Safe Patient Handling In Health Care: Applied Ergonomics .
Oregon Nurses Association,Bay Area HospitalandThe University of Oregon Labor Education and Research CenterPresentSafe Patient Handling in Health Care:Applied Ergonomics for Nurses andHealth Care WorkersAndPatient OrientationA Guide for Instructors
Safe Patient Handling in Health CareThis material has been made possible by a grant from Oregon Occupational Safety and HealthDivision, Department of Consumer and Business Services.Brand names mentioned or seen in the training materials do not constitute endorsement of thedevice, equipment or product by the Oregon Occupational Safety and Health Division, OregonNurses Association, Bay Area Hospital, the University of Oregon Labor Education andResearch Center or other organizations that support this grant.The information in this booklet is intended to provide general guidance. There may beinstances in which workplace issues are more complex than those presented here. You mayneed the advice of a professional Ergonomist or other experts.The content is intended to provide current information about ergonomics and safety issuesrelated to patient handling and care tasks. The field of ergonomics is dynamic, and newinformation is constantly being developed.Instructional written materials were developed by Lynda Enos, RN, MS, COHN-S, CPE,Nursing Practice Specialist and Ergonomist, Oregon Nurses Association 2004.Supporting partners:Legacy Health SystemsMt. Hood Community College Allied HealthOregon Association of Hospitals and Health SystemsPeaceHealthSamaritan Health ServicesSAIF CorporationPrinted 2004
Safe Patient Handling in Health CareBackgroundNurses, nursing aides, orderlies and attendants suffer more work related musculoskeletal disorders(WRMSDs) that require time off work than any other occupation in the United States (United StatesDepartment of Labor [U.S. DOL], 2000). Back injuries, caused by repeated exposure to forcefulexertions (lifting or pushing) and awkward and prolonged postures associated with lifting andmoving patients manually, are the most common WRMSDs reported by nurses and health careworkers.According to Oregon Workers' Compensation Division data for 2002, over 1,500 health careprofessionals in Oregon received serious injuries on the job that year, 68 percent of those fromsprains, strains and muscle tears.Unfortunately nurses and health care workers are still manually moving and lifting patients using thesame methods that have been taught for over 30 years in the United States, that is, techniques thatare unsafe for both nurses and patients and have been ineffective to reduce the incidence of backinjuries in health care professionals.Ergonomics is about designing work environments and tasks and equipment to fit the physical andcognitive capabilities of workers with the goal of reducing injuries, such as strains and sprains andother WRMSDs, and the risk of mistakes or human errors.This program has been created to assist your organization to reduce WRMSDS associated withmanual patient handling and care tasks. Ergonomics principles that can be used at your facility toidentify and address hazards associated with manual patient handling and other patient care tasks aredemonstrated.Overall Program GoalsThe program is designed to facilitate the use of evidence-based musculoskeletal injury preventionstrategies by nurses and health care workers that: Increase acceptance and use of patient lift and transfer equipment available by nurses andother health care workers, to facilitate safe patient handling and movement. Provide nurses and health care workers with strategies to reduce their risk of WRMSDsthrough participation in the selection of patient handling and other equipment appropriate fortheir work setting and the use of best work practices. Enhance patient perception regarding comfort and security of patient handling equipment,thereby, facilitating patient cooperation to allow use of such equipment.i
Safe Patient Handling in Health CareBackground (continued)About the ProgramThe program is designed with flexibility in mind. Tailor this program to meet your organization’sspecific needs, for example, the materials provided can be used to develop or enhance an existingergonomics or safe-lift program at your facility.This training program is designed to be used as a supplement and in conjunction with the OregonOSHA A Back Injury Prevention Guide for Health Care Providers (provided on the enclosed CDROM) and “Ergonomics Awareness Training” courses available through Oregon OSHA. For moreinformation, go to www.orosha.org or call Oregon OSHA toll-free (888) 292-5247, Option 2.This program is not a substitute for specific training on the safe use of patient handlingequipment. Not all patient handling equipment available is shown in the training videos.The training program is divided into two sections:1. Applied Ergonomics for Nurses and Health Care WorkersMaterials Provided: Instructor guide Video PowerPoint Presentation Participant Handouts Attendance sheet Training quiz Course evaluation2. Patient OrientationMaterials Provided: Instructor guide Video Participant HandoutAll written training documents and other useful reference materials are available on theCD-ROM provided.ii
