Patient Care Ergonomics Training for Healthcare Workers

1. Patient Care Ergonomics Training for Healthcare Workers OSHA Nursing Home Guidelines

2. 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

3. 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.

4. 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 worker’s comp costs in Nursing Homes

5. 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_etool/hazards/ergo/ergo.html)

6. 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)

7. OSHA Guidelines for Nursing Homes: Ergonomics for the Prevention of Musculoskeletal Disorders Reducing Staff Injury and Improving Patient Safety

8. 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

9. Strategies to Reduce Ergonomic Injuries in Industries Enforcement • General Duty Clause Ergonomic Guidelines • Act as ‘Guidelines’ • Offer Best Practices & Sources of Information

10. 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.”

11. OSHA Guidelines for Nursing Homes “OSHA recommends that manual lifting of Patients be minimized in ALL cases and eliminated when feasible.”

12. 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)

13. 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

14. 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 *

15. 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… 3. Identify Problems & Implement Solutions for ‘Other’ Activities

16. Consider employee exposure to: Forceful exertions Repetitive activities Awkward postures Consider these aspects of the 3 types of Exposures: Duration Frequency Magnitude of exposure 3. Identify Problems & Implement Solutions for ‘Other’ Activities To determine if problems exist with these ‘Other’ activities…

17. 4. Training Train • Nursing Assistants and Other Workers at Risk of Injury • Charge Nurses & Supervisors • Designated Program Managers

18. OSHA Ergonomic Guidelines for Nursing Homes Training Recommendations for Nursing Assistants and Other Workers at Risk of Injury

19. 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

20. 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

21. Injuries and illnesses affecting muscles, nerves, tendons, ligaments, joints or spine Some common MSD’s are: De Quervain’s disease Epicondylitis Rotator Cuff Syndrome Sciatica Carpal Tunnel Syndrome What are MSD’s?

22. Causes of Workplace MDS’s • Exposure to: • Repetition • Forceful Exertions • Awkward Postures • Contact Stress • Vibration

23. 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)

24. Musculoskeletal Disorders • How do you know if you’re developing a MSD? • Pain that won’t go away • Joints won’t move easily • Swelling  

25. 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

26. 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 Signs & Symptoms of MSDs

27. 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!

28. 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.

29. OSHA Ergonomic Guidelines for Nursing Homes Training Recommendations for Charge Nurses & Supervisors

30. 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

31. OSHA Ergonomic Guidelines for Nursing Homes Training Recommendations for Designated Program Managers

32. 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

33. You Have Help! • This Training Program • VA Patient Care Resource Guide: Safe Patient Handling & Movement • VA Technology Resource Guide • www.patientsafetycenter.com

34. You Have Help! • OSHA Ergonomic Guidelines for Nursing Homes www.osha.gov/ergonomics/guidelines/nursinghome/index.html • OSHA website www.osha.gov • OSHA Compliance Assistance Specialists in OSHA area offices

35. 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_publications/ backinj.pdf)