CORE SKILLS FRAMEWORK MOVING AND HANDLING PRINCIPLES FOR STAFF: LESSON NOTES & TIPS FOR A SUGGESTED APPROACH These notes are designed to be used in conjunction with the Moving and Handling PowerPoint slides. The purpose of the session is to provide basic/induction level training in manual handling for all staff. The content of the slides relates to the general information that all employees should be presented with. How you choose to present this information is up to you you know your own training style and have better insight into what your audience wants and needs. It is anticipated that this core skill will be supported with a practical skill development session that will be separately assessed. This should include the following techniques: - Pushing and pulling Lifting and lowering load from the floor or low level Correct posture whilst sitting at an office desk Carrying a load Basic safety checks of equipment If you have the time, feel free to add exercises, games, video clips, etc. In keeping with the guidance offered in the Core Skills Framework, it is anticipated that this session should last for 45mins to 1hour. Moving and Handling Trainer Notes March 2014 Page 1 of 31
SLIDE 1: Introduction This is an opportunity for you to introduce yourself and explain how you intend to run the session. This will depend on your own training style, but you should consider: when and how you will take questions? E.G. Do you want these as you proceed through the presentation or at the end? what activities will you use? In addition to presentation, will you have exercises, activities, assessment, etc. what happens next? E.G. how will their attendance and any subsequent assessment be recorded? Please remember to update this slide to reflect local information. Moving and Handling Trainer Notes March 2014 Page 2 of 31
SLIDE 2: What you will learn in this session This effectively relates to the learning outcomes that have been defined as part of the core skills project. To make this more user-friendly, these are articulated as what participants will learn and have been mapped to the Core Skills Framework learning outcomes as indicated below: Moving and Handling Trainer Notes March 2014 Page 3 of 31
What participants will learn a. Accessing resources including legislation, local/national policies & guidelines b. An organisation s responsibilities for promoting a safe working environment including best moving & handling practices c. Your responsibilities for ensuring & promoting best moving & handling practices d. Recognising risk factors that may cause injury e. Correct posture for safe moving and handling practices UK Core Skills Training Framework Outcomes 4.Know where additional advice and information can be sought relating to Moving and Handling issues. 2.Understand employers and employees responsibilities under relevant national Health & Safety legislation including most recent versions of the Manual Handling Operations Regulations. 3.Understand their own responsibilities under local organisational policies for Moving and Handling 1.Be able to recognise manual handling risk factors and how injuries can occur. 5. Be able to use an ergonomic approach to manual handling and other work tasks leading to improved working posture f. Importance of good back care 6. Understand principles of good back care to promote general musculo-skeletal health. g. (see a, b,c,d,e,f.h,j,k) 7.Understand the principles of safer handling. h. How to carry out a risk assessment 8. Know the factors to be included in undertaking an on the spot risk assessment prior to undertaking a moving and handling activity. i. (see a,b & c) 9. Understand how the organisation uses its risk management processes to inform safe systems of work. j. How to control risk 10. Be able to choose suitable risk control strategies, resources and support available to facilitate good practice following a risk assessment appropriate to the staff member role k. Importance of good communication and a team approach Moving and Handling Trainer Notes March 2014 Page 4 of 31
SLIDE 3: Why is this so important?... This slide can be used to highlight the importance of the subject. The focus should be on work-related injuries in the health sector: moving and handling is a key part of the working day for most employees in health and social care services, moving and handling injuries account for 40% of work-related sickness absence. around 5000 moving and handling injuries are reported each year in health services back pain and musculoskeletal disorders, which can lead to inability to work It would be ideal to provide some true life examples from your experience based on the mix of attendees, and their roles within the organisation. The examples should consider both employer/employee and clinical service provider/client/patient situations. Moving and Handling Trainer Notes March 2014 Page 5 of 31
