Course 623 - Healthcare: Preventing Ergonomic Injuries

Safety guides and audits to make your job as a safety professional easier

Safety and Health Program

Introduction

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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1. Ergonomics is the science of fitting the _____ to the _____.

a. job, worker
b. position, location
c. qualifications, worker
d. job, position

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wheelchair

Ergonomic Injuries

Employees can suffer ergonomic injuries during the handling, transferring, and positioning of patients.

Patient handling tasks pose increased ergonomic risk if they:

  • are repetitive (e.g., repeatedly cranking manual adjustments for beds)
  • done using awkward postures (e.g., reaching across beds to lift patients)
  • require a large amount of force (e.g., pushing chairs or gurneys across elevation changes or up ramps)
  • include lifting heavy objects (e.g., manually lifting immobile patients alone)
  • require twisting the back while lifting and moving patients

2. Patient handling tasks pose increased ergonomic risks if they _____.

a. are done using static postures
b. are not too repetitive
c. require a large amount of force
d. contain many steps

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lifting

Other Hazardous Actions

Other hazardous actions that can cause ergonomic injuries due to overexertion include:

  • trying to stop a patient from falling or picking patient/residents up from floor or bed
  • performing multiple lifts per shift (more than 20)
  • lifting alone, no available staff to help
  • lifting uncooperative, confused patients
  • lifting patients who cannot support their own weight
  • moving patients who are overweight (bariatric patients)
  • stretching to lift or pull patients or objects
  • working in awkward postures created by the task

3. A hazardous action that can cause ergonomic injuries due to overexertion is _____.

a. walking to the aid of a patient
b. working in an awkward posture
c. excessive use of lifting devices
d. talking while lifting a patient

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Potential Hazards

nursing home

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.

Possible Solutions

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:

  • management leadership/employee participation
  • workplace analysis
  • accident and record analysis
  • hazard prevention and control
  • medical management
  • training

Let’s take a closer look at each of these components.

4. OSHA recommends minimizing the manual lifting of patients in _____ cases.

a. 50% of
b. majority of
c. all
d. minimum of

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Management Commitment

Management should demonstrate a commitment to reduce or eliminate patient handling hazards by developing a written program that addresses issues, such as:

  • continued training of employees in injury prevention
  • methods of transfer and lifting to be used by all staff
  • compliance with transfer and lift procedures
  • procedures for reporting early signs and symptoms of back pain and other musculoskeletal injuries

Employee Participation

Employee participation should include:

  • complaint/suggestion program which includes employee reports of unsafe working conditions
  • prompt reporting of signs and symptoms as well as injuries

5. Management should demonstrate a commitment to reduce patient handling hazards by _____.

a. developing a written program
b. increasing the number of healthcare workers
c. preventing patients from getting out of bed
d. allowing workers to delay reporting signs and symptoms

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workplace analysis
Employers should conduct a workplace analysis to identify hazards.

Workplace Analysis

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:

  • determining the duration of tasks;
  • determining the frequency of tasks; and
  • identifying ergonomic stressors such as force, repetition, awkward postures, and vibration encountered in tasks.

Observation, workplace walkthrough inspections, talking with employees, and periodic surveys are the methods used to help identify the hazards inherent in patient-handling tasks.

6. Which task factors can increase the probability and severity of worker injuries?

a. Accurate recordkeeping of noncompliance
b. The duration and frequency of tasks
c. Prompt reporting of signs and symptoms
d. The nature and extent of all injuries

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recordkeeping

Accident and Record Analysis

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.

Potential Hazard

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.

Possible Solutions

  • Follow the OSHA Recordkeeping Standard.
  • Employers must record each fatality, injury or illness that:
    • is work related
    • is a new case
    • meets one or more of the criteria contained in sections 29 CFR 1904.7 through 1904.12 of the regulation

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.

7. Employers must record each fatality, injury, or illness that is _____.

a. not work-related and an old case
b. serious and dangerous
c. work-related and an old case
d. work-related and a new case

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Hazard Prevention and Control

hazard prevention
Employers should implement administrative and engineering controls to help prevent ergonomic injuries.

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.

Medical Management

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:

  • accurate injury and illness recording
  • early identification and treatment of injured employees
  • "light duty" or "no lifting" work restrictions during recovery periods
  • systematic monitoring of injured employees to identify when they are ready to return to regular duty

8. These are typically rules or procedures established by management to decrease the likelihood of an injury.

a. Administrative controls
b. Engineering controls
c. Workplace analysis
d. Hazard prevention

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Training

training

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:

  • The opportunity to ask questions of the trainer.
  • An overview of the potential risks, causes, and symptoms of back injury and other injuries. Be able to identify existing ergonomic stressors and methods of control, such as the use of engineering, administrative, and work practice controls particularly safe resident handling techniques.
  • Recognizing the signs and symptoms of MSDs and the procedures for reporting potential problems.
  • Encouragement of staff physical fitness.
  • Lifting guidelines for health care workers (nurse assistants, licensed practical nurses, registered nurses) which should include:
    • Never transfer patients when off balance.
    • Lift loads close to the body.
    • Never lift alone, particularly fallen patients, use team lifts or use mechanical assistance.
    • Limit the number of allowed lifts per worker per day.
    • Avoid heavy lifting especially with spine rotated.
    • Training in when and how to use mechanical assistance.

9. A training program should be implemented by _____.

a. management
b. employees
c. qualified persons
d. supervisors

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Case Study

Success with Ergonomics-Case Study

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.

The Problem

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 Solution

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 Impact

The company had three times achieved its goal of 100 consecutive days with a lost-time injury.

Caring for Caregivers

A Missouri health-care foundation is teaching its workers to look out for their own health and safety as well as their residents’. Read more here.

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