SMART Basic Training 2017

1. SMART Basic Training 2017

2. Today’s Session • Welcome! • Agenda • SMART is required injury prevention training as per Health PEI’s MSIP Policy • Expectation of active participation in discussions, activities and practice components.

3. Outline • Welcome& TLR Feedback • Introduction to SMART • Legislation • Steps to a moving task • Anatomy & Physiology • Safe body mechanics & Ergonomics • Risk Assessment – Self, Environment, Equipment, Object • General moving techniques • Practical skills for Environmental Services • Summary & Evaluations

4. Housekeeping • Bathroom Locations • Cell phones/pagers • Park aid • Evaluation forms

5. Please take a few minutes and fill in the TLR evaluation “Prior to Session” section

6. SMART FEEDBACK • In respect to moving and lift tasks: • What does your department do well? • What are some improvements that could be implemented? • What are the biggest challenge you have?

7. Introduction to SMART

8. Three Levels of Intervention • Administrative – how work is organized, e.g. scheduling, safe work procedures • Engineering – physical change to work, e.g. equipment, workstation modification • Behavioral – worker changes how he works, e.g. use of safe body mechanics, not rushing

9. Areas of Risk Assessment • Self • Environment • Equipment • Object

10. Lifting vs. Repositioning • Lifting –moving an object from one place to another place/location. • Repositioning – sliding an object from one position to another, on the same surface or to another surface, or between two surfaces of equal height. Weight fully supported by the surface(s).

11. Health PEI Legislation

12. Employee’s Responsibilities Occupational Health & Safety Regulations Employer’s Responsibilities Provide a safe & healthy workplace Provide equipment Provide training Provide competent supervision • Use the equipment/Personal Protective Equipment provided • Take training and use skills taught • Report incidents/hazards • Protect themselves and colleagues

13. OH&S – Refusal to Work • A worker may refuse to do an act where the worker has reasonable grounds for believing that the act will likely endanger his/her or another workers’ health or safety. • This needs to be communicated to your manager/supervisor and proper paperwork needs to be filed.

14. Health PEI MSIP Policy All employees are responsible for the following: • Applying principles of SMART/MSIP to their daily work activities; • Attending basic and refresher training • Following safe work procedures for specific tasks/equipment; • Using equipment provided/assigned by SMART Assessment;

15. Health PEI MSIP Policy All employees are responsible for the following: • Refusing to use equipment they have not been trained to use; • Identifying and reporting hazardous tasks/environments, unsafe acts and faulty equipment immediately; • Participating in incident investigations as requested; • Conducting ongoing assessments at all times in conjunction with posted logos/safe work procedures

16. Injury Prevention Culture • Patient safety & staff safety: equally important • HPEI wants to ↓ injuries & retain valued staff If you were injured, your team would lose a valuable player!

17. SMART Training • MSIP Policy and PEI’s OH&S regulations require all employees to have injury prevention training • SMART Requirements for Support Services staff: • 4 hrs (min.) basic SMART training • 2 hrs (min.) Refresher training every 3 yrs • SMART designed to manage/eliminate the risks of musculoskeletal injuries during object moving

18. Module 1: Overview of the Moving Task

19. Steps to a Moving Task TLR THEME: Step-by-step process for all moving tasks (Page 2 in Participant Handbook)

20. Step 1: Assess • Assessment = important part of SMART • Complete a risk assessment • Yourself • Environment • Equipment • Object • Always assess “in the moment”

21. Step 2: Select • Select the safest moving technique based on risk assessment • Standard techniques • Lift • Reposition

22. Step 3: Prepare • Wearing appropriate footwear • Wearing personal protective equipment • Plan for the move is in place • Appropriate equipment • Worker roles clarified • “1-2-3-command” determined • Route planned • Clear visibility

23. Step 4: Move • Use safe body mechanics • Worker duties are assigned: worker provides clear direction & obtains assistance if needed. • All workers ensure safety of moving task and stop if risk factors arise Today we will practice moving techniques so you feel confident doing them

24. Step 5: Evaluate • Ask yourself : • Did the move compromise safe body mechanics? • Was the object too heavy, awkward or unstable? • Were all risk factors involved with this task identified? • What could be done differently?

25. Step 6: Communicate • Important for safety of all workers • Pass on what you learned: • What went well? • What is the recommended moving technique? • How were risks managed or eliminated?

