Occupational Health, Safety and Welfare: Manual handling

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Occupational Health, Safety and Welfare Manual
handling

• Dr Merri Paech, 2007
• School of Nursing Midwifery

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Content

• Occupational Health Safety Welfare
• Manual Handling
• Manual handling issues for radiographers
• Conclusion

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Occupational Health, Safety Welfare

• Promotion of a healthy work environment, healthy
  work practices and health at work
• Development of occupational health standards
  based on scientific risk assessment
• (WHO 2004)

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OHSW legislation in SA

• SA Workers Rehabilitation Compensation Act,
  1986
• Occupational Health, Safety Welfare Act, 1986
• Hundreds of regulations and codes of practice
  (minimum standards) exist - including Manual
  Handling Regulations, 1990

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OHSW terminology

• HAZARD a set of circumstances that may cause
  harmful consequences
• RISK the likelihood of harm occurring from a
  hazard

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OHSW processes

• Workplace hazards are identified.
• Risks are assessed and controlled.
• Nothing is considered safe. It may be termed
  negligible risk.
• E.g. a moving barouche is a hazard. If it is
  being pushed quickly the risk increases.

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Steps taken to protect workers in SA

• Consultation with employees and their
  representatives.
• Hazard identification risk assessment of each
  hazard risk control to prevent/minimise injury
  or illness.
• Provision of education and training, and
  supervision for employees.
• Reporting (to Workcover) of hazardous situations,
  fatalities, illness and injuries to prevent them
  happening again.

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OHSW information is available from

• World Health Organisation
• http//www.who.int/
• National Occupational Health and Safety Council
• http//nohsc.gov.au/
• Workcover Corporation (SA)
• http//www.workcover.com.au/
• See the Workcover Corporation (2002) Workplace
  Health and Safety Handbook

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OHSW hazards for healthcare professionals

• Manual handling
• Infection control
• Violent/aggressive clients
• Exposure to chemicals/drugs (cleaning agents,
  cytotoxic drugs, gases)
• Environmental hazards machinery, electricity
  and water
• Hazardous disposals human excreta, body fluids
  and sharps
• Stress due to the nature and hours of work

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OHSW (Manual Handling) Regulations, 1990 pp1

• Define manual handling as
• Any activity requiring the use of force exerted
  by a person to lift, lower, push, pull, carry or
  otherwise move, hold or restrain a person, animal
  or thing.
• (There are also National Manual Handling
  Regulations 1998)

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Manual handling practices

• Under the OHSW legislation, employers and
  employees have responsibilities.
• ANF No lift, no injury Policy for nursing
  staff.
• Employees need to
• be aware of the structure of the spine -
  ligaments, muscles and discs
• have good posture
• reduces musculoskeletal strain
• aids in maintaining muscle tone
• reduces injury risk

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Back care

• Maintain the natural curves of the spine
• Prevent stress on intervertebral discs
• Avoid bending and twisting the spine
• Use large skeletal muscles when manual handling
• Vary posture
• Incorporate rest breaks
• Gentle and regular stretching
• Job rotation or change of tasks
• (Timbs Dean 1997)

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Safe manual handling

• Feet apart, knees bent (semi-squat)
• Maintain natural curves of the spine (back
  straight, buttocks protruding)
• Brace abdominal and arm muscles
• Work with elbows in, if possible
• Use your body weight to move things/people
  (lunge)
• Remember the pivot points of the adult body
• Communicate clearly
• Use the clients momentum
• (Timbs Dean 1997)

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Principles of Manual Handling

• Assess
• Plan discuss reduce the load (cooperation and
  preparation)
• Implement using good body mechanics (isometric
  tensing of arms, legs, abdomen and gluteals to
  reduce the energy used), with the load close to
  your centre of gravity
• Evaluate

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A scenario reported to members of the Australian
Association for the Manual Handling of People
(AAMHP), June 2005
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E-mail discussion list

• I work in the Nuclear Medicine department. The
  technologists that work here have asked if we
  have any equipment that can aid them with
  transferring patients onto the scanning beds.
• At the moment, the patient walks into the room,
  steps on a stool and lies on a scanning bed. The
  technologists state that this is presenting a few
  problems because . . .

