Getting to grips with hoisting people

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1 Healh and Safey Execuive Geing o grips wih hoising people HSE informaion shee A shor guide This informaion shee explains he problems associaed wih hoising people and ses ou guidance o deal wih hem. I covers fixed, mobile and overhead hoiss. The advice is inended for healh and social care providers or oher organisaions who move and handle people and will help hem o comply wih heir legal duies. Wha are he issues? The use of hoiss has become an inegral par of delivering healh and social care services. Alhough he use of hoiss can reduce musculoskeleal risks, you should consider he oher risks associaed wih hoising people. Each year a significan number of incidens are repored in which people have been injured while being moved using hoising equipmen. Beween April 2001 and December 2007 here were 163 hoising accidens repored o he Healh and Safey Execuive under he Reporing of Injuries, Diseases and Dangerous Occurrences Regulaions (RIDDOR). An average of 120 incidens per year are repored o he Medicines and Healhcare producs Regulaory Agency (MHRA). The degree of injury varies, depending on he vulnerabiliy of he hoised person, he naure and consequences of he fall and wha he falling person makes conac wih. Falls during hoising have resuled in severe injuries, from broken bones hrough o faaliies. Wha can go wrong? People can fall during hoising for a variey of reasons. Problems include: Selecion of he wrong size sling resuling in discomfor if he sling is oo small and a risk of he person slipping hrough he sling if i is oo large.* Selecion of he wrong ype of hois or sling for he individual, or for he specific ask resuling in inadequae suppor and increased risk of falling Healh Services Informaion Shee No 3 from he sling. For example, access/oileing slings give a grea degree of access bu very lile suppor and heir use should herefore be resriced o oileing purposes, where appropriae.* Incompaibiliy of he hois and sling resuling in insecure aachmen beween he wo. For example, incorrecly aaching a loop on a sling o a spreader bar designed for a clip aachmen, or aaching a clip on a sling o a spreader bar designed o ake a loop aachmen. Follow he manufacurer s advice and refer any concerns abou sling/hois design, supply, manufacurer s insrucions or compaibiliy claims o he MHRA, he regulaor for medical devices ( Failure of equipmen due o poor mainenance, lack of inspecion, inappropriae laundering processes or as a resul of inadequae repair or modificaion. Leaving a vulnerable person unaended in a hois, or in a posiion where hey migh be a risk of falling from he bed or chair. Hois overurning when manoeuvring over difficul surfaces, ransporing an individual over a long disance on a hois, or no following manufacurer s insrucions for use or safe sysems of work. No using he safey harness/aachmen (if he sling specified for he individual has one). * Noe: Sling sizes and coding varies beween manufacurers. There is a risk of using an inappropriaely sized sling if you make assumpions wihou checking he suiabiliy of a specific sling for he individual. For example, wo large slings from differen manufacurers may be differen sizes he body of he sling may be a differen lengh or he number of loop aachmens may differ, resuling in a differen lifing posiion. Addiionally, sling designs can aler over ime, so a new sling from a manufacurer may differ in size or aachmen srap lengh from one previously purchased. Some slings come wih a range of differen lengh loops for aachmen o he hois. These can be used o increase he comfor of he individual or pu hem in a more reclined or uprigh posiion. However, you should ake grea care o choose he correc loops for he individual so ha hey are no a risk of slipping from he sling, and o use he same loop configuraion on boh sides o reduce he risk of he person falling from he sling sideways. 1 of 8 pages

