

36
Assess the Patient (continued)
  • This brief observation includes assessment of the
    patients
  • Ability to provide assistance
  • Physical status ability to bear weight, upper
    extremity strength, coordination and balance
  • Ability to cooperate and follow instructions
  • Medical status changes in diagnosis or
    symptoms, pain, fatigue, medications

When in doubt, assume the patient cannot assist
with the transfer/ repositioning
37
Assess Prepare the Environment
  • Ensure that the path for transfer or movement is
    clear and remove (using good body posture)
    obstacles and clutter that constrain use of good
    posture and access to the patient, e.g.,
  • bed tables, and chairs
  • trip hazards, e.g., cords from medical equipment
  • slip hazards , e.g., spilled beverages or other
    fluids on the floor

38
Assess Prepare the Environment (continued)
  • Consider safe handling of medical devices, such
    as catheters, intravenous tubing, oxygen tubing,
    and monitoring devices
  • Ensure good lighting.
  • Adjust equipment, such as beds to correct working
    height to promote good postures
  • Keep supplies close to body to avoid long reaches

39
Get Necessary Equipment Help
  • Get the correct equipment and supplies for the
    task as determined in the Patient Care Plan and
    after the Patient Assessment in Step 1
  • Get additional help as required
  • Ensure that
  • Equipment is in good working order
  • Devices such as gait belts and slings are in good
    condition and the correct size
  • The patient is wearing non-slip footwear if they
    are to be weight bearing

40
Perform the Patient Care Task, Lift or Movement
Safely
You should receive training on correct use of
equipment, patient assessment and safe work
practices before handling patients
  • Explain the task to the patient agree on how
    much help he or she can give during the task
  • Position equipment correctly, e.g., height
    between a stretcher and bed is equal
  • Apply brakes on equipment and furniture used
  • Lower bed rails when necessary

41
Perform the Patient Care Task, Lift or Movement
Safely (continued)
  • Coordinate the task as a team (nurses and
    patient)
  • Have the patient assist as much as possible
  • Use good body posture keep work close to the
    body and at optimal height
  • Know your physical limits and do not exceed them

Follow your organizations safe patient handling
policy and procedures
42
What Else Can You Do?
  • Report Ergonomic Problems to Your Supervisor
  • Apply Back Injury Prevention Principles to Your
    Off -The-Job Activities
  • Report Any Physical Problems Early
  • Quicker Recovery

43
Case Studies
Case Study 1 Repositioning Patient in Bed Case
Study 2 Transfer from Chair to Bed Case Study
3 Transfer from Bed to Stretcher Case Study
4 Transfer from Wheel Chair to Bed Case Study
5 Making a Bed Repositioning Patient in
Bed Case Study 6 Patient Ambulation and Fall
Recovery
44
Case Studies
  • Remember What you are about to practice is not
    a substitute for specific training on safe use of
    patient handling equipment.
  • Not all patient handling equipment available is
    shown in the video.
  • Always follow the patient handling policy at your
    facility.

45
Case Study 1Repositioning Patient in Bed
  • What Did You See?
  • Identify primary risk factors for MSDs
  • Identify hazards that may cause slips, trips,
    falls or other acute or traumatic injuries
  • Determine the cause or the primary risk factors
    and hazards observed
  • Determine a safer way to perform the task

46
Case Study 1Repositioning Patient in Bed
Task Risk Factors Hazards Cause
Injection of medication Back bent twisted coupled with static posture Trip Hazard Bed too low Rail up Bed table obstructs access Phone on bed cord on floor
Dispose of needle Back bent Neck bent backwards Long reach (arm overhead) Bed table obstructs access
47
Case Study 1Repositioning Patient in Bed
(continued)
Task Risk Factors Hazards Cause
Reposition patient Back bent twisted Neck bent backwards Forceful exertion back and shoulder Bed too low Rail up Weight of patient Patient did not assist
48
Case Study 1Repositioning Patient in Bed The
Safer Way
  • Assess the Patient
  • Has upper extremity strength, can sit unaided, is
    non-weight bearing, cooperative (consider medical
    status etc.)
  • Assess the Environment
  • Move bed table and phone, raise bed, lower rail
    when administering injection
  • Raise bed and lower bed rails before moving
    patient

49
Case Study 1Repositioning Patient in Bed The
Safer Way (continued)
  • Get Necessary Equipment Help
  • Friction reducing device (slippery sheet) two
    nurses or caregivers
  • Perform the Task Safely
  • Coordinate the move
  • Use good posture
  • Have patient assist

50
Case Study 2Transfer from Chair to Bed
  • What Did You See?
  • Identify primary risk factors for MSDs
  • Identify hazards that may cause slips, trips,
    falls or other acute or traumatic injuries
  • Determine the cause or the primary risk factors
    and hazards observed
  • Determine a safer way to perform the task

