Risk assessment

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Risk assessment identifying the best options

• Carole Johnson
• Freelance Manual Handling Adviser

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Evidence

• Well designed meta analysis of gt1 randomised
  control study
• Randomised control study
• Well designed control study without randomisation
• Well designed non experimental control studies
  (correlational and case studies)
• Expert committee report, consensus conference,
  clinical experience of respected authorities
• Scottish Intercollegiate Guidelines Network

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Aim

• To inspire us to make our manual handling
  decisions making more measurable.

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Evidence

• What were you doing 15 years ago?
• What decisions were you making?
• Where did you get your evidence from?

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Decision Making

• The Question
• The Evidence
• Assessing the Evidence
• Have I missed anything?
• Making the Decision
• Evaluation

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DIY Assessment Template
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Encouraging Good Practice

• The Tools
•  
• Effort (Handler)
• Risk Matrix (person)
• Risk Matrix (handler)
• Body map
• Considerations
• Alternatives

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The Tools Child Ability (FIM)
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The Tools Skill (Drefus)
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The Tools Comfort
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The Tools Effort
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The Tools Risk Matrix
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The Tools Body Map
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Case Study - Empowering Staff

• Andrew
• Child size E
• FIM (for personal care transfers) 1
• Anti-spasm sling supplied by OT but previously
  used walking harness type sling
• Single (angled) overhead hoist with delayed
  start/stop and tensioner
• New staff

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Andrew

• Task transfer from wheelchair to height
  adjustable change bed
• Previous manual handling risk assessment
  completed, no problems reported by staff
• Andrew distressed in new class now taking 5
  staff to transfer, leaving only one person in the
  class

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Assessment Nr 2 3rd September 2012
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Assessment Nr 1 20th April 2012
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Drivers - pain
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Drivers number of staff
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Drivers - time
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Drivers Effort
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Issues
The Date.
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Issues
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Issues
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Julie

• Julie, age 5 recent diagnosis (within last 18
  months) of a muscular dystrophy
• Underweight (16 kg)
• 94 cm
• Shuffles around home on her bottom
• Head and trunk control if remains in the mid
  line.

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The Question

• How will Julie transfer from the floor to her
  wheelchair?

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Evidence

• Manual Handling of Children (NBE 2011)
• The HOPs (BackCare 2005, 2011)
• Local Policies
• Manual Handling Adviser
• Colleagues

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Collecting your own evidence

• Comparison of options

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Comparison

• Repeated 20 times per day
• Needs to encourage independence

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Comparison
Time (secs) Effort (Borg) Skill (Dreyfus) Nr Handlers Comfort (1 10) Risk (Matrix) Indepen-dence
Scoop lt60 16 Ab 1 6 No
Top tail lt60 14 Ab 2 4 No
Lift Sling gt 120 10 C 2 7 No
ELK gt 120 9 C 2 8 Yes
Stand Up 60 - 120 8 C 1 10 Yes
Hoist gt120 16 C 2 7 No
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Comparison
Time (secs) Effort (Borg) Skill (Dreyfus) Nr Handlers Comfort (1 10) Risk (Matrix) Indepen-dence
Scoop lt60 16 Ab 1 6 No
Top tail lt60 14 Ab 2 4 No
Lift Sling gt 120 10 C 2 7 No
ELK gt 120 9 C 2 8 Yes
Stand Up 60 - 120 8 C 1 10 Yes
Hoist gt120 16 C 2 7 No
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Comparison
Time (secs) Effort (Borg) Skill (Dreyfus) Nr Handlers Comfort (1 10) Risk (Matrix) Indepen-dence
Scoop lt60 16 Ab 1 6 No
Top tail lt60 14 Ab 2 4 No
Lift Sling gt 120 10 C 2 7 No
ELK gt 120 9 C 2 8 Yes
Stand Up 60 - 120 8 C 1 10 Yes
Hoist gt120 16 C 2 7 No
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Comparison
Time (secs) Effort (Borg) Skill (Dreyfus) Nr Handlers Comfort (1 10) Risk (Matrix) Indepen-dence
Scoop lt60 16 Ab 1 6 No
Top tail lt60 14 Ab 2 4 No
Lift Sling gt 120 10 C 2 7 No
ELK gt 120 9 C 2 8 Yes
Stand Up 60 - 120 8 C 1 10 Yes
Hoist gt120 16 C 2 7 No
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References

• Manual Handling of Children, NBE 2011
•  
• Handling of People, (5th Edition) BackCare 2005
• Handling of People, (6th Edition) BackCare 2011
•  
• Handle with Care, Scottish Commission for
  Children and Young People 2008
• Moving And Handling SEN Magazine July 2009
• Back Care - Looking after the Workforce PIR
  Magazine April 2011