Back Injury Prevention Paul Hilton Images have the same licence as the project ( CC BY NC SA ) unless otherwise noted.CC BY NC SA

Back Facts Go the Back Care Website and look at the some facts and figures es

Back Facts – Nurse & Midwives 80,000 nurses sustain a back injury annually. 3,600 nurses invalided out annually due to back problems. Seccombe and Smith (1993) 6,000 midwives sustain a back injury annually. 300 midwives leave the profession annually due to back injury. (Royal College of Midwives (1999, ‘Handle with care’.)

Back Facts – cost implications NHS costs approx. £803.2 million million GP consultations, £140 million Outpatients, A&E, inpatient and day care, £512 million Physiotherapy £150.6 million Back Care (2012)

Back Facts – Work Related Costs UK’s primary cause of disability million people affected. Approx 430,000 receive benefits primarily for back pain. 119 million lost working days annually (1997/8) BACK CARE 2012

Personal Risk Factors Lack of fitness Previous injury Hereditary Smoking Pregnancy / motherhood Stress NATIONAL BACK PAIN ASSOCIATION 1997

Implications for the Individual Pain, disability. Low self esteem, depression. Altered lifestyle Effect on family unit Finance, compensation, litigation.

Implications for the Organisation Loss of skilled personnel Sick pay, overtime, agency, bank staff. Low moral, stress on remaining staff. Recruitment and retention Litigation, compensation Corporate image

Spinal Anatomy 33 Vertebrae Separated by Intervertebral Discs Linked by Ligaments and Apophyseal Joints Supported by Muscles

Spinal Function Support the Upper Body Protect the Spinal Cord Enable movement and flexibility

Intervertebral Disc - structure Outer layer - Annulus Fibrosus – tough cartilage Inner layer Nucleus Pulposus – fluid Poor blood and nerve supply. Receive nutrition via the End Plates

Intervertebral discs - functions Shock absorbers Spacers between vertebrae Reduce friction Prevent excessive movement

Types of Injury Accidental – unplanned, unanticipated, uncontrolled. Can generally be prevented Over-exertion – force applied to anatomical structure exceeded its mechanical strength. Over use – cumulative damage to anatomical structure exceeds natural ability to heal and repair.

Injury Causation Muscles, ligaments, tendons etc.may be overstretched or damaged leading to inflammation, bruising, swelling and pain. Discs may become weak and distorted. Eventually the disc may herniate.

Postures Likely to cause back pain Stooping and bending Twisting Over reaching Holding load away from body Static posture Extreme joint movement

Activities likely to cause back pain Rapid movements Repetition Duration and intensity Heavy loads/forces Muscle fatigue Cold muscles Sudden movement

Injury Prevention –Safe handling Principles Wide, stable base Keep load close Maintain natural curves of back Soft knees Full, firm grip Head up, chin in

Legal Responsibilities You are legally and contractually obliged to adhere to Health and Safety Law. Ignorance is no excuse. It is up to you to know what your responsibilities are.

Health and Safety at Work Act 1974 The Employer must:- Ensure, so far as reasonably possible, the Health, Safety and Welfare of all employees. Provide and maintain safe systems of work and plant. Provide information, instruction, training and supervision.

Health and Safety at Work Act 1974 The Employee must :- Take reasonable care for his own Health and Safety and that of others who may be affected by his acts or omissions. To cooperate with his employer.

Manual Handling Operations Regulation 1992 AVOID ASSESS REDUCE REVIEW

Risk Assessment Factors LOAD TASK ENVIRONMENT INDIVIDUAL

RCN: Safer Patient Handling Policy “The aim is to eliminate hazardous manual handling in all but the most exceptional of life threatening situations. Patients should be encouraged to assist in their own transfers and handling aids must be used whenever they can reduce the risk of injury. Handling patients manually may continue only if it does not involve lifting most or all of a patient’s weight. Care must also be taken when supporting a patient and pushing and pulling should be kept to a minimum. Staff should assess the capabilities and rehabilitation needs of a patient to decide on which, if any handling aids are suitable. “ (RCN, 2000:1)

Practical Workshops

This is MANDATORY training Stay in designated group to ensure no larger group than 12. Wear appropriate clothing and footwear Arrive on time for Health and Safety Briefing Fitness declaration will be required at commencement of workshop Practical Workshops

References Back Care (2012) (accessed 19/10/12) Health and Safety at Work Act ( 1974) ( accessed 19/10/12) Manual Handling Operations Regulation (1992) ( accessed 19/10/12) RCM. (1999) Handle with care: a midwife’s guide to preventing back injury. RCM: London. Royal College of Nursing (2000) Safe Staff, Better Care RCN Manual Handling Training Guoide available from (accessed 1/12/12) Seccombe, I. and Ball, J. (1993) Back injured nurses: A profile, A discussion report for the RCN, London: RCN.

Further Reading RCM (2011) Manual handling. See: /support-at-work/workplace-reps/health- safety-reps/manual-handling-/ (accessed 19/10/12http:// /support-at-work/workplace-reps/health- safety-reps/manual-handling-/ RCM. (1999) Handle with care: a midwife’s guide to preventing back injury. RCM: London