Patient Care Ergonomics Training for Healthcare Workers

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Patient Care Ergonomics Training for Healthcare
Workers

OSHA Nursing Home Guidelines
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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

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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.

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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
  workers comp costs in Nursing Homes

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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_eto
  ol/hazards/ergo/ergo.html)

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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
  )

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OSHA Guidelines for Nursing Homes Ergonomics for
the Prevention of Musculoskeletal Disorders

Reducing Staff Injury and Improving Patient Safety
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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

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Strategies to Reduce Ergonomic Injuries in
Industries

• Enforcement
• General Duty Clause
• Ergonomic Guidelines
• Act as Guidelines
• Offer Best Practices Sources of Information

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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.

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OSHA Guidelines for Nursing Homes

• OSHA recommends that manual lifting of
  Patients be minimized in ALL cases and eliminated
  when feasible.

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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)

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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

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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

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3. Identify Problems Implement Solutions for
Other Activities

• Making beds
• Feeding Patients
• Lifting food trays
• Collecting wastes
• Pushing heavy carts
• Bending to remove items from a deep cart

• Lifting carrying when receiving stocking
  supplies
• Bending manually cranking bed
• Removing laundry from washer/dryer
• More

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3. Identify Problems Implement Solutions for
Other Activities
To determine if problems exist with these Other
activities

• Consider these aspects of the 3 types of
  Exposures
• Duration
• Frequency
• Magnitude of exposure

• Consider employee exposure to
• Forceful exertions
• Repetitive activities
• Awkward postures

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4. Training

• Train
• Nursing Assistants and Other Workers at Risk of
  Injury
• Charge Nurses Supervisors
• Designated Program Managers

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OSHA Ergonomic Guidelines for Nursing Homes

• Training Recommendations
• for
• Nursing Assistants and Other Workers at Risk of
  Injury

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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

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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

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What are MSDs?

• Injuries and illnesses affecting muscles, nerves,
  tendons, ligaments, joints or spine

• Some common MSDs are
• De Quervains disease
• Epicondylitis
• Rotator Cuff Syndrome
• Sciatica
• Carpal Tunnel Syndrome

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Causes of Workplace MDSs

• Exposure to
• Repetition
• Forceful Exertions
• Awkward Postures
• Contact Stress
• Vibration

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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)

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Musculoskeletal Disorders

• How do you know if youre developing a MSD?
• Pain that wont go away
• Joints wont move easily
• Swelling  

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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

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Signs Symptoms of MSDs

• Back or neck pain
• Stiffness
• Painful joints
• Pain, tingling or numbness in hands or legs

• Shooting or stabbing pain in arms or legs
• Swelling or inflammation
• Burning sensation

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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!

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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.

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OSHA Ergonomic Guidelines for Nursing Homes

• Training Recommendations
• for
• Charge Nurses Supervisors

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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

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OSHA Ergonomic Guidelines for Nursing Homes

• Training Recommendations
• for
• Designated Program Managers

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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

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You Have Help!

• This Training Program
• VA Patient Care Resource Guide Safe Patient
  Handling Movement
• VA Technology Resource Guide
• www.patientsafetycenter.com

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You Have Help!

• OSHA Ergonomic Guidelines for Nursing Homes
  www.osha.gov/ergonomics/guidelines/nursinghome/ind
  ex.html
• OSHA website www.osha.gov
• OSHA Compliance Assistance Specialists in OSHA
  area offices

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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_p
  ublications/ backinj.pdf)