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. . the problems

• The patient has nothing to hold onto when
  stepping on and off the stool, apart from the
  technologist.
• The unsteadiness of the patient stepping on and
  off the stool has caused some patients to scrape
  their legs on the side of the stool, ending up
  with skin tears.
• The technologists state that continually bending
  down to move the stools is causing a lot of
  strain on their backs.

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Simple solution . . . . .

• Handrails fitted to the steps
• May need to be custom - made

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On-line discussion item posted 25th July 2006 for
AAMHP members
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Any good equipment design solutions?Any
alternative organisational procedures?

• Would anyone have any suggestions to address
  some of the manual handling problems faced by
  radiographers?
• Having to assume awkward working postures to
  access equipment controls/assist patients into
  position/during ultrasound scanning
• Forceful exertions to place x-ray films into
  position
• Problems are compounded by staff shortages and
  psychosocial factors (dealing with anxious
  patients/working to time constraints/waiting
  lists).

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OHS outcome?

• What should have occurred?

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Traditionally cited risk factors for manual
handling injuries

• Frequent bending
• Stress
• Prolonged static posture
• Fatigue
• Heavy physical work
• Sudden unexpected loads
• Poor muscle tone
• (Timbs Dean 1997)

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Manual handling . . a team sport?

• Be fit - exercise, eat breakfast, have calcium,
  iron and protein in your diet
• Warm up
• Work as a team - include the client (lighten the
  load)
• Use equipment provided
• Keep equipment in good working order
• Practice skills to develop expertise

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Lifelong learning of new skills

• Develop manual handling expertise by
• Becoming bio-mechanically more efficient
• Improving the self-monitoring of your actions
• Spending time problem-solving before acting
• Be part of a positive safety culture in clinical
  areas
• Encourages better decision-making (Hignett
  Crumpton 2006).
• Also be concerned for client welfare they are
  sometimes forgotten.

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Competence in Manual Handling

• Knowledge
• Identify, assess and control risks plan
  communicate requirements
• Skills
• Apply ergonomic principles to prevent injury to
  self/others apply correct techniques and
  equipment
• Personal values/attributes
• Self-monitor own fitness seek assistance prn
  participate in ongoing education
• (NSW Nurses Association and WorkCover NSW, 1998)

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Conclusion

• OHSW promotes the health of people at work.
• Employers must provide a safe work environment.
• All healthcare personnel need to be pro-active
  about manual handling issues.

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References

• Australian Government Comcare (1998) Manual
  Handling Regulations and Approved Code of
  Practice, viewed July 31 2006 http//www.comcare.g
  ov.au/publiactions/factsheets/fact-sheet-5.html
• Government of South Australia (1986) Workers
  Rehabilitation Compensation Act, viewed 31 July
  2006 lthttp//www.austlii.edu.au/au/legis/sa/consol
  _act/wraca1986400/gt
• Government of South Australia (1986) Occupational
  Health, Safety Welfare Act, viewed 31 July 2006
  lthttp//www.austlii.edu.au/au/legis/sa/consol_act
  /ohsawa1986336/gt
• Hignett S, Crumpton E (2007) Competency based
  training for patient handling. Applied
  Ergonomics, Vol 38 7-17.
• NSW Nurses Association and WorkCover NSW (1998)
  Manual Handling COmpetecnies for Nurses.
  WorkCover NSW, September.
• Timbs P, Dean P (1997) The Manual Handling
  Instruction Book. Timbs Dean, South Australia.
• World Health Organisation (2004) Occupational
  Health, viewed 31 July 2006 lthttp//www.who.int/to
  pics/occupational_health/en/gt