STAFF SAFETY Body Mechanics Healthcare Safety & Injury Prevention Code Silver

1. STAFF SAFETY • Body Mechanics • Healthcare Safety & Injury Prevention • Code Silver

2. Body Mechanics/Ergonomics Contents: This component of the Staff Safety module details important aspects of body mechanics and ergonomics in the workplace. It examines what can cause pain in the workplace, the five principles of body mechanics, and the "Do's and Don'ts" of good body mechanics. Do not lift this!!!

3. Ergonomics • Ergonomics is the science of fitting jobs to the people who work in them. • The goal of an ergonomics program is to reduce activities that stress the musculoskeletal system due to being repetitive in nature. Examples include: • reaching • bending • lifting • using continuous force • working with vibrant equipment • •repetitive motion

4. What are MSD? • Musculoskeletal Disorders (MSD) are injuries and illnesses that affect muscles, nerves, tendons, ligaments, joints, or spinal discs. • MSD are not caused by a single traumatic injury, but rather by repeated exposure to the following risk factors: • repetition • forceful exertions • awkward positions • contact stress vibration • months or years of poor body mechanics • stressful living • poor work habits • a general lack of physical fitness

5. What are the Signs of MSD? • Persons suffering from MSD may experience less strength for gripping, less range of motion, loss of muscle function, and inability to do everyday tasks. • Common symptoms include: • painful joints • pain, tingling or numbness in hands or feet • fingers or toes turning white • shooting or stabbing pains in arms or legs • back or neck pain • swelling or inflammation • stiffness or burning sensation

6. What Are the Five Principles of Body Mechanics? • The five principles of body mechanics include: • posture • how to hold objects • facing objects • symmetry • using a wide base of support

7. Posture • When using posture as a principle of body mechanics: • - keep your chin level and slightly tucked • - keep your chest up but notout • - stomach muscles should be tight • - knees should not be locked • Keep objects close to your body • • Keep your elbows close to your sides • • Hold the object close to your stomach • Face the Object • • Properly align the hips and shoulders

8. Continued.. • Symmetry • Use symmetry as a principle of body mechanics by: • - using both sides of your body equally • - using both hands whenever possible • Wide Base of Support • Always use a wide base of support- feet apart

9. Sitting • Sit in a chair that: • is low enough that both feet are on the floor • supports your back • allows you to work with your elbows bent at 90 degrees with shoulders relaxed • keep weight evenly distributed in the chair • When sitting,DO NOT: • slump or lean forward or downward to reach for or look at your work • sit for more than 15-30 minutes without getting up or changing position

10. Standing • Legs should be at least shoulder-width apart • They can be either side to side or one in front of the other • Good Balance when Standing • Elevate or incline the work surface to bring your work closer to you • Put one foot up, shift your weight, or squat down occasionally • Keep your work at a comfortable height • Stand on an anti-fatigue mat • DO NOT: • Stand in one place too long • Stand with poor posture • Stand bent forward at your waist or neck

11. Pushing • Push whenever possible • Maintain good posture • Side-step versus twisting to turn • Remain close to the item being pushed • Pulling or Twisting • DO NOT: • Pull when you can push • Twist your body

12. Carrying Objects • When carrying objects: • carry the load in front • pivot with your feet • make multiple trips • use two hands • keep objects near your body • • ask for assistance with heavy items • DO NOT: • carry with one hand • twist • carry with a bent-over, stooped posture

13. Reaching • When reaching for an object, remember to: • reach with two hands • face the object • stand on a stable step-stool to reach high items • When reaching for an object,DO NOT: • overreach • reach with one hand • twist • stand on an unsafe surface

14. Lifting • When lifting objects, always: • use good posture • face the object • keep objects close to your body • keep feet at least shoulder-width apart • bend your knees • test the load before lifting • request help with heavy items • When lifting objects,DO NOT: • lift in a bent-over, stooped position • twist • lift with one hand • lift with outstretched arms • keep feet together

15. At Mt. Ascutney Hospital • Other helpful tools at this facility include ergonomically correct office chairs, keyboard trays, adjustable monitors and computer wrist pads. For more information about additional tools, see the hospital's Occupational Health Department. • It is important that you report MSD signs and symptoms to your supervisor right away to avoid long-lasting problems. It is important to fill out a Quantros report. Occupational Health or your supervisor can assist you in filling this out. • Apply the Five Principles of Body Mechanics. • • Notify your supervisor as soon as MSD signs and symptoms appear.

16. Healthcare Safety & Injury Prevention The Occupational Safety and Health Administration (OSHA) regulations direct health care facilities to maintain a safe environment. State and local laws also put safety requirements in place. This component of the Staff Safety module will discuss what Mt. Ascutney Hospital does as we seek to provide a safe environment for patients, visitors, and employees. The course will also discuss ways employees can prevent injuries to themselves and others, as well as actions to take when injury occurs.