SLIDE 4: What the law says Clarify that there is a legal responsibility and a significant amount of legislation and guidance related to moving and handling aimed at protecting employers, employees and the public. The slide could be used to demonstrate that the law is there, not to make things difficult but to help, support and protect people in the work place and to assist employers/employees and organisations to understand their responsibilities. Health and Safety at Work Act etc. 1974 This Act places general duties on employers and others. Other regulations impose specific requirements including Manual Handling Operations Regulations 1992 (as amended 2002) Management of Health and Safety at Work Regulations 1999 Provision and Use of Work Equipment Regulations 1998 Lifting Operations and Lifting Equipment Regulations 1998. Moving and Handling Trainer Notes March 2014 Page 6 of 31
SLIDE 5: Your employer has a responsibility to Use this slide to highlight that employers have a responsibility towards their staff. As well as a general legal responsibility to ensure the health and safety at work of their staff, employers must also consider the prevention of accidents and work-related ill health such as musculoskeletal disorders. Employees should be consulted on health and safety matters as it is legal requirement and also it makes good sense. You may then wish to expand on employer responsibilities aimed at reducing manual handling injuries. NHS guidance states employers should: avoid the need for hazardous manual handling, as far as is reasonably practicable assess the risk of injury from any unavoidable hazardous manual handling reduce risks to the lowest level that is reasonably practicable ensure that assessments and action plans are written, and are available to all develop, implement and communicate a policy and local codes of practice relating to manual handling in the workplace employ a competent person such as a Manual Handling adviser monitor policy and codes of practice, and take action if they are not properly applied. Highlight how employers should do all they can to make working practices as safe as possible and how there should be an accessible a safer handling policy for the tailored to each organisations employee needs. Moving and Handling Trainer Notes March 2014 Page 7 of 31
SLIDE 6: Organisations: Actions required to promote a Safer Workplace This slide emphasises the actions that healthcare organisations should (and typically ensure) put in place to promote a safe workplace. Identify any additional actions that your organisation has put in place. Provide practical examples and highlight where policies and procedures can be accessed. It may be an idea to talk briefly about the role of the Moving and Handling coordinator. Moving and Handling Trainer Notes March 2014 Page 8 of 31
SLIDE 7: You have a responsibility to This slide relates to employee responsibility. You may wish to use examples that Would make this slide applicable to your organisation and specifically the mix of attendees. Enlarge on and provide relevant examples around the key employee principles and duties. NHS guidance states employee should: follow prescribed systems of work laid down for their safety be aware of and understand their organisation s manual handling policy make proper use of equipment provided for their safety not tamper with any safety equipment provided co-operate with their employer on health and safety matters inform their employer if they identify hazardous handling activities or any dangerous defects in equipment take care to ensure that their activities or their omissions do not put others at risk. Moving and Handling Trainer Notes March 2014 Page 9 of 31
SLIDE 8: Definition of Manual Handling Discuss with participants that people often think that manual handling training is just about lifting. This slide could be used to express how manual handling has a broad definition and includes, transporting or supporting of a load (including the lifting, putting down, pushing, pulling, carrying or moving thereof) by hand or bodily force and that musculo-skeletal injuries are a risk from any of these practices. Discuss moving and handling issues outside work. Provide practical examples. Moving and Handling Trainer Notes March 2014 Page 10 of 31
SLIDE 9: The spine and back Use this slide to emphasise that the back is particularly vulnerable to injury The spinal cord is a thick cord of nerve tissue which is enclosed by the spine.together with the brain it forms the central nervous system. The vertebrae are the bones which act as the building blocks of the spine. They can be damaged by impact injury as with any other bone. The intervertebral discs are kind of shock absorbers they are soft fibrous discs with a jelly like centre and are positioned between the vertebrae. They allow the spine to move by cushioning movements between the vertebrae. This is also an opportunity to begin to introduce the concept that back injuries at work can be prevented injury and good back care is essential for safe moving and handling. Moving and Handling Trainer Notes March 2014 Page 11 of 31
