Back Care for People Handlers - Welcome to the IOW NHS Centre/Development and... · Web viewBed rest does not help simple back pain- it's much better to return to normal physical

Back Care for People Handlers E-Learning Module

Back Care for People Handlers

(Mandatory - People Handlers)

Introduction

This is a printed copy of the Training Tracker e-learning module on Backcare for People Handlers. This course is aimed at all Non- Clinical Trust staff.

The purpose of this course is to ensure that all members of staff who handle patients as part of their work are up to date with background information and recognised good practice in back care and people handling.

This course will:

Answer the questions most frequently asked about back care and load handling.

Give a summary of the legal framework and what is required by employers and employees.

Provide detailed information about the safer moving and handling of loads.

Provide basic information on risk assessment in manual handling.

Provide information on controversial people-handling techniques.

Provide information on access to, the safe use of, and demonstration of, moving and handling equipment.

Provide information on how and where to access additional advice and support.

Check your understanding of the information given.

This course and the information it contains applies to all types of moving and handling. However, if your main concern is load handling, please navigate to the course specific to this: 'Back Care for Load Handlers'.

Continued...........

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Background

Back pain is an extremely common complaint. An estimated 80% of people in the UK are affected at some time in their lives.

It is also one of the main reasons for sickness absence.

On any one day about 1% of the working age population are on sickness absence due to a back problem.

Nearly 5 million working days were lost through bad backs in 2003/04. On average each person affected took about 20 days off in that period.

Most back pain is caused by strains and minor injury rather than serious injury and is often called "simple back pain". Although the pain often comes suddenly and may be triggered by a particular movement, the causes may have been building for some time.

Some of the commonest causes of stress and strain on the spine are:

On-going poor posture

Slouching in chairs

Driving in hunched positions

Standing badly

Lifting incorrectly

Sleeping on sagging mattresses

Being unfit, and

Generally overdoing it.

Posture Good Posture encourages your muscles, joints and ligaments to work as nature intended. Remember that many adults with chronic back pain can trace their problem to years of bad posture habits.

Avoid slouching and stooping.

To encourage good posture, try and think about the way you sit and stand.

When standing for long periods of time, consider whether your shoulders are hunched; if so, stretch them back gently.

Remember that placing pressure unevenly on one leg throws your spine’s curvature, which can make the shoulders and hips uneven.

We do not anticipate that you will start carrying your shopping on your head, but there is no denying this lady’s good posture!


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We have already mentioned a few ways you may damage your back. You are at as much risk at home as you are at work.

Whenever possible: Avoid lifting and carrying heavy objects.

Use a shallow trolley at the supermarket to avoid stooping and bending.

Avoid spending long periods of time hunched over the computer.

Adjust the car seat to provide you with support and a good position.

Take breaks on a long journey; take time to stretch your spine and limbs.

Gardening can be a good form of exercise but try not to get too hot or cold as this can increase body stress, as can excessive bending and twisting.

Maintain a regular exercise programme. Walking and swimming can contribute to reducing back pain.

Activity and Exercise may offer some of the following:-

Strengthen the muscles that support your spine

Improve balance and posture

Counter the effects of depression

Help you become more flexible and supple

Improve circulation

Help keep your weight under control

Help you sleep better and be more alert mentally

Improve your general level of fitness and stamina

Remember:- Start gently, always warm up first, pace yourself and exercise steadily.


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The Spine and Back Pain

The spine is made up of many small bones called vertebrae. The bones of the spine are connected to one another by the inter-vertebral discs at the front and by the facet joints at the back. The discs and facet joints allow the spinal column to bend and be flexible.

This structure of vertebrae and discs is supported along its length by muscles and ligaments, which help to keep the back strong. The spinal cord threads through the centre of each vertebra, carrying the nerves from the brain to the rest of the body.

Most back pain does not have an identifiable cause. Worrying about back pain may make it worse and hold back recovery. Sprains and strains usually heal themselves within a short time. This recovery will be assisted by keeping to normal levels of day-to-day activity, using simple pain relief if needed.

A painful back need not necessarily stop anyone going to work. In fact, the longer someone is off work because of back pain, the less likely they are to ever go back. A gradual return to work, with modified tasks and/or shorter work periods, will often help recovery.

