Presentation on theme: "Applied Ergonomics for LTC"— Presentation transcript:
1 Applied Ergonomics for LTC University of Oregon, Labor Education and Research Center (LERC) and Oregon Occupational Safety and Health Administration (OR-OSHA)This material has been made possible by a grant from the Oregon Occupational Safety and Health Division, Department of Consumer and Business Services
2 AcknowledgementsMaterials for this presentation material made possiblebyOregon OSHAVeterans Health AffairsSAIF CorporationHumanFitBay Area Hospital, Coos Bay, OROregon Nurses Association (ONA)University of Oregon, Labor Education and Research CenterBack Injury Resource Nurses (BIRN)National Institute of Occupational Safety and Health (NIOSH)
3 Introduction Today’s workshop will cover Ergonomic concepts Risk factors for musculoskeletal injuryElements of an ergonomics programSRH Case studies
4 Learning ObjectivesBy the completion of this class you should be able to:List 4 risk factors for musculoskeletal injuryDescribe 4 action steps that can reduce your risk of injury during resident handling activitiesIdentify effective solutions to prevent injuries in for number of common resident handling activities
5 What is Ergonomics? Worker Task/job EnvironmentPurpose: To review the definition of ergonomics:Emphasis: Ergonomics is the fit between the worker, the job and the work environment. It is important to stress that ergonomics is adapting the workplace, rather than adapting the worker. Many people believe that ergonomics is just making the worker more fit through fitness training, such as stretching and strength training. For some people, body mechanics is their idea of ergonomics. These activities are important for staying healthy and preventing injury but research has shown that body mechanics and fitness alone are ineffective approaches to injury prevention.Action Point: explain the above point to the group and ask them why fitness alone can not prevent injury. They should be able to point out that no matter how fit you are, there are many situations in Fire and EMS that require workers to use lift heavy loads, such as very heavy Residents being removed from a crowded bedroom or bathroom. Ask them to come up with two or three other examples. Such as repetitive activities, and activities requiring awkward postures.The goal of ergonomics is to design thejob to fit the workerNOT make the worker fit the job
6 What kinds of Injuries are Musculoskeletal Disorders (MSDs)? Acute injuriesHappen immediately due to overloadCan become chronicRe-injury possibleStrains, sprains, disc herniationsChronic injuriesPain or symptoms lasting morethan a monthCumulative traumaHappen over timeDifficult to cure
7 Cumulative Trauma/Injury Activitymicrotrauma (small tears)irritation to tissueproduces scar tissueKeeps repeatingas long asactivity continuesresults in: flexibility strengthFunction*INJURY*adhesions formtears combine
8 Nurses/CNAs report here The Cumulative EffectFatigueContinued exposure to risk factorsDiscomfortNurses/CNAs report herePainRisk of injury is increased with increased exposure, greater intensity and a combination of factorsInjuryDisabilityTime
9 Terms for Disorders Work-related Musculoskeletal Disorder (WRMSD) Cumulative Trauma DisorderRepetitive Strain InjuryOverexertion or Overuse InjuryTypes of disordersStrains and sprainsRotator cuff injuriesDisc herniationsCarpal Tunnel SyndromeBursitis, tendonitisSciaticaPurpose: Introduce terms for cumulative traumasEmphasis: There are many names for musculoskeletal injuries but they all refer to the same types of injuries. These are not ‘acute’ injuries such as a fracture due to a fall.Action Points: Ask the class if they are familiar with these terms. Ask them to provide examples of a few of these types of injuries. For example, carpal tunnel syndrome, tendonitis at the elbow, shoulder bursitis. Would a lumbar disc herniation be an example of a cumulative trauma injury? Why or why not?
10 Why is Manual Resident Handling so Hazardous? Physical demands of the workJob exceeds physical demands of individualsPoor equipment and facility designPoor work practicesIndividual characteristicsAge, past injuries, physical condition, leisurely activities
11 What are the Risk Factors for Musculoskeletal Disorders? Excessive forceAwkward posturesProlonged posturesRepetitionPurpose: Begin the discussion of risk factorsEmphasis: There are known risk factors that are related to the incidence of musculoskeletal disorders. (read through list). We will discuss these in more detail in the following slides.Action point: There is a risk factor handout that goes with this section. The handout has the risk factors listed and for some of the risk factors there is space for the workers to write down examples. Have the class write in examples of tasks they do on the job that has the risk factor after you review each risk factor is with them. Give them about 3-4 minutes to complete the handout. Then, ask the class to tell you their examples of each risk factor and write their responses on the board. Plan on 10 minutes for this exercise.
