Safe Client Handling

Objectives  Ergonomics  Risk factors  High risk client care activities  Conditions that result in high risk environments  Best solutions for moving and handling clients

The Basic Problem  Fundamental ergonomics  The National Institute of Occupational Safety and Health (NIOSH) research: –Under IDEAL CONDITIONS, 90% of males, and 75% of females can safely lift 23 kilograms (~51 pounds), MAXIMUM. –Some settings do not provide ideal conditions (straight back, no bending, no twisting, positive grasp, infrequent lifts, etc.)  Conclusion –One worker cannot safely lift an adult client alone, and positioning tasks that require greater than 23Kg of exertion are also hazardous.

What Makes Clients Risky?  They are bulky—adults are > 51 pounds  No handles! (Technical term is “coupling” = good grasp)  The unpredictable occurrence  Possible lack of help from client  Possible consideration of wounds

Risks of Job Tasks  What factors contribute to a worker being hurt during client positioning? –Awkward postures –Lifting heavy loads –Length of lifting (supporting the client over a period of time) –Reaching –Frequency of positioning tasks

OSHA “Regulations” Regarding client Positioning  OSHA recommends minimizing manual lifting of clients in all cases and eliminating lifting when possible.

Basic Safe Client-Positioning Process  Identify –Characteristics of the client to be positioned –Type of positioning to be accomplished –If movement, where the client is being moved to. –Task-related Hazards –Environment/facility-related hazards –What personnel/equipment will be needed –How to move or lift the client.

Possible Risks In Job Environment  Slip, trip, and fall hazards  Uneven work surfaces (bed to stretcher, chairs, toilets)  Space limitations—(i.e. client fallen in the bathroom)  Equipment hazards (respirators, IV pumps etc.)

Other Risks  Help unavailable when needed (understaffed facility)  Client handling equipment in poor working order  Combative clients  Others?

Assessing the Client Before Moving  Always review the client care plan before attempting to move the client.  A client care plan describes a specific client’s needs, degree of assistance required, special treatments, etc.

Assessing a Client  Next ask the following questions before moving or transferring the client.  Can they provide assistance?  Can they bear weight?  Can they cooperate and follow instructions?  How big and heavy is the client?  Note client’s wounds, dressings, and any machinery.

Types of Client Moves and Lifts  Lateral transfers: Moving a client sideways  Repositioning: Moving a client up and down or side to side in a bed or chair  Transfers involving sitting position: bed to chair, bed to bed, chair to toilet, car to chair  Floor: Recovering a client that has fallen on the floor

Why Use client Equipment?  When a client weighs too much for safe manual positioning  Frequent unassisted lifting and movement of clients causes muscle and joint pain/damage.

client handling/moving equipment  Sling – for clients that are totally dependent  Lean Stand Assist – for clients that have some lifting ability  Ceiling Mounted Lift Device – for clients that are totally dependent

Client Assist Devices  Sliding boards (also called back boards)  Slip sheet, roller sheet, or draw sheet  Trapeze lift attached to bed (mostly used on orthopedic clients)  Walking or gait belt  Shower chairs  Toilet seat risers  And many more…

Lifting and Moving Algorithms  What are lifting and moving algorithms? –They were developed by a group of nursing experts and tested in different client populations  How do algorithms help you? –They give you a safe process to accomplish the task you are trying to perform –Ensure that you and the client will not get hurt during the move  Now lets look at one example of a lifting and moving algorithm…

Reposition in Bed: Side-to-Side, Up

Basic Lifting Techniques  Always remember basic safe lifting techniques while performing duties –Stand as close to the client as possible –Keep back straight –Get a good grip on the client –Lift with legs when possible

SUMMARY  Back injuries are among the most costly and disabling of all injuries.  A back injury now could cause pain for a lifetime – it is important to treat the back well.  Always use the proper lifting techniques and systems, doing so will allow a healthy back for tomorrow and years to come.