Ergonomic Safety. Take care of yourself, so you can care for others

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1 Ergonomic Safety Take care of yourself, so you can care for others

2 What is Ergonomics? an applied science concerned with designing and arranging things people use so that the people and things interact most efficiently and safely--- called also biotechnology, human engineering, human factors (Mirriam-Webster, 2011)

3 Risk factors for injury o Force- the amount of physical exertion required to perform a task o Repetition- performing the same motion, or series of motions, frequently or continuously o Awkward positions- positions that put unnecessary stress on parts of the body (Occupational Safety & Health Administrations [OSHA], 2009)

4 Most common causes of injuries for nurses o Overexertion o Cumulative trauma disorder o Poor posture o Improper technique o Over weight o Out of shape o Advanced age (Premier, 2011)

5 Muscloskeletal Disorders (MSD) MSDs are the most common type of injury sustained by nurses and ancillary staff and include: o Low back pain o Sciatica o Rotator cuff injuries o Epicondylitis o Carpal Tunnel Syndrome (OSHA, 2009)

6 Incidence of MSD o In 2009; nurses aides, orderlies, and attendants ranked #1 in the U.S. for these types of injuries o Registered Nurses ranked 6th o In 2009; over 46,000 reports of injuries were made o More then 1/3 of back injuries were a direct result of patient handling (American Nurses Association [ANA], 2011)

7 Cost of MSD in Healthcare o In 2008, the estimated cost was $7.4 billion in direct and indirect costs for worker compensation claims, medical bills, and staff replacements. o Injured Nurses make up 1/4 of all claims o Injured Nurses make up 1/3 of total compensation costs (ANA, 2011)

8 High risk activities o Repositioning in bed o Lateral transfers o Bed to chair o Floor to bed o Reaching o Patient transport o Performing tasks alone o Bathing (Nelson & Baptiste, 2004)

9 Types of Assist Devices o Draw sheets o Slide boards o Gait belts o Shower-toilet chairs o Hoyer lifts o Slippery sheet with handles o Stand assist devices o Adjustable height beds/gurnies (OSHA, 1997)

10 Barriers to assist devices o Patient aversion o Time constraints o Unstable equipment o Poor maintenance of equipment/cleaning o Weight limitations o Inadequate space/storage o Lack of training (Nelson & Baptiste, 2004)

11 Techniques for manual patient handling If you must manually move a patient: o Adjust height of bed to waist height o Assure bed/gurney is locked o Do not twist, pivot your whole body o Bend your legs, not your back o Neutral spine o Know your own limitations o Get help (OSHA, 1997)

12 Manual patient handling o Most techniques are not evidenced based o Can be harmful to nurse and patient o Training in body mechanics and body mechanics have been shown to be ineffective at reducing injury rates (Nelson & Baptiste, 2004)

13 Important body mechanics o Keep feet flat on the floor o Wear slip resistant shoes o Lower your body to get close to an object o Bend from hips and knees, not back o Get help if the person or object is too heavy o Do not reach above head, use a stool or ladder for high objects (Nursing fundamentals, 2007)

14 Alternative solutions o Lift teams o Peer leaders with ergonomic specific training that work as educators/coaches o Assessment tools for utilizing proper equipment o Implementing algorithms based on the assessment o Education and training on equipment o No-lift policies (Nelson & Baptiste, 2004)

15 No-lift policies o An administrative control o Assist devices must be used when indicated o Does not mean nurses will never move/assist a patient o Patients should be encouraged to assist in their own transfers and repositioning o Manual lifting may only be continued if it does not involve lifting most or all of a patients weight. (Nelson & Baptiste, 2004)

16 Important Considerations o Manual lifting of patients should be minimized or eliminated o Ask for help o Training and evaluation for competence o Make suggestions to management for areas of improvement o Evaluate/inspect equipment prior to use o ALWAYS report injuries (OSHA, 2009)

17 References American Nurses Association. (2011). Background on safe patient handling. Retrieved from: Background/Background.aspx Nelson, A. & Baptiste, A. S. (2004). Evidenced based practices for safe patient handling and movement. The Online Journal of Nursing, 9(3). Retrieved from: e/anaperiodicals/ojin/tableofcontents/volume92004/no3 Sept04/EvidenceBasedPractices.aspx Nursing fundamentals. (2007). Body mechanics. Retrieved from: mentals_1/lesson_4_section_1.htm Mirriam-Webster (2011). Ergonomics. Retrieved from:

18 References Continued Occupational Safety & Health Administration. (1997). A back injury prevention guide for healthcare workers. Retrieved from: f Occupational Safety & Health Administration. (2009). Guidelines for nursing homes: ergonomics for the prevention of musculoskeletal disorders. Retrieved from: e/final_nh_guidelines.html Premier. (2011). Back injury prevention. Retrieved from:

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