12 Excessive Forces Common activities contributing to excessive force: Lifting and carryingPushing and pullingReaching to pick up loadsProlonged holdingPinching or squeezingPurpose: To introduce and explain excessive forcesEmphasis: High forces occur when excessive strength must be used to accomplish a task.Action Points: Ask if other examples come to mind.
13 Awkward Postures Common risky postures: Kneeling all day Working overheadKneeling all dayReaching to pick up loadsTwisting while liftingBending over to floor/groundWorking with wrist bentPurpose: To introduce and explain awkward posturesEmphasis: An awkward posture is any uncomfortable position. For each joint, anything that is out of ‘anatomical position’ is considered awkward, especially when you hold the position for a prolonged period of time.Action Points: Ask class to provide specific examples from there work.
14 Prolonged Postures Standing or sitting for long periods of time Holding arms in fixedpositions for extendedperiods
15 Repetitive Motions Common problem to look for: Same posture or motions again and againcan be very frequent over short period of timecan be less frequent but repeated over timeinjurytimePurpose: Introduce and explain the concept of repetitive motionsEmphasis: Repetitive motions can be motions that are repeated either at a high frequency over a short period of time as shown in this top example or low frequency but repeated over a long period of time as shown in the bottom example. The one that is of most concern for emergency service workers is the latter since most tasks are not repeated several times in a minute but more risky tasks are repeated several times in a shift. An example may be lifting the gurney with a Resident into the medic unit.The top example represents a job such as manufacturing, or computer keyboarding, where a worker might use the same hand movements hundreds or more times a day and the time until injury manifests is relatively short. The lower example is more like the jobs performed by fire/EMS personnel, since most tasks are not repeated several times in a minute but more risky tasks are repeated several times in a shift through a working career. A good example of this type of repetition would be lifting the gurney with a Resident into the medic unit.Action Points: Ask the class how this relates to their workinjurytime
16 Common Problems Leading to MSDS :Poorly Designed EquipmentDoes not have a good gripToo heavyHard to useUncomfortableBad conditionWrong tool/equipment for the jobPurpose: Introduce and discuss direct pressure and poorly designed equipmentEmphasis: Direct pressure or poorly designed equipment or tools is when tools or equipment that you use causes discomfort because of the way the tool or equipment is held. Direct pressure on any part of the body can compromise blood flow and therefore compromise the soft tissues.Action Points: Ask for examples for their jobs.
17 Common Problems Leading to MSDs Poor work organizationIn adequate schedulingLack of planningPoor communication among staff and otherresident stakeholdersPoor work practicesPurpose: Introduce the concept of work organization as it relates to ergonomicsEmphasis: Work organization is also a risk factor for MS injury. This include the way in which departments are organized and administered.Action Points: Ask for examples of work organization changes that might reduce the risk of MS injury. For example, crews of 4 rather than 3 reduce the loads carried by having 4 people lift instead of 3. Are there other examples? Are these types of ergonomic changes practical? Why or why not? Identify barriers and ask how can they move beyond the barriers?
18 When is an Activity Likely to Become an Injury? Activity performed frequentlyYou do the activity a long timeWork intensity is highThere are a combination of risk factorsPurpose: Introduce the idea of combined factorsEmphasis: These factors alone, time, frequency and intensity do not make an activity risky. When an activity is frequent, lasts a long time, is intense and combines risk factors, then it is more likely to eventually become an injury. These are important to remember when you are doing a hazard assessment.Action Points: Ask the group what these terms mean.
