OSAG Training April 2017

1. OSAG Training April 2017

2. Credits Thanks to Todd Smoot-Healthcare Safety Solutions and Joe McFarlane-Select Physical Therapy for their assistance.

3. Contact OSAG If you have any questions or need copies of today’s materials, contact the OSAG office. • OSAG office: 800-699-5905, 405-842-2337 • www.okschoolassurancegroup.org • Tina Wamsley- twamsley@okschoolassurancegroup.org • Victoria Lapham- vlapham@okschoolassurancegroup.org

4. Why Basics? • The majority of School claims are due to trips, slips and lifting. Back injuries dominate the statistics. • Therefore, it PAYS to remember the basics.

5. Poor Lifting Practices Cause Injuries • There are clinical consequences of awkward student handling and movement • Negative impact on student experience • Decreased student safety/comfort • Increased fear and pain • Hip fractures & shoulder damage • Loss of dignity • Increased dependency • Skin tears

6. How to Prevent Injuries • Gait or transfer belts • Lift equipment: floor or ceiling lifts • Use balanced posture and positioning • Practice controlled lifting • Perform on the job stretches • Assess and Plan before moving a student • Know your limitations and get help when you need it • Explain to the student what you are about to do, why and ask if they can assist (even if you don’t think they can understand you) • “Coordination count” with team members: “We will lift on the count of 3”

7. More of the Basics • Understand the safe postures when transferring students. • Understand how to make decisions that will risk the least amount of injury to the student and school personnel. • Learn how to communicate with your team what level of assistance or equipment is needed to properly transfer students. • Do not hesitate to ask for help.

8. Ideal Situations • The student can follow directions and isn’t combative. • The amount of weight handled can be estimated. • The lifting is smooth and slow. • The body and hand positions in relation to the student being lifted are not subject to change. • Lifting with extended arms • Lifting when near or off the floor • Lifting when sitting or kneeling • Lifting with the trunk twisted • Lifting with the student off to the side of the body

9. Student vs Boxes

10. Dead Weight Lifting dead weight is not easy. Lifting a leg alone contains considerable weight. • 150 lb. Person = 24 lb. Leg • 200 lb. Person = 31 lb. Leg • 250 lb. Person = 39 lb. Leg • 300 lb. Person = 47 lb. Leg

11. WALKING WITH THE STUDENT • Stand-by assist (SBA) • Behind student with hands ready to assist as needed • Contact guarding (CG) • Behind or to one side of student. – choice of which side • One hand at waist, one on shoulder or 2 at waist • Maximum assist • Hands positioned to assist with balance &/or Webbing • Knees bent & body close to student for optimal body mechanics • If using a walker may put one hand on walker to maintain control of the walker and keep it from getting ahead of the student

12. Your Part in the Prevention • Voice • Use a calm voice, speak slowly and use proper distance when giving instructions to prevent agitation. • Facial Expressions • Proper facial expressions, voice tone, and physical body movements can de-escalate difficult behavior. • Limits/Support • Recognize your limits and understandthat you can’t handle everything. • Knowing you have support and backup is crucial to staying in control of your behavior and response. • Accept your limits; the best decision may be to let someone else handle the situation.

13. Rolling on table • Assisted – what is the starting position • Use the shoulder and/or the hip to initiate rolling • Ideally let the student control the head-looking in same direction of roll • Have student reach with opposite arm towards edge of bed and push with opposite foot on bed to initiate roll if able • Directed – verbal and tactile cues • Initiate at the shoulder or the hip • Don’t forget about the head • Use momentum to overcome inertia

15. Chair to Bed Transfer • Position hands for optimal leverage & lean forward onto the hands to establish BOS • Be sure feet are flat on ground, under knees, as part of the BOS • Use shoulder depressors to lift body weight (lift with strongest muscles)

16. BODY MECHANICS OF A DEPRESSION TRANSFER • Lift weight up then shift weight in transfer • The hips move opposite the head, so drop head down & turn head in opposite direction of the transfer.