Safe Patient Handling in Health CareTable of ContentsApplied Ergonomics for Nurses and Health Care Workers Instructor Guide .1Course OverviewIntroduction.2Program Objectives.2Training Materials.3Training Organization .4Scheduling the Training .5Instructor Preparation.6Training Preparation .7After Training Is Completed .8Course Instructional Plan .9Part 1 - Instruction.10Part 2 - Case Studies .33Case Study 1 .35Case Study 2 .37Case Study 3 .39Case Study 4 .41Case Study 5 .43Case Study 6 .45Quiz & Review.47Patient Orientation Instructor Guide .48Course OverviewIntroduction.49Program Objectives.49Training Materials.50Training Organization .50Scheduling the Training .50Training Preparation .51Course Instructional Plan .52Training Presentation .52iii
Safe Patient Handling in Health CareTable of Contents (continued)Appendix: Applied Ergonomics for Nurses and Health Care WorkersAppendix IAppendix IIAppendix IIIAppendix IVAppendix VParticipant Handout: Applied Ergonomics for Nurses and Health CareWorkers Participant GuideAttendance SheetQuizClass EvaluationDefinitions of MSDSAppendix: Patient OrientationAppendix VIAppendix VIIParticipant Handout: A Guide to Equipment used to safely Move, Lift and/orReposition Patients or ResidentsReferences for all MaterialsContents of Safe Patient Handling in Health Care CD-ROM Safe Patient Handling in Health Care: A Guide for Instructors including all appendices. “Applied Ergonomics for Nurses and Health Care Workers” PowerPoint Presentation. A Back Injury Prevention Guide for Health Care Providers. Feletto M., Graze W. (1997).OR-OSHA Consultation Programs. OSHA Guidelines for Nursing Homes: Ergonomics for the Prevention of MusculoskeletalDisorders. (2003). Occupational Safety and Health Administration. Ergonomics Program Steps for Health Care Flow Chart. Enos, L. (2003). Patient Safety Center of Inquiry, Veterans Health Administration, and Department ofDefense Veterans Administration Hospital, Tampa, Florida, resource documents: -Patient Care Ergonomics Resource Guide: “Safe Patient Handling and Movement.2001, Part 1 & 2”-Algorithms for Patient Handling-Algorithms for BariatricsResource list for further information.iv
Safe Patient Handling in Health CareApplied Ergonomics for Nurses and Health Care WorkersSafe Patient Handling in Health Care:Applied Ergonomics for Nurses andHealth Care WorkersInstructor Guide1
Safe Patient Handling in Health Care:Applied Ergonomics for Nurses and Health Care WorkersCourse OverviewIntroductionThe Safe Patient Handling Program: Applied Ergonomics forNurses and Health Care Workers is a training program designedto help health care facilities and nursing educators teach nursesand other health care workers how to reduce their risk of back andother work related musculoskeletal disorders (WRMSDs).Participants will learn to identify and implement strategies toeliminate or reduce hazards associated with patient handling andmovement and other patient care tasks, using engineering, workpractice and administrative controls.It is recommended that this training session be conducted byoccupational health and safety personnel, ergonomists, educatorsor health care providers who are knowledgeable in the principlesof ergonomics and safe patient handling.Use the A Back Injury Prevention Guide for Health CareProviders, the OSHA Guidelines for Nursing Homes: Ergonomicsfor the Prevention of Musculoskeletal Disorders and otherreference documents provided in the enclosed CD-ROM foradditional guidance as needed when planning your trainingprogram.Program ObjectivesThe content of the training teaches employees to: Identify why there is no Safe Way to perform manualpatient handling tasks. Identify risk factors that contribute to WRMSDsassociated with manual patient handling tasks. Define strategies to eliminate or reduce hazards forWRMSDs, using engineering, work practice andadministrative controls.2
Safe Patient Handling in Health CareApplied Ergonomics for Nurses and Health Care WorkersCourse OverviewTraining MaterialsThe Safe Patient Handling Program: Applied Ergonomics forNurses and Health Care Workers includes the followingmaterials:1. Video“Applied Ergonomics for Nurses and Health Care Workers”Section 1 – Instruction. Allow 12 minutes to view thissection of the video.Section 2 – Practice Activity: Six Case Studies. Allow 18minutes to view all case studies plus additional time fordiscussion and/or group work.2. PowerPoint slides on CD-ROM that provides optionalsupporting materials for Sections 1 and 2 of the video.3. Facilitator guide that includes: A course overview (which you are reading now) Instructional plan An appendix that includes:- Participant handout (which includes a PracticeActivity worksheet)- Attendance sheet- Quiz- Class evaluation- Definitions of MSDsThe materials listed above are also available on theenclosed CD-ROM.Additional required materials: VCR Computer projector and laptop computer with PowerPointsoftware or an overhead projector and printed PowerPointoverheads Projector screen Flip chart and pens3