19 How do you find solutions? JobTasksSolutionHazardsSolutionForm SRH teamErgonomic Risk AnalysisNeeds AssessmentFormulate solutionsSolutionPurpose:Emphasis: So once you have identified and prioritized the risky jobs and hazardous tasks have been identified, these hazards need to be addressed. The people charged with finding solutions to the identified hazards must brain storm a list of potential solutions that can be taken to the command staff. This could be done in conjunction with an ergonomics team, the equipment selection committee, a shift crew, the safety committee, the training crew or even an individual. It is also important for the department to decide how to manage the flow of information on solutions. There are potentially many solutions that could reduce the hazards.Action Point:Solution
21 Choose Effective Solutions MostEffectiveEngineeringTools/equipmentWorkplace designAdministrativeJob rotationNumber of workersWork practicesChanging bed heightBehavioralBody mechanicsStretching/FitnessPPEEmphasize that some solutions are more effective than others. Behavior solutions, such as body mechanics and stretching programs are generally NOT effective and should only be used as a last resort.LeastEffective
22 Preventing MSDS First Choice: Engineering Controls Eliminate or reduce primary risk factorsUse resident handling equipment, such as,ceiling and portable floor lifts, air assist transfer devices, and mechanical sit to stand liftsMust match equipment use withResident dependency (physical and cognitive abilities)Type of lift, transfer or movementNumber of staff available
23 Preventing MSDS Second Choice: Administrative Controls Reduce employee exposure to primary risk factorsErgonomics trainingPolicy & procedures that define good work practicesStaffing and overtime practicesJob rotation
24 Preventing MSDS Second Choice: Work Practice Controls Reduce employee exposure to primary risk factors by using best work methods:Plan work organizationUse good housekeeping practicesUse adjustments on equipmentGet help when neededEliminate unnecessary movementsDon’t use broken equipmentRemember – it’s the employee’s responsibility to use good work practices and follow the organizations’ safe resident handling policy and procedures
25 Preventing MSDs Second Choice: Work Practice Controls Neutral spine posture - 3 Curves make your spine strong and minimize physical stressIt is important to KEEP THESE CURVES when moving, bending and liftingNeutral spine is the reason body builders can lift so much weight without injuryCervicalThoracicLumbarPurpose: Explain neutral spine.Emphasis: Neutral spine reduces stress to the bones, discs, muscles, ligaments. Many disc herniations occur due to fracture of the vertebral endplate. This can happen when the spine is overloaded. Neutral spine posture distributes the load to the vertebrae and reduces the chance of an end fracture or disc herniation.Neutral spine is the place where the spine is most stable and least likely to be injured. The reason the lumbar lordosis is so important is that this part of the spine bears most of the body weight plus the weight of whatever load is being lifted and carried.Action Point: none.Using good body mechanics is important, even when using equipment, but alone body mechanics will NOT prevent MSDs
26 Conduct Ergonomic Risk Assessment Recognizing hazards is the first step toward injury preventionJob analysis performed by people with ergonomics trainingErgonomics teamSafety committee membersLine personnelPurpose: Introduce the concept of Job Hazard AssessmentEmphasis: Before you can come up with solutions, you must do an assessment to understand the hazard. Recognizing the hazards is the first step toward injury prevention. With some training, line personnel can perform a hazard analysis or you can have the ergonomics team or safety committee members complete hazard analyses. Let them know that this topic will be covered in greater depth in another module.Action Points: none
27 Reduce Your Risk of MSDs? What Can You Do toReduce Your Risk of MSDs?The following materials from the Safe Resident Handling in Health Care Guide, and made possible by a grant from Oregon OSHA, Department of Consumer and Business Services,Used with permission from Oregon Nurses Association, UO LERC and Bay Area Hospital, Coos Bay, OR
28 Plan and Prepare – It only takes a minute but can save a career Risk Assessment stepsAssess the residentAssess & prepare the environmentGet necessary equipment & helpPerform the Resident care task, lift or movement safelyDiscuss what is the current practice for assessing residents. Discuss VA algorithms for patient handling.Plan and Prepare – It only takes a minute but can save a career
29 Assess the Resident Goal: To assess if resident status (physical and cognitive abilities) has changed and to determine the safest method to transfer or move the resident.Compare assessment with resident handling orders or instructions in the Resident's Care Plan and ensure that staff are alerted to changes in resident status.