Legal Framework

The Health and Safety at Work Act 1974 (HSWA) is a piece of legislation that provides a framework for the more detailed regulations that followed. There are duties outlined for both employers and employees. Employers general duties include:

To ensure, as far as reasonably practicable*, the health, safety and welfare of all employees are without risk. Not to expose those in their employment to risk. They have a duty of care to themselves, their employees and others present on their premises, e.g. customers, contractors, patients etc.

* "Reasonably practicable" means to balance the cost (time, money, resources, inconvenience) against the risk (injury, damage).


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Employees are required to follow the safeguards put in place by their employers. They have a duty of care to themselves, their colleagues and others they encounter in their work e.g. patients, visitors, contractors etc.

There is a range of health and safety regulations that may impact on the individual at work and may affect them in manual handling. The most relevant is the Manual Handling Operations Regulations 1992. Further advice and information on other regulations can be obtained from your manager or the Health and Safety Department.

Manual Handling Operations Regulations 1992

Manual Handling Operations are:

The transporting or supporting of a load, (including the lifting, putting down, pushing, pulling, carrying or moving thereof) by hand or by bodily force.

The Manual Handling Operations Regulations 1992 impose the following duties on employers:

To avoid hazardous manual handling, where possible

To reduce risk of injury by using the assessment as the basis for action

To provide information on the load, (where reasonably practicable)

To review the assessment as needed.

The employees must make full and proper use of any system of work and equipment provided by their employer to promote safety during the handling of loads. Also the employee should be aware of their own capabilities and limitations in the handling of loads and take care not to put themselves or others at risk.


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The load handling equipment available within the Trust has been provided to reduce the risk of injury to staff and patients. Do you know how to use the equipment in your area safely? If not, speak to your line manager. Is there still hazardous manual handling happening in your area? If so, speak to your line manager.

Balanced Decision Making

Essentially, this means balancing the safety (and human rights) of paid staff with the assessed needs and human rights of service users/patients.

Blanket policies are inappropriate and should not be used.

In practice, some staff put themselves at excessive and unnecessary risk and alternatively others are directed to take extreme precautions so that the welfare of people can suffer, their assessed needs may not be met and sometimes their human rights may be breached.

Neither party's rights should over ride the other.

Moving and handling policies need to be modified to adopt a risk management approach. This will aim to optimise the person's and the handler's safety and balance this with the person's mobility and broader care needs.

Risk Assessment

What is a Hazard?

Anything with the potential to cause harm A faulty electrical item A heavy unstable load A person who needs to be moved An electrical lead running across the path.

What is a Risk?

The likelihood that harm will occur and the severity of the outcome.

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Low risk is if harm is unlikely or possible and the outcome would be minor. High risk is if it is likely or almost certain that harm will occur and the outcome would be severe or catastrophic

When handling people, each individual person requires their own personal handling profile. This outlines their capabilities, the specific equipment, and the techniques required to assist them to move.

Principles of Safer Handling Stop and Think! - All these principles apply to the moving and handling of people too.

Plan the move - including:

Where are you taking the load? Plan the whole route first.

Will you be placing the load in a safe place? - avoid high and low locations

Is it a long route?

Might you need to rest mid-way?

Are there obstacles that need removing?

Can you get a firm grip of the load?

Is the load unstable or unpredictable?

Is there room for you to get into a good posture?

Is the environment too hot or too cold?

Can you see what you are doing?

Is moving the load within your capabilities?

Do you require assistance or aids or equipment?

Remember - Think!

Equipment

Load

Individual Capabilities

Task

Environment

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Risk Assessment Guidelines

It is important to understand that GUIDELINE FIGURES ARE NOT LIMITS, but they do highlight risk areas. They may be exceeded where a more detailed assessment shows that it is appropriate to do so.

There is a wide range of individual physical capability, for the working population the guideline figures will give reasonable protection to about 95% of all workers.

The guideline figures assume that the load is readily grasped with both hands, the operation is taking place in reasonable working conditions and with the handler in a stable body position.

The figures take into account the horizontal and vertical position of the hands during the move, as well as the height and reach of the individual.

If you want further advice on the moving of loads do not hesitate to ask for advice.

Risk Management

Moving people is a complex procedural task that may involve a number of associated tasks including clearing the environment, managing any attachments to the person, rearranging the person’s clothing or moving the person in stages from one place to another.

Over the years techniques and equipment have been developed to enable people to be moved or assisted to move and transferred as comfortably as possible.