51
Case Study 2Transfer from Chair to Bed
Task Risk Factors Hazards Cause
Assisting patient from chair to bed Forceful exertion back Back bent twisted Patient weight Patient not capable of bearing full Weight Patient not assessed Chair too low
52
Case Study 2Transfer from Chair to Bed
(continued)
Task Risk Factors Hazards Cause
Assisting patient onto bed Forceful and sudden exertion back Back bent twisted Neck bent backwards Patient not capable of full weight bearing Patient not assessed
Repositioning in bed Forceful exertion back Back bent twisted Neck bent backwards Patient not capable of full weight bearing Bed too low
53
Case Study 2Transfer from Chair to Bed The
Safer Way
  • Assess the Patient
  • Partial weight bearing, cooperative, has upper
    extremity strength and can sit unaided
  • Assess the Environment
  • Move bed table, lower head of bed lower bed rail
    using good posture

54
Case Study 2Transfer from Chair to Bed The
Safer Way (continued)
  • Get Necessary Equipment Help
  • Powered Sit-to-Stand device
  • Only one caregiver needed
  • Perform the Task Safely
  • Apply equipment brakes when raising and lowering
    patient
  • Raise bed before lifting patients legs
  • Use good posture
  • Have patient assist

55
Case Study 3Transfer from Bed to Stretcher
  • What Did You See?
  • Identify primary risk factors for MSDs
  • Identify hazards that may cause slips, trips,
    falls or other acute or traumatic injuries
  • Determine the cause or the primary risk factors
    and hazards observed
  • Determine a safer way to perform the task

56
Case Study 3Transfer from Bed to Stretcher
Task Risk Factors Hazards Cause
Positioning stretcher in room Back bent and twisted Sharp corners or protruding edges on furniture (risk of soft tissue contusion) Poor posture or bodymechanics Moving furniture in constricted space
Preparing transfer Back bent Long reach (arm overhead) Passing IV bag and tubing over bed
57
Case Study 3Transfer from Bed to Stretcher
(continued)
Task Risk Factors Hazards Cause
Performing transfer Extreme forceful exertion back and shoulders Back bent Neck bent backwards Extreme bending of knee (on bed) coupled with force Extended reach to grasp drawsheet Forceful grip (poor hand hold) Patient weight and shape Patient unable to assist Stretcher higher than bed height Width of stretcher and bed Use of drawsheet to move patient
58
Case Study 3Transfer from Bed to Stretcher
(continued)
Task Risk Factors Hazards Cause
Moving the stretcher Forceful exertion - back and shoulder Back bent and twisted Neck bent backwards and twisted Arms extended away from body Pushing and Pulling stretcher on carpeted surface Lack of holder on stretcher for oxygen tank Lack of steering control on stretcher Stretcher too low
59
Case Study 3Transfer from Bed to Stretcher The
Safer Way
  • Assess the Patient
  • This is a Bariatric patient who cannot assist
    with the transfer
  • Assess the Environment
  • Move furniture from of work area before bringing
    stretcher into room

60
Case Study 3Transfer from Bed to Stretcher
The Safer Way (continued)
  • Get Necessary Equipment Help
  • Air assisted friction-reducing device three
    caregivers
  • Pass IV bag around patient
  • Stretcher has holder for IV and Oxygen tank
  • Larger wheels and steering assist mechanism

61
Case Study 3Transfer from Bed to Stretcher
The Safer Way (continued)
  • Perform the Task Safely
  • Coordinate the preparation and transfer
  • Work heights equal and equipment/bed brakes
    applied
  • Use good posture
  • Adjust stretcher height for movement to allow
    good posture
  • 2nd person required to guide front of stretcher
    only

62
Case Study 4Transfer from Wheel Chair to Bed
  • What Did You See?
  • Identify primary risk factors for MSDs
  • Identify hazards that may cause slips, trips,
    falls or other acute or traumatic injuries
  • Determine the cause or the primary risk factors
    and hazards observed
  • Determine a safer way to perform the task

63
Case Study 4Transfer from Wheel Chair to Bed
Task Risk Factors Hazards Cause
Preparing to Assist the Patient Forceful exertion - back Back bent Neck bent backwards Holding patients leg while adjusting foot rest Adjusting leg supports/foot rests
Assisting patient from wheelchair to bed Forceful exertion back Back bent twisted Patient not capable of full weight bearing Patient weight Patient not assessed
64
Case Study 4Transfer from Wheel Chair to Bed
(continued)
Task Risk Factors Hazards Cause
Assisting patient onto bed Forceful and sudden exertion back Back bent twisted Neck bent backwards Patient not capable of full weight bearing Patient not Assessed Wheel chair away from bed
65
Case Study 4Transfer from Wheel Chair to Bed
(continued)
Task Risk Factors Hazards Cause
Repositioning in bed Forceful exertion -back Back bent twisted Neck bent backwards Bed too low Bed rail up Head of Bed partially raised Patient does not assist
66
Case Study 4Transfer from Wheel Chair to Bed
The Safer Way
  • Assess the Patient
  • Partial weight bearing, cooperative, has upper
    extremity strength and can sit unaided
  • Assess the Environment
  • Move bed table, raise bed, raise head of bed,
    lower bed rail using good posture

