Introductions Housekeeping items Washrooms Refreshment breaks Overview of lab style Discuss Demonstrate Do 1

Explains the principles of good body mechanics Demonstrates back care knowledge and injury prevention techniques Describes guidelines for footwear, clothing and safety Demonstrates assisted walking using transfer belt, safely. Demonstrates pivot transfers Identifies core strengthening exercises using center of gravity principles Demonstrates position principles when assisting students Discusses ways to prevent injuries 2

Musculoskeletal injuries (MSI) account for approximately 30% of all lost time injuries to workers in British Columbia. ( ) 3

Patient handling is the top cause of injury among healthcare workers. Care workers who manually transfer or reposition patients are at significant risk of musculoskeletal injuries Causes of back injury Improper lifting Poor posture Overexertion Slips and falls Excessive weight Lack of exercise 4

Education Identify risk factors: ◦ Lifting, reaching, overexertion, pushing, pulling, kneeling, repetitive movements, unexpected movements of students, leaning… Understand steps to prevention of injury: ◦ Ask for help ◦ Use your professionals (Occupational Therapists-OT, Physiotherapists-PT, NSS Coordinators-Nurses) ◦ Work Safe BC ( s-General.asp ) s-General.asp ◦ Free PDF files that include: 1.Understanding the Risks of Musculoskeletal Injury (MSI): An Educational Guide for Workers, on Sprains, Strains, and Other MSIs BK78 2.Back Talk: An Owner's Manual for Backs BK4 5

Prepare the setting and equipment before starting any lift or move. Encourage student to assist as much as possible! Use good posture: – Feet apart (wide base of support) or walking stance. – Keep back straight, bend with your knees. – Keep your chin tucked in. – Elbows slightly bent, at your sides, closest to your body. Your shoes must have adequate support with non-slip soles: – No sandals, no open toe shoes, no heels. 6

Group Discussion Consider the following questions: Jewelry concerns? Risk to student? Yourself? What is appropriate clothing? Why is this important in back care? What things need to be considered when dressing for work? Are student age and gender factors? 7

Disc Protrusion Video WorkSafeBC Multimedia/Videos.asp?ReportID=

1. Sitting to Stand 2. Standing to Sitting What happens to your body during this? How do you sit? Think arms, thighs, shoulders, abdomen, pelvis, back, knees 3. Now try both without using your arms What happened? 4. Assist person into sitting position Have your partner discuss their comfort level. Where were their knees? Buttocks? Shoulders? Review the body mechanics of sitting to stand and stand to sit. Discuss point of ‘no return’ when sliding forward on chair. 9

Hold weight close to your body. Use your legs and thigh muscles, as they are stronger than arms and trunk. Avoid twisting of trunk, use pivot or step motion. Use momentum, gravity and mechanical devices. Use both hands to avoid twisting. Palm up grip gives stronger movement. ASK for ASSISTANCE if weight is too heavy, don’t be intimidated! Co-ordinate move by saying, “1-2-3 Lift” (ensure you discuss with partner, BEFORE move/lift). 10

Core Strengthening Pelvic Floor Muscles Kegel exercises strengthen the pelvic floor Abdominal Wall Strengthen the oblique's (side abdominal muscles) Upper and lower abdominal exercise Quadriceps/Back Wall squats with good back posture Leg lifts and arm raises Warm-up exercises Not warming up before stretching leaves your back susceptible to injuries. Warm muscles are more flexible than cold muscles and are less likely to tear. Balancing Exercises also help to strengthen the core muscles (back. abs, hips and buttocks), which are used in balancing. ml#backstrengtheningexercises 11

Used When: Student is able to bear weight. Rehabilitation therapist (OT, PT) has determined student is safe to transfer. EA can safely manage pivot, after considering height and weight of self and height and weight of student. Student is able to participate in transfer. *NOTE: *NOTE: This is a pivot, not a LIFT of the student, if the student requires lifting then alternative mechanical device is required* 12

Discuss principle of pivot transfer DEMONSTRATE BREAK INTO GROUPS OF TWO PRACTICE 13

1. EA ensures safety of area 2. EA explains transfer to student 3. EA ensures brakes are on (if wheelchair or mobile chair) 4. Position chair parallel to toilet (or alternate chair) 5. Remove footrests (if applicable) 6. Position transfer belt securely 7. Position students arms around EA’s waist (not your neck area) 8. Ensure students feet are on floor 9. Face student with hips and knees slightly bent 10. Unlock safety belt (if used) 11. Block student’s knees and feet if required 12. Lean student forward from the hips 13. Grasp transfer belt with both hands at students waist 14. Count STAND. 15. Pivot student towards destination, slowly 16. Lean student’s shoulders slightly forward while lowering hips to the chair or toilet. 14

Used When: Student can take steps. Student requires assistance for safety. Rehabilitation therapist (PT, OT) has assessed and approved the safety of assisted walking. 15

DEMONSTRATE BREAK INTO GROUPS OF TWO PRACTICE ASSISTED WALKING PRACTICE SLIDE TO GROUND (FALL) 16

1. Ensure area is free of obstacles 2. Ensure enough space for two people 3. Apply transfer belt securely to student 4. Ensure student’s feet are firmly on floor 5. Ensure student is aware of movements and is ready 6. Grasp transfer belt at waist 7. Count STAND 8. Assist student to standing position 9. Maintain firm grasp on transfer belt at back and side position 10. Slowly walk with student, EA is slightly behind supporting self in walking stance (one foot forward) to ensure good center of gravity 17

Points to remember during assisted walking: Ensure a good center of balance for EA at all times. DO NOT ATTEMPT TO CATCH A FALLING STUDENT! If you can: – Place your body behind the student, place your arms around their torso, pull them closer to your center. – Widen your base of support by placing one foot behind the other. – Allow the student to slide down your body toward the floor. – As they slide down, gently lower them to the floor. 18

ABC’s ABC’s – A – Alignment = Good posture Proper alignment is necessary to ensure no excess strain on joints and muscles. – B – Balance Holding your center of gravity, close to your base of support. Moving your feet further apart, increases your base. – C – Coordinated body movement using your weight to help with movement. (often the momentum, rocking that gets you going!) 19

REMEMBER It is up to you to identify the risk factors and request help to prevent risk to YOU and YOUR student Don’t be afraid to ask for help! 20