Course 623 - Healthcare: Preventing Ergonomic Injuries

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

Other Ergonomic Hazards

Introduction

Shower Gurney
Shower Gurney: Use for bathing non-weight bearing patients. The cart can be raised to eliminate bending and reaching to the caregiver.

Some reports indicate a significant number of work-related MSDs in the healthcare facilities occur in activities other than patient lifting.

Slips, Trips, and Falls

Potential Hazard

Slips/trips and falls from spills or environmental hazards.

Environmental hazards such as:

  • slippery or wet floors
  • uneven floor surfaces
  • lifting in confined spaces
  • cluttered or obstructed work areas/passageways
  • poorly maintained walkway or broken equipment
  • inadequate staffing levels to deal with the workload, leading to single person lifts and greater chances of falls
  • inadequate lighting, especially during evening shifts

Possible Solutions

Good work practice includes implementing engineering and work practices controls to help prevent slips/falls such as:

  • Eliminate uneven floor surfaces.
  • Create non slip surfaces in toilet/shower areas.
  • Immediately clean-up of fluids spilled on floor.
  • Safely work in cramped working spaces-avoiding awkward positions, using equipment that makes lifts less awkward.
  • Eliminate cluttered or obstructed work areas.
  • Provide adequate staffing levels to deal with the workload.

1. What is a good example of an engineering control to help prevent slips and falls?

a. Wait for approval to clean up spilled fluids on the floor
b. Eliminate uneven floor surfaces
c. Only allow a few workers in the area to limit exposure
d. Place warning signs when floors are wet

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Awkward Postures

Awkward postures occur with twisted, hyper-extended or flexed back positions. They are unsafe back postures for patient lifting.

Potential Hazard

Increased potential for employee injury exists when awkward postures are used when handling or lifting patients. Awkward postures include:

  • forces on the spine increase when lifting, lowering or handling objects with the back bent or twisted;
  • more muscular force is required when awkward postures are used because muscles cannot perform efficiently;
  • fixed awkward postures (i.e., holding the arm out straight for several minutes) contribute to muscle and tendon fatigue, and joint soreness; and
  • reaching forward or twisting to support a patient from behind to assist them in walking.

Possible Solutions

Good work practice recommends avoiding awkward postures while lifting or moving patients.

  • Educate and train employees about safer lifting techniques.
  • Use assist devices or other equipment whenever possible.
  • Use team lifting based on assessment.

2. Which of the following is a good work practice technique to avoid awkward postures while lifting or moving patients?

a. Twist only when lifting while standing
b. Bending only forward when lifting
c. Using team lifting methods
d. Lifting with both hands

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Transferring Equipment

Strains and sprains can occur if an employee is transferring equipment like IV poles, wheelchairs, oxygen canisters, respiratory equipment, dialysis equipment, x-ray machines, or multiple items at the same time.

To reduce the hazards of transferring equipment:

  • Place equipment on a rolling device if possible to allow for easier transport, or have wheels attached to the equipment.
  • Push rather than pull equipment when possible. Keep arms close to your body and push with your whole body not just your arms.
  • Assure that passageways are unobstructed.
  • Attach handles to equipment to help with the transfer process.
  • Get help moving heavy or bulky equipment or equipment that you can't see over.
  • Don't transport multiple items alone. For example, if you are moving a patient in a wheelchair in addition to an IV pole and/or other equipment get help. Do not overexert yourself.

3. What should you do to reduce the hazards when transferring equipment?

a. Push rather than pull
b. Pull rather than push
c. Push quickly in short movements
d. Pull slowly using a back belt

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Reaching Into Deep Sinks or Containers

If washing dishes, laundry, or working in maintenance areas and using a deep sink, limit excessive reaching and back flexion by:

  • Placing an object such as a plastic basin in the bottom of the sink, to raise the surface up while washing items in the sink, or
  • Removing objects to be washed into a smaller container on the counter for scrubbing or soaking and then replacing back in the sink for final rinse.

Lifting Heavy Bags

Limit reaching or lifting hazards when lifting trash, laundry or other kinds of bags by:

  • Using handling bags for laundry, garbage, and housekeeping when possible. Bags which have side openings to allow for easy disposal without reaching into and pulling bags up and out. The bags should be able to slide off the cart without lifting.
    • Limit the size and weight of these bags and provide handles to further decrease lifting hazards.
  • Using garbage cans that have a frame versus a solid can to prevent plastic bags from sticking to the inside of the can.
  • Use products that stick to the inside of the garbage can to prevent the bag from sticking.
    • Limit the size of the container to limit the weight of the load employee must lift and dump.
    • Place receptacles in unobstructed and easy to reach places.
  • Installing chutes and dumpsters at or below grade level.
  • Using spring-loaded platforms to help lift items such as laundry. These keep work at a comfortable uniform level.
handling bags
Handling bags
spring loaded platform
Spring-loaded platform

4. Why should you use a framed garbage can rather than a solid can?

a. They are easy to maneuver
b. To prevent plastic bags from sticking
c. They are harder to use
d. Solid cans are not as useful

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Using Hand Tools

Limit strains and sprains of the wrists, arms, and shoulders, of maintenance workers by choosing hand tools carefully. Hand tools should:

  • be properly designed, and fit to the user;
  • have padded non-slip handles;
  • have ergonomic handles that allow the wrist to remain straight;
  • have minimal tool weight;
  • have minimal vibration;
  • have trigger bars rather than single finger triggers; and
  • not be used when performing highly repetitive manual motions by hand. Use power tools instead.

For more guidelines on safe hand tool use the CDC's Easy Ergonomics: A Guide to Selecting Non-Powered Hand Tools.

5. When should you NOT use hand tools in a healthcare setting?

a. Never use hand tools in a healthcare setting
b. When patients are sleeping
c. When performing highly repetitive manual motions
d. Whenever power tools are available

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Housekeeping Tasks

To decrease ergonomic stressors when employees are performing cleaning tasks employees should:

  • Alternate the leading hand.
  • Avoid tight and static grip and use padded, non-slip handles.
  • Clean objects at waist level if possible, rather than bending over them (e.g., push wheelchairs up a ramped platform to perform cleaning work, or raise beds to waist level before cleaning).
  • Use knee pads when kneeling.
  • Use tools with extended handles, or use step stools or ladders to avoid or limit overhead reaching.
  • When sweeping or dusting, use flat head dusters and push with the leading edge; sweep all areas into one pile and pick up with a vacuum.
  • Use chemical cleaners and soaks to minimize force needed for scrubbing.
  • Frequently change mopping styles when mopping (e.g. push/pull and rocking side to side) to alternate stress on muscles.
  • Be sure buckets, vacuums, and other cleaning tools, have wheels or are on wheeled containers with functional brakes.
  • Alternate tasks or rotate employees through stressful tasks.
  • Avoid awkward postures while cleaning (e.g. twisting and bending).
  • Use carts to transport supplies rather than carrying.
  • Use buffers and vacuums that have lightweight construction and adjustable handle heights.
  • Use spray bottles and equipment that have trigger bars rather than single finger triggers.

6. To decrease ergonomic stressors when performing cleaning tasks, you should _____.

a. not alternate the leading hand
b. ensure tight and static grip
c. clean objects at waist level
d. scrub objects rather than soaking

Check your Work

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