Ergonomics and Safe Patient Handling Formerly known as L&T

Supporting Good Health Objectives Demonstrate appropriate staff body mechanics during lifts, transfers of individuals, direct (including bed mobility and ROM) and indirect care of individuals. Demonstrate understanding of principles of repositioning individuals. Demonstrate approved safe patient handling techniques and identify location of individual-specific safe patient handling information. *Core Competency Goal #4 Supporting Good Health “Supporting Health and Wellness = Demonstrate knowledge and understanding of an individual’s medical, physical, psychological, and dental health care needs.”

The “Golden Rules” of Back Safety “Keep your back straight.” “No loaded twist.” (jelly donut) “Use your legs, not your back.” (bend your knees) “Keep your load close.” Ergonomics is the science of making people (staff) and their environment (where we work) interact more safely and efficiently.

(Good) Body Mechanics Or… How Not to Hurt Your Back Maintain the natural curves of your spine in all situations. (= good posture) The injury caused by “load and twist” can be life-changing (involving the disc and nerves vs. muscles and tendons). “KEEP YOUR BACK STRAIGHT” LOAD AND TWIST = worst case scenario; disc explanation

“Use your legs instead of your back.” “Wide and low” allows your legs to do their job, gives you a good base of support, and helps to align your spine. Using legs properly = wide and low stance (best line of pull for hamstrings and quads). Wide and low also gives us stability and maneuverability. Additional benefit = sets spine up for ideal posture from the bottom (pelvis).

Keep the Load Close Always keep the object (or individual) as close to you as possible. Why? Do the math…

The Environmental part of Ergonomics… Communicate!! With your staff partner and/or the individual you are helping!! Check your space…Plan Ahead and… RE-CAP: Good posture No load and twist Use legs Load Close But things can still go wrong!! IF we don’t do these two things ALL the time.

So do I only use Ergonomics or “Safe Patient Handling” if I have mechanical lifts or two-person transfers?? NO. We all use it, every day: “Indirect care” tasks and “direct care” tasks Any time you “give someone a hand” make sure that the individuals IPOP or Safeguard has words that describe your physical assistance and you’ve used appropriate body mechanics.

Work-related Injury Report P&P 409.1 Core Competency Goal #3 Demonstrating Professionalism ”Organizational Participation = adheres to corporate compliance policies and procedures” “Education, Training, and Self-Development Activities = applies knowledge and skills gained to the job.” Work-related Injury Report

Some of the wonderful folks we work for….

Core Competency Goal #1 Putting People First “Supporting a Person’s unique capacities, personality, and potential = demonstrates respect for all individuals being supported.”

Core Competency Goal # 4 Supporting Good Health “Demonstrates knowledge and understanding of an individual’s medical, physical, psychological, and dental health care needs = assists individual in the safe use and maintenance of adaptive equipment.”

Bed Mobility Basics or “Flat Person” Mobility Good working height. Flatten surface (do NOT slide people up hill). TWO assist whenever possible – or work both sides. Use fabric.

How to:

Bed Mobility/ Using the Individual’s Mobility to Help Bend the (outside) knee Roll to outside Feet down Push up Demo a 2-person “up in bed’ assist, 2-person roll assist, and a 1-person supine-to-sit.

Fall/ Floor Transfer Management Assess: 1. Medical emergency? 2. In Harms Way? If no and no: 3. Stay on the floor for calming; run BSP, etc. 4. When they’re ready to participate, they can often get up or will require much less assistance. 5. In the meantime – you’ve gathered tools. Tools can include staff, mechanical lift, fabric, a chair, etc. Assisted Ambulation and Fall Prevention Guideline

Repositioning and Skin Care Braden Scale/ Risk assessment Prevention of pressure sores and contractures Repositioning every 2 hours for a minimum of 30 minutes= minimum standard

Pressure and Skin Breakdown Risk Factors: Age Nutrition Hydration Sensation Communication Moisture (key!) Pressure distribution to different tissues

Repositioning and Head of Bed Elevation Core Competency #3 Demonstrating Professionalism “Creating Meaningful Documentation records = maintains accurate records by collecting, compiling, evaluating data and submitting it in a timely manner to the appropriate sources.” Example: HOB is elevated – individual is NOT. Refer to Repositioning and Head of Bed Elevation Guideline.

Ambulatory Transfer Procedures (and walking with our folks) Close supervision = physical proximity; closer than “arm’s reach;” close enough to catch and to provide… Contact Guard = touch for balance/ security Hands-On Assistance = physical assistance is required. Gait belts

Stand and Sit-Pivot Transfers In order to use a SPT: Individual MUST be able to participate and Individual MUST be able to bear weight Proper set-up One-and two-person assistance Core Competency #1 Putting People First “Facilitation of supports and services = continuously shares observations, insights, and recommendations with the individual and his/her support team.” Demo a 1-person SPT and a 2-person SPT

Mechanical Lift Transfers Two staff at all times. Lift base must be in open position in all situations involving lifting/moving of individuals. Sling options/ rationale.

Things to remember Demo a mechanical lift transfer Safe slings (when to dispose). Seams on the outside! Safe sling placement. Safety check before moving. Options in approaching your destination. How to effectively seat your individual. Don’t push lifts under lowered beds! Demo a mechanical lift transfer

Emergency Evacuation Procedures and everyday safe use of lifts Emergency Sling Transfer Use the four “golden rules” AND good communication AND clear/ prepare your space Secure your individual; wrists through loops = your back-up to grip Always break down the move into at least 2 steps Demo 2-person emergency sling lift transfer

Emergency Evacuation Procedures and everyday safe use of lifts Two-Person Lift Transfers Core Competency #5 Supporting Safety “Supports the safety of all individuals in every day situations – is able to operate emergency equipment, as required.” Demo a 2-person emergency lift transfer

You are an integral part of each Individual’s Care Team Resources Clinical Procedures Manual PT Shawn Bibeau PTA Jackie Scott OT Liz Eldredge SLP Carrie Nutt Behavior Specialists and Counselor The Individual’s MSC Your managers You are an integral part of each Individual’s Care Team