Patient Care Ergonomics Training for Healthcare Workers

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					    Patient Care
Ergonomics Training
   for Healthcare
      Workers

 OSHA Nursing
Home Guidelines
    OSHA Nursing Home
       Guidelines

 OSHA also saw the need to address
     this serious problem in the
       Healthcare Industry….

 OSHA Targeted Several Industries –
Nursing Home Industry – 1st Targeted
           March 13, 2003
  Why has OSHA targeted
    Nursing Homes?


OSHA recognized that direct
 care staff in nursing homes
 experience high numbers of
       back and other
  musculoskeletal injuries
         every year.
    Why has OSHA targeted
      Nursing Homes?

  OSHA targets Patient
 handling as the greatest
 risk factor contributing
    to the majority of
injuries, lost & restricted
 workdays, and worker‟s
  comp costs in Nursing
           Homes
    Why has OSHA targeted
      Nursing Homes?

According to OSHA…
 • The nursing home industry injury
   incident rate is 13.9 injuries and
   illnesses per 100 full-time workers.
 • This is more than double the incident
   rate of 6.1 of industry as a whole.

  (US Department of Labor, Occupational Safety & Health
  Administration. Hospital eTool-HealthCare wide hazards module:
  Ergonomics. Retrieved 6/12/02 from
  http://www.osha.gov/SLTC/hospital_etool/hazards/ergo/ergo.html)
        Why has OSHA targeted
          Nursing Homes?
OSHA summarized these findings:
   Nursing Home workers suffer most
    injuries (51.2 %) when handling Patients.
   58% of their injuries are strains and
    sprains.
   While back injuries account for 27% of all
    injuries in the private sector, in nursing
    homes they account for 42% of all injuries.
    (OSHA. (n.d.) Worker safety and health in the nursing home industry.
    Retrieved 6/10/02 from
    http://www.osha.gov/NewInit/NurseHome/factsht.html)
  OSHA Guidelines for
    Nursing Homes:
  Ergonomics for the
     Prevention of
Musculoskeletal Disorders


Reducing Staff Injury
   and Improving
   Patient Safety
Strategies to Reduce Ergonomic
   Injuries in ALL Industries

OSHA Outreach & Assistance
 • Consultation Services
 • Compliance Assistance Specialists
 • Regional Office (Atlanta)
 • OSHA Training Institute (OTI)
 • Educational Resource Centers
 • www.osha.gov
Strategies to Reduce Ergonomic
     Injuries in Industries

 Enforcement
  • General Duty Clause
 Ergonomic Guidelines
  • Act as „Guidelines‟
  • Offer Best Practices & Sources
    of Information
    OSHA Guidelines for
      Nursing Homes
Primary Goal…

“Providing an alternative to manual
  Patient lifting is the primary goal
   of the ergonomic process in the
  nursing home setting and of these
              Guidelines.”
  OSHA Guidelines for
    Nursing Homes


 “OSHA recommends that
manual lifting of Patients
be minimized in ALL cases
   and eliminated when
        feasible.”
          Recommendations
            for Employers

• Develop Process for Protecting
  Workers *
• Identify Problems/Implement
  solutions for Patient lifting and
  repositioning *
• Identify Problems/Implement
  solutions for activities other than
  Patient lifting and repositioning *
• Training *        (* included in this Training)
   1. Develop Process for
 Protecting Workers that…

• Provides Management Support
• Involves Employees
• Identifies Problems
• Implements Solutions
• Addresses Reports of Injuries
• Provides Training
• Evaluates Ergonomic Efforts
  2. Identify Problems/Implement
  Solutions for Patient Lifting and
            Repositioning

• Analyze needs and abilities of
  Patients *
• Use established protocols to
  determine appropriate handling &
  movement methods specific for
  each Patient *
• Integrate Patient handling
  solutions & equipment into
  Nursing Home *
     3. Identify Problems & Implement
       Solutions for „Other‟ Activities


   Making beds              Lifting & carrying
   Feeding Patients          when receiving &
   Lifting food trays        stocking supplies
   Collecting wastes        Bending & manually
                              cranking bed
   Pushing heavy carts
                             Removing laundry
   Bending to remove         from washer/dryer
    items from a deep
    cart                     More…
      3. Identify Problems & Implement
        Solutions for „Other‟ Activities