Safe Patient Handling in Health CareApplied Ergonomics for Nurses and Health Care WorkersCourse OverviewTraining OrganizationThe Safe Patient Handling Program: Applied Ergonomics forNurses and Health Care Workers is designed with built-inflexibility for you to adjust training timeframes to meet yourspecific needs.This training employs the following activities and instructionaltools: Section 1 of the instructional video Applied Ergonomics forNurses and Health Care Workers reviews common causes ofWRMSDs, such as back injuries associated with patienthandling and care tasks, and identifies ergonomics principlesused to eliminate or reduce the employee’s risk of injury. Asystematic 4-step process that employees can use to helpreduce their risk of injury is presented. Optional review and further exploration of WRMSDprevention strategies for nurses and health care workers, usingthe PowerPoint presentation. In Section 2 of the instructional video Applied Ergonomics forNurses and Health Care Workers, case studies providestructured activities that allow participants to practiceidentifying risk factors for WRMSDs and use the 4-stepprocess to define engineering and work practice solutions. Multiple choice quiz.4
Safe Patient Handling in Health CareApplied Ergonomics for Nurses and Health Care WorkersCourse OverviewScheduling the TrainingWhen scheduling the training session, groups of no more than 20employees are recommended. This promotes interaction betweenthe trainer and participants and facilitation of the structuredactivities.You might want to identify an employee(s) who would like toshare their experience with the group of an injury related topatient handling and the impact of the injury on their life.A testimonial from a respected co-worker can be extremelyeffective in convincing staff to improve their injury preventionbehaviors, such as using lift equipment and best work practices.Section 2 of the video provides six case studies or scenarios thatto allow participants to identify risk factors and hazards thatcontribute to WRMSDs and to determine a safer way to performeach patient handling and care task. Each study demonstrates anunsafe method of performing a patient handling task and thenshows the same task performed in a safer manner using goodwork practices and appropriate patient handling equipment.Case Studies Provided:Case Study 1:Repositioning Patient in BedCase Study 2:Transfer from Chair to BedCase Study 3:Transfer from Bed to StretcherCase Study 4:Transfer from Wheel Chair to BedCase Study 5:Making a Bed and RepositioningPatient in BedCase Study 6:Patient Ambulation and Fall RecoveryIf this material is used as is, this session could last one to one andone-half hours. Choose from the supplied materials what isappropriate for your participants. Incorporate items specific toyour organization and/or additional material related to certaintopics, such as access to and safe use of patient handlingequipment and best work practices.5
Safe Patient Handling in Health CareApplied Ergonomics for Nurses and Health Care WorkersCourse OverviewInstructor PreparationLearning Objectives:Upon completion of the Safe Patient Handling Program: AppliedErgonomics for Nurses and Health Care Workers programparticipants will be able to: Identify activities at work or away from work that could putyou at risk of musculoskeletal disorders (MSDs). Identify the primary risk factors that can contribute to thedevelopment of work related MSDs. Define why manual patient handling tasks are unsafe. Define health care ergonomics. Define engineering, work practice and administrativecontrols. Identify examples of work practice controls that can helpreduce your risk of injury when performing patient handlingand care tasks. Describe the four action steps that can reduce your risk ofinjury.Behavioral Objectives:Upon completion of the Safe Patient Handling Program: AppliedErgonomics for Nurses and Health Care Workers programparticipants will be able to demonstrate the following behaviors:Use the following four step process when performing patienthandling and transfer and other care tasks:1. Assess the patient to determine appropriate method of liftor transfer.2. Assess the environment and remove hazards.3. Get necessary equipment and help as required.4. Perform the task safely.6