17. PIVOT TRANSFERS • Used when coming to standing. Often the most efficient or safe method to transfer • Allows transfers to surfaces which are at a significantly different height • Uses different body mechanics than the depression transfer • Student has to control their body both as they come up to standing then again as they lower themselves onto the transfer surface

18. PIVOT TRANSFER MECHANICS • Student transfers towards “strong” side • Use arms to help lift if strength of legs alone is insufficient • Arms are also used to increase the BOS and assist with balance • Use normal squat mechanics to come up to standing & sit down when possible • As student pivots, the head & hips ideally move in opposite directions • Hold onto belt or waistline if more support is needed.

19. Lifting After a Fall • First ask the student if they are OK and investigate for any signs of injuries • Attempt to move the person if you feel you are both able to work safely together • Position the student into a safe position and move furniture and obstacles to assist in giving them and you room to move. • Then get them into a crawling position. • Have them crawl to the nearest stable chair or table.

20. Lifting After a Fall • Once they are holding onto the table or chair, help them to pull their leg up so they are in a half kneeling position. Use their strongest leg. • Stand on other side of the person and hold one arm under their arm and the other on their belt or waist line and remind them to lean forward while pushing up. • Have them stand for a moment to ensure they are not dizzy and turn and sit. If you think they will be dizzy get a chair close at a 90 degree angle so that they can sit once they are standing without turning completely around.

21. Break Time Return in 10 Minutes

22. OSAG Annual Gene Keith Scholarship A $4,000 OSAG scholarship is awarded annually in honor of the OSAG Founding Director, Mr. Eugene Keith. The qualifying recipient is selected based on academic excellence, leadership in school activities, work experience and community service, with intent to pursue a career in education. Congratulations to the following recipients of the OSAG Gene Keith Scholarship Award:  2004-05: Lindsay Duncan Tulsa 2005-06: Rachel Lewis Bethel 2006-07: Kamie Casey Morrison 2007-08: Alyssa Holt Sentinel 2008-09: Brea Jones Dickson 2009-10: Mark Johnson Enid 2010-11: Rachel Yauk Buffalo 2011-12: Robyn Simma Perkins 2012-13: Chelsea Coker Tuttle 2013-14: Erika Vinson Warner 2014-15: Maria Maples Ringwood 2015-16: Madison McDonald Choctaw

23. State Law While the number of injuries from handling students with special needs is very low, these injuries and scenarios often present the greatest challenges to the School District.

24. Regulations Once a Student has been identified and placed on an IEP (Individualized Education Program), the regulations in the State Department of Education Handbook apply. The School will then be required to hire qualified personnel to comply with the IEP http://sde.ok.gov/sde/special-education-handbooks-manuals-guides

25. Student Profiles IEP and students with special needs should have a master profile retained in Principal’s office. Share that profile with all school personnel who may be involved with those students.

26. Sample Profile

28. Sargent Cory Sutton • Sargent Cory Sutton from the OU police department provides training for first responders who interact with autistic individuals. He trains at various locations in the state. • You may contact him at 405-740-1645 or sutton42@ou.edu.

29. Real Life Scenario Issue:    6’3’’ student keeps trying to undress the teacher and see her underwear.

30. Solution The school has a panic button in the room for the staff to buzz the principals office. They also have the desks set up in a maze so that the student does not have direct access to the teacher. The Principal then helps calm the student and tells him that unless he is willing to show his underwear, then he needs to sit down. It normally works.

31. Real Life Scenario Issue:  A 6’ male student went to the bathroom but did not come out.  After 15 minutes the female TA went into the bathroom to check on him.  the student was agitated and pushed her away whereby she hit her head on the sink and was knocked out. How should the TA have handed this scenario?

32. Real Life Scenario Issue:  17 year old male student is fond of a girl in the class and keeps trying to kiss her.  How do we handle?

33. Real Life Scenario Issue:  Student has bitten the Teachers Aid 7 times this school year.  What do we do?

34. Real Life Scenario Issue:  A student keeps looking for ways to bolt from the school and run down the street.  The school restricts outside activity, but he will run out a door on the way to the cafeteria or bathroom.  What do we do?