    To determine if problems exist with
    these „Other‟ activities…
   Consider employee          Consider these
    exposure to:                aspects of the 3
     • Forceful exertions       types of Exposures:
     • Repetitive                • Duration
       activities                • Frequency
     • Awkward postures          • Magnitude of
                                   exposure
          4. Training

Train
• Nursing Assistants and Other
  Workers at Risk of Injury
• Charge Nurses & Supervisors
• Designated Program Managers
OSHA Ergonomic
 Guidelines for
 Nursing Homes

      Training
  Recommendations
            for
Nursing Assistants and Other
 Workers at Risk of Injury
OSHA Ergonomic Guidelines
   for Nursing Homes

Training for Nursing Assistants and
  Other Workers at Risk of Injury
 • NH Policies & Procedures to follow to
   avoid injury, including proper work
   practices & use of equipment
 • NH Procedures for reporting work-
   related injuries & illnesses as required
   by OSHA
   OSHA Ergonomic Guidelines
      for Nursing Homes

Training for Nursing Assistants and
  Other Workers at Risk of Injury
 • How to recognize Musculoskeletal
   Disorders (MSDs) and their early
   detection
 • Advantages of addressing early
   indications of MSDs before serious
   injury develops
         What are MSD‟s?

   Injuries and           Some common
    illnesses               MSD‟s are:
    affecting                De Quervain‟s
                              disease
    muscles, nerves,
                             Epicondylitis
    tendons,
                             Rotator Cuff
    ligaments, joints         Syndrome
    or spine                 Sciatica
                             Carpal Tunnel
                              Syndrome
Causes of Workplace MDS‟s

   Exposure to:
    Repetition
    Forceful Exertions
    Awkward Postures
    Contact Stress
    Vibration
Musculoskeletal Disorders

   Lifting and moving Patients can
    also lead to MSDs
    MSDs can happen two ways:
    • Develop gradually and get worse
      over time (cumulative trauma)
    • Result from a single event
      (lifting a very heavy Patient)
Musculoskeletal Disorders

   How do you know if you‟re
    developing a MSD?
    • Pain that won‟t go away
    • Joints won‟t move easily
    • Swelling
Signs & Symptoms of MSDs

   Decreased gripping strength
   Decreased range of motion
   Loss of muscle function
   Inability to complete daily tasks
   Pain in wrists, shoulders,
    forearms, knees
   Fingers/toes turning white
Signs & Symptoms of MSDs

   Back or neck           Shooting or
    pain                    stabbing pain in
   Stiffness               arms or legs
   Painful joints         Swelling or
   Pain, tingling or       inflammation
    numbness in            Burning
    hands or legs           sensation
Musculoskeletal Disorders

   To prevent serious injury…
    • If you think you may be
      developing a MSD, take care
      of it NOW!
    • Use lifting equipment to
      reduce or eliminate the need
      for lifting Patients and
      possibly hurting yourself!
      Consequences of not
       reporting promptly

   If you have signs & symptoms
    that are not reported early,
    permanent disability may result.
   Employers are required to
    respond promptly to those
    reports.
OSHA Ergonomic
 Guidelines for
 Nursing Homes

     Training
 Recommendations
           for
Charge Nurses & Supervisors
      Training for Charge
     Nurses & Supervisors
   Reinforce safety program at
    facility
   Oversee reporting guidelines &
    implement ergonomic
    recommendations
   Ensure proper staff work
    practices
   Responses to injury reports
OSHA Ergonomic
 Guidelines for
 Nursing Homes

      Training
  Recommendations
           for
Designated Program Managers
    Training for Designated
      Program Managers
   Problem identification via
    checklists, injury data analysis
   Selection of proper equipment &
    work practices
   Assist workers implement
    solutions
   Evaluate effectiveness of
    ergonomics
       You Have Help!

• This Training Program
• VA Patient Care Resource Guide:
  Safe Patient Handling & Movement
• VA Technology Resource Guide
• www.patientsafetycenter.com
       You Have Help!

• OSHA Ergonomic Guidelines for
  Nursing Homes
 www.osha.gov/ergonomics/guidelines/nur
 singhome/index.html
• OSHA website www.osha.gov
• OSHA Compliance Assistance
  Specialists in OSHA area offices
       You Have Help!

• OSHA Regional Office in Atlanta, GA
• OSHA Training Institute (OTI)
  Educational Resource Center
• Cal/OSHA “A Back Injury Prevention
  Guide for Health Care Providers”
 (www.dir.ca.gov/dosh/dosh_publications/
 backinj.pdf)