26. Module 2: Anatomy & Physiology

27. The Spine • Houses & protects spinal cord • Keeps trunk in upright position • Gives body flexibility Majority of body weight goes through the spine, ↑ risk of injury!

28. Poor Posture Neutral Spine = S-Curve Neutral Posture • Exaggerates curves • Stress and strain on all the structures of the back Neutral posture is the strongest most stable position. If you are not working in a neutral posture, ↑ risk of injury!

29. Good standing posture • Tighten core • Flex the knees often • Work at an appropriate height for the task • Wear appropriate comfortable footwear • Stand on anti-fatigue mats if standing for long periods • Relieve pressure in standing by placing one foot up on elevated surface

30. Good Posture in Sitting • Sit in alignment with ears over shoulders and shoulders over hips • Position reading material to avoid looking up or down for prolonged periods • Use a chair with lumbar support • Feet flat on floor, thighs at around 90 degree angle, and knees slightly lower than hips • Use foot rest if required • Sit close to work • Stretch frequently Participant Handbook – page 2

31. Pressure on the Spine Lying on the back = 25% Lying on the side = 75% Standing = 100% Sitting = 140%

32. Standing & leaning forward = 150-220% Sitting & leaning forward = 150-220% Bending and lifting improperly = 300-400%

33. Back Muscles vs. Leg Muscles Back Legs • Keep the body upright • Short muscles • Stabilizers with very little power • Ambulation/walking • Raising/lowering the body, getting up/down NOT designed for lifting! Designed for lifting!

34. Vertebrae NervesLigaments • Support weight of body & protect spinal cord Disc

35. Discs • Located between vertebrae • Act as shock absorbers • Hold vertebrae together strongly

36. Disc Structure • Annulus (outer) = strong, criss-crossing elastic fibres • Nucleus (inner) = Jelly-like substance • 88% water when discs are healthy and young

37. Abdominal Muscles • Support abdominal content and spine • Maintain pelvic tilt & protect lower back

38. Shoulder • “Ball and socket” joint = allows for flexibility and a great range of movement in exchange for stability • Neutral safe position: arms close to sides (elbows tucked in)

39. Module 3:Safe Body Mechanics/Ergonomics

40. Participant Handbook – page 3

41. 1. Think & Plan Ahead • Know what the task is, from start to finish • Ensure appropriate equipment available • Seek assistance when needed & take your time • Plan a safe route • Listen to your body • Use the brain and not the back!

42. 2. Safe Stance Parallel Stance & Stride Stance • Feet shoulder-width apart • Knees bent slightly • Trunk aligned over your centre of gravity • Avoid twisting or rotating • Activity 1 – feet together vs. feet apart • Activity 2 – Centre of body demo

43. 3. Maintain 3 natural curves of spine For the Top: • Ears over shoulders • Shoulders over hips For the Bottom: • Bend at the knees • Bend at the hips • Tighten core • “Sit” into it Body’s strongest and most stable position

44. 4. Use Core, Buttocks, Thigh & Calf Muscles • Core - stabilize & support lumbar spine for safe dynamic movements • Buttocks, thighs and calf muscles –provide power and movement to move entire weight of body • Lowering/raising body • Standing • Walking • Pushing • Pulling • Activity – knees straight vs. “for the bottom”

45. 5. Use a Safe & Effective Grip • Use whole hand • Wrists in neutral position • Elbows close to sides; at/near a 90 degree angle • Thumbs up or out • Activity – table exercise – palms up vs down

46. 6. Work Within Your Comfort Zone • Vertical zone: • Between the shoulders and where your fingertips touch your thighs • Horizontal zone: • Area in front of you when your elbows are at a 90 degree angle and are close to your sides • Keep the load close

48. 7. Weight Transfer • Transfer weight from one leg to the other • Side-to-side or front-to-back • Creates movement/momentum and help maintain balance. • Activity – centre of gravity with weight shifting

49. Pushing vs. Pulling • Push rather than pull when possible • Initiate push or pull with weight transfer rather than using the upper body • DO NOT push one item and pull another at the same time • Push or pull one object at a time • Use two hands vs. one • Lighten the load • Divide the load • Alternate tasks

50. Carrying • Slide, push or roll rather than carry if possible • For short distances only • Enhance grip if possible (handles, gloves, etc.) • Use two hands vs. one • Lighten loads • Divide the load • Alternate tasks