2 Healh and Safey Execuive Insabiliy when moving someone on a mobile hois resuling in hem sriking objecs. This is likely o cause injury, especially o hose wih vulnerable skin, and will increase he risk of a fall or overurn. In many cases, assessmen will show ha wo handlers are required: one o operae he hois; he oher o help seady hings and, where needed, suppor he person s lower legs o keep hem in a safe posiion when moving from one place o anoher. Imporanly, hey can also provide direc reassurance o he person being hoised o mainain heir co-operaion and reduce he likelihood of hem conribuing o unsable movemen. Case example: Mrs W had been residen in a nursing home for wo years. She was unable o weigh bear or move independenly. While being hoised from a bah by a new care assisan who had no received raining, and had no used ha paricular ype of hois and sling before, Mrs W slipped from he sling and fracured her shoulder. She died as a resul of a subsequen pneumonia infecion. The hois and sling used required acive paricipaion of he residen and was no suiable for Mrs W, or for hoising from a bah. Risk assessmens and procedures for manual handling and bahing had, in general, no been brough o he aenion of care assisans and supervision was inadequae. The company was prosecued and fined Wha should I do? The person Consider wheher a hois is he mos suiable handling aid and, if so, devise a handling plan o mach he individual s abiliy and mee heir needs and hose of he workers involved. I should specify he appropriae hoiss and slings for he individual and he ype of ransfers required. I should also ake ino accoun he views and preferences of he individual being hoised. If in any doub, seek compeen advice. The handling plan should cover he range of aciviies where a person may require assisance wih moving and handling, eg ransfers bed o chair, ino bah ec. The plan should be easy o read and clearly sae he conrol measures for moving and handling he individual, including: specific equipmen needed; echniques o be used; number of handlers required; sling aachmen loops o be used; and, where applicable leg configuraions ec. Examples of a paien moving and handling assessmen form and safer handling plan can be found in he All Wales NHS Manual Handling Training Passpor and Informaion Scheme: hp:// handling_passpor.pdf The equipmen Lifing equipmen is subjec o addiional requiremens, including a horough examinaion by a compeen person. Hoiss and slings are medical devices and he equipmen manufacurer is required o provide suiable insrucions for use, including compaibiliy informaion and guidance on he checks you should carry ou before each use. The saff Share he handling plan wih all hose involved o ensure ha workers know how o handle each individual. They may also be able o conribue o he developmen of he handling plan o ensure he chosen opions are workable. Make sure ha saff are rained in he specific equipmen and echniques so ha hey have he skills and compeence o carry ou he handling plan and undersand he risks and measures o conrol hem. The Managemen of Healh and Safey a Work Regulaions 1999 require employers o have access o compeen persons who can assis hem in he measures needed o comply wih healh and safey requiremens. Employees have duies oo; hey should: follow appropriae sysems of work, as idenified for individuals in heir handling plan, and use he equipmen provided; co-operae wih heir employer and le hem know of any problems; and ake care o ensure ha heir aciviies do no pu ohers a risk. The lif Before hoising, underake an assessmen of he risks, aking accoun of he individual s handling plan, and pu in place acions o reduce he risk of injury. Lifing operaions should be properly planned and carried ou in a safe manner in accordance wih he Lifing Operaions and Lifing Equipmen Regulaions 1998 (LOLER). The Workplace, Healh, Safey and Welfare Regulaions 1992 require hose in conrol of workplaces o make sure ha floors and raffic roues are mainained in good condiion and free from obsrucions, and ha here is suiable lighing and venilaion in he workplace 2 of 8 pages