SLIDE 10: Most common Injuries This slide may be used to highlight the disorders and injuries that can occur because of poor manual handling. Explain to participants the meaning of the term Musculoskeletal disorders and that the term covers any injury, damage or disorder of the joints or other tissues in the upper/lower limbs or the back. You may also wish to introduce here common factors that can cause injury such as static posture, bending, manual handling on a regular basis particularly when it involves bending or twisting, lifting heavy loads and poor seating posture. Back injuries trapped nerves, disc injury, muscular strain Muscles and tendons repetitive strain injury Ligaments gristly straps which stretch between bones holding them together and mainly control the direction of motion and limit movement at the end of the normal range Tendons the means by which the muscles are attached to the bones Muscles muscles are found in pairs on either side of the spine and provide the main stability for the vertebral column Ligaments tendons and muscles can be injured as a result of twisting and stretching, particularly if carried out repetitively. These types of injuries are called soft tissue injuries and tend to be the cause of the majority of reported back injuries. Cumulative strain is when these injuries occur as a result of repetitively carrying out these activities and is a loss of elasticity in muscle structures until ordinary movement becomes harmful movement. Moving and Handling Trainer Notes March 2014 Page 12 of 31
Pulling something due to the weight of the item can be a cause of injury as can the number of times you have to pick up or carry an item, the distance you are carrying it, the height you are picking it up from or putting it down at (picking it up from the floor, putting it on a shelf above shoulder level) and any twisting, bending stretching or other awkward posture you may get in whilst doing a task. Slide 11: Promoting healthy back care Use this slide to introduce some key tips for promoting healthy back care. Emphasise that maintaining good posture is essential. The body can only tolerate being in one position for a short time, so frequent adjustment is essential. Back pain can be a common complaint, particularly for those working in the health sector, but ensuring good posture, remaining active, avoiding risk factors such as smoking and excess weight can protect your back, prevent discomfort and reduce the risk of potential injury. You may wish to talk about contributory factors including: cumulative stress and strain over a period of time leading to pain & disability, static/lifting postures, ageing & natural degeneration, repetition, psychological (stress, mood), previous injury & trauma, overexertion or direct impact. Moving and Handling Trainer Notes March 2014 Page 13 of 31
SLIDE 12: Ergonomic Approach to Assessment of Risk Use this slide to explain that the Manual Handling Operations Regulations 1992, require that tasks that involve risk should be eliminated if at all possible. Only when this is not possible, a risk assessment should be carried out and action taken to reduce the risks associated with that task to the lowest level that is reasonably practicable. Explain that do not set specific requirements such as weight limits. Introduce the concept of an ergonomic assessment, based on a range of factors which they should use to determine the risk of injury and which would begin to give direction for appropriate corrective action. You may wish to show copies of and discuss local risk assessment forms. Highlight that risk assessment is not just a paper exercise, but that it s about taking sensible steps to control risks in your area. Discuss also the importance of appropriately communicating any findings to others. Emphasise the concept of fitting the job to the person rather than the person to the job. When a more detailed assessment is necessary the Health and Safety executive recommend following the broad structure set out in Schedule 1 of the Manual Handling Regulations. The Schedule lists a number of questions in five categories: The acronym T.I.L.E. that is commonly used to shape the risk assessment during Moving and Handling Trainer Notes March 2014 Page 14 of 31
manual handling procedures can then be introduced. Then you are asked to consider other possible risk factors. SLIDE 13: Ergonomic Risk Assessment: TASK Explain the importance of considering the task and the potential risks before it is undertaken. They should ask themselves a series of questions pertinent to the work area and the work load. The slide suggests possible questions they may want to ask. You may wish to introduce others depending on the mix of participants. Such as: Why am I moving this box? Why am I moving this desk? Can I avoid the move in some way? Is there an alternative? How often will I perform this task? Where am I going to and from? What is the most effective/safer way of fulfilling the task? Moving and Handling Trainer Notes March 2014 Page 15 of 31
