Course 623 - Preventing Ergonomic Injuries in Healthcare

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.

Ergonomic Injuries

wheelchair

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 in awkward postures (e.g., reaching across beds to lift patients)
  • done using a great deal of force (e.g., pushing chairs or gurneys across elevation changes or up ramps)
  • lifting heavy objects (e.g., manually lifting immobile patients alone)

Other Hazards

lifting

Other hazards include:

  • overexertion
  • trying to stop a patient from falling or picking patient/residents up from floor or bed
  • multiple lifts per shift (more than 20)
  • lifting alone, no available staff to help
  • lifting un-cooperative, confused patients
  • lifting patients who cannot support their own weight
  • patient weight (bariatric patients)
  • expecting employees to perform work beyond their physical capabilities
  • distance to be moved, and the distance the patient is from the employee (it is more stressful to reach away from the body to lift or pull a patient)
  • awkward postures required by the activity
  • ineffective training of employees in body mechanics and proper lifting techniques

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.

Management Leadership

Management leadership should demonstrate a commitment to reduce or eliminate patient handling hazards through establishing 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

Workplace Analysis

Employers should conduct an analysis of the workplace to identify existing and potential workplace hazards and find ways to correct these hazards.

Assessment of work tasks involves:

  • examination of duration
  • frequency
  • magnitude of exposure to ergonomic stressors such as force, repetition, awkward postures, vibration and contact stress to determine if employees are at risk of pain or injury
Observation, workplace walkthroughs, talking with employees and periodic screening surveys are used to help identify hazards such as stressful tasks.
recordkeeping

Accident and Record Analysis

Records of injuries and illnesses should be analyzed to identify patterns of injury that occur over time, enabling the hazards to be addressed and prevented.

This includes reviewing OSHA 300 logs, OSHA 301 forms and Workers' Compensation reports. For more on recordkeeping basics, please check out OSHAcademy course 708-OSHA Recordkeeping Basics.

Hazard Prevention and Control

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

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.

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.

Video

Instructions

Before beginning this quiz, we highly recommend you review the module material. This quiz is designed to allow you to self-check your comprehension of the module content, but only focuses on key concepts and ideas.

Read each question carefully. Select the best answer, even if more than one answer seems possible. When done, click on the "Get Quiz Answers" button. If you do not answer all the questions, you will receive an error message.

Good luck!

1. Patient handling tasks pose increased ergonomic risks if they are _____.

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

3. Which of the following should be addressed in a facility’s safety and health program?

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

5. A training program, designed and implemented by qualified persons, should be in place to provide _____ education and training about ergonomic hazards.


Have a great day!

Important! You will receive an "error" message unless all questions are answered.