3 Healh and Safey Execuive Mainenance Ensure here are adequae sysems in place for mainenance and inspecion of hoiss and slings in line wih he manufacurer s insrucions, he Provision and Use of Work Equipmen Regulaions 1998 (PUWER) and LOLER. The MHRA device bullein on managing medical devices, DB2006(05), gives some guidance on his opic. LOLER: Where lifing equipmen, including hoiss and slings, is used by people a work he Lifing Operaions and Lifing Equipmen Regulaions apply. In addiion o rouine mainenance and servicing, LOLER requires lifing equipmen o be inspeced and horoughly examined. Thorough examinaion by a compeen person is required eiher a sixmonhly inervals or in accordance wih a wrien scheme of examinaion drawn up by a compeen person. A compeen person is someone wih he relevan echnical knowledge and pracical experience of lifing equipmen o enable hem o deec defecs or weaknesses and o assess heir imporance in relaion o he safey and coninued use of he specific equipmen being examined. Monioring Check ha handling plans are being followed, and revise and updae if he needs of he individual or oher facors affecing he plan change. Training Employers need o make sure ha saff receive adequae raining and informaion on people moving and handling. Pracical raining has an imporan role o play in ensuring ha saff have he skills and confidence o hois people safely. In addiion o pracising equipmen selecion and use, saff need o undersand he principles of hoising, he poenial risks, how o use he specific equipmen hey have in heir workplace and how o implemen individual handling plans. I is imporan ha supervisors also receive raining so ha hey are able o monior, idenify and correc poor pracice. There is no firm rule abou how ofen raining should be given. However, skills will ineviably deeriorae over ime. Provide updae or refresher raining periodically, or when compeency assessmen idenifies he need for furher raining. You will also need o provide raining when new lifing aids are inroduced, or here are changes o he mehod of work. Case example: An immobile, 90-year-old paien, Mrs B, suffering from demenia, had been on a rehabiliaion uni for some ime following a fall. She was assessed by a nurse as needing a smallsized full-body sling for all ransfers in hospial. No oher paiens on he ward a ha ime required he small sling and he sling was usually found in her wardrobe. The sling had no been deailed on her moving and handling risk assessmen or care plan, which simply saed hois for all ransfers plus wo people. When wo saff, who had no been on duy for some weeks, were geing he dependen paiens up and washed, hey found he small sling in Mrs B s room. Mrs B proesed ha i wasn he righ sling and ha he sling had hur her. So, insead, hey used he large full-body sling, which was draped over he hois, o lif her from he bed o a commode. During hoising, Mrs B slipped down hrough he access aperure in he sling and rapidly fell, sriking her head. Mrs B died and he hospial was subsequenly prosecued and fined plus coss for failing o ensure her safey because he correc sling size had no been communicaed o saff, nor did hey know how o correcly size and selec a sling for his individual. The annexes o his guidance provide safey checks and oher measures for employers and hose hoising people o consider o help hem ensure safe handling. Figure 1 provides a checklis for using a mobile hois in he form of a useful flowchar. 3 of 8 pages

4 Healh and Safey Execuive Annex 1 Checklis o help wih hoising The following checklis, compiled by a group of manual handling professionals, represens safe handling pracice and will remind hose hoising people of poins o consider o reduce he risk. The lis does no aim o cover every individual circumsance and assumes ha he handler has received relevan and curren raining in he ransfers and equipmen used. Checklis All hoising asks Read he handling plan and ensure i is curren and relevan. Review he person s condiion prior o each ransfer o ensure coninued suiabiliy for hoising and he use of he equipmen. Ensure he person s weigh does no exceed he SWL of boh he hois and sling. Do no use he hois/sling unless you have had he necessary raining. Check he correc hois and sling specified in he handling plan are available and servicing and horough examinaion are in dae. Ensure he equipmen works and is free from observable defecs before saring. Hoiss and slings mus no be adaped or misused. Before each use, check he hois and sling in accordance wih he equipmen manufacurer s guidance on inspecions and pre-use checks. Familiarise yourself wih he hois s emergency lowering sysems. Check here is a sufficien number of handlers o carry ou he ask safely in accordance wih he handling plan. Ensure he environmen is free from obsacles and he floor free of slip and rip risks. Ensure he suppor surface is ready and safe o receive he person. When manoeuvring he hois ino posiion o connec o he sling, bring he spreader bar/carry bar down slowly, holding where necessary, o avoid conac injuries wih he individual. If here are any concerns abou he equipmen, ask, person, environmen ec, handlers mus follow organisaional procedures immediaely. Communicae wih everyone involved in he ask a all imes. Ensure safey and comfor of he person a all imes. Reassure he person a all imes and involve hem as much as possible. Prior o raising, check he sling is posiioned correcly and double check he sling aachmens. Hois he person jus above he surface from which hey are being lifed o obain sufficien clearance. Check aachmens remain secure and he person is comforable before proceeding furher. If here are any problems, lower he person ino a safe posiion and seek furher advice. Follow manufacurer s insrucions and local policies and procedures wih regard o care and cleaning of he hois. Place baery-powered hoiss on charge, as idenified in he insrucions, when no in use or ensure back-up baery is charged. Do no leave he person unaended in a hois. Addiional guidance for mobile hoiss Avoid using he hois o ranspor over disances, hresholds or differen surfaces unless oherwise saed in he handling plan. Do no apply brakes during hoising wih mobile hoiss (unless oherwise saed by he manufacurer and handling plan). Noe: This does no apply o cerain ypes of equipmen where he brakes need o be applied, for example sandaids. Ensure hois legs are in he mos sable posiion. Sore he hois in a safe place wih boom/jib in lowes posiion and wih brakes on when no in use. Addiional guidance for ceiling rack/overhead hoising sysems The moor should be direcly overhead, and make sure he lifing ape is verical o he lif o avoid wear and ear and/or malfuncion. Elevae he spreader bar o is highes possible posiion when no in use. Reurn he hois o is docking saion, where appropriae, for charging when no in use. Ensure he racking and pahway is clear of obsrucions. Be familiar wih how freely he moor moves on he racking. If using a porable lifing pod/moor, develop, implemen and follow guidance for a safe way of ransporing and aaching. Do no drag he pod/moor using he lifing ape as i may cause damage o he hois. Addiional guidance for sanding hoiss The person mus be able o consisenly and reliably bear weigh hrough heir legs and have sufficien upper body muscle srengh/siing balance. The person mus be able o co-operae and physically paricipae in he hoising process. Some sanding hoiss need using wih care if he person has knee problems, sensiiviy or vulnerable skin on heir legs. 4 of 8 pages