17. This facility has a plan for assuring a safe environment for patients, visitors, and staff. This plan includes schedules for conducting inspections to assess safety risks and opportunities to improve the safety of the environment. Safety inspections are conducted at least every 6 months in areas where individuals are served and annually in areas where individuals are not served. Safety inspections are used to: • Identify problem areas—for example, a lack of available personal protective equipment (PPE). • Assess employee knowledge and behaviors — for example, employees could be asked to identify appropriate reporting procedures if an injury occurs. • Identify ways to improve the environment — employees know the most about their own space and its use. Including employees working in a particular area in a process to enhance the operation and safety of employees using the area is one way MAHHC protects workers and prevent injuries. • You should know all of the safety policies and procedures. It is your responsibility to follow good safety practices and to help identify safety deficiencies. Any safety hazards identified should be reported immediately to the supervisor and/or maintenance.

18. Common Workplace Injuries • Employees must report health problems that result from: • Slips, trips, and falls • Back and other musculoskeletal injuries • Hazardous product use • Those who work in the health care industry are especially at risk of these common workplace injuries. Everyone needs to take preventive actions against such injuries.

19. Health care employees, patients, and visitors are all at risk of injury from falling on slippery surfaces in buildings and in common areas such as walkways or parking lots. • Slippery floors may be the result of: • Floor cleaning • Spills that have not been cleaned up properly • Floor coverings (such as rugs) that are used improperly • A lack of a slip-resistant surface in areas that get wet • The following measures help reduce the risk of slips from slippery floors: • Keep floors dry and free from slippery substances. • Use protective nonslip mats and/or protective slip-resistant footwear when working in areas that will be damp or wet. • Post “Wet Floor” signs to indicate where usually dry surfaces have gotten wet. • Clean up spills or wet spots on floors • Report uneven or slick surfaces on floors so they can be repaired by calling maintenance immediately at ext. 7238 or 7212

20. Risk of Trips and Falls in Work Areas and Walkways including Outside Grounds Injuries from trips and falls range from strains and sprains to broken bones. We live in New England- remember to wear proper footwear especially during inclement weather. Such injuries can result in the workplace when walkways and work areas become cluttered. Causes of these types of injuries include: • Stacked supplies, forcing employees to reach or climb to get them • Improperly stored supplies blocking walkways • Inadequate lighting • Unsecured equipment cords crossing walking areas • Uneven walking surfaces • Climbing on objects other than ladders to retrieve materials • Using alternative routes off paths from parking areas to/from the hospital

21. Injury Risk in Patient Transport Transporting patients can lead to injury. An accident could injure the patient, the employee, or visitors and employees who are nearby. If a patient is being transported in a wheelchair or on a stretcher, follow slip, trip, and fall prevention guidelines to assure patient safety. MAHHC has a no-lift policy for patient and employee safety that promotes the use of assistive equipment. Such equipment lifts patients so that employees do not have to do such lifting manually. Every employee is mandated to review the hospital’s policy at this link: Injury Free Transfer Program Measures to Reduce Injury Risk in Patient Transport To reduce the risk of injury from transporting patients: Remember to use the curved mirrors at hallway intersections and other areas to watch for hazards. If you encounter a patient who is being transported in a hallway, provide room for the wheelchair or stretcher to pass by.

22. Measures to Reduce Risk in Equipment Use To reduce the risk of injury from equipment use, use only the equipment you have been trained to use and with which you have demonstrated competence. For instance, equipment that contains radioactive materials requires very specific training and education before a person is qualified to operate the equipment. These precautionary measures can reduce injury for both the patient and the employee operating the equipment.

23. Measures to Reduce Injury or Illness Risks of Working with Hazardous Products Following proper safety procedures when using a product labeled as a hazardous material will protect patients, employees, visitors, and the environment. Always know what products you are using and how to use them properly. To inform yourself about potentially hazardous products: Read available information about products that may be hazardous. In addition to reading the information on container labels, request and read the material safety data sheet outlining health-related information on the product. To assure completeness Department managers should review the MSDS list for their department at least twice a year. At MAHHC all MSDS are available on the hospital’s intranet site. Please access this link now to review your departments products MSDSonline binderVIEWMSDS. You may also access this by going to the Intranet and clicking on MAHHC Applications.

24. Injury Risks Specific to Health Care Facilities • Health care employees are exposed to special risks at work including: • • Needle sticks • • Exposure to disease • • Back injury during patient lift, patient transport, and special equipment transport • • Injuries resulting from workplace violence • • Patient care employees who work with needles or other sharp objects are at risk of injury. Needle sticks increase the risk of contracting infectious disease, including hepatitis and HIV. • The following measures should be taken to prevent needle sticks: • Never re-cap used needles • • Used needles should always be placed in sharps containers, and universal precautions should be followed. • • Any needle sticks should be reported immediately to the supervisor. The individual must be evaluated in the ER and complete a Quantros report before leaving work for the day.

25. Maintaining a safe environment is important for the health of patients, visitors, and employees. A health care worker can recognize risk of injury in a wide range of work environments and take actions to reduce those hazardous situations before an injury occurs. When these risks are recognized, the employee should complete a “Near-Miss” Quantros report. This will help the facility to make any necessary changes to keep all staff as safe as possible. As a health care worker, you should remember that when a hazard cannot be completely prevented, you must use the appropriate measures to reduce injury risk. Be Safe!!

