1. MSDs, Back Care & Zero Lift

2. Musculoskeletal disorder (MSD) When performing every day tasks:
It can happen to you:
Back injury
Musculoskeletal disorder (MSD)
When performing every day tasks:
Moving residents
Housekeeping
Reaching for supplies
Typing
Back injuries and other musculoskeletal disorders are rampant in the healthcare industry.

3. Musculoskeletal Disorders (MSD)
Injuries that affect muscles, tendons, ligaments and nerves
Can develop when the same muscles are used over and over again or for a long time without taking time to rest
Chance of getting this type of injury increases if the force exerted is high and/or the job requires an awkward posture
Examples of musculoskeletal disorders include back pain, carpal tunnel syndrome, tendonitis and tenosynovitis.
MSD’s account for 54% of all Lost Time Injuries in the health care sector, with 40% of these related to client handling.
The back is the most common, but the shoulders, neck, elbows, hands and wrists are also frequently involved. MSD-related pain and discomfort have also been reported in the hips, knees, legs and feet.
A musculoskeletal disorder, or MSD, is an injury or disorder of the muscles, tendons, ligaments, joints, cartilage or spinal disks.
MSDs occur when you strain your body beyond its safe limits or do the same thing over and over again without time for your body to recover.
Recognizing and then removing or reducing the stress can prevent back injuries and other MSDs from developing.

4. MDS Symptoms The symptoms generally include:
Pain with or without movement
Swelling and tenderness
Reduced range of motion and/or stiffness, and
Tingling and/or numbness in nerve-related injuries or disorders.
While different body parts can be affected by these disorders, the symptoms of MSDs are similar no matter where they occur.

5. Preventing Musculoskeletal Disorders
Avoid awkward body positions
Avoid overextended and awkward reaches
Avoid repetitive or heavy bending, twisting, reaching, lifting, lowering, pushing and pulling
Take rest breaks from repetitive or forceful tasks
Move around and occasionally change positions

6. Preventing Musculoskeletal Disorders
Use the equipment and tools provided to reduce exposure to MSD hazards
Go to your supervisor with questions, concerns and for additional training
Suggest ways to improve working conditions through the JHSC
Be aware of the symptoms of MSD and if you have any, report them to your supervisor.

7. Back Care Reducing the Risk of Injury

8. Back Anatomy Spine has 24 bones (vertebrae)
Discs between vertebrae absorb shock
Spinal cord carries nerves that control all activities below the neck
Unbalanced/stressed spine can cause a progression of back problems
Interesting Facts:
Back injuries are second only to the common cold as a reason for lost time at work.
Back injuries are a leading cause of long-term illness from injuries in the workplace.
Back injuries account for millions of dollars of lost revenue for companies each year.
About 80% of people have back pain at some time in their lives.

9. Causes of a Stressed Spine
Lack of exercise
Weak abdominal and back muscles can’t support spine
Leads to sway back and weakened joints
Pot belly pulls back muscles/stretches and weakens abdominal muscles
Poor Physical Condition

10. Bad Posture/Chronic Strain
Causes of a Stressed Spine
Bad Posture/Chronic Strain
Slouching, rounded shoulders, one hip higher than the other
Sitting for long periods of time (higher compressive force on discs then standing)
Standing for long periods without keeping spine in balance
Working in awkward, uncomfortable positions

11. Improper Lifting Causes of a Stressed Spine Twisting at the waist
Overhead lifting/lifting below knuckle height
Lifting or carrying objects with awkward shapes/no handles
Lifting heavy objects unsafely
The greater the horizontal reach (away from the navel) = greater risk
Improper Lifting

12. Prevention of Back Injuries

13. Lift Safely Use proper lift procedures . .
Test the weight of an object before lifting
Get help if it’s too heavy for you to lift it alone
Take a balanced stance, feet shoulder-width apart
Squat down to lift, get as close as you can

14. Lift Safely Tighten the abdominal muscles
Get a secure grip, hug the load
Lift gradually using your legs, keep load close to you, keep back and neck straight

15. Lift Safely
Once standing, change directions by pointing your feet and turn your whole body
Avoid twisting at your waist
To put load down, use these guidelines in reverse
Push, Don’t Pull when moving heavy objects. Pushing is easier on your back than pulling.

16. Safe Work Practices
Rearrange your work area to eliminate lifting, bending and reaching
Tasks done most often should be done at waist level
When possible, move the work to you, instead of stretching to reach the work
If you stand for long periods, take the stress off your back by placing one foot higher and in front of you
Divide the items into smaller loads. Moving several small loads is much easier on your back

17. Safe Work Practices
Reaching at a lower level, bend your knees, keeping your center of gravity between your feet, and your knees over your toes
Reaching a high shelf, place one foot slightly ahead of the other as you face the shelf. Shift your weight from the back foot onto the front foot as you move the item toward the shelf
Reduce the weight of the containers
Use lifting devices and carts whenever possible
Mopping is a repetitive motion; it can twist your spine if not done correctly

18. Client Handling
Zero Lift Policy

19. Marianhill’s Commitment to Client Handling Zero Lift Policies
Zero Lift Definition
No manual resident lifting, where the entire weight of the resident or object is anticipated. This pertains to 1 person, 2 person and/or 3 person lifting (not transferring)
All total lifts must be completed with the use of resident lifting devices (total lifts, sit stand lifts and re-positioning in bed devices such as slider sheets)
* The only exception to this policy is an Emergency situation whereby a resident must be moved to safety immediately to prevent further threats to safety and security
Goals of the Zero lift program are:
-decrease the risk of musculoskeletal disorders associated with resident handling activities
-promote and support the health and safety of all residents and employees
-provide equipment, resources and training.