5 Healh and Safey Execuive Addiional guidance for slings Ensure he sling is compaible wih he hois. Double check he loops/clips are aached o he spreader bar hroughou he hoising procedure. Use he correc loop/clip configuraions as idenified in he handling plan. Ensure he sling and aachmens are no caugh/ suck on any equipmen when saring he lif. Addiional guidance for bah hoiss Make sure saff are fully rained on he specific bah hois and wih he equipmen in he bahrooms. For example, heigh-adjusable bahs ec. Ensure he environmen is safe. For example, floors no slippery/we, sufficien space. Using bah oils, bubble bah, loion, alc ec may make he surfaces slippery and affec he use of he equipmen. Check he emperaure of he waer. Ensure correc fiing of lap srap (also known as safey bel/sea bel/safey harness) unless oherwise risk assessed. Mobile and ceiling rack hoiss may also be used for bahing see mobile and ceiling rack hois guidance. 5 of 8 pages

6 Healh and Safey Execuive Annex 2 Equipmen safey checks prior o each use Is he equipmen as specified in he handling plan? Do he hois and sling have a CE mark on hem? Is he person s weigh below he SWL of boh he hois and sling? Are hoiss and slings wihin LOLER horough examinaion daes? Has he hois been serviced in accordance wih manufacurer s insrucions? Has here been any change in he individual s circumsances since he handling plan was devised? Has a visual check of he equipmen been carried ou prior o using i? Is he environmen ready? Is here sufficien space o use he hois safely? Environmen Ensure: he environmen is prepared for he ask; here is sufficien space and access around and under furniure o use he hois safely; he floor is clear of obsacles, eg railing cables; and here is a suiable and safe area o sore and charge (if applicable) he hois. If you idenify a faul wih eiher he hois or sling wihdraw from use immediaely and follow he organisaion s reporing procedures. These guidelines have been developed in conjuncion wih Naional Back Exchange (Yorkshire branch). Hoiss mobile (elecric and hydraulic), ceiling rack sysems, sand aid, bah Ensure: he hois is fully charged, he baery and any leads are fied correcly; here are no obvious signs of damage or fluid leaks from he hois; he raise/lower mechanism works and he emergency sop buon is se correcly; he lifing ape is inac and no frayed (applies o ceiling rack, cerain mobile hoiss); he casors move freely, ie free from carpe fibres/ fluff ec (mobile and sanding hoiss); and he base adjusmen/hois legs move freely (mobile and sanding hoiss). Slings Ensure: he sling is he correc size and ype for he clien and is fi for purpose; sling and hois are compaible; all labels are legible and show he SWL and unique idenifier and size; here are no signs of fraying, ears or deerioraion ec; all siching is presen and inac; he velcro (if applicable) is clean and free of fibres/ fluff ec; he buckle (if applicable) has no signs of damage ec; he loops/clips have no obvious signs of damage, fraying ec; and i has been cleaned. 6 of 8 pages