SLIDE 14: Ergonomic Risk Assessment: Individual Capability... This slide highlights the importance of considering both themselves (and others if this is a team situation), in relation to the task. Discuss the impact medical or physical characteristics/ problems they or their colleagues may have which would affect ability to carry out the task. You may wish to provide some common examples such as previous injuries, pregnancy, differences in height if the task requires a team approach. Highlight how tiredness can affect ones physical and mental ability including concentration. It may be useful to also discuss what to do if they don t feel they are capable and also how to manage the situation if team members may be considered a risk for the task. Participants may suggest that they sometimes find themselves in situations where there are inadequate staff numbers to consider undertaking this task in a particular way or at all. Start to introduce possible approaches and alternatives. Moving and Handling Trainer Notes March 2014 Page 16 of 31
SLIDE 15: Ergonomic Risk Assessment: The Load This slide can be used to highlight that personal assessment of risk applies to the moving and handling of any type of load including big, small, awkward slippery etc. Again, provide relevant examples depending on the mix of participants. Moving and Handling Trainer Notes March 2014 Page 17 of 31
SLIDE 16: Ergonomic Risk Assessment : The Environment People don t often think about the environment they work in. Introduce the importance of recognising that the environment itself may be a hazard. Explain how they should assess the constraints imposed by the environment and consider ways in which it could be improved. Again use relevant examples depending on the mix of participants. Moving and Handling Trainer Notes March 2014 Page 18 of 31
Slide 17: Other possible risk factors Use this slide to emphasise that as well as the task, individual capability, the load and the environment they should also consider other possible factors that may contribute to the risk of injury. Provide examples here such as tiredness, distractions etc. Moving and Handling Trainer Notes March 2014 Page 19 of 31
SLIDE 18: Principles of Safer Handing Use this slide to raise awareness of the key principles to ensure safer moving and handling. Building upon the T.I.L.E risk assessment, awareness and application of the safer principles will aid personal safety Moving and Handling Trainer Notes March 2014 Page 20 of 31
SLIDE 19: Assessment leads to a plan Use this slide emphasise the importance of stopping, thinking and planning the Handling process. Provide examples of questions they should be asking themselves and include that they should never manually handle unless they have no other option. Remind them to always ask Do I need to handle manually - can I use a handling aid to move the inanimate load? Ask What control measures/strategies can be employed to improve safety. Identify how these principles can be applied to various handling situations. Moving and Handling Trainer Notes March 2014 Page 21 of 31
SLIDE 20: Position your feet correctly Discuss and demonstrate how feet should be positioned for safer manual handling Stand astride object Feet shoulder width apart One foot in front of the other for balance Point leading foot in the direction of travel. Moving and Handling Trainer Notes March 2014 Page 22 of 31
SLIDE 21: Adopt a good posture Discuss and demonstrate good posture for safer manual handling. Moving and Handling Trainer Notes March 2014 Page 23 of 31
SLIDE 22: Get a good hold Discuss and demonstrate the importance of getting a good grip of the object for safer manual handling. Highlight the importance of using the whole length of the fingers and not just the finger tips to hold. Highlight how a load becomes more difficult to handle if it is held: Above the shoulders Below your knees Away from the body. i.e. with arms stretched out. Sharp, hot or cold SLIDE 23: Use equipment to move objects This slide highlights the importance of avoiding manual handling whenever possible. Identify, discuss and demonstrate equipment available to them to move objects and loads. You may want to explain the procedure for maintenance and checking equipment in your organisation. Highlight that, using equipment should only be considered after assessment and should be used in accordance with the care plan and manufacturer s instructions. Moving and Handling Trainer Notes March 2014 Page 24 of 31