30 Assess the ResidentThis brief observation includes assessment of the resident’s:Ability to provide assistancePhysical status – ability to bear weight, upper extremity strength, coordination and balanceAbility to cooperate and follow instructionsMedical status – changes in diagnosis or symptoms, pain, fatigue, medicationsWhen in doubt, assume the resident cannot assist with the transfer/ repositioning
31 Assess & Prepare the Environment Ensure that the path for transfer or movement is clear and remove obstacles and clutter that constrain use of good posture and access to the Resident, e.g.,bed tables, and chairstrip hazards, e.g., cords from medical equipmentslip hazards , e.g., spilled beverages or other fluids on the floor
32 Assess & Prepare the Environment Consider safe handling of medical devices, such as catheters, intravenous tubing, oxygen tubing, and monitoring devicesEnsure good lighting.Adjust equipment, such as beds to correct working height to promote good posturesKeep supplies close to body to avoid long reaches
33 Get Necessary Equipment & Help Get the correct equipment and supplies for the task as determined in the Resident Care Plan and after the Resident Assessment in Step 1Get additional help as requiredEnsure thatEquipment is in good working orderDevices such as gait belts and slings are in good condition and the correct sizeThe resident is wearing non-slip footwear if they are to be weight bearing
34 Perform Resident Care Task, Lift or Movement Safely Explain the task to the resident – agree on how much help he or she can give during the taskPosition equipment correctly, e.g., height between a stretcher and bed is equalApply brakes on equipment and furniture usedLower bed rails when necessaryYou should receive training on correct use of equipment, resident assessment and safe work practices before handling Residents
35 Perform Resident Care Task, Lift or Movement Safely Coordinate the task as a team (nurses and Resident)Have the Resident assist as much as possibleUse good body posture – keep work close to the body and at optimal heightKnow your physical limits and do not exceed themFollow your organizations safe Resident handling policy and procedures
36 What else can you do? Report ergonomic problems to your supervisor Apply back injury prevention principles to your off -the-job activitiesReport any physical problems early – leads to a quicker recovery
37 Safe Resident Handling Program: Applied Ergonomics for Nurses and Case StudiesSafe Resident Handling Program: Applied Ergonomics for Nurses andHealth Care Workers
38 Case Studies Case study 1: Repositioning resident in bed Case study 2: Transfer from chair to bedCase study 3: Transfer from bed to stretcherCase study 4: Transfer from wheelchair to bedCase study 5: Making a bed & repositioningresident in bedCase study 6: Resident ambulation and fallrecovery
39 Ergonomic Analysis Form Potential Risk Factors and Body RegionsRoot Causes Observed (Reason)Possible SolutionsRepetitive Forward bend of torso >60 coupled with twisting and side bending backLifting bags from floor.Dirty linen bagsWeighing about20 lbs eachConsider carts for garbage and soiled laundry with spring load bases that reduce reach and force required to load and unload bags.
40 Case StudiesRemember – what you are about to practice is not a substitute for specific training on safe use of resident handling equipmentNot all resident handling equipment available is shown in the videoAlways follow the Resident handling policy at your facility
41 Case Study 1 Repositioning Resident in Bed What Did You See?Identify primary risk factors for MSDsIdentify hazards that may cause slips, trips, falls or other acute or traumatic injuriesDetermine the cause or the primary risk factors and hazards observedDetermine a safer way to perform the taskAsk participants not to look at the power point handout for each case until after working on that case.
42 Case Study 1 Repositioning Resident in Bed TaskRisk Factors & HazardsCauseInjection of medicationBack bent & twisted coupled with static postureTrip HazardBed too lowRail upBed table obstructs accessPhone on bed – cord on floorDispose of needleBack bentNeck bent backwardsLong reach (arm overhead)
43 Case Study 1 Repositioning Resident in Bed TaskRisk Factors & HazardsCauseReposition residentBack bent & twistedNeck bent backwardsForceful exertion– back and shoulderBed too lowRail upResident weightResident did not assist
44 Case Study 1 Repositioning Resident in Bed: The Safer WayAssess the ResidentHas upper extremity strength, can sit unaided, is non-weight bearing, cooperative (consider medical status etc.)Assess the EnvironmentMove bed table and phone, raise bed, lower rail when administering injectionRaise bed and lower bed rails before moving resident
45 Case Study 1 Repositioning Resident in Bed: The Safer WayGet Necessary Equipment & HelpFriction reducing device (slippery sheet) & two nurses or CNAsPerform the Task SafelyCoordinate the moveUse good postureHave resident assist
