MSDs, Back Care & Zero Lift

Musculoskeletal disorder (MSD) When performing every day tasks: It can happen to you: Back injury Musculoskeletal disorder (MSD) When performing every day tasks: Moving residents Housekeeping Reaching for supplies Typing Back injuries and other musculoskeletal disorders are rampant in the healthcare industry.

Musculoskeletal Disorders (MSD) Injuries that affect muscles, tendons, ligaments and nerves Can develop when the same muscles are used over and over again or for a long time without taking time to rest Chance of getting this type of injury increases if the force exerted is high and/or the job requires an awkward posture Examples of musculoskeletal disorders include back pain, carpal tunnel syndrome, tendonitis and tenosynovitis. MSD’s account for 54% of all Lost Time Injuries in the health care sector, with 40% of these related to client handling. The back is the most common, but the shoulders, neck, elbows, hands and wrists are also frequently involved. MSD-related pain and discomfort have also been reported in the hips, knees, legs and feet. A musculoskeletal disorder, or MSD, is an injury or disorder of the muscles, tendons, ligaments, joints, cartilage or spinal disks. MSDs occur when you strain your body beyond its safe limits or do the same thing over and over again without time for your body to recover. Recognizing and then removing or reducing the stress can prevent back injuries and other MSDs from developing.

MDS Symptoms The symptoms generally include: Pain with or without movement Swelling and tenderness Reduced range of motion and/or stiffness, and Tingling and/or numbness in nerve-related injuries or disorders. While different body parts can be affected by these disorders, the symptoms of MSDs are similar no matter where they occur.

Preventing Musculoskeletal Disorders Avoid awkward body positions Avoid overextended and awkward reaches Avoid repetitive or heavy bending, twisting, reaching, lifting, lowering, pushing and pulling Take rest breaks from repetitive or forceful tasks Move around and occasionally change positions

Preventing Musculoskeletal Disorders Use the equipment and tools provided to reduce exposure to MSD hazards Go to your supervisor with questions, concerns and for additional training Suggest ways to improve working conditions through the JHSC Be aware of the symptoms of MSD and if you have any, report them to your supervisor.

Back Care Reducing the Risk of Injury

Back Anatomy Spine has 24 bones (vertebrae) Discs between vertebrae absorb shock Spinal cord carries nerves that control all activities below the neck Unbalanced/stressed spine can cause a progression of back problems Interesting Facts: Back injuries are second only to the common cold as a reason for lost time at work. Back injuries are a leading cause of long-term illness from injuries in the workplace. Back injuries account for millions of dollars of lost revenue for companies each year. About 80% of people have back pain at some time in their lives.

Causes of a Stressed Spine Lack of exercise Weak abdominal and back muscles can’t support spine Leads to sway back and weakened joints Pot belly pulls back muscles/stretches and weakens abdominal muscles Poor Physical Condition

Bad Posture/Chronic Strain Causes of a Stressed Spine Bad Posture/Chronic Strain Slouching, rounded shoulders, one hip higher than the other Sitting for long periods of time (higher compressive force on discs then standing) Standing for long periods without keeping spine in balance Working in awkward, uncomfortable positions

Improper Lifting Causes of a Stressed Spine Twisting at the waist Overhead lifting/lifting below knuckle height Lifting or carrying objects with awkward shapes/no handles Lifting heavy objects unsafely The greater the horizontal reach (away from the navel) = greater risk Improper Lifting

Prevention of Back Injuries

Lift Safely Use proper lift procedures . . Test the weight of an object before lifting Get help if it’s too heavy for you to lift it alone Take a balanced stance, feet shoulder-width apart Squat down to lift, get as close as you can

Lift Safely Tighten the abdominal muscles Get a secure grip, hug the load Lift gradually using your legs, keep load close to you, keep back and neck straight

Lift Safely Once standing, change directions by pointing your feet and turn your whole body Avoid twisting at your waist To put load down, use these guidelines in reverse Push, Don’t Pull when moving heavy objects. Pushing is easier on your back than pulling.

Safe Work Practices Rearrange your work area to eliminate lifting, bending and reaching Tasks done most often should be done at waist level When possible, move the work to you, instead of stretching to reach the work If you stand for long periods, take the stress off your back by placing one foot higher and in front of you Divide the items into smaller loads. Moving several small loads is much easier on your back

Safe Work Practices Reaching at a lower level, bend your knees, keeping your center of gravity between your feet, and your knees over your toes Reaching a high shelf, place one foot slightly ahead of the other as you face the shelf. Shift your weight from the back foot onto the front foot as you move the item toward the shelf Reduce the weight of the containers Use lifting devices and carts whenever possible Mopping is a repetitive motion; it can twist your spine if not done correctly

Client Handling Zero Lift Policy

Marianhill’s Commitment to Client Handling Zero Lift Policies Zero Lift Definition No manual resident lifting, where the entire weight of the resident or object is anticipated. This pertains to 1 person, 2 person and/or 3 person lifting (not transferring) All total lifts must be completed with the use of resident lifting devices (total lifts, sit stand lifts and re-positioning in bed devices such as slider sheets) * The only exception to this policy is an Emergency situation whereby a resident must be moved to safety immediately to prevent further threats to safety and security Goals of the Zero lift program are: -decrease the risk of musculoskeletal disorders associated with resident handling activities -promote and support the health and safety of all residents and employees -provide equipment, resources and training.

