Ergonomics is the science of fitting the job to the worker. When there is a mismatch between the physical requirements of the job and the physical capacity of the worker, work-related musculoskeletal disorders (MSDs) can result.
Ergonomics provides a means for adjusting the work environment and work practices to prevent injuries before they occur. Health care facilities have been identified as an environment where ergonomic stressors exist.
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Employees can suffer ergonomic injuries during the handling, transferring, and positioning of patients.
Patient handling tasks pose increased ergonomic risk if they:
Other hazardous actions that can cause ergonomic injuries due to overexertion include:
Employee exposure to work related MSDs from ergonomic stressors that have not been effectively identified and addressed in a safety and health program could be a potentially hazardous situation.
Many patients, especially nursing home residents, are totally dependent on staff members to provide activities of daily living, such as dressing, bathing, feeding, and toileting. Each of these activities involve multiple interactions with handling or transferring of patients and could result in employee injuries. Employee injuries lead to increased injury costs, higher turnover rates, increased sick and/or injured days, and staffing shortages.
OSHA recommends minimizing the manual lifting of patients in all cases. Employees should eliminate lifting whenever possible. Employers should also identify and address ergonomic stressors in their facility’s safety and health plan.
Areas that should be addressed a facility's safety and health program include:
Let’s take a closer look at each of these components.
Management should demonstrate a commitment to reduce or eliminate patient handling hazards by developing a written program that addresses issues, such as:
Employee participation should include:
Employers should conduct an analysis of workplace tasks to identify existing and potential workplace hazards and find ways to correct these hazards.
Analysis of work task factors that can increase the probability and severity of worker injuries involves:
Observation, workplace walkthrough inspections, talking with employees, and periodic surveys are the methods used to help identify the hazards inherent in patient-handling tasks.
OSHA issued a revised Recordkeeping Rule to improve the system employers use to track and record workplace injuries and illnesses. Final rule became effective on Jan. 1, 2002.
Without proper recordkeeping, illness and injury trends would go unreported and unstudied and valuable information about causes and possible prevention of injuries would be lost.
Exposure to ergonomic stressors in healthcare workplaces can result in a variety of disorders in affected workers referred to as musculoskeletal disorders (MSDs). MSDs may develop gradually over time or may result from instantaneous events such as a single heavy lift. These conditions will be classified on recordkeeping forms as either injuries or illnesses. It is critical for recording keeping data to be kept accurately and that employers do not under report these events.
For more on recordkeeping basics, please check out OSHAcademy course 708-OSHA Recordkeeping Basics.
This includes implementing administrative and engineering controls to help prevent ergonomic injuries.
Administrative controls: These are typically rules or procedures established by management to decrease the likelihood of an injury. For example, providing for adequate staffing, assessment of patient needs and restricted admittance policies.
Engineering controls: Help to isolate or remove the hazard from the workplace. Providing proper selection, training, and use of assist devices or equipment are all examples of engineering controls.
A medical management program, supervised by a person trained in the prevention of musculoskeletal disorders, should be in place to manage the care of those injured. The program should include:
A training program, designed and implemented by qualified persons, should be in place to provide continual education and training about ergonomic hazards and controls to managers, supervisors and all healthcare providers, including "new employee" orientation.
Training should be updated and presented to employees as changes occur at the workplace, and be at a level of understanding appropriate for those individuals being trained, and should also include:
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Borderview Rehabilitation and Living Center in Maine reduced musculoskeletal injury rates through an ergonomics program. The program involved employee participation and feedback, workstation and equipment modifications, and reassessment of the changes that are made.
Let’s take a closer look at the problem and how management, along with employees, fixed the issue.
All 153 employees were trained in proper body mechanics for job-related tasks; however, several back injuries were still being reported over a short period of time.
The company already had annual department-specific “back care” training in place to teach employees about proper body mechanics. After the numerous back injuries were reported, Borderview developed and implemented a program of separate analysis of the jobs in each department. As part of the job task analyses, the employees also completed a questionnaire where they could voice their concerns and comments. With input from the employees, the department heads worked with an ergonomics team to modify tasks and/or change the work environment and/or equipment.
After the changes were made, management consulted employees to determine if the changes were effective or if additional modifications were needed. Employees also participated in exercise programs designed by the company’s physical therapists to increase strength and reduce the likelihood of injury.
The company had three times achieved its goal of 100 consecutive days with a lost-time injury.