46 Case Study 2 Transfer from Chair to Bed What Did You See?Identify primary risk factors for MSDsIdentify hazards that may cause slips, trips, falls or other acute or traumatic injuriesDetermine the cause or the primary risk factors and hazards observedDetermine a safer way to perform the task
47 Case Study 2 Transfer from Chair to Bed TaskRisk Factors & HazardsCauseAssisting resident from chair to bedForceful exertion – backBack bent & twistedResident weightResident not capableof bearing full weightResident not assessedChair too low
48 Case Study 2 Transfer from Chair to Bed TaskRisk Factors & HazardsCauseAssisting resident onto bedForceful and suddenexertion – backBack bent & twistedNeck bent backwardsResident not capable of full weight bearingResident not assessedRepositioning in bedForceful exertion – backBed too low
49 Case Study 2 Transfer from Chair to Bed: The Safer Way Assess the ResidentPartial weight bearing, cooperative, has upper extremity strength and can sit unaidedAssess the EnvironmentMove bed table, lower head of bed; lower bed rail using good posture
50 Case Study 2 Transfer from Chair to Bed: The Safer Way Get Necessary Equipment & HelpPowered Sit-to-Stand deviceOnly one caregiver neededPerform the Task SafelyApply equipment brakes when raising or lowering residentRaise bed before lifting resident’s legsUse good postureHave Resident assist
51 Case Study 3 Transfer from Bed to Stretcher What Did You See?Identify primary risk factors for MSDsIdentify hazards that may cause slips, trips, falls or other acute or traumatic injuriesDetermine the cause or the primary risk factors and hazards observedDetermine a safer way to perform the task
52 Case Study 3 Transfer from Bed to Stretcher TaskRisk Factors & HazardsCausePositioning stretcher in roomBack bent and twistedSharp corners or protruding edges on furniture (risk of soft tissue contusion)Poor posture orbodymechanicsMoving furniture inconstricted spacePreparing transferBack bentLong reach (armoverhead)Passing IV bag and tubing over bed
53 Case Study 3 Transfer from Bed to Stretcher TaskRisk Factors & HazardsCausePerforming transferExtreme forceful exertion – back and shouldersBack bentNeck bent backwardsExtreme bending of knee (on bed) coupled with forceExtended reach to grasp drawsheetForceful grip (poor hand hold)Resident weight/shapeResident unable toassistStretcher higher thanbed heightWidth of stretcherand bedUse of drawsheet tomove resident
54 Case Study 3 Transfer from Bed to Stretcher TaskRisk Factors & HazardsCauseMoving stretcherForceful exertion - back and shoulderBack bent and twistedNeck bent backwards and twistedArms extended away from bodyPushing andpulling stretcher oncarpeted surfaceLack of holder onstretcher for O2 tankLack of steeringcontrol on stretcherStretcher too low
55 Case Study 3 Transfer from Bed to Stretcher: The Safer Way Assess the ResidentThis is a Bariatric resident who cannot assist with the transferAssess the EnvironmentMove furniture from of work area before bringing stretcher into room
56 Case Study 3 Transfer from Bed to Stretcher: The Safer Way Get Necessary Equipment & HelpAir assisted friction-reducing device & three caregiversPass IV bag around residentStretcher has holder for IV and Oxygen tankLarger wheels and steering assist mechanism
57 Case Study 3 Transfer from Bed to Stretcher: The Safer Way Perform the Task SafelyCoordinate the preparation and transferWork heights equal and equipment/bed brakes appliedUse good postureAdjust stretcher height for movement to allow good posture2nd person required to guide front of stretcher only
58 Case Study 4 Transfer from Wheel Chair to Bed What Did You See?Identify primary risk factors for MSDsIdentify hazards that may cause slips, trips, falls or other acute or traumatic injuriesDetermine the cause or the primary risk factors and hazards observedDetermine a safer way to perform the task
59 Case Study 4 Transfer from Wheel Chair to Bed TaskRisk Factors & HazardsCausePreparing to assist the residentForceful exertion - backBack bentNeck bent backwardsHolding resident’s legwhile adjusting foot restAdjusting leg supports/foot restsAssisting resident from wheelchair to bedForceful exertion – backBack bent & twistedresident not capable of full weight bearingResident weightResident not assessed
60 Case Study 4 Transfer from Wheel Chair to Bed TaskRisk Factors & HazardsCauseAssisting resident onto bedForceful and sudden exertion – backBack bent & twistedNeck bent backwardsResident not capableof full weight bearingResident not assessedWheel chair awayfrom bed
61 Case Study 4 Transfer from Wheel Chair to Bed TaskRisk Factors & HazardsCauseRepositioning in bedForceful exertion-backBack bent & twistedNeck bent backwardsBed too lowBed rail upHead of bed partially raisedResident does not assist
62 Case Study 4 Transfer from Wheel Chair to Bed: The Safer Way Assess the ResidentPartial weight bearing, cooperative, has upper extremity strength and can sit unaidedAssess the EnvironmentMove bed table, raise bed, raise head of bed, lower bed rail using good posture