7 Healh and Safey Execuive START THE TASK n Had up-o-dae moving and handling raining, including hois raining? n Feel confiden o use hois? n Curren and relevan person-specific handling plan for using hois? DO T USE Check wih supervisor n Person s condiion/abiliy same as when hey were assessed for his equipmen? n Do you have consen? n Number of handlers available as per handling plan? n Familiar wih his specific hois & sling? BEFORE THE TASK ENVIRONMENT Area safe for hoising, ie n sufficien space? n clear of obsacles? n access around/under furniure? n clean/dry? HOIST n Familiar wih emergency sop and lowering sysems? SLING n Sling compaible for use wih his hois? n Sling is one idenified in handling plan and is sill appropriae (ie righ size and ype, cross reference wih care plan)? Visual check made of sling, ie n clean and undamaged? n label legible SWL clearly displayed? n unique idenifier? n LOLER examinaion/service up o dae (6 monhly)? Visual check made of hois, ie n baery charged? n LOLER examinaion/service up o dae (6 monhly)? n no obvious signs of damage? n hois moves freely on casors backwards and forwards? n base adjusmen and lifing/lowering mechanisms move freely? n emergency buon se in correc posiion? n SWL clearly displayed and no exceeded? n Hois brakes OFF (unless oherwise specified in manufacurer s insrucions)? n Sling loops/clips aached securely and correcly o hois? n Unlock hois brakes (unless oherwise assessed) n Re-aach and re-check DURING TASK n Sling safey harness/bel secured if here is one? n Person looks safe and comforable? n Sling smooh under person? n Sling leg configuraion correc? n Person s legs safe disance from mas? n Hois wih hois legs widened (unless handling plan saes oherwise) unil sraps igh n Recheck person is safe, comforable and correcly posiioned n Sar full hois n Fi as per handling plan n Re-fi sling n Turn spreader bar, giving person more leg room n Person s posiion correc? n Are hey comforable? n Hois again, hen reposiion AFTER TASK n Deach sling from hois n Remove sling (if applicable) ensuring person lef in safe posiion n Hois & sling suiable for nex use, ie clean, undamaged? n Sore hois in suiable, safe place n Recharge hois (if applicable) n Clean hois and/or repor damage and/or launder sling following organisaional procedures Figure 1 Checklis using a mobile hois 7 of 8 pages

8 Healh and Safey Execuive Furher reading The Guide o he Handling of People a sysems approach (Sixh ediion) BackCare 2011 ISBN Back in work Back pack 22 June Pages/Backinwork-backpack.aspx Managing medical devices DB2006(05) Medicines and Healhcare producs Regulaory Agency 6 November 2006 Furher informaion For informaion abou healh and safey, or o repor inconsisencies or inaccuracies in his guidance, visi You can view HSE guidance online and order priced publicaions from he websie. HSE priced publicaions are also available from bookshops. This guidance is issued by he Healh and Safey Execuive. Following he guidance is no compulsory, unless specifically saed, and you are free o ake oher acion. Bu if you do follow he guidance you will normally be doing enough o comply wih he law. Healh and safey inspecors seek o secure compliance wih he law and may refer o his guidance. This documen is available a hsis3.pdf. Crown copyrigh If you wish o reuse his informaion visi for deails. Firs published 06/11. Amended 12/11. Published by he Healh and Safey Execuive HSIS3 09/12 8 of 8 pages

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