20. Policies and Procedures are in place and address:
Zero Lift Policy statement with Employee Statement of Understanding
Form for Initial Assessment and Re-assessments
Logo System to identify type of transfer/mechanical lift
Policies for:
Mechanical Lifting
Transferring
Re-positioning
Lift: The procedure used to lift or carry the weight of a person or object. A lift is used to move a resident who is physically unable to bear weight and/or mentally unable to help with the procedure. Lifting the entire weight of the resident from one surface to another using a mechanical device.
Mechanical Lift:
-Mechanical lifting device, either mobile (total lift) or ceiling lift which requires two people to operate.
Sit to Stand Lift:
-Mechanical lifting device, using a specialized sling for residents who have some weight bearing capability. Use to raise a resident from a sitting position to a standing position and vis versa.
Transferring: The procedure used to assist a resident who can bear weight. A transfer procedure should be used when appropriate transfer devices are available to match the resident’s need, when the resident is mentally capable, and when the resident car bear weight through one leg or both arms. Guiding and or assisting the movement of a resident from one surface to another. Resident can weight bear.
Repositioning: The procedure used to move a resident to a new position on the same surface. Repositioning should be used to move a resident up in bed or a chair, when the resident is physically unable to assist or mentally unable to follow instructions. Reposition also includes shifting, adjusting or changing the resident's position in a bed or wheelchair, chair or other supportive surface.
More education on types of lifts, transfers and repositioning residents will be provided in Jumpstart II- Nursing Orientation.

21. Logo’s for Resident Transfers
Independent
Unsupervised
Transfer
One Person Pivot
Independent Supervised
Transfer
All staff should be aware of what the logo’s are.
Registered staff and PSW staff must follow the appropriate lift and transfer that has been designated to each resident.
Two Person Pivot
Minimum Assistance Transfer

22. Logo’s for Resident Lifts
Sit/Stand Lift
Mechanical Lift
Ceiling Lift

23. Roles and Responsibilities of Workplace Parties
We are all responsible for ours and each others health and safety.
Employer
Supervisors
Staff
Joint Health &Safety Committee
Maintenance of Equipment by Staff
Maintenance of Equipment by Facility staff

24. Client Handling Zero Lift Policy Statement of Understanding
Marianhill is committed to providing a safe and healthy working environment for all staff and residents and has a client handling zero lift policy and protocol to eliminate manual lifting of residents. Any employee who violates this policy and manually lifts residents will be subject to disciplinary action.
Other Departments (dietary/janitor/house keeping/ maintenance etc) are to review with Department Manager the “physical demands analysis” of their job for safe lifting requirements.

25. Wellness and Exercise
Research indicates that workers who have a good level of physical fitness, experience fewer back injuries and recover faster from MSDs than unfit workers
Adopt a balanced exercise program, that includes cardio, aerobics, flexibility, muscle strength (ability to produce force) and endurance (ability of muscles to sustain static postures): 1. Warm up 2. Stretch 3. Perform activity or muscle training 4. Cool down (to remove lactic acid and reduce soreness) Consult your family physician before initiating an exercise program

26. Review of Back Care Strategies
Lift safely
Exercise regularly/improve muscle strength
Maintain ideal body weight
Sleep smart
Manage Stress (anxiety & stress tighten muscles in your back)
Assess work tasks and modify the work environment to reduce the risks of back injury:
Use carts and dollies, hoists and other lift- assist devices whenever you can
Inspect the workplace to keep it free of slip/fall hazards
Wear appropriate footwear
Keep communication flowing

27. Prevent Slips, Trips and Falls
Clean up wet surfaces
Avoid short cuts
Get rid of clutter
Use a ladder or step stool
Turn on the lights
Wear slip resistant shoes
Clean up wet surfaces:
-any time you see (or cause) a spill, clean it up right away. If you can’t, mark it with a sign or paper towels and report it to the appropriate person for cleanup.
Avoid Short Cuts:
-the more short cuts you take, the greater your chance for talking a tumble. For safety’s sake, use designated walkways and only carry loads you can handle.
Get Rid of Clutter:
-Put away clutter-especially in walkways and on stairs-and don’t leave tools, boxes, books and other materials lying about.
Use a ladder or step stool:
-Use the right climbing equipment or the job. Rather than standing on the nearest tall object you can find, take a minute to find a ladder or step stool.
Turn on the lights:
-Good lighting helps you see any hazards in your way. Turn on lights before entering a room, and replace dead bulbs as soon as they burn out.
Wear Slip-resistant shoes:
-Increasing the friction between your shoes and the surface you walk on helps prevent slip injuries.

28. Questions