26. This component of the Staff Safety module will review the Weapon/Hostage Situations policy to provide guidance to staff when confronted with a violent situation, which may involve weapons, hostage or deadly force and to minimize the initial potential impact on staff, patients and visitors. The policy can be reviewed at this link: Code Silver(Section IV Annex C)

27. This policy covers Mt. Ascutney Hospital and Health Center, all Hospital run clinics, and the Professional Building This policy applies to: Patients, staff and visitors whoare potentially at risk of being confronted by a person with a weapon or being involved in a violent crime or hostage situation. If this arises staff members should not attempt to intervene or negotiate. 1. A weapon is any firearm, knife or instrument that can cause bodily harm or injury. 2. Mt. Ascutney Hospital and Health Center reserves the right to inspect the contents of all packages or articles entering or being removed from the facility. 3. Firearms and illegal weapons are prohibited on the premises with the exception of law enforcement. Weapons, dangerous devices and illegal or unsafe items may be retained by Security and will be turned over to the Windsor Police Department.

28. Weapon / Hostage Situation The safety of staff and patients is the first priority. The purpose of this procedure is to protect patients and staff from violence. Staff should never enter a violent situation. If staff suspects a situation may be violent, call Security and /or Police to be in attendance with you. Use the panic button if able. Some signals that it may be a violent situation:       Fighting or loud voices     Weapons visible or in use      Signs of alcohol or other drug use    Unusual silence       Patient or family has history of prior violence It is not the staff’s responsibility to subdue a violent person or wrestle a weapon away from anyone. Always try to remain calm. Press the police emergency panic alarm button as soon as you can safely do so. Keep your voice level. If a perpetrator demands drugs, tell them the drugs are locked in the pyxis machine. If forced because of a weapon, give the drugs on demand.

29. Weapon/Hostage Situation con’t. In the event you are unable or prevented from making a phone call or pushing the panic alarm, comply with the requests of the person with the weapon. Do not try to resist. If you can move other patients and staff without escalating the situation, take action to move them off the unit to a safe location.

30. Procedure: • Press the emergency police alarm button in the event of any violent situation involving a weapon related situation, the switchboard will be immediately notified (7999) This will ring thru to Acute if on night connection. • Communications: • • Switchboard will call 9-911 to notify the police and initiate their response • - Notify Security via beeper and portable radio • - Notify administrator or his designee • - Notify the nursing supervisor • • Switchboard will then institute the Code White plan for Incident Command System only. ***Code Silver will now be paged overhead.*** • Police will be in command of the hostage / weapon situation upon their arrival.

31. Security: Will  respond to the scene and establish a perimeter, remove unaffected persons to a safe area and prevent further access into the incident scene. Security will obtain as much information as possible regarding:     - Number of perpetrators, victims and hostages     - Number and types of weapons involved     - Number of injuries Security will assemble the witness(es) in a safe location until the police can interview them.

32. Incident Command : • • Set up Incident Command, receiving report from the Nursing Supervisor  • • Immediately issue an all staff e-mail to inform all persons of the situation • • Prepare for Unified Command with law enforcement. • • May involve Local and State Police: • - Identify a separate area for their Incident Command • - Provide logistical support for Law Enforcement • • Activate a debriefing plan for patients, staff and visitors. • • If the Emergency Department is involved, set up another area with staff for Emergency patients. • • Identify a separate area, with counselors or clergy, for hostage and staff families to wait • • Set up a Media Relations Center • Consider notifying other area Hospitals

33. Other staff on duty at this time:  • Stay away from the scene  • Remain in your work areas; do as much as possible to secure your work area.  • Move patients out of public area to locations within work areas.  • Close main corridors doors • Account for all patients and visitors • Report any discrepancies to Incident Command  • Continue normal operations until otherwise advised by the Incident Commander or the “Cancel Code Silver” is heard.

34. Recovery: Once the incident has concluded the following actions need to be accomplished: • Switchboard will page “CANCEL CODE SILVER” three times • Switchboard will send a hospital-wide e-mail of the “Cancel Code Silver” • Provide immediate medical attention for all patients, staff or visitors who were injured • Collection and preservation of evidence by the police • Families should be reunited with their loved ones as soon as possible • Emotional support / debriefing for patients and visitors who are affected by the incident • Staff will receive mandatory debriefing either thru MAHHC or CISD (Critical Incident Stress Debriefing) team • Repair of any physical damage to the area • Actions needed to return the unit area to full operational status

35. Mitigation:Mt Ascutney Hospital and Health Center offers a MOAB (Management of Aggressive Behavior) communication class to all employees. It is mandatory for all Security, Emergency staff, and Rehab staff to attend the communication/hands-on training class annually. The communication portion of the class is strongly recommended for all other staff.

36. We hope this Computer Based Learning course has been both informative and helpful. Feel free to review the screens of this course until you are confident about your knowledge of the material presented. Click the Take Test button when you are ready to complete the requirements for this course.