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Methods which involve handlers lifting all or most of the person’s weight present a high risk of musculo-skeletal risk to the handlers.

The risk of handler injury is further compounded by additional factors within the required task e.g. stooping, leaning sideways, and twisting.

Awkward postures are difficult to avoid especially in areas where access to the person is restricted.

The risk of cumulative strain injury is further increased by the number of times per shift the moves are repeated, the weight of the person and the postures adopted during the whole task.

The use of the patient handling profile should identify these risks and suitable methods of reducing them.

Transfer of Skills

Although many people handlers regularly attend mandatory training sessions, in practice the transference of the skills to the clinical area can be difficult to achieve.

In hurried and pressured situations staff may revert to certain methods despite knowing they are not recommended practice.

Handlers who use poor handling and lifting techniques in the work environment often expect and encourage new staff and others to use them as well.

The Moving Advice Support Team members within the working team are available to provide advice and support to their colleagues in moving and handling tasks and procedures and equipment use. If you are interested in undergoing the MAST training, first speak to your manager and then contact the BCAT for details of relevant training courses.


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Controversial Techniques

The Drag Lift (Under arm or Axilla Lift)

This is the most common method of manually lifting a patient either in a bed, a chair or from the floor.

A person is lifted with the handlers' hands or arms positioned under the patient's axilla (armpit) or upper arm. Whilst usually carried out from the front, it can be performed from the back.

Dangers to the person being lifted: Pain, soft tissue injury or even fracture of

the person's arm

Development of pressure sores from dragging, of sacrum, buttocks and/or heels

Encourages feelings of helplessness as person cannot assist in move

Discourages normal movement, so restricting independence and impeding rehabilitation.

Dangers to handlers:

Handler lifting in asymmetrical, stooped, twisted and side flexed posture.

Other Controversial techniques include:

The Orthodox Lift - the handlers are either side of the person, facing each other and their arms (or equipment) are positioned under the person’s trunk and thighs.

The Through Arm Lift - The person is lifted in a slumped position by two handlers, grasping the person’s forearms and under the upper thighs.

The Australian (Shoulder) Lift - The person is lifted in a seated position by two handlers facing in the opposite direction to the person, with their shoulders close to the person’s axilla and arms clasped under the upper thighs. The person rests their hands on the handlers? Backs.

Front Assisted Stand and Pivot Transfers (Bear Hug) - The person, in a seated position, is either assisted into standing or transferred using a pivot movement to another seated position, by a handler standing directly in front.

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Controversial Techniques (Continued)

All people moving and handling decisions should be made as a result of a risk assessment and recorded on the patient handling profile.

If a decision is made to use a manual lifting technique this must be supported by a thorough risk assessment and suitable and sufficient documentation to support the decision.

Further details on the controversial techniques and hazardous postures is accessible to all in the Guide to the Handling of People 5th edition (Blue Book). Available in all wards and departments.

Wherever possible contact your MAST team member if you require advice and support with the handling of a person in your work area.

Specialist Equipment and Advice

All people handling equipment has a safe working load (SWL). It is vital that staff are aware of the SWL of the equipment they are using and the weight of the people being moved.

There are several powered beds within the Trust that have a SWL of 250 kgs or above (approx. 40 stone). These are a Trust resource and need to be shared amongst wards on a risk assessment basis. The Trust has now purchased a bariatric bed with a SWL of 500kgs (70 stone). This includes an integral weighing scale too. If you think you may require access to this bed please contact the BCAT or out of hours the switchboard to access the health and safety manager on call.

The Back Care Advisory Team (BCAT) manages the Trust's resource of large, heavyweight equipment including a mobile hoist (SWL 250kgs) extra large commodes, wheelchairs and patient chairs.

Advice and support on moving and handling issues and equipment provision can be accessed out of standard working hours by contacting switchboard.


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Transfer of Care and Information

To ensure a smooth transfer of care from the community to the hospital or vice versa it is essential that due consideration is given to the person's moving and handling requirements and risk assessment. This will minimise the disruption to the patient and the risk of injury to the staff involved.

Prior to admission, it is useful to know if an individual has a particular hoist or other moving and handling equipment, in order for similar to be made available to them during their in-patient stay.

When planning for discharge, arrangements may need to be made to ensure suitable moving and handling equipment will be available for use in the person's home environment. If you require advice or assistance please contact the Occupational Therapy team as soon as possible. Please remember that not all equipment is available in stock and it may take some time to access something that is suitable.