Safe Patient Handling in Health CareApplied Ergonomics for Nurses and Health Care WorkersCourse OverviewTraining Preparation1. Identify the location of the room in which you will conductthe training. Ideally, the room will be quiet, well ventilated,and well lighted. Classroom style seating will allowparticipants to take notes and form discussion groups ifdesired.2. Schedule the session and send out notices to managers andsupervisors. Prepare employees for training by distributingflyers and posters and/or using e-mail distribution and Intranetpostings.Before you conduct the training session:3. Review all program materials thoroughly. Customize theprogram to meet your training goals and to includeinformation pertinent to your organization. Consider usingpictures or videos from your facility whenever appropriate.4. Make notes of example discussion questions and anticipatequestions participants are likely to ask.5. Determine how to best facilitate case studies activities in Part2 of the video.6. Practice presenting the program.7. Make enough copies of the Participant Handout (including thePractice Activity worksheet) as necessary and the session quizfor all those attending the session.8. Copy the quiz to your PowerPoint presentation or make anoverhead transparency to facilitate discussion of answers withthe group.9. Copy the attendance and evaluation sheets.10. Gather and prepare other materials specific to yourorganization that you need for the training and practice, suchas your facility’s safe lift policy and procedure, and patienthandling equipment instructional materials.7
Safe Patient Handling in Health CareApplied Ergonomics for Nurses and Health Care WorkersCourse OverviewTraining Preparation(continued)11. Prepare flip chart pages and/or use PowerPoint slides: Agenda Objectives An outline of your organization’s ergonomics and/orsafe patient handling and movement program Other pertinent information and/or discussion points12. Test computer and TV/VCR equipment.13. Cue up the video so it is at the starting point.14. Remember, wherever possible, it is important to allow theparticipants to actively participate in the session. This allowsparticipants to take an active role in learning, and increasesthe ability to recall what is learned.After Training IsComplet
other WRMSDs, and the risk of mistakes or human errors. This program has been created to assist your organization to reduce WRMSDS associated with manual patient handling and care tasks. Ergonomics principles that can be used at your facility to identify and address hazards associated with manual patient
Safe Patient Handling Point of Contact, Minneapolis VA Health Care System, Minneapolis, MN *Charlotte Lynch, MS, CNS, CSPHP, Safe Patient Handling Coordinator, Dayton VA Medical Center, Dayton, OH Marie Martin, Ph.D., Acting National Program Manager, Patient Care Ergonomics (10P3D) and Industrial Hygienist/Safe Patient Handling Facility .
experience with high-risk patient handling tasks, general patient mobility status for their unit and special patient needs. sAfe LIft component specific Action(s) sAfe LIft Audit Questions safe patient handling policies and practices are in place which address any gaps identified during the assessment process and include, at a minimum:
Safe Patient Handling Policy POLICY 1.1.3 Environment of Care Safe Patient Handling Program Issued: February 2013 Revised: July 2014 Page 4 of 7 d. Avoid high-risk patient handling tasks whenever possible. If unavoidable, assess the situation carefully and plan to minimize risks as best possible prior to initiating task. e.
Safe Patient Handling Program – Gap Analysis Checklist 2014 INSTRUCTIONS: This comprehensive Safe Patient Handling Program (SPH) program Gap Analysis . potential safety issue related to patient handling has been identified by staff Notes (timelines, responsibilities, etc.)
“Safe Patient Handling” refers to Safe Patient Handling and Mobility that is, the use of technology such as powered lifts and evidence based work practices and processes that are used to facilitate movement of a patient with the goal of reducing the risk of injury to both the healthcare employee and the patient.
Safe Work Bulletin #246 Safe Lifting Safe Patient Handling and Movement; The Illustrated Guide, Springer Publishing Co; 2009 Winnipeg Regional Health Authority. Safe Patient Handling and Movement Program. Winnipeg: Winnipeg Regional Health Authority, May, 2008. The Nursing Assistant’s Handbook by Jetta Lee Fuzy
AV2800 – SAFE PATIENT HANDLING Employees: Follow all safe patient handling policies, procedures, and/or guidelines related to this policy. Complete a point-of-care risk assessment/screen and pre-use inspection of equipment prior to carrying out any care activity.
been slow to adopt new patient-handling technologies and still rely on old-fashioned manual handling.”* *Nelson, A., Motacki, K., Menzel, N. (2009). The illustrated guide to safe patient handling and movement. New York, NY: Springer Publishing Company PPT-075-02 4 I