Policies and Procedures are in place and address: Zero Lift Policy statement with Employee Statement of Understanding Form for Initial Assessment and Re-assessments Logo System to identify type of transfer/mechanical lift Policies for: Mechanical Lifting Transferring Re-positioning Lift: The procedure used to lift or carry the weight of a person or object. A lift is used to move a resident who is physically unable to bear weight and/or mentally unable to help with the procedure. Lifting the entire weight of the resident from one surface to another using a mechanical device. Mechanical Lift: -Mechanical lifting device, either mobile (total lift) or ceiling lift which requires two people to operate. Sit to Stand Lift: -Mechanical lifting device, using a specialized sling for residents who have some weight bearing capability. Use to raise a resident from a sitting position to a standing position and vis versa. Transferring: The procedure used to assist a resident who can bear weight. A transfer procedure should be used when appropriate transfer devices are available to match the resident’s need, when the resident is mentally capable, and when the resident car bear weight through one leg or both arms. Guiding and or assisting the movement of a resident from one surface to another. Resident can weight bear. Repositioning: The procedure used to move a resident to a new position on the same surface. Repositioning should be used to move a resident up in bed or a chair, when the resident is physically unable to assist or mentally unable to follow instructions. Reposition also includes shifting, adjusting or changing the resident's position in a bed or wheelchair, chair or other supportive surface. More education on types of lifts, transfers and repositioning residents will be provided in Jumpstart II- Nursing Orientation.

Logo’s for Resident Transfers Independent Unsupervised Transfer One Person Pivot Independent Supervised Transfer All staff should be aware of what the logo’s are. Registered staff and PSW staff must follow the appropriate lift and transfer that has been designated to each resident. Two Person Pivot Minimum Assistance Transfer

Logo’s for Resident Lifts Sit/Stand Lift Mechanical Lift Ceiling Lift

Roles and Responsibilities of Workplace Parties We are all responsible for ours and each others health and safety. Employer Supervisors Staff Joint Health &Safety Committee Maintenance of Equipment by Staff Maintenance of Equipment by Facility staff

Client Handling Zero Lift Policy Statement of Understanding Marianhill is committed to providing a safe and healthy working environment for all staff and residents and has a client handling zero lift policy and protocol to eliminate manual lifting of residents. Any employee who violates this policy and manually lifts residents will be subject to disciplinary action. Other Departments (dietary/janitor/house keeping/ maintenance etc) are to review with Department Manager the “physical demands analysis” of their job for safe lifting requirements.

Wellness and Exercise Research indicates that workers who have a good level of physical fitness, experience fewer back injuries and recover faster from MSDs than unfit workers Adopt a balanced exercise program, that includes cardio, aerobics, flexibility, muscle strength (ability to produce force) and endurance (ability of muscles to sustain static postures): 1. Warm up 2. Stretch 3. Perform activity or muscle training 4. Cool down (to remove lactic acid and reduce soreness) Consult your family physician before initiating an exercise program

Review of Back Care Strategies Lift safely Exercise regularly/improve muscle strength Maintain ideal body weight Sleep smart Manage Stress (anxiety & stress tighten muscles in your back) Assess work tasks and modify the work environment to reduce the risks of back injury: Use carts and dollies, hoists and other lift- assist devices whenever you can Inspect the workplace to keep it free of slip/fall hazards Wear appropriate footwear Keep communication flowing

Prevent Slips, Trips and Falls Clean up wet surfaces Avoid short cuts Get rid of clutter Use a ladder or step stool Turn on the lights Wear slip resistant shoes Clean up wet surfaces: -any time you see (or cause) a spill, clean it up right away. If you can’t, mark it with a sign or paper towels and report it to the appropriate person for cleanup. Avoid Short Cuts: -the more short cuts you take, the greater your chance for talking a tumble. For safety’s sake, use designated walkways and only carry loads you can handle. Get Rid of Clutter: -Put away clutter-especially in walkways and on stairs-and don’t leave tools, boxes, books and other materials lying about. Use a ladder or step stool: -Use the right climbing equipment or the job. Rather than standing on the nearest tall object you can find, take a minute to find a ladder or step stool. Turn on the lights: -Good lighting helps you see any hazards in your way. Turn on lights before entering a room, and replace dead bulbs as soon as they burn out. Wear Slip-resistant shoes: -Increasing the friction between your shoes and the surface you walk on helps prevent slip injuries.

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