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SLIDES 24, 25 and 26: Lifting, Moving and Pushing/Pulling Guidance You may then want to introduce the slide with the Health & Safety Executive suggestions about maximum weights. Slide 24 shows that the amounts we can transport will change depending on how close to the body it can be held and how high up or low down it is. Discuss how heavier weights need to be held close to the body. Slide 25 shows the amounts we can lift whilst seated and slide 26 the amounts of force we can apply when pushing/pulling. Remind them of the key point though that these weights are guides only and they may not be able to manage these weights. If they have any doubts they should ask for assistance or use equipment (they are trained to use) to move, lift or push/lift the load. Discuss how these weights will also decrease if the manoeuvre involves bending, stretching, twisting, pushing loads on faulty trolleys or up slopes and over uneven floors. Stress the principle is always to lift only when necessary. Highlight that how much individuals can manage to move safely varies from person to person and it s better to ask how much should I lift? The amount will also vary depending on any factors they discover from the assessment. Emphasise the importance of the ergonomic approach. The Manual Handling Operations Regulations 1992 (as amended) set no specific requirements such as weight limits. Explain how ergonomics can be explained as fitting the job to the person, rather than the person to the job. The ergonomic approach looks at manual handling as a whole. It takes into account a range of relevant factors, including the nature of the task, the load, the working environment and individual capability and Moving and Handling Trainer Notes March 2014 Page 26 of 31
requires worker participation. The ergonomic approach shows clearly that emphasis on how much weight can be lifted is too simple a view of the problem and may lead to incorrect conclusions. Instead, an ergonomic assessment based on a range of relevant factors should be used to determine the risk of injury and point the way to remedial action. SLIDE 27: Team Handling You may wish to refer to the guidance that accompanies the Manual Handling Operations Regulations 1992 (as amended) when discussing team handling: Handling by two or more people may make possible an operation that is beyond the capability of one person, or reduce the risk of injury to a single handler. However, team handling may introduce additional problems which the assessment should consider. During the handling operation the proportion of the load that is borne by each member of the team will inevitably vary to some extent. Such variation is likely to be more pronounced on sloping or uneven ground. Therefore, the load that a team can handle safely is less than the sum of the loads that the individual team members could cope with when working alone. As an approximate guide, the capability of a two-person team is two-thirds the sum of their individual capabilities and for a three-person team the capability is half the sum of their individual capabilities. Teams of more than four members are unlikely to work successfully. If steps or slopes must be negotiated, most of the weight may be Moving and Handling Trainer Notes March 2014 Page 27 of 31
borne by the handler or handlers at the lower end, further reducing the capability of the team as a whole. There may be additional difficulties if: 1. team members get in the way of each others sight or movement; or 2. the load does not have enough good handholds. This can occur particularly with compact loads which force the handlers to work close together or where the space available for movement is limited; or 3. the background noise level is too high to allow easy communication between team members. For safe team handling there should be enough space for the handlers to manoeuvre as a group. They should have adequate access to the load, and the load should provide sufficient handholds. If the load is particularly small or difficult to grasp, then a handling aid such as a stretcher or slings should be used. One person should plan and then take charge of the operation, ensuring that movements are co-ordinated. However, there should be good communication between team members. A clear protocol should be agreed between the team about timing for the lift. This is particularly necessary when the team contains employees who don t regularly work together. Team members should preferably be of similar build and physical capability. Where the weight of the load is unevenly distributed, the strongest members of the team should take the heavier end. Moving and Handling Trainer Notes March 2014 Page 28 of 31
SLIDE 28: Sources of information about Moving and Handling.. It is important that participants are initially introduced to the principle of evidence based practice here. That is evidence of what works to reduce the risk of injury. This will then put the important role of organisations such as the National Back Exchange and Health and Safety Executive and many others into perspective. This should assist with understanding of how guidelines change based on best evidence available and the importance of regular updating of skills and attendance at refresher training. Moving and Handling Trainer Notes March 2014 Page 29 of 31
Moving and Handling Trainer Notes March 2014 Page 30 of 31
SLIDES 29 and 30: Acknowledgments and Any questions Remember to leave some time at the end for questions and answers. Use this as an opportunity to remind them who you are and where they can go for extra information. Don t forget to add relevant local details. Moving and Handling Trainer Notes March 2014 Page 31 of 31