The hospital based equipment is always required on-site and is not available to support a discharge package. Early planning should prevent later delays.

Maintenance and Care of Equipment

In order to facilitate effective and efficient use of equipment, it is vital that all staff take responsibility for ensuring the safe use, care and maintenance of all patient handling equipment.

Whenever possible component parts should not be separated from equipment, e.g. footplates from wheelchairs, headboards, footboards and bed-sides from beds. A great deal of time and energy is spent trying to locate missing parts.

If it is essential to remove any component parts from beds, wheelchairs etc, ensure they are stored appropriately in a designated place to ensure easy access and to be replaced as soon as possible.

All hoists are serviced annually and re-checked six months later and all slings are checked on a six monthly basis.


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Decontamination and Cleaning of Equipment

All moving and handling equipment should be kept clean and in good working order. Hoists and large pieces of equipment should be wiped clean between use by different persons.

Slings and slide sheets should be allocated for individual person use and laundered if soiled or on discharge. Single-patient-use disposable slings and slide sheets may be purchased instead of launderable ones.

Any items of equipment being returned to the BCAT should be cleaned and decontaminated appropriately before being transported from one area to another

Wheelchairs which are used by patients should be kept in a clean state and only returned to centralised use after suitable and sufficient cleaning.

Reporting of Adverse Incidents and Damaged Equipment

All moving and handling incidents resulting in patient or staff harm (or near misses) should be reported using the incident form and processed as appropriate to the severity of the incidents.

Advice and support in manual handling issues and incidents can be accessed from the BCAT.

Damaged or broken beds should be reported to Estates/Medical Electronics as soon as possible.

Damaged or broken wheelchairs or commodes should be cleaned and sent via the porters to the BCAT for repair and servicing.

What to do if you have back pain

Most people manage back pain by themselves and recover without any lasting problems. To help protect yourself from further problems you need to keep your back flexible and strong. You also need to think about prevention and identify what might be the risk factors in your life.


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Simple painkillers such as paracetamol or ibuprofen are usually enough to relieve simple back pain. A hot water bottle or an ice pack applied to the painful area may offer some relief. Bed rest does not help simple back pain- it's much better to return to normal physical activity as soon as possible. Staying active may hurt more at first but helps the back to heal quickly and reduces the risk of the problem occurring again.

If this initial bout of pain persists you may lose confidence in your ability to resume your normal life. This may affect your work, social life and relationships. Naturally you may feel depressed and anxious and this can lead to further anxiety, frustration and anger and you may not feel like exercising....

Physical and psychological factors are combining to create two interconnected vicious circles.

Summary

Throughout this course we have identified ways of preventing you from injuring your back. These include:

The Health and Safety Legal Framework

The Management

Risk Assessments

Principles of Safer Handling and the Use of Equipment

Safe Systems of Work

Your Colleagues

Training and Information


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In addition, you can contact the Back Care Advisory Team to provide you with advice and support in:

Assisting you and your manager to carry out a risk assessment

Finding a solution to a manual handling issue

Identify suitable equipment to reduce the risks

Loan of specialist equipment for trial e.g. trolley, office chair

Improved working postures

Avoidance of static loading

24 hour back care

Working with Occupational Health the team will assist you with your return to work, if you do sustain an injury or are off work with back pain.

What do I do now? –

Access Training Tracker to take your test

If you already have a username and password you can log into training tracker and start your test via this link http://iow.trainingtracker.co.uk that can be found on:

Intranet Homepage Learning Zone E- Learning

To obtain a username and password, please contact Development & Training on extension 5409, and we will ensure that the details are e-mailed to you as soon as possible, usually within 24 hours.

If you have any difficulties with logging in please do not hesitate to contact us on the above number.

IF YOU DO NOT FEEL CONFIDENT USING A COMPUTER AND WOULD LIKE ONE TO ONE SUPPORT AND GUIDANCE PLEASE CONTACT US ON THE ABOVE NUMBER AND WE CAN ARRANGE FOR AN IT TRAINER TO HELP YOU TO LOG ON AND TAKE YOUR TEST

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http://iow.trainingtracker.co.uk/

Documents

Back Care for People Handlers - Welcome to the IOW NHS Centre/Development and... · Web viewBed rest does not help simple back pain- it's much better to return to normal physical