Patient Care Ergonomics Training for Healthcare Workers

OSHA Nursing Home Guidelines

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

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.

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

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)

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)

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

Reducing Staff Injury and Improving Patient Safety

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

Strategies to Reduce Ergonomic Injuries in Industries

Enforcement
General Duty Clause

Ergonomic Guidelines
Act as Guidelines Offer Best Practices & Sources of Information

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.

OSHA Guidelines for Nursing Homes

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

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)

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

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 *

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

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

Consider employee exposure to: Forceful exertions Repetitive activities Awkward postures

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

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

OSHA Ergonomic Guidelines for Nursing Homes

Training Recommendations
for

Nursing Assistants and Other Workers at Risk of Injury

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 workrelated injuries & illnesses as required by OSHA

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

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

Causes of Workplace MDSs

Exposure to:
Repetition Forceful Exertions Awkward Postures Contact Stress Vibration

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)

Musculoskeletal Disorders

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

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

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

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!

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.

OSHA Ergonomic Guidelines for Nursing Homes

Training Recommendations
for

Charge Nurses & Supervisors

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

OSHA Ergonomic Guidelines for Nursing Homes

Training Recommendations
for

Designated Program Managers

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

You Have Help!

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

You Have Help!

OSHA Ergonomic Guidelines for Nursing Homes
www.osha.gov/ergonomics/guidelines/nur singhome/index.html

OSHA website www.osha.gov OSHA Compliance Assistance Specialists in OSHA area offices

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)