67
Case Study 4Transfer from Wheel Chair to Bed
The Safer Way (continued)
  • Get Necessary Equipment Help
  • Gait belt crutches and trapeze bar
  • Only one caregiver needed

68
Case Study 4Transfer from Wheel Chair to Bed
The Safer Way (continued)
  • Perform the Task Safely
  • Use good posture to apply gait belt and to adjust
    wheel chair foot supports
  • Have patient assist to hold leg while adjusting
    foot support
  • Do NOT lift but guide patient to a standing
    position
  • Have patient transfer self to bed with stand-by
    assist
  • Have patient reposition self on bed

69
Case Study 5Making a Bed and Repositioning
Patient in Bed
  • What Did You See?
  • Identify primary risk factors for MSDs
  • Identify hazards that may cause slips, trips,
    falls or other acute or traumatic injuries
  • Determine the cause or the primary risk factors
    and hazards observed
  • Determine a safer way to perform the task

70
Case Study 5Making a Bed and Repositioning
Patient in Bed (continued)
Task Risk Factors Hazards Cause
Making the bed Forceful exertion back and shoulders (nurse turning holding patient) Back bent twisted in static posture (nurse turning holding patient) Repetitive bending twisting of back (nurse making bed) Neck bent backwards (both nurses) Weight of patient Patient unable to assist Bed too low Bed Rails up
71
Case Study 5Making a Bed and Repositioning
Patient in Bed (continued)
Task Risk Factors Hazards Cause
Making the bed Forceful grip - Poor hand hold (nurse turning holding patient) Slip Hazard Using drawsheet Spill on floor
Repositioning patient up in bed Forceful exertion back and shoulder Back bent twisted Neck bent backwards twisted Weight of patient Patient unable to assist Bed too low Rail up
72
Case Study 5Making a Bed and Repositioning
Patient in Bed The Safer Way
  • Assess the Patient
  • This is a semi-conscious patient who is unable to
    assist
  • Assess the Environment
  • Clean up spill, have bed linens ready, raise bed
    and lower rails

73
Case Study 5Making a Bed and Repositioning
Patient in Bed The Safer Way (continued)
  • Get Necessary Equipment Help
  • Ceiling hoist and 2 nurses or caregivers
  • Perform the Task Safely
  • Coordinate lift and movement
  • Each nurse makes a side of the bed
  • Move bed and/or use ceiling lift to reposition
    patient safely

74
Case Study 6Patient Ambulation and Fall Recovery
  • What Did You See?
  • Identify primary risk factors for MSDs
  • Identify hazards that may cause slips, trips,
    falls or other acute or traumatic injuries
  • Determine the cause or the primary risk factors
    and hazards observed
  • Determine a safer way to perform the task

75
Case Study 6Patient Ambulation and Fall Recovery
Task Risk Factors Hazards Cause
Ambulating patient Trip hazards Sharp corners or protruding edges on furniture (risk of soft tissue contusion) Poor and unstable coupling (handhold) Equipment in walkway No safe way to support patient holding wrist may cause soft tissue trauma to patient during fall
76
Case Study 6Patient Ambulation and Fall Recovery
(continued)
Task Risk Factors Hazards Cause
Attempting to control the patient fall Forceful exertion back and shoulders Back bent twisted Neck bent backwards Forceful twisting of left forearm when attempting to hold patient during fall Patient weight coupled with sudden motion Location of patient at floor level Poor coupling no location to securely support patient and control the fall safely
77
Case Study 6Patient Ambulation and Fall Recovery
(continued)
Task Risk Factors Hazards Cause
Lifting patient from floor Forceful exertion back and shoulder Back bent Neck bent backwards Forceful grip - Poor coupling hand hold Weight of patient Patient unable to Assist Location of patient - lift from floor level No safe way to hold patients arms and legs. Risk of soft tissue trauma to patient
78
Case Study 6Patient Ambulation and Fall
Recovery The Safer Way
  • Assess the Patient
  • Can weight bear with standby assist and is
    cooperative
  • The patient cannot stand without assistance after
    fall
  • Assess the Environment
  • Move IV pole and wheelchair in walkway

79
Case Study 6Patient Ambulation and Fall
Recovery The Safer Way (continued)
  • Get Necessary Equipment Help
  • Use gait belt for ambulation
  • Only one nurse or caregiver needed
  • Portable powered floor lift and two nurses or
    caregivers to safely lift patient from floor
    using equipment

80
Case Study 6Patient Ambulation and Fall
Recovery The Safer Way (continued)
  • Perform the Task Safely
  • Improve coupling or handhold by using gait belt
    with handles (less grip force required)
  • Control fall correctly using gait belt as aid
    (but not to lift patient)
  • Maintain good posture while controlling the fall
    and supporting patient in floor lift sling
  • Use of portable powered floor lift reduces injury
    risk for caregiver and patient
About PowerShow.com