63 Case Study 4 Transfer from Wheel Chair to Bed: The Safer Way Get Necessary Equipment & HelpGait belt; crutches and trapeze barOnly one caregiver needed
64 Case Study 4 Transfer from Wheel Chair to Be The Safer Way Perform the Task SafelyUse good posture to apply gait belt and to adjust wheel chair foot supportsHave resident assist to hold leg while adjusting foot supportDo NOT lift but guide resident to a standingHave resident transfer self to bed with stand-by assistHave resident reposition self on bed
65 Case Study 5 Making Bed & Repositioning Resident in Bed What Did You See?Identify primary risk factors for MSDsIdentify hazards that may cause slips, trips, falls or other acute or traumatic injuriesDetermine the cause or the primary risk factors and hazards observedDetermine a safer way to perform the task
66 Case Study 5 Making a Bed and Repositioning Resident in Bed TaskRisk Factors & HazardsCauseMaking bedForceful exertion – back and shoulders (CNA turning & holding resident)Back bent & twisted in static posture (CNA turning & holding resident)Repetitive bending & twisting of back (CNA making bed)Neck bent backwards (both CNAs)Resident weightResident unableto assistBed too lowBed Rails up
67 Case Study 5 Making a Bed and Repositioning Resident in Bed TaskRisk Factors & HazardsCauseMaking the bedForceful grip - Poor hand hold (nurse turning & holding resident)Slip HazardUsing drawsheetSpill on floorRepositioning resident in bedForceful exertion – back and shoulderBack bent & twistedNeck bent backwards & twistedResident weightResident unableto assistBed too lowRail up
68 Case Study 5 Making a Bed and Repositioning Resident in Bed: The Safer WayAssess the ResidentThis is a semi-conscious resident who is unable to assistAssess the EnvironmentClean up spill, have bed linens ready, raise bed and lower rails
69 Case Study 5 Making a Bed and Repositioning Resident in Bed: The Safer WayGet Necessary Equipment & HelpCeiling hoist and 2 nurses or caregiversPerform the Task SafelyCoordinate lift and movementEach nurse makes a side of the bedMove bed and/or use ceiling lift to reposition resident safely
70 Case Study 6 Resident Ambulation & Fall Recovery What Did You See?Identify primary risk factors for MSDsIdentify hazards that may cause slips, trips, falls or other acute or traumatic injuriesDetermine the cause or the primary risk factors and hazards observedDetermine a safer way to perform the task
71 Case Study 6 Resident Ambulation and Fall Recovery TaskRisk Factors & HazardsCauseAmbulating residentTrip hazardsSharp corners or protruding edges on furniture (risk of soft tissue contusion)Poor and unstable coupling (handhold)Equipment in walkwayNo safe way to supportresident – holding wristmay cause soft tissuetrauma to residentduring fall
72 Case Study 6 Resident Ambulation and Fall Recovery TaskRisk Factors & HazardsCauseAttempting to control the resident fallForceful exertion – backand shouldersBack bent & twistedNeck bent backwardsForceful twisting of leftforearm when attemptingto ‘hold’ resident duringfallResident weight coupled with sudden motionLocation of resident at floor levelPoor coupling –no location to securely support resident and control the fall safely
73 Case Study 6 Resident Ambulation and Fall Recovery TaskRisk Factors & HazardsCauseLifting Resident from floorForceful exertion – back and shoulderBack bentNeck bent backwardsForceful grip - Poor coupling hand holdResident weightResident unable to assistLocation of Resident- lift from floor levelNo safe way to holdresident’s arms and legs.Risk of soft tissuetrauma to resident
74 Case Study 6 Resident Ambulation and Fall Recovery: The Safer WayAssess the ResidentCan weight bear with standby assist and is cooperativeThe resident cannot stand without assistance after fallAssess the EnvironmentMove IV pole and wheelchair in walkway
75 Case Study 6 Resident Ambulation and Fall Recovery: The Safer WayGet Necessary Equipment & HelpUse gait belt for ambulationOnly one nurse or caregiver neededPortable powered floor lift and two nurses or caregivers to safely lift resident from floor using equipment
76 Case Study 6 Resident Ambulation and Fall Recovery: The Safer WayPerform the Task SafelyImprove coupling or handhold by using gait belt with handles (less grip force required)Control fall correctly using gait belt as aid (but not to ‘lift’ Resident)Maintain good posture while controlling the fall and supporting resident in floor lift slingUse of portable powered floor lift reduces injury risk for caregiver and resident
77 Applying your knowledge: Conducting a risk assessment
78 Resources National Center for Resident Safety http://www.va.gov/ncps/ Resident Safety Center of InquiryNational Institute of Occupational Safety and HealthOSHA (federal)Oregon OSHA:SAIF Corporation:
79 Wrap up & Evaluation Final questions Have audience fill out post assessment (white sheet).Do not separate from lavender sheet.