Safe Movement of Residents, Health and Wellness at Work and at Home for STNA’s Cleveland State University and Jennings Center for Older Adults Grant Program Funded by the Ohio Bureau of Workers Compensation Ohio Safety and Health Research Program

Program Objectives Participants Will Review and Practice Safe Movement of Residents in Every Day Activities at Jennings Center for Older Adults Upper Level Neighborhood Identify Factors that Lead to Productive, Injury Free, and Satisfying Work Lives Identify and Apply Methods to Balance Work, Self Care, and Leisure in their Daily Lives

Important Statistics related to Safe Movement of Residents In 2010, nursing aides, orderlies, and attendants had the highest rates of musculoskeletal disorders (MSDs) of all occupations with an incidence of 249 per 10,000 compared to 34 per 10,000 for all workers (Labor, 2012 The financial burden of back injuries in the healthcare industry is estimated to add up to $20 billion annually. In healthcare, one of the most frequent causes of injury is the manual handling of patients. Musculoskeletal disorders are aggravated by working in awkward postures with very repetitive or static forceful exertions.

Important Statistics related to Safe Movement of Residents Certified Nursing Assistants (CNAs, or referred to in Ohio as STNA’s) have a higher risk of work absenteeism due to spinal pain. Nursing aides are particularly susceptible to manual handling injuries because they have the primary responsibility for heavy lifting. If a CNA tries to catch a patient who is falling, large compressive forces are applied to the spine (Andersen & Simonsen, 2005).

Important Statistics related to Safe Movement of Residents Risk of an injury due to lifting is greater among CNAs compared to nurses for both non-lost work time and lost work time injuries. Most of the injuries requiring time away from work are related to the process of delivering direct patient care While nursing aides' manual handling knowledge is adequate, they rarely use mechanical aids. This is partly due to an over-reliance on their strength and abilities, lack of suitable mechanical aids on the wards, or a lack of familiarity with the available lifting aids. Neither training alone, nor the purchase of equipment alone, is likely to resolve manual handling problems

Ergonomic Issues related to safe movement of residents and other tasks completed by STNA’s The US National Institute of Safety and Health (NIOSH) recommends that health care workers lift a maximum of 35 lbs. for any direct resident movement activities. The average direct health care worker (e.g. nurses or STNA’s lifts 1.8 tons per day! The most common injury to direct health care workers is in the lower back. other common injuries are to shoulders, wrists and hands, and knees. These injuries can be due to a single incident or repetitive motions such as reaching into a high cupboard to put away supplies

Ergonomic Issues related to safe movement of residents and other tasks completed by STNA’s The most common movement tasks that can result in injury to STNA’s includes transfers from toilet to chair, chair to bed, bathtub to chair, bed to stretcher, bed to wheelchair or other type of chair, and repositioning of residents in bed or chair. The other most common tasks done by an STNA that result in injury include weighing residents, making beds, feeding, bathing, dressing, or toileting activities for residents in bed, stocking supplies, laundry tasks, and applying anti-embolism or compression stockings

Ergonomic Issues related to safe movement of residents and other tasks completed by STNA’s Equipment that has been associated with increased injuries includes food trays, waste baskets, heavy or deep carts, and manual beds

Ergonomic Issues related to safe movement of residents and other tasks completed by STNA’s Personal factors that relate to injuries among STNA’s include Age Genetics Psychosocial Factors Job Dissatisfaction Monotonous Nature of Work Limited Control of Job Factors at Work Site

Ergonomic Issues related to safe movement of residents and other tasks completed by STNA’s Excellent principles to protect your back at work Keep your back in a balanced, powerful position Plan movements in advance Ask for help for lifting over 50 lbs. Avoid staying in one position for a long time Spread your feet apart to form a wide, stable base of support Pivot with your feet, not your back Keep your stomach muscles firm, especially when lifting Keep items close to your body when carrying Use a power lift by bending at your hips, and keeping the natural curve of your spine (chest up, seat out)

Ergonomic Issues related to safe movement of residents and other tasks completed by STNA’s Specific Ergonomic Factors Include Force Repetition Awkward positions Vibration Contact stress (rubbing against things or people) Distances required to reach away from your center of gravity Reaching very high or very low

Specific Ergonomic Factors Include Ergonomic Issues related to safe movement of residents and other tasks completed by STNA’s Specific Ergonomic Factors Include Force Use wheels or carts to reduce force needed to move heavy objects

Ergonomic Issues related to safe movement of residents and other tasks completed by STNA’s Specific Ergonomic Factors Include Repetition- Avoid tasks that require repeated use of excessive force and movement of especially, hands and wrist

Specific Ergonomic Factors Ergonomic Issues related to safe movement of residents and other tasks completed by STNA’s Specific Ergonomic Factors Awkward positions- avoid excessive rotation or bending of your back

Specific Ergonomic Factors Include Ergonomic Issues related to safe movement of residents and other tasks completed by STNA’s Specific Ergonomic Factors Include Vibration- If you do happen to use tools that vibrate during your job – for example a back massager or electric toothbrush- excessive use can lead to problems with muscles and nerves of the upper body

Specific Ergonomic Factors Include Ergonomic Issues related to safe movement of residents and other tasks completed by STNA’s Specific Ergonomic Factors Include Contact stress (rubbing against things or people)

Specific Ergonomic Factors Include Ergonomic Issues related to safe movement of residents and other tasks completed by STNA’s Specific Ergonomic Factors Include Distances required to reach away from your center of gravity

Specific Ergonomic Factors Include Ergonomic Issues related to safe movement of residents and other tasks completed by STNA’s Specific Ergonomic Factors Include Reaching very high or very low

Energy conservation and Work simplification Respect proper reaching limits Organize and gather all supplies beforehand Lift with legs not back or arms Sit to work when possible Use equipment to help

Resident Factors Include Ergonomic Issues related to safe movement of residents and other tasks completed by STNA’s Resident Factors Include Amount of Assistance Needed Weight Level of Understanding (Cognitive Function) Medical Complications

Suggestions to Reduce Injuries Clue the Resident to What You Are Going to be Doing Get Help for Tasks That are High Risk Check your Footing Before Attempting to Lift Objects Move Close to the Resident or Object

Suggestions to Reduce Injuries Teach Others to Apply These Principles Report Incidents of Unsafe Behavior or Activities Remove any Clutter or Obstacles Use the Guidelines Provided from Resident Assessments to Provide the Appropriate Type of Transfer or Movement Using the Appropriate Equipment

General Health and wellness Job satisfaction Monotonous aspects of job Improving job control internal control of job conditions Avoiding alcohol and tobacco Balanced lifestyle Communication at work and home Time